Category Archives: musings

cool, data saving lives, facts & data points, musings, silly

Facial hair trends:1842 – 1976

  • Terrific find on facial hair trends over the 20th century
  • The introduction of the safety razor and world wars have had neglible impact on trends

Source Paper: robinson1976a_facialhairtrends

Source: http://flowingdata.com/2014/01/08/facial-hair-trends-over-time/

Facial hair trends over time

JANUARY 8, 2014  |  STATISTICAL VISUALIZATION

Facial hair trends

In 1976, Dwight E. Robinson, an economist at the University of Washington, studied facial hair of the men who appeared in the Illustrated London News from 1842 to 1972 [pdf].

The remarkable regularity of our wavelike fluctuations suggests a large measure of independence from outside historical events. The innovation of the safety razor and the wars which occurred during the period studied appear to have had negligible effects on the time series. King C. Gillette’s patented safety razor began its meteoric sales rise in 1905. But by that year beardlessness had already been on the rise for more than 30 years, and its rate of expansion seems not to have augmented appreciably afterward.

Someone has to update this to the present. I’m pretty sure we’re headed towards a bearded peak, if we’re not at the top already.

 

BUT THEN THIS FROM THE ATLANTIC:

http://www.theatlantic.com/health/archive/2014/01/the-rise-and-fall-and-rise-of-facial-hair/282951/

The Rise and Fall—and Rise—of Facial Hair

There was a time when the best option was to wear both sideburns and a mustache.
 Library Company of Philadelphia/flickr

In 1940, the anthropologists Jane Richardson and Alfred Kroeber examined pictures of catalogues, magazines, and drawings dating back to the 1600s in an attempt to find trends in the cuts and styles of women’s dresses. What they produced were fascinating graphs of evolving social mores, with periods of plunging necklines quickly succeeded by buttoned-up decades of modesty, and vice-versa. One particularly entertaining chart shows generally Amish-length skirts throughout history — save for a racy, rapid shortening during the libidinous 1920s.

Skirt lengths by decade, from 1600 to 1940. (Richardson and Kroeber)

In 1976, University of Washington economist Dwight E. Robinson sought to apply the same technique to fashion trends in the opposite sex—specifically, in men’s “facial barbering.”

For the study, published in the American Journal of Sociology, he examined the period between 1842 and 1972, the years of continuous weekly publication of the Illustrated London News. Since this was the “world’s most venerable pictorial news magazine,” it would serve as his sole source.

With the acknowledgement that the “gentlemen of the News” were largely limited to prominent members of society, he set about counting the frequency with which five different facial hair styles appeared: sideburns alone, sideburns and mustache, a beard (“any amount of whiskers centering on the chin,” in case you were confused), mustache alone, and clean-shaven. He excluded pictures of royalty, models, and non-Europeans, and gathered about 100 images for each year.

Here are the bristly results:

American Journal of Sociology

Beards and sideburns began losing their luster in the mid-late 1800s, while mustaches hit their apex in the early 20th century and have been increasingly less popular ever since. The number of brave souls who sported both sideburns and mustaches peaked in 1877, though the study did not address their later resurgence in modern-day Bushwick.

Few were clean-shaven in the late 1800s, but by the 1970s, nearly everyone was:

American Journal of Sociology

What’s more, the great “beard wave” of 1844 to 1955 corresponded to a similar heydey, for whatever reason, of extra-wide skirts in the Richardson-Kroeber study:

American Journal of Sociology 

Robinson’s theory as to why fashion—both sartorial and hirsute—seems to come in waves is this: Young people tend to eschew the tastes of their elders, but old trends seem new again after a sufficient amount of time has passed. So while long skirts may fall out of favor for one generation, their grandchildren will think they’re the cat’s pajamas.

1890s and 1950s dresses (Herbert Art Gallery & Museum, Coventry/Bess Georgette/flickr)

And most men might have been anti-beard between the 1940s and 1976, but a spin around the nearest artisanal cheese shop today will show that’s no longer the case.

entrepreneurship, musings

There’s something about TED

  • excellent talk by a Visual Arts Professor about the light, deceptive folly of TED
  • despite the entirely valid criticisms, I think TED still fills a void in the public discourse
  • placebo technoradicalism
  • middlebrow megachurch infotainment

We need to talk about TED

Science, philosophy and technology run on the model of American Idol – as embodied by TED talks – is a recipe for civilisational disaster
theguardian.com, 
In our culture, talking about the future is sometimes a polite way of saying things about the present that would otherwise be rude or risky.

But have you ever wondered why so little of the future promised in TED talks actually happens? So much potential and enthusiasm, and so little actual change. Are the ideas wrong? Or is the idea about what ideas can do all by themselves wrong?

I write about entanglements of technology and culture, how technologies enable the making of certain worlds, and at the same time how culture structures how those technologies will evolve, this way or that. It’s where philosophy and design intersect.

So the conceptualization of possibilities is something that I take very seriously. That’s why I, and many people, think it’s way past time to take a step back and ask some serious questions about the intellectual viability of things like TED.

So my TED talk is not about my work or my new book – the usual spiel – but about TED itself, what it is and why it doesn’t work.

The first reason is over-simplification.

To be clear, I think that having smart people who do very smart things explain what they doing in a way that everyone can understand is a good thing. But TED goes way beyond that.

Let me tell you a story. I was at a presentation that a friend, an astrophysicist, gave to a potential donor. I thought the presentation was lucid and compelling (and I’m a professor of visual arts here at UC San Diego so at the end of the day, I know really nothing about astrophysics). After the talk the sponsor said to him, “you know what, I’m gonna pass because I just don’t feel inspired …you should be more like Malcolm Gladwell.”

At this point I kind of lost it. Can you imagine?

Think about it: an actual scientist who produces actual knowledge should be more like a journalist who recycles fake insights! This is beyond popularisation. This is taking something with value and substance and coring it out so that it can be swallowed without chewing. This is not the solution to our most frightening problems – rather this is one of our most frightening problems.

So I ask the question: does TED epitomize a situation where if a scientist’s work (or an artist’s or philosopher’s or activist’s or whoever) is told that their work is not worthy of support, because the public doesn’t feel good listening to them?

I submit that astrophysics run on the model of American Idol is a recipe for civilizational disaster.

What is TED?

So what is TED exactly?

Perhaps it’s the proposition that if we talk about world-changing ideas enough, then the world will change. But this is not true, and that’s the second problem.

TED of course stands for Technology, Entertainment, Design, and I’ll talk a bit about all three. I Think TED actually stands for: middlebrow megachurch infotainment.

The key rhetorical device for TED talks is a combination of epiphany and personal testimony (an “epiphimony” if you like ) through which the speaker shares a personal journey of insight and realisation, its triumphs and tribulations.

What is it that the TED audience hopes to get from this? A vicarious insight, a fleeting moment of wonder, an inkling that maybe it’s all going to work out after all? A spiritual buzz?

I’m sorry but this fails to meet the challenges that we are supposedly here to confront. These are complicated and difficult and are not given to tidy just-so solutions. They don’t care about anyone’s experience of optimism. Given the stakes, making our best and brightest waste their time – and the audience’s time – dancing like infomercial hosts is too high a price. It is cynical.

Also, it just doesn’t work.

Recently there was a bit of a dust up when TEDGlobal sent out a note toTEDx organisers asking them not to not book speakers whose work spans the paranormal, the conspiratorial, new age “quantum neuroenergy”, etc: what is called woo. Instead of these placebos, TEDx should instead curate talks that are imaginative but grounded in reality.  In fairness, they took some heat, so their gesture should be acknowledged. A lot of people take TED very seriously, and might lend credence to specious ideas if stamped with TED credentials. “No” to placebo science and medicine.

But … the corollaries of placebo science and placebo medicine areplacebo politics and placebo innovation. On this point, TED has a long way to go.

Perhaps the pinnacle of placebo politics and innovation was featured at TEDx San Diego in 2011. You’re familiar I assume with Kony2012, the social media campaign to stop war crimes in central Africa? So what happened here? Evangelical surfer bro goes to help kids in Africa. He makes a campy video explaining genocide to the cast of Glee. The world finds his public epiphany to be shallow to the point of self-delusion. The complex geopolitics of central Africa are left undisturbed. Kony’s still there. The end.

You see, when inspiration becomes manipulation, inspiration becomes obfuscation. If you are not cynical you should be sceptical. You should be as sceptical of placebo politics as you are placebo medicine.

T and Technology

T – E – D. I’ll go through them each quickly.

So first technology …

We hear that not only is change accelerating but that the pace of change is accelerating as well. While this is true of computational carrying-capacity at a planetary level, at the same time – and in fact the two are connected – we are also in a moment of cultural de-acceleration.

We invest our energy in futuristic information technologies, including our cars, but drive them home to kitsch architecture copied from the 18th century. The future on offer is one in which everything changes, so long as everything stays the same. We’ll have Google Glass, but still also business casual.

This timidity is our path to the future? No, this is incredibly conservative, and there is no reason to think that more gigaflops will inoculate us.

Because, if a problem is in fact endemic to a system, then the exponential effects of Moore’s law also serve to amplify what’s broken. It is more computation along the wrong curve, and I doubt this is necessarily a triumph of reason.

Part of my work explores deep technocultural shifts, from post-humanism to the post-anthropocene, but TED’s version has too much faith in technology, and not nearly enough commitment to technology. It isplacebo technoradicalism, toying with risk so as to reaffirm the comfortable.

So our machines get smarter and we get stupider. But it doesn’t have to be like that. Both can be much more intelligent. Another futurism is possible.

E and economics

A better ‘E’ in TED would stand for economics, and the need for, yes imagining and designing, different systems of valuation, exchange, accounting of transaction externalities, financing of coordinated planning, etc. Because states plus markets, states versus markets, these are insufficient models, and our conversation is stuck in Cold War gear.

Worse is when economics is debated like metaphysics, as if the reality of a system is merely a bad example of the ideal.

Communism in theory is an egalitarian utopia.

Actually existing communism meant ecological devastation, government spying, crappy cars and gulags.

Capitalism in theory is rocket ships, nanomedicine, and Bono saving Africa.

Actually existing capitalism means Walmart jobs, McMansions, people living in the sewers under Las Vegas, Ryan Seacrest … plus – ecological devastation, government spying, crappy public transportation and for-profit prisons.

Our options for change range from basically what we have plus a little more Hayek, to what we have plus a little more Keynes. Why?

The most recent centuries have seen extraordinary accomplishments in improving quality of life. The paradox is that the system we have now –whatever you want to call it – is in the short term what makes the amazing new technologies possible, but in the long run it is also what suppresses their full flowering. Another economic architecture is prerequisite.

D and design

Instead of our designers prototyping the same “change agent for good” projects over and over again, and then wondering why they don’t get implemented at scale, perhaps we should resolve that design is not some magic answer. Design matters a lot, but for very different reasons. It’s easy to get enthusiastic about design because, like talking about the future, it is more polite than referring to white elephants in the room.

Such as…

Phones, drones and genomes, that’s what we do here in San Diego and La Jolla. In addition to the other insanely great things these technologies do, they are the basis of NSA spying, flying robots killing people, and the wholesale privatisation of biological life itself. That’s also what we do.

The potential for these technologies are both wonderful and horrifying at the same time, and to make them serve good futures, design as “innovation” just isn’t a strong enough idea by itself. We need to talk more about design as “immunisation,” actively preventing certain potential “innovations” that we do not want from happening.

And so…

As for one simple take away … I don’t have one simple take away, one magic idea. That’s kind of the point. I will say that if and when the key problems facing our species were to be solved, then perhaps many of us in this room would be out of work (and perhaps in jail).

But it’s not as though there is a shortage of topics for serious discussion. We need a deeper conversation about the difference between digital cosmopolitanism and cloud feudalism (and toward that, a queer history of computer science and Alan Turing’s birthday as holiday!)

I would like new maps of the world, ones not based on settler colonialism, legacy genomes and bronze age myths, but instead on something more … scalable.

TED today is not that.

Problems are not “puzzles” to be solved. That metaphor assumes that all the necessary pieces are already on the table, they just need to be rearranged and reprogrammed. It’s not true.

“Innovation” defined as moving the pieces around and adding more processing power is not some Big Idea that will disrupt a broken status quo: that precisely is the broken status quo.

One TED speaker said recently, “If you remove this boundary … the only boundary left is our imagination”. Wrong.

If we really want transformation, we have to slog through the hard stuff (history, economics, philosophy, art, ambiguities, contradictions). Bracketing it off to the side to focus just on technology, or just on innovation, actually prevents transformation.

Instead of dumbing-down the future, we need to raise the level of general understanding to the level of complexity of the systems in which we are embedded and which are embedded in us. This is not about “personal stories of inspiration”, it’s about the difficult and uncertain work of demystification and reconceptualisation: the hard stuff that really changes how we think. More Copernicus, less Tony Robbins.

At a societal level, the bottom line is if we invest in things that make us feel good but which don’t work, and don’t invest in things that don’t make us feel good but which may solve problems, then our fate is that it will just get harder to feel good about not solving problems.

In this case the placebo is worse than ineffective, it’s harmful. It’s divertsyour interest, enthusiasm and outrage until it’s absorbed into this black hole of affectation.

Keep calm and carry on “innovating” … is that the real message of TED? To me that’s not inspirational, it’s cynical.

In the US the rightwing has certain media channels that allow it to bracket reality … other constituencies have TED.

• This article first appeared on Benjamin Bratton’s website and is republished with permission. It is the text of a talk given at TEDx San Diego

complex adaptive systems, healthcare, musings, policy, politics, storytelling

Sir Muir Gray – ACSQHC Presentation

  • We’re entering a new era in the NHS where there is “NO MORE MONEY“

@19min: describes “three big businesses in respiratory disease – asthma, COPD, apnoea”

  • Value = Outcomes / Costs
  • Outcome = Effectiveness (EBM+Quality) – Harm (Safety)
  • Costs = Money + Time + Carbon

@22mins: moving from guideline care to personalised care

@26mins: Bureaucracy is important and necessary, but should stick to what it’s good at doing:

  1. The fair and open employment and promotion of people
  2. The un-corrupt management of money
  3. !! Not the curing of disease or delivery of health care – populations defined by need, not jurisdiction

@32mins: law of diminishing returns – benefits plateau as invested resources rise

@33mins: Harmful effects of healthcare increase in direct proportion to the resources invested

@34mins: combine the 2 curves – get a j-shaped curve with a point of optimality – the point of investment after which, the health gain may start to decline

@35mins: as the rate of intervention in the population increases, the balance of benefit and harm also changes for the individual patient

@37mins: value spectrum

[HIGH VALUE]
– necessary
– appropriate
[LOW VALUE]
– inappropriate
– futile
[NEGATIVE VALUE]

@39mins: The Payers’ Archipelago

20th Century Care >> 21st Century Care
Doctor >> Patient
Bureaucracy >> Network
Institutions >> Systems

@42mins: clinicians responsible for whole populations, not just the patients in front of them

@45mins: How to start a revolution
– change the culture – destabilise and constrain; control language
– engage patients and citizens, and the future leaders of 2033
– structure doesn’t matter (5%)
– systems (40%)
– culture or mindset (50%)

@46mins: Culture – the shared tacit assumptions of a group that it has learned in coping with external threats and dealing with internal relationships” Schein (1999) The Corporate Culture Survival Guide

@47mins50s: data doesn’t change the world, emotion changes the world
– atlases written for OMG effect
– programme budgeting

destabilise then constrain then change the language

@49mins: MUDA means waste — resource consumption that doesn’t contribute to the outcome. motonai – the feeling of regret that resources are being wasted. ban old language.

@51mins: mandatory training in new thinking

The Third Healthcare Revolution is already underway
1. PHONE
2. CITIZENS
3. KNOWLEDGE

The third healthcare revolution will come out of the barrel of a smartphone

@56mins: Healthcare is too complex to be run by bureaucracies or markets. Work like an ant colony – neither markets nor bureaucracies can solve the challenges of complexity.

 

PDF: Sir-Muir-Gray-Masterclass-presentation-1-Oct-2013

ASQHC Presentation link: http://www.safetyandquality.gov.au/our-work/medical-practice-variation/presentations/

complex adaptive systems, cool, data saving lives, entrepreneurship, file note, healthcare, healthy habits, musings, nutrition, policy, politics, rapid learning health systems

Prevention Economics

Right. So I’m now comfortable with the idea that the greatest failing of modern healthcare is for it to have extended lifespan without having extended healthy life years. The challenge then, is to extend fully productive life to something far closer to our life expectancy. This can be done with a plant based diet, fasting and moderate exercise. No pills. No fads. Jus a new norm.

But how do we pay for it? Determine the economic cost of extending a life’s productivity by a year seems like a reasonable first step. Then take a piece of that?

Bring in the direct beneficiaries of such a change – the life insurers, super funds and broccoli farmers.

What a great bunch of business partners they’d be.

Giddy up….

healthy habits, musings, storytelling

Upworthy, flow, dopamine…

This is actually about behaviour change, flow and dopamine…  vulnerable, manipulable moments in conscious life being exploited by new online offerings like upworthy. Downloadable crack. Hope it starts being used more for good…

http://bigthink.com/21st-century-spirituality/this-cat-may-have-just-saved-canada-you-wont-believe-how

This Cat May Have Just Saved Canada. You Won’t Believe How.

DECEMBER 10, 2013, 4:37 PM
Bt-cat

Last Friday, Guelph resident Andrew McPherson’s cat, Tutu, appears to have achieved the impossible. Local residents claim their small town will never be the same again, and the future of Canada now seems certain.

Ok, so this article has nothing to do with a mystical cat or the sleepy suburb an hour outside of Toronto, but if you’re reading this, your curiosity was piqued. And there’s good reason.

Part of it is what is now dubbed the Upworthy-style headlines. Started in March 2012 by ex-employees of Move On and The Onion, the viral media site clocked an incredible 87 million unique visitors last month. The site’s headline aesthetic—a mini-story that makes clicking through irresistible—has been cloned by numerous websites attempting to create their own clickbait.

Advertising

While The Atlantic’s Robinson Meyer recently explained the analyticsbehind the massive surge in Upworthy’s traffic, what is really interesting is why the titles are so seductive. It all has to do with our SEEKING system.

While not usually considered an emotional system in our brain, Estonian-born American neuroscientist Jak Panksepp argues that SEEKING is a function of the main instinctual-emotional system in humans in The Archaeology of Mind. We need to be in this mode in order to chase a romantic partner, find food, get to work in the morning…even get out of bed in the morning.

While such regular activities seem everyday, it is in this enormous neural pathway—from the midbrain to the Lateral hypothalamus into the medial frontal cortex—that dopamine is released. And without dopamine, we would have no motivation to do anything in life.

Yet what makes this system even more incredible is not that dopamine is released during gratification, but several seconds before we’re gratified. That is, while we’re engaged in seeking, our anticipation of an event—the first sip of beer, the moments before you undress a partner, the build up before the beat drops—forces dopamine to be released.

Relating this pathway to music, Ohio State university music researcherDavid Huron writes,

As we listen to music our anticipation builds, which generates pleasurable experiences for the listener. When a stimulus is anticipated, a positively-valenced emotional response arises.

This is why disappointment ensues if you’re expecting a beat to drop and it doesn’t—or if you click through an article about nationalistic Canadian cats to find out it has nothing to do with feline life.

The anticipation phase could also help explain the ‘magical’ experience one encounters when engaged in what Hungarian psychology professorMihály Csíkszentmihályi calls Flow: a runner’s high, being immersed in a novel, any moment when your complete and total reality is present in one focused effort.

When musicians, athletes, actors and chess players describe being in Flow experiences, they claim the impetus for action was not consciously initiated. Their movements seem to flow like a river with no consciousness of how they were moving or acting. Neuroscientist and author Sam Harrissays, “This experience has been at the core of human spirituality for millennia.”

The tiny squirts of dopamine we receive when hearing the ding of a text message or seeing a snazzy headline taps into that same anticipatory neural system. If the content matches our expectations, we feel satisfied, and depending on how much it blows us away—Zach Galifianakis Says Everything You Want to Say to Justin Bieber Right to His Face is one great example—we can then feel inspired, outraged and a whole host of other emotions. This is the brilliance of Upworthy: tapping into our ancient neural networks of anticipation and gratification.

Image: Renata Apanaviciene/shutterstock.com

cool, musings, technology

Service presses loved ones’ ashes as a playable vinyl record

Say no more…

http://www.springwise.com/service-presses-loved-ones-ashes-playable-vinyl-record/

Service presses loved ones’ ashes as a playable vinyl record

The UK’s And Vinyly is enabling the recently departed to have their ashes pressed as a vinyl record.

alttext

United Kingdom 6th December 2013 in Weird of the Week.
This is part of a new series of articles that looks at some of the most bizarre and niche business ideas we see here at Springwise.

Remembering loved ones is a highly personal experience, and placing ashes into an urn can be too traditional for some. The first of our Weird of the Week series focused on Holy Smokes, a service that puts ashes into bullets. Now the UK’s And Vinyly is enabling the recently departed to have their ashes pressed as a vinyl record.

Founded by Jason Leach, who also runs a number of record labels such as Subhead, Daftwerk and Death to Vinyl, the service allows anyone to have a loved one’s ashes pressed as a working record, where it can be accompanied by music, the sound of their voice or simply left blank — allowing the pops and clicks to provide an audio representation of the ashes. The ashes are placed onto the raw piece of vinyl before it gets pressed, enabling the ashes to be compressed into the material. Each record comes with personalized artwork — either a simple name and date of birth and death, or a portrait by artist James Hague, who creates his images using ashes mixed into the paint. The GBP 2,000 package gets customers 30 discs with the sounds of their choice, or they can also have a Daftwerk artist record a song about the deceased.

While some may feel uncomfortable handling the ashes of their loved ones, others may cherish the opportunity to connect with them after they die through a very personal artifact. What other unusual ways are there to commemorate the dead?

Website: www.andvinyly.com

Spotted by Denise Kuperman, written by Springwise

complex adaptive systems, cool, data saving lives, entrepreneurship, file note, healthcare, healthy habits, meaning, musings, nutrition, policy, politics, quantified self, rapid learning health systems, research methodology

Healthways…

http://www.healthways.com  || http://www.healthways.com.au

Christian Sellars from MSD put on a terrific dinner in Crows Nest, inviting a group of interesting people to come meet with his team, with no agenda:

  • Dr Paul Nicolarakis, former advisor to the Health Minister
  • Dr Linda Swan, CEO Healthways
  • Ian Corless, Business Development & Program Manager, Wentwest
  • Dr Kevin Cheng, Project Lead Diabetes Care Project
  • Dr Stephen Barnett, GP & University of Wollongong
  •  Warren Brooks, Customer Centricity Lead
  • Brendan Price, Pricing Manager
  • Wayne Sparks, I.T. Director
  • Greg Lyubomirsky, Director, New Commercial Initiatives
  • Christian Sellars, Director, Access 

MSD are doing interesting things in health. In Christian’s words, they are trying to uncouple their future from pills.

After some chair swapping, I managed to sit across from Linda Swan from Healthways. It was terrific. She’s a Stephen Leeder disciple, spent time at MSD, would have been an actuary if she didn’t do medicine, and has been on a search that sounds similar to mine.

Healthways do data-driven, full-body, full-community wellness.

They’re getting $100M multi-years contracts from PHIs.

Amazingly, they’ve incorporated social determinants of health into their framework.

And even more amazingly, they’ve been given Iowa to make healthier.

They terraform communities – the whole lot.

Linda believes their most powerful intervention is a 20min evidence-based phone questionnaire administered to patients on returning home, similar to what Shane Solomon was rolling out at the HKHA. But they also supplant junk food sponsorship of sport and lobby for improvements to footpaths etc.

Just terrific. We’re catching up for coffee in January.

healthcare, musings, policy, politics

MJA Insight: Hard choices – Will Cairns

  • We cannot continue on our current course without depriving other societal domains that are essential to the long-term wellbeing of our community, such as education, physical infrastructure, aged care, environmental protection, the arts and recreation
  • When we eventually do act we will realise that there are a limited number of ways to constrain the proportion of community resources expended on health care.

    One is for funders to pay less for the things that are done.

    The second, and perhaps the simplest, is to not do things that are of little or no benefit. We could also ensure that, when there is a choice, the less expensive options are used. This is primarily a task for doctors but everyone is responsible.

    The third is to make sure that people do not have treatment that they do not want. This merely supports the right of people to make a choice not to start or persist with treatment that will not bring them sufficient benefit in terms of a quantity of a life of quality as they define it. This also requires community acceptance that individuals have the right to make such choices.

While thoughtful medical practice, systemic support of the right to individual choice and improved efficiency can buy us some time they are unlikely to be sufficient.

Perhaps the complex ecology of gridlocked self-interest means that struggling health systems must collapse and fail before they can be rebuilt, and we will just have to watch while it happens.

Surely a better outcome would be to work towards spending only what we can afford. These are not simple issues and the process might begin with an open discussion of our community values and the goals of health care. The sooner we start that discussion the better.

From: https://www.mja.com.au/insight/2013/47/will-cairns-hard-choices