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April 17th, 2017

À une semaine des élections, il est de bon ton, puisque le Brexit n’a pas eu lieu et que Trump n’a pas été élu, de prétendre que Marine ne passera pas. Aux États-Unis, la méfiance est quand-même de mise, comme le prouve cette géniale émission Last Week Tonight avec John Oliver (@iamjohnoliver) (HBO)

Comme "ne pas prévoir c’est déjà gémir", il est assez édifiant de consulter le tableau réalisé par l’équipe de TTSO et titré "ne croyez rien" où ils calculent le ratio "score réalisé / moyenne des sondages" aux dernières présidentielles :

Feeling like an elephant on a trampoline

April 8th, 2017

On Trump’s Mental State

February 23rd, 2017


In a letter to the editor published on February 14, 2017 on the New York Times’ web site, an eminent psychiatrist demurs on Trump’s mental state:

Fevered media speculation about Donald Trump’s psychological motivations and psychiatric diagnosis has recently encouraged mental health professionals to disregard the usual ethical constraints against diagnosing public figures at a distance. They have sponsored several petitions and a Feb. 14 letter to The New York Times suggesting that Mr. Trump is incapable, on psychiatric grounds, of serving as president.

Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.

Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither).

Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy. He can, and should, be appropriately denounced for his ignorance, incompetence, impulsivity and pursuit of dictatorial powers.

His psychological motivations are too obvious to be interesting, and analyzing them will not halt his headlong power grab. The antidote to a dystopic Trumpean dark age is political, not psychological.

ALLEN FRANCES

Coronado, Calif.


The writer, professor emeritus of psychiatry and behavioral sciences at Duke University Medical College, was chairman of the task force that wrote the Diagnostic and Statistical Manual of Mental Disorders IV (D.S.M.-IV).

Île vierge

February 22nd, 2017

Lie Lie Land

February 17th, 2017

Artist Bambi – Picture Kirsty Wigglesworth / AP

Fou de Bassan

February 12th, 2017

Picture by Olivier Brunet

Flags, Countries & Stereotypes

February 4th, 2017

Nice project by by Russian art director Kirill Zaytsev that smartly mixes country flags and stereotypes. Here are my favorites:

What patients should ask their physicians when ordered a new drug

February 4th, 2017

Great list, from a paper by Ranit Mishori (@ranitmd), of questions to ask your physician to when ordered a new drug:

  • What is this medication, and why am I taking it?
  • Are there non-pharmacologic options to treat this condition?
  • How long do I need to be on it?
  • What are the benefits of continuing to take it?
  • What are the possible harms of using that medication?
  • Do any of my medications interact with any another?
  • Can I lower the doses of any of these medications?
  • Which of my medications are more likely to be nonbeneficial considering my age, my other medical conditions and my life expectancy?
  • Are there any medications I can get off completely?

Isabella Mocks Donald

February 4th, 2017

Surrounded by female colleagues, Sweden’s deputy prime minister Isabella Lövin signs a climate bill in a way that clearly mocks a well known picture where Donald Trump, with all-male colleagues around, signed a decree barring US federal funding for foreign NGOs that support abortion.

No need to say that neither Trump, nor his fans, will get the point. But the real issue is actually not there. Let’s hope that those who can smile at this picture can detect others with a similar inner joy and build together a genuine meshed society.

I wish Isabella smiled.

Hula Hoop

February 1st, 2017

Just discovered Julie Winegard… looks like this year, in spite of recent Trumpisms could be pretty poetic after all if they decide to make Hula hoop again.

America First

January 29th, 2017

Screen-And-Treat to Prevent Diabetes Doomed to Fail

January 5th, 2017

Larry Husten (@cardiobrief) just commented on a large new systematic review and meta-analysis published in The BMJ. In short, his point is that screen and treat strategies to prevent type 2 diabetes are doomed to failure unless screening is supplemented by broader public health approaches.

In his paper, Larry Husten quotes Victor Montori (@vmontori) who, when asked to comment on the BMJ study, expressed a trully hindsightful opinion:

It is so hard to articulate the issues because there is obvious good in preventing bad things, but let’s give this another go:

  • Type 2 diabetes is a bad thing when it reduces the quality of your life, because of its symptoms, complications or the burden of its treatment.
  • So preventing diabetes is obviously a good thing.
  • The scale of diabetes is huge and the proportion of people who live one step before that diagnosis is very large. (The review shows we will disagree in labeling who exactly is one step closer to the diagnosis depending on what definitions we choose and the ideology behind the definition selection.)
  • Individuals who choose to live more actively and eat healthier meals do better and delay diabetes, but they do so by swimming against the current, which explains the very high rates of drop offs and "failures."
  • The response should be massive in scale and persistent in time directed at the determinants of the environments, at the environments themselves, and at the lifestyles that emerge as people adapt to those environments. These changes should make healthier lifestyles the easy default —= the direction of the current that drags those who are and are not interested in swimming.
  • Screen and treat is a clinical response, individual, one-at-a-time. It seems ideally suited to people who already are chronic patients by virtue of their comorbidities and thus are already in the healthcare system as it requires the resources of the healthcare system for its success. However, any clinical success leaves the determinants of the environments and the environments unchanged, guaranteeing a steady stream of candidates for screen and treat forever. Furthermore, patients with prediabetes who "fail" to improve with lifestyle interventions may be considered candidates for diabetes drugs like metformin – in essence they are preventing the diagnosis of diabetes by ensuring they get treatment for diabetes instead— a lousy proposition.
  • Meanwhile people bemoan the low quality of treatment of type 2 diabetes, in part because of lack of time, training, and resources. These are lacks from the same system we are ready to load with people who screen positive for prediabetes. And since the epidemic hits the underserved hardest (suggesting again problems with the contexts in which people try to make a living rather than a massive epidemic of poor judgment among the poor and socioeconomically distressed) and these folks have trouble getting healthcare in the first place, a solution reliant on healthcare access, if effective, would make disparities in the incidence of diabetes worse.
  • Thus, we need solutions that don’t leave the conditions that have created the epidemic intact, making the efforts of those set on improving their lifestyle often seem futile in the long run, producing more at-risk people, burdening the sick-care system with healthy people seeking wellness. In all these ways, policies of screen and treat are accidentally (I hope) cruel, particularly toward the sick and the needy, people living "in the shadows of life."
  • I wholeheartedly endorse the priority of preventing type 2 diabetes, but effective sustainable solutions are more likely to be found through evidence-informed deliberative democracy (the population version of shared decision making). The work there is to determine the kind of environments we want — for ourselves and our children — and the public health policies that must be implemented to realize them.
  • Those who seek a more expedient solution to match the urgency of the problem would do best to start this long-term process as soon as possible rather than waste time, attention, and resources, in palliating the problem one screen-and-treated patient at a time.


Emphasis (bold) is mine.

Complex vs Complicated

January 2nd, 2017

Two pictures to start this new year well. First, by John Saddington (@8BIT), The Emotional Journey of Creating Anything Great. Actually, it applies to creating anything at all; the greatness is about ending joyfully, but lame (or simply ordinary) creations mostly share the same path. The real message here is "look at what happens the days, months or years after the glorious instant when you decide that Yes You Can" :-)

The second picture, by Niels Pflaeging (@Complexitools), delineates a clear separation between the keywords to be used in our current complex universe versus the concepts that have always been used in (only) complicated environments. The blue domain is the place where "Puzzle Makers" can keep working as usual while the red area describes a world that already shifted to a highly networked universe. Better embrace the red… if you are not to retire really soon ;-)

Harold Jarche’s Best Finds in 2016

December 30th, 2016

Harold Jarche (@hjarche) shares its best finds in 2016, and I specially liked his "quotes" chapter:

@Tom_Peters: "Presidents rarely get good advice. Every ‘presenter’ presents a totally biased solution–often suppressing competing evidence."

@atduskgreg: "Machine learning is automated bureaucracy. It spits back the systemic biases we feed it in feature vectors, training sets, reward functions."

"The demagogue is one who preaches doctrines he knows to be untrue to men he knows to be idiots." ‐ H.L. Mencken via @normsmusic

@HughCards: "As the Internet makes everything cheaper, access to real networks (Harvard, Wall St., Silicon Valley etc) gets even more expensive."

"Power not only corrupts, it addicts." ‐ Ursula Le Guin via @ndcollaborative

"The object of life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." ‐ Marcus Aurelius via @MickFealty

Michèle Morgan

December 21st, 2016

The most beautiful eyes in cinema were permanently closed this morning… and it makes me sad because I must confess that I have always considered Michèle Morgan as very close from the perfect woman.


Image from Passage to Marseille (1944)


Portrait by Ernest Bachrach (1940)

Welcome to Nobody Cares

December 20th, 2016

This image is a riff on Seth’s Godin’s first lesson of marketing in the Internet Age: "Nobody Cares About You".

i.e. Nobody is going to click on your link/download your app/buy your product/read your blog because you’re so utterly fascinating, Darling. They do it because there’s something in it for them- and no, you’re not the one who gets to decide what that something is.

But then again, that’s quite liberating. It frees you up to think about what what matters to other people, not what emotional bauble strokes your ego.

It makes it much easier to be engaged. Which, in the Holiday Season, is no bad thing.

Image and text by @gapingvoid

The idea awareness cycle

December 9th, 2016

Yet another great post by Seth Godin (@ThisIsSethsBlog) describing the typical idea awareness cycle.

Ignorance We’re too busy doing our jobs to notice that.
Dismissal That? It’s trivial. Kids.
Nervousness Let’s take a look at what they’re up to, benchmark it, buy a research report… Bob, can you handle this?
Poor Copies See, I told you it was no big deal. Our new model is almost the same.
Admiration Wow, look at them go. Every once in awhile, someone comes up with something special. Good for them.
Special case Of course, this won’t effect our core business. It’s working really well here because that’s unique.
Superman Holy smokes. Who is this guy?
Catastrophe/Doomsday Run for your lives. It’s over. Over forever and ever.
  Repeat

Make the invisible visible

December 8th, 2016

Listening to your customers isn’t figuring out what they want — it’s figuring out their needs.

We don’t always know what’s missing. Sometimes thirst feels like hunger. Sometimes a headache means stress. Sometimes we’re so deep within ourselves that we can’t read ourselves.

The art of business is anticipating needs. It’s going above and beyond. It’s being so attuned to your customers’ needs that you figure out their solution before they’ve identified the problem.

Naming the invisible problem is the first step to creating the visible solution.

Image and text by @gapingvoid

You may feel that it is yet another interpretation of the apocryphal Henry Ford quote: If I’d asked customers what they wanted, they would have said "a faster horse".

It is also close from the theories behind Interaction Design: you shouldn’t ask people to describe the products or services they would need, but what wishes they would ask the "genius out of the lamp" to fulfill for them… then build accurate enough Personas to be able to design the solutions that fit.

Finally, it is less about asking good questions (any question can lead to the proper answers if you listen properly) than it is about keeping in mind that innovation occurs out of the box and that, if innovators must have enough skin in the game to deliver consistent solutions, they also must keep dreaming in the wild.

Voices from Trumpland: Have malice toward none, with charity for all

December 4th, 2016

  1. Read and learn the Declaration of Independence, the Constitution, and the Bill of Rights. Know that our basic rights are inalienable.
  2. Identify and follow many credible sources of news. Be very well informed and learn to discern truth from untruth.
  3. Watch every word, decision and action of Trump and his administration extremely closely, like we have never done before in America.
  4. Be very vocal in every forum available to us when we observe Trump’s violations of our rights and our democracy. Write, speak, act.
  5. Support journalists, artists, academics, clergy and others who speak truth and who inform, inspire and unite us.
  6. Build bridges with Americans from the other side of the traditional political spectrum and with members of diverse American communities.
  7. Defend others who may be threatened by Trump even if they don’t look, think or believe like us. An attack on one is an attack on all.
  8. Organize online and in person with other Americans who understand the danger Trump poses and who are also willing to speak up.
  9. Hold members of Congress accountable for protecting our rights and democracy through elections and by making public demands of them now.
  10. And finally, in the words of Abraham Lincoln, have "malice toward none, with charity for all" and never ever lose hope!

Health Creation

December 2nd, 2016

The NHS Alliance’s 2016 Action Summit just occurred on December 1, 2016. It titled "In search of health creation: community by community". The subtitle read "None of us as smart than all of us" and I guess that I would have loved being there.

I discovered this Change Agents plot from this image embedded in a tweet:

Since the brits are often "borderline punks", I was not that astonished that they can write such things as Our mission is to infect the NHS with wellness. And what follows is rock’n'roll as well:


We’ve committed to address health inequalities through the concept and practice of Health Creation. Our mission is to infect the NHS with wellness.

We think Health Creation is the single most important driver to change our thinking around delivering health care. We want to press a cultural reset button, which will move us towards a health service that focuses on what keeps people well.

Our Summit on December 1 is all about being forward thinking. It’ll be highly interactive and focus on how we can achieve big change. If you’d like to attend – and be part of a new, determined movement, please get in touch with us at conference@nhsalliance.org.

The complete program is there… but it is unfortunately too late to attend to it.


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