Tuesday, April 26, 2005

Ubuntu-Kubuntu Mini-Review

Ubuntu appears to be gaining momentum in the Linux world.  For several weeks now, it has led the hits-per-day list at Distrowatch.  I actually installed Ubuntu several months ago, but did not care for its Gnome-centric interface.  Kubuntu, though, is Ubuntu with a KDE interface. 

Linux, for those who do not know, but who might care, at least a little, is a computer operating system.  You can get Linux for free, or you can pay for it.  If you pay for it, you get technical support.  If you get it for free, you have to use the Internet or call a friend to get support.

Unadorned Linux is sort of like DOS used to be: it has a command-line-only interface.  That is great for some things, but most people want to have windows and icons and be able to point and click.  For that reason, Linux usually is used to run a window manager.  This is like versions of Windows before XP.  Windows versions through Windows ME actually were graphical interfaces than ran on top of DOS. 

Linux is different, though, because it is much more stable than Windows; it crashes rarely.  (In fact, I have never crashed it, even though I do some pretty strange things.)  Also, you can choose what kind of graphical interface you want.  There are some simple interfaces, like BlackBox, that are minimalistic, but don't use much memory or processing power.  They are great if performance is your primary concern.  Linux generally is distributed with one or more window managers already configured.  Such a package is called a distro.

The most popular window managers are Gnome and KDE.  People argue about which is better, which is pointless.  Some people find one more intuitively simple to use than the other.  Since I prefer KDE, Ubuntu was not as easy for me to use as some other distributions.  When Kubuntu came out, I decided to try it. 

Since I live in broadband wasteland, I downloaded it at work, and burned it to a CD.  I downloaded it using a download manager that allows me to regulate the speed, so I did not hog all the bandwidth from everyone else in the office. 

Last time I formatted one of my hard drives, I left a lot of unformatted space, just for this kind of project.  Installation was pretty easy, although it did require some technical know-how, such as what network addresses to enter.  One thing I liked was that it detected other operating systems, and offered to set up a multi-boot system, and it did so correctly.  It told me what it was going to do before it did it, letting me know where it was going to put the boot manager and what it was going to put in the boot menu.  Windows does not do either of those things.  Granted, most people don't want a multi-boot system; or at least, they do not know that they want it. 

Kubuntu booted right away.  No fiddling around.  However, it did not set up my dual-monitor arrangement properly, nor did it detect the need to offer me options for the set up.  I could not find a simple set-up tool.  No problem for most people, since most people use only one monitor at a time.  It shouldn't have been any problem for me, either, since it is not difficult to set it up manually.  That is where I hit my first annoyance.

I wanted to refer to the set-up file (/etc/X11/XF86Config) in one of my other installed distros.  That is the simplest way to configure a new system the way you want it.  The problem was, Kubuntu would not let me mount the other drives.  That is because mounting a drive is something that requires a higher level of privileges than an ordinary user has.  One quirk of K/Ubuntu is that it does not set up a root account during installation.  I actually knew that ahead of time, but did not worry about it.  I did not worry about it, because I thought that, when the time came, I would just use the Internet to find out how to do it.  That led to the next snag. 

I opened the program that is used to dial a modem, KPPP.  Except ordinary users do not have the privilege to dial out.  Fedora is the same way, but with Fedora, a root (high level) account is set up during the installation.  No root account meant no internet access, which meant I could not find out how to set up a root account.  The help files were almost empty.  If I had had Internet access, I could have downloaded them, but that was not possible, so I was out of luck. 

To be fair, most people who would use Linux will have always-on Internet access, and would not run into this problem.  Or they would write down the instructions for creating a root account before starting the installation.  Also, most people do not have multiple drives, nor a two-monitor set-up.  Thus, most people would not experience those problems.  And many who do have such systems are more adept at using Linux than I am, and would have had no problem troubleshooting the snags.  Since I am not really a geek (I thought I was, but my wife tells me I am not), I tend to learn just enough to let me figure out how to do what I want to do, then use the Internet to figure out new things as they arise. 

Once I got it set up, it worked perfectly.  The programs that come with it are sufficient for pretty much anything that an average computer user would want to do.  That includes wordprocessing, e-mail, browsing the Internet, and playing games.  Image processing, photo scanning, and the like are a snap.  Synchronizing a PDA is fairly simple, although not yet entirely a plug-and-play operation.  Using a USB flash drive is simple. 

Probably all distros these days come with OpenOffice, a very good clone of Microsoft Office.  OpenOffice can open, edit, and save Microsoft files from Word, Excel, and PowerPoint.  I have created PowerPoint presentations at work using the Microsoft product, edited them at home, then taken them back to work for more editing, then used them in front of a real audience.  No problem. 

There are zillions of games for Linux, and almost all of them are freely available.  Some are simple, such as the omnipresent Solitare and Tetris.  Some are more elaborate, such as FreeCiv (a clone of Civilization II).  Most popular old arcade games have been cloned. 

In summary, Linux is a good option for either people with normal computers, or people with strange computers and a lot of technical knowledge, or people with strange computers with a lot of time or their hands.  High-speed Internet access is a definite plus.  People like me, with a strange computer, intermediate computer knowledge, and dial-up access, have to expect some snags.  Even then, mature distros, such as Fedora, Mandriva, or SuSE, are likely to work pretty well.  K/Ubuntu is getting close, but is not there yet.  I actually think it would be a good choice for someone with an off-the-shelf computer, because it doesn't present the user with multiple different ways to do the same thing. 

Persons who are curious about this should download one of the "Live CD" versions and try it that way.  It boots right from the CD, and does not affect your hard drive.  If it seems appealing, you can install it with an Install CD.  If you are new to Linux and have no specific reason to try K/Ubuntu, probably the best Live CD to get would be Knoppix.  If you are unsure of your ability to download and/or burn the CD, you can order one for $1.99 (plus shipping, which isn't much) from BudgetLinuxCD's.

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Monday, April 25, 2005

School Fined for Not Reporting Sex Abuse

In among all the crummy news today, there is this item:

click for their homepage
School Fined for Not Reporting Sex Abuse
US News
Monday, April 25, 2005

CAMBRIDGE, Mass. (AP) - The elite Groton School pleaded guilty Monday to failing to report students' sexual abuse complaints to the state.

Groton officials entered the plea on the day the case was scheduled to go to trial. The school was fined $1,250 and avoided a public airing of damaging testimony.

The investigation began in 1999 after the parents of one student told school administrators that he had been sexually assaulted by a group of older male students. Another student later came forward to say that he'd also been abused by fellow students.

State law requires school officials, doctors, clergy and others to alert social services of any suspected abuse. The boarding school was indicted last summer on one charge of failing to file an abuse report. No individuals were charged.

School officials have said they never hid any abuse, and that they reported three allegations to the state in prior years. They said the student in question did not provide enough information to make a report. [...]
I don't know the state law in Massachusetts, but it probably is similar to the law in Michigan.  Here, all suspected abuse must be reported, even if there is "not enough information."  If the alleged victim is a child, the suspicion is reported to Children's Protective Services; if it is a vulnerable adult, it is reported to Adult Protective Services.  Those two agencies were part of the Department of Social Services before Governor Engler changed the name to Family Independence Agency.  The name change was one of those meaningless political statements that made some conservatives feel good.  Now the name has been changed again, to Department of Human Services.  I suppose that the second name change made  the company that makes their stationery happy. 

I'm not saying this just to be snarky.  Those name changes made it hard for people to figure out whom they should call for various things, so it caused practical problems when the respective governors made their political points. 

To clarify: the emergency contact numbers are here, and the criteria for making a referral are here (110KB PDF).  (I know that those links are not useful to persons outside of Michigan, but I suspect all states have similar sites.)  Note that the referral guide pertains to mandated reporters: health care workers, social workers, school officials, etc.  However, anyone can (and should) make a report.  Don't assume that someone else will report it.  In fact, multiple reports can be helpful in the investigation.  All reports are anonymous, although, admittedly, sometimes it is obvious who must have filed the report.  Persons who knowingly file a false report can get in a lot of trouble.  There is, at least theoretically, no risk to a person who files a report in good faith, even if the report cannot be substantiated.

Unfortunately, the agencies involved are grossly understaffed.  Most investigations are cursory.  In cases of suspected physical abuse, often nothing is done unless there are burns, broken bones, or numerous bruises of different stages of development.  (Bruises change color over time, so often a person who is getting hit a lot will have some purple bruises, some greenish, and so on.)  The fact that these agencies are underfunded and understaffed is an embarrassment to us all.

The reason I mention this is twofold.  For one, it is sort of a public service announcement.  Second, it shows that social service agencies are not just in the business of handing out food stamps and the like.  Persons who agitate for funding cuts need to know that these agencies exist in order to protect the children of our great Nation.  In fact, we will not be a great nation, unless these children are protected.  We all need to demonstrate character, intellect, and leadership on this issue.

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Sunday, April 24, 2005

Heterosexual-Affirming Therapy Endorsed by Insurance Behemoth

Heterosexual-Affirming Therapy Endorsed by Insurance Behemoth...despite lack of empirical support.

I started to write about the lawsuit threatened by the Thomas More Law Center against the Gull Lake school district, near Kalamazoo, Michigan.  The TMLC decided to come to the aid of two teachers who had been barred from teaching Intelligent Design (1  2  3). I'm sure, though, that others will write about this, and I probably don't have much to add. 

The TMLC site included a separate news release that I noticed, which deserves a little more attention:
Health Board Reinstates Controversial Therapist
Fri, Apr 22, 2005

(CNSNews.com) - After booting a controversial Christian therapist from its advisory council in February, the nation's largest behavioral health services company this week confirmed it had invited him to participate once again.

A press release from Magellan Health Services on Wednesday announced that Dr. Warren Throckmorton, a psychologist and counselor who advocates what he calls "heterosexual-affirming therapy," will serve on the company's advisory council.

Throckmorton advocates a type of counseling intended to change the orientation of homosexuals who feel uneasy about their sexual preference. [...]
Magellan is an insurance company that contracts with other insurance companies to manage (i.e. restrict) mental health benefits.  It is a large and influential organization, which, by the way, got "relief" from six hundred million dollars of debt by filing bankruptcy in 2003. 

I guess that's one way to lower the cost of health care.  Just don't pay your bills.

In any case, Magellan hired this guy in 1999, but on February 14, 2005, dismissed him.  Then, in April 2005, they appointed him to their new National Professional Advisory Council. 
 "As the largest behavioral health disease management company in the nation, Magellan has the opportunity to positively influence health care outcomes for millions of individuals every day," said Alex Rodriguez, M.D., chief medical officer for Magellan. "Establishing the National Professional Advisory Council allows us to tap into the extensive clinical knowledge, intellectual rigor and creativity of leaders in the health care delivery system for the benefit of our members, customers and the practitioners without whom we could not fulfill our mission."
Why do we care?  In 1998 he published an article1, arguing that there is a valid clinical role for therapists to assist clients who are bothered by their sexual orientation and who want to convert from homosexuality to heterosexuality.  A fiskophile could spend weeks on the article.  Most of what he says, though, only supports his statement that "it has not been shown that such counseling is intrinsically harmful."  He does cite some findings that appear to show that some persons maintain different sexual orientation following therapy, but there is a conspicuous lack of evidence that anything clinically significant was changed, or even measured.  He seems to accept the presence of behavioral change as evidence of efficacy.  That is meaningful only if one assumes a priori  that such behavioral change is beneficial to the patient, an assumption that has no empirical support.

Throckmorton.jpgThrockmorton has a list of references on his website, but there are only three items there.  His therapeutic approach is referred to as "heterosexual-affirming therapy," or "reparative therapy."  A Medline search for the former string yields exactly one hit.  The latter yields 1,756 hits, but most of them have nothing to do with psychotherapy.  The first hit, for example, is a Czech article about ligneous conjunctivitis.  Increasing the specificity by searching for "reparative therapy homosexual" yields eight hits.  In contrast, "interpersonal psychotherapy" yields 5,882 hits, and "cognitive-behavioral therapy" yields 2,539.  This tells us that the scientific basis for his treatment method has about as much scientific support as Intelligent Design. 

Not only does Throckmorton have remarkably little support for his method, but several major organizations have adopted policy statements opposing it.  In December 1998, a few months after his publication on the subject, the American Psychiatric Association formally opposed such treatment:
APA Position Statement on Psychiatric Treatment and Sexual Orientation December 11, 1998

The Board of Trustees of the American Psychiatric Association removed homosexuality from the DSM in 1973 after reviewing the evidence that it was not a mental disorder. In 1987, ego-dystonic homosexuality was not included in the DSM-III-R after a similar review.

The American Psychiatric Association does not currently have a formal position statement on treatments that attempt to change a persons sexual orientation, also known as reparative or conversion therapy. There is an APA 1997 Fact Sheet on Homosexual and Bisexual Issues which states that there is no published scientific evidence supporting the efficacy of reparative therapy as a treatment to change ones sexual orientation.

The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient. [...]
In 2000, they adopted a revised Statement that is even more strongly-worded than the first one.  They point out that most other pertinent organizations have similar positions:
In doing so, the APA joined many other professional organizations that either oppose or are critical of "reparative" therapies, including the American Academy of Pediatrics, the American Medical Association, the American Psychological Association, The American Counseling Association, and the National Association of Social Workers (1).
This being the case, it is perplexing that Magellan would have appointed him in the first place, let alone reappoint him.  I tried to figure out exactly what they did, and why.  Their website is not very informative. It does not have a global search function, but it is possible to search their press releases.  Such a search on the string "Throckmorton" only turns up one hit, which is the one announcing his appointment to their NPAC.

Curiously, some of the news articles on the subject, such as this one from the Philadelphia Enquirer, state that Throckmorton had been dismissed from the NPAC in February, while the Magellan press release from April is an announcement that the NPAC was just created.  This would imply that he was dismissed from the NPAC before it was created, which I should think would be impossible.  In fact, searching their press releases, I did find a prior reference to a "national professional advisory board," which is not capitalized in the press releases, while the NPAC is written out as "National Professional Advisory Council".  This suggests that they disbanded the original organization, then reconstituted it with a slightly different name, possibly with different membership.  I think that has been a source of confusion for the mainstream media.

When Throckmorton was appointed to the NPAC, Magellan was fully aware of his views.  In the Washington Times article, linked to previously, stated on 3/17/2005:
Magellan Health Services Inc. expelled Warren Throckmorton, psychology professor and counseling director at Grove City College in northwestern Pennsylvania, as "a business decision."

The company said Mr. Throckmorton's positions on homosexuality were "potentially controversial" and not "in the best interests" of the company's corporate clients and employees, company spokesman Erin S. Somers told The Washington Times.

"We made the decision ... out of concern that certain of his publicly expressed views could be potentially controversial to Magellan's stakeholders," she said.
Interestingly, that same article contains a statement by a psychiatrist at he University of Utah, who is critical of the expulsion:
Dean Byrd, clinical professor of psychiatry at the University of Utah, said Magellan's expulsion of Mr. Throckmorton "is merely a cloak for intolerance and a blatant disregard for differing worldviews, the essence of true diversity."

"I would hope that there would be an investigation of Magellan's business practices by both the government as well as their subscribers," he said.
Regarding his first statement, I would encourage Dr. Byrd to acquaint himself with the position statements of the American Medical Association and the American Psychiatric Association.  Magellan dismissed someone who practices a form of therapy that major professional organizations have denounced.  That is hardly a "disregard for differing worldviews."  Rather, it is a recognition of generally accepted standards of practice. 

Regarding his second statement, I must say I agree with him.  I do hope there is an investigation.  Recall that the Magellan press release states:
"As the largest behavioral health disease management company in the nation, Magellan has the opportunity to positively influence health care outcomes for millions of individuals every day," said Alex Rodriguez, M.D., chief medical officer for Magellan.
Indeed, they are highly influential; therefore, they can be dangerous, especially if they deviate from accepted practice.  Magellan claims that the creation of their NPAC is supposed to be a positive influence.  It light of the fact that they have just appointed a therapist who advocates a denounced form of therapy, a treatment that has nanoscale empirical support, I would say that an investigation is needed. 

Magellan is a corporation, one that does not have a reputation of acting in accord with humanistic values.  If it is true that the dismissal of Throckmorton was due to concern about offending the gay/lesbian population, then the reinstatement probably resulted from a recognition of the fact that a large corporation is better off offending that population, than offending Christian fundamentalists.  While that may be good for their bottom line, it serves to reinforce a malignant social prejudice.
1 Throckmorton, W. (1998). Efforts to modify sexual orientation: A review of the outcome literature and ethical issues. Journal of Mental Health Counseling, 20, 283-304. (The author kindly provides a copy on his own website.)

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