Dr. Robert Pearl Talks About Addiction To Pain Killers


Robert Pearl, M.D.Robert Pearl, M.D.Contributor

I cover the business and culture of health care every Thursday.full bio →

 
PHARMA & HEALTHCARE 2/27/2014 @ 1:00PM 1,007 views

Prescription Addiction: What Can Be Done About Rising Rx Overdoses?

The evening news is filled with fatal car crashes and shootings. But drug overdoses kill nearly 40,000 people a year, accounting for more deaths than vehicular accidents or homicides.

Drug overdoses are on the rise in America, fueled largely by prescription meds. Reversing the course of this epidemic will require some dramatic changes.

The Facts

Drug overdose rates climbed more than 100 percent between 1990 and 2012. But what most people don’t recognize is that nearly 60 percent of drug overdoses result from prescription medications. In fact, 3 in 4 drug overdose deaths involve an “opioid analgesic” pain killer such as oxycodone, hydrocodone or methadone.

Opioids can exact an enormous toll on human lives. Opioid use damages families and communities, and costs U.S. employers a fortune.

Non-medical use of prescription opioids costs the U.S. upward of $53 billion, according to the Clinical Journal of Pain. That’s $42 billion from lost workplace productivity, $8.2 billion in criminal justice costs, $2.2 billion from treatment and $944 million from medical complications.

Morphine was isolated and synthesized in the 1800s. (Photo credit: Wikipedia)

The chemical structure of morphine, an opioid that was isolated, synthesized and marketed commercially in the 1800s. (Photo credit: Wikipedia)

These devastating effects aren’t isolated to any one community. They’re found in all communities: rural and urban, affluent and low income, minority and majority.

The History

For about 6,000 years, opioids have been used to treat pain and other medical conditions. The initial source of opioids was opium, derived from the Eurasian poppy. In the 1800s, morphine was isolated and synthesized, making it commercially available for the first time.

For several decades leading up to the 21st century, physicians debated the most appropriate use of these powerful drugs and their place in the therapeutic arsenal.

In the 1960s, America saw a sharp increase in the abuse of both prescription and illicit drugs. In response, the federal government began a crackdown on prescription drugs as Congress tightened restrictions to limit counterfeit prescriptions.

In parallel, there was a cultural shift within the field of medicine, resulting in a significant decrease in how frequently physicians used opioids to treat acute and chronic pain.

The Pendulum Swings

These developments drove down the quantity of opioids prescribed for pain, but some critics were concerned doctors and politicians had gone too far. Studies conducted in the late ‘80s and early ‘90s confirmed health care providers were, in some cases, under-treating pain.

So, the pendulum swung yet again. The field of medicine shifted its stance on pain management in the mid-1990s, viewing the broader use of opioids as a relatively safe treatment approach. There was a belief that a patient experiencing pain should be given as high of a dose of opioids as necessary for as long as necessary, regardless of the exact cause of discomfort.

Simultaneously, pain management experts – some funded by the manufacturers of these powerful medications – began assuring participants at continuing medical education meetings that dependence and addiction would not occur in the face of genuine pain.

We have since learned these assertions were wrong. But the damage was done.

And so we find ourselves yet again experiencing high use of opioids, prescribed in large quantities for the treatment of chronic pain.

As a nation, we have become the dominant prescribers and consumers of pain medications. While the U.S. makes up only 4.6 percent of the world’s population, we consume 80 percent of the world’s opioids and 99 percent of its hydrocodone, which is found in Vicodin.

The spillover beyond medicine is significant. According to the White House, nearly a third of people using illicit drugs for the first time began by using a prescription drug illegally.

Protecting America’s Patients

The Institute of Medicine estimates that chronic pain affects roughly 100 million Americans, nearly a third of our country.

So there is a role for the use of opioids in treating acute pain after surgery or trauma, and in providing comfort care for chronic pain during terminal illness. But before prescribing them for conditions that are likely to be long-term, physicians need to assess whether a patient is at risk for drug dependence, addiction, abuse and overdose.

In addition, doctors must exercise caution when prescribing opioids, especially to people under the age of 18 who are at a much greater risk for dependence.

Further, physicians should take greater care in prescribing the minimal number of tablets necessary for the specific medical situation. If a patient has a surgical procedure or suffers an injury for which discomfort is anticipated to resolve in three days, then prescribing a three-day supply of opioids would be more prudent than 100 pills. Taken a step further, doctors should avoid prescribing these addicting medications for most patients with conditions that are likely to be chronic, including low-back pain, fibromyalgia and recurrent headaches.

Physicians and patients alike need to be aware of the “90-day cliff.” People who use opioids continuously for more than 90 days increase their likelihood of lifelong dependence.

And the longer a person takes these medications, the higher the dose needed to achieve the same level of pain relief, putting them at greater and greater risk of overdose. The risk of overdose and respiratory depression increases dramatically in patients who also have been prescribed muscle relaxants or benzodiazepines like Valium.

And once patients become opioid-dependent, weaning them off these medications can be extremely difficult. Unfortunately, many patients who become addicted to the drugs will engage in a variety of drug-seeking behaviors – many of which are criminal.

While integrated health care systems can use electronic medical records (EMR) for signs of doctor shopping and drug-seeking behavior, only broader statewide or regional databases can obtain the fuller picture. For example, prescription drug monitoring programs like the Controlled Substance Utilization Review and Evaluation System (CURES) in California has provide doctors with access to all of the different controlled substances a patient has been prescribed.

Improving Care In The Future
  
To stop the epidemic of prescription opioid abuse, overdose and death, physicians who prescribe these medications need to rethink their approach to these powerful drugs. Before ordering, each doctor should:

  • Weigh the risks and benefits of prescribing these powerful medications as part of a holistic treatment plan.
  • Ensure opioids are prescribed only for patients with conditions shown to respond well to them – and in the appropriate dosages.
  • Use the lowest dose possible to achieve the desired clinical effect and have a plan for tapering or discontinuing the medication when symptoms are controlled.
  • Monitor patients for signs of side effects and for abuse, misuse, dependency and diversion.
  • Ensure those patients who do start opioid therapy are aware of the risks inherent in long-term use and understand the plan to stop them.

Families and friends can encourage loved ones on these medications to obtain medical help in ending their dependence. Every patient with pain deserves compassionate and appropriate treatment. But physicians need to so in ways that protect lives, not jeopardize them.

 

Stratfor Warns About The Risks Of Travel To Mexico

Understanding the Risks of Travel To Mexico

THURSDAY, FEBRUARY 27, 2014 – 04:00  Print  Text Size 

By Tristan Reed

Many people who visit Mexican resort areas during North America’s spring break season ignore travel warnings, meaning they may not be aware of the threat posed by transnational criminal organizations, more commonly known as cartels. Since 2012, cartel violence has spread from the northern border regions of Mexico south into Mexican states hosting popular destinations for spring break travelers. Nothing in the behavior of Mexican cartels indicates that they would consciously keep tourists out of the line of fire.

Learn more about travel security in our seven-part series.

While most of the approximately 150,000 U.S. citizens who travel to Mexico each year do so without incident, tourists are by no means immune to cartel violence or even common crime. Mexico’s criminal cartels are more than just drug traffickers — they participate in extortion, robbery, kidnapping and carjacking. And where cartels are fighting each other violently, local gangs are able to take advantage of law enforcement’s resulting distraction to commit crimes of their own. We will explore the nature of the risk from cartel and ordinary violence before giving an in-depth review of select major tourist destinations.

Cartel Crime

For more than two decades, Mexico’s criminal cartels have fought each another for control of drug trafficking operations in various parts of Mexico. Cartel turf wars typically focus on specific drug trafficking routes, ports of entries into the United States along Mexico’s northern border towns and areas where illicit drug production and cultivation are concentrated. Mexico’s cartels increasingly have turned to other criminal activities to fund the defense of their territories from potential rivals. Such operations include human smuggling, kidnapping, extortion, counterfeiting goods and hydrocarbon theft. This diversification has seen turf wars break out in resorts.

While cartels typically direct their violence toward rival groups, outside parties often wind up in the crossfire. In one instance, gunmen belonging to a faction of the Gulf cartel opened fire on a bar in Cancun, Quintana Roo state, on March 14, 2013, killing seven people and wounding five others. Though the gunmen were targeting three leaders of a taxi union in Cancun, they were clearly unconcerned by the presence of bystanders. Similarly, five students in Reynosa, Tamaulipas state, were killed Dec. 19, 2013, after a vehicle carrying cartel gunmen fleeing the Mexican army struck the group. And in probably the most extreme example, Los Zetas set fire to the Casino Royale in Monterrey, Nuevo Leon state, on Aug. 25, 2011, allegedly in an effort to send a message to the casino’s owner. More than 50 patrons and staff died in the blaze.

In the past decade, violence in Mexico escalated nearly every year, from 25,133 overall homicides in 2007 to 38,052 in 2012, according to the National System of Public Safety, though 2013 saw a drop to 34,648. Years of law enforcement and military efforts to contain cartel violence have allowed already-high levels of other crimes, many of which could affect tourists, to persist or even rise. For example, 1,407 kidnappings were reported in 2012 versus 1,702 in 2013, the highest level since at least 1997, according to the National System of Public Safety. Since most kidnappings in Mexico go unreported, the true number is likely much higher.

Much of the reduction in homicides in 2013 can be attributed to the continued decline of turf wars in what were once among Mexico’s most violent states — places such as Chihuahua, Coahuila, Nuevo Leon and Tamaulipas. At the same time, however, cartel turf wars intensified in states farther south, including Guanajuato, Michoacan and Jalisco. These southern states contain several towns and areas popular with tourists. These conflicts are likely to continue in 2014, and they could even spread due to increased challenges to the Sinaloa Federation, whose top leader Joaquin “El Chapo” Guzman Loera was arrested Feb. 22.

Ongoing conflicts between Mexico’s most powerful crime bosses and their diversifying criminal activities have resulted in growing ties between previously unaffiliated street gangs and the cartels. Cartels often hire street gangs as foot soldiers, something seen with Los Aztecas, Los Mexicles and the Artistas Asesinos in Ciudad Juarez. Los Aztecas, a Juarez cartel ally, fought against Los Mexicles and the Artistas Asesinos, which in turn were helping the Sinaloa Federation take over the Juarez plaza. As cartels continue to expand into other criminal activities, their contact with local street gangs already engaged in such crimes expands, creating alliances and, at times, new turf wars. An example of the latter is Los Pelones’ turf war with Los Zetas and the Gulf cartel in Cancun. While cartels may not specifically target foreigners, more localized criminal actors often see tourists as potential targets. In any case, the dividing lines between cartel and local gang activity have become increasingly blurred.

Local Crime

Common criminals belonging to a local gang or acting alone are more likely than cartel enforcers to target foreigners in Mexico. But the presence of cartels, especially in areas where multiple cartels are engaged in competition, causes a deterioration of security conditions that lends itself to the formation of local gangs. These local gangs may not be affiliated with the cartels, but still present many of the same security concerns: Like the cartels, they may be involved in killings, extortion, carjacking, sexual assaults and kidnappings, and they may cause collateral damage.

According to a Jan. 9, 2014, travel warning update by the U.S. Department of State, Tamaulipas state witnessed a 75 percent increase in kidnappings of U.S. citizens in 2013. (The actual number of incidents was not reported). The same travel warning stated that the U.S. Embassy in Mexico City received reports of 90 U.S. citizens kidnapped throughout Mexico between April and November 2013.

Citizens of many countries have fallen victim to such crime. For example, a gang targeted Spanish tourists in a bungalow on Feb. 4, 2013, in Acapulco, Guerrero state, binding and robbing the males before sexually assaulting the females. In the same part of Acapulco, a gunman shot and killed a Belgian national in a parking lot in the Diamante tourist zone on Feb. 23, 2013. Authorities discovered the victim’s body next to his vehicle with a gunshot wound to the chest and a spent .45-caliber casing nearby. And sometime after Jan. 25, 2014, a U.S. citizen who had been traveling through the southwestern states of Michoacan and Guerrero was reported missing. The missing person had been headed to Zihuatanejo, Guerrero state, a popular spot with foreign travelers for fishing and surfing close to some of the most violent, and underreported, criminal turf wars in Mexico.

Kidnappings do not always follow the same pattern. They could involve anything from classic high-value target abductions to express kidnappings in which the victim can spend a week in the trunk of a vehicle as the kidnappers go from one ATM to the next withdrawing all the money in the victim’s account. They even include so-called virtual kidnappings, a technique by which perpetrators falsely claim to have kidnapped someone to extract a ransom from a friend or relative of the victim. Reports of virtual kidnappings in Mexico have become more frequent, even in popular resort destinations such as Cancun.

While there are examples of groups such as the Gulf cartel and Los Zetas participating in kidnappings throughout the country, localized kidnapping rings that operate independently from the drug trade have flourished due to the lack of security in Mexican cities. There is little uniformity with kidnapping rings in terms of resources, targets and tactics. Though the vast majority of reported kidnapping victims have been Mexican nationals, the risk to tourists remains, especially for tourists perceived as being wealthy. The gangs’ victims range from wealthy businessmen to poor farmers, so assumptions should not be made regarding their typical target set.

Law Enforcement

Visitors to Mexico should not expect law enforcement officers to behave in the same way as their North American counterparts. As mentioned, law enforcement efforts in many areas of Mexico primarily are aimed at combating drug trafficking. In some cases, law enforcement officers have been found to be on the cartel payroll, forcing the Mexican military to assume law enforcement responsibilities in some areas. For example, Tamaulipas state’s municipal and state police were effectively disarmed over corruption concerns, which required the military to assume the role of the state police.

As previously mentioned, the country’s security services sometimes pose security risks, too. When driving, it is important to pay attention to highway roadblocks manned by military personnel and to checkpoints established to screen vehicles for drugs and cartel operatives. Police officers and soldiers have opened fire on vehicles driven by innocent people who failed to obey instructions at such checkpoints, which often are poorly marked.

Resorts

Many popular spring break locations foreigners perceive as having “acceptable” levels of crime have experienced violence related to the drug wars raging in Mexico. Firefights between federal police or soldiers and gunmen armed with assault rifles have erupted without warning throughout Mexico, affecting mountain villages, large cities like Monterrey, and resort towns like Acapulco and Cancun. While the cartels have not often intentionally targeted tourists, their violence increasingly has been on public display in popular tourist districts.

While there are important differences among the security environments in Mexico’s various resort areas and other parts of Mexico, the country’s overall reputation for crime and kidnapping is deserved. Locals and foreigners alike often become victims of assault, express kidnappings, high-value target kidnappings, sexual assaults, carjackings and other crimes.

Far more dangerous to tourists and others than government roadblocks are instances of cartel gunmen operating mobile or stationary roadblocks disguised as government troops, a well-documented phenomenon. We have not confirmed whether these have been encountered in popular resort areas, but there is the strong possibility they will be eventually, given the increased violence in major port cities. An encounter with a checkpoint or roadblock operated by gunmen disguised as federal police or military personnel can be deadly. Driving city streets in resort towns or roads in the surrounding countryside is also becoming increasingly dangerous because of such roadblocks.

Many Mexican coastal resort areas better known for their beautiful beaches also depend on their port facilities, and these have come to play a strategic role in the country’s drug trade. Drug trafficking organizations use legitimate commercial ships as well as fishing boats and other small surface vessels to carry cocaine from South America to Mexico, and many cartels often rely on hotels and resorts to launder drug proceeds. Because of the importance of these facilities, the assumption has been that drug trafficking organizations seek to limit violence in such areas not only to protect existing infrastructure but also to avoid the attention that violence affecting wealthy foreign tourists would draw.

This is no longer a safe assumption. The profound escalation of cartel-related conflict in Mexico has created an environment in which deadly violence can occur anywhere, with cartels displaying complete disregard for bystanders whatever their nationality or status. As violence escalates near Mexico’s resort towns, Stratfor anticipates that the cartels will not hesitate to use all tools at their disposal to defeat their opponents. Moreover, the threat to vacationing foreigners is not just the potential of being caught in the crossfire but also of inadvertently drawing the attention and anger of cartel gunmen.

Acapulco

Acapulco has become one of the most violent cities in Mexico, with 143 murders per 100,000 residents during 2012. Homicides per capita dropped in 2013, but nonetheless remain high. According to Mexican nongovernmental organization the Citizen Council for Public Safety, Acapulco ranked third in the world for homicides per capita in 2013, with 113 per 100,000. Most violence related to organized crime in the city resulted from the collapse of the Beltran Leyva Organization in 2010, which spawned a set of competing organizations. In addition to conflicts between the Beltran Leyva Organization’s remnant groups, such as the Independent Cartel of Acapulco and Cartel Pacifico Sur, other rival organizations such as the Sinaloa Federation, Gulf cartel and Los Zetas have competed for control of the city.

The frequent conflicts among Mexican cartels, including conflicts with authorities, have taxed authorities’ ability to protect against more localized crime. Additionally, criminal actors actively seek to recruit or collude with law enforcement members. During October 2013, authorities arrested 13 federal police officers in Acapulco for working with a kidnapping gang.

Cancun

Cancun’s port remains an important transshipment point for maritime drug trafficking routes from the Caribbean basin. The high volume of tourism in Cancun makes the area a lucrative draw for localized crime such as drug dealing and theft. Until 2013, Los Zetas maintained the greatest presence in the area, occasionally fighting a local street gang, Los Pelones, for control of retail drug sales throughout Cancun, including popular resorts.

When Ivan “El Taliban” Velazquez Caballero, who oversaw Los Zetas operations in Cancun among other areas, split with Los Zetas and then rebranded his own criminal network as a faction of the Gulf cartel, he triggered more frequent organized crime-related violence in the city. This included executions, dismemberments and the targeting of law enforcement officers. After a number of arrests of the Velazquez faction of the Gulf cartel in Quintana Roo, Los Pelones in 2014 have thus far managed to take control over retail drug sales in Cancun, including the resort areas along Kukulcan Boulevard. The Gulf cartel, or even Los Zetas, could once again vie for control, which would further elevate the levels of violence in Cancun.

Recent examples of violence in the city include the killing of Gumersindo Martinez Gomez, the night operations coordinator for the Cancun police, by two gunmen early Aug. 14, 2013, outside his home on the western edge of the city. And on April 12, 2013, authorities discovered a dismembered body in three black plastic bags in the Cancun suburb of Puerto Juarez, Quintana Roo. Such incidents emphasize that cartel-related violence is not absent just because a town draws substantial tourism.

Puerto Vallarta

Several of Mexico’s largest and most powerful cartels maintain a trafficking presence in Puerto Vallarta, Jalisco state. Though violence related to organized crime is much less frequent than in other areas beset by criminal turf wars, it is still present in Puerto Vallarta and thus presents risks to bystanders.

Gunmen opened fire on a vehicle carrying three passengers, killing two and critically wounding the third, early Oct. 17, 2013, in the Romantic Zone in Puerto Vallarta. Gunmen in two trucks cut off the victims’ vehicle at the intersection of Emiliano Zapata and Venustiano Carranza streets before opening fire. At least 35 rounds struck the victims’ vehicle, killing two occupants, who were brothers. The tactics and the number of rounds fired suggest the killing was a targeted hit by an unidentified organized criminal group.

As stated, unrelated crime tends to appear wherever criminal organizations compete for turf, and Puerto Vallarta is no exception. Thus, in August 2013 burglars killed a U.S. citizen living in Puerto Vallarta. His body was discovered after his maid, who was tied up during the robbery, managed to escape and alert authorities.

Threats from kidnapping gangs or other criminal groups also are said to be lower in this resort city than in the rest of the country. Still, a February 2012 incident illustrated why caution and situational awareness should always be exercised: A group of 22 tourists ventured off their cruise ship to tour El Nogalito, an area near Puerto Vallarta, where they were held at gunpoint and robbed.

Cabo San Lucas

Located on the southern tip of the Baja California Peninsula, Cabo San Lucas and the Greater Los Cabos region have remained relatively insulated from the country’s drug-related violence, and so are considered among the safer places in Mexico for foreign tourists. Although historically a stop on drug trafficking routes, Cabo San Lucas’ strategic importance has not spawned violent competition among drug traffickers. Over the past five years, organized crime-related violence in the area has accordingly been limited.

Mazatlan

Mazatlan, located about 450 kilometers (280 miles) north of Puerto Vallarta, had been perhaps the most consistently violent of Mexico’s resort cities during the past year, although 2012 and 2013 saw a substantial drop in violence. It is located in Sinaloa state, home of the country’s largest cartel, the Sinaloa Federation, as well as of the rival crime group Los Mazatlecos.

Even with decreasing violence in Mazatlan, the surrounding areas have experienced notable levels of violence as a result of incursions by Los Zetas and Los Mazatlecos into southern Sinaloa state. Such violence may increase in frequency as rivals of the Sinaloa Federation attempt to capitalize on perceived Sinaloa weaknesses after the Feb. 22 arrest of Joaquin “El Chapo” Guzman Loera in a condominium in Mazatlan.

Matamoros

Though Matamoros is no longer a common spring break destination, we address it because of its proximity to South Padre Island, Texas. Adventurous vacationers to South Padre Island often cross the nearby border, mainly to Matamoros and the surrounding towns clustered along the south side of the Rio Grande.

The area sees constant drug- and human-smuggling activities vital to Los Zetas and the Gulf cartel, which are ruthlessly carried out. Since the Zetas’ offensive against the Gulf cartel of Matamoros in 2011, Matamoros has experienced significant violence among competing organizations and between such organizations and the military. In addition to cartel-related violence, Matamoros has experienced a surge in local crimes such as robberies and kidnappings. The U.S. Consulate in Matamoros posted a travel advisory regarding escalated kidnapping threats on Dec. 14, 2012, and on Feb. 21, 2013. For these reasons, visitors are strongly advised not to venture south into Mexico from South Padre Island.

Read more: Understanding the Risks of Travel To Mexico | Stratfor 
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Elena ANd I Have A Special Dinner With A Dear Friend

Andy Narain has been my dear friend since I first came to the San Francisco Bay area some 17.5 years ago. Elena and I were blessed to have a wonderful dinner with him last night at the Best Western Hotel in Grosvenor square. He looks good and is doing well in life. His son just graduated from law school and passed the rigorous California bar exam that only 46% of the test takers pass. Andy has seen me in really hard times and really good times. He is always a very special friend! It was a wonderful evening.

The Founder Of SETI Leaves Us Much Too Soon

Thomas Pierson, 1950 – 2014

Thomas Pierson

Tom Pierson, who founded the SETI Institute and went on to become its Chief Executive Officer for most of the organization’s first thirty years, died on February 20 of cancer.  He had been on medical leave since 2012.

Under Pierson’s guidance, the Institute grew from a tiny, narrowly focused research center with a handful of employees to its current status: an internationally known organization that is home to more than 130 scientists, educators, and support staff.  While founded to conduct SETI searches, the Institute soon broadened its mandate to encompass all aspects of understanding the nature and prevalence of life beyond Earth.

Growing up in Norman, Oklahoma, Pierson studied aerospace engineering at the University of Oklahoma.  By the early 1980s, Pierson was working as a grants administrator at San Francisco State University where he helped adjunct Professor Charles Seeger obtain research funds for the new SETI project headquartered at NASA’s Ames Research Center, an hour’s drive to the south. Intrigued, he made a proposal to project participants Barney Oliver, John Billingham and Jill Tarter, suggesting a more efficient way to organize the NASA efforts. Pierson laid out the benefits – both organizational and financial – of setting up a non-profit entity, dedicated to the research.  In this way, the administrative and other costs associated with the project could be kept low, and more of the budgeted monies could go to the science.

Finding broad agreement with his idea, Pierson completed the paper work in the Fall of 1984, at which point the SETI Institute became a reality.

A decade later, the existence of this non-profit organization became crucially important in saving the nation’s largest SETI program. In 1993, a Senate amendment cancelled funding for NASA SETI, and the Institute stepped into the breach to keep the research going with private funding.  Over the course of the last two decades, these efforts raised approximately $90 million in private monies from donors such as Barney Oliver, Paul Allen, Gordon Moore, Bill Hewlett and David Packard, making possible the construction of the Allen Telescope Array, now used for the Institute’s SETI searches.  Today, monies won by its scientists in competitive solicitations generate approximately $17 million annually for astrobiology research.

For his extensive contributions to furthering the field of astrobiology, Pierson was recently recognized with NASA’s Distinguished Public Service Award, the highest honor given by the agency to non-government employees. The citation reads: For distinguished service to NASA and the scientific community through leadership of the SETI Institute, supporting basic research and education dealing with life in the universe.

Tom Pierson was not a scientist, but he was as fervent about the Institute’s varied research agenda as any of its investigators.  He would exuberantly convey the excitement of SETI and astrobiology at any gathering, professional or amateur, formal or casual.  His management style was characterized by a fierce loyalty to the Institute’s employees, and an easy willingness to let them try new ideas.

The persona and personality of Tom Pierson continues to define the organization that he founded.  He was the touchstone for everyone who works at the SETI Institute: his enthusiasm, upbeat attitude, sense of humor, and humility are the organization’s DNA.  He was always pleased to let his employees take the credit for any of the Institute’s many accomplishments.  And yet those who had the great fortune to work here during the nearly three decades of his tenure know that their work and their rewards were made possible by Tom Pierson.  The SETI Institute remains a burnished legacy of the man who conjured its existence.

Tom Pierson is survived by his wife, Elyse, his daughter Elizabeth and son Thomas, and Justin, his son by a previous marriage.

A Wonderful Person Now Doing Well In Life!!!!!

When I worked at Telewave I had a wonderful engineer assigned to me.  He did a great job of making my projects work in the technical sense. He was also a wonderful friend who helped me through some hard times. I shall not mention his name but I will leave the clue that a major Argentina beer brand has his last name. I lost track of him after I left the company. I did a computer follow-up on him yesterday.(Many times such follow-ups end with sad news like someone has passed away.) In this case I got the marvelous good news that this man now lives in New Caanan, Conn in a 6,300 square foot house. I’m so happy to see a good and decent person in such good circumstances.Steve you deserve every good thing that you get in life!!!!

A Buenos Aires Lady Gets Some Empanadas

Elena is a Buenos Aires lady who loves her empanadas. (For those of you not familiar with South American food these are pastries filled with meat, cheese, etc and baked) The best vendor of this delightful food in the Bay Area is El Porteno. Sadly one can only find them in the Ferry Building in San Francisco,at farmer’s markets and sometimes at Whole Foods. It’s always along car ride with traffic and parking hassles to find these.

I ordered three dozen and had them delivered to the house. Luah and Elena pointed out that nothing takes the pace of fresh food. I agree with them. But thanks to Costco we have a wonderful food packaging system that takes all of the air out of a package before it’s frozen. Using this system food can last up to 2 years and taste relatively fresh.
Elena will  be able to enjoy empanadas at lunch and we can all have them at night.

La vida con una bicicleta

Querida Patricia:
    Veo que montas en bicicleta, todo el tiempo. De 1996 a 1999 yo estaba tan mal que yo monté una bicicleta todo el tiempo también. Para una gran parte de ese tiempo yo era tan pobre que no podía pagar el alquiler en esta zona. Yo dormía en las calles o vivido en centros de acogida para personas muy pobres.
    Usted hace un trabajo increíble con los limitados recursos que tiene. Usted está criando a dos hijos maravillosos. Usted tiene mucho de que estar orgulloso.

Con cordiales saludos

The FT of London Talks About Data Pioneers Watching Us Work

February 17, 2014 6:18 pm

Data pioneers watching us work

By Hannah Kuchler

In a back street in San Francisco’s start-up dominated SoMa district, a rapidly growing business is busy studying how millions of employees behave each day. Its computers know in real time why a worker was hired, how productive they are and can even follow them as they move to a new job.

Evolv is a leader in the nascent Quantified Workplace movement, where big data analytics companies are springing up to measure how we work. “Every week we figure out more things to track,” says Max Simkoff, Evolv’s co-founder and chief executive, who claims it can help improve productivity by at least 5 per cent in two-thirds of jobs.

More than half of human resources departments around the world report an increase in the use of data analytics compared with three years ago, according to a recent survey by the Economist Intelligence Unit. But many employees are still blissfully unaware of how information they may deem private is being analysed by their managers.

 

For its part, Evolv analyses more than half a billion “employee data points” from across 13 countries, seeking to identify patterns across companies and industries. These data points range from how often employees interact with their supervisor to how long it takes a worker to get to the office.

Evolv’s clients use them to help guide their hiring decisions, as well as to evaluate an employee’s performance throughout his or her career.

The company has so far focused on customer-facing industries such as retailers and call centres. One client is Kelly, an employment agency. It says it has seen a 7 per cent improvement in employee efficiency across the board by incorporating Evolv’s insights into its hiring policy.

Novo1, a US company that runs customer call centres and has more than 2,000 employees, identified the characteristics of its most successful call operators and hired more people like them. This cut job interviews down to 12 minutes from an hour, reduced average call time by a minute and slashed attrition by 39 per cent.

Another pioneering outfit is Sociometric Solutions, which puts sensors in name badges to discover social dynamics at work. The badges monitor how employees move around the workplace, who they talk to and in what tone of voice.

One client, Bank of America, discovered that its more productive workers were those allowed to take their breaks together, in which they let off steam and shared tips about dealing with frustrated customers.

Your opinion

Should employers be allowed to monitor staff?
Yes, absolutely.Yes, but only if the business benefits are clear.Yes, but only if it directly benefits the employees.No, employees have a right to privacy.

The bank took heed and switched to collective breaks, after which performance improved 23 per cent and the amount of stress in workers’ voices fell 19 per cent.

Ben Waber, Sociometric Solutions co-founder and chief executive, thinks the badges can be deployed far beyond sales and customer service. He sees big opportunities in pharmaceuticals, for instance, where productivity is hard to measure because new drugs might emerge only once in a decade: “The rest of the time, they have no idea.”

Another company, Steelcase, which puts sensors in office furniture and buildings to see how workers interact, thinks the real opportunity for workplace monitoring is far from the call-centre floor – in opaque creative departments and even boardrooms, where time is especially precious.

Sushi test for surgery

US hospitals are using a game called Wasabi Waiter to select surgeons in a leap forward for data analytics in recruitment.

Set in a cartoon sushi restaurant, the game promises to measure decision-making and communication skills, among other attributes.

Its maker, the Silicon Valley-based Knack, profiled what makes a successful surgeon above and beyond medical expertise and experience.

Professor Kenneth Egol, vice-chair of orthopaedic surgery at the NYU Medical Center Hospital, is using it to select resident surgeons.

Swamped by applicants who are top of their class at good universities, he wanted to identify those who were also hardworking team players. “Sometimes you have people who are super intelligent and it all came very easy, they didn’t have to work. It is hard to be a good resident if you don’t work.”

David Lathrop, its director of research and strategy, says the sensors are now so cheap they can be put “practically everywhere”, arguing that employees could benefit by tracking their own performance.

Improving the productivity of top executives “has a disproportionate effect on the company”, he adds.

Advocates say quantifying the workplace is especially useful in areas where there are often culture clashes: such as cross-border teams and acquisitions.

For example, clients of Polycom, a video conferencing company, can already replay their recorded meetings. Stuart Monks, its group vice-president for technology and architecture, wants to go further and let customers analyse that information.

Mr Monks says within Polycom, the HR department has been able to use the data to ascertain that a group in one continent was not understanding a team in another.

Not everyone is convinced that the growing use of technology to monitor workers’ productivity offers an un­equivocal improvement, however.

Teresa Amabile, a professor and director of research at Harvard Business School, says it could be “very positive” or “very negative” depending on the existing workplace culture.

Monitoring can work if the teams, departments or whole offices using the software or devices have what she calls “a high degree of psychological safety”.

If people feel able to experiment, potentially fail and learn from those lessons, then they can be motivated by gaining a better understanding of how they spend their days.

But she warned that the technology was still in its early days and could be “too crude” an instrument to rely on. “There is definitely a danger of seeing technology as a silver bullet,” she says.

Lew Maltby, president of the US National Workrights Institute, says electronic monitoring could be a “very valuable tool” for employers, by providing evidence for sexual harassment suits or assessing productivity in data entry jobs, for example.

But he says most employees “haven’t got a clue” about the extent to which their emails are already monitored, or about the information their employer can access from their work computer and smartphone.

Employees may have little in the way of legal grounds for challenging an extension of this data gathering. He says there was a spate of legal cases in the US a few years ago about the monitoring of work computers and employees lost every one of them.

“No employee has ever won an in­vasion of privacy case based on an employer monitoring their computer,” he says.

Even those who are involved in the growing industry believe there needs to be more discussion about when and how the data are used. Professor Andrew Knight from Washington University in St Louis works with data from both Evolv and Sociometric Solutions to study workplace behaviour.

But he thinks constant monitoring is a “scary image for the future” that could “remove some of the authenticity of those [workplace] relationships”.

Steelcase’s Mr Lathrop may be busy thinking up innovative places in which to slip sensors, but he does consider the potential impact on employees. In the wake of the Edward Snowden affair, he says people may have been temporarily put off by what they see as an infringement of their privacy. But he thinks that will fade.

“It is easy to paint a creepy scenario about this,” he says. “But it is also possible to create quite a positive scenario – where people benefit directly.”

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Politics Is The Dirtiest Business There Is!

My friends my father fought against the Japanese in the island campaigns. He got sick with malaria and had to be evacuated. After he got his health back he ended up serving with General George Patton in the Third Army. He landed in France 6 days after D-Day. He roared all the way across France. He fought at the Battle of the Bulge. He ended up linking up with Russian troops in Czechoslovakia. Dad knew the horrors of war. He toured German death camps. He saw friends near to him get killed.

Dad also had some profound words of wisdom for me when I joined the Houston Teen Democrats in 1966 as follows:

“Son war is not the dirtiest business there is. Politics is the dirtiest business there is.”

Elena cannot help but take note of my passion for the Netflix series House of Cards. She commented that the show is too grim and sad. She said that the show lacked joy and humor.

I pointed out to her that real life politics is often very grim and very sad. People who go into that career generally make very low wages. They work very long hours under very high pressure. They rarely get credit or appreciation for the good things they do. They get brutally lambasted when they make a mistake or something goes wrong. Their personal life,financial affairs, and family become “an open book” for all to read. They often have to make very unpleasant decisions.

Over a decade ago my daughter in law was studying political science at San Jose State University. She had dreams of running for public office. I gave her one cautionary warning as follows:

“Part of being an elected official is the possibility that in a law enforcement or military situation, you might have to order that people be killed or order your own workers to give their lives for their country.”

My first wife worked for then Senate Minority Leader Hugh Scott of Pennsylvania in the 1970’s. I have participated in many political campaigns. I have had the honor of meeting two American presidents-Ronald Reagan and Jimmy Carter.

When I watch House of Cards, I think to myself:

“Oh my God that’s the way it really is!!!!”