State-Society-Culture Dynamics

--> In a country of thousand islands, you’ll have water: tons and tons of it. If all this water isn’t stocked, used, harnessed and conserved, you’ll have problems: more tons and tons of it, as in floods, or so few tons of it, as in drought. The recent history of the Philippines is an exciting tale of the power and terror of water. My ancestral home stands next to a creek, which during heavy rains overflows its banks and floods a “delta” that it forms with the Danio branch of the San Francisco River. This delta, which is actually a flood plain for both creek and river, was once a lush greenland of wild fruits and trees, and nesting ground for wild birds and reptiles (it was near the water, after all). Fortunately for our home, it stands on the left bank of the creek, which from its channel bed slopes steeply upwards, so that the rising floodwaters are pushed back to the delta, which results in its annual flooding and submergence. That there is no limit to the rapacity

When reading studies on the effect of different drugs on illness, I notice that cost per mg is rarely considered. For over a year, I have been reading relative effectiveness of antihypertensive medication, specifically Angiotensin Converting Enzyme (ACE) Inhibitors against Angiotensin II Receptor Blockers (ARB) and their comparative strengths on lowering both systolic and diastolic pressures, and it is always a wonder to me why, for example, Telmisartan at 80 mg is compared to Enalapril at 10 mg, when the cost of one drug relative to the other is so large. This question is relevant because pharmacological effects of each drug clearly vary with dose: Telmisartran at 40 mg has differential effectiveness compared to 80 mg; and so also for Enalapril at 10 mg against 20 mg. I am hoping for some comments to this blog from biochemists or cardiovascular specialists because I am clearly puzzled. If dose is operationalized as mg/dL for example, shouldn't a comparative effects study