Why Incentives to Attract Doctors to Rural Areas Haven’t Worked

Arjun Sharma in Undark:

IN THE 1960s and 1970s, researchers offered financial incentives to patients to get them to lose weight, quit smoking, and abstain from alcohol. To some degree, it worked. But when governmental bodies proffered a pecuniary boon to physicians to move their practice to rural areas, the outcomes were less clear-cut. In fact, new evidence suggests that such monetary incentives barely move the needle.

In 1965, as Medicare was being launched, state lawmakers were in the process of identifying regional gaps in the American health care landscape. These places, which were designated under the nationally established Health Professional Shortage Area program, or HPSA, disproportionately lacked medical practitioners and are now areas where a single physician could be tasked to juggle the health of thousands of people. Such medical deserts include more than 5,300 rural areas, in which almost 33 million people face a dearth of primary care services.

More here.



Margaret Raspé (1933–2023)

Pia-Marie Remmers at Artforum:

FOR THE PAST FIFTY YEARS, artist Margaret Raspé has produced a sensitive, trenchant, and profoundly uncompromising body of work that has, until very recently, received only scant attention.

Born in Wrocław, Poland, Raspé grew up in southern Germany, studying art in the 1950s in Munich before settling in Berlin with her husband. Her budding practice came to a standstill as marriage and motherhood forced Raspé into the traditional role of the housewife. After a divorce in the late 1960s, she found herself with meager financial resources and began renting out her home to artists and theorists of the Fluxus and Viennese Actionism schools. Many of these figures became lasting companions and encouraged Raspé to resume her practice. Raspé’s so-called camera helmet films, which date to the early ’70s, are among her first pieces of this period. Comprising point-of-view shots as the artist prepared schnitzel, washed dishes, or gutted a chicken, they overflow with anger at both the patriarchal structures that dominated her everyday life and her own failure to resist the oppression and alienation that so thoroughly trapped her.

more here.

Kate Zambreno Collects Herself

Katy Waldman at The New Yorker:

Toward the end of “The Light Room,” Kate Zambreno’s memoir of the early pandemic, she describes corresponding with a friend, the author and professor Sofia Samatar, about the difference between hoarding and collecting.

Hoarding, I muse, is about ugliness. Yes! She writes me back. Ugliness as well as shame. Collecting, perhaps, is about beauty, I suggest. An organizing spirit.

At this point in the book, Zambreno is thinking about the artist Joseph Cornell—specifically, about how he cleaned out the cellar of his mother’s house in Queens so that he could use it as a workshop. He had to organize the old miscellany and sort it into boxes, which he then gave whimsical labels: “notions,” “cordials,” “wooden balls only.” Zambreno posits that this collecting-and-cataloguing project “became as much a part of [Cornell’s] art as the construction of his collages.” In his diary, she notes, Cornell compared the “creative arrangement” of clutter to a “poetics.”

As is often the case when Zambreno is writing about another artist, she is also implicitly writing about herself.

more here.

Thursday Poem

Write it on Your Heart

Write it on your heart
that every day is the best day in the year.
He is rich who owns the day,
and no one owns the day
who allows it to be invaded
with fret and anxiety.

Finish every day and be done with it.
You have done what you could.
Some blunders and absurdities,
no doubt crept in.
Forget them as soon as you can,
tomorrow is a new day;
begin it well and serenely,
with too high a spirit
to be cumbered with
your old nonsense.

This new day is too dear,
with its hopes and invitations,
to waste a moment
on the yesterdays.

by Ralph Waldo Emerson
from
Poetic Outlaws

Wednesday, January 10, 2024

Wednesday Poem

Immanuel Kant

The philosophy of white blood cells:
this is self,
this in non-self.
The starry sky of non-self,
perfectly mirrored
deep inside.
Immanuel Kant,
perfectly mirrored
deep inside.

And he knows nothing about it,
he is only afraid of drafts.
And he knows nothing about it,
though this is the critique
of pure reason.

Deep inside.

by Miroslav Holub
from
The Vintage Book of Contemporary World Poetry
Vintage Books, 1996

On Alexandra Hudson’s “The Soul of Civility”

Alex Bronzini-Vender in the Los Angeles Review of Books:

I understand why many find civility a deeply questionable—if not totally worthless—discourse: cries for civility are often just attempts to silence desperate demands for justice, cloaked in the language of liberal rationality and tolerance. As Martin Luther King Jr. himself famously put it, civility is too often a weapon of the “white moderate, who is more devoted to ‘order’ than to justice; who prefers a negative peace which is the absence of tension to a positive peace which is the presence of justice.” Many of us are skeptical when someone brings up civility, and for good reason.

Nevertheless, I found Alexandra Hudson’s new book The Soul of Civility: Timeless Principles to Heal Society and Ourselves unexpectedly compelling. Civility, as Hudson rightly defines it, does not preclude, and even requires, conflict. Hudson writes that civility is rooted in “shared humanity.” To truly recognize someone as your equal, you must be willing to tell them hard truths. And rather than merely bemoaning the loss of vaguely defined civility in American culture, Hudson offers a deeply informed, cross-cultural study of what civility is, and, arguably even more importantly, isn’t.

More here.

Neuroscience is pre-paradigmatic

Eric Hoel in The Intrinsic Perspective:

The hardest question in neuroscience [is] a very simple one, and devastating in its simplicity. If even small artificial neural networks are mathematical black boxes, such that the people who build them don’t know how to control them, nor why they work, nor what their true capabilities are… why do you think that the brain, a higher-parameter and more messy biological neural network, is not similarly a black box?

And if the answer is that it is; indeed, that we should expect even greater opacity from the brain compared to artificial neural networks, then why does every neuroscience textbook not start with that? Because it means neuroscience is not just hard, it’s closing in on impossibly hard for intelligible mathematical reasons. AI researchers struggle with these reasons every day, and that’s despite having perfect access; meanwhile neuroscientists are always three steps removed, their choice of study locked behind blood and bone, with only partial views and poor access. Why is the assumption that you can just fumble at the brain, and that, if enough people are fumbling all together, the truth will reveal itself?

More here.

Your Eco-Friendly Lifestyle Is a Big Lie

Matt Reynolds in Wired:

In 2021 the polling firm Ipsos asked 21,000 people in 30 countries to choose from a list of nine actions which ones they thought would most reduce greenhouse gas emissions for individuals living in a richer country. Most people picked recycling, followed by buying renewable energy, switching to an electric/hybrid car, and opting for low-energy light bulbs. When these actions were ranked by their actual impact on emissions, recycling was third-from-bottom and low-energy light bulbs were last. None of the top-three options selected by people appeared in the “real” top three when ranked by greenhouse gas reductions, which were having one fewer child, not having a car, and avoiding one long-distance flight.

This point isn’t that people are dumb; it’s that the most impactful options don’t always intuitively feel that way to us.

More here.

Is America More United than You Think? What Readers Told Us

Eli Steele in Newsweek:

The media headlines of the past year suggest that things have gotten a lot worse since 2017—and both Thomas and Fox played a part in the divisiveness. But if you look beyond the headlines, including those on Newsweek, a different picture emerges. Even in what feels like an angry, factionalized society, there are signs of unity.

…”My genuine belief is that most Americans don’t really think much about politics, and to the extent they do, they are largely united in the agreement that they dislike it. As a nation, we are far more concerned with celebrity gossip and sports than we are with culture wars or wonkish policy debates. That’s why the average American could almost certainly name more of Pete Davidson’s former lovers than they could members of Congress. Most of the division that we see is manufactured and amplified by a media ecosystem that primarily feeds off of anger and fear. This is particularly true for cable news, which thrives off of a constant stream of outrage porn that rarely befits the designation of journalism. Even so, the fact remains that the overwhelming majority of Americans don’t ever tune in to these outlets. For example, the most successful shows on Fox News, the leader in cable news viewership, only commands an audience that is about one-third the size of the most popular sitcoms on CBS. As a college professor who has taught overtly political topics for years, I’ve also experienced evidence of this united spirit of indifference toward politics that most Americans innately possess. In a classroom of 35 students, maybe four or five on average will routinely speak up and express strong opinions about anything political. The other 85 percent of the class just sits back and hopes they don’t get called on.”
Nicholas Creel, assistant professor of business law at Georgia College and State University

More here.

What You Don’t Know About Sperm

David Barash in Nautilus:

Sperm don’t get much respect. They’re little more than a bare-bones package of DNA outfitted with a lashing tail. And they’re produced in such vast numbers that no single pollywog counts for very much. We all know about their co-starring role in reproduction. But as a 2023 Nature paper underscores, sperm represent some of the most extraordinary and counterintuitive processes of evolution—which got us all here in the first place. So maybe it’s time we get to know sperm better.

To begin with, spermatozoa not only embody the reproductive prospects of males who make them, they have remarkable agency in themselves. Evolutionary biologists have long known that among many species, males compete with other males, the ultimate fitness payoff being that winners will get to project their genes (via their sperm) to the next generation. But competition is also being waged inside male bodies. Sperm battle to fertilize a female’s egg, but they continue to battle even after copulation, perhaps for their own evolutionary payoff.

More here.

Why We Love/Hate Brutalist Architecture

Ashley Gardini at JSTOR Daily:

Brutalist architecture. You either love it or hate it, right? However you feel, we can all agree that Brutalism is an architectural style that continues to elicit strong reactions some seventy years into its existence. At times, it seems like everyone hates it. Take, for instance, Ian Fleming, who named one of the James Bond villains Goldfinger after Ernő Goldfinger, the architect best known for London’s Brutalist Trellick Tower. Or how about the incredible difficulties faced by preservationists when it comes to saving important Brutalist structures? Neither Paul Rudolph’s Orange County Government Center nor Alison and Peter Smithson’s Robin Hood Gardens, both Brutalist icons, were preserved successfully. On the other hand, Brutalism has entered our everyday lexicon. From books to fashion to household decor, you can buy a Brutalist version for yourself. It seems that the influence of Brutalism is here to stay.

more here.

A Conversation With Israeli And Palestinian Activists

The Editors at The Point:

In this issue, in lieu of our own commentary, we have decided to publish a conversation that took place on October 24th between Israeli and Palestinian activists. In the nearly two months since, the conflict has continued and deepened, notwithstanding the week-long “pause” for the exchange of hostages and political prisoners at the end of November. As we finish this issue, Israel’s aerial bombardment of Gaza and ground war are ongoing, resulting in a humanitarian crisis and the deaths of a reported sixteen thousand Palestinians, while Hamas and affiliated groups still hold 136 hostages abducted from Israel. Yet these developments have done little to alter the backdrop under which this dialogue was convened—a “very dark passage,” in the words of moderator Charles Lenchner—while only making even more urgent its central themes. We recommend it for many reasons: because the speakers’ understanding of the situation is extensive, nuanced and personal; because they are not addressing captive, convinced audiences but each other; because they are attempting, as they speak, to come to terms with both the possibilities and the limitations of their power; because the stakes for them are in no way symbolic or abstract; because they speak, credibly, as if their lives depend on what they say and do.

more here.

Tuesday, January 9, 2024

Love in the sickle cell capital of the world

Krithika Varagur in The Guardian:

Nigeria is the sickle cell capital of the world. Its residents account for about half of all new cases of severe haemoglobin disorders worldwide. And SCD is one of the world’s most prevalent autosomal recessive genetic disorders; the sickle cell trait is more than six times more common in Nigerians than the cystic fibrosis gene is among people of northern European descent, or the Tay-Sachs gene among Ashkenazi Jews.

In the 1950s, a number of scientists speculated that the sickle cell trait confers some resistance to malaria – now a widely accepted theory – which would account for the prevalence of the gene in sub-Saharan Africa, home to more than 90% of all malaria cases in the world. Over millennia, according to this hypothesis, as more AS than AA children survived acute malaria infections and reached reproductive age, they passed on their single S genes. But for those with two such genes, the potential complications include acute pain episodes, acute chest syndrome, strokes, priapism, jaundice, numb chin syndrome, an enlarged spleen, leg ulcers and blindness.

More here.

Advances in Mind-Decoding Technologies Raise Hopes (and Worries)

Fletcher Reveley in Undark:

In the last 10 years, the field of neurotechnology has proliferated at an astonishing pace. According to a report by NeuroTech Analytics, an industry research firm, annual investment in the sector increased more than 20-fold between 2010 and 2020, rising to more than $7 billion per year. Over 1,200 companies have crowded into the space, while large-scale government efforts, such as former president Barack Obama’s BRAIN Initiative, have unlocked billions in public funding. Advances in the field have proved life-changing for individuals living with conditions like Parkinson’s, spinal cord injury, and stroke. People who cannot speak or type due to paralysis have regained the ability to communicate with loved ones, people with severe epilepsy have significantly improved their quality of life, and people with blindness have been able to perceive partial vision.

But in opening the door to the brain, scientists have also unleashed a torrent of novel ethical concerns, raising fundamental questions about humanity and, crucially, where it may be heading.

More here.

How to name specific grievances without undermining universal principles

Matt Lutz in Persuasion:

One recurring point of contention in political debates is what language we should use to discuss matters of moral and political significance. Many on the progressive left prefer particularist moral language, which emphasizes the specific needs and grievances of particular groups. Others prefer to use universalistic language, which refuses to draw distinctions between groups and focuses on what unites us. The paradigm of this disagreement is the debate between those who prefer the slogan “all lives matter” and those who prefer “black lives matter,” although the conflict is larger than this. For example, many progressives have adopted slogans like “black is beautiful” or “the future is female” that those on the right dislike.

As heated as these debates over language can be, there is not any inherent conflict between universalist and particularist language.

More here.

Where to start with: Wilkie Collins

Elly Griffiths in The Guardian:

Monday marks the 200th anniversary of the birth of Wilkie Collins, the Victorian writer known for his mystery novels. His writing became foundational to the way modern crime novels are constructed, and his most famous works – The Woman in White, No Name, Armadale, and The Moonstone – have earned him an international reputation. British crime novelist and Collins fan Elly Griffiths offers a guide for those new to the author’s work.

The entry point

The Moonstone has all the ingredients we have come to expect from a cosy crime novel: a country house, a deadly crime, a brilliant detective. This recipe is now so well known that it’s almost a cliche but, in fact, this is thought to have been the first time these particular ingredients were mixed together. Sergeant Cuff is the first incarnation of the enigmatic sleuth, arriving at the scene after the bungling attempts of local officers, seemingly more interested in his unusual hobbies (in this case, rose-growing) than in the crime. The story is told by several narrators, not all of whom are trustworthy, and the solution, though definitely surprising, makes perfect retrospective sense. TS Eliot described The Moonstone as “the first, the longest and the best of modern English detective novels”, making it the perfect place to start for those new to the writer. It is long but you won’t notice because the story bowls along and you will be captivated by the characters.

More here.