Friday, May 31, 2013

Fakes & Big Boys: Breasts, Cameras, Wine & Coffee.

It used to be small timers that fake genuine goods: handbags, watches and clothings. Most customers knew that they were getting the fakes but at a small fraction of the genuine item, nobody minds.

Looks like the big boys are moving in.

©2008 Am Ang Zhang

First with Breasts: PIP implants manufactured by a French farm using non medical grade material: read it all here>>>>

Then Cameras: Nikon.
Nikon was the big boy of Japanese camera and at one point dominated the market ousting the likes of Leica in the photo-journalistic world. The Cockroach Catcher knows his cameras as he is a devotee of Leica, Hasselblad and dare I say it: Nikon.

Then came Canon: who sort of pushed Nikon into 2nd place. The 5Dll is one hell of a camera and is even used for movie filming.

Now Nikon D800 arrived and is supposed to be the Canon 5Dlll basher.
First it has a serious focusing problem: how can you beat the other guy if your IT people cannot get the software right!

That has nothing to do with faking, you might say. But in my search for the problems with focusing I found that Nikon used a Canon 5Dll shot movie pretending it was shot with the D800. Wow!!! The Big Boy!

Wait for this: they lifted it from the web infringing copyright and they have now settled: sum undisclosed.

In my post on PIP implant I suggested that the French should stick to wine making: I was unfortunately wrong. They only make the labels it would seem.

Wine faking:

In the wine worlds most dramatic news since the Austrians added anti-freeze to their wines years ago one of the big Burgundian houses is in serious trouble.

 ©2008 Am Ang Zhang

Four directors of Maison Labouré-Roi, the 180-year-old Burgundy negociant house, have been accused of various counts of wine fraud.

…..Public Prosecutor Eric Lallement said during a press conference held in Dijon last night (13 June) that the fraud office was first alerted due to a disparity in figures between what the company was actually bottling and what it should have been, given the yields declared at harvest time. ‘It was as if the company was managing to vinify 100% of its musts, which is impossible,’ he said.

On investigating this, he said police found evidence of several specific frauds: firstly bypassing legal blending limits, affecting every level of the production from Grand Cru, Premier Cru and Village appellations, and adding table wine to wine musts to top up the ‘angel’s share’, Lallement said. He said the suspected fraud related to 500,000 bottles of wine, worth €2.7m in sales.

The second fraud detailed was over wine quality and labeling. ‘When the company needed to fulfil an order of a wine that it had run out of, it swapped labels with other wines,’ said Lallement. The magnitude of this fraud is estimated to be around 1.1m bottles.

Big Boys indeed:

The oenologist, the administrator, and now the two owners, Armand and Louis Cottin (aged 82 and 83), have all been arrested. The fraud is believed to have taken place between 2005 and 2009.

Labouré-Roi, owned by Cottin Freres since 1974, is the largest supplier of Burgundy wines to airlines, including British Airways, Air France and United Arab Emirates. It also supplies major retailers, deriving 50% of net sales from exports, and works with hundreds of Burgundy growers.

Masters of wines:
2009 and none of us knew? We must also be asking the Masters of Wine: Did you not taste any of the duds? Decanter gave a 2008 one a Bronze Medal

We should asked the Cottins: what wines did you use and perhaps we should buy those.

The Cockroach Catcher has been drinking South American for sometime and hopefully nobody is faking them yet.

Remember Coffee faking?
In 1996 in California, a certain Michel Norton, owner of Kona Kai Coffee was sentenced to 30 months in prison. Apparently for an extended period of time (some reckoned a decade may not be an over estimate), cheaper and “lower grade” Panamanian and Costa Rican coffee were used to pass off as “Pure Kona Coffee”.

Cheaper, certainly, as you would not otherwise be doing it. But, INFERIOR? I think many would certainly dispute that. I do not think you can really use an inferior product to pass off as something superior and fool people for long.

Read all about it here>>>>,here>>>>.

Thursday, May 30, 2013

Broccoli & NHS: Thought control!

Pink Floyd could have been:

If you don't eat yer Broccoli, you can't have any pudding!

3Ds for getting your child to eat Broccoli:

Demand, Disguise & Deceive!

Old Chinese Urban Myth:

If three generations did not eat broccoli, someone will get Leprosy. Scary!

Young toddlers seem to dislike broccoli. So what can the poor mum do? The Cockroach Catcher in his Child Psychiatrist hat has the 3 D approach: Demand, Disguise & Deceive.

Looks like someone else has borrowed those approaches:

NHS Reform:

Demand: The government wants all hospitals to become Foundation Trusts by the end of 2013 and we are currently completing our application with the aim to become a Foundation Trust in July 2011.  GOSH. 

It is in effect the privatisation of Secondary Care. There are 240 consultants at GOSH. FT status will mean no cap on private income. More private work means one thing: less NHS work. I just hope they collect the medical fees first before some of the “clients” claim diplomatic immunity.

For Hospital FTs that are failing, they will be bought by the likes of Circle. There is no guarantee that the successful ones won’t be either. Business is business.

All GPs in consortia by 2013.

At least half the board members of some GP consortia, the new bodies that will take over commissioning, have links with a single private healthcare company, an investigation by Bureau of Investigative Journalism, published in the Independent and Pulse Magazine can reveal.

Assura Medical, majority controlled by Sir Richard Branson’s Virgin Group, has links with 50 per cent or more of the board members at three of the 52 first-wave GP pathfinders.
The Department of Health responded to the investigation by saying it planned new guidance on the make-up of consortia and how to deal with potential conflicts of interest following Professor Steve Field’s ‘listening exercise’ report.

U.S. Appeal Court:

'Eat your broccoli': Moms demand it. Can government?

RICHMONDVa.— About 20 minutes into Tuesday's hearings, Appeals Court Judge Diana Gribbon Motz told Liberty University lawyer Mathew Staver that she was surprised a certain topic had yet to come up: "the broccoli question."
"There is a lot of talk in the papers about if Congress can do this, it can require people to buy broccoli," Motz said.

"Yes," Staver agreed, "certainly the (judge) in this case in Virginia … said that."
Motz said she had a broccoli question herself: "Could the Congress prohibit people from buying broccoli, or to make it more real-world, prohibit people from buying trans fats, because of its bad effects?"

I don’t want any broccoli!

“Do whatever!”
“Listen to him. Pretend you are doing what he wants. Better still get his trusted elder sister to listen to him!”

But I don’t want any broccoli!

“Mix it with his favourite Red Berry Juice and grind it up. Tell him it is not broccoli!”

NHS Reform:

He told a conference of GPs in London: "So for those of you concerned that the listening exercise represents a tearing up of our plans to modernise the NHS, don't be. For those of you worried that in places the detail of the bill was at odds with the principles of reform, be reassured."

He also maintained the forum's approach to the bill was "not to tear it up, not to start from scratch [and] not to reject or undermine the fundamental principles of the reforms and the bill." His comments prompted claims that the experts' work, under professor Steve Field, was mainly about public relations and had produced changes to Lansley's original plans that are "totally cosmetic".

The government says:
We will outlaw any policy to increase the market share of any particular sector of provider. This will prevent current or future Ministers, the NHS Commissioning Board or Monitor from having a deliberate policy of encouraging the growth of the private sector over existing state providers – or vice versa. What matters is the quality of care, not the ownership model.

This statement is disguised as a control on privatisation, but note "or vice versa". This means the revised bill will outlaw the Government now, or in the future, from naming the NHS as preferred provider.

The terminology of the NHS as preferred provider implies a deliberate attempt to encourage NHS public provision, so this policy will be outlawed (by legislation if the bill passes). However, the key point is that the policy of "Any qualified/willing provider" does not explicitly encourage private sector provision per se (although it is obvious that this is what it is designed to do.)

As long as Government policy is not seen to deliberately and directly encourage private sector provision, the market share will be allowed to change. In fact, the decisions to involve private companies will actually be made locally by the clinical commissioning groups. This is therefore local decision making and not Government policy itself. So increasing NHS privatisation is still clearly on the agenda and the idea of the NHS being the preferred provider with be confined to the dustbin of history.

You really have to hand it to the politicians and policy makers. They have managed to produce of paragraph that looks as though they are preventing further NHS privatisation, but it actually means that they are legislating against the NHS being the preferred provider!                   Guardian Live blog Dr Clive Peedell

Twitter: No references in Future Forum Report to keeping the SOS's duty to provide the NHS in England!

Andrew George MP (Liberal Democrats, St Ives): ‘New’ NHS reforms a lot like the old reforms

Evan Harris: There are new threats to the NHS emerging as the Conservatives appear to try to bring in competition and privatisation through another route".

No! It is broccoli! I don’t want it!

Pink Floyd:

We don't need no education / We dont need no thought control!

Wednesday, May 29, 2013

NHS & Hong Kong: Health Care Class Struggle!

 I have always maintained that we were distracted into talking about GPs and ignore the most important aspect of Health Care in most countries: specialist care. We are fast heading towards a new class struggle: Health Care Class Struggle: Private & Dumped Public.                                 

                                    US $ 50,000 for Stent Procedure©Am Ang Zhang 2011
In most western and not so western countries the demand for Hospital Specialists (Consultants in England) has never been higher.

Check out the Mayo clinic.

A friend had a STENT procedure In Hong Kong (like the one Prince Philip had) for a reasonable US $ 50,000.  I worked out that his cardiology specialist is earning a humble $10 million a year.

You begin to get the picture that for a long time, NHS is extremely good value.

When there are not enough specialists to go round in any country money is used to ration care. Just look at Canada.

There is unfortunately little realisation that soon, a large number of consultants would no longer be working in NHS Hospitals.

Stent, Hips and others

They will be working for Private Hospitals that initially will be offering services to NHS patients. But because of shortage of the said consultants, those that are concerned that at 78% obstruction, their heart and life may not last the wait and they will pay for the job.

My friend thought it was a bargain at US$ 50,000.

What about your painful hips, the CCG may decide to impose a wait time to limit cost. So you too will pay for it. That is what my golfing friend did in Flroida for a bargain US$90,000 as he paid a co-pay of 25%.

So there are not enough Consultants and shortage creates demand and you can name your price. Consultants do not really want to waste time in CCGs arguing about the price of Stents or Hips.

Soon with changes in the amount of private work FT Hospitals may do, what successful, skillful and sought after Consultant would want to stay within the NHS only to have his pension contribution increased and ultimate pension reduced.

Why not be 100% private and where are FT Hospitals going to find consultants for the phantom private patients.

Private hospitals will continue to provide NHS work but more to fill in their money making gaps. Very smart management indeed.

Consultants in private hospitals are generally extremely well treated, not like the way CEOs of old NHS Hospitals used to sideline them.

In Hong Kong, private Consultants work with several private hospitals and all private hospitals knew that these are the geese that lay the golden eggs. All hospitals provide excellent facilities for them including free valet parking as time is precious.

Could this be why so few consultants are objecting to the changes? I remember one such Private Hospital in Sheffield where there is no charge for parking and there was even free Cappuccino!

What about the quality of work?

Remember, in England, NHS or Private, they are the same consultants.

Monday, May 27, 2013

Booby: Stupid or Smart?

The Blue-footed Booby is perhaps more famous than the Brown  Booby by virtue of it unusual blue feet. The Brown one is no less with its fairly bright yellow feet.

The Cockroach Catcher was fortunate enough to be joined by his wife and a number of high school friends for a special reunion on a secluded island resort in Bocas del Toro.

We knew we were in for a treat when we get morning views like this:
Laguna Azul, Bocas del Toro©Am Ang Zhang 2013

The highlight of the reunion has to be the visit to Bird Island. The greatest surprise was that the young Boobies just hatched and it was truly a photographer’s delight.

Brown Booby, Sula leucogaster©Am Ang Zhang 2013
Brown Booby, Sula leucogaster©Am Ang Zhang 2013

The diet is comprised mainly of flying-fish, squid and some other cephalopods, as well as mullet and anchovy. Prey is usually caught by plunge-diving. Their nostrils are closed to help with diving for food. On land they open their beaks for breathing.

Brown Booby, Sula leucogaster©Am Ang Zhang 2013
Booby (which sounds rude) is meant to be but it was derived from the Spanish word Bobo which means stupid. When Darwin first studied Boobies in the Galapagos Islands they showed little fear of the human intruders.

Brown Booby, Sula leucogaster©Am Ang Zhang 2013

Yet, called them stupid or what they are one of the few bird species that is not in any danger of extinction. 

Brown Booby, Sula leucogaster©Am Ang Zhang 2013

Thanks for the visit:

 Brown Booby, Sula leucogaster©Am Ang Zhang 2013

Boobies use the colour of their feet for attracting mates and apparently for survival as the vividness of the feet is an indication of health. 

Saturday, May 25, 2013

Korea & Sunshine: Golf, Music & Autism

South Korea has enjoyed its link to the west and has embraced advances in modern technology that has helped to establish itself as a major force in Steel and Car production. It is not backward in embracing modern electronic technology and is a major player in Computers, Cell Phones and of course Television.

They have a culture of taking things seriously and that shows in their attention to technical details in advance production. Why else do you think much of Apple’s iPhone4 is made by its rival, Samsung.

South Korean children were brought up to play golf and western music instruments. South Korea supplies western orchestras with a large number of musicians.

South Koreans embrace western idea of medical advance as well. Could this be the cause of one of its problems?

The Independent:
Saturday, 14 May 2011
A population-wide study of South Korean children has shown autism rates much higher than in the United States, suggesting more people worldwide may have the disorder than previously thought.

By examining 55,000 children age 7-12, even those not enrolled in special education programs, researchers found that one in 38 children had some form of autism, including the more mild social disorder known as Asperger's Syndrome.
In the United States, the autism prevalence rate is believed to be one in 110.
1: 38?
In my recent cruise of Central America crossing the Panama Canal, it is not difficult to spot the South Koreans. They were dressed to be protected from the sun.
Despite temperatures reaching the mid 90s F, long sleeves, long slacks and hats with near complete surround was the order of the day; and Golf gloves as well, for both hands. And that is just for walking around town.
I have no idea how much Sunscreen they use, but that would be 50 SPF minimum.

You stay indoors with music instruments!
So lets look at their golfers:

Very little sun tan!!!

In an earlier post:
April 1,2009
Confirming the fears of Somali immigrants in Minneapolis, the Minnesota Health Department agreed Tuesday that young Somali children there appeared to have higher-than-usual rates of autism.

"Though health officials emphasized that their report was based on very limited data, they concluded that young Somali children appeared to be two to seven times as likely as other children to be in classes for autistic pupils.”
Could sunshine or the relative lack of it be the culprit here. Sunshine and Vitamin D3 is the new black. 

In the history of Medicine, we sometimes ignore the most obvious. Just like mosquitoes in diseases in Panama.
Autism posts:

Friday, May 24, 2013

NHS: Internal Market vs Integration!

Dawn anyone?

Laguna Azul, Bocas del Toro©Am Ang Zhang 2013
There is much to commend about the integrated health care that Kaiser Permanente is famous for.
When I was working, I used to know every single GP in my locality and every consultant that worked in our Hospitals. Monday lunch time was when we had our clinical presentations and GPs turned up regularly and it was a good time to know them over drug firm sponsored lunches.
We would often pick up the phone and talk to the referring GPs or they would talk to us about someone they worry about.
No need to get clearance from anyone. Until later that is.
It was not written anywhere about the need to avoid XYZ because of money.
We did what is best and often we would initiate prescriptions and even repeat them if we see the patient for regular follow-ups. More often with adult psychiatrists than with child psychiarists.
But now: we have to let the GPs prescribe as it is going to cost the trust XYZ more otherwise.
How sad!!!
In the MPS Casebook:
Mrs B was a 49-year-old deputy headteacher who, for 18 months, had been increasingly troubled by heavy irregular menstrual bleeding. She was referred to a gynaecologist who carried out a pelvic US and an endomentrial biopsy. In her follow-up appointment with the gynaecologist, Mrs B was told that her investigations had been normal and hormone replacement therapy (HRT) was suggested to regulate her bleeding. The gynaecologist told Mrs B that he would be writing to her GP with his opinion and treatment recommendations.
Mrs B was therefore advised to go and see her GP to get a prescription for HRT in two weeks, which was thought to be sufficient time for the clinic letter to reach the GP. In the meantime, the gynaecologist scribbled down the name of the recommended HRT and gave it to Mrs B.
Unfortunately she was prescribed unopposed oestrogen.
………… Dr T realised that for many months Mrs B had been mistakenly prescribed an unopposed oestrogen and now had heavy bleeding. Dr T apologised to Mrs B and also explained that she needed to be quickly referred back to the gynaecologist for investigation. She was referred urgently and in view of her history of increasingly heavy bleeding and prolonged exposure to an unopposed oestrogen, a hysteroscopy was carried out. This led to a diagnosis of endometrial cancer. Mrs B had a hysterectomy and made a full recovery.
She made a claim against all the doctors involved in her care at the GP practice.
The confusion could have been avoided if the consultant had issued the first prescription. In shared care situations there is a reduction in risk if the initial prescription is commenced by secondary care.          Read the whole story here>>>>>>

This would probably not happen in Kaiser Permanente nor in the good old days of our NHS.
Can someone do something before it is too late! 

From one of their own advisers: Prof Chris Ham
Parliament debate: Public Bill Committee
Chris Ham"May I add something briefly? The big question is not whether GP commissioners need expert advice or patient input or other sources of information. The big problem that we have had over the past 20 years, in successive attempts to apply market principles in the NHS, has been the fundamental weakness of commissioning, whether done by managers or GPs, and whether it has been fundholding or total purchasing."                             

“………The barriers include government policies that risk further fragmenting care rather than supporting closer integration. Particularly important in this respect are NHS Foundation Trusts based on acute hospitals only, the system of payment by results that rewards additional hospital activity, and practice based commissioning that, in the wrong hands, could accentuate instead of reduce divisions between primary and secondary care.”

NHS-Kaiser Permanente: Integration?