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Author Topic: Yay yay pepper spray!
rivka
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quote:
Originally posted by CT:
(Foreshadowing, a sign of quality literature.)

[Big Grin]
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CT
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So at the time, there were less than a half-dozen states that did routine cystic fibrosis screening. This state set up a pilot program whereby (IIRC) newborns were all screened with the same heel prick as before. The difference was that once the blood sample arrived at the state public health lab, it was randomly assigned to either the known test or the control group.

Blood from both groups was tested, but in the control group, the results were sealed without being revealed. In the known test group, the results were released to the child's physician and, through them, the family.

At that point, most screening for cystic fibrosis (as in this state) was done by clinical assessment. If a newborn had trouble passing his or her meconium (first poop) in the first 24 hours, or developed a rectal prolapse, or recurrent pulmonary infections, or diarrhea and failure to thrive -- well, then is when the test usually would have been done.

During this study, if a physician had a clinical suspicion of cystic fibrosis and the patient's newborn screen results were not yet known (i.e., he or she was in the control group), then the envelope would be opened. So there wouldn't even be an extra blood draw.

Note that this means patients weren't getting worse care than before -- it's just that the care changed only for some of them. When it hit the media, though, there was an uproar. Many parents were angry that their child might have this disease and the information was being kept from them. There were arguments in the letters to the editor, even legal challenges. Why not tell us if our kids are sick, so they can get treated? This is insane!

Why not, indeed. The reasons why was because those involved were trying to test for unintended consequences. And they found them. You know what the main difference between the groups was, when they were analyzed?

One of the groups was dying younger.

And it was the group who had been diagnosed earlier, by that very same newborn screen.They didn't live as long.

Of course the big question was "Why?"

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rivka
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Is this an interactive game? May I make an educated guess?
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CT
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Sure! Have at it. [Smile]
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rivka
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False positives leading to unnecessary treatment?
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The Rabbit
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Not just false positives but ambiguous results.
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Orincoro
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quote:
Originally posted by CT:

Stone_Wolf_, you've been citing the Protection Against Crime website for numbers. It's worth noting that it is a commercial website that is set up to sell personal defense items (see the "OMEGA" link in sidebar), and they don't specify how those numbers are calculated. Whoever did the analysis may well have made the same assumptions as noted above, and those are serious errors.

I've been recruited as a writer for similar sites, and from what I learned about that type of work, it's all aimed at harvesting ad-clicks anyway. The person writing it is probably a) writing to increase exposure to search engines and b) increase ad-clicks. I never took any of that kind of work because of how horrible it sounded.
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The Rabbit
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quote:
Originally posted by The Rabbit:
Not just false positives but ambiguous results.

One more problem that might arise is false negatives. It's likely that the inexpensive screening tests are less accurate than the diagnostic tests that would be given to a child that is showing symptoms of the disease. But a negative in the screening test will mean that doctors will be less likely to suspect Cystic Fibrosis when the child begins to exhibit symptoms. As a result, diagnosis could be significantly delayed for children who get a false negative on the screening test.
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CT
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There was a problem with false positives, but that was a separate and less severe issue.

When the data analysis was combed through, they found that it was a subgroup of the known test group which had the shorter lifespan: namely, the ones who were sent to the Cystic Fibrosis Clinic.

So what happened was that most kids diagnosed with CF were sent if possible to the CF Clinic, a multidisciplinary clinic where they would see a pediatric pulmonologist, nutritionist, social worker, infectious disease specialist if needed, you name it. They also were able to meet other kids with CF, and the parents could network for peer support. It was the same model as Diabetes Clinic.

The kids at CF Clinic did have much improved early intervention for nutrition and growth, which did improve their ability to fight infection. Their medications were tweaked as per the latest protocols. But the really rural kids, the ones who were getting managed through outlying offices, were living longer (the expected lifespan at that time was (IIRC) into the twenties, whereas it is now into the thirties).

So what was happening?

This was the study that first established the primary determinant of lifespan was colonization with a particular bacterium, Pseudomonas aeruginosa, which concentrates in the throat and lungs of patients with tracheostomies and those with altered immune systems. It can cause serious infections, but it mainly sits there and irritates the lungs, predisposing to infection with other agents. Kids at CF clinic would sit in the waiting room together, walk in groups, and share breathing space. The young ones who weren't yet colonized were more likely to become so, and then the clock started ticking.

The knowledge that they had CF was putting them more at risk than not knowing. That means the problem with early diagnosis was that the benefits of knowing you had it -- though real -- were outweighed by another factor, which was person-to-person exposure. And so Wisconsin kept the screening but restructured its CF Clinic with staggered appointments, and kids didn't congregate together in groups.

And the test that "couldn't hurt" ... finally didn't. It helps. [Smile] It also means that the way CF Clinics are generally run has changed forever, and for the better.

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CT
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False positives and false negatives would be a great follow-up discussion, if people are interested.
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The Rabbit
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Interesting CT. Evening knowing that colonization with P. aeruginosa is a critical issue in CF, I would never have guessed that. It does suggest that people with CF should avoid associating with other people with CF.
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Stone_Wolf_
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I think the real lesson here is, hang back and let others be the front runners, and then analyze what they did and improve on it.

It's easier to avoid the bear pits when they are filled with bodies.

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kmbboots
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quote:
Originally posted by The Rabbit:
Interesting CT. Evening knowing that colonization with P. aeruginosa is a critical issue in CF, I would never have guessed that. It does suggest that people with CF should avoid associating with other people with CF.

Wasn't there some medical show episode recently with that as a story line? Two CF patients who fell in love but had to break up. I don't recall which show.

Stone_Wolf, I think the lesson is that what seems like an easy fix and simple safeguard is often not as easy as it seems and may, in fact, cause worse problems than it solves.

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rivka
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quote:
Originally posted by kmbboots:
quote:
Originally posted by The Rabbit:
Interesting CT. Evening knowing that colonization with P. aeruginosa is a critical issue in CF, I would never have guessed that. It does suggest that people with CF should avoid associating with other people with CF.

Wasn't there some medical show episode recently with that as a story line? Two CF patients who fell in love but had to break up. I don't recall which show.
It was Grey's Anatomy.
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kmbboots
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I thought it probably was that or Private Practice. Too lazy to check.
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ambyr
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Yeah--I have a young friend who has CF, and when she was going to summer camp several years ago, another kid who went to the same camp also had CF. The camp worked pretty hard to stagger their sessions and activities so they weren't there--or at least weren't at the same place--at the same time.

(and wow, this is pretty epic thread drift!)

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rivka
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quote:
Originally posted by kmbboots:
I thought it probably was that or Private Practice. Too lazy to check.

Heh. Definitely Grey's -- featured arguments between the two sisters, and Alex about what to do with the patient, as I recall.
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Stone_Wolf_
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Boots: Sorry, I missed putting up a smiley there.

ambyr: Thread drift to the tenth power.

How can I change the thread label to show that each individual person should consider carrying pepper spray, and not *everyone should* carry it, like the government mass shipping it to all citizens?

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Bokonon
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You could say "Why I think..."
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kmbboots
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"Why I love pepper spray"

"I really recommend pepper spray. Here's why."

"Hurry for Pepper Spray"

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Stone_Wolf_
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Here's what I went with:

Why I think everyone should consider owning/carrying pepper spray.

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katharina
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If everyone is carrying, that means whoever wanted to do me harm is also carrying. So it's the status quo, only with more pain and coughing.
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fugu13
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Except whoever wanted to do you harm was presumably already capable of dominating the situation (quite possibly through an even more potent weapon), whereas if you get off a shot of pepper spray, even if he has one, you'll quite possibly get away.

I'm hardly a proponent of general carrying, but the "everyone carrying doesn't change things" argument is wrong.

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Stone_Wolf_
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Are you seriously suggesting that I (posting here on this board) add "this doesn't mean you violent criminals" to the thread title? Really kat?

I'm sure all the violent criminals who frequent this board would take my advice and exclude themselves.

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katharina
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Who do you think "everyone" pertains to? And yes, I really do think you need to think carefully about suggesting that EVERYONE arm themselves, because it isn't like if that turns into a thing that criminals won't catch on.

You might as well suggest everyone learn how to trip people, because falling down HURTS, even if you're a criminal, and that would give you time to get away.

That's part of the implications of actions - you can't suggest an action and then not take into account how that suggestion will change the world. And if EVERYONE started carrying pepper spray, then the world in general is a more dangerous place, because everyone would include those who know that their first action if they want anything should be to immediately spray pepper spray into the eyes of their victims.

That's absolutely basic, fundamental strategy. No such thing as a magic weapon, because the other side can use it, too.

Advocating for the universal carrying of a weapon must include the warning that this means it will be used against victims more frequently as well.

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katharina
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As another side note, the world isn't divided into "violent criminals" and "everyone else." From what I know of statistics (and young people), I have no doubt that there are people posting on and/or reading this board who have committed or will commit violent crimes. I KNOW there are people posting on and/or reading this board who have been convicted of personal (as opposed to property) crimes, period.
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Stone_Wolf_
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As fugi pointed out, just because the other guy has pepper spray, doesn't change the advantage you have by carrying it.

Further, if criminals (and they are to some extent) adapt pepper spray over, say, guns, knifes, bombs, fists or baseball bats, then I personally say, good.

I'd rather have a few hours of burning eyes, nose, mouth and throat then be stabbed, punched, shot, clubbed or blown up.

As to the rest of your arguments...well, most of them are pretty silly...tripping people, really?

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Stone_Wolf_
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While I understand the point you are trying to make kat, that the world isn't just us and them, you have to take into consideration that even if my advocacy for pepper spray and self defense were to be read by a violent criminal, that's not a good reason for me to be silent. I am not responsible for the crimes and wrong doings of others, and like any powerful thing, information can be used to hurt people. This fact in and of itself is and should not be given weight when deciding to try and spread useful information. If only benign and harmless info was passed out in fear of negative use, we would not know of fire, how to drive a car, use a kitchen knife, etc, ad nausium.
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katharina
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I'm not chastising you for talking about pepper spray. I think it's a bad idea for everyone to carry it. If you meant "everyone but bad guys", then I don't think it works that way.

However, I suspect that it won't make the slightest difference either way, so it doesn't matter to me. No need to defend yourself - I was not confused about your motives and so the explanation doesn nothing for me.

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Stone_Wolf_
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Well, I'm glad I could "doesn nothing" for you. [Razz]
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steven
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I'm pointing out that pepper spray is an absolutely terrible weapon for direct attacks, unlike a knife, gun, or bat. You can pepper spray someone running away from you in the back all you want...it's unlikely to harm them. It's quite possible to stab, club, or shoot someone in the back VERY effectively.

Pepper spray is mainly just a defensive weapon. The people who should be worried about it are mainly muggers, rapists, and the like.

I still don't think everyone carrying it will make the world better. I don't think it would really make it worse. I imagine it would have all kinds of unintended consequences, good, bad, and neutral.

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Stone_Wolf_
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Did anyone here get pepper spray because of this thread? Or change their mind about it at all? Or seriously consider it?

Just wondering.

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Stone_Wolf_
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And now, I am sad.
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Hobbes
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This guy is glad he had pepper spray, just not for the reasons put forward here.

Hobbes [Smile]

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Stone_Wolf_
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I've said many a time that it's good on animals.

Thanks for trying to cheer me up...I'm still sad though.

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Orincoro
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You're sad because people don't see things your way on this issue with clearly stated reasoning delivered convincingly and with respect for your views? I should be chronically depressed.
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Stone_Wolf_
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I'm not sad because I couldn't get people to think like I do...what a boring world if everyone thought like me.

I'm sad because I genuinely care about people's safety and do not want to see them suffer. I put forth some effort to try and get people (not just random people, but a community I belong to and enjoy) to increase their ability to stay safe, and failed to even get anyone to even give the possibility a serious consideration.

Perhaps the lesson here is not to take things I care deeply about to an internet disagreement board.

[ July 16, 2011, 11:03 AM: Message edited by: Stone_Wolf_ ]

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Orincoro
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No, the lesson is that you care deeply about something that others do not. And that their reasons for not caring are actually pretty good. I've explained to you why I think people are ignoring your advice, and it has everything to do with your advice not being very good. We understand that you care and that it matters to you, but if we based our daily decisions on those kinds of considerations, rather than what matters to *us* we would be living rather stressful sorts of lives, spending our time accounting for the concerns of other people.

Frankly I'm a lrttle disappointed in your whining. You didnt accomplish what you wanted, but you ought to have learned something in the process. You'd give that up to spare yourself the hurt of not being heeded in your advice?

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Stone_Wolf_
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Stating my dissatisfaction at the outcome is not whining.

I disagree with the "lesson" you think I should learn.

I'm not "hurt" that I'm not being "heeded"...I'm saddened that people feel so safe that even taking small preventative measures which can have such positive effect are seen as too much of a nuisance to bother with.

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Samprimary
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quote:
I'm sad because I genuinely care about people's safety and do not want to see them suffer. I put forth some effort to try and get people (not just random people, but a community I belong to and enjoy) to increase their ability to stay safe, and failed to even get anyone to even give the possibility a serious consideration.
I think more than their fair share gave it serious consideration. I even got into a discussion with it because I was intrigued by what we could guess would be the risk homeostasis response to common mace carrying habits. Would it make people safer in high-crime areas? Probably not. Most likely it would just draft in a compensatory more aggressive and more armed behavioral structure in aggressors and predators. Would it be easy to maintain in low-crime areas? Definitely not. With practically no payoff for the level of inconvenience entailed, adherence to the strategy would level off back to, well, where it is now.

I'll tell you right now that on its face, it doesn't seem like the problem is people not considering it; it's people coming unanimously to a decision that they're not persuaded to change their habits; that a critical point of merit is not present to affect such change.

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Stone_Wolf_
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I appreciate what you are saying Samp...but when I asked if anyone had considered it and no one answered, I took that to mean no.

I'm sure the information I presented will in some form or other be helpful at some point, even if it simply becomes a google search result, and I do not regret having invested my time in it.

I had hoped going into it that some here might see the merit in the suggestion and take action toward their self defense.

If history teaches us anything, the stability and safety that is currently the norm will melt down into anarchy and violence, given enough time.

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Samprimary
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quote:
I appreciate what you are saying Samp...but when I asked if anyone had considered it and no one answered, I took that to mean no.
Yet, there's ample evidence of consideration here in the thread. But if you don't regret your investment, that's all that matters!

quote:
If history teaches us anything, the stability and safety that is currently the norm will melt down into anarchy and violence, given enough time.
I'll tell you this much; if our social stability melts down into violent anarchy, pepper spray won't even be worth carrying.
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Stone_Wolf_
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quote:
I'll tell you this much; if our social stability melts down into violent anarchy, pepper spray won't even be worth carrying.
Maybe not when we have hit "melted", but might be quite nice to have for the "melting".
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CT
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From my point of view, Stone_Wolf_, I had already seriously considered the question of whether to carry pepper spray more than once, and this conversation did not change that decision. So there were no "yes"s for me in response to the above post.

However, I'm still happy to have had the conversation with you.

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Stone_Wolf_
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Thanks CT...likewise.
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CT
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[Smile]
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Orincoro
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quote:
Originally posted by Stone_Wolf_:

I'm not "hurt" that I'm not being "heeded"...I'm saddened that people feel so safe that even taking small preventative measures which can have such positive effect are seen as too much of a nuisance to bother with.

I would accept you disagreeing with my points on this score. I don't accept you ignoring them entirely. This demonstrates that you either ignored them or do not understand them. We do not ignore these considerations because they are a "nuisance." the issue has more nuance.

You're sad that people feel safe? Okay. I'm really not. I'd say many people have reason to feel safe, because in relative terms, they are.

As for whining: "I state my dissatisfaction" is not whining. However stating ones dissatisfaction in other ways is *often* whining.

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Stone_Wolf_
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Your point is that my advice is "not very good". How exactly would you expect me to address that other then disagreeing?

And while stating dissatisfaction might *often* be whining, pointing out that someone is whining (if they are or not) is *always* rude.

All and all I think I've handled your "comments" with a large dollop of decorum.

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Orincoro
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I explained before, in much More detail, why I thought your advice was not good. You ignored me then, and I'm not going to suffer the trial of repeating myself in less detail, only to have you respond to those points as if they were all I have had to say. I don't actually require a response at all, I'm just annoyed that you've been told several times why "this one little action" doesn't exist in isolation, and why people ignoring your advice is not a refusal to believe that it can possibly save your life, and you have completely failed to even acknowledge that you understand or have tried to understand that mode of reasoning. You even excused yourself from even trying to do so by claiming a personal emotional stake in the outcome. Well, that'll make a lot of people see things the way you do: "if you don't agree with me, I may become upset". Which is of a rather different degree from just a strongly held belief. Once you crossed into that kind of territory, you effectively announced that you would dismiss any reasoning against your view, and moreover, be hurt by any attempt to actually change your mind.

So you wanna talk about decorum? Yeah, you managed to make sure everybody would be super nice to you and disagree very politely, and then had the temerity to whine when they didn't enthusiastically agree. Then you go so far as to sarcastically dismiss my very carefully measured contributions as quoits and unquote "comments", while lecturing me on politeness. You've impolitely imposed your emotional needs on other s in this discussion already, and begged them for even more ego stroking after the fact. Top notch on decorum. Really. This is why I rarely get all huffy about manners. People are rarely aware of themselves enough to know when theirs have failed, but they're always ready to point out my breaches even when they are quite intentional, and effective.

So then you griping that your advice was ignored is, well, a bit much for me. Particularly as I had taken some effort to explain why I felt many people would ignore it.

[ July 17, 2011, 12:58 AM: Message edited by: Orincoro ]

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El JT de Spang
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I have been considering personal protection a lot recently, not for me, but for my girlfriend. I considered pepper spray but ultimately decided to just get her a small, but powerful flashlight (after talking with several female friends, researching online, and talking with an ex-army friend who works in security now). So I appreciated your views on pepper spray, but it's not the best choice for us at this point, simply because she wouldn't be comfortable using it if it were necessary. Thus defeating any purpose it could serve.
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