Sig sauer magazines
I’m not real happy right now. I literally just walked in the door from the range. Out of 102 rounds I fired with my new Sig sauer magazines I had 96 failures to extract.
I was shooting S&B and my carry load. Both had FTEx. The pistol was also dropping the brass from the last round in a magazine and leaving the brass resting on top of the empty mag.
Pistol was cleaned and lubed before heading out. I soaked the extractor in CLP at the range and cleaned it there. That didn’t make any difference in the frequency of FTEx.
This is a real disappointment for me. I really, really like the way the P250 feels and points. The trigger was fine and for the 6 times the pistol actually functioned as a auto-loader follow-up shots seemed to be fast. I was hoping that this was going to be my new carry pistol, but that isn’t going to happen until it’s fixed.
Obviously, I’ll be calling Sig sauer magazine tomorrow and sending it back to them for repair/replacement.
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FWC moves forward on improving hunting quota system
[12/3/08]
N.C. ACORN Proposes Stricter Ammunition Laws
The grassroots community organization, ACORN, is fighting for a new law it says will save lives. “Stop the Bullet” is a campaign that would make it harder for felons to buy ammunition from stores. When you buy a gun, gun shops have to run a background check first to make sure you’re not a convicted felon.
Screening for Autism
I Screen, You Screen: The American Academy of Pediatrics is recommending that all children be screened for autism. They’ve only press-released their recommendations, however, so it’s difficult to assess them. Wouldn’t it be nice if professional organizations actually released their recommendations to their members before they did so to the public? It would make it so much easier for doctors to discuss the news stories with their patients. They’re releasing them today at their annual conference, and later in the November issue of their journal, which is not yet available online. (Though it may be in AAP member’s mailboxes.)
Part of any well child visit is screening for developmental delays, so one has to wonder what’s different about these recommendations. Are they setting lower limits for what’s abnormal so that those mild cases of autism (which some argue aren’t really autism or even disease) can be treated? If that’s the case, then don’t be surprised when a couple of years from now there’s a upward spike in the number of cases of autism. And don’t blame it on vaccines.
Talladega Germs
Talladega Germs: This was some overly cautious and politically foolish advice:
NASCAR fans might seem rabid, but are they actually contagious?
Getting a hepatitis shot is standard procedure for travelers to parts of Africa and Asia, but some congressional aides were instructed to get immunized before going to Lowe’s Motor Speedway in Concord and the racetrack in Talladega, Ala.
….Staff who organized the trips advised the NASCAR-bound aides to get a range of vaccines before attending — hepatitis A, hepatitis B, tetanus, diphtheria and influenza.
Some thoughts: 1) It isn’t influenza season, so getting a flu shot now to protect you in Alabama for the weekend is useless. (But not a bad idea if you’re thinking forward to January or February 2008.) 2) The hepatitis B vaccine is a series of three shots given over six months. They won’t be getting much protection from one shot given just before the trip. Unless the staff is travelling to Alabama with the expectation of one night stands and IV drug needle sharing, the hepatitis B vaccine seems a bit superfluous. (Even for international travel, it’s only recommended if a person is expected to have contact with blood or the sex industry.) 3) If there’s been an outbreak of hepatitis A among food vendors at the race track, then that makes sense, but evidently that isn’t the case. 4) Tetanus is everywhere. Always keep your tetanus booster (which comes included with diphtheria) up to date.
In defense of Congress, the organizers say that their staffers were going to be visiting hospitals and police stations where they had the potential to be exposed to hepatitis. Maybe. But unless they were planning to subdue the criminal elements and nurse the ill themselves, they didn’t really need the shots. As it turns out, what they really needed was carpal tunnel splints:
Walker said he hadn’t recommended the immunizations, nor were they necessary. He suggested a possible health risk to them was the voluminous notes they took.
“I’m sure they needed to soak their wrists, they wrote so much,” he said.
UPDATE: More on the thinking behind the advice:
Homeland Security Chairman Bennie Thompson of Mississippi said he never meant to offend or scare anyone about health risks at the races. The measure was advised to provide congressional staff with the same disease protection first responders get, especially as they head out on a series of fact-finding missions around the country.
“It’s not about whether the people have shots. … Our staffs as they go forward will be going into sterile areas, they will be working in public health facilities, they will be talking to many holding facilities where criminals are being held….
“The NASCAR event is just one date, but after that they will be doing a number of things,” said Thompson, adding that the World Series and Super Bowl are two other mass gatherings that are going to be researched for readiness.
During the trip to North Carolina, staffers were to visit a medical facility with patients at the Lowe’s Motor Speedway. They were also set to inspect an empty mobile hospital. After the House physician told Republican staffers that shots were not necessary to go to North Carolina, they didn’t get them. Democratic staffers reportedly did.
That explains the influenza shots, anyway.
Eugenics Past and Present
Eugenics Past and Present: I’ve been reading an essay from 1907 by David Starr Jordan, a great mind of his time - scientist, peace activist, president of Standford, and eugenicist. The essay is the The Human Harvest, an anti-war argument grounded in eugenics. From a eugenics perspective, wars are bad because they kill the best men, leaving behind the weakest to perpetuate the race- and weaken the human harvest. Even in the service of a profound good the the callousness and cruelty of eugenics:
Startling results may follow from the selective breeding and preservation of paupers. In the valley of Aosta in northern Italy, and in other Alpine regions, is found the form of idiocy known as cretinism. What is the primitive cause of the cretin, and what is the causal connection of cretinism with goiter, a disease of the thyroid glands which always accompanies it, I do not know.
It suffices for our purpose to notice that the severe military selection which ruled in Switzerland, Savoy, and Lombardy for many generations took the strongest and healthiest peasants to the wars, and left the idiot and goitrous to carry on the affairs of life at home. To bear a goiter was to be exempt from military service. Thusin some regions the disease has been a local badge of honor. It is said that when iodine lozenges were given to the children of Savoy in the hope of preventing the enlargement and degeneration of the thyroid gland, mother would take this remedy away from the boys, preferring the goiter to military service.
In the city of Aosta the goitrous cretin has been for centuries an object of charity. There is a special hospice or asylum devoted to his care and propagation. The idiot has received generous support, while the poor farmer or laborer with brains and no goiter has had the severest of struggles. In the competition of life a premium has thus been placed on imbecility and disease. The cretin has mated with the cretin, the goiter with the goiter, and charity and religion have presided over the union. The result is that idiocy is multiplied and intensified. The cretin of Aosta has been developed as a new type of man. In fair weather the roads about the city a re lined with these awful paupers - human beings with less intelligence than the goose, with less decency than the pig.
No acknowledgment that those cretins might have even a glimmer of a soul. The disabled are genetically impure. Eugenics caught up with the goitrous of Aosta. They were forbidden to marry and ceased to be a pollute the public streets. They also became a celebrated example of the power of eugenics to improve the human harvest public health. Many an American eugenicist cited the success of Aosta in ridding itself of goitrous cretins when advocating state eugenic boards.
David Jordan Starr must have been horrified by World War I and it’s toll on the best and brightest. he died in 1931, before the supreme triumph of eugenics in Europe. No doubt, he would have argued that eugenics was misused in Europe precisely because the best men had all perished on the battlefields of World War I. But the problem with eugenics is its denial of the humanity of those it deems unworthy - whether they be cretins or those with seizure disorders (they were sterlized, too, under the compulsory sterilization laws) or Jews.
Science (and society) has pretty much given up on the old fashioned eugenics that relied on controlling reproduction the same way one would in plants or livestock. But we still flirt with eugenics using modern methods of RichardDawkins.net>genetic selection. It might not seem like eugenics because it isn’t imposed by the state, but it is. It may be framed as a personal choice, but the end result is the same - to cull those deemed inferior or undesirable. Today prospective parents can prevent a Down’s syndrome child from being born, or a child with cystic fibrosis. Tomorrow they may be able to de-select the hyperactive child or the child prone to depression. It seems like such a positive thing when framed as a personal choice that improves the life of a family, but is it good to kill off certain traits? Don’t we diminish biological diversity when we do that?
Micropractice vs. Reality
My Long Absence: I have been away too long from the internets and blogosphere. These forced, long absences always leave me a little depressed. But just as I was leaving for a conference in Chicago about a month ago, events forced me into an ideal micropractice. What does that mean? It means I’m short staffed and doing a lot of extra work myself.
There are two schools of thought when it comes to the business of running a medical practice. The conventional wisdom is that it’s a waste of a doctor’s productivity to do the small things - rooming a patient, getting the vital signs, giving shots, performing EKG’s. It’s a better use of resources to have someone else do those things while the doctor concentrates on treating the patient. Some physicians take it even farther - they have ancillary staff take the history and they just concern themselves with the exam and plan. (Not being someone who practices this way, I give them the benefit of the doubt and assume that they confirm that history before acting on it.) In theory, this allows them to see more patients. This is basically my style of practice. Except for this short staffed month.
This month, I’ve been almost practicing the ideal micropractice way. In the ideal micropractice the doctor does everything himself to reduce overhead. At least, that’s the original intent, but even the micropractice guru has hired a nurse to help him out. One of my friends has a micropractice, and she keeps telling me that I do, too, but I don’t believe I do. Once you start hiring staff, are you really a micropractice or just a solo practice?
The truth of the matter is that micropractices work only for micropopulations. Most people who practice that way limit themselves to 200-500 patients, whereas traditional practices handle 1500-2000. So which is better for the public good? A practice that can treat more patients and provide jobs or one that sees few patients and has no employees?
Universal Pander
The Universal Pander: There’s nothing like a presidential election to bring out the healthcare crisis. And, since the presidential primary process is stretching into a two year long spectacle, there’s been no shortage of proposals on how to fix our current system. Recently, Dennis Kucinich pointed out that his ideas are the closest thing to what the American people want:
In a CNN poll this spring, 64 percent of respondents said the government should “provide a national insurance program for all Americans, even if this would require higher taxes,” and 73 percent approve of higher taxes to insure children under 18. Those results track New York Times and Gallup polls last year, in which about two-thirds of respondents said it is the federal government’s responsibility to guarantee health coverage to all Americans.
Such polls allow Kucinich to joke that, far from being in the loony left, “I’m in the center. Everyone else is to the right of me.”
Ask the American public a different question about the healthcare system, and you’ll get a different answer:
For the fifth time in six years, Harris Interactive has asked the insured public to rate their own insurance plans. Two thirds of them continue to give their plans an A or a B, with only 10% giving them a D or an F. Substantial but not overwhelming majorities continue to say that they would recommend their own health plans to family members who are basically healthy (76%) or who have a serious or chronic illness (68%).
Health insurance companies are like politicians. We dislike all but our own. We should be careful what we wish for, however, for it won’t just be our own politicians designing a nationalized health insurance plan; it will be all the others that we dislike, including politicians who believe hospital pork is a public service, that healthcare and personal autonomy are mutually exclusive, and that the right to earn a living takes second place to health insurance.
What are people really wishing for when they say they wish for a single nationalized health insurance program? Security. Our current employer-provided system means that most of us are just a pink slip away from losing our insurance coverage. It also means that, deprived of the bargaining power of large corporations and unions, the self-employed are left with fewer choices and higher premiums. Handing over the whole kit and kaboodle to the government is a seductively simple solution. But it would also be a very expensive solution.
The British are often held up as the standard to which we should aspire. But we don’t live under a British style of government. We live under a government that’s truly government of the people, by the people, for the people. And what the people want, the people get. Witness the influence of disease activism even now on disease specific government funding and treatment mandates. In England, the government only pays for colonoscopies to check for colon cancer if there are symptoms suggestive of cancer or a family history of colon cancer. In the United States, the Medicare pays for a colonoscopy every ten years for everyone over 50, regardless of symptoms or risk. So do many insurance companies., sometimes if not by choice, by mandate. In England, mammograms are only covered for women between the ages of 50 and 70, and then only every three years. In the United States, we pay for mammograms beginning at age 40, yearly, and with no upper age limit. We just don’t have the heart for rationing that they have in other countries.
A common theme in politician crafted health care schemes is that by paying for prevention we will save money, and thus be able to offer limitless healthcare services without bankrupting the country. Both Hillary Clinton and John Edwards have explicitly emphasized the importance of preventive healthcare in their plans- even to the point of patient-directed mandates in the case of Edwards. But if preventive services save money and lives, then why is the United Kingdom, which offers less expansive preventive services than the United States, both healthier and cheaper? (Hint: Dead people neither spend health insurance dollars nor complain about their health.)
Don’t be fooled by the promises of health and wealth to be found in government-provided, or even mandated, health insurance coverage. It may bring you health, but it will be at a very steep price - both in money and liberty.
(Note: Next installment, a look at the Republican candidates approach to “universal coverage.”)
Texas: Senator to Propose Concealed Handguns on College Campuses
“All we’re asking is that you allow us to make that choice. If I can legally carry somewhere else, allow me to make the decision whether or not I want to carry here on campus,” said Matthew Rogers, founder of Texas A&M’s chapter of Students for Concealed Carry on Campus. At least one person in the Texas Legislature agrees. State Senator Jeff Wentworth of San Antonio, an Aggie himself, has promised to propose a bill that would allow those with a permit to pack heat on campus.
In Error
Errors, Errors: The sad story of a medical error and learning to deal with errors.
All Saints Medical
All Saints’ Day: A list of medical saints - albeit an incomplete one.