Columns
HEADLINES [click on headline to view story]:

Your Health & Happiness

The Doctor's Consultation 

Agony Column

Camera Class by Snapshot

Dogs - Man’s best friend

Money Matters

Life in the Laugh Lane

Your Health & Happiness:  BUPA donates £100,000 and launches staff fundraising campaign for tsunami disaster

International health and care group BUPA has given £100,000 to the Disasters Emergency Committee and launched an internal fundraising campaign to support the relief of the hundreds of thousands of people affected by the Indian Ocean tsunami disaster.

Chief executive Val Gooding said that the fundraising campaign would involve the company’s 40,000 staff worldwide. She said, “Our deepest sympathies go out to all those suffering from the impact of the past week’s events. We have a business in Thailand and 11,000 BUPA members in the region, with customers in each of the countries affected. Also, many of our people have families and friends in the region, many of whom are anxious to hear news of loved ones. We will be offering them all our assistance and support at this very distressing time.”

BUPA, which provides private health cover to two million people through local operations in Thailand, Australia, Hong Kong and Saudi Arabia, as well as to expatriates, is covering members needing medical attention and making sure they get home from the affected countries, regardless of what level of policy they have.


The Doctor's Consultation: DNR - is it the end?

by Dr. Iain Corness

A few years ago, a consultant in a hospital in the UK was reported to have hung a sign over a patient’s bed that had only three letters - DNR. They stood for “Do Not Resuscitate”! Needless to say there was a great furore over this, with much heated argument on all sides.

There were those who looked at the resuscitation matter as a bean-counter would. If the patient was not a member of the productive community, then this patient was a drain upon community resources. What was to be gained by resuscitating non-producers? This approach always amazed me, to be quite frank. Do bean-counters not have mothers and fathers?

Then there was the all human life is sacred group and everything possible must be done to keep the patient alive, no matter how horrendous those procedures. Quality of Life was not under consideration for this group.

Eventually some reason returned and it was decided that the correct way was for the treating physician to discuss all the options with the patient, and let the patient decide regarding resuscitation.

However, there was still the vexed question as to what happens when the patient is incapable of making such informed decisions through conditions such as Dementia, for example.

Further ethical argument and discussion ensued, and it is the consensus these days that ‘resuscitation’ only refers to Cardio-Pulmonary Resuscitation (CPR). In other words, the resuscitation that would be done following a cardio-pulmonary arrest. The question of DNR does not refer to other treatments such as antibiotics, transfusions, dialysis, ventilator support or even care in an ICU.

This to me looks like a reasoned approach and the American Medical Association Council on Ethical and Judicial Affairs issued an eight point guideline to be used. The first is the most important, and the rest hang upon that. Point 1 stated that “Efforts should be made to resuscitate patients who suffer cardiac or respiratory arrest, except when CPR would be futile, or not in accordance with the desires or best interests of the patient.”

The efforts would be considered futile if they could not be expected to restore cardiac or respiratory function. This is the situation where you already have a seriously ill and dying patient, and even if you could get the heart started again, the damage to the heart would be such that the patient would become a coronary ‘cripple’, on top of all his or her other problems. And that gets us back to the Quality of Life.

In my mind, unless we (as treating physicians) can offer the patient a better quality of life, are we treating the patient ethically by embarking on a course of treatment or therapy that leaves the patient with a poorer quality of life?

I had a friend who developed stomach cancer. By the time he consulted a doctor after months of symptoms, it was really too late. He had been continuing to work in his small business, but he could continue to function. Unfortunately, he consulted a surgeon who could only see the fact that the man had stomach cancer and he operated. The operation was hazardous, the cancer could not be totally excised, he never recovered and spent his last three months in hospital with tubes out of every orifice, begging to die.

As medical practitioners we must never forget the Quality of Life, and as patients you owe it to yourselves to always inquire as to what the Quality of Life will be after any proposed course of action. It may be the most important decision you will ever make.


Agony Column

Dear Hillary,
I left my mobile phone in a hotel lobby and someone appears to have stolen it. I had it “locked” thinking that that would stop any would be thieves. Should I just forget about it or what do you suggest?
Freda

Dear Foneless Freda,
Locking and unlocking phones is done very easily, and even if you had done something very tricky, the local helpful mobile phone shop that asks no questions and gets no lies would soon have it working. If the worst came to the worst, a new SIM card only costs a few hundred baht. You should go down to the shop where you bought it and tell them. You will also have to get a form from the police. If the phone is not registered in your name, you will have to take the person whose name it is in with you. It is one gigantic pain, my Petal. The answer is to keep the phone on your person at all times, or securely attached to your handbag. Mind you, will you be writing in next week to say you’ve left your handbag in the lobby?
Dear Hillary,
It seems impossible to buy furniture here that is not in “kit” form. Since I do not know which end of a screwdriver to use (and my husband is just as technically challenged) what should I do? Any suggestions? I am afraid to buy and we do need some wardrobes.
Screw Loose

Dear Screw Loose,
You’ve got the wrong end of the pineapple here, Petal, or maybe that’s the wrong end of the screwdriver. You don’t need to be a handyman or handywoman, the shop where you are buying the furniture will come out, assemble and install and even take the cardboard containers away too. Give them a little tip when they’ve finished they’ll put the wardrobes in place for you as well. They will appreciate it, and you don’t have to take screwdriver lessons.
Dear Hillary,
This sounds silly, but how do you get a girl to leave you alone in this town? I have had a couple of “liaisons” and the next day the girl returns and starts bringing in her clothes and other personal gear! Two suitcases with the last one. Is this “normal” here? I should add that I am 24 years old, very well built and handsome and earn very good money.
Adonis

Dear Adonis,
Some people do have all the problems! However, I do not believe that your overnight personality is the draw card, nor is it because you are such a well built hunk, but more likely because your wallet is well filled. Be warned, a girl with whom you so delicately put it, who is willing to have a “liaison” is interested in what she can extract from the liaison in the financial sense. She is not interested in joining the gym with you. If you are going to invite professional ladies home, never give any girl a key. Never admit any girl who has more luggage than one small handbag, even (and especially) if she is crying with some very plausible tale of woe (this is sick buffalo season at present). Stop flashing lots of cash around. Keep your wallet and credit cards under lock and key at all times. Read the scores of books that describe the relationship between you (the sucker) and her (the money sucker!). Stephen Leather’s Private Dancer can be downloaded free from the internet and will save you money. Read it!
Dear Hillary,
Why is it that whenever you go to a Thai restaurant and order a Thai meal the waitress will always ask you if you want rice to go with it? I mean, this is Thai food we are talking about here and everyone knows it is only eaten with rice, right? Just to test what would happen I asked the stupid waitress the other night to bring ‘mun farung’ (potatoes) instead. Her jaw dropped and she gave me a look I couldn’t interpret. Why do they continue with this asking, when you know and they know, you’re going to get rice whether you like it or not?
Edgar

Dear Edgar (Rice Burroughs?),
Some people certainly try hard to make their life here more difficult than it needs to be, Petal, and you sure are one of them. Have you ever stopped to consider that the waitress was actually thinking about you? They are not stupid. They know that many farangs are not as fond of rice as the Thai people, so by asking they are making sure that the rice (which is an important commodity) is not wasted. You should try and be as nice to the waitresses as they are being to you. And by the way, not all Thai dishes are eaten with rice, and there are also several styles of rice. Rice is also a very healthy dish that no budding Tarzan would be without. (Look up Edgar Rice Burroughs, Petal, I know you’re probably not into reading much, but they do have picture books these days. They’d probably suit you better.)


Camera Class: The Digital Debate continues!

by Harry Flashman

Three weeks back I mentioned the swing to digital photography, and after many years of saying “Hang back, hang back,” I said that perhaps now was the time to look at changing - but I qualified that response.

What I wrote was, “The photographic print is the final factor as far as I am concerned. Despite digital owners showing you tiny images on the viewing screen at the back of the camera, this is less than satisfactory. You need a physical print you can put in the baby’s photo album. This was an area where print film cameras were way ahead of their digital brothers, but no more. The better ones, such as the Cyber-shot, have a ‘memory stick’. This you can take to the ‘digital’ photo shops which can download the images and give you prints for around the same price as print film photographs!

If you want ‘compact camera point and shoot’ ability only, I would now suggest that it is time to go digital.”

So digital for point and shooters (and that does make up the bulk of the weekend photographers); however, what about the SLR, semi-serious photographers?

In response to that question, my photographic friend Ernie Kuehnelt brought in an article to my attention, published a week after mine, which was written by Don Sambandaraksa, who was described as an “open source advocate”.

I have to admit ignorance, I do not know what an “open source advocate” really is, but when I read the article I warmed to Don Sambandaraksa. Not because of the technical detail (and there was plenty of it), but because when he detailed in the article the camera he personally uses, this showed me that he was a true enthusiast. Don does not use the latest Nikon F5, or a Canon EOS, but a 1981 Pentax Super-A, fitted with a 1976 50 mm, f1.4 lens which he bought in a second hand shop for 7,500 baht. His flash gun was also second hand, for which he paid round about 1,000 baht on ebay.

So here we had a pro photographer, who had sold his photographs of the opening of Asustek Computer Thailand HQ, taken with a 23 year old camera and a 28 year old lens. It was later revealed in the article that Don Sambandaraksa is an IT journalist, the sort of man you expect to have two micro-mobile phones jammed in his ears, a palm PC that rivals NASA for its computing power and having a watch using IR radiation from the sun for power, which can also be used as a microwave oven. As someone who has problems with the remote on my TV set, I stand in awe of the Don Sambandaraksa’s of this world.

However, when the same IT guru uses a 1981 camera when I use a 1982 FM2 Nikon, we have much in common. And it is more than a love of ‘old’ cameras. It is a love, or desire even, for photographic excellence.

In his very balanced article, he explains why, despite the new technology, the digital revolution still cannot deliver the goods, in the way that a good camera system can deliver (which is just a light-tight box that keeps film flat with an excellent piece of glass that can correctly focus on the film, which itself is of high quality with small grain size).

He finished his dissertation by writing, “Digital cameras are expensive, do not let in enough light, are not sensitive to the light they do let in, have serious problems of noise, lack powerful flashes and are generally incapable of true wide-angle shots.”

To that list I would also add that of being generally unable to take rapid action shots. My Nikon allows me to take five frames a second, while all but the most expensive digital cameras take their time to ‘store’ the image before they can take the next shot.

So although I suggested that if you want to ‘point and shoot’, then go digital, I continue to say that if you are a ‘real’ photographer, then hang on to your old cameras, while waiting for the digital technology to truly catch up.


Dogs - Man’s best friend: Environmental influence on the dog’s mind

Nienke Parma

40 percent of a dog’s behavior is genetically influenced, the other 60 percent is influenced by the environment; that what a dog learns during its life from its mother, its littermates, other dogs and animals, environments other than where it lives and us.

A dog learns by observing and copying, trial and error and through training. This learning process starts when still a fetus as it picks up its mother’s moods. During the first two weeks of the puppy’s life it won’t do more than eat, sleep, keep warm and defecate (the latter only possible with the help of its mom!).

However, we can already play a role in the behavior development by sometimes removing the puppy from the nipple and holding it gently, though briefly, in our hands. Through the biofeedback process (as described in the last article: ‘Hormonal influence on the dog’s mind’, Chiangmai Mail Vol. IV no. 1) this little amount of stress the puppy experiences will help it cope better with stress situations later in life.

Once the puppy can see, hear and walk, an extremely important period starts, which is called the socialization period, and runs basically from 3 to 14 weeks of age. It is so important as it lays the basis for the dog’s behavior later in life. It is in this period, the dog learns it is a dog and its social and communication skills are developed: bite inhibition, displays of dominance and submission, calming and play signals, interaction with other dogs, animals and human beings, etc. And as curiosity is contrary to fear it is THE period to habituate the little animal to all sorts of environmental elements.

Further, through play, experimenting under safe conditions is permitted, coordination is stimulated, skillfulness and mental flexibility promoted, inventiveness stimulated and problem solving taught. Dogs (young and adult) use play to establish their social status, i.e. their place on the hierarchic ladder. Regular play, socialization and interaction with other dogs, animal species and environmental elements (also after the socialization period) builds confidence in the dog, improves its communications skills and maintains its soft mouth.

Dogs lacking proper socialization and regular play with other dogs show disturbed behavior: they are clumsy in reading other dogs’ communication signals, are tense, asocial or antisocial and are often scared in unfamiliar situations. As a consequence, they are at higher risk for dog-dog aggression as well as fear reactions like flight or fight. For example, most Rottweilers often will bite in order to bring themselves into safety, while a poodle probably will run. Or, they direct their normal dog (play) behavior at humans which is both annoying and potentially dangerous.

For more information on dog-issues, boarding, training or behavior please contact LuckyDogs: 09 99 78 146 or [email protected]


Money Matters: The Long and Short of it (part 1)

Alan Hall
MBMG International Ltd.

Of the five asset classes that we have been discussing recently, you’d be forgiven for thinking that stocks should be avoided at all costs. However, the recent discussions have focused on the downsides of investing in stocks in the traditional manner. One way of trying to harness the upside volatility of stocks while avoiding the risks is to take exposure to equities via long/short funds.

What are long short funds?

Long/Short Equity funds combine long equity holdings and the short sale of stocks, along with other instruments to vary their net exposures depending on their views on the market. The funds tend to increase their exposures in bull market periods and, decrease them when they feel that the markets will be in decline. By varying exposures in this fashion, long/short managers have a valuable tool to control their participation in directional market movements.

The long side of the portfolios are constructed from stocks that are expected to outperform the market. These stocks will most likely have strong fundamentals with a good market position, an attractive rate of earning growth and offer a high return on equity.

An example of a long trade would be Google, the market leader in internet search engines. Google was floated on August 18 with a price of $85 per share after a controversial auction mechanism that set the flotation price. From a fundamental point of view, the company had a promising valuation with high margins, strong, 3-digit rates of sales growth and an above-30% return on equity. At the end of the first day of trading, Google shares were in the region of $100 per share; indicating that the market was pricing in their expectations.

A long/short manager, who could not participate in the IPO, having a bullish view on Google could have invested $500,000 in the stock on the following day at a price of $100.33 and could have closed his position October 27 at the historical highest price of $187.56. This would have been a perfect trade for the manager’s long side of his portfolio, realising a profit around $434,000. This would constitute a return of nearly 100% in three months.

On the other hand, the short side of a manager’s portfolio, particularly focuses on the stocks that he maintains a bullish view on. These short ideas originate from flawed business models, poor balance sheets, and/or expected/emerging litigation cases acting as negative catalysts.

The negative exposure obtained through taking short positions serves two different purposes. First of all, the shorted individual stocks identified through deteriorating fundamentals create an opportunity to provide additional returns when the markets maintain their bullish sentiment. Secondly, when there is a general downturn, these short positions in their entirety will act as a hedge to offset the losses incurred by the long side of the portfolio.

Next week: more on how short-selling can earn a profit.

The above data and research was compiled from sources believed to be reliable. However, neither MBMG International Ltd nor its officers can accept any liability for any errors or omissions in the above article nor bear any responsibility for any losses achieved as a result of any actions taken or not taken as a consequence of reading the above article. For more information please contact Alan Hall on [email protected]


Life in the Laugh Lane: The Thailight Zone: Where tomorrow never comes

by Scott Jones

If you need anything repaired in America, shops discourage you immediately. “Well, we’re very busy and we’ll have to order parts from Mars. It’s cheaper to buy a new one.” “Okay, fine. We’ll take it, but we can’t even start for five years. How old are you?” “I see. Give this receipt to your next of kin.” “You need it when? Ha, ha, ha. What’s the limit on your Visa card?”

Face changed to protect the guilty.

Here it’s possible they’ll drop everything and fix it while you watch. Seven minutes later, it’s workable, magically renewed with bamboo, rubber bands, a plastic bag, parts from a used hairbrush and some sticky stuff. Or they’ll smile and say, “No problem. It done tomorrow.” When you come back anytime during the next week to 24 months, you are normally given three answers: 1) “Finish tomorrow.” 2) “It in Bangkok.” 3) “We trying to find it.” It’s very important for them not to lose face, which is doubly important in this situation because you want to rip it off and keep it until you get your whatever back.

I took my high-tech Kawasaki into a bike shop. At first he didn’t say tomorrow, but it soon became his only answer: “Finish tomorrow. I say yesterday, finish tomorrow.” He lived in The Thailight Zone where the concept of time is very simply - then, now and tomorrow. Whenever I stopped by, he’d be surrounded by my entire and completely disassembled engine, cleaning every valve, screw, ligament, carbuncle and contrabulator. My engine used to be a half meter high and a half meter square. It had become 15 centimetres tall and a 5 meter polygon. (I didn’t want to upset him because he could just return the parts in buckets and boxes. I might have been able to make a wind chime out of them.)

Cleaning accomplished, some assembly was required. A sweet guy, but this job was beyond him. He had one greasy 19-whenever Honda manual that, considering his comprehension of English matched mine of Thai, gave him a few random pictures and numbers. Basically he was now doing a 10,000 piece jigsaw puzzle without the picture on the box. Mountains were smashed on top of buildings; city folk and antelope were hammered together; any missing landscape was filled with metal bits and sticky stuff.

It’s like giving George W. Bush the job of president. Personally I would never let him have my country. (Nor my bike, though I’d prefer him to be a mechanic in a small shop somewhere.) Half of the USA, or less, give or take Florida (meaning: Feeble Little Old Retired Idiots Driving Around) where his brother is governor, handed him the job of commander in chief, which involves millions of little soldiers, big machines and the red button. Unfortunately he’s trying to write his own manual. I hear Emperor Bush recently went to check out the Iraq Conquest, disappeared and was later found aimlessly wandering around the desert, carrying a piece of sandpaper. He thought it was a map.