Monday, May 30, 2011

Medical teams as pit crews

The core structure of medicine—how health care is organized and practiced—emerged in an era when doctors could hold all the key information patients needed in their heads and manage everything required themselves. ... The nature of the knowledge lent itself to prizing autonomy, independence, and self-sufficiency among our highest values, and to designing medicine accordingly. But you can’t hold all the information in your head any longer, and you can’t master all the skills. ...

Before Elias Zerhouni became director of the National Institutes of Health, he was a senior hospital leader at Johns Hopkins, and he calculated how many clinical staff were involved in the care of their typical hospital patient—how many doctors, nurses, and so on. In 1970, he found, it was 2.5 full-time equivalents. By the end of the nineteen-nineties, it was more than fifteen. The number must be even larger today. ...

We train, hire, and pay doctors to be cowboys. But it’s pit crews people need. ...

When I was in medical school, for instance, one of the last ways I’d have imagined spending time in my future surgical career would have been working on things like checklists. Robots and surgical techniques, sure. Information technology, maybe. But checklists?

They turn out, however, to be among the basic tools of the quality and productivity revolution in aviation, engineering, construction—in virtually every field combining high risk and complexity. Checklists seem lowly and simplistic, but they help fill in for the gaps in our brains and between our brains. They emphasize group precision in execution. ...

Recently, you might be interested to know, I met an actual cowboy. He described to me how cowboys do their job today, herding thousands of cattle. They have tightly organized teams, with everyone assigned specific positions and communicating with each other constantly. They have protocols and checklists for bad weather, emergencies, the inoculations they must dispense. Even the cowboys, it turns out, function like pit crews now. It may be time for us to join them.
--Atul Gawande's Harvard Medical School commencement address. HT: Franklin Shaddy

In favor of immigrant children II

Only 12 percent of Americans are foreign-born, the [National Foundation for American Policy] report says. Even so, children of immigrants took 70 percent of the finalist slots in the 2011 Intel Science Talent Search Competition, an original-research competition for high school seniors.

Of the 40 finalists, 28 had parents born in other countries: 16 from China, 10 from India, one from South Korea and one from Iran.

"In proportion to their presence in the U.S. population, one would expect only one child of an Indian (or Chinese) immigrant parent every two and a half years to be an Intel Science Search finalist, not 10 in a year," wrote the report's author, NFAP director Stuart Anderson.
--Stephanie Pappas, LiveScience, on immigrant children and science. See also Part 1.

Counterfeit luxury items as gateway drugs

But a dirty little secret is that Prada rip-offs can also function as free advertising for real Prada handbags—partly by signaling the brand's popularity, but, less obviously, by creating what MIT marketing professor Renee Richardson Gosline has described as a "gateway" product. For her doctoral thesis, Gosline immersed herself in the counterfeit "purse parties" of upper-middle-class moms. She found that her subjects formed attachments to their phony Vuittons and came to crave the real thing when, inevitably, they found the stitches falling apart on their cheap knockoffs. Within a couple of years, more than half of the women—many of whom had never fancied themselves consumers of $1,300 purses—abandoned their counterfeits for authentic items.
--Ray Fisman, Slate, on building desire through proximity

Sunday, May 29, 2011

The region of death in Hamlet

Franco Moretti, however, often doesn’t read the books he studies. Instead, he analyzes them as data. Working with a small group of graduate students, the Stanford University English professor has fed thousands of digitized texts into databases and then mined the accumulated information for new answers to new questions. How far, on average, do characters in 19th-century English novels walk over the course of a book? How frequently are new genres of popular fiction invented? How many words does the average novel’s protagonist speak? By posing these and other questions, Moretti has become the unofficial leader of a new, more quantitative kind of literary study. ...

Most recently Moretti has turned his attention to what might be the most familiar text in English literature: “Hamlet.” Using the play as a kind of test case, Moretti diagrammed and quantified the plot, charting the relationships among characters as a network based strictly on whether they speak to one another at any point in the play. He published the results in an article, “Network Theory, Plot Analysis,” in the March/April 2011 issue of the New Left Review.

Seen through Moretti’s network diagrams, “Hamlet” often seems brand new. One notices, for example, that of all the characters who speak to both Hamlet and Claudius, only two manage to survive the play (Moretti calls this part of the network the “region of death”). Or one notices that Rosencrantz and Guildenstern, the most famous pair of minor characters in all of Shakespeare, never speak to each other. ...

MORETTI: One thing is the discovery of how central Horatio is to the play. And that is interesting in itself, because Horatio is usually not one of the characters on whom people focus. He’s a very bland character, and he usually speaks very blandly....Usually we think of central characters as important in every possible way, but this is not the case here.
--Richard Beck, Boston Globe, on quantitative literary analysis

Thursday, May 26, 2011

Killer commutes

This week, researchers at Umea University in Sweden released a startling finding: Couples in which one partner commutes for longer than 45 minutes are 40 percent likelier to divorce. ...

In 2006, Nobel laureate Daniel Kahneman and Princeton economist Alan Krueger surveyed 900 Texan women, asking them how much they enjoyed a number of common activities. Having sex came in first. Socializing after work came second. Commuting came in dead last. ...

Long commutes also make us feel lonely. Robert Putnam, the famed Harvard political scientist and author of Bowling Alone, names long commuting times as one of the most robust predictors of social isolation. He posits that every 10 minutes spent commuting results in 10 percent fewer "social connections." Those social connections tend to make us feel happy and fulfilled. ...

Those stressful hours spent listening to drive-time radio do not merely make us less happy. They also make us less healthy. The Gallup survey, for instance, found that one in three workers with a 90-minute daily commute has recurrent neck or back problems. Our behaviors change as well, conspiring to make us less fit: When we spend more time commuting, we spend less time exercising and fixing ourselves meals at home. ...

It is commuting, not the total length of the workday, that matters, [Thomas James Christian of Brown University] found. Take a worker with a negligible commute and a 12-hour workday and a worker with an hourlong commute and a 10-hour workday. The former will have healthier habits than the latter, even though total time spent on the relatively stressful, unpleasant tasks is equal. ...

Vehicle-miles traveled had a stronger correlation with obesity than any other factor. ...

Two economists at the University of Zurich, Bruno Frey and Alois Stutzer, actually went about quantifying it, in a now famous 2004 paper entitled "Stress That Doesn't Pay: The Commuting Paradox." They found that for an extra hour of commuting time, you would need to be compensated with a massive 40 percent increase in salary to make it worthwhile.
--Annie Lowrey, Slate, on the benefits of living close to work

Guinness is better in Ireland

[Obama] remarked that the last time he'd ordered a Guinness in Ireland, during a stopover at Shannon Airport en route to Afghanistan, it was much tastier than any he'd had in the United States. "What I realized is you guys are keeping all the best stuff here," he concluded. Was the president blarneying his hosts—or is Guinness really better in Ireland?

It is. After the Institute of Food Technologists asked tasters to sample the so-called "black stuff" in 71 bars, 33 cities, and 14 countries over the course of a year, they gave it an average rating of 74 points out of 100 on the Emerald Isle, about 20 points higher than it got anywhere else. "This difference remained statistically significant after adjusting for researcher, pub ambience, [and] Guinness appearance," the researchers noted.

Freshness is the key factor. Beer is liquid bread, or so the saying goes—both are made out of grains and rich in carbohydrates—and just like a baguette, the fresher beer is, the more delicious it tastes. (Wherever you are, order the kind from the closest brewery, the experts advise.) All Guinness sold in Ireland, the United Kingdom, and North America is made in Dublin—so the time it takes for a keg to cross the Atlantic puts it at an immediate disadvantage.
--Maura Kelly, Slate, on the pale shadow of Guinness found in the U.S.

Monday, May 23, 2011

Goldman Sachs's opinion on LinkedIn

Goldman Sachs, which was an early investor in LinkedIn before the offering, sold its entire stake at $45 a share at the open, leaving some $30 million in missed profit on the table. Goldman clearly did not believe that LinkedIn’s stock price — even at $45 a share — was sustainable. What do they know that the rest of the world does not?
--Andrew Ross Sorkin, NYT, on revealed opinion

Unhappiness in South Korea

Young people in South Korea are a chronically unhappy group. A recent survey found them to be — for the third year in a row — the unhappiest subset among countries in the Organization for Economic Cooperation and Development. The Education Ministry in Seoul said 146 students committed suicide last year, including 53 in junior high and 3 in elementary school. ...

South Korea as a whole ranks first among O.E.C.D. nations in suicide and is routinely among the leaders in developed nations. Subway stations in Seoul have barriers to prevent people from jumping in front of arriving trains, and eight bridges in the capital have installed closed-circuit suicide-watch cameras. ...

The competition for a place in a leading university begins in middle school for most South Korean students. More than 80 percent of Korean young people go to college, and parents here spend more money per child on extra classes and outside tutoring — including military-style “cram schools” — than any other country in the O.E.C.D.

The pressure builds to a single day in November, when a national college entrance exam is held. Some mothers pray at churches or temples throughout the day as their children take the test, which is given only once a year and lasts nine hours. The South Korean Air Force even adjusts its flight schedule so as not to disturb the test takers.
--Mark McDonald, NYT, on the price of educational obsession

Saturday, May 21, 2011

What is this Rapture thing about?

Jesus on the Rapture:
Then [Jesus] said to his disciples, “The time is coming when you will long to see one of the days of the Son of Man, but you will not see it. People will tell you, ‘There he is!’ or ‘Here he is!’ Do not go running off after them. For the Son of Man in his day will be like the lightning, which flashes and lights up the sky from one end to the other. But first he must suffer many things and be rejected by this generation.

“Just as it was in the days of Noah, so also will it be in the days of the Son of Man. People were eating, drinking, marrying and being given in marriage up to the day Noah entered the ark. Then the flood came and destroyed them all. ...

I tell you, on that night two people will be in one bed; one will be taken and the other left. Two women will be grinding grain together; one will be taken and the other left.”
--Luke 17:22-26, 34-35

[Jesus said,] “Be dressed ready for service and keep your lamps burning, like servants waiting for their master to return from a wedding banquet, so that when he comes and knocks they can immediately open the door for him. It will be good for those servants whose master finds them watching when he comes. Truly I tell you, he will dress himself to serve, will have them recline at the table and will come and wait on them. It will be good for those servants whose master finds them ready, even if he comes in the middle of the night or toward daybreak. But understand this: If the owner of the house had known at what hour the thief was coming, he would not have let his house be broken into. You also must be ready, because the Son of Man will come at an hour when you do not expect him.”
--Luke 12:35-40

The apostle Paul on the Rapture:
For the Lord himself will come down from heaven, with a loud command, with the voice of the archangel and with the trumpet call of God, and the dead in Christ will rise first. After that, we who are still alive and are left will be caught up together with them in the clouds to meet the Lord in the air. And so we will be with the Lord forever. Therefore encourage one another with these words.

Now, brothers and sisters, about times and dates we do not need to write to you, for you know very well that the day of the Lord will come like a thief in the night.
--1 Thessalonians 4:16-5:2

The apostle Peter on the Rapture:
Above all, you must understand that in the last days scoffers will come, scoffing and following their own evil desires. They will say, “Where is this ‘coming’ he promised? Ever since our ancestors died, everything goes on as it has since the beginning of creation.” But they deliberately forget that long ago by God’s word the heavens came into being and the earth was formed out of water and by water. By these waters also the world of that time was deluged and destroyed. By the same word the present heavens and earth are reserved for fire, being kept for the day of judgment and destruction of the ungodly.

But do not forget this one thing, dear friends: With the Lord a day is like a thousand years, and a thousand years are like a day. The Lord is not slow in keeping his promise, as some understand slowness. Instead he is patient with you, not wanting anyone to perish, but everyone to come to repentance.

But the day of the Lord will come like a thief. The heavens will disappear with a roar; the elements will be destroyed by fire, and the earth and everything done in it will be laid bare.

Since everything will be destroyed in this way, what kind of people ought you to be? You ought to live holy and godly lives as you look forward to the day of God and speed its coming. That day will bring about the destruction of the heavens by fire, and the elements will melt in the heat. But in keeping with his promise we are looking forward to a new heaven and a new earth, where righteousness dwells.
--2 Peter 3:3-13

The price of Ivy League pampering

Kia Grasty makes $140,000 cleaning up after Penn’s messiest students—and after her tales (and photos) of clogged toilets and filthy bathtubs, few would begrudge her it. ...

Kia has parlayed the effusive recommendation of one student, who found her on Google, into a customer base of dozens of Ivy League neat freaks and slobs—including high-profile scions like [NYPD Blue actress Kim] Delaney’s son, Vera Wang’s daughter, and the heir to the Beverly Hilton—many of whom pay her for the entire year in advance.

Grasty doesn’t judge her clients for a sense of entitlement because she doesn’t see entitlement as a bad thing. “Students should be focusing on books not disinfectant and cleaning the bathroom,” she says. That said, what she sees could sometimes inspire a proper horror movie, from hay-bale-sized piles of clothes to clogged toilets to, at one frat, mounds of defecation in a bathtub, which she captures for posterity with her cell phone camera. ...

More than a cleaner, many students view Grasty as something of a surrogate mother (Kim Delaney is far from the only parent with Grasty on speed-dial), who goes so far as to help coordinate moves and stock up apartments in advance of the new academic year. ...

Never married and with no children of her own, the maternal feeling runs both ways, especially since the death of her own mother last year (she has since also become a regular churchgoer). ...

Come graduation, Grasty takes a front-and-center seat at Penn¹s historic Franklin Field to watch her favorite kids sport their cap and gown.
--Daniella Wexler, Daily Beast, on compensating differentials

Friday, May 20, 2011

Corporate finance brainteaser hint

The original brainteaser post is here.

Hint: The answer is found in Eugene Fama's 1977 Journal of Financial Economics paper, "Risk-adjusted discount rates and capital budgeting under uncertainty."

Thursday, May 19, 2011

What's priceless to spammers

Now [a team of computer scientists has] concluded an experiment that is not for the faint of heart: for three months they set out to receive all the spam they could (no quarantines or filters need apply), then systematically made purchases from the Web sites advertised in the messages. ...

It turned out that 95 percent of the credit card transactions for the spam-advertised drugs and herbal remedies they bought were handled by just three financial companies — one based in Azerbaijan, one in Denmark and one in Nevis, in the West Indies. ...

If a handful of companies like these refused to authorize online credit card payments to the merchants, “you’d cut off the money that supports the entire spam enterprise,” said one of the scientists, Stefan Savage of the University of California, San Diego, who worked with colleagues at San Diego and Berkeley. ...

The weak link in the system, the researchers noted, was that the Visa payment system handled the transaction between the customer’s bank in the United States and the bank in Azerbaijan.
--John Markoff, NYT, on spam's dependence on Visa and Mastercard

Wednesday, May 18, 2011

Living in Manhattan and psoriasis

[Affluent white people in Manhattan] tend not to view themselves as affluent because they believe that living in Manhattan is a natural condition, like psoriasis, rather than a very expensive personal choice.
--Megan McArdle, Atlantic Monthly, on the role of personal agency in residential choices

Tuesday, May 17, 2011

Face time and scientific impact

The benefits of collaboration are well accepted in the scientific world, but researchers with the HMS Center for Biomedical Informatics wondered whether physical proximity affects the quality of those collaborations: Do scientists who have more “face time” with colleagues produce higher-impact results? To test the hypothesis, they examined data from 35,000 biomedical science papers published between 1999 and 2003, each with at least one Harvard author. The articles appeared in 2,000 journals and involved 200,000 authors.

After analyzing the number of citations each paper generated (a standard way to gauge article quality) and the distances between coauthors, they concluded that personal contact, especially between an article’s first and last authors, still matters—even in an age of e-mail, social networking, and video conferencing. (Their analysis, “Does Collocation Inform the Impact of Collaboration?” appeared in the online journal PLoS ONE in December.)

“Our data show that if the first and last authors are physically close, they get cited more, on average,” says research assistant Kyungjoon Lee. As that distance grew, citations generally declined. (Typically, the first author is a graduate student or postdoctoral fellow and the last is a more senior faculty member; they are often affiliated with the same lab, but do not necessarily work closely together.) The effect didn’t hold true for other author combinations, such as first and third; in fact, the middle authors normally don’t interact much on a project, Lee notes. The team also found that, on average, a paper with four or fewer authors based in the same building was cited 45 percent more than one with authors in different buildings—“So if you put people who have the potential to collaborate close together,” he says, “it might lead to better results.”
--Debra Bradley Ruder, Harvard Magazine, on the importance of physical proximity

Thursday, May 12, 2011

Lifeguards of the O.C.

According to a [Newport Beach] city report on lifeguard pay for the calendar year 2010, of the 14 full-time lifeguards, 13 collected more than $120,000 in total compensation; one lifeguard collected $98,160.65. More than half the lifeguards collected more than $150,000 for 2010 with the two highest-paid collecting $211,451 and $203,481 in total compensation respectively. Even excluding benefits like health care and pension, more than half the lifeguards receive a total salary, including overtime pay, exceeding $100,000. And they also receive an annual allowance of $400 for “Sun Protection.” Many work four days a week, 10 hours a day. ...

The Lifeguard Management Association represents the 13 full-time, salaried employees in collective bargaining with the city...

In a phone conversation, Brent Jacobsen, president of the Lifeguard Management Association, defended the lifeguard pay in Newport Beach: “We have negotiated very fair and very reasonable salaries in conjunction with comparable positions and other cities up and down the coast.”

Lifeguards are able to retire with 90 percent of their salary, after only 30 years of work at as early as the age of 50.
--Brian Calle, Orange County Register, on how to hire and retain the best lifeguards in the world. HT: Greg Mankiw

The problems with electric cars

Electric cars are all the rage today, but some of the smartest people I know believe that moving towards electric vehicles is a terrible idea. Looking casually as an outsider at the unappealing economics of electric vehicles (the need for a new and immensely expensive infrastructure, cars that cost much more than either traditional gas engines or hybrids, limited ranges and long recharging times), I find it hard to understand why the Obama administration is pushing electric cars.

One argument I’ve heard is “national security,” the idea being that electric vehicles would make the United States less dependent on imported oil. Be careful what you wish for, however, because if electric cars become a mainstay, we may be trading one dependence for another that is even more troubling. Ninety-five percent of the world’s output of rare-earth metals today comes from one country: China. By some estimates, demand will outstrip supply within five years. At least with oil we know there are fifty years of oil reserves readily available. Moreover, oil is produced all over the world, limiting the monopoly power of any one country.
--Steve Levitt, Freakonomics blog, on going from the oven to the fire

Tuesday, May 10, 2011

Dealing with the dead grandmother excuse

A colleague many years ago told me he always accepted the student's report of a death. And then always sent a sympathy card to the family. If the death really happened, he often received a kind thank-you note. If there was no death, well... One student's parents were so mad at their child that they pulled him out of school. Win-win for the instructor.
--dabozak's comment on

Saturday, May 7, 2011

When reasons stop mattering

[Steve] Jobs imagines his garbage regularly not being emptied in his office, and when he asks the janitor why, he gets an excuse: The locks have been changed, and the janitor doesn’t have a key. This is an acceptable excuse coming from someone who empties trash bins for a living. The janitor gets to explain why something went wrong. Senior people do not. “When you’re the janitor,” Jobs has repeatedly told incoming VPs, “reasons matter.” He continues: “Somewhere between the janitor and the CEO, reasons stop mattering.” That “Rubicon,” he has said, “is crossed when you become a VP.
--Adam Lashinsky, Fortune, on taking responsibility for results

Thursday, May 5, 2011

What's different about K-12 education?

Suppose that groceries were supplied in the same way as K-12 education. Residents of each county would pay taxes on their properties. Nearly half of those tax revenues would then be spent by government officials to build and operate supermarkets. Each family would be assigned to a particular supermarket according to its home address. And each family would get its weekly allotment of groceries—"for free"—from its neighborhood public supermarket.

No family would be permitted to get groceries from a public supermarket outside of its district. Fortunately, though, thanks to a Supreme Court decision, families would be free to shop at private supermarkets that charge directly for the groceries they offer. Private-supermarket families, however, would receive no reductions in their property taxes.

Of course, the quality of public supermarkets would play a major role in families' choices about where to live. Real-estate agents and chambers of commerce in prosperous neighborhoods would brag about the high quality of public supermarkets to which families in their cities and towns are assigned. ...

...thoughtful souls would call for "supermarket choice" fueled by vouchers or tax credits.

Opponents of supermarket choice would accuse its proponents of demonizing supermarket workers (who, after all, have no control over their customers' poor eating habits at home). Advocates of choice would also be accused of trying to deny ordinary families the food needed for survival. Such choice, it would be alleged, would drain precious resources from public supermarkets whose poor performance testifies to their overwhelming need for more public funds. ...

As for the handful of radicals who call for total separation of supermarket and state—well, they would be criticized by almost everyone as antisocial devils indifferent to the starvation that would haunt the land if the provision of groceries were governed exclusively by private market forces. ...

In reality, of course, groceries and many other staples of daily life are distributed with extraordinary effectiveness by competitive markets responding to consumer choice. The same could be true of education...
--Don Boudreaux on the peculiar boundaries we draw on the private market. I would add that we organize university education closer to the "supermarket choice" model. HT: Greg Mankiw

Tuesday, May 3, 2011

How MLK got a new quote

Here's the [false Martin Luther King] quote as most people on Facebook saw it:
I will mourn the loss of thousands of precious lives, but I will not rejoice in the death of one, not even an enemy. Returning hate for hate multiplies hate, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate, only love can do that.
Everything except the first sentence is found in King's book, Strength to Love, and seems to have been said originally in a 1957 sermon he gave on loving your enemies. Unlike the first quotation, it does sound like King, and it was easy to assume that the whole thing came from him.

So how did they get mixed together?

Thanks to Jessica Dovey, a Facebook user, that's how. And contrary to my initial assumption, it wasn't malicious. Ms. Dovey, a 24-year old Penn State graduate who now teaches English to middle schoolers in Kobe, Japan, posted a very timely and moving thought on her Facebook status, and then followed it up with the Martin Luther King Jr. quote.
I will mourn the loss of thousands of precious lives, but I will not rejoice in the death of one, not even an enemy. "Returning hate for hate multiplies hate, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate, only love can do that." MLK Jr.
At some point, someone cut and pasted the quote, and--for reasons that I, appropriately chastened, will not speculate on--stripped out the quotation marks. Eventually, the mangled quotation somehow came to the attention of Penn Jillette, of Penn and Teller fame. He tweeted it to his 1.6 million Facebook followers, and the rest was internet history. Twenty-four hours later, the quote brought back over 9,000 hits on Google.

The quote also went viral on Twitter, and since the 140-character limit precluded quoting the whole thing, people stripped it down to the most timely and appropriate part: the fake quote.
--Megan McArdle, Atlantic Monthly, on the importance of punctuation