2012-11-28 10:20 am
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And again.... the card season!

Once again it's time for the seasonal cards, in this case involving a baby boy and a big girl. Want one? Send me your address - comments here are screened.

Not communicated with me in ages, but my blog shows up in your feed and you haven't removed me yet? Feel included - send me your address :)

And if I forget to post again this year: Merry Yule, Happy New Year and Happy $whatever_you_want_happiness_for!
2012-06-24 09:21 pm
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Baby announcement: Torjus is born!

Welcome to Magni's baby blog, part three! (The previous parts are the two last entries - I have not made a third child.)

The result of the development process for the new version is now released: Torjus, born on 2012-06-19 at 21:57 CEST. He was 49 cm and 4400 cm (babies usually come in size large in my family).



Proud sister and dad with new family addition.

Everything is fine, we've been home since Wednesday. Well, not Ada - my parents were fabulous and took care of her most of the week before we return to everyday life again tomorrow! Torjus nurses like a pro, perheps with a slight contribution from his more-so-than-two-years-ago pro mum.
2012-04-06 01:11 pm

Contraceptives and public healthcare in Norway

After my last entry about expecting another baby, it is very appropriate to have an entry about contraceptives, isn't it?

I was inspired by Val and Mary, who have written a bit about contraceptives in USA and Australia. When reading Val's entry, I was amazed that the prices of contraceptives in USA were so high, two or three times the prices in Norway.

One could think that Norway relied on heavy governmental sponsoring of contraceptives, since we have our evil socialist public health system. But alas. While we do have a good public health system, it does hardly cover contraceptives.

The health care system here seems rather similar to the Australian one, in that it is universal and private insurances covers extras. In our case they cover less extras than in Australia, as we have free ambulances everywhere, and there are not options to "upgrade" your hospital stay by paying extras. In some hospitals you may get a private room if your condition requires it (or if they simply can offer it to you), in other (like the one in my town, very recently built) all rooms are single rooms, so that's what you get (including internet and en suite bathrooms). What the private insurances do cover, though, is shorter waiting lists, usually maximum 3 or 4 weeks to start treatment. There are some exceptions, like major conditions that require "university hospital treatment" are not covered (because there are no private options the insurance company can buy us into for them), but most conditions people want speedy examinations for (including heart and cancer) are covered (you'll often be referred to the public system for treatment, but once they get you with a diagnosis and the necessary exams, they will often speed up, too), and also free physical treatment. Most of these insurances are paid for by employers, like my own. I have not used it, but I guess perhaps 25% of my colleagues have, most of them for physical therapy of one kind or another, and a few for surgeries. When I broke my back, all the emergency treatment was done by the hospital anyway, and physical treatment for 3 or 6 months was free since it was post-surgery. I considered using the insurance to remove the implants, because it might have given me a more fixed date for the surgery, but then I wanted "my" surgeon to do it so I stayed with the hospital.

The public health care system also buy some capacity in the private clinics, especially for image diagnostics and small surgeries (which does not require an overnight stay). Then the patient pay the same as she would in a public hospital, usually around $45. The government buy an annual fixed number of exams/operations from the private clinics, so sometimes you will get an examination far into the future after a referral from your GP, but with a note that if you will pay the clinic's full fee for it, you can have the same procedure immediately.

GPs are partly funded by the government. They have about 1500-2500 patients (lists with a maximum number of patients), and get a flat rate per patient per year to cover overhead expenses (office nurse, the office they rent, basic equipment, etc). Then there is a rate per patient visit, set by the government, which is shared with 2/3 paid by the government and 1/3 by the patient ("copay"). For office-hour appointments the copay is about $30, but maximum $380 per calendar year. Your copays (no medical information, just the amounts you have paid) are reported to the health care administration, and when you reach $380 you will receive a card that entitles you to free health care for the rest of the year (any excess you have paid will be reimbursed automatically if they have your bank account number).

The same policy is also valid for medicines for a lot of chronic conditions (i.e. most medical conditions that last more than a year, but not necessarily all kinds of drugs for that condition - new and usually very expensive drugs are often not covered), where you will get a "blue prescription" and pay 1/3 of the drug expenses until you reach the copay limit. You must choose the cheapest (usually generic) brand, but if medically indicated the doctor can say you must have a specific brand, and you can also pay the difference between generic and specific brands yourself. Usually the specific brand is rather similar in price to the generic, and most doctors will write the specific brand on the prescription and the pharmacy takes care of the substitution or the extra payment, as you like it.

When it comes to contraceptives they are not covered neither by the public health system or by insurances. They are however administered by regular GPs (or by your obgyn if you insist, but most women use their GP). You need an appointment with your GP, who will usually just talk a bit, check your blood pressure and do a pap smear (pelvic exam), if it's been more than 3 years since the last time (every 3 years is the recommended rate for women above 25, and you'll get a reminder from the cancer register if they haven't registered a new test within the last 3 years. You can opt out from that, though.). The pap smear is by no means compulsory. The doctor can refuse to write you a prescription for medical reasons, but I don't think refusing to do a pap smear is a valid reason for most doctors unless there are indications that you should do one now. The GP will usually give you a 1 year prescription (though prescriptions for contraceptives are valid for (and may be enough for) 3 years, but I guess doctors don't usually remember it since all other prescriptions are for 1 year only), and you can get all of it at the same time from the pharmacy if you want to. Getting a refill weeks or even months before you actually run out is not a problem, and I think most doctors will help you so you can be covered all your stay abroad to study, for instance. (Even if you can get a 3 year prescription, you should pop in to check your blood pressure from time to time. It can probably be done in the lab, though, or when you're there for other reasons.)

The price for an appointment to get contraceptives is about $30, plus about $10 extra for a pap smear (which covers gloves and equipment for the examination, the test itself is free) and $8 extra if you need to do any blood work (usually not).

If you are running out of contraception and the GP or you can't fit an appointment into the schedule in time, you can usually get a new supply for a short time by calling your GP, and they may also fax the prescription to your most convenient pharmacy for no (or a very low - like $2-3) extra fee (plus $7-8 for writing a prescription without an appointment). I have used this a couple of times when I have misplaced by pills.

Then you go to the pharmacy, queue up and have you pills or other medicines within 10 minutes. I have never heard of them being out of stock, and there is not bureaucracy beyond having to wait in a queue and then wait for the pharmacy technician to have her buddy check the package before you get it. You can get up to a year's worth of medicines at once, except when it's for chronic illnesses where the government covers 2/3 - then you can only have for 3 months at a time (there are also special rules for potentially abused drugs), so I usually got 12 boxes of contraceptive pills when I got mine since it was harder for me to displace them than a slip of paper. The pharmacy I usually use also offers to store the prescription for you, but I prefer to have the visual overview myself.

Women under 20 get free contraceptives, and can visit a school nurse or midwife in stead of their own doctor. They will usually only check medical history and blood pressure, since pap smears aren't recommended until you are 25 anyway. When saying "free" that means they get about $17 covered pr 3 months. With the prices of contraceptives here, that means free for most of them, and cheap for the rest.

Free contraceptives for women under 20 was introduced in 2002. Apparently the influence on the abortion rates haven't been quite as high as they expected/hoped when they started the project. But the abortion rates seem to have been reduced by about 20-40% for women under 20. There have been trials in a couple of cities with free contraceptives also to women between 20 and 24, and the abortion rates there were halved in that age group. The reason is probably that administration itself of contraceptives (including condoms) is harder the younger you are, it isn't easy to remember to take a pill every morning (especially if you don't want to put the pill sheet with your toothbrush in the family bathroom). The older the women are, the higher probability of having a life compatible with a daily pill at a set time. Ironically one of the political parties that are pro free contraceptives to women under 24 is the Christian Democratic party (Norwegian article). They argue that it will lower the abortion rates. The other political parties seem to be against the extension of the scheme, for economical reasons.

(Condoms can also be ordered online for free, and lots of organizations hand them out (including the student parish at university - I guess a few people have been surprised by their huge bowls of condoms in the common area. A friend of mine works for them, and she gets like 30,000 condoms delivered well before the annual AIDS day on 1 December. Which again means handicraft projects involving condoms and glue (not needles!) during our sewing circle meetings where about half the attendants belong to a, ehrm, slightly more conservative church.)

And then to the prices, the information from Val that inspired me to write this.
Most combination and mini-pills are in the $13 to $36 range for a 3 month prescription: Microgynon $13, Marvelon $20, Cerazette $28, Loette $36. There are also other options below $17, so there are a few to choose between also for those getting them for free. Not all pills work the same way for all women, so it's not like we could be done with having one brand for all. According to Val, it is possible to get a generic pill for $24/3 months in USA, but she has never paid less than $30 a month. It's a bit unclear if this was the copay she paid after insurance or if it was the actual price of the pill - I suspect the first, though.

NuvaRing is a low-dose alternative to oral estrogen that is inserted into the vagina and replaced once a month. They cost about $55 for 3 months in Norway. The price for Val was $45 per month - and that was the copay part of it! A Mirena IUD cost about $200, and will last for 5 years. It is usually inserted by your GP, so that's another $40. Another alternative to oral contraceptives are injections, Depo-Provera is about $15 for 3 months, and can be injected by the school nurse for free. Nexplanon, an implant for 3 years, is about $200 plus GP.

"Plan B" contraceptives (NorLevo) are available over the counter in stores that sell paracetamol, nasal spray, mild coughing mixtures etc (gas stations, supermarkets, kiosks), and in pharmacies. They are about $35 per pill. Since it's OTC the price may vary, but not very much (at least not if you compare pharmacies - everything is usually more expensive in a kiosk or gas station).

What is important to note here, is that ALL these prices are the prices of the market. They are not regulated by the government, but set by the manufacturer or their representative in Norway. The prices are regulated in the sense that they are fixed (not for OTC drugs) between all pharmacies, so there is no need to shop around to find the cheapest pharmacy - it's the same whether you are downtown Oslo or near North Cape. They may also be de facto regulated since the government pay for a lot of drugs for chronic illnesses, and have set maximum prices they will cover. But the manufacturer won't get any more money than the fixed price, it's not like the government buys a lot of these drugs for chronic patients in addition to giving money so they can keep the prices down, and the government regularly evaluates their maximum prices and have been pushing prices for branded drugs down when a cheap generic drug has become available. If a blood pressure medicine costs $20 a month, that's what the manufacturer are paid for it, no matter if the patient has a chronic diagnosis (and thus only pays about $6 copay for it) or is using it short term for some other non-chronic condition (and pays the full price of $20).

A few words on abortion, even if I don't think about it as a contraceptive. They are performed medically (before week 9) or surgically in public hospitals all over the country, with or without a referral from your GP (the hospitals prefer referrals through a GP and will probably urge you to see your GP first, but you can contact the hospital directly should you want to). As all exams and appointments related to an actual pregnancy are completely free of charge, this also goes for abortions. Travel costs above $50 to the hospital are covered. Abortions can be performed until week 12 after the last period. After that they can still be done, but it has to be due to a medical condition for either mother or fetus/baby, and the criterias are stricter the longer the pregnancy has lasted. After week 23-24 (when the foetus is considered viable) no abortions will be done no matter what (but birth will be induced to save a mother's life, the mother's life is always prioritized before the unborn child until the child is actually born). Vaginal ultrasounds are done, but only to confirm the length of pregnancy (and vaginally since that's the only practical way of doing it for most women before week 12), and the pregnant woman is by no means required to watch it.

Recently there as been a debate about doctors' rights with regard to abortions. Since our abortion law came into effect in 1972, doctors and nurses have been able to abstain from performing abortions if it's against their beliefs. The right to get an abortion is with the hospital, not with the individual doctors, so as long as the hospital is able to find other doctors to do it, the patients won't suffer and thus the government says it's ok for individuals to abstain. For large hospitals this is not a problem, but I have seen smaller hospitals adverting for doctors/nurses with a clause that the person must be able to perform abortions. As long as this clause is known before the medical staff is employed, it is allowed. The hospitals must also be able to have skilled doctors at any time in case of emergency, not just during office hours - after all the medical procedure is the same whether it's an abortion or a surgery to clean the linen of the uterus after a bad miscarriage.

The exceptions for hospital doctors haven't been much of an issue. Recently it was known that also GPs have been engaged under a no-referral-to-abortion clause (we're talking referrals, not performing them), which for many also included the right not to prescribe contraceptives (and also referring lesbians to IVF treatment). THIS engaged a debate. GPs are the first line in the health care system, the first person the patient sees. There are no ways to inform patients in advance about the doctor's consciousness about abortions and contraceptives, and while most doctors were able to deal with this quite easily by referring to other GPs, not all women (and men) were quite happy with this. Apparently it's wrong to sign the referral or prescription yourself, but they have no problems asking another GP to put her signature on the same paper - what's the logic here?

I don't know the prices of other prescription drugs in USA, and due to the insurance system it's apparently impossible to find any relevant prices of them either. OTC drugs seem quite a lot cheaper than here, so if the same price scheme was used the price the pharmaceutical company is paid for a prescription drug should be quite a lot less than here. And they might as well be, since I guess the insurance company takes quite a big share of the price on the way.
2012-01-26 11:36 am
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It's a boy!

We had the standard ultrasound appt this week, and it was quite obvious that Ada is not getting a sister (unless she's transgendered). Even I, who can hardly differ a chicken from a human baby at this stage, could see that. No shyness there! Everything else looked fine. I had already had a sneakpeak last week, as part of a research study I ended up not being qualified for (disqualified for research, is that bad?). (I was too far along.) They focused on the heart, so there shouldn't be any anomalities they can spot at 19 weeks there. And he has to arms and two legs and a nice lip and split brain and all that. The due date is around July.

We have started to tell Ada that I have a baby in my tummy. She usually responds by pointing at her own tummy or by saying the baby is in my pants. But the other day she started putting raisins into my belly button, claiming that the baby was hungry. And then picked them out again to eat them. At least she shows some understanding of anatomy and the use of navels...

As for pregnancy as such it's going ok. It's much tougher this time than the first time, and I am still sick. Morning sickness (or rather evening sickness) is not fun at all, and eating is the only thing that helps. I am also rather exhausted, but I can manage that. Going to work is ok, the three hours between work and someone's bedtime not so fun - but I manage that, too, and Ada can live fine with a mum on the couch and a dad who does the reading, feeding and bathing with her.

We're still breastfeeding - after all the struggle to get her started I am not in for giving up yet! Or at least I don't want to initiate weaning - she can do that. She only nurses about twice a day, and I don't have much milk. I am pretty sure I have started to have colostrum, the kind of milk that's in the breasts until the milk "comes in" a couple of days after birth. Production usually starts in the 5th month of pregnancy. The milk is not stored in the breast until birth, like other bodily fluids milk is absorbed by the body if it's not drained/secreted, and the production is continuously. It's driven by hormones, not by demand (even though I guess the production even of colostrum may increase by demand even if the lactation process is not yet "there" - "there" being the processes that happen during and after birth, with the actual birth, the release of placenta etc).

Colostrum is fascinating stuff, I may write more about it later. It has a laxative effect, which helps the body dispose of meconium, the waste product made in the bowel during pregnancy when the baby swallows water. After birth the bowels should be empted of meconium, and colostrum helps with this. This also work with older kids. I am pretty sure I started making colostrum in the middle of last week, as Ada started having looser stools then. The reason why I make this connection is that they went back to normal when I was away for 36 hours - then the looser ones returned again when I was back. It's potent!
2012-01-02 09:11 pm
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Happy 2012

Last year we said we'd write a report from 2011 to send with the Christmas cards. Well, we didn't quite get there, so I thought I'd write a report on my blog. I didn't quite get there before Christmas. Then I thought I could write it before the new year. Uhm, well, not quite. Then 2012 came, and I thought I'd manage this year. At least a 2011 report - don't hold your breath for a 2012 report this year.

The year started with daycare for Ada from early January. She was about 10 months then, and both she and we liked daycare (or maybe she did't know better). She had a few sick days during the first month, but not as much as expected, and in general she continued to stay well. A 5 day fever&sickness resulted in 3 new teeth - or whatever comes first.

In March she turned one, which was celebrated with two parties, lots of cupcakes (with pink frosting! And tractor paper cups.), and a green crown at daycare. She took her first step the day after her birthday, but didn't want to walk anymore until May, 17 (our national day). We spent Easter in Arendal, as well as a couple of weeks during summer.
In addition to Arendal we also spent a week in Denmark. We rented a house there with an old friend of mine (who now lives in Oslo so we don't meet often), her fiancé and 4 year old daughter. In general it went very well, with no major fights and we can still talk to each other :) We'll certainly do this again - although not this summer...

The nice summer was brought to an end on the afternoon of July, 22. 5 months later the nation is not mourning anymore, but there is still quite a lot of debate. The gunman is declared unfit for prison, but will be judged in a normal, fair trial and probably sentenced to an infinite stay in a mental hospital. Unfortunately the debates on the internet haven't changed much after the attack - the right wing supporters are still as active as before, there are no (or very few) voices speaking up against them, and most of the right wingers seem to see themselves as part of the solution rather than the problem. They claim to be anti-violent, but I have seen many entries where they indicate that they understand why the bomber/gunman did what he did, although they claim to be against the massive violence. I must admit I am part of the problem myself - as being among those not raising my voice against them. It takes so much energy and time I don't have. (And it does make me wonder how many of those people who have a paid job.)

Anyway.

Ada is quite obsessed with her "PC" - my iPad (I won it in a quiz last winter - someone actually wins in these quizzes!). Just like her cousin she quickly managed it, I think she was around 18 months when she really started to use it. Before that she could watch it like she watches TV, but didn't really use it. Now (at 22 months) she still can't start the program she wants herself, but once it's started she can usually use it by herself. I am looking at ways to child proof the iPad and its applications - it's annoying when she quits (well, hides) a program because she pushes the Button on the iPad, or when she ends up on soft porn on youtube because she pushes the "most popular" button in the app. It's not about moral or censorship, neither is it about not watching what she is doing - it's just about having a happy toddler within an arm's reach (not necessarily on my lap).

Now at Christmas we have been rather busy. We originally planned to go to Arendal the weekend before Christmas, but due to forecast and road conditions we stayed home. It was like having a bonus weekend off - i.e. very nice :) For Christmas eve we invited my parents and my grandmother here for dinner. On Christmas Day we went to my parents for a family lunch, and on Dec, 26 my parents came for dinner. Ada had the week between Christmas and New Year off, so either I or Anders stayed home with her. I felt lousy one of "my" days, so it was quite tough, but besides that I think both she and we enjoyed it. She got some entertainment from her cousins, and on Friday we drove to my parents for a cousin party. Puh. On New Year's Eve we had a small dinner party at home, for once with so little leftovers that we had to be creative for dinner on New Year's Day!

Hopefully 2012 will be a nice year, with no surprising events. I can rarely say we hope for a calm year, as we will grow from a family of 3 to 4 in June, and I am very aware that it is rarely a calming event for any of the involved!

Merry Christmas from Geekhouse!


Merry Christmas from Geekhouse!
2011-11-29 12:10 pm

It's that time of the year again: the card season!

Gina and Cannie reminded med that it's soon time for the card season again. This year I will send out a rather cute picture of a little santa girl. If that is offending to you, just tell me so, and I will send you a pony head in stead. Or a card with flowers or santas or something like that.

To those new to this tradition: for the past, uhm, many years I have sent seasonal (yule) cards (the old fashioned kind on paper) to people reading my blog. As long as you don't mind giving me a postal address I can mail the card to, I don't mind how well I know you either.

So, comment on this entry (comments are screened) with your name and post adress, and remember to tell me if you'd rather have the dead pony :-)
2011-08-23 09:23 pm
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The elections are approaching.

The elections are approaching and once again I am reminded that I am an election geek. Not a political geek, but one loving elections for the case of elections.

I am (for the 4th time) elected as polling committee member during the elections here in September, and tonight was the semi-compulsory information meeting for all officers. It was very interesting. I thought I had been to a couple of these meetings before (except 2 years ago), but I didn't remember the guy organizing it being som witty. Either he wasn't last time, or someone else held them.

Anyway, the elections (municipality and county this year, it alternates with the parliament election every two years, each has a 4 year term) are much the same as they have been during my terms in the the polling committee, with two exceptions: the ballot boxes are now sealed, and the voters should show photo id. (But if they don't have any, they should be allowed to vote. The risk of election fraud among 91 year old women is considered low and acceptable.)

As a petimeter election geek I have requested sealed ballots and tougher photo id requirements for a while.

Norway may be a country full of love, democracy and nice people, but we are also part of the world, and I think any election organisation in Norway should also be acceptable in USA, Somalia, India or any other country we may or may not like to compare to.

One factor that perhaps makes the unsealed boxes and the unidentified voters less serious is that much of the election actions are performed on a low level in the organization. Everything is organized top-down, with committees on different levels from the national via counties and municipalities to each polling station. The counting, though, expands bottom-up. Each polling station does a temporary count after closing time, making sure there are no more votes than voters (it's not an exact match at the local elections, since there are two elections and you can vote in either or both, but with only one mark in the electoral rolls), and then counting the votes and reporting the numbers up.

After the first report (which is first reported via phone, then the official papers are handing over to the next level of officials) the numbers can't really be adjusted much. Some adjustments are expected, though each polling committee put some honour in getting it right at first attempt, but it's usually not more than 10 votes from each polling station (so less than 500 for all the city). It's not possible to adjust the numbers after the final count is out, and it's very hard to affect the numbers much at all. You'd have to be very organized and do a lot of work at all the polling stations to make an impact.

(Ok, there is voting before election day, about 20% of the votes are cast there. These votes are counted on municipal level, so in theory it would be easier to cast a lot of pre-votes and try to affect the elections that way. But the requirements for id are stronger for voting before election day, you must have one with photo and personal id number. The chances of anyone discovering the suspicious activities will increase the more you abuse it, since the voters are marked in the electoral rolls and it will look suspicious if many complain that their votes were already registered on election day.)

I like being a part of this system and to make the election day go as smooth as possible. It's hard work, from 8 am to midnight or so, but very rewarding and I feel it's my part of making democracy work. And this year I have a stronger feeling that our way of doing it might even work in Somalia, USA or India, too.
2011-07-26 11:25 am

The Norwegian Answer.

Our prime minister, our king, our media. All are unison about continuing with an open society, an open democracy.

This weekend our royal family visited downtown Oslo, to see the damage, to join memorial services and to put down flowers. This pictures is taken by a friend of mine, and shows pretty well how open we still are.



(Photo: Ron Holan. All rights reserved.)

This is our Crown Prince's family: Prince Sverre, Princess Ingrid, Marius, Crown Prince Håkon, Crown princess Mette-Marit. Besides that you can see bystanders sharing the grief (and taking pictures), and you can probably measure the distance by counting cobble stones.

There are no fences. No police officers[1]. No chain of soldiers between the royals and the regular people. No dogs or horses holding the public back.

Yesterday we had a minute of national grief, with the King, Crown Prince and prime minister standing in a row in the University Square in Oslo. Afterwards the prime minister walked around in the crowd and received hugs and flowers from unknown people.

Yesterday evening 150,000-200,000 people participated in a peaceful "rose rally"[2] in Oslo (which has 500,000 people). In Trondheim 20000 gathered, in Bergen 30000, in Stavanger 75000. The total number of participants throughout the country are said to be at least 700,000. People gathered with roses and torches, calm and peaceful, with songs and music.

We want a Norway:

Where we live together in fellowship and with freedom of opinion and speech.
Where we see our differences as opportunities.
Where freedom is stronger than fear.

Tonight the streets are filled with love.


HRH Crown Prince Håkon, Oslo, 2011-07-25[3]

[1] if you study the other pictures by lilchief, you can clearly see police officers there. Ten of them, maybe.
[2] Incidentally Ron is in the left picture in the "spirit of togetherness"-part of the article. He is a freelance photographer and was on his way to family in Israel when the bomb in Oslo exploded.
[3] Translation by a friend of a friend on Facebook, I hope it's available to everyone.
2011-07-26 11:22 am

Moving to Dreamwidth

I think I am moving to Dreamwidth now. LJ has been down-ish for about 24 hours, and I am using that as an excuse to finally move over here, at least so I can finally get the entry I wrote yesterday posted.... with some luck my previous entries will be imported here, too (but not right now). When LJ is up again, I will cross post, though.
2009-12-27 08:43 pm
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From LJ to DW?

I have decided to test dreamwidth to see if it will work as a substitute for my livejournal account. The first step is to see if I can post anything, the next will be to see how easy it is to import settings and contacts from Livejournal, then I will start exploring it and see if there is any advantages to using DW in stead of LJ (except possible ideological reasons). No reasearch is done on step two and three so far, so unless you are really eager there is no need to lead the blind quite yet :-)