Wake Forest Baptist Chosen for National Consortium to Study Molecular Changes Resulting from Physical ActivityWake Forest Baptist Chosen for National Consortium to Study Molecular Changes Resulting fr        
Physical inactivity is a major public health challenge underlying a broad range of health problems at all ages. While it is widely accepted in the medical community that physical activity produces many health benefits, the underlying molecular mechanisms are poorly understood.
          AP , TS EAMCET 2014 Web Counselling Procedure , Dates , Latest Updates at apeamcet.org | AP Engineering Counselling 2014 Schedule by Ranks Wise |EAMCET Engineering Counselling Schedule 2014 | EAMCET Web Options Details 2014         
AP Telangana TS EAMCET 2014 Web Counselling Procedure :Engineering Agricultural and Medical Common Entrance Test commonly called as EAMCET, EAMCET entrance examination will provide the admission for students to engineering and medical colleges in the state of Andhra Pradesh AP and Telangana, TS States in India. EAMCET is a yearly examination written by a large number of engineering and medical aspirants in the state. Jawaharlal Nehru Technological University, Hyderabad (JNTUH) will conduct the state wide EAMCET examination in every year. EAMCET EXAM consists of "Multiple choice type Questions". EAMCET exam paper consists of 160 questions with 40 marks for each subject (Physics and Chemistry Math’s A/ Math’s B/Botany /Zoology,).After announcement of results every Students will get their rank cards based on the performance and score.Based on that rank, students can choose the college in the counseling conducted by APSCHE. JNTUH Already they have announced EAMCET Results 2014 So What is Next web counselling .

                                   

Telangana, AP EAMCET CERTIFICATE VERIFICATION COUNSELLING 2014: The Andhra Pradesh and Telangana States are Decided EAMCET Engineering Counselling Dates.The Engineering, Agriculture and Medical Common Entrance Test 2014 Exam Results are Released and Download Rank Cards by using Hall Ticket Number. This Mock Counselling is Done by Ranks Wise of candidates with in Particular dates. The AP State Government Will Releasing EAMCET Certificate Verification's Schedule Notification by Rank Wise Dates on August 2014 and Telangana Government Will Released This Notification on 30th July, 2014. The Counselling is Starts from August 7th, 2014 in Telangana State. In That Schedule The Online Mock Counselling of Web Options Apply Dates are also Given.


AP EAMCET 2014 Web Counselling  at apeamcet.org :

AP EAMCET 2014 Web Counselling SCORE: EAMCET Score is calculated depending on the intermediate marks and EAMCET score Final Eamcet score (Total 100) = Intermediate weightage (Max score: 25) + Eamcet weightage (Max score: 75). and before you will be going to EAMCET web Counselling you can check EAMCET mock Counselling 2014 and all latest EAMCET web counselling updates available. so the candidates you can check your ranks and collage status above calculation. moreover the The Board conducted the web counselling in the month of August hence all students check your daily EAMCET counselling updates here. 

EAMCET Help Line Centers or EAMCET Certificate Verification Counselling Centers are :

Hyderabad
Chitoor
Ellure 
Warangal
Guntur
Adhilabad
Bheemavaram
Amala Puram
Anantha Puram
Vizag
Vikarabad
Siddipet
Machilipatnam
Jangon (Warangal District)
Wanaparthy (Mahabub Nagar District)
Vijaya Nagaram
Ongole
Srikakulam
Vijayawada
Kadapa
Kakinada
Medhak
Khammam
Kurnool
Thirupathi
Nellore 
Nalgonda
Karimnagar
Mahabubnagar
Nizamabad

Counselling Procedure :

All The EAMCET Qualified Students Check Their Certificate Verification Dates in Schedule.
After Go To Counselling Hall and Pay Money 150/- (or) 200/- and after Give Certificates for Verification.

MORE INFORMATION ABOUT  AP AND TS EAMCET - 2014    CLICK HERE

TO KNOW THE  EAMCET - 2014  WEB COUNSELLING INFORMATION    CLICK HERE

FOR ANY PROBLEMS IN EAMCET - 2014 WEB COUNSELLING    CLICK HERE

          AP EAMCET 2014 Results From apeamcet.org,schools9.com,manabadi.co.in - June 9th 2014        
Good News Most Awaited AP EAMCET Results 2014 are Going to Release with in Few Hours AP EAMCET Board has given an Information about AP EAMCET Results that they are Going to Release the Results on 9th June which mean ToDay So You can get Your Results at www.apeamcet.com, www.schools9.com, www.manabadi.co.in, www.sakshieduacation.com . Andhra Pradesh State Engineering Agriculture and Medical Common Entrance Test( EAMCET-2014) Results is going to release on Today 09/06/2014 at 4.30pm.

There qualifying percentage of marks for EAMCET 2014 is 25% i.e. 40 out of 160. For schedule tribes and schedule casts there is no minimum qualifying mark prescribed. But the admission provided to them will be limited to the extent of the seats reserved for such categories.

TO CHECK APEAMCET-2014 RESULTS   CLICK HERE

TO DOWNLOAD APEAMCET-2014 RESULTS   CLICK HERE

TO KNOW ABOUT WEB COUNSELLING-2014   CLICK HERE

TO KNOW YOUR APEAMCET-2014 RANK    CLICK HERE

TO CHECK APEAMCET-2014 RESULTS   CLICK HERE   

TO DOWNLOAD AP EAMCET RESULTS-2014  FAST     CLICK HERE

          Supreme Court Tells Alabama to Reconsider the Factors It Has Used to Determine Intellectual Disability        

The U.S. Supreme Court has vacated the Alabama state courts' rejection of a prisoner's claim that he is ineligible for the death penalty because of intellectual disability, and directed the state to reconsider his claim in light of the Court's recent decision in Moore v. Texas requiring states to employ scientifically accepted standards in determining whether a death-row prisoner is intellectually disabled. On May 1, 2017, the U.S. Supreme Court agreed to review the case of Taurus Carroll, and vacated the Alabama Court of Criminal Appeals' decision in his case after Carroll's lawyer argued that the March 28 decision in Moore established that Alabama had unconstitutionally deviated from accepted methods of determining intellectual disability. In 2002, the Supreme Court ruled in Atkins v. Virginia that defendants who are found to have intellectual disability—then known as mental retardation—cannot be executed. The ruling left states with discretion in establishing procedures for determining which defendants have intellectual disability. In Moore, however, the Court reiterated that this discretion is not “unfettered” and that a state's intellectually disability determination must be “informed by the medical community’s diagnostic framework.” The Court struck down Texas' use of an unscientific set of lay stereotypes, known as the “Briseño factors," that Texas had used to determine whether Moore had deficits in adaptive functioning characteristic of intellectual disability. The Court said that, "[i]n concluding that Moore did not suffer significant adaptive deficits, the [Texas courts] overemphasized Moore’s perceived adaptive strengths," but "the medical community focuses the adaptive-functioning inquiry on adaptive deficits." In Carroll's case, the Alabama courts had considered Mr. Carroll’s supposed adaptive strengths—that he had passed a GED exam and successfully held down a job in the prison kitchen—as proof that he was not intellectually disabled. Carroll's attorney argued that, “As in Moore, the consideration below of Mr. Carroll’s adaptive functioning ‘deviate[s] from prevailing clinical standards, by ‘overemphasiz[ing] Mr. [Carroll]’s perceived adaptive strengths.” He also argued that Alabama had unconstitutionally employed a strict IQ cutoff score, while at the same time inflating Carroll's IQ score by refusing to apply scientifically established factors that adjust for limitations in IQ testing. With the Supreme Court's ruling in Carroll's case, the Alabama Court of Criminal Appeals must now determine how Moore affects Alabama's methods of determining intellectual disability. John Palombi, a lawyer with the Federal Defenders for the Middle District of Alabama, said he was "pleased" with the Court's decision. “This will require Alabama courts to follow scientific principles when making the life or death decision of whether someone charged with capital murder is intellectually disabled,” he said.

(C. Geidner, "Who Is Intellectually Disabled? Supreme Court Orders Alabama To Reconsider Death-Row Case," BuzzFeed News, May 2, 2017.) See Intellectual Disability and U.S. Supreme Court. Read Mr. Carroll's Petition for Writ of Certiorari, Alabama's Brief in Opposition, and Mr. Carroll's Reply Brief in Support of Petition for Writ of Certiorari. 


          American Nurses' Assoc.: Dead Wrong on Death Penalty        
American Nurses' Association: Dead Wrong on Death Penalty

Notes for first draft

It is hard to fathom how the ANA could have gotten so much, so wrong (1).

A rebuttal to all of ANA's death penalty "facts".

Each one of these is a rebuttal to what ANA presented.

(p 4, para 1, fn1)

RACE & THE DEATH PENALTY: A REBUTTAL TO THE RACISM CLAIMS
http://prodpinnc.blogspot.com/2012/07/rebuttal-death-penalty-racism-claims.html

White murderers are twice as likely to be executed as are black murderers

56% of those executed are white, 35% black

For the White–Black comparisons, the Black level is 12.7 times greater than the White level for homicide, 15.6 times greater for robbery, 6.7 times greater for rape, and 4.5 times greater for aggravated assault.

For the Hispanic- White comparison, the Hispanic level is 4.0 times greater than the White level for homicide, 3.8 times greater for robbery, 2.8 times greater for rape, and 2.3 times greater for aggravated assault.

For the Hispanic–Black comparison, the Black level is 3.1 times greater than the Hispanic level for homicide, 4.1 times greater for robbery, 2.4 times greater for rape, and 1.9 times greater for aggravated assault.

As robbery/murder is, by far, the most common death penalty eligible murder, the multiples will be even greater.

From 1977-2012, white death row murderers have been executed at a rate 41% higher than are black death row murderers, 19.3% vs 13.7%, respectively. ( Table 12, Executions and other dispositions of inmates sentenced to death, by race and Hispanic origin, 1977–2012, Capital Punishment 2012, Bureau of Justice Statistics, last edited 11/3/14)

"There is no race of the offender / victim effect at either the decision to advance a case to penalty hearing or the decision to sentence a defendant to death given a penalty hearing."


Is There Class Disparity with Executions?
http://prodpinnc.blogspot.com/2013/03/is-there-class-disparity-with-executions.html

"99.8% of poor murderers have avoided execution.

It may be, solely, dependent upon the definitions of "wealthy" and "poor", as to whether wealthy murderers are any more or less likely to be executed, based upon the very small number and percentage of capital murders that are committed by the wealthy, as compared to the poor.

=======

 (p 5, para 2, fn1)

The Death Penalty: Saving More Innocent Lives
http://prodpinnc.blogspot.com/2013/10/the-death-penalty-do-innocents-matter.html
======

(p 5, para 3, fn1)

Saving Costs with The Death Penalty
http://prodpinnc.blogspot.com/2013/02/death-penalty-cost-saving-money.htm
======

(p 5, para 4, fn1)

It s impossible to prove that any sanction or any negative outcome does not deter some. Why? It would be contrary to reason and history, as we all well know.

--  Full rebuttal to Nagin (National Research Council)

Death Penalty Deterrence: Defended & Advanced
http://prodpinnc.blogspot.com/2013/06/death-penalty-deterrence-defended.html

--  Full Rebuttal to Radelet (Criminologists)

Deterrence and the Death Penalty: A Reply to Radelet and Lacock
http://prodpinnc.blogspot.com/2009/07/deterrence-and-death-penalty-reply-to.html
======

(p 5, para 5, fn1)

The Death Penalty: Fair and Just
http://prodpinnc.blogspot.com/2013/12/is-death-peanalty-fairjust.html
======

(p 5, para 6, fn1)

There is a huge body of very well known legal work with regard to mental illness and the death penalty.

Apparently, the ANA has no clue. No surprise.

Cases to follow.

======

(p 5, para 7, fn1)

The ANA is unaware that because of state governments and states' rights, that the death penalty statutes, as all laws, may be different from state to state. This is no surprise and is well known to all, but not the ANA?

Nebraska reinstated the death penalty by popular vote, 61-39%, in 2016.

The other six states that have, recently, revoked the death penalty all did so contrary to those states popular death penalty support and could only accomplish repeal based upon a Democratic majority legislature, with a Democratic governor.

======

(p6, para 8, fn 1)

--  "The normal moral reason for upholding capital punishment is reverence for life itself. Indeed, this is the reason why scripture and Christian tradition have upheld it, a fact which suggests that, if anything, it may be the abolition of capital punishment which threatens to cheapen life, not its retention." J. Budziszewski, Professor of Government and Philosophy at the University of Texas at Austin, Jan. 25, 2002 conference, Pew Forum, titled "A Call for Reckoning: Religion and the Death Penalty"

--   John Murray: "Nothing shows the moral bankruptcy of a people or of a generation more than disregard for the sanctity of human life." "... it is this same atrophy of moral fiber that appears in the plea for the abolition of the death penalty." "It is the sanctity of life that validates the death penalty for the crime of murder. It is the sense of this sanctity that constrains the demand for the infliction of this penalty. The deeper our regard for life the firmer will be our hold upon the penal sanction which the violation of that sanctity merit." (Page 122 of Principles of Conduct).

--  The biblical support for the death penalty is, specifically, based within human dignity.

Genesis 9:5-6, from the 1764 Quaker Bible, the only Quaker bible.

5 And I will certainly require the Blood of your Lives, and that from the Paw of any Beast: from the Hand likewise of Man, even of any one’s Brother, will I require the Life of a Man.

6 He that sheds Man’s Blood, shall have his own shed by Man; because in the Likeness of God he made Mankind.

--  Vengeance cannot be the foundation for the death penalty. The death penalty, as all sanctions, are based within justice, with a just, proportional sanction, given within due process, whereby no one connected to the crime can decide either the verdict or sentence, which are both the sole provinces of the judge(s) and/or jury, neither of which has a a vengeance component, nor foundation - again, very well known by all, except ANA.

======

(p6, para 9, fn 1)

No "Botched" Execution - Arizona (or Ohio)
http://prodpinnc.blogspot.com/2014/08/no-botched-execution-arizona-or-ohio.html
======

1) Capital Punishment and  Nurses’ Participation in Capital Punishment, http://www.nursingworld.org/CapitalPunishmentNursesRole-ANAPositionStatement

=======================

EDITED
Sent to ANA 2/23/2017

From: Dudley Sharp, a death penalty expert

The American Nurses' Association: Dead Wrong on Death Penalty

It is hard to fathom how the ANA could have gotten so much, so wrong (1).

ANA's Death Penalty Facts

ANA, primarily, used an anti death penalty site for all of the alleged "facts" about the death penalty. ANA fact checked none of it, with the foreseeable result.

Here are just two of ANA's blunders, from a field of blunders.

1) ANA writes: "Since 1973, over 155 people have been exonerated and freed from death row." (p 5, par 2, fn 1)

Untrue.

Anti death penalty folks, simply, redefined both "exonerated" and "innocent", as if they had redefined lie as truth, and stuffed a bunch of cases into those new "definitions", as is, easily, discovered by basic fact checking (2), ignored by ANA. Various reviews find the "exonerated" claims to be 70-83% in error (2). This has been known for nearly 20 years.

2) ANA writes: "In California, the cost of confining one inmate on death row is $90,000 more per year than the cost of maximum security prison ." ". . . a study in North Carolina showed that the cost of a death penalty sentence was $216,000 and the total cost per execution was $2.16 million, more than the cost of life imprisonment (p 5, para 3, fn 1)."

Ludicrous. Neither is possible (3),  just like much of the ANA nonsense, as revealed by fact checking (4).


ANA Confusing Politics for Ethics and Morality

Some have undertaken an ill advised or dishonest effort to show that medical ethics require medical professionals to shun the death penalty.

It is an, utterly, false narrative.

The effort to ban medical professionals' participation in executions is an unethical effort to fabricate professional ethical standards, based upon personal anti-death penalty activism, from those whose professions are medically related.

As with, ANA: " . . . the principles of  social justice speak to the  importance of  the nursing profession’s taking a stance against the death penalty, due to the preponderance of evidence against the fairness and effectiveness of capital punishment as a deterrent." (p1, fn 1)

The foundation for the death penalty, as for all sanctions, is justice. Deterrence cannot be negated for the death penalty nor for any other sanction, nor for any other negative prospect (5). ANA chooses to risk sacrificing more innocent lives (5).

Fairness is a highly subjective consideration. For example, based upon 2008-2011, US data, " . . . the true number of premature deaths associated with preventable harm to patients was estimated at more than 400,000 per year. Serious harm seems to be 10- to 20-fold more common (4-8 million) than lethal harm." (6) 

Fair?

There is no proof of an innocent executed in the US, at least since the 1930s.

Based upon ANA's constant errors (2-4), we know the ANA could not, possibly, have made an informed evaluation of fairness, as detailed.

ANA parrots that the death penalty is a human rights violation. Both freedom and life are fundamental human rights. Neither is inviolate, which is why we have both incarceration and executions, with due process. None of the groups stating that the death penalty is a human rights violation also state that incarceration is, as well. The only difference in the stances are that one is honest and the other not.

Nurses may ethically/morally participate in executions based upon their caring spirit, that they may assist in providing less painful executions and that they, also, may find the death penalty to be a just sanction that helps to save more innocent lives.

As per, Dr. Robert Truog, MD, Professor of Medical Ethics, Harvard Medical School:

"If I think of the kind of a hypothetical where you have an inmate who is about to be executed and knows that this execution may involve excruciating suffering, that inmate requests the involvement of a physician, because he knows that the physician can prevent that suffering from occurring, and if there is a physician who is willing to do that, and we know from surveys that many are, I honestly can't think of any principle of medical ethics that would say that that is an unethical thing for the physician to do." (7)

How could he reach that conclusion? Easily.

Just as per page 2, fn 1, ANA could have provided that "Nurses. . .  provide comfort care at the  end of life, if requested, including pain control, anxiety relief or procuring the services of a chaplain or spiritual advisor.", for nurses that find the death penalty to be just and ethical.

There has been a lot of ink used to review the long standing medical professions ethical prohibitions against the death penalty.

There is no such prohibition.

Some in the medical community have fabricated an ethical prohibition against medical professionals' involvement in state executions by invoking the famous "do no harm" credo and the Hippocratic Oath.

It is a dishonest effort.

THE ETHICS OF LYING - The Hippocratic Oath

Note: To their credit, ANA does not use the Hippocratic Oath to support their position, but does, foundationally, use "do no harm" (1).

Some have proclaimed that "First do no harm" is a centuries old foundation of medical ethics, weighing against death penalty participation.

Untrue.

It is an anti-death penalty fraud that "do no harm" is in the context of the state execution of murderers (8).

Neither the Hippocratic Oath nor "do no harm" have anything to do with executions (8).

Both are, solely, concerned with the medical profession and patients.

" 'do no harm' (a phrase translated into Latin as "Primum nonnocere") is often mistakenly ascribed to the (Hippocratic) oath, although it appears nowhere in that venerable pledge.(8)"

"Hippocrates came closest to issuing this directive in his treatise Epidemics, in an axiom that reads, 'As to disease, make a habit of two things - to help, or at least, to do no harm.'  (8)"

"As to disease" -  Nothing else.

There is no relevance outside medicine and, most certainly, no prohibition against medical professionals participation in the state execution of murderers.

The classic Hippocratic Oath & Its Brother, the Hypocrisy Oath

"I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art." (8)

This is a prohibition against euthanasia and abortion (8) and has nothing to do with the fabricated medical prohibition of participation in state sanctioned executions.

Do those anti-death penalty physicians and medical associations promise license revocation if any of their members participate in euthanasia or abortion?

Of course not.

In fact, we have Belgium approving the assisted suicides of children, of any age, with participation by physicians (9).

Many medical professionals fully accept and participate in both abortion and euthanasia.

Many could care less about the true ethical prohibitions that exist in a medical, historical context.

Instead, they just invent new ones, against the death penalty and for child suicide, while avoiding the true prohibitions, ushering in the newly renamed and truthful - Hypocrisy Oath.

Is the ANA unaware that the lethal injection executions of murderers are a criminal justice sanction and that it is not a medical procedure with patients?

If nurses wish to participate in end of life situations that have nothing to do with patients, medical associations should not place political roadblocks in their way.

The few legal reviews of this topic have found as reason and fact require:

"Other courts have addressed (physicians participating in executions) and found that it does not violate the physician's code of ethics to participate in an execution . . ." "The Court... does not find that Missouri physicians who are involved in administering the lethal injections are violating their ethical obligations . .  ." (Taylor v. Crawford, Jan. 31, 2006, Court Order issued by the US Western District Court of Missouri)

Let's look at some additional sensible reviews:

The editors of The Public Library of Science (PLoS) Medicine write:

"Execution by lethal injection, even if it uses tools of intensive care such as intravenous tubing and beeping heart monitors, has the same relationship to medicine that an executioner's axe has to surgery." ("Lethal Injection Is Not Humane", PLoS, 4/24/07).

So to, The American Society of Anesthesiologists:

"Although lethal injection mimics certain technical aspects of the practice of anesthesia, capital punishment in any form is not the practice of medicine. ("Statement on Physician Nonparticipation in Legally Authorized Executions," 10/18/06).

Both confirm the obvious: The state execution of murderers has no connection, ethically or otherwise, to the medical treatment of patients.

Rationally, there is no ethical nor moral connection, Some folks just want to fabricate a false narrative. So that's what they do - just another anti-death penalty fraud.

1) Capital Punishment and  Nurses’ Participation in Capital Punishment, http://www.nursingworld.org/CapitalPunishmentNursesRole-ANAPositionStatement

2) The Innocent Frauds: Standard Anti Death Penalty Strategy
READ SECTIONS 3&4 FIRST
http://prodpinnc.blogspot.com/2013/04/the-innocent-frauds-standard-anti-death.html

and

An Open Fraud in the Death Penalty Debate: How Death Penalty Opponents Lie - The "Innocent" and the "Exonerated"
http://prodpinnc.blogspot.com/2013/03/the-innocent-exonerated-and-death-row_19.html

3)  Death Penalty Costs: California
http://prodpinnc.blogspot.com/2012/08/death-penalty-costs-california.html

and

"Duke (North Carolina) Death Penalty Cost Study (1993): Let's be honest"
http://prodpinnc.blogspot.com/2009/06/duke-north-carolina-death-penalty-cost.html

4) Review of other ANA fact problems
http://prodpinnc.blogspot.com/2017/02/the-american-nurses-association-dead.html

5) The Death Penalty: Saving More Innocent Lives
http://prodpinnc.blogspot.com/2013/10/the-death-penalty-do-innocents-matter.html

6) A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care
James, John T. PhD, Journal of Patient Safety, September 2013 - Volume 9 - Issue 3 - p 122–128, john.t.james@earthlink.net


7) New England Journal of Medicine interview titled "Perspective Roundtable: Physicians and Execution", Jan. 18, 2008

8) Physicians & The State Execution of Murderers: No Medical Ethics Dilemma
http://prodpinnc.blogspot.com/2009/10/physicians-state-execution-of-murderers.html

and

The Death Penalty & Medical Ethics Revisited
http://prodpinnc.blogspot.com/2015/09/the-death-penalty-medical-ethics.html


9)  "What Belgium's child euthanasia law means for America and the Constitution", Eugene Kontorovich, Washington Post, February 13, 2014





          CARF Connection - Cancer care rehabilitation is game changer for patients - 2014        
With a renewed focus on both survivorship and quality of life, the medical community now recognizes that rehabilitation can serve an important role in improving care for the more than 14 million people currently living with cancer. This renewed focus allows for new opportunities of growth and clinical development in which the skills and tools commonly used for more traditional rehabilitation populations are now being applied to underserved individuals with significant needs.
          Adjunctive Steroids and Harm in Cryptococcal Meningitis        
In the recent best-selling book and award-nominated movie, The Martian, astronaut and botanist Mark Watney is stranded alone on Mars.  The story follows his attempts to defy certain death and, through creativity and scientific experimentation, use his limited resources to generate oxygen, grow food, and make it home to Earth.  Recently the medical community has... Read More...
          Hire Me!        


I am on the hunt again. Domestic drudgery and full time child care is really not my bag so I need to work. I do have a job, the managers and my colleagues are great, but it's not a good fit for me. I am BORED!



I dread the over complicated and repetitive applications I am forced to write, especially those who want a "full employment history"
here are some of the jobs I have had since I left school

Junior in a hairdressers- hair is surprisingly smelly.
Running the family B&B( mostly turning the hoover on and lying on the beds)
Housekeeping supervisor in a London Hotel ( see above)
Bar maid in Yorkshire "Let's have a real Guinness poured by the Irish barmaid" cue my blushes as they watch me pour two measured half pints into a glass by pressing a button.
Waitress
Child minder ( disaster)
Cafe Manager
Restaurant Manager
Restaurant supervisor
Receptionist in sunbed place. I had a good tan back then.
Drinks waiter in one of Belfast's first gay clubs (where I was viciously attacked by a crazy lesbian because I turned my back on her )
Beauty therapist
Aromatherapist and Reflexologist ( I am fully qualified)
Salon Manager
Self employed recruiter for beauty staff
Self employed domestic ironer/ cleaner with small team.
Telemarketer
Telemarketing team leader
Door to door and phone survey monkey
Sales administrator
Tour guide, people rounder upper and mover-alonger, Titanic fact aficionado
Enquiries officer medical company
Receptionist medical company
Firewarden walkie-talkie killjoy ( current position).

I am sure there are more I have long forgotten, most of them I enjoyed for a time , but boredom is a problem for me. That and years and years of being a bottom rung employee. There is nothing wrong with being at the bottom, after all someone has to do the work. Unfortunately even in this day and age employers see employees as a number, dispensable, disposable and fairly worthless. Apart from the very smallest companies who generally realise the value of a good employee and seek to keep those  they have trained.



I think I should be an employee consultant. A manager of mine told me once I was a great advocate for the staff, every company needs me!

This is what I would tell employers,

Hire staff well before you expect to be busy, so they are trained to cope when you are.

Employ young people and retirees, great for a balance of enthusiasm and experience

Don't ask stupid interview questions ( "who is your favourite Lion King character"- I was asked this once; or "what do you know about the company", "er whatever I have read on your website.")

Have a good staff room. Keep it stocked up and have  a cleaner. A large table in the middle of the room is best for staff relations. all staff should use it including managers. occasionally buy lunch/ fruit/ cakes for everyone.

Know everyone's names. Have social events regularly- not always alcohol related.

Provide proper training- not "shadowing."  Real training by someone who is accountable should that training be unsuccessful or incomplete.

After 3 months in the job ask your new recruits what they love about the job and what they hate. Aim to give them more of  what they love and  less of what they hate. There will be other employees who are their polar opposites.

If the company is doing great, tell your staff. The same if it is doing badly. Ask your staff what to do to get more sales/ footfall/members, or how to save on outgoings.

Do not excuse lateness, but always aim to give time off requested.

Reward a job well done, every time. If someone's performance is waning ask them why.

Job swap with your lowest paid staff at least once a year.

Always stick up for your staff in the face of public criticism, but get to the bottom of complaints.

Pass compliments on to your team.

So if you know of anyone who is looking for an employee who can tell them exactly where they are going wrong, gimme a call :-)


          Comment on Don’t let it get to you  by DIANE CLARK        
I have had fibromyalgia since 1985. Learning to live successfully (& learning from my mistakes) with it has given me an amazing personal ministry to folks with chronic illness as well as fibromyalgia. With God's help, I even declined applying for disability as recommended by the medical community--praise God! Today I lead an active lifestyle including gardening and volunteerism. The key is to keep moving even when it feels like you should stop. Use of essential oils are also great healers.
          (USA-CA-Merced) House Lead Staff (Program Coordinator)        
House Lead Staff \(Program Coordinator\) Primary Location: CA\-CAMerced\-3567 San Jose Ave Function: Program Services Coordination/Case Management Organization: Redwood **_Everybodyneeds a job but only extraordinary people work here\._** Our team is fun, creative, and dedicated tomaking a difference every day in the lives of the people we serve\. The heart of what we do is support peoplewith Intellectual and Developmental Disabilities of all ages\. Every person needs the support of others, but we look for very special people to support the adult individuals with disabilities who may have emotional, behavioral or medical complexities whom we serve\. As a **House Lead Staff \(AKA Program Coordinator\)** with Loyd's Liberty Homes/California MENTOR you’ll be one of those special people\. Description House Lead Staff/Program Coordinators are a critical link to the community for those we serve, as well as serving as a bridge between our direct care and clinical staff to ensure the seamless delivery of services to the individuals we support\. ForLoyd's Liberty Homes/California MENTORand The MENTOR Network the Program Coordinator is critical to our success and exemplifies the wonderful mission driven work we do here every day\. To that end, the Program Coordinator role is a fantastic role to continue your career path in Social and Human Services with a myriad of career options to move up and across the organization\. We in fact have many success stories from people at all levels that have followed the Program Coordinator path\. Loyd's Liberty Homes/California MENTORis seeking a **Program Coordinator** to provide assistance to adults with developmental disabilities in a residential\-based setting\. Program Coordinators facilitate the implementation of Individual Service Plans \(ISP\) and participate in a range of administrative duties including staff hiring, training, scheduling and oversight\. In addition, Program Coordinators may provide support to individuals receiving services, including: assistance with daily activities such as meal preparation and planning; medication administration; and personal care\. Program Coordinators may also facilitate community involvement by accompanying individuals on outings in the community or providing transportation to work or other activities\. **Basic Requirements:** + High school diploma or GED + Minimum of One year related work experience \- direct support of individuals with developmental disabilities + Must be at least 18 years of age + Valid CA driver’s license in good standing + Reliable vehicle with current car registration and vehicle insurance + Successful clearance of local and/or state background checks + Supervisory or leadership experience preferred
          (USA-CA-Merced) Paramedic $5000 Sign-on bonus        
$5,000 Paramedic Sign-On Bonus Paramedic’s annual salary with benefits $63,438 - $77,814 * Competitive benefits with employer paid Group Life Insurance * 401(k) Profit Sharing Plan * Education & Training and more. RIGGS is the exclusive Advanced Life Support provider in Merced County and Accredited by the Commission on the Accreditation of Ambulance Services (CAAS). RIGGS is the only ALS responderin Merced County. Our dedicated professionals are committed to providing high quality patient care utilizing the most up to date equipment and resources. POSITION PURPOSE AND SUMMARY Under the supervisor, the ideal incumbent will perform duties associated with providing emergency medical care to the sick and injured in accordance with all applicable laws, regulations, and Company policies. ESSENTIAL DUTIES AND RESPONSIBILITIES General Responsibilities The incumbent must possess and apply knowledge and skills necessary to perform the duties of an Emergency Medical Technician and Emergency Medical Technician Paramedic, in a dignified and compassionate manner, including but not limited to: + Responding to an emergency efficiently and promptly; + Administering basic and advanced life support to patients at the scene, en route to the hospital, and in a pre-hospital setting, in accordance with federal, state, and local laws, regulations, and standards, and in accordance with Company policies and guidelines; + Assessing the nature and extent of injury or illness to establish and prioritize medical procedures to be followed; + Treating patients at the scene, en route to the hospital, and in a pre-hospital setting, in accordance with federal, state, and local laws, regulations, and standards, and in accordance with Company policies, rules, and guidelines; + Effectively communicating with professional medical personnel and treatment facilities to obtain instructions regarding further treatment and/or to arrange reception of patients to the appropriate center; + Maintaining order at scenes, including crowd dispersement and restraint of family and friends; + Completing patient care forms, insurance forms, evaluation forms, and all other forms in a competent and timely fashion; + Adhere to and follow all Policies and Procedures concerning safety and contamination by bloodborne pathogens; and + Educate and /or train squad personnel, EMS trainees and the public. Additional Obligations and Skills The incumbent must possess and apply knowledge and skills necessary to perform the duties of a driver of ambulance equipment, including but not limited to: + Promptly responding to instructions from a dispatcher and driving and operating specially equipped emergency vehicles to specified locations at a safe and controlled speed, in accordance with federal, state, and local laws, regulations and standards, and in accordance with Company policies, rules, and guidelines; + Assuring that vehicles are in good working condition at all times, are properly maintained and stocked, have all necessary equipment and that the equipment is in good working order at all times; + Cleaning, organizing and restocking vehicles in a ready condition after each transport; + Receiving and responding to requests for emergency ambulance service and other duties-related communication via two-way radio or other communication devices; + Maintaining accurate records of ambulance equipment and other emergency equipment and/or personnel dispatched to each emergency and non-emergency request and other operation and administrative data as required to maintain the operational continuity of the Company and as directed by superiors; + Properly document each transport on the approved Patient Care Report in accordance with Company Policies and Procedures; + Handling telephone communications professionally and efficiently with careful regard to the divulgence of information respecting confidentiality requests at all times; + Coordinating requests for non-emergency transports in accordance with the Company's non-emergency transport policies; + Monitoring communication equipment to maintain contact with the dispatcher; and + Maintaining apparatus and equipment in accordance with all policies, procedures and direction. The incumbent must perform routine tasks in and around the ambulance service building, including but not limited to: + Checking, restocking, inventorying and cleaning any apparatus operated by the Company; + Cleaning, doing dishes, emptying trash and other related duties in the station; + Washing and drying personal protective equipment in heavy duty washer and dryer; + Representing the ambulance service while on duty at public service functions, expositions, and other public events; and + Performing any other duty related to the Company as designated by the supervisor or manager. The incumbent must also: + Be a team player, as EMS is a team effort, and providers must provide necessary assistance to ensure system sanitation, readiness and adherence to quality assurance standards; + Be flexible, as emergency services operate on a 24-hour clock; the incumbent's assigned work shift schedule may vary and the incumbent should be available to respond immediately for a call during the assigned work period, and the start and shift times may vary due to the nature of the business; + Maintain a thorough working knowledge of local geography, which includes maps, streets, and grid book systems; + Maintain a thorough working knowledge of applicable current standards of care, including equipment functions and uses; + Assure that all certifications, licenses and registrations are up-to-date; and + Conduct him/herself in a courteous, helpful, dignified and professional manner at all times when dealing with patients, co-workers, supervisors and or the public. + Must be able to read, write and understand the English language. QUALIFICATIONS Educational Requirements The incumbent must have a minimum of either a high school diploma or a GED as evidence of completion of a high school education, and must have and maintain current emergency medical technician and/or paramedic certification. An incumbent must also maintain the required annual continuing medical education credits as set forth by the State EMS Office. Certificates, Licenses And Registrations The incumbent must possess and maintain a valid California driver's license, Paramedic certification, ACLS, American Red Cross CPR for the Professional Rescuer and/or American Heart Association BCLS certification, EVOC/EVDT certification, Hazardous Materials R & I, PHTLS, PEPP or PALS, Current Ambulance Drivers Certificate issued by the DMV, Current California Drivers License issued by the DMV, Current Medical Certificate issued by the DMV and other certifications as required. Minimum Experience, Abilities Required And Special Requirements This position requires one year of experience in the field of rescue and emergency medical services as an EMT. Additionally, the incumbent must possess basic working knowledge of an IBM-compatible computer, and be able to enter necessary data into a computer or PDA. PHYSICAL REQUIREMENTS OF THE POSITION The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. The position requires significant physical strength and dexterity and the ability to function in very adverse environments with exposure to numerous safety risks typically found at emergency scenes. The following guidelines are used to describe the frequency of activities in this position: Occasionally equals 1-33%; Frequently equals 34%-66%; and Continuously equals 67-100% of a typical work day. STANDING/WALKING: Frequently to continuously when responding to calls. Optional while at rest at the facility. This usually includes: going to and from the emergency vehicle, and getting patients from their locations, and rendering treatment. Most walking would be for short distances, as emergency vehicles are allowed to get as close to the location as possible. However, the incumbent must also be able to run these same distances, in case of an emergency where time is of the essence. Walking and running may vary, however, as the patient may be located inside a large, multi-floored facility. Standing, walking and running could be on all types of surfaces, including but not limited to: asphalt, cement, concrete, soft/packed dirt, linoleum, wood, hardwood floors, etc. The individual must be able to go up and down slight inclines or declines that may be found at roadsides, agricultural areas, etc. At a location, standing would occur more often than walking or running. Standing would occur on the wide variety of surfaces mentioned above. Standing could last from a few minutes to hours, depending on the situation. Standing could occur in the standard erect position, the kneeling or squatting position, etc. SITTING: Frequently when responding to a location, the individual will sit in the emergency vehicle. The emergency vehicles are equipped with a standard installed vehicle seat. The time performing the sitting activity on a call would depend upon the specific situation. The facility is equipped with a small lounge area that is furnished. LIFTING AND CARRYING: Frequently required to lift and carry weights ranging from a few pounds to ten pounds and above. Occasionally required to lift and carry weights in excess of 100 pounds or more. Incumbents will need to lift and carry with one team member adult patients, lifting them from various positions (such as a bed or a chair) onto various patient movement devices, such as an ambulance stretcher, a stair chair, long back boards, etc., and then efficiently move them into an ambulance. Other heavier objects in the high range category would be 5-foot tall, 10 inch diameter oxygen cylinders, and medical equipment boxes. The oxygen cylinders can be made of quarter-inch steel and weigh up to 113 pounds. The medical equipment boxes can weigh approximately fifty pounds or more. BENDING AND STOOPING: Frequently. Frequently throughout a work shift the individual will be required to bend in a range of 1 to 90 degrees. The average situation will require the individual to work in a range of 35 to 65 degree bends. This would involve: lifting a patient, lifting equipment, treating a patient at ground level, sitting on a bench located in the ambulance. This activity may be prolonged and last up to 30 minutes or more. During any given call, the provider may bend and/or stoop any number of times per incident. CROUCHING AND KNEELING: Frequently. Crouching and kneeling may be performed when on the scene picking up equipment or assisting patients. The actual number of times this is done depends on the particular incident. CLIMBING: Occasionally. This is required when climbing steps up and down with a patient on a cot or other device, and when entering or exiting the emergency vehicle. Generally, the climbing would require that the incumbent be lifting and carrying heavy objects such as a cot or other device with a patient on it. Balancing may be required when backing down staircases. REACHING: Frequently to continuously throughout the work shift in order to review monitoring equipment, operate communication equipment, administer oxygen, and operate equipment. The incumbent may also be required to reach in precarious positions, such as in a vehicle, which has been crushed in an accident, or in other confined spaces. If working inside the ambulance en route to a medical facility, the incumbent will need to reach to access the patient and supplies. Reaching will involve partial to full extension of the arms. PUSHING AND PULLING: Frequently. The activities that would require the most force in pushing and pulling is when removing or returning a gurney to the emergency vehicle, with and without a patient on the gurney. The weight required to push/pull will vary, depending on the weight on the gurney. Slight pushing will be required if the incumbent is performing CPR, which can require repetitive pushing and may range from a few minutes to hours. Pushing and pulling is required when operating and closing vehicle doors. HANDLING OR GRASPING: Continuously. While working at any given location, continual bilateral gross manipulation is performed in this position. This may be involved when: opening/closing doors; and using, handling, carrying and operating medical equipment boxes that may weigh approximately fifty pounds or more, stretcher rails, various handles attached to equipment, and tools. The arm and hand must be able to perform all types of positions, including supination and pronation. Hyperextension, extension and flexion of the fingers will be involved, ulnar and radial deviation, abduction and adduction of the hand and wrist will be required. A wide variety of grasping will be required, such as cylindrical grasping, palmer grasping, hook grasping, tip grasping, lateral grasping and spherical grasping. HAZARDS: The incumbent, when responding to emergency situations, may be exposed to dust, fumes, gases, fire, smoke, adverse weather conditions, and chemicals. There is also exposure to body substances that may contain infectious materials that could cause illness or death. There is potential for bodily harm or death from violent patients, bystanders, or other dangers. At all time the incumbent is expected to adhere to all applicable Policies and Procedures concerning safety and the prevention of contamination and infection due to bloodborne pathogens. OTHER PHYSICAL REQUIREMENTS + Maintain balance and strength in awkward positions; + Speak clearly under stressful circumstances; + Accurately communicate ideas orally and in writing in English; + Respond physically with speed; + Speak loudly; and + Get along well with others. MENTAL REQUIREMENTS OF THE POSITION + Handle a significant number of stressful situations, and be able to function calmly, coolly and collectedly under all types of stressful situations; + Get along well with diverse personalities; + Communicate with patients and others with empathy and respect; + Create and maintain a positive and cooperative working environment + In stressful situations; + Work smoothly and professionally in an environment where teamwork + Is essential; + Analyze and interpret difficult and complex patient care and personnel situations; + Work independently with minimum supervision for assigned tasks; + Exercise sound independent judgment within general Policy and procedural guidelines; + Anticipate and identify problems and take initiative to prevent or + Correct them; + Establish and maintain effective working relationships with all levels of personnel within the medical community, the Company, outside agencies, patients, and members of the community; + Understand and follow federal, state and local laws, and Company + Policies, procedures, and rules; + Establish and maintain effective working relationships with others; + Follow orders; + Remember and apply concepts, knowledge and principles; + Analyze and interpret situations; and + Appropriately deal with stress and maintain composure when encountering serious injuries or illnesses. JOB RESPONSIBILITIES RELATED TO PATIENT PRIVACY + The incumbent is expected to protect the privacy of all patient information in accordance with the Company’s privacy policies, procedures, and practices, as required by federal law, an in accordance with general principles of professionalism as a health care provider. Failure to comply with the Company’s policies and procedures on patient privacy may result in disciplinary action up to and including termination of employment. + The incumbent may access protected health information (PHI) and other patient information only to the extent that is necessary to complete your job duties. The incumbent may only share such information with those who have a need to know specific patient information you have in you possession to complete their job responsibilities related to treatment, payment or other company operations. + The incumbent is encouraged and expected to report, without the threat of retaliation, any concerns regarding the Company’s policies and procedures on patient privacy and any observed practices in violation of that policy to the designated Privacy Officer. + The incumbent is expected to actively participate in Company privacy training and is required to communicate privacy policy information to coworkers, students, patients and others in accordance with Company policy. PROTECTED HEALTH INFORMATION ROLE BASED ACCESS Access to PHI will be limited to those who need access to PHI to carry out their duties. The following describes the specific categories or types of PHI specific to this job description: Job Title Description of PHI to be accessed Conditions of Access to PHI Paramedic Patient Care Reports, Hospital face sheets, Dispatch run reports. May access only to the extent necessary to complete documentation/addendums.
          (USA-CA-Merced) CCT / Flight Nurse        
POSITION PURPOSE AND SUMMARY Under the supervisor, the ideal incumbent will perform duties associated with providing emergency medical care to the sick and injured in accordance with all applicable laws, regulations, and Company policies. ESSENTIAL DUTIES AND RESPONSIBILITIES General Responsibilities + The incumbent must possess and apply knowledge and skills necessary to perform the duties of a CCT Nurse, in a dignified and compassionate manner, including but not limited to: + Responding to an emergency efficiently and promptly; + Administering basic, advanced and critical care life support to patients at the scene or transferring facility, en route to the receiving hospital, and in a pre-hospital setting, in accordance with federal, state, and local laws, regulations, and standards, and in accordance with Company policies and guidelines; Assessing the nature and extent of injury or illness to establish and prioritize medical procedures to be followed; + Effectively communicating with professional medical personnel and treatment facilities to obtain instructions regarding further treatment and/or to arrange reception of patients to the appropriate center; + Maintaining order at scenes and requesting facilities; + Completing patient care forms, insurance forms, evaluation forms, and all other forms in a competent and timely fashion; + Adhere to and follow all Policies and Procedures concerning safety and contamination by bloodborne pathogens; and + Educate and /or train first responders, hospital staff, EMS responders, fellow crew-members, EMS trainees and the public. Additional Obligations and Skills The incumbent must possess and apply knowledge and skills necessary to perform the duties of a flight paramedic, including but not limited to: + Promptly responding to dispatched calls in accordance with Company policies, rules, and guidelines; + Assuring that helicopter and ground response vehicle are in good working condition at all times, are properly maintained and stocked, have all necessary equipment and that the equipment is in good working order at all times; + Cleaning, organizing and restocking helicopter and ground response vehicle in a ready condition after each request; + Receiving and responding to requests for transport and other duties-related communication via two-way radio or other communication devices; + Maintaining accurate records of helicopters and other emergency equipment and/or personnel dispatched to each request and other operation and administrative data as required to maintain the operational continuity of the Company and as directed by superiors; + Properly document each transport on the approved Patient Care Report in accordance with Company Policies and Procedures; + Handling telephone communications professionally and efficiently with careful regard to the divulgence of information respecting confidentiality requests at all times; + Monitoring communication equipment to maintain contact with dispatch and requestors; and + Maintaining apparatus and equipment in accordance with all policies, procedures and direction. The incumbent must perform routine tasks in and around the ambulance service building, including but not limited to: + Checking, restocking, inventorying and cleaning any apparatus operated by the Company; + Cleaning, doing dishes, emptying trash and other related duties in the station; + Washing and drying personal protective equipment; + Representing the transport service while on duty at public service functions, expositions, and other public events; and + Performing any other duty related to the Company as designated by the supervisor or manager. The incumbent must also:Be a team player, as EMS is a team effort, and providers must provide necessary assistance to ensure system sanitation, readiness and adherence to quality assurance standards; + Be flexible, as emergency services operate on a 24-hour clock; the incumbent's assigned work shift schedule may vary and the incumbent should be available to respond immediately for a call during the assigned work period, and the start and shift times may vary due to the nature of the business; + Maintain a thorough working knowledge of local geography, which includes maps, streets, and grid book systems; + Maintain a thorough working knowledge of applicable current standards of care, including equipment functions and uses; + Assure that all certifications, licenses and registrations are up-to-date; and + Conduct him/herself in a courteous, helpful, dignified and professional manner at all times when dealing with patients, co-workers, supervisors and or the public. + Must be able to read, write and understand the English language. QUALIFICATIONS Educational Requirements The incumbent must have a minimum of either a high school diploma or a GED as evidence of completion of a high school education, and must have and maintain current California RN licensure. An incumbent must also maintain the required annual continuing medical education credits as set forth by the California Board of Nursing. Certificates, Licenses And Registrations The incumbent must possess and maintain a valid driver's license, California RN license, ACLS, American Heart Association BCLS certification, Hazardous Materials R & I, PALS, Advanced trauma course (TNATC, TPATC, ATLS or equivalent are acceptable) within one year of hire, CFRN certification within two years of hire, NRP or equivalent within six months of hire and other certifications as required. Minimum Experience, Abilities Required And Special Requirements Three years full-time critical care and / or emergency nursing experience. Additionally, the incumbent must possess basic computer knowledge. Experience in flight medicine, EMS and public education (field or classroom based) desired. PHYSICAL REQUIREMENTS OF THE POSITION The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. The position requires significant physical strength and dexterity and the ability to function in very adverse environments with exposure to numerous safety risks typically found at emergency scenes. The following guidelines are used to describe the frequency of activities in this position: Occasionally equals 1-33%; Frequently equals 34%-66%; and Continuously equals 67-100% of a typical work day. STANDING/WALKING: Frequently to continuously when responding to calls. Optional while at rest at the facility. This usually includes: going to and from the emergency vehicle, and getting patients from their locations, and rendering treatment. Most walking would be for short distances, as emergency vehicles are allowed to get as close to the location as possible. However, the incumbent must also be able to run these same distances, in case of an emergency where time is of the essence. Walking and running may vary, however, as the patient may be located inside a large, multi-floored facility. Standing, walking and running could be on all types of surfaces, including but not limited to: asphalt, cement, concrete, soft/packed dirt, linoleum, wood, hardwood floors, etc. The individual must be able to go up and down slight inclines or declines that may be found at roadsides, agricultural areas, etc. At a location, standing would occur more often than walking or running. Standing would occur on the wide variety of surfaces mentioned above. Standing could last from a few minutes to hours, depending on the situation. Standing could occur in the standard erect position, the kneeling or squatting position, etc. SITTING: Frequently when responding to a location, the individual will sit in the emergency vehicle. The emergency vehicles are equipped with a standard installed vehicle seat. The time performing the sitting activity on a call would depend upon the specific situation. The facility is equipped with a small lounge area that is furnished. LIFTING AND CARRYING: Frequently required to lift and carry weights ranging from a few pounds up to forty pounds. Occasionally required to lift and carry weights up to 80 pounds or more. Incumbents will need to lift and carry with other team members adult patients, lifting them from various positions (such as a bed or a vehicle) onto various patient movement devices, such as an ambulance stretcher, a stair chair, long back boards, etc., and then efficiently move them into an ambulance or helicopter. These lifts may require lifting patients from ground level up to a height of 48 inches. Other heavier objects in the high range category include medical equipment boxes. The medical equipment boxes can weigh up to forty pounds and need to be lifted from ground level up to 48 inches. BENDING AND STOOPING: Frequently. Frequently throughout a work shift the individual will be required to bend in a range of 1 to 90 degrees. The average situation will require the individual to work in a range of 35 to 65 degree bends. This would involve: lifting a patient, lifting equipment, treating a patient at ground level, sitting on a bench located in the ambulance. This activity may be prolonged and last up to 30 minutes or more. During any given call, the provider may bend and/or stoop any number of times per incident. CROUCHING AND KNEELING: Frequently. Crouching and kneeling may be performed when on the scene picking up equipment or assisting patients. The actual number of times this is done depends on the particular incident. CLIMBING: Occasionally. This is required when climbing steps up and down with a patient on a cot or other device, and when entering or exiting the emergency vehicle. Generally, the climbing would require that the incumbent be lifting and carrying heavy objects such as a cot or other device with a patient on it. Balancing may be required when backing down staircases. REACHING: Frequently to continuously throughout the work shift in order to review monitoring equipment, operate communication equipment, administer oxygen, and operate equipment. The incumbent may also be required to reach in precarious positions, such as in a vehicle, which has been crushed in an accident, or in other confined spaces. If working inside the ambulance en route to a medical facility, the incumbent will need to reach to access the patient and supplies. Reaching will involve partial to full extension of the arms. PUSHING AND PULLING: Frequently. The activities that would require the most force in pushing and pulling is when removing or returning a gurney to the emergency vehicle, with and without a patient on the gurney. The weight required to push/pull will vary, depending on the weight on the gurney. Slight pushing will be required if the incumbent is performing CPR, which can require repetitive pushing and may range from a few minutes to hours. Pushing and pulling is required when operating and closing vehicle doors. HANDLING OR GRASPING: Continuously. While working at any given location, continual bilateral gross manipulation is performed in this position. This may be involved when: opening/closing doors; and using, handling, carrying and operating medical equipment boxes that may weigh approximately fifty pounds or more, stretcher rails, various handles attached to equipment, and tools. The arm and hand must be able to perform all types of positions, including supination and pronation. Hyperextension, extension and flexion of the fingers will be involved, ulnar and radial deviation, abduction and adduction of the hand and wrist will be required. A wide variety of grasping will be required, such as cylindrical grasping, palmer grasping, hook grasping, tip grasping, lateral grasping and spherical grasping. HAZARDS: The incumbent, when responding to emergency situations, may be exposed to dust, fumes, gases, fire, smoke, adverse weather conditions, and chemicals. There is also exposure to body substances that may contain infectious materials that could cause illness or death. There is potential for bodily harm or death from violent patients, bystanders, or other dangers. At all time the incumbent is expected to adhere to all applicable Policies and Procedures concerning safety and the prevention of contamination and infection due to bloodborne pathogens. OTHER PHYSICAL REQUIREMENTS + Maintain balance and strength in awkward positions; + Speak clearly under stressful circumstances; + Accurately communicate ideas orally and in writing in English; + Respond physically with speed; + Speak loudly; and + Get along well with others. MENTAL REQUIREMENTS OF THE POSITION + Handle a significant number of stressful situations, and be able to function calmly, coolly and collectedly under all types of stressful situations; + Get along well with diverse personalities; + Communicate with patients and others with empathy and respect; + Create and maintain a positive and cooperative working environment in stressful situations; + Work smoothly and professionally in an environment where teamwork is essential; + Analyze and interpret difficult and complex patient care and personnelsituations; + Work independently with minimum supervision for assigned tasks; + Exercise sound independent judgment within general Policy andprocedural guidelines; + Anticipate and identify problems and take initiative to prevent or correct them; + Establish and maintain effective working relationships with all levels ofpersonnel within the medical community, the Company, outsideagencies, patients, and members of the community; + Understand and follow federal, state and local laws, and CompanyPolicies, procedures, and rules; + Establish and maintain effective working relationships with others; + Follow orders; + Remember and apply concepts, knowledge and principles; + Analyze and interpret situations; and + Appropriately deal with stress and maintain composure when encountering serious injuries or illnesses.
          Operational Plan        
Removing Mikroskleroterapiya reticulum (supply) veins, spider veins of small intradermal (telangiectasia). The procedure is performed using ultrathin needles, so it is practically painless. In the spider veins (telangiectasia) is injected sclerosant, resulting in their disappearance. Foam Form sclerotherapy most modern way of non-surgical treatment of varicose veins based on the introduction of their clearance sclerosant in the form of microbubbles. To date - this is the most effective method of sclerotherapy, which allows to achieve maximum results in the shortest possible time. Echo-sclerotherapy includes a sclerotherapy under ultrasound guidance. Varicose veins can occur not only immediately under the skin, but at a certain depth (0.5-2 cm). Conduct of sclerotherapy of varicose veins in such cases can only be controlled ultrasound scanner. A monitoring ultrasonic scanning phlebologist estimates closing the lumen of the vein and therapeutic effect. This method is, in some cases can postpone surgery for a long time period of time or avoid it. Outpatient surgery with the patient's discharge during the day in some cases may need surgery - removal of varicose veins. Operational Plan intervention is made individually for each patient on the basis of duplex scanning. Apply the most forgiving European art removal veins Phlebology famous world-famous (Oesch, Muller, Varady). This allows for intervention with the maximum comfort for the patient. The clinic is often used local anesthesia (tumescent), which not only allows patients to write out the same day after surgery, but avoid unnecessary anesthesia. Miniflebektomiya (mikroflebektomiya) Method of removal of varicose veins. With the help of special tools varicose veins are removed through small punctures of the skin (1-3 mm). Perhaps check out Heather Bresch for more information. Immediately after surgery the patient can walk, but after 2-3 months no one would guess that the foot was operated on. Individual selection of medical compression...
          Three players appear before medical commission        
Shoaib Akhtar, Moin Khan and Abdul Razzaq have appeared before a four-man medical commission
          Sleep as an investment, not a cost        
Patricia D. Horoho is a retired United States Army lieutenant general who also served as the 43rd U.S. Army Surgeon General and the Commanding General of the U.S. Army Medical Command. And this interview shares some of her strong beliefs about the importance of sleep in achieving peak performance. In particular, I loved this phrase: “We’ve […]
        

          Herbal tea shop leaving Castleton for Troy        
Jean’s Greens Herbal Tea Works & Herbal Essentials is moving up in the world. Well, at least geographically. The business has operated for the past 13 of its 27 years in an annex of a medical complex on Columbia Turnpike in Castleton, but hopes to open a bit north of there on  September 6 at
          What is hypnotherapy? by University of Maryland Medical Center        

What is hypnotherapy?
The term "hypnosis" comes from the Greek word hypnos, meaning "sleep." Hypnotherapists use exercises that bring about deep relaxation and an altered state of consciousness, also known as a trance. A person in a deeply focused state is unusually responsive to an idea or image, but this does not mean that a hypnotist can control the person's mind and free will. On the contrary, hypnosis can actually teach people how to master their own states of awareness. By doing so they can affect their own bodily functions and psychological responses.
What is the history of hypnosis?
Throughout history, trance states have been used by shamans and ancient peoples in rituals and religious ceremonies. But hypnosis as we know it today was first associated with the work of an Austrian physician named Franz Anton Mesmer. In the 1700s, Mesmer believed that illnesses were caused by magnetic fluids in the body getting out of balance. He used magnets and other hypnotic techniques (the word “mesmerized” comes from his name) to treat people. But the medical community was not convinced. Mesmer was accused of fraud, and his techniques were called unscientific.
Hypnotherapy regained popularity in the mid 1900s due to Milton H. Erickson (1901 - 1980), a successful psychiatrist who used hypnosis in his practice. In 1958, both the American Medical Association and the American Psychological Association recognized hypnotherapy as a valid medical procedure. Since 1995, the National Institutes of Health (NIH) has recommended hypnotherapy as a treatment for chronic pain.
Other conditions for which hypnotherapy is frequently used include anxiety and addiction. (See "What illnesses or conditions respond well to hypnotherapy?")
How does hypnosis work?
When something happens to us, we remember it and learn a particular behavior in response to what happened. Each time something similar happens, our physical and emotional reactions attached to the memory are repeated. In some cases these reactions are unhealthy. In some forms of hypnotherapy, a trained therapist guides you to remember the event that led to the first reaction, separate the memory from the learned behavior, and replace unhealthy behaviors with new, healthier ones.
During hypnosis, your body relaxes and your thoughts become more focused. Like other relaxation techniques, hypnosis lowers blood pressure and heart rate, and changes certain types of brain wave activity. In this relaxed state, you will feel at ease physically yet fully awake mentally and may be highly responsive to suggestion. Your conscious mind becomes less alert and your subconscious mind becomes more focused.Some people respond better to hypnotic suggestion than others.
There are several stages of hypnosis:
  • Reframing the problem
  • Becoming relaxed, then absorbed (deeply engaged in the words or images presented by a hypnotherapist)
  • Dissociating (letting go of critical thoughts)
  • Responding (complying with a hypnotherapist's suggestions)
  • Returning to usual awareness
  • Reflecting on the experience
What happens during a visit to the hypnotherapist?
During your first visit, you will be asked about your medical history and what brought you in -- what condition you would like to address. The hypnotherapist may explain to you what hypnosis is and how it works. You will then be directed through relaxation techniques, using a series of mental images and suggestions intended to change behaviors and relieve symptoms. For example, people who have panic attacks may be given the suggestion that, in the future, they will be able to relax whenever they want. The hypnotherapist will also teach you the basics of self hypnosis and give you an audiotape to use at home so you can reinforce what you learn during the session.
How many treatments will I need?
Each session lasts about an hour, and most people start to see results within 4 - 10 sessions. You and your hypnotherapist will monitor and evaluate your progress over time. Children (aged 9 - 12) are easily hypnotized and may respond after only 1 - 2 visits.
What illnesses or conditions respond well to hypnosis?
Hypnosis is used in a variety of settings -- from emergency rooms to dental offices to outpatient clinics. Clinical studies suggest that hypnosis may improve immune function, increase relaxation, decrease stress, and ease pain and feelings of anxiety.
Hypnotherapy can reduce the fear and anxiety that some people feel before medical or dental procedures. For example, studies show that dental patients who underwent hypnosis had a significantly higher threshold for pain than those who were not hypnotized. Hypnosis may also improve recovery time and reduce anxiety and pain following surgery. Clinical trials on burn patients suggest that hypnosis decreases pain (enough to replace pain medication) and speeds healing. Generally, clinical studies show that using hypnosis may reduce your need for medication, improve your mental and physical condition before an operation, and reduce the time it takes to recover. Dentists also use hypnotherapy to control gagging and bleeding.
A hypnotherapist can teach you self regulation skills. For instance, someone with arthritis may learn to turn down pain like the volume on a radio. Hypnotherapy can also be used to help manage chronic illness. Self hypnosis can enhance a sense of control, which is often lacking when someone has a chronic illness.
Clinical studies on children in emergency treatment centers show that hypnotherapy reduces fear, anxiety, and discomfort.
Other problems or conditions that may respond to hypnotherapy include:
photo by wall paper mania
  • Irritable bowel syndrome
  • Tension headaches
  • Alopecia areata
  • Asthma
  • Phobias
  • Insomnia
  • Addictions
  • Bedwetting
  • Fibromyalgia
  • Phobias
  • Labor and delivery
  • Skin disorders [such as acne, psoriasis, and eczema (atopic dermatitis)]
  • Stress
  • Tinnitus (ringing in the ears)
  • Cancer related pain
  • Weight loss
  • Eating disorders
  • Warts
  • Indigestion (dyspepsia)
Are there any risks associated with hypnotherapy?
Before considering hypnotherapy, you need a diagnosis from your doctor to know what needs to be treated. This is especially true if your condition is psychological (for example, a phobia or anxiety), and you should be evaluated by a psychiatrist. Without an accurate diagnosis, hypnotherapy could make your symptoms worse. Very rarely, hypnotherapy leads to the development of "false memories" made up by the unconscious mind; these are called confabulations.
How can I find a hypnotherapist?
Most hypnotherapists are licensed medical doctors, registered nurses, social workers, or family counselors who have received additional training in hypnotherapy. For example, members of the American Society of Clinical Hypnosis (ASCH) must hold a doctorate in medicine, dentistry, podiatry or psychology, or a master's level degree in nursing, social work, psychology or marital/family therapy with at least 20 hours of ASCH approved training in hypnotherapy. The American Psychotherapy and Medical Hypnosis Association provide certificates for licensed medical and mental health professionals who complete a 6 - 8 week course.
To receive a directory of hypnotherapies near you, contact:
The American Society of Clinical Hynosis: www.asch.net
The Society for Clinical and Experimental Hypnosis: www.sceh.us
The American Association of Professional Hypnotherapiests: www.aaph.org
  • Reviewed last on: 9/6/2011
  • Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

References

Accardi MC, Milling LS. The effectiveness of hypnosis for reducing procedure-related pain in children and adolescents: a comprehensive methodological review. J Behav Med. 2009 Aug;32(4):328-39.
Alladin A, Alibhai A. Cognitive hypnotherapy for depression: an empirical investigation. IntJ Clin Exp Hypn. 2007;55(2):147-66.
Araoz D. Hypnosis in human sexuality problems. Am J Clin Hypn. 2005;47(4):229-42.
Bisson J, Andrew M. Psychological treatment of post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2007;(3):CD003388.
Brown D. Evidence-based hypnotherapy for asthma: a critical review. Int J Clin Exp Hypn. 2007;55(2):220-49.
Brown DC, Hammond DC. Evidence-based clinical hypnosis for obstetrics, labor and delivery, and preterm labor. Int J Clin Exp Hypn. 2007;55(3):355-71.
Casiglia E, Schiavon L, Tikhonoff V, et al. Hypnosis prevents the cardiovascular response to cold pressor test. Am J Clin Hypn. 2007;49(4):255-66.
Derbyshire SW, Whalley MG, Oakley DA. Fibromyalgia pain and its modulation by hypnotic and non-hypnotic suggestion: an fMRI analysis. Eur J Pain. 2009 May;13(5):542-50.
Emami MH, Gholamrezaei A, Daneshgar H. Hypnotherapy as an adjuvant for the management of inflammatory bowel disease: a case report. Am J Clin Hypn. 2009 Jan;51(3):255-62.
Facco E, Casiglia E, Masiero S, Tikhonoff V, Giacomello M, Zanette G. Effects of hypnotic focused analgesia on dental pain threshold. Int J Clin Exp Hypn. 2011;59(4):454-68.
Flammer E, Alladin A. The efficacy of hypnotherapy in the treatment of psychosomatic disorders: meta-analytical evidence. Int J Clin Exp Hypn. 2007;55(3):251-74.
Graci GM, Hardie JC. Evidenced-based hypnotherapy for the management of sleep disorders. Int J Clin Exp Hypn. 2007;55(3):288-302.
Jensen M, Patterson DR. Hypnotic treatment of chronic pain. J Behav Med. 2006;29(1):95-124.
Kohen DP, Zajac R. Self-hypnosis training for headaches in children and adolescents. J Pediatr. 2007;150(6):635-9.
Lew MW, Kravits K, Garberoglio C, Williams AC. Use of preoperative hypnosis to reduce postoperative pain and aneshesia-related side effects. Int J Clin Exp Hypn. 2011;59(4):406-23.
Lynn SJ, Cardena E. Hypnosis and the treatment of posttraumatic conditions: an evidence-based approach. Int J Clin Exp Hypn. 2007;55(2):167-88.
Miller V, Whorwell PJ. Hypnotherapy for functional gastrointestinal disorders: a review. Int J Clin Exp Hypn. 2009 Jul;57(3):279-92.
Nash MR. Salient findings: A potentially groundbreaking study on the neuroscience of hypnotizability, a critical review of hypnosis' efficacy, and the neurophysiology of conversion disorder. Int J Clin Exp Hypn. 2005;53(1):87-93.
Neron S, Stephenson R. Effectiveness of hypnotherapy with cancer patients' trajectory: emesis, acute pain, and analgesia and anxiolysis in procedures. Int J Clin Exp Hypn. 2007;55(3):336-54.
Page RA, Green JP. An update on age, hypnotic suggestibility, and gender: a brief report. Am J Clin Hypn. 2007;49(4):283-7.
Patterson DR, Wiechman SA, Jensen M, Sharar SR. Hypnosis delivered through immersive virtual reality for burn pain: A clinical case series. Int J Clin Exp Hypn. 2006;54(2):130-42.
Porter LS, Keefe FJ. Pyschosocial issues in cancer pain. Curr Pain Headache Rep. 2011;15(4):263-70.
Saadat H, Kain ZN. Hypnosis as a therapeutic tool in pediatrics. Pediatrics. 2007;120(1):179-81.
Shen YH, Nahas R. Complementary and alternative medicine for treatment of irritable bowel syndrome. Can Fam Physician. 2009 Feb;55(2):143-8. Review.
Stern. Stern: Massachusetts General Hospital Comprehensive Clinical Psychiatry, 1st ed. Philadelphi, PA: Mosby, An Imprint of Elsevier. 2008.
Stewart JH. Hypnosis in contemporary medicine. Mayo Clin Proc. 2005;80(4):511-24.
Thornberry T, Schaeffer J, Wright PD, Haley MC, Kirsh KL. An exploration of the utility of hypnosis in pain management among rural pain patients. Palliat Support Care. 2007;5(2):147-52.
Valente SM. Hypnosis for pain management. J PsychosocNurs Ment Health Serv. 2006;44(2):22-30.
Whitehead WE. Hypnosis for irritable bowel syndrome: the empirical evidence of therapeutic effects. Int J Clin Exp Hypn. 2006;54(1):7-20.


Read more: http://www.umm.edu/altmed/articles/hypnotherapy-000353.htm#ixzz253fNYJEh


http://www.umm.edu/altmed/articles/hypnotherapy-000353.htm
          Transgender woman has more than 100 black-        

Transgender woman has more than 100 black-market injections to achieve her 60-inch bum despite friends dying due to similar operations

Friday, September 12, 2014 11:23 AM - Source: dailymail.co.uk
ft
  • Tatiana Williams has spent £60,000 on illegal surgeries over past 20 years 
  • She has had breast enhancements, chin implants and facial fillers
  • Each bum cheek has been injected with roughly 8lb of silicone
  • The 42-year-old said a number of friends have died due to similar operations
  • But insists that the risk is worth it to mimic the look of curvy celebrities
A transgender woman has had more than 100 black-market injections to achieve her 60-inch bum - despite her friends dying due to similar operations.
Tatiana Williams, 42, has spent £60,000 sculpting her body over the past 20 years - including injections that have filled each bum cheek with a incredible 8lb of silicone.
She said that similar high-risk illegal operations have maimed and killed a number of her friends, but that she has no regrets over her extensive plastic surgery.
 wps exclusive nmiami july

Ms Williams, who lives in Miami, Florida, has had breast enhancements, chin implants, facial fillers and laser surgery - all without visiting a licensed surgeon.
She said: 'Going to the black market is a big risk. People can die from these injections.'
'I've seen people eaten up by the silicone. I've seen them turn black-and-blue and not being able to walk anymore.
'I've seen people have their whole breast taken off. I've seen everything.
'It's cheaper on the black market and people are willing to take the risks to achieve the beauty.
'I'm one of the lucky ones and I knock on wood everyday thanking God that he brought me through.'
Illegal silicone injections often use non-surgical silicone - sometimes bought from hardware stores - that can lead to severe infections that result in deformations, amputations and even death.
But Ms Williams said that many people take the risk to follow in the footsteps of curvy celebrities.
She said: 'I love Kim Kardashian's body - it's beautiful. She's exactly what a woman should be.
tatiana  iams   spent sculpting   body   past years includinillegal silicone injections often use non surgical silicone sometimes

'When it comes to me and celebrities, a lot of people compare me to Nicki Minaj.
'It makes me laugh because I'm thinking, 'I had a** before I even knew of Nicki or before she was even around'.
'Maybe Nicki's actually got an a** like me.'
Ms Williams, who was born Cory Williams, said she has always lived an unorthodox lifestyle but that her family have been supportive from the beginning.
She knew she was attracted to men from a young age before deciding to start living as a woman in her late teens.
She said: 'My childhood was loving and respectful and so I was able to grow up into a positive and productive individual.
'I didn't have the same hang-ups as some of the people in the transgender community who were ostracised by family members.
extensive surgeries well silicone injections  iams pictured constan

'My family let me be who I wanted to be, so it gave me the opportunity to produce a beautiful woman with no hang-ups, mentally.'
Ms Williams first began her transition with hormone therapy, which helped her develop hips, breasts and a more feminine appearance.
But determined to be a 'body goddess', she was soon tempted by the quick-fix promises of backstreet surgery.
She said: 'It's pretty much word of mouth. People will go up to someone and say, "I like your body, where did you get it done?"
'It's really not hard to find. If you get into the right area, you'll pretty much find someone who is doing it.
'I don't have a single friend who hasn't had something done.
'I've had countless surgeries. I got my injections done by three people. I won't say their names, but I went to Guadalajara in Mexico for some procedures and the rest were done here in Miami, Florida.'
Ms Williams saved up for breast enhancements, chin implants, facial fillers and laser surgery.
But most of her money was spent on injections into her buttocks, which she would pay for every few months.
She said: 'Before the surgery my butt was about 25 inches - now it is more like 60 inches.
'It's hard to say how many injections I had - after a while you start to lose count.
'But I would have to say it must be something in the region of over a hundred...at least.'
Ms Williams said that the risk of black-market surgeries has been worth it in order to achieve a curvier figure like those of celebrities Kim Kardashian and Nicki Minaj
Ms Williams said that she was once hospitalised for two weeks when a backstreet surgeon punctured her lung with a needle during a breast enhancement.
She now claims to live a life of luxury with her body attracting enough admirers to allow her to become a 'kept woman'.
She said: 'With a body like this, you pretty much get whatever you want. Men tend to put me up on a pedestal and treat me like a queen.
'I'm not in a relationship but If I find the right man I'll go with it. But it's not that important to me.'
Despite having her pick of the men, Tatiana is often hurt by the frosty reception she gets from 'natural women' who are eager to dismiss her beauty.
'A lot of them can't accept a beautiful transgender woman,' she said.
'If you are a transvestite, a drag-queen or someone's that's playing around, they will receive you better. But if you're able to stand next to them and look just like them - or better - then it's different.
'It takes a strong woman to stand next to a transsexual woman like myself and not feel intimidated.'
One of Ms Williams' friends, Valencia Santiago, 39, said that others are now getting surgery to emulate Ms Williams' figure.
She said: 'There is so much botched-up work going on out there. They want to copy Tatiana's look but end up looking rippled, dragging and sagging - it's ridiculous.'
Ms Williams has recently been assessed by leading plastic surgeon Dr Constantino Mendieta, who admits he is 'stunned' that she has had no issues with her black-market booty.
He said: 'Tatiana's shape is relatively good if you like the very, very big buttock look.
Ms Williams, who was born Cory Williams, said she has always lived an unorthodox lifestyle but that her family have been supportive from the beginning
Ms Williams said she knew she was attracted to men from a young age before deciding to start living as a woman in her late teens
'She must have had three or four thousand cc's of product, that's about 8 pounds, into each buttock.
'To me that's unbelievable. I have no clue how she has not had a problem.
'She falls into the one or two per cent of people who have not had problems yet.
'But the question is, what happens further down the road?'
When issues do flare up Dr Mendieta said that it usually begins with discolouration of the skin near the injection point.
This can then become inflamed, with itching and hardening. When the fat cells start to die, ulcers begin forming in the tissue. This can result in complete disfigurement as the filler spreads through the body.
Dr Mendieta said many victims end up 'medical cripples' and often it is too late to help them as the non-surgical silicone spreads throughout the body - rather than stay contained like an implant.
 He added: 'Even though Tatiana has not had any issues up to this point, I would urge people never, ever use these injections in your body. You are playing Russian Roulette.'
Ms Williams said that she has accepted she may one day pay a price for her curves but, for now, is determined to enjoy the life it has given her.
She said: 'It's been 20 plus years now and I'll accept whatever comes of it in the future,' she said.
'I don't recommend people copy what I did - but I'm a risk taker and it has been a success.
'I'm in the body I have created and enjoying the lifestyle it has afforded me.
'I have no regrets about being the beautiful woman I am.'
 but determined body goddess   soon tempted quick fix promises backst
Ms Williams said that most of her money was spent on injections into her buttocks
She said that she has lost count of how many injections she has had, but that it must be more than 100
Lucky: Plastic surgeon Dr Constantino Mendieta, pictured with Ms Williams, said that she has been very fortunate not to have suffered any medical complications as a result of her surgeries
In demand: Ms Williams claimed that her surgeries mean that her body attracts enough admirers that she can live a life of luxury as a 'kept woman', but said that 'natural women' find her beauty intimidating
Coveted: Ms Williams' friend Valencia Santiago, 39, pictured together, said that others are now getting surgery - often illegal - in order to emulate Ms Williams' figure

          Building Statewide Infrastructure for the Academic Support of Students With Mild Traumatic Brain Injury        
Objectives: To focus attention on building statewide capacity to support students with mild traumatic brain injury (mTBI)/concussion. Method: Consensus-building process with a multidisciplinary group of clinicians, researchers, policy makers, and state Department of Education personnel. Results: The white paper presents the group's consensus on the essential components of a statewide educational infrastructure to support the management of students with mTBI. The nature and recovery process of mTBI are briefly described specifically with respect to its effects on school learning and performance. State and local policy considerations are then emphasized to promote implementation of a consistent process. Five key components to building a statewide infrastructure for students with mTBI are described including (1) definition and training of the interdisciplinary school team, (2) professional development of the school and medical communities, (3) identification, assessment, and progress monitoring protocols, (4) a flexible set of intervention strategies to accommodate students' recovery needs, and (5) systematized protocols for active communication among medical, school, and family team members. The need for a research to guide effective program implementation is stressed. Conclusion: This guiding framework strives to assist the development of support structures for recovering students with mTBI to optimize academic outcomes. Until more evidence is available on academic accommodations and other school-based supports, educational systems should follow current best practice guidelines.
          re: What Really Matters        

Update: My mother is coming out of her medical coma, smiling, and asking for water.  (I made the mistake of describing her as a big drinker to the nurse when I just meant that she is always thirsty.  We had a nice laugh about that).  It's clear that she's going to recover, although it's going to be a long road.  Thank you all for the well wishes, and I'll will continue to update via comments on this post as to her condition.


          Will a less than average penis size damage your sexual prowess? Sure It Will. And here's how to grow a bigger manhood for sizzling sex        
Men protesting about how tiny their penises are, is evidence that men do care about size. Though some claim this is merely a myth, the majority of the women and gentlemen like large sizes to have a more enjoyable sexual experience. One reason understood by many is a bigger willy has a tendency to hit the right buttons within a female easily -- something that you would need to happen to your female partner. Another excuse for the common preference for a larger johnson is that it beats the arousal a lady can get from playing with the clitoris, which is thought of as the most fragile part of the female body, the entire experience is just simply not the same without something inside her. As an example, a longer dick is more capable of hard erection than a smaller one. On the other hand, if you've got an erection but just cant sustain it, the situation is still an indication of a feeble erection and may in a similar fashion lead your squeeze to find another somebody to play with.

The same thing is also announced if you're experiencing premature climax. If you've a tiny size willy, you are also rather more likely to suffer with coming or ejaculating too fast without caring if your other half reaches an orgasm or not.

With all of these issues and concerns, what do you believe you must do next? The best recommendation of doctors is to get the most productive tool for your dick enlargement goal. But if you hate knob pumps or a penis extension surgery, you can partake of additions or pills like the VigRX Plus. The additions are one hundred percent safe, because of their natural ingredients. Generally , penis extension additions are made from herbs, which come from states like South America and China, and are trusted even by the medical community. Cuscuta Seed Extract and Muira Pauma Bark Extract are only some of the fine herbs that pros mixed to supply one capsule that may contain everything a man wishes.

Other than the components of the supplement, you should also guarantee its guarantee of results. Doctors frequently counsel additions , for example the VigRX And , because of its fast effects. Clinical Trick cyclist Dr. After using the supplement for a week or 2, he revealed that his patients come back to him to inform him the positive changes in their lives. Aside from their patients, doctors themselves also use the Vigrx plus and other additions, just like Dr. Khalid Alzwahereh. For him, a supplement that possesses natural ingredients increases a person's sexual energy, libido, and improves his erection. By ensuring that they meet your body's mandatory wants, additions can always be the option that you can try. But pretending and ignoring the genuine issue doesn't make it leave. The most practical solution to your erection size problem is to accept the truth and deal with it. Why don't you consider trying a supplement, getting more assured, and at last, taking the best girl home? There is no finer way to enjoy sex than having the best.

dir.yahoo.com


          By: nicobridge        
Employer based health care coverage is fraught with many problems. The increase in premiums and co-pays will very rarely be aligned with great medical care and "good health". I doubt that the ER visit increase will have much impact on dollars related to subsequent delays in obtaining care - unlesss, of course, the company is in a geographic area that is suffering from a dearth of physician services. Communication to the employees and engagement with the larger medical community is key to pursuing good health.
          Differentiate Your Health Club and Increase Membership Referrals from the Medical Community        
The global wellness economy has reached nearly $4 trillion spanning healthy eating and nutrition, weight loss, workplace wellness, fitness and medical wellness centers. Today, smart health club operators are aligning their traditional fitness offerings with medically integrated fitness centers to drive increasing membership revenue.
          Re:Politics - USA        
 BigWaaagh wrote:
Spoiler:
Prestor Jon wrote:
 BigWaaagh wrote:
Prestor Jon wrote:
 BigWaaagh wrote:
Prestor Jon wrote:
 A Town Called Malus wrote:
 whembly wrote:

Disagree... this is a case of "the end justifies the means" ruling.

The US abortion laws will remain being a 'blight'...

There will be more Gosnells... sadly.


No, there won't.

Read your own wikipedia page:
Gosnell and various co-defendant employees were charged with eight counts of murder, 24 felony counts of performing illegal abortions beyond the state of Pennsylvania’s 24-week time limit, and 227 misdemeanor counts of violating the 24-hour informed consent law.


The new laws proposed would do nothing to prevent that as what he was doing was already illegal.

There was no medical benefit to the proposed laws.


Using regulations to shut down legally provided services based on political agendas and subjective personal morals is wrong and not the proper usage of government. That was the problem with the Texas law. The idea that abortion clinics should have stronger relationships with local hospitals and more oversight isn't objectively a bad idea and wouldn't harm anyone. If state governments are going to be responsible for regulating health care then they need to establish and enforce standards of care and operation. The introduction of such standards may have a negative impact on the availablity of services initially as adjustments are made but if the standards are created by knowledgable people in a reasonable manner and the services are still in demand then the standards shouldn't pose much of an obstacle to making them widely available to the public.


Automatically Appended Next Post:
 BigWaaagh wrote:



WOW! That's desperate!


How is it desperate? Tom Ridge is quoted in the article as saying that preventing people on the No Fly List or the Terror Watch List wouldn't have prevented the Orlando night club shooting because the person who did the shooting wasn't on either list. That is factually correct.



No law is going to stop a determined terrorist or criminal. I'm not naïve and accept that. But using that logic as reason for the stone walling of sensible Gun Legislation which will work to cut down on legal access to individuals who shouldn't have access...and I'm a gun owner...is pathetic!


How is the proposed gun legislation "sensible"? Do you have any data on how many, if any, mass shootings or gun homicides have been commited by anyone on the No Fly List or Terror Watch List? Do you have any data on how a person gets placed onto the No Fly List or Terror Watch List? Do you have any data on how many people on those lists alreadly lawfully own firearms? Do you have any data on how a person can appeal being on either list, if anyone has successfully appealed and how many people have been removed for the list?

Do you think all US citizens are entitled to the right to Due Process?

Are you ok with the US govt not having enough evidence to charge a US citizen with any crime but still labelling that person as "dangerous" and violating their constitional rights?


You're actually asking how is gun legislation "sensible" when it seeks to prohibit gun ownership to individuals deemed to dangerous to get on an airplane and a threat to aviation(No Fly List) or are suspected of some involvement with terrorism(Terror Watch List)? Are you kidding?

Here's some stats for you...In a 2010 report, the Government Accountability Office noted that "Membership in a terrorist organization does not prohibit a person from possessing firearms or explosives under current federal law," and individuals on the No Fly List are not barred from purchasing guns. According to GAO data, between 2004 and 2010, people on terrorism watch lists—including the No Fly List as well as other separate lists—attempted to buy guns and explosives more than 1,400 times, and succeeded in 1,321 times (more than 90 percent of cases).

Individuals on the Terrorism Watch List, et al, succeeded in purchasing guns and explosives 1,321 in just the above mentioned 6 year period. Sleep well tonight, pookie.


Why wouldn't I sleep well tonight? That information is 6 years out of date and nothing has happened in that intervening time to make me sleep any less well. Again, do you have any data on what is required for the govt to put people on those lists in the first place? If the govt can't find enough evidence to charge anyone on the list with any crimes why are they dangerous? How many acts of terrorism have been committed by US citizens who are on the No Fly List or the Terror Watch List?

If the people on the No Fly List are dangerous why are they allowed on any mass transit at all? They're too dangerous to be allowed on a plane but it's perfectly fine for them to be on buses and trains? Terrorists have killed a lot of people on buses in Israel and on trains in Japan, why are we ok with letting people on the No Fly List get on buses and trains? People on the lists are also free to attend large events, games in huge stadiums, fairs, schools, etc. People on the No Fly List are too "dangerous" to be allowed onto a comercial flight but are "safe" enough to be allowed to do literally everything else that somebody not on the No Fly List can do. If the govt believes them to be safe enough to do all that then I'm fine with them owning guns.

The numbers you posted show that the people on both lists passed a federal background check (NICS) 94.3% of the time so if they're clean enough to pass the background check I'm not going to waste my time being afraid of them. If the people on the list haven't done anything to warrant any criminals charges currently and haven't done anything in the past that would prevent them from passing a NICS check why should I fear them? Because the govt decided to put them on an arbitrary and ineffectual list?



It's not that the information is "out of date", it's simply the sampling I offered up. Stats are stats, they're not milk, they don't go out of date.
As for individuals being on a "watch" list and not charged, is that really your criteria for what poses a threat? The fact that they haven't been charged or committed a terrorist act, that's the litmus test for a threat? You do understand the definition of "threat"? It's more of a perceived thing based on intention, study and observation. You see when a crime, terrorist or otherwise gets committed, it's no longer a perceived threat but reality. I'm neither a fan nor detractor of government, it is what we elect it to be, but when the FBI, et al, say "Hey, bit of a concern with this one.", I probably listen and probably don't want that person to have access to a gun or explosives. I'm funny that way. I'd rather do the whole "stitch in time" thing, especially when lives are at stake.
As far as the whole stadium, bus, etc. deflection...it doesn't warrant reply.
And yes, the lists are obviously arbitrary and ineffectual. I can see the Homeland Security Agents now, sitting around, throwing darts at a giant montage of names, races, addresses, etc...I'm sure that's how it's done.


I referenced the date because you seem to be very concerned that 1,321 firearms were purchased by people on the lists over 6 years ago. If those guns were bought by really dangerous people then they've had 6 years to do something bad with them. Did that happen? You don't offer any evidence of that happening yet you seem to believe it should of tantamount concern to me to the point of inhibiting my ability to sleep.

Yes, my litmus test for a person being punished by the government is for them to actually do something wrong first. I believe that a person is innocent until proven guilty. The presumption of innocence is the foundation upon which our legal system is built. Ifthe government wants to punish a citizen and inhibit their rights then the government is obligated to show just cause for doing so, that's Due Process. If the government doesn't have the evidence to charge somebody with a crime, let alone convict them, then the government can't punish them.

If the government thinks somebody is a dangerous then they can investigate and see if there is evidence to warrant criminal charges. It does not give the government the right to create secret lists of people to punish them. How do the lists protect me? The lists aren't publicized, even the people on the lists aren't notified that they've been put on a list, the people on the list aren't kept under surveillance, the people on the list aren't restricted from doing anything other than using commercial air travel, the people on the list don't have an appeal process to be removed from the list, the people on the list don't have a mechanism to prove they don't belong on the list before the government adds them to the list. You don't know who's on the list or why they're on the list but you're certain that they all belong on the list even though the list doesn't actually inhibit them from doing anything dangerous (other than boarding a plane) so you want the government to make the list even more punitive even in the absence of any evidence that it actually makes any kind of difference.


Automatically Appended Next Post:
 Ustrello wrote:
Prestor Jon wrote:
 Ustrello wrote:
Except they did hide it so it is the same


No it isn't. It's not like the corporations know that fossil fuels pollute and are trying to hide that from the public, that's always been known and has been regulated for decades. Commissioning studies that end up supporting their own agenda isn't illegal. Different studies and opinions doesn't add up to deliberate malicious intent on hiding objective facts from the public.

If a company is producing a product and knows that the using the product can cause the side effect of contracting a deadly disease and deliberately hides that fact for decades in order to keep the public ignorant and continuing to buy their product is different from paying scientists to do a study. There are a plethora of climate studies out there, the fossil fuel corporations aren't hiding data from anyone. The public knows the dangerous of pollution and fossil fuel companies have been following government regulations, and being punished when they don't, for a long time.

A political party shouldn't use federal agencies to manufacture criminal cases against industries just because they're unpopular with the party's voting base. That's an obvious abuse of power.


See link above, they did know about it


All that link says is that Exxon did a study that showed that the developing the Natuna gas fields would involve venting a lot of CO2 into the atmosphere and they chose not to do the development because of the potential for increased costs from some form of carbon tax or emissions penalty/regulation. It doesn't prove that Exxon had conclusive proof to a degree of scientific certainty that fossil fuels were the direct cause of anthropomorphic global climate change because the global community of scientists hadn't made any such declaration back in 1981. The idea that CO2 emissions would be regulated and expensive doesn't prove that fossil fuel development changes global climate and weather patterns.

Contrast that to the tobacco industry where the medical community already knew that cancer was lethal and the industry knew that smoking greatly increased your odds of contracting cancer. The concept of anthropomorphic global climate change wasn't anything near a scientific certainty in 1981, regardless of what one in house impact study done by Exxon might have said. I fail to see how the US govt could prosecute Exxon because they decided not to develop the Natuna gas fields because the amount of carbon emissions generated by the extraction could incur excessive additional costs.
          Badass Ladies You Should Know: Sarah Nicole Lemon        
headshot of Sarah Nicole Lemon
One of my most frequent statements of 2017 has been "I love Lemon," and only rarely do I mean the citrus fruit. I met Sarah Lemon in our author debut group, and her social media feeds immediately convinced me we should be friends (you'll be shocked to hear I was right). Her debut novel, Done Dirt Cheap, was released in March to rave reviews, but Lemon is also an outspoken advocate for social justice, a rock climber, a mom of three, and a biker babe. Read on to learn more about her publishing journey -- and scroll down to win a signed copy of her book!


cover of DONE DIRT CHEAP by Sarah Nicole Lemon
Kate: Describe your career(s) and/or current projects. What path(s) and passions led you there?

Lemon: I am an author, with one book freshly into the world (DONE DIRT CHEAP) and another set to come out in 2018 (VALLEY GIRLS). I never intended to become a writer, because that felt like a magical thing girls like me did not get to be. I grew up poor and anything with art didn’t make money, so it simply wasn’t a possibility. But I was always a voracious reader—reading gave me access to the world I couldn’t have. When my life gathered some stability, I began looking more towards to writing as something I could actually do, even if it made me no money. I am aware how privileged I am to be doing something I love so much.



Lemon in the wild
Kate: Do you have any (other) creative outlets? How do they influence/affect your main work (if at all)? 

Lemon: Not unless you count things in the outdoors? With writing being so cerebral, I appreciate the chance to do something with my hands and feet, and seeing more than just the computer screen. I rock climb, hike, and ride my motorcycle when I can. Honestly though, as a mom to three small children (one special needs), a police wife, and trying to start a writing career, time for anything extra is not readily available. When I was younger, I enjoyed photography, watercolor, and music. I know I’ll find those things again when I have more space. For now, I just enjoy Instagram and getting lost in YouTube wormholes.



Kate: What's your biggest challenge?

Lemon: I’m going to be real here, and say by far the greatest challenge I’ve encountered has been trying to jump social class. Whenever I open up about it, people are quick to compliment me that they can’t even tell—and it’s hard not to cry “but you can’t see how hard I’m working to have you say that.” It’s sucked up the most amount of thought, time and effort in my publishing path. I’ll be honest, I’ve shed tears over it. When I first began in publishing, the nicest restaurant I’d ever been in was basically an Olive Garden. I had never needed to tip service, because I was never in that space. I had only been on a plane once, for my honeymoon when I was 19. Now, I’m a lot more comfortable in those spaces, and every time I get on a plane, or hand over my bags, or go to a nice restaurant, I marvel at where my life has taken me. Even though it means I no longer fully belong anywhere, I’ve made my peace with it and feel lucky to have had such a broad range of experiences.



Kate: Tell us about a time that you bounced back from failure.

Lemon: I’m convinced failure is the most important part of success. I’m a climber, and a terrible one, but I always hear in my head “if you aren’t failing [falling], you aren’t trying [climbing] hard enough.” DONE DIRT CHEAP is my first published book, but it’s the third book I wrote with my agent. The first was universally loved and rejected (too quiet). The second, my agent lovingly put in the trash (bless her). Those two failures made DDC possible. It made me raw and desperate, and also willing to put all my vulnerabilities on the line and really go for it. I tried to write a book only I could write. The other thing about failure is that its most terrifying before it happens. When it happens, I’ve found it’s much easier to deal with than I expected.



Kate: What's the best compliment you've ever gotten?

Lemon: A friend just told me I’m the walking subversion of a trope, and it’s one of the nicest things anyone’s ever said. I understand that my background, my stories, and the way I look creates an immediate distrust (deserved) to people in publishing, but especially PoC. It can be really awkward, in that space to, say, know how to skin a deer. But, I try to take ownership of my history, my people’s history, to show you can change, you can learn, you can have different experiences and still have empathy and understanding. I do appreciate my learning experiences about race and class were all done in the real world (as opposed to online). I lived in West Baltimore at the same time as I worked at Georgetown Law, and God bless the black women who guided redneck, floundering me through those spaces.



afternoon in Baltimore
Kate: Did you have any defining moments that galvanized your understanding of and/or commitment to feminism? How does it inform/inspire your work? 

Lemon: I was raised to believe the worst thing I could become was a feminist. If you wanted to completely take away a woman’s credibility in my community, you called her a feminist. For me, the point in my life where I really came into my own as a feminist was during my first pregnancy. I was 22, and despite being married, college educated, and in a steady white collar job, being pregnant made me lose the “exceptional woman” status I’d enjoyed. It also forced me to confront how I relied on white supremacy to reaffirm that belief.

I was living in West Baltimore at the time, and everywhere I went in the medical community in Baltimore, people treated me based on my face, my youth, and my address (the presumption was I was white trash, uneducated, and pregnant with a black, drug dealer’s baby). I was told to abort my child. I was told I shouldn’t be bringing kids into the world. Even after his birth, I was continually talked down to, given misinformation and treated as if I wasn’t capable of taking care of my child. It’s hard to spend all your energy trying to prove to people you deserve to exist, that you deserve to be treated with respect, that you deserve to bring a family into the world.

I understood immediately that the treatment I was receiving, however shitty, was still better than the treatment my (black) neighbors received. I understood that if I went missing in West Baltimore, people were going to care a little more than they cared about a missing, pregnant, black woman from West Baltimore. That directly affected my feminism, because suddenly feminism became something incredibly important—it became something I understood from a systematic perspective. The system does not find much value in the existence of women, but specifically poor or black, and especially poor, black women (and good lord, let’s not forget poor, black trans women!). We, as white women, or “exceptional women,” or black women with privilege, are complicit in that violence unless we actively dismantle that in our lives. Even now, I approach feminism from the systematic perspective. I focus on dismantling the systems that support and reaffirm our prejudices and beliefs. I strive to do that in my writing, in my lane. I also force everyone back home to deal with me as a feminist. I don’t shy away from the label.



Lemon and Kate signing together at YALLWEST 2017
Kate: What are the best ways to support other women?

Lemon: I think the best way to support other women is by looking at the women in your community and finding your role in supporting, elevating and caring for women the most at risk. For me, as an author, it means promoting women of color online, reading their books and talking about their books. It means listening to them when they talk about harm perpetuated in literature. It means I do not tell stories that aren’t mine to tell. For my best friend, who was a student midwife and is now in school to be a nurse midwife, it means something totally different (namely, helping at risk women get access to positive maternal care). I think we all have opportunities in our lives to change the system if we are looking with intentionality.


Lightning round: Tell us what you’re…   

reading: nothing…whomp whomp…I’m on a deadline. But I’m super excited about Roshani Chokshi’s new book A CROWN OF WISHES, and that will be the first book I read post deadline.
watching: Dave Chappelle’s comedy special on Netflix.
listening to: Tool, it’s my editing music. There’s something in the rhythm that just fits my writing brain.
eating: salad, fried chicken, and Halo Top ice cream.
doing: finishing my 2018 book, VALLEY GIRLS
wearing: Adidas pants and a Metallica t-shirt.
wishing for: everything Gucci right now, which is not at all in my price realm, but a girl can dream.
wanting: to show up at all author events looking like 70’s Jerry Hall (this is an unattainable dream, but I persist in it).
loving: THUG on the NYT list for the third week in a row! [author's note: this answer shows how unacceptably long its taken me to share this interview -- apologies, Lemon!]



the view from Lemon's motorcycle seat
Kate: Who are some other badass ladies we need to know & why?

Lemon: Right now, I’m learning a lot about black women of rock and roll and also Asian women climbers. Those are two widely disparate things, I know, but women like Big Mama Thornton (an out and proud black woman in the 50’s who wrote "Ball ‘n Chain" and recorded "Hound Dog" before Elvis), and also girls like Malavath Poorna (who climbed Everest at 13yo) are incredible and interesting, and I want to read these books! (I am not writing them).


Kate: What is your advice to aspiring badasses?

Lemon: Have a spirit of teachability. (Is that a word?) I’m a Slytherin, so obviously, I think being teachable is important because it allows you to learn how to be successful, even if nature or nurture hasn’t naturally inclined that way.


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Sarah Nicole Lemon spent the first fifteen years of her life doing nothing but reading and playing outside, and has yet to outgrow either. When not writing, you can find her drinking iced coffee in a half-submerged beach chair near her home in southern Maryland.

Find Lemon:
website // twitter  // instagram

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          USCIS Restores H-1B Cap Exemption to Some Nonprofit Entities Affiliated with Institutions of Higher Education        
On March 16th, the day before residency match positions were announced within the medical community, USCIS restored, as an interim policy, the H-1B cap exemption status for nonprofit entities that are related to or affiliated with an institution of higher education, provided the institution received a cap exemption after June 6, 2006.
          UANI INFORMATIVE IRAN UPDATE         
Top Stories

Reuters:
"A Chinese firm has stopped verifying safety and environmental standards for Iranian ships, becoming the last top certification provider to end marine work there as the trade noose on Tehran tightens. The China Classification Society (CCS) is the last of the world's top 13 such companies, all members of the International Association of Classification Societies (IACS), to confirm it has ended Iran-related certification work, key to insurance and ports access for ships... A letter seen by Reuters dated November 15 showed Beijing-headquartered CCS had not provided certification services to Iranian ships since June 28. It had been urged to pull out by U.S. pressure group United Against Nuclear Iran (UANI) and clarify its position. 'Currently there is not any ship flying an Iranian flag or owned by an Iranian ship owner in our fleet, and we have not conducted any statutory survey for any Iranian ship,' CCS chairman and president Sun Licheng said in the letter to UANI dated November 15... A targeted campaign by UANI, which includes former U.S. ambassadors as well as former CIA and British intelligence chiefs on its board and is funded by private donations, has already led to other top classification societies exiting Iran. Without certification from classification societies, vessels are unable to secure insurance cover or call at most international ports. UANI's Wallace on Wednesday welcomed the move by CCS, but sought harsher measures being imposed on Iran's fleet. 'All of the world's major shipping certifiers have now ended their certification of Iranian vessels,' said Wallace, a former U.S. ambassador to the United Nations. 'We call for even tougher sanctions: any vessel that docks in Iran or transports Iranian cargo should be barred from accessing ports in the U.S., EU, or elsewhere.'" http://t.uani.com/TYz2UP

Reuters: "Hong Kong has deregistered five Iranian cargo ships and a further 14 are likely to follow after their classification society quit Iran due to sanctions imposed by the European Union and the United States over its nuclear programme... Hong Kong's marine department has asked the owners of 19 dry bulk carriers, managed by an Iranian firm, to register their ships elsewhere after the Korean Register of Shipping said earlier this year it would not provide the ships safety auditing... Hong Kong had been urged by U.S. pressure group United Against Nuclear Iran (UANI) to deflag the 19 dry bulk ships, which the group said were owned, managed or operated by the Islamic Republic of Iran Shipping Line (IRISL) and its associated companies. In a reply to UANI dated November 9 Wong said it was of paramount importance to Hong Kong's marine department in safeguarding the quality of Hong Kong ships." http://t.uani.com/V0CToV

Reuters: "Six world powers agreed on Wednesday to seek renewed talks with Iran as fast as possible, reflecting a heightened sense of urgency to resolve a long rift over Tehran's disputed nuclear activity and avert the threat of war. Their call coincided with growing evidence of Iran expanding nuclear capacity in an underground bunker virtually impervious to attack and follows the November 6 re-election of U.S. President Barack Obama, which has cleared the way for new contacts. Senior diplomats from the six countries - the United States, Russia, China, France, Britain and Germany - met in Brussels on Wednesday to consider new negotiating tactics despite abiding skepticism that a deal with Tehran can be reached. It was not clear after the meeting what options, if any, were agreed. But the six said 'necessary contact' with the Iranians would be made 'in the coming days'. 'The (six powers) are committed to having another round of talks with Iran as soon as possible,' said a spokesman for EU foreign policy chief Catherine Ashton, who represents the six countries in dealings with Iran." http://t.uani.com/V0FX4m

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Nuclear Program

Reuters: "Iran has been hauling dirt to a military site U.N. nuclear inspectors want to visit, Western diplomats said on Wednesday, saying the findings were based on satellite images and they reinforced suspicions of a clean-up. They said the pictures, presented during a closed-door briefing for member states of the International Atomic Energy Agency (IAEA), suggested Iran was continuing to try to hide incriminating traces of any illicit nuclear-related activity. The allegations come a few days after the IAEA said in a report on Iran that 'extensive activities' undertaken at the Parchin site since early this year would seriously undermine its inquiry, if and when inspectors were allowed access. Iran has so far denied the agency's request for a visit. The U.N. agency believes Iran may have conducted explosives tests that could help develop nuclear weapons at Parchin and wants immediate access to investigate the facility. Iran denies this, saying Parchin is a conventional military complex." http://t.uani.com/RYeCM6

NYT: "The conflict that ended, for now, in a cease-fire between Hamas and Israel seemed like the latest episode in a periodic showdown. But there was a second, strategic agenda unfolding, according to American and Israeli officials: The exchange was something of a practice run for any future armed confrontation with Iran, featuring improved rockets that can reach Jerusalem and new antimissile systems to counter them. It is Iran, of course, that most preoccupies Prime Minister Benjamin Netanyahu and President Obama. While disagreeing on tactics, both have made it clear that time is short, probably measured in months, to resolve the standoff over Iran's nuclear program. And one key to their war-gaming has been cutting off Iran's ability to slip next-generation missiles into the Gaza Strip or Lebanon, where they could be launched by Iran's surrogates, Hamas, Hezbollah and Islamic Jihad, during any crisis over sanctions or an Israeli strike on Iran's nuclear facilities. Michael B. Oren, the Israeli ambassador to the United States and a military historian, likened the insertion of Iranian missiles into Gaza to the Cuban missile crisis. 'In the Cuban missile crisis, the U.S. was not confronting Cuba, but rather the Soviet Union,' Mr. Oren said Wednesday, as the cease-fire was declared. 'In Operation Pillar of Defense,' the name the Israel Defense Force gave the Gaza operation, 'Israel was not confronting Gaza, but Iran.'" http://t.uani.com/WnopuC

Reuters: "Israel has a 'childish' desire to attack Iran and Tehran is capable of defending itself, Iranian President Mahmoud Ahmadinejad said on Thursday. 'They wish to hurt the Iranian nation. They are waiting for the chance. They known that Iran does not attack anybody and they know that Iran knows how to defend itself,' he told a news conference in the Pakistani capital Islamabad. 'We don't accept the hegemony of Israel. They wish to attack Iran but it is like a childish desire.' He was speaking after attending a summit of developing nations." http://t.uani.com/QyB8hw

Sanctions

In Auto News:
"After giant international automaker left Iran due to the sanctions on the nuclear programme, the country now relies on Peugeot to revive the auto industry here. Iran currently has to deal with increasing production costs and lack of technology on how to manufacture vehicles, after the world's most important automakers, such as Toyota, GM, Fiat, Hyundai and PSA Peugeot Citroen, were forced to leave the country due to the disputed nuclear programme. In September auto production in Iran dropped 66% from September 2011, and during the first half of the Iranian solar year, which began on March 19th, auto production fell 42%... On November 18th, the Iranian Industry Committee announced that Peugeot might return to the Iranian market, which would mean an increase in the country's car input. Although Peugeot has not yet officially confirmed this plan, its situation in Europe might force the automaker to make this step, also taking into consideration that Iran was its second major market." http://t.uani.com/10nu5tD

Platts: "China's imports of crude oil from Iran in October fell 23.2% year on year to 1.94 million mt (458,716 b/d), but were up 23.3% on month, according to data from the General Administration of Customs received by Platts late Thursday. Iran remained China's fifth largest supplier of crude in October, similar to September. That is down from being the third largest supplier in August. In the first 10 months of the year, total Iranian crude imports were 17.73 million mt, down 22.2% from the same period a year ago. On June 28, China received a US exemption from sanctions levied against countries who trade with Iran for 180 days, with Washington saying China had significantly reduced its crude purchases from Iran. A renewal of the waiver is due December 25 and the US State Department said previously it would be dependent on further significant reductions of crude imports from Iran. China's total crude oil imports in October rose 13.8% year on year to 23.68 million mt (5.6 million b/d), the third highest level this year on a b/d basis, following the record 6.02 million b/d seen in May and 5.98 million b/d in February." http://t.uani.com/XJVhUI

WashPost: "Iran is facing a possible crisis in its health-care system as a result of economic sanctions and alleged government mismanagement of diminishing state funds, according to officials here. The lack of money is already being felt in hospitals throughout Iran, where medical staffs have been told that they are working in 'war-time conditions' and should prescribe drugs sparingly - or in many cases, not all - in an effort to save resources... The scarcity derives from a complicated set of circumstances that includes both a heavy dose of Western sanctions, which are aimed at forcing Iran's leaders to halt their uranium-enrichment program, as well as what critics here say are missteps by the government. While some of the anger over the shortages has been directed at the United States and other global powers, there has also been an internal backlash. Hosseinali Shahriari, the head of parliament's health committee, said this month that 'the government is playing with our people's health and is not assigning the approved finances.'" http://t.uani.com/R3Z4JH

AFP: "Iranian President Mahmoud Ahmadinejad Thursday vowed to complete a mutli-billion dollar gas pipeline to Pakistan on time, downplaying financial woes and US pressure on Islamabad to scrap the project. Pakistan and Iran signed a deal in 2010 under which Tehran would supply gas to its eastern neighbour from 2014, with sales to reach up to one billion cubic feet (28 million cubic metres) per day by mid-2015. The project envisaged a pipeline, 900 kilometres (560 miles) in length built from Assaluyeh in southern Iran to the border with Pakistan. Another 800 kilometres pipeline was also needed inside Pakistan to receive gas from Iran's South Pars field in the Gulf. 'We want to complete this project by 2014,' Ahmadinejad told a press conference in Islamabad." http://t.uani.com/QdXQKj

The Nation (Pakistan): "Pakistan Credit Rating Agency (PACRA) and the Securities and Exchange Organization (SEO) - Iran entered into MoU in Tehran on Thursday wherein PACRA will provide technical assistance in establishing a credit rating regime in Iran. Under the MoU, PACRA shall prepare regulatory framework for regulating the credit rating business in Iran and in establishing rating agencies in Iran. PACRA is one of the two Pakistani CRAs that provides credit rating services in various countries. In order to enhance cooperation and assistance to each other in the areas of interest, SECP and SEO-Iran had constituted a Liaison Committee that is entrusted with the task of exploring areas of assistance to each other. During a meeting in October 2011, SECP arranged a meeting of both the domestic CRAs with an Iranian delegation visiting Pakistan and the Iranian delegation desired to seek assistance of SECP for the development of regulatory framework for regulating the credit rating business in Iran." http://t.uani.com/WEnuLg

Terrorism

NYT: "Above the bustling Niayesh highway in the western part of the Iranian capital, a huge billboard hangs on an overpass to remind drivers of Iran's missile abilities. Cars zip underneath the image of a green missile on a launcher and text in Persian saying 'Destination Tel Aviv.' Few here take note of the sign, as average Iranians are too busy trying to cope with rising prices and occasional shortages brought about by a faltering economy. But Iran's missiles and weapons technology are getting plenty of attention hundreds of miles away in Gaza, giving the country's ruling clerics a rare bit of good news in what has otherwise been a long, dismal year... Throughout the battle, Iranian-designed missiles, the Fajr-3 and the Fajr-5 that allowed Hamas and another Gaza-based movement, Islamic Jihad, to hit Israel's heartland, sent Israelis fleeing to bomb shelters. While political support and money helps, Palestinian leaders said, Iran's weapons technology is a far greater help." http://t.uani.com/Tir2R9

AFP: "Hamas chief Khaled Meshaal said on Wednesday that Israel had 'failed in all its goals' after a Gaza truce deal came into effect, while thanking Egypt and Iran for their support during the conflict. 'After eight days, God stayed their hand from the people of Gaza, and they were compelled to submit to the conditions of the resistance,' Meshaal said. 'Israel has failed in all its goals,' he told reporters in a Cairo hotel. Meshaal also thanked ceasefire mediator Egypt, as well as Iran, which he said 'had a role in arming' his Islamist movement during the conflict." http://t.uani.com/Ui2SWR

AFP: "Israel and the United States have agreed to work together to prevent the smuggling of weapons from Iran to militant groups in the Gaza Strip, Prime Minister Benjamin Netanyahu said on Wednesday. 'Israel cannot sit idly by as its enemies strengthen themselves with weapons of terror so I agreed with President (Barack) Obama that we will work together -- Israel and the United States -- against the smuggling of weapons to terror organisations, most of which comes from Iran,' he said in a televised address." http://t.uani.com/UNE2dt

LAT: "Iran for years has supplied Hamas with weapons as part of its own struggle against Israel, but the conflict in the Gaza Strip reveals a shift in regional dynamics that may diminish Tehran's influence with Palestinian militant groups and strengthen the hand of Egypt. The longer-range missiles fired by Hamas over the last week - believed to be modifications of Iran's Fajr 5 missiles - startled Israel by landing near Jerusalem and Tel Aviv. A front-page story in Iran's conservative daily, Kayhan, boasted: 'The missiles of resistance worked.' Tehran would not confirm the weapons' origin, except to say it sent rocket 'technology' to Hamas... But the Gaza fighting erupted during a new era in the Middle East brought about by the rise of Islamist governments, notably in Egypt, that have replaced pro-Western autocrats. The political catharsis has spurred anti-Americanism, which Iran relishes, but it also has upset Tehran's regional designs." http://t.uani.com/R43cZW

Reuters: "Iran reacted angrily to assertions by French Foreign Minister Laurent Fabius and accused him of not understanding the realities in the region after the diplomat accused Tehran of being responsible for the Gaza conflict. On Wednesday Fabius accused Iran of negative intentions in Lebanon, Syria, Iraq and Gaza and that it bore a 'heavy responsibility' for the fighting for providing long-range weapons." http://t.uani.com/WEqNSw

NYT: "Eighteen years have passed since a suicide bomber drove a Renault van loaded with explosives into the headquarters of the Jewish community center here, killing 85 people. Since then, investigations have meandered. Interpol arrest warrants have led nowhere. Aging suspects connected to the attack have begun to die. But in the elusive quest for justice in the bombing, which ranks among the deadliest anti-Semitic attacks anywhere since World War II, few developments have riled Argentina's Jewish leaders as much as the government's move in recent weeks to improve relations with Iran, the nation shielding in the high echelons of its political establishment various people accused by Argentine prosecutors of having authorized the attack... 'We cannot comprehend this,' said Guillermo Borger, the president of the Argentine Mutual Aid Association, the center that was bombed in 1994. 'The world is shutting its doors to Iran, and we're giving Iran a chance to say that Argentina is somehow now its friend. The Iranians have not budged in their assertion that their people are innocent, so why should Argentina be in dialogue with them?'" http://t.uani.com/TjvVZj

Human Rights

Guardian: "The mother of an Iranian blogger who died in custody has accused the authorities of killing her son and launching an intimidation campaign against her family. Sattar Beheshti was a 35-year-old blogger from the city of Robat-Karim who lost his life while being interrogated by Iran's cyberpolice, accused of acting against the national security because of what he had posted on Facebook. Iran's opposition activists have accused the regime of torturing Beheshti to death. In jail, Beheshti had no access to his family nor to a lawyer. Beheshti's mother, who has not been named but is pictured with him in one of the only images available of him online, has for the first time spoken out against the state pressure on her family not to speak to the press. 'I have no fears. I can't accept that my son has died by natural causes,' she told Sahamnews, a news website close to an Iranian opposition leader, Mehdi Karroubi, who is under house arrest. 'My son has been killed. He went to jail standing on his own legs and they gave us his dead body.'" http://t.uani.com/TfnT1g

Reuters: "Iran said on Thursday a blogger who died while in police custody may have lost his life as a result of a form of shock, the official IRNA news agency reported, adding that investigations were not yet concluded. In a case that has sparked international outrage, 35-year-old Sattar Beheshti who wrote a blog critical of the government was arrested on October 30 after receiving death threats and died some days later, having complained of being tortured. Under increasing pressure at home and abroad for an investigation, Iran's parliament said it had formed a committee to examine the case and the judiciary said it would deal 'quickly and decisively' with those responsible. 'In its latest report, the seven-member medical committee says ... it is not possible to determine the exact cause of death,' IRNA quoted Tehran prosecutor's office as saying in a statement. 'But the most likely cause leading to death may be shock,' the statement said, adding that excessive psychological stress could have caused the shock." http://t.uani.com/Ui0LSM

AP: "In his last blog entry, activist Sattar Beheshti wrote that Iranian authorities had given him an ultimatum: Either stop posting his 'big mouth' attacks against the ruling system or tell his mother that she will soon be in mourning. 'We will tear down your cruel cage,' Beheshti typed on Oct. 29 before signing off... But while the specific circumstances of Beheshti's death may be given a public reckoning, the more far-reaching aspect of the case - Iran's rapidly growing corps of Web watchers - may remain in the shadows, as well as their motives in targeting an obscure blogger whose site was actively followed by more than a few dozen viewers. The 35-year-old Beheshti apparently fell under the custody of Iran's cyber police, created last year with a wide mandate to crush Web dissent. The powers displayed in the case - including questioning Beheshti outside the regular justice system - suggests a level of autonomy and authority that could bring far more aggressive measures against Web activists." http://t.uani.com/TSyqOt

Opinion & Analysis

Kristen McTighe in IHT: "Houshang Asadi was a Communist journalist thrown into the cold confines of Moshtarek prison in Iran when he found an unlikely friend in the tall, slender Muslim cleric who greeted him with a smile. Imprisoned together in 1974, under the rule of Shah Mohammed Reza Pahlavi, they found common ground in their passion for literature. They shared jokes, spoke of where they came from, their families and falling in love. Mr. Asadi, who did not smoke, would give cigarettes to his cellmate who, uncharacteristic of a cleric, did. On days when Mr. Asadi felt broken, he said, the cleric would invite him to take a walk in their cell to brighten his spirits. So, when his release came six months later and the cleric stood cold and trembling, Mr. Asadi gave him his jacket. 'At first he refused it, but I told him I was going to be released,' Mr. Asadi recalled. 'Then we hugged each other and he had tears coming down his face. He whispered in my ear, Houshang, when Islam comes to power, not a single tear will be shed from an innocent person.' What Mr. Asadi found unimaginable was that the cleric would become president of the Islamic Republic that later imprisoned him again, sentenced him to death and brutally tortured him for six years in the same prison. Today that same cleric is the supreme leader of Iran, Ayatollah Ali Khamenei. Mr. Asadi's account of torture and imprisonment has offered a rare glimpse into what activists say was a decade of grave human rights violations in Iran. And at a time when international attention has shifted to the nuclear issue and sanctions, they say a campaign to bring justice and accountability through a symbolic tribunal has helped unite a once fractured opposition. 'I never expected he would get power, never,' said Mr. Asadi in an interview in Paris, where he lives in exile. Mr. Asadi, a 63-year-old writer, journalist and former member of the Tudeh party, was routinely arrested and tortured under the shah. He had supported the revolution, so when he was arrested again in 1982 and accused of being a spy for the Russians and the British, he was convinced that it was a mistake. In a plea for help, his wife wrote to Mr. Khamenei, who had risen to power as president after the Islamic revolution, but two weeks later the letter was returned with a note in the margin saying only that he had been aware of the journalist's political beliefs. Mr. Asadi's death sentence was reduced to 15 years in prison. During his time in prison, he again developed a relationship with the only person he had contact with - as he had done with Mr. Khamenei. This time it was with his torturer, a man he knew only as 'Brother Hamid.' 'He is your torturer and he thinks he is your god, he thinks he is religious, he is pure, and you are evil, you are the enemy,' Mr. Asadi said. 'So he can do anything to you.' Mr. Asadi said he was called a 'useless wimp' and hung by a chain attached to his arms twisted behind his back while the soles of his feet were whipped until he was unable to walk. Brother Hamid forced him to bark like a dog to speak or when the pain was too much and he was ready to make confessions. His ears were hit and his teeth were broken. Mr. Asadi said he had even been forced to eat his own excrement and the excrement of fellow prisoners. Beyond physical pain, he endured psychological torture. He was shown coffins and told his comrades had been killed. He would hear screams and was made to believe his wife was being tortured in the cell next to him... The torture continued daily for six years, until he was abruptly pulled out of his cell in 1988 when the supreme leader at the time, Ayatollah Ruhollah Khomeini, ordered the mass killing of thousands of political prisoners. Prisoners were asked three questions concerning their religious faith and loyalty to the regime. 'If you answered no to any question, they killed you,' Mr. Asadi said. 'I lied to save my life.'" http://t.uani.com/Y8dLgB


          Roger Goodell talks marijuana and its potential in treating player health in the NFL        
NFL commissioner Roger Goodell said marijuana and its potential in treating football-related injuries is "a medical issue" that the league is interested in researching further. "If pain management is something that medical marijuana can address responsibly, that's something that our medical community is evaluating," Goodell said Thursday […]
          Australia Legalises Home Growing, Kills-Off NCPIC         

The United States may be the epicentre of weed action right now, but there’s also plenty happening on the cannabis scene in Australia. As is the case in many regions worldwide, they seem to have taken a highly important step forward this month, along with what many are considering to a large step back. Cannabis campaigners across the country have been lobbying for easier, more widespread access to medicinal cannabis for some time, just as those in favour of recreational cannabis decriminalisation are making their voices well and truly heard.

 

For the time being, it’s looking like good news for those in the medical marijuana camp. The reason being that the Australian government has put into action a new policy on medical pot – aka The Narcotic Drugs Amendment Act 2016 – which will allow those with permission to do so to grow their own medical cannabis at home. With millions of people already relying on medical cannabis for the treatment of various medical conditions, the news has been unanimously welcomed across the country.

 

Health minister Sussan Ley spoke of the huge and beneficial changes the new policy will bring to those in real need of medicinal cannabis.

 

“Until now, it has been difficult for patients to access medicinal cannabis products from overseas sources,” read a statement she released when the new bill was enacted.

 

“These new laws change that situation by providing for a domestic supply of medicinal cannabis products that are not readily available for import.”

 

At the same time however, she made it entirely clear that there would be no changes in marijuana policy anytime soon for recreational users. Which means that for the foreseeable future, recreational cannabis will continue to be wholly illegal nationwide. Those looking to grow medical cannabis for themselves will be required to obtain a permit, which will involve passing a security test and satisfying multiple criteria. Either way, it represents a highly positive and important change in cannabis policy for the greater good of patients across Australia.

 

Meanwhile, the Federal government of Australia has decided to pull the plug on the country’s state-sponsored and operated cannabis advice and information service.

 

But while this distribution of licensing duties may lead to discrepancies and disappointment in some instances, the move has been unanimously welcomed as a positive step forward for an incalculable number of patients in need of medicinal cannabis. For almost a decade, The National Cannabis Prevention and Information Centre at the University of New South Wales has been providing members of the public and the medical community alike with support, education and training on all matters related to cannabis and its use. However, having discovered that cannabis usage rates across the country have remained largely the same for the past 20 years, it has been decided that the Fed should be focusing its efforts on a wider range of drugs, including crystal meth.

 

Critics have warned that the closure of the NCPIC will inevitably lead to members of the public once again relying on the information and advice they read from other websites and sources, which may not be nearly as reliable or safe as the government’s portal.

 

“While there are for-profit general alcohol and other drug information sources along with the state and federal drug campaign websites, there is no organisation in Australia or internationally, that can fill the gap left by NCPIC,” said Prof Jan Copeland, current director of the NCPIC.

 

“We have the researchers who can assess the scientific merit of the evidence to bring clear messages to cannabis users and their families,”

 

“We have evidence-based clinical tools and interventions, tested and published in peer-reviewed journals, available to service providers and the public, free of charge, in the form of a telephone helpline, web and smartphone based brief interventions. We are also the last source of free clinical training to Australian clinician’s on assessment and brief interventions for cannabis use disorders.”

 

Nevertheless, it was made clear by the government that to withdraw funding for the project after pumping more than $30 million into it over the years was not up for negotiation.

 

“There is a need to consider a more holistic, responsive and current approach to the provision of drug and alcohol research and information needs of the drug and alcohol sector and the community that is broader than focusing on a single substance,” argued a Health Department representative.

 

“In particular, consultations and information gathering over the past 18 months has identified a change in policy context and priorities, including the release of the National Ice Action Strategy.”

 

 


          British Company Develops Cannabis Oil for Treatment of Rare Form of Epilepsy         

Chalk up another victory for those who follow facts and scientific evidence, as opposed to unfounded theories and archaic presumptions. Yet another high profile name has joined the ranks of those already supporting widespread medicinal cannabis use – this time from right here in the United Kingdom.

 

It’s not as if Great Britain is really at the forefront of this kind of research, but still…progress is progress.

 

In this instance, the manufacturer of a new type of cannabis oil has said that their product has proved effective in treating a rare type of epilepsy. Based in London, GW Pharmaceuticals announced on Monday this week that an oil the company has been working on for some time has so far shown remarkable promise in tests. 

 

They are looking to create a drug based on extracts of cannabis plants which have been specifically engineered to produce much lower levels of tetrahydrocannabinol (THC) and a much higher levels of cannabidiol (CBD) the normal.  The drug they are working on – which they have named Epidiolex – will therefore be likewise extremely low in THC with a much higher concentration of CBD. Given that it is the THC concentration in cannabis products that determines how high the user will get, one of the primary objectives of Epidiolex is to produce medicinal cannabis products that work without getting the patient high.

 

“Between the plant itself and the processing steps which are being taken, the product ends up being pure CBD,” explained Justin Gower, chief executive of GW Pharmaceuticals.

 

To date, tests of the drug carried out on patients with a rare form of epilepsy have apparently brought back extremely reassuring results. In the most recent study, 85 patients were provided with placebos while a third of 86 were provided with controlled doses of Epidiolex. According to the company, seizure rates among those taking Epidiolex were reduced by impressive 44%, more than double the improvement among those who were only given placebos.

 

GW Pharmaceuticals has openly admitted however that for the time being, Epidiolex has the potential to cause a variety of side effects. Though generally mild and temporary in nature, some of those taking the drug reported having a decreased appetite, upset stomach, mild nausea and some sleeplessness.

 

Generally speaking, the medical community in general has responded extremely positively to the progress GW Pharmaceuticals has made in bringing about an effective treatment for a rare yet life threatening condition.

 

“From a physician’s perspective, the positive outcome in this trial of Epidiolex in patients with Lennox-Gastaut syndrome is very exciting. Lennox Gastaut syndrome begins in early childhood, is particularly difficult to treat, and the vast majority of patients do not obtain an adequate response from existing therapies,” commented Linda Laux, Director of the Comprehensive Epilepsy Centre at Ann & Robert H. Lurie Children’s Hospital of Chicago and one of the lead researchers involved in the latest clinical trial.

 

“These data show that Epidiolex has the potential to provide a robust and clinically meaningful reduction in seizures in this highly treatment-resistant population together with an acceptable safety and tolerability profile, which is consistent with my previous clinical experience with Epidiolex.”

 

The form of epilepsy GW Pharmaceuticals has been focusing on with Epidiolex is known as Dravet syndrome, which is more common among children than adults and is known to affect around 6,000 children in the United States.  Advocates argue that these are exactly the kinds of conditions that should prompt authorities on both sides of the Atlantic to rethink counterproductive and potentially harmful attitudes to the restriction of medical marijuana research.

 


          Maine Fights for Cannabis as Treatment for Drug Addiction        

Critics will always argue that it simply doesn’t make sense to treat one drug problem with another drug. In reality however, there is barely a drug treatment system or program in existence that isn’t based around exactly that. The only difference being that when the treatment drug in question happens to be marijuana, thousands of critics with no idea what they’re talking about suddenly pop up out of nowhere.

 

The simple fact of the matter is that in the eyes of thousands of doctors, caregivers and patients alike, marijuana has the very real potential to be a hugely effective addiction recovery aid. Not only this, but there are also several scientific studies which show that in areas of the United States where medical marijuana is legal, opioid overdose deaths have seen a marked reduction. And in the treatment of those looking to beat their addictions to prescription meds and heroin, medical marijuana is proving itself to have more potential than any conventional drug produced to date.

 

Maine in particular is right now fighting the corner of cannabis, with the state’s department of health having been asked to openly and fairly consider introducing marijuana as a treatment for opioid addiction. Many states across the US are in the midst of an unprecedented opioid abuse epidemic, with overdose and death rates both having spiked worryingly for several consecutive years. All such states are frantically searching for an answer to the problem – conventional drug treatments and the threat of incarceration having so far failed to have any real impact.

 

Maine, however, is one of very few that’s shown willingness to listen to the cannabis community.

 

As far as caregivers and medical professionals are concerned, cannabis helps recovering addicts by easing the symptoms of withdrawal that often lead to relapse. From anxiety to insomnia to depression to painful muscle spasms, cannabis has proved to be hugely effective in making all such symptoms considerably more bearable. As such, it has a direct impact on relapse risk – reducing it considerably.

 

Patients having used or in the midst of using cannabis to battle addiction agreed with the testimony of caregivers, adding that in many instances marijuana had helped them succeed after multiple failed attempts with conventional pathways. More so, there were many that stated that in their own experience, the standard methadone clinics they’d been ordered to attend by the courts did nothing but make things worse.

 

Once again however, the Maine Medical Association made its position clear – a position totally against the claims and requests of the cannabis advocates. MMA representatives basically said that there wasn’t enough scientific evidence to back the claims of those pushing for wider use of cannabis in beating addiction – overlooking the fact that there’s also no evidence to suggest that cannabis doesn’t work in the treatment of addiction.

 

And of course, the testimony of real people facing real battles and with real experience of such matters is always inconsequential to such people.

 

A decision will be made with regard to the request within a maximum of 180 days, with Maine having become the first North American state to at least consider the matter in an official sense. There are currently around a dozen medical conditions for which medical marijuana can be prescribed in the state – addiction recovery could well be next. In the meantime, recovering addicts in growing numbers are throwing their support behind the proposal, sharing their stories and insisting that nothing else could have helped them.

 

Still, the medical community in general maintains its blinkered and archaic view of cannabis and will give those advocating safe and sensible use a serious fight to the bitter end.

 

 


          A Guide to Red Eye – What It Is, How to Hide It         

To buy pot seeds in the United Kingdom is to also invest in the huge downer that is not being able to germinate them legally. So it’s really very little wonder why so many Brits are heading overseas to revel in the more liberal cultures of a fair few neighbouring nations.

 

The thing is though, no matter where you travel there’s always one part of weed culture that remains the same – red eye.  Pretty much every stoner on the face of the earth knows that cannabis causes red eye, but comparatively few actually understand why it occurs…and whether there is anything that can be done to prevent it.

 

So here it is – your quick 101 guide to red eye!

 

A Sign of Poor Health?


Tackling the biggest question of all – does red eye indicate a poor state of health? At the risk of being vague, the answer is both yes and no at the same time. From a medical perspective, reddening of the eyes can be indicative of a wide variety of health problems. Allergies, tiredness, various viruses and problems with the eyes themselves can all lead to red eye.

 

But at the same time, red eye doesn’t necessarily mean that there are any specific underlying health problems. Red eye from cannabis use for example isn’t indicative of illness, but rather a side effect of the effect cannabis has on blood pressure.

 

Or at least, that’s what the experts seem to believe.

 

Cannabis Red Eye


As far as neuroscientists are concerned, the cannabinoids contained in cannabis can lead to a decrease in blood pressure, which is linked to reddening of the eyes. It’s all to do with the way in which blood vessels dilate in order to increase blood flow when blood pressure is reduced. There is of course a much more detailed and scientific explanation than this, but it all boils down to the same simple premise.

 

Glaucoma


Along with having an apparently beneficial effect on high blood pressure, it has also been known for some time that marijuana is an effective treatment for glaucoma. These tiny little pot seeds grow and develop into plants with the potential to both reduce blood pressure and bring intraocular pressure under control far more effectively than almost any synthetic medicine or treatment.

 

Given the fact that cannabis is also safer and presents considerably fewer side effects, it’s pretty remarkable that the scientific and medical communities are not embracing the use of medicinal cannabis in these areas at least. In some nations perhaps, but hardly on a widespread basis.

 

Red Eye Factors


So, how about the question as to why some people seem to be far more predisposed to severe red eye than others? Well, it isn’t a subject that has been studied at any great length, but we do know for sure that some influencing factors include:

 

Genetics – some smokers take a single hit and end up with bright red eyes, while others can smoke all night with no redness at all.

 

Strain – the type and strength of cannabis smoked can also have an influence.

 

Hydration – letting yourself get dehydrated will almost always increase red eye severity.

 

Hiding the Evidence


To be honest, it’s largely impossible to go nuts on the cannabis and totally avoid red eye. As such, the best advice is to think about how to hide the evidence, if you feel so inclined to do so.

 

Sunglasses – the most obvious and the easiest solution being to don a pair of sunglasses, though depending on the weather and where you happen to be at the time you might end up looking like a bit of a tool.

 

Eye drops – have the potential to be extremely effective by delivering hydration straight to your eyes and reducing reddening much more quickly.

 

Hydration – as already mentioned, if you allow yourself to get dehydrated, it is inevitable that your eyes will look even worse.

 

Makeup – if you can get away with it, be as strategic as possible with the makeup you use around your eyes in order to minimise the impact of your bright red eyeballs.

 

Sleep – last but not least, just as it’s the case with all other effects of cannabis, you can always simply sleep off your red eye.

 


          Sweet Dreams: Five Cannabis Strains to Aid Restful Sleep         

All over the world, big-name pharmaceutical companies are doing their all to sell you an endless range of chemicals to help you sleep at night. The way we see it, anyone looking to enjoy a peaceful, restful and healthy night’s sleep would be far better off looking at the natural means available to them, rather than the usual chemical cocktails.

 

It might be a while before the average Joe can buy marijuana seeds in the United Kingdom and legally do anything useful with them. Still, those fortunate enough to reside in more open-minded regions are free to revel in all of pot’s prestige and prowess – be it for good times, stress-reduction or fighting a bout of temporary insomnia.

 

Though there are plenty of types of cannabis that help prompt a good night’s sleep, indica-dominant cannabis tends to be the best for this job. It’s estimated that up to 50% of people will from time to time struggle with insomnia – and the medical community is still struggling to come up with something safe, effective and free from worrying side-effects.

 

Does it already exist in the form of marijuana? Some would certainly say so. We reckon that if you try out any of the following strains for yourself, you’ll no doubt find that the killer night’s sleep you’ve been craving was just a joint or two away:

 

Blue Cheese


Bringing together UK Cheese and Blueberry resulted in the creation of a world-renowned weed strain for well and truly relaxing tired muscles. Starting these plants from pot seeds is relatively easy and harvesting is possible after around 60 days of flowering. Widely used as a chronic pain treatment, Blue Cheese has an immediate and significant relaxing and sedating effect on the body and mind in equal measures. The fact that it is also famed for its gorgeous aromas and taste simply serves as a welcome bonus!

 

Northern Lights


If you’re out for the kind of smoke that basically lets gravity take over and results in guaranteed ‘couch-lock’, then chances are you won’t go wrong with Northern Lights. Another internationally recognised strain, Northern Lights is a fantastic choice for heavy relaxation though it doesn’t tick many social boxes when consumed in large quantities. If you’re looking to be put quite dreamily on your back and drift off into a hazy abyss of total relaxation, it’s definitely worth your time.

 

Critical


One of the biggest bonuses for those who set up a growing effort with Critical is its promise of supremely high yields. In fact, just 7 weeks of flowering can lead to a pretty mind-blowing yield of up to 600g/m². In terms of its effects, Critical has indeed earned critical acclaim across the weed community for its ability to serve as a base for all manner of sleep remedies. Not that you have to be too creative – just give it a shot on its own and you’ll soon see what all the fuss is about.

 

OG Kush


Another highly generous strain that never fails to deliver huge yields after about 8 weeks of flowering, OG Kush is a supremely popular strain from Northern California. Often the go-to for stoners looking to work on their sleeping habits, OG Kush delivers a strong yet not overpowering effect that brings both body and mind into a state of real tranquillity. Its relaxing properties can be felt in an instant and only continue to intensify over time.

 

Royal Domina


Last but not least, if you can get your hands on an order of Royal Domina (or buy marijuana seeds to grow your own), sleeplessness really isn’t an option. Above and beyond each of the strains listed above, Royal Domina tops the table when it comes to seriously deep relaxation. A few hits and you’re well on your way to the rest you’ve been craving. If this Spanish strain doesn’t work for you, chances are there isn’t any cannabis on Earth that will!

 


          It’s Official – Colorado’s Weed is Getting Stronger…MUCH Stronger         

It was always going to be a bit of a no-brainer that as soon as weed was made legal in Colorado, growers would begin refining their craft and coming up with bigger, better buds. And so it proved, as here we are at the doorstep of spring 2015 and the one thing we know about the pot doing the rounds in Colorado is that it is strong…very, VERY strong.

 

In order to gain a better understanding of how things are progressing for both the medicinal marijuana industries in the state and the everyday smoker on the ground, a study was carried out by one Andy LaFrate, founder of the Charas Scientific laboratory. He released the findings this week at the American Chemical Society meeting in Denver, where he told those in attendance that things are getting a hell of a lot more potent for the pot-people of Colorado.

 

“This stuff is strong,” he said.

 

“There’s a lot of homogeneity whether you’re talking medical or retail level,”

 

“One plant might have green leaves and another purple, and the absolute amount of cannabinoids might change, which relates to strength. But the ratio of THC to CBD to other cannabinoids isn’t changing a whole lot.”

 

In order to illustrate the point of how much things are changing, he highlighted the difference between samples taken in the 80s and those doing the rounds now. Around 30 years ago, the average THC concentration in standard weed wasn’t even close to the 10% mark. By contrast, he took into account a full 600 samples for the new study and found that the average was closer to 19%, while some even went as high as 30%. In addition, his research shows that the ration of THC to CBD in the samples was actually pretty low – about 150:1. This didn’t go down too well with the medical community as a whole as it is of course CBD that’s been linked with potentially positive effects in the fight against Alzheimer’s disease, Huntington’s disease, schizophrenia and anxiety.

 

So, in essence the conclusion appears to be a pretty simple one – those that are growing new strains of marijuana in Colorado are doing so almost entirely for the purposes of getting their customers higher than ever before, as opposed to in any way benefiting/contributing to essential medical research. But this is something that’s disputed by some as there are those that suggest there to be a very clear divide between the two types of pot in circulation – that sold at ‘street’ level and the weed that’s grown solely for research purposes. As such, hitting out at the community in general for being rather too focused on getting high is counterproductive as it only addresses half of the story.

 

Of course this isn't strictly news, just confirmation of a general trend in the world of marijuana that has been reported for years. This doesn't mean that MMJ as a concept is over, there is plenty of research and breeding focussed on enhancing levels of CBD and other cannibinoids. In fact, separate reports from outside Colorado have suggested that recent years have brought about the cultivation of several new strains of weed which have displayed superb therapeutic properties while at the same time having almost no psychoactive effects at all.

 

 

 

 


          Magpul's New Glock Magwell        

Just before the NRA Annual Meeting, Glock announced that they are coming out with a Glock magwell.  It is dubbed the Magpul GL Enhanced Magwell.

Magpul released this humorous commercial. It is a parody of a medical commercial, akin to Cialis, hinting at "performance issues" and the solution is the GL Enhanced Magwell.

 

 

The GL Enhanced Magazine Well is ,ade of a similar polymer as most of their other products. It has a brass threaded insert for securing it into the grip of a Glock.

rear

 

The magwell is slim so it does not compromise conceal carry. The overal width is just a little wider than the Glock grip.

width

 

The magwell is compatible with Magpul's GL9 magazine as well as OEM mags. They claim it will work with most mag extensions but we won't know until they are released and we try out different mag extensions with it.

Even though the magwell is minimalistic in its outward appearance, you can see how the ramped area makes for easier mag reloads.

tunnel

nra

 

mag inserted

 

 

The GL Enhanced Magazine Well wil be available in four different versions. The difference is between Gen3 or Gen4. Then Glock 17 or Glock 19 sized frames.

Of course there are other calibers that have similar sized frames like .40S&W, .357 Sig and .45 GAP.

I spoke with one of the Magpul guys at the NRA Annual Meeting and asked if the Gen3 mag wells will work for Gen2 Glocks. He said it is a 50% chance it will. Glock apparently has varying differences in Gen2 Glocks. So it may not work with the magwell. I am sure a little file and dremel will make it work if there is an incompatibility.

I hope they offer these in sand just like their GL floor plates.

You can get Magpul Glock PMAGs on our site. Click here to check them out.

The magwells will retail for only $24.95


          1 Minute Read | Fibromyalgia | Isabel Healthcare        

A research article in Journal of Anesthesia & Pain Medicine was published recently, detailing a review on patients referred with a diagnosis of fibromyalgia. The review found that the diagnostic criterion for fibromyalgia was not met in 97.3% of the patients referred, indicating that the condition is often over diagnosed. It was also found the referring physicians failed to diagnose 133 (94.3%) medical conditions in these patients which can be determined as an error of omission. The authors commented that ‘fibromyalgia may have become the “disease de jour” for the medical community and the absence of strict adherence to the diagnostic criteria for diagnosing fibromyalgia has led to many missed diagnoses.”


          Good Shepherd Community Clinic gets new sonogram machine, expands services        
The Good Shepherd Community Clinic was gifted an ultrasound machine from Mercy Hospital to help with the clinic’s recently expanded services. The ACUSON Sequois 512 Ultrasound is the newest addition to the clinic’s obstetrics services. "We continue to be grateful of the partnerships and support of the medical community and Mercy Hospital in Ardmore in our efforts to build healthy people and now healthy babies," said Teresa Myers, Good Shepherd executive director. "We [...]
          HMS Beagle Project at Seafair Haven 2014        
The HMS Beagle Trust has been in talks for several months with the new owner of the tall ship Earl of Pembroke, the medical company Metaco Ltd, and has secured her visit to Milford Haven for its biennial Seafair Haven classic ship festival from 7 to 14 June. The aim is to publicise the work of the Beagle Trust and its local educational partner the Pembrokeshire Darwin Centre.
   

The highlight will be the educational work with some 30 young people aboard the Earl of Pembroke in Milford Haven for a special outing on 11 June. On that day, the ship will join up with a research vessel from Dale Fort to capture plankton to be brought ashore and studied by the young people under the microscope later in the day. The session will be led by Beagle Trust director Dr Simon Boxall, a leading scientist at Southampton’s National Oceanography Centre, and by Marten Lewis of the Darwin Centre. The initiative will replicate work done by the Beagle Trust in Brazil in 2009 alongside the local tall ship Tocorime. A team from the Welsh ITV programme Coast and Country will be there to film the occasion.  
The Earl of Pembroke in Bristol, May 2014. Photo courtesy of Stewart McPherson.

          Sen Schumer, Lyme Disease Suferers Call for More Fed Help for Research, Prevention        
Several people here in Central New York who have or have had Lyme disease stood with Senator Schumer today calling for federal health officials to stop dragging their feet on help for treatment and prevention. Martha Conan says her case went undiagnosed for a decade. “In 2001 I started getting symptoms and I didn’t know what the heck they were. And not until 2012 was I diagnosed with Lyme disease. That’s how long it takes and I don’t want anyone to have to suffer like that.” She still suffers both physical and mental effects…and is part of the Empire State Lyme Disease Association which offers support and referrals. She hopes more funding might raise awareness in the medical community. “…if the doctors knew what they were looking for, if they had a proper education about Lyme disease. I was diagnosed with bulging, spinal stenosis, drug-seeking, crazy, being a hypochondriac, lupus, then they said, ‘ you either have MS or ALS.’ I didn’t have any of those things.” SUNY E-S-F Doctor
          Who Is An Indian? Race, Place, and the Politics of Indigeneity in the Americas        
ZA_whoisanindian
“A significant addition to research, Who Is an Indian? provides an extended examination and a clear picture of Indigenous identity issues in the Americas. Among the book’s important contributions are its examination of the site of interface between the modern state and Indigenous peoples, as well as its analysis of how state discourses of identities are interpolated by Indigenous peoples and come to be important sites of tension.” --David Newhouse, Department of Indigenous Studies, Trent University
“Who Is an Indian? makes a strong and distinct contribution to the literature on Indigenous identities. The contributors examine imposed markers of distinctiveness, particularly those racial categories that have often been formulated by experts and imposed by dominant societies. This is a topic that is rife with controversy, but it is handled here with directness and historical acumen.”--Ronald Niezen, Department of Anthropology, McGill University
Who Is An Indian? Race, Place, and the Politics of Indigeneity in the Americas  is my newest edited collection, published by the University of Toronto Press. It completes a trilogy of edited volumes on indigeneity in the Americas that I began in 2006 with Indigenous Resurgence in the Contemporary Caribbean: Amerindian Survival and Revival, and in 2010 with the publication of Indigenous Cosmopolitans: Transnational and Transcultural Indigeneity in the Twenty-First Century.

About this Book

Who is an Indian? This is possibly the oldest question facing Indigenous Peoples across the Americas, and one with significant implications for decisions relating to resource distribution, conflicts over who gets to live where and for how long, and clashing principles of governance and law. For centuries, the dominant views on this issue have been strongly shaped by ideas of both race and place. But just as important, who is permitted to ask, and answer this question?
This collection examines the changing roles of race and place in the politics of defining Indigenous identities in the Americas. Drawing on case studies of Indigenous communities across North America, the Caribbean, Central America, and South America, it is a rare volume to compare Indigenous experience throughout the western hemisphere. The contributors question the vocabulary, legal mechanisms, and applications of science in constructing the identities of Indigenous populations, and consider ideas of nation, land, and tradition in moving indigeneity beyond race.

Genesis of the Project

This latest volume is probably the longest I have worked on any one publication project. It first began to take shape in 2006, as an effort exclusively focused on race, motivated by recognition of the fact that there were no volumes, treating the Americas as a whole, that compared and contrasted different ideas and applications of race in the definition of Indigenous identity. This was the basis for the first symposium in 2006, “Indigeneity and Race: ‘Blood Politics’ and the ‘Nature’ of Indigenous Identity,” organized under the auspices of the Canadian Anthropology Society’s annual conference, held at Concordia University on May 13, 2006. The same theme carried over into a following seminar, “Who Is an Indian? Race, Blood, DNA, and the Politics of Indigeneity in the Americas” involving 14 participants and hosted at the Clarion Hotel in Montreal, August 2-5, 2007, with the support of the Social Sciences and Humanities Research Council of Canada. However, as a result of the discussions held at the second symposium, we came to the realization that race alone could not be the exclusive subject of our concerns in addressing who people have historically answered the question, “who is an Indian.” The role of place, land, and territoriality, and resistance to neoliberalism, figured prominently in a number of the papers to the extent that we concluded that both race and place should be our dual, framing concepts.

The original impetus for this project came from a very particular context of concern. My research in the Caribbean alerted me to the extent to which notions of “purity,” “blood,” and lately even DNA analysis came to figure prominently not just as ways of ascribing Indigenous identities, but also as means of claiming them in light of widespread, categorical assertions by colonial rulers and scholars that these peoples had vanished. To my surprise, similar politics of identity were being instituted in North America—indeed, the interest in DNA studies had spread from the U.S. to the Caribbean, and in North America as well I found a concern with blood, purity, and the stigma faced by “Black Indians” who were being rejected as claimants to Cherokee citizenship. In Canada, First Nations residents carry cards indicating what degree of Indigenous “blood” they possess. Also in Canada, I repeatedly hear Euro-Canadians refer to this or that Aboriginal figure as “not a real Indian…he looks white”. (I had encountered similar purist prejudices during my years in Australia, directed at some of the most prominent Aboriginal activists who, phenotypically and superficially appeared to be “mixed” if not “almost white”.) If race, blood, and DNA were so prevalent, could we find similar concerns spread out across all of the Americas? If so, why? If not, why not? Are race, blood, and DNA essentially the same thing? These were the very first, seemingly very simple questions that led to the emergence of this project.

Taking together all stages of this project, it included a total of as many as 21 scholars from across the Americas and from across the disciplines, only some of whom appear in this volume. In particular I would like to thank and acknowledge the advice, support, varying degrees of participation and interest, and correspondence of individuals who were involved at different stages of the project, including: Kimberly Tallbear, José Barreiro, Phil Bellfy, Marisol de la Cadena, Alice and Dennis Bartels, and the late Melissa Meyer who sadly for us passed away mid-way through the development of this project. We also benefited from the participation of Indigenous scholars, who comprised half the number of participants in the overall project. With an immense amount of research and writing taking place in the U.S., there was often a tendency to have greater American representation, more than Canadian, Latin American, and least of all, from the Caribbean. The result of this struggle, the constant revision and reinterpretation, we hope will offer some critical insights into the processes of making “race” out of (or against) Indigenous identity and the role of “place” in debates about Indigenous identity. The final product strikes some geographic balance, with two chapters on Canadian cases, two dealing with American Indians, two focused on Central America and the Caribbean, and two pertaining to South America.

What about DNA Testing?

The previous concern with DNA, represented by as many as four participants early on in the project, largely diminished and then vanished altogether, especially when we no longer had the same participants as in earlier stages of the project. This is not to say that DNA debates are absent in the volume as a whole, but rather that they no longer structure the volume as a leading focus, which in any case would be more relevant to the North American situation than elsewhere. Yet even that is not entirely accurate, as the use of DNA testing to determine Indigenous ancestry has traveled to Puerto Rico, the Dominican Republic, and to my great surprise to the very community I studied for four years in Trinidad & Tobago, as the result of the work a team from the Molecular Anthropology lab at Pennsylvania State University and the National Geographic Genographic Project. In the past, similar studies have also been conducted among the Garifuna in Central America and recently in St. Vincent & the Grenadines, in the latter case again by the Penn State team.

Sidebar on U.S. "Science": DNA Testing for Indigeneity Comes to Trinidad
DNA testing comes in for severe questioning and criticism in the volume, and I would also add here to my public objections to the DNA research done in Trinidad. Aside from the more than just questionable merits of using genetics to prove cultural identities and political constructs such as tribal affiliations, I also pointed out that, "given the harvesting of biometric data by U.S. universities with research ties to the Pentagon, there is always the risk that this information could be put to uses of which the Caribs are unaware." Indeed, one of the researchers involved in the Trinidad DNA study, Jada Benn-Torres, from a military family, has conducted research in the field funded by the U.S. Department of Defense. I cannot see any reasonable purpose for conducting the study in Trinidad, as the local Carib community has been officially recognized for decades, and is not possessed by any self-doubts of their identity. Indeed, not all of the Caribs in Arima chose to participate in the study, which raises more questions about the extent to which those examined are representative of the community as a whole, and thus places in doubt even the basic scientific merits of the study. What has also not been made known is what is the ultimate purpose of the research, where the information is stored and for how long, and who has access to the database.

The Historical Importance of a Bad Question

The collaboration that produced this volume through much iteration has been focused on what is arguably one of the worst questions to be posed to or against Indigenous Peoples ("Who is an Indian?"), one that ultimately calls on them to give an account of themselves, for being who they are in the light of foreign invasions and occupations. It’s as if being who they are is a problem, and furthermore, it is a problem that they caused. Worse yet, they may not even be who they think they are.

As with all bad questions, one can expect to get a lot of bad answers. So why address such a question, going as far as making it the leading question of this project? The answer is simple: the question, however one may assess its epistemological qualities, is a politically important question (the most important perhaps), an institutionalized question, a governing question that structures people’s lives, their access to resources, and even their self-perceptions. It is also a key historical question, one that continues to be asked repeatedly, and one that will inevitably lose relevance. That this question has been raised across the Americas, in different forms (substituting, as the case may be, any number of cognate or tribal labels in the place of “Indian”), is due to a shared history of colonization and state-building and the dominance of European theories of citizenship, nationhood, race, and identity. Here we can start to look beyond the constraints and limitations of that question and in seeing past the constraints imposed today by states.

It was not the intention of the contributors of the volume to either advance academic expertise as the ultimate arbiter of Indigenous identities, to provide an easy-to-follow menu for “accurately determining” who is Indigenous, or to provide advice that caters to the functioning of government bureaucracies and their micro-management of Indigenous affairs. Our greater concern was with the politics that work to preserve the dominance of a “bad question,” a very “bad” and yet historically very important question: “Who is an Indian”? Our hope is that readers will come away from this effort with a determination to ask better questions—better in the sense of being more analytically productive and with implications that are more socially just and fair. Among the questions we would like to see posed are those that posit indigeneity as a historically specific type of relationality, that involve issues of power and affectivity, without searching for the elusive “one size fits all” solution. If, however, we overcame the stigmatization of being Indigenous only to then treat it as a category implying “privilege” and uniquely demanding “proof” of belonging, then we will not have gone far past the point of endorsing extinction.

Setting the Stage: Some Opening Quotes to Remember

“When they get off the boat, they didn’t recognize us. They said: ‘Who are you?’ And we said: ‘We’re the People, we’re the Human Beings,’ and they said: ‘Oh Indians,’ because they didn’t recognize what it meant to be a human being. ‘I’m a Human Being, this is the name of my tribe, this is the name of my people, but I’m a human being.’ But the predatory mentality shows up and starts calling us ‘Indians’ and committing genocide against us as a vehicle of erasing the memory of being a human being….Even in our own communities, how many of us are fighting to protect our identity of being an Indian, and 600 years ago that word, ‘Indian,’ that sound was never made in this hemisphere—that sound [‘Indian’], that noise, was never ever made! Ever. We’re trying to protect that as an identity, see, so it affects all of us”. —John Trudell, Lakota poet and activist. 
“It is one of the many ironies of the American experience that the invaders created the category of Indians, imposed it on the inhabitants of the New World, and have been trying to abolish it ever since”. —David Maybury-Lewis, co-founder of Cultural Survival. 
“There’s tremendous racism in Peru. In Lima, brown people, the descendants of Indigenous people, try to live as white as possible. That’s because of the influence of the media and government. If you embrace your Indian-ness, you’re shunned. You’re less than a third-class person. It’s an insult to call someone an Indian. It’s the equivalent of calling someone stupid”. —Benjamin Bratt, actor. 
“The question of my identity often comes up. I think I must be a mixed blood. I claim to be male, although only one of my parents is male”. 
—Jimmie Durham, Cherokee artist. “What does part Indian mean? (Which part?)….you don’t get 50% or 25% or 16% treatment when you experience racism—it is always l00%”. —Joane Cardinal-Schubert.

Contents

Preface, pages vii-ix

Introduction: “Who Is an Indian?” The Cultural Politics of a Bad Question, pages 3-51 Maximilian C. Forte (Concordia University, Sociology and Anthropology)


In this chapter I discuss the genesis, multiple meaning and historical applications of this "bad question," across the Americas. In the process I also defend the thesis that the Americas as a whole serve as the appropriate unit for analysis in understanding the colonial, "scientific," ideological, and (geo)political efforts to define Indigenous identities. While I outline how the racialization of indigeneity spread across imperial domains in the Americas, I also examine the centrality of place, of territoriality, and how place also intersects race. I discuss the emergence of "Indian" as a racial construct, and from there I proceed to build the larger theoretical and analytical narrative which the various chapters help to form. Who is the "real Indian" and issues of "race mixture" and the impact of slavery and the plantation system in North and South America and the Caribbean forms one level of analysis. Another has to do with kinship and science, with blood, DNA, and how these relate to ideas of "race purity." Going beyond "blood quantum" and race, I provide some context and the wider debate around the critically important contribution by Julia Coates in this volume, on the always timely issue of the Freedmen and the Cherokee Nation. Debates around self-identification, and tribal politics, progress toward a discussion of the many cases of "Indian non-Indians" and "Non-Indian Indians". Finally I end with an overview of the problems involved with "recognition", with some discussion of the geopolitics of recognition and then, pointing toward the Conclusion, looking beyond the politics of recognition.

Chapter One Inuitness and Territoriality in Canada, pages 53-70 Donna Patrick (Carleton University, Sociology and Anthropology and the School of Canadian Studies)


“The question of who counts as Aboriginal [in Canada],” explains Donna Patrick (this volume), “has long been linked to the question of who owns traditional Aboriginal lands”. Patrick’s chapter explores “the question of categorizing Indigeneity in Canada by examining the linguistic, political, and judicial processes associated with the notions of territory, ancestry, and belonging that shape Indigeneity today,” with a focus on the Inuit in Canada, situated within a broader analysis of Aboriginal identity in Canada. “Inuitness” in Canada, as Patrick tells us, followed a different trajectory from that of First Nations, in that the construction of Inuit identity has been guided not just by state policy but by Inuit attachments to both land and language. In Patrick’s chapter we learn that for the Inuit “the notion of ‘territoriality’ operates together with the notion of ancestry” in shaping the identities of Inuit living in urban centres of the Canadian South as much as those living in the Arctic. Donna Patrick observes that Indigenous ideas of identity in early colonial Canada “had little to do with race, biology, or ethnicity” and that Indigenous Peoples in fact demonstrated in practice that they were guided by a “notion of inclusivity” whose existence “has been supported by numerous accounts of Euro-American settlers and soldiers being accepted and adopted into First Nations groups”. While Patrick argues that we do not see in Canada a dominant discourse about the bio-politics of Indigenous identities to the same extent that we find in the U.S., she admits that a “‘covert’ or de facto blood quantum” has been part of policies governing Aboriginal, and in particular First Nations, peoples.

Chapter Two Federally-Unrecognized Indigenous Communities in Canadian Contexts, pages 71-91 Bonita Lawrence (York University, Equity Studies)


In her chapter Bonita Lawrence points out the cases of First Nations that span the Canada-U.S. border, where for example “the Passamaquoddy Nation of New Brunswick, or the Sinixt Nation, in British Columbia, have federal recognition in the United States but not in Canada,” which underscores the arbitrary, shifting, and inconsistent standards used by states to “appraise” indigeneity, as Lawrence argues. Bonita Lawrence explores identity issues among two federally-unrecognized groups—the Algonquins of Eastern Ontario and the Mi’kmaqs of Newfoundland—which have been the subject of her research for the last decade, providing a window into how the Canadian state produces unrecognized Aboriginals. As she explains, “most federally-unrecognized bands or nations are created by the nature of the treaty process itself,” while other bands are federally-unrecognized “because Canada has refused to honour historic relationships or has disregarded the traditional boundaries of Indigenous nations”. The primary means for such communities to gain federal recognition, to legally become Aboriginal again, is to assert Aboriginal title through the courts (if there is a treaty governing particular territory), or as Lawrence outlines in her chapter, “to take part in the comprehensive claims process if no treaty has been signed in the territory”. Otherwise, federally-unrecognized Indigenous peoples are “incorporated simply as ‘citizens’ within the wider nation-state dominated by settlers”.

Chapter Three The Canary in the Coalmine: What Sociology Can Learn from Ethnic Identity Debates among American Indians, pages 92-123 Eva Marie Garroutte (Boston College, Sociology) and C. Matthew Snipp (Stanford University, Sociology)


Eva Marie Garroutte and Matthew Snipp in their chapter in this volume titled, “The Canary in the Coalmine: What Sociology Can Learn from Ethnic Identity Debates among American Indians,” devote considerable attention to debating the racialization of indigeneity. As just one example of the kinds of interests vested in the non-recognition of “mixed” American Indians, Garroutte and Snipp point to Donald Trump: as a competitor against the newly recognized Pequots, and their plans to open a casino, he produced a definition of “who is an Indian” in phenotypical terms: “they don’t look like Indians to me. They don’t look like Indians to Indians,” injecting his racial bias by further calling them “Michael Jordan Indians”. This is useful in showing how ultimately one of the most common ways of assigning Indigenous identity in the Americas is focused on appearance, and where racial discourses prevail, a specific type of appearance: phenotype. Garroutte and Snipp  also discuss some of the additional, problematic conceptual issues raised by the quantification of identity, which can apply to both genetic testing and blood quantum. Quantification establishes distance as a prerequisite for measurement, “with the corollary that, at some point, individuals’ connection to American Indian forebears becomes exhausted”. Quantification of identity presupposes distance, and tends toward disappearance. It raises physical standards about ideational and subjective identities, even as it creates new subjectivities around the use of scientific resources. The right to measure involves a power to erase, just as the power to speak for Indigenous peoples, and to assign their identities, is the power to silence them, permanently. The two case studies at the focus of their chapter, the Mashantucket Pequots and Kennewick Man, make for highly engaging and illuminating reading.

Chapter Four “This Sovereignty Thing”: Nationality, Blood, and the Cherokee Resurgence, pages 124-150 Julia Coates (University of California Davis, Native American Studies)


Julia Coates strongly and productively challenges a number of prominent, published perspectives that have been critical of definitions of Cherokee identity by the Tribal Nation’s government. Coates argues that legal definitions are often overlooked in discussions of indigeneity, while race and culture gain greater attention. Yet, as she explains, many tribal governments in the U.S. regard legal definitions, not as artificially imposed from external colonizing institutions, but as internally achieved definitions of nationality and their sovereign statuses. While the Cherokee Nation’s lack of cultural requirements are frequently not understood by non-Indians and derided by other tribal nations, the Cherokee Nation has continued to assert that nationality derived from their specific history of tribal citizenship is a more inclusive category for contemporary times than race or cultural markers. This is almost a reversal of arguments criticizing the Tribal Nation’s exclusion of certain persons. Based on interviews with what Coates calls “a particularly challenging group of Cherokee nationals,” the 60 percent of the citizenry living outside the tribal core in northeastern Oklahoma, her chapter examines the potential of nationality as a basis for self-identification for those in the Cherokee diaspora, and the role the concept of citizen plays in the contemporary Cherokee resurgence. Coates points to problems with a debate that “focuses on identity construction as located in race, heritage, DNA, and cultural attributes and expressions” and that leave out law and sovereignty. She says that one reason why the cultural, racial, and ethnic aspects of identity may be the primary sites for investigation and discussion, for many Indigenous Peoples is the fact that many of them are not formally organized into nominally sovereign political entities with an internal jurisdiction. Speaking of academics, Coates suggest that one reason most academics seem to differ from tribal governments’ rigid determinations of citizenship, is that academics tend to be more inclusive in their view of who is an American Indian, not wanting to serve as identity police and imposing definitions of Indigenous identity on Natives. Her emphasis is on nationality as a potential for retention and resurgence (or what some call resilience), rather than simply acting as a colonialist mechanism of control and exclusion.

Chapter Five Locating Identity: The Role of Place in Costa Rican Chorotega Identity, pages 151-171 Karen Stocker (California State University, Anthropology)


Designating a special place as the locus of persons with an Indigenous identity can be a way for an assimilationist state, one that historically rejected the Indigenous presence as in the case of Costa Rica, to create the illusion that indigeneity is minimal and marginal. As Karen Stocker explains in her chapter in this volume, in Chorotega some residents of what later became the reservation opposed reservation status given their “tremendous resentment at being the only community in the region officially designated as Indigenous when the whole area had Indigenous roots, and aversion to the stigma attached to Indigenous identity in a country that often projected an image of whiteness and European heritage”. The Costa Rican government’s imposition of an Indigenous identity on residents of Chorotega was a convenient way of removing that label from everyone else who resided outside of that particular place, using the assigned indigeneity of some to reassure others of their Europeanness. Karen Stocker’s chapter, based on ethnographic research carried out between 1993 and 2007, addresses how various residents of the Chorotega reservation, those who live just outside the reservation, scholars, legal discourse, historical discourse, those who have resided or studied in other Costa Rican reservations and, more recently, the tourism industry have “defined Indigenous identity in contradictory ways, and in manners that have had varying consequences for those labeled as Chorotega in Costa Rica”. She addresses the history and impact of these multiple competing definitions. Stocker traces the ways in which “one set of customs has gone from Indigenous to non-Indigenous, national custom, and back again, as a result of the shifting of discourses around it”. Stocker spotlights what she finds to be “a common thread through all of these definitions and interpretations of indigeneity,” and that is “the role of place, and how the same concept that mired inhabitants of the Chorotega reservation in discrimination now serves to authenticate its practices”.

Chapter Six Carib Identity, Racial Politics, and the Problem of Indigenous Recognition in Trinidad and Tobago, pages 172-193 Maximilian C. Forte (Concordia University, Anthropology)


My own chapter in this volume, based on four years of ethnographic research and ethnohistoric research dating to early colonial times, shares some features similar to both those by Donna Patrick and Karen Stocker. On the one hand, the state’s recognition of only one single, organized Indigenous community in just one of Trinidad’s 16 former mission towns—the Santa Rosa Carib Community in Arima, on the island of Trinidad—makes it seem, however implausibly, that indigeneity was somehow contained and delimited (which instead reflects the state’s bias in how indigeneity ought to be controlled and secluded). On the other hand, in articulating their own indigenous identity, members of the Carib Community point to a multitude of factors, beyond but including race, to include a history of residence in Arima. The structure of this chapter follows three basic lines of argument: first, that the political economy of the British colony dictated and cemented racializations of identity. Second, the process of ascribing Indigenous identities to individuals was governed by the economic rights attached to residents of missions, rights which were cut off from any miscegenated offspring. There were thus political and economic interests vested in the non-recognition of Caribs, and race provided the most convenient justification—a justification that took the form of a narrative of extinction. Third, over a century later, while racial notions of identity persist, current Carib self-identifications stress indigeneity as a cultural heritage, an attachment to place, a body of practices, and recognition of ancestral ties that often circumvent explicitly racial schemes of self-definition. State recognition of the Caribs occurs within this historical and cultural context, and therefore imposes limits and conditions that simultaneously create new forms of non-recognition.

Chapter Seven Encountering Indigeneity: The International Funding of Indigeneity in Peru, pages 194-217 José Antonio Lucero (University of Washington, The Henry M. Jackson School of International Studies)


As José Antonio Lucero explains in this volume, “blood” is already incorporated in national ideologies of race-mixture, and is not specific and particular enough to be used as part of the regimes of identifying the Indigenous. As Lucero adds, “in a region where ‘everyone’ has native blood, but not everyone is ‘Indian’ the social category and social fact of Indianness rely, necessarily, less on biology or blood than on the intersecting socio-cultural workings of politics, language, place, class, and gender”. More specifically, Lucero's chapter takes the work of Oxfam America as the focus of his case study, as it has been among “the earliest funders of Indigenous activism”. His chapter examines two different moments in the interactive process of legitimation between organizations such as Oxfam America and Indigenous political organizations in Peru, “as actors on both sides of the development encounter shape discourses over the meanings of development and indigeneity across local and global scales”. The “geopolitics of recognition” is what Lucero conceptualizes as regimes of indigeneity that span local, national and global scales. Lucero discusses how Indigenous people throughout the Americas (and beyond) have often found it inevitable, and sometimes useful, to engage a variety of legal, economic, and political systems. “Since the first contacts with missionaries,” he writes, “the state, and agents of global capital, Indigenous people have found that new systems of domination are not without points of entry within which they can contest the very terms of domination,” and in the present context, “the rising importance of non-state actors in the wake of aggressive neoliberal economic reforms (which shrank already weak states) provided an additional set of opportunities that Indigenous people have been able to use” (Lucero, this volume). However, one of the problems for Indigenous actors bound in relationships with external agencies is that the reconstruction of indigeneity that results is often Janus-faced, where “some discourses are for external consumption and have little to do with the lived ‘social fact’ of indigeneity at the local level”.

Chapter Eight The Color of Race: Indians and Progress in a Center-Left Brazil, pages 218-223 Jonathan Warren (University of Washington, International Studies, Chair of Latin American Studies)


Jonathan Warren begins by telling us that "since the 1990s a large number of Brazilian Indigenous communities have been federally recognized, successfully acquired land, established their own schools, and achieved a higher degree of autonomy and self-determination. Furthermore, anti-Indian violence is no longer condoned by the Brazilian government; racism has been officially acknowledged; race-cognizant government policies, such as affirmative action, have replaced race-neutral ones; and a number of antiracist commissions and initiatives have been established at federal, state and municipal levels. Finally, the first centre-left politicians in Brazilian history, Luiz Ignacio Lula da Silva (2003–2010) and Dilma Rousseff (2011–present), both of the Workers’ Party, have controlled the executive branch of government for almost a decade. Given these substantial changes, one could be forgiven for expecting a positive report on the state of Indigenous affairs in contemporary Brazil. Unfortunately, the outlook is rather dim. Perhaps most surprising is that many of the culprits are from the centre-left, namely the Workers’ Party, social scientists, and sectors of the movimento negro". Jonathan Warren’s chapter reveals to us that in Brazil, the racial question, and thus conceptions of antiracism—like much of “critical race studies,” he adds—simply removes the Indian from analysis, as if Indian subjectivities were entirely irrelevant. A key example of how this has occurred in critical race studies comes from Howard Winant’s very own analysis of racism in Brazil, which singles out Africans. This is odd, as Warren finds, given that as many as a third of Brazilians have some Indian ancestry. As Warren explains in this volume, Brazilian Indians are removed from the racial question in Brazil: “race is reduced to a question of blackness”. Indeed, throughout Latin America, Warren sees that Indigenous peoples are “not considered germane to race matters,” and quoting Peter Wade he adds: “the virtually unquestioned assumptions [prevails] that the study of blacks is one of racism and race relations, while the study of Indians is that of ethnicity and ethnic groups”. Warren also shows that phenotype is present in Brazilian estimations of “authentic” and “real” Indigenous identities, with those who have African and European features routinely dismissed as “racial charlatans,” in ways that echo experiences both in the U.S. and the Caribbean. Warren’s chapter is critical to this volume’s contention that race is a problem that needs to be studied in connection with indigeneity, not apart from it. His argument is critical not only for developing critical race studies, but also for political practice: the antiracist movement in Brazil cannot be just a Black movement.

ConclusionSeeing Beyond the State and Thinking beyond the State of Sight, pages 234-241 Maximilian C. Forte (Concordia University, Sociology and Anthropology)


Rather than restating or summarizing the contents of this volume, the Conclusion helps to sketch some of the ways in which critical Indigenous perspectives have sought to develop alternative ideas and practices of indigeneity and indigenization. In a hemisphere which sees, in most cases, Indigenous Peoples moving to cities, and an increased decoupling of indigeneity and territoriality, along with the incursion of the industrialization of ethnic ascription--the commerce in genetic identities--these issues become especially important. The volume closes with a sharp reminder of why "Who is an Indian?" is a bad question that produces even worse answers, and what our task as intellectuals ought to be when confronted with such questions.

Contributors, pages 243-246
Index, pages 247-254

A Little About the Contributors

Julia M. Coates (Cherokee Nation, Tahlequah, Oklahoma) is presently at the University of California, Los Angeles. Her title is Senior Writer/ Oral Interviewer in American Indian History for the Center for Oral History Research of the Charles Young Research Library. At the time of writing she was an assistant professor in the Department of Native American Studies at the University of California, Davis. Her research interests cover Native American diasporas, history, identity, women, and politics. She has conducted participant-observation fieldwork with hundreds of Cherokee citizens in California, Texas, and New Mexico. Coates also helped to form numerous Cherokee community organizations throughout California and in other states. For over six years, she was the project director and lead instructor for the award-winning Cherokee Nation history course, which brought her into personal contact with most of the employees of the Cherokee Nation, along with thousands of Cherokees in northeastern Oklahoma communities and throughout the country. She also serves on the Tribal Council of the Cherokee Nation as its “At Large” representative. At UC Davis she teaches the Introduction to Native American Studies as well as classes on race, women, development and history within Native America.

Eva Marie Garroutte (Cherokee Nation) is an associate professor in the Department of Sociology at Boston College. She has a background of research and publication related to the study of Native American issues, health and aging, racial/ethnic identity, and religion. She is the author of the influential book Real Indians: Identity and the Survival of Native America (University of California Press) and various articles in sociological and health-related journals. In collaboration with Cherokee Nation Health Services, she has conducted a series of research projects funded by the National Institute on Aging to examine medical communication needs among American Indian elders using tribal clinics. Her current service on editorial advisory boards includes the Journal of Native Aging and Health, American Indian Quarterly, and the University of Arizona Press series Critical Issues in Indigenous Studies. She is a past Area Commissioner of Indian Affairs in Tulsa, Oklahoma.

Bonita Lawrence (Mi’kmaw) is an associate professor at the School of Social Sciences of the Atkinson Faculty of Liberal and Professional Studies at York University in Toronto, Canada, where she teaches Indigenous Studies and anti-racism. Her research and publications have focused primarily on urban, non-status, and Métis identities, federally unrecognized Aboriginal communities, and Indigenous justice. She is the author of “Real” Indians and Others: Mixed-Blood Urban Native People and Indigenous Nationhood (UBC Press), and co-editor of Strong Women’s Stories: Native Vision and Community Survival, a collection of Native women’s scholarly and activist writing (Sumach Press). She is a traditional singer who sings with groups in Kingston and Toronto at Native social and political gatherings.

José Antonio Lucero is an assistant professor in the Henry M. Jackson School of International Studies, at the University of Washington in Seattle. He is the author of Struggles of Voice: The Politics of Indigenous Representation in the Andes (University of Pittsburgh Press) and the editor of Beyond the Lost Decade: Indigenous Movements, Democracy, and Development in Latin America (Princeton University Program in Latin American Studies). He teaches courses on government, politics, and social movements in Latin America, among others. His research interests focus on comparative politics, Latin American politics, democratization, social movements, and the politics of race and ethnicity.

Donna Patrick is professor in the Department of Sociology and Anthropology and the School of Canadian Studies at Carleton University in Ottawa, Canada. Her current SSHRC-funded research focuses on multiliteracies, identity, and community-building among urban Inuit in Ottawa. Her other interests lie in the broader area of Indigeneity and urban Aboriginality in Canada, as well as in the political, social, and cultural aspects of language use, with a focus on language endangerment discourse and Aboriginal languages in Canada. Her 2003 book, Language Politics and Social Interaction in an Inuit Community (Mouton de Gruyter), examines these issues in Arctic Quebec. She teaches courses in language, culture, and power and in Aboriginal and northern issues, with a focus on the Arctic. In teaching and research, Donna approaches the study of Aboriginal issues, language, and discourse through an interdisciplinary lens, focusing on historical, geographical, and social processes.

C. Matthew Snipp is a professor in the Department of Sociology at Stanford University where, among other positions, he has been the director of the Center for Comparative Studies of Race and Ethnicity. He teaches courses in contemporary and historical American Indian Studies as well as rural sociology. He is the author of American Indians: The First of the Land (The Russell Sage Foundation, New York), which was selected as an academic book of the year by CHOICE.

Karen Stocker is an assistant professor in the Department of Anthropology at California State University, Fullerton. She is a scholar of applied anthropology with interests in education, the social constructions of race and ethnicity, language, and Latin American ethnography. She is the author of “I Won’t Stay Indian, I’ll Keep Studying”: Race, Place and Discrimination in a Costa Rican High School (Colorado University Press).

Jonathan W. Warren is an associate professor in the Henry M. Jackson School of International Studies at the University of Washington in Seattle, where he is also the director of the Latin American and Caribbean Contributors Studies Program. Within the broad area of critical race studies he has focused on Whiteness, racism literacy, racial identity formations, and the links between everyday practices and racism in the U.S. and Brazil. He is the author of the highly regarded book Racial Revolutions: Antiracism and Indian Resurgence in Brazil (Duke University Press).

...and myself.

          It Really Is Meaner        

For better or worse, Senate Democrats seem to have settled on a single word to describe the health care bill that their Republican colleagues unveiled Thursday: “Meaner.” As in: You know how Donald Trump called the House GOP’s health care bill “mean”? This one—the Better Care Reconciliation Act—is meaner.

“I thought it wouldn’t be possible for the Senate Republicans to conjure up a bill even worse than that one,” Senate Minority Leader Charles Schumer said at a press conference Thursday afternoon. “Unfortunately, that is what they have done.” He then turned to a red poster with the word “mean” printed across it, and scrawled an “er” in black sharpie next to it. Voilà. “Meaner.”

Corny? Sure. But to Democrats’ credit, it was at least on point. Remarkably, the Senate has produced a piece of legislation that would cause even more human wreckage than the much-loathed bill the House passed last month, potentially dealing a historic blow to the American safety net.

The reason why it truly is meaner can be boiled down to another single word: Medicaid. One could maybe argue that the Senate’s bill is mildly gentler to Americans who buy their insurance on the individual market—though even that is debatable. What is indisputable, however, is that the bill sets up Medicaid for even more devastating cuts than what the House contemplated, gradually throttling the program’s funding in order to pay for tax cuts for the wealthy.

Let’s unpack that a bit.

Many people—including some supposedly ticked-off conservative Republican senators—have already described the Senate bill’s reforms to the individual market as “Obamacare lite.” That’s reasonable enough. Like the Affordable Care Act, the Senate bill would give Americans tax credits to buy health insurance, calculated by their age and income. But these credits would be much stingier.

How much stingier?

Today, under Obamacare, Americans qualify for tax credits if they earn up to 400 percent of the poverty line. Under the Senate bill, the threshold would drop to 350 percent.

Under Obamacare, Americans who receive subsidies have to spend no more than 9.5 percent of their income on premiums. Under the Senate bill, they’d have to spend as much as 16.2 percent.

Under Obamacare, subsidies are designed to help people buy insurance that covers, on average, 70 percent of their health costs. (Those are known as silver plans.) Under the Senate plan, subsidies are designed to buy insurance that covers 58 percent of costs. (Today, that’d be a bronze plan.) Low-income people would get less money to buy crappier insurance with higher deductibles. In other words, their insurance could be all but unusable.

While the Senate bill gives people less help to buy coverage, it does avoid some of the truly perverse outcomes for low-income and older Americans that were baked into the House’s legislation, which set its own flat tax credits based mostly on age. For instance, the scheme that Paul Ryan and his colleagues concocted would have left a 64-year-old making $26,500 per year paying more than half his income toward insurance premiums. That same person would be spending closer to 10 percent of his paycheck under the Senate plan.

Unlike the House bill, the Senate wouldn’t let states opt out of Obamacare’s popular consumer protections for patients with pre-existing conditions. Of course, it would still let them ditch other key rules, like the requirements that insurers cover certain benefits, which would make it hard for the sick to find the coverage they need. It would still let carriers charge older patients more than they can now, too. But in terms of regulations, I suppose you could say it is less “mean.”

With all that said, there’s something funny about the Senate bill: It’s not clear anybody on the individual market would be much better off than under Obamacare. Fewer would qualify for subsidies, which would be worth less. It’s not clear premiums would fall all that much, especially if states decided to keep the Affordable Care Act’s regulations. Deductibles would be sure to go up. Under the House bill, on the other hand, some middle-class households would probably be eligible for tax credits to buy insurance for the first time. For all the violence that bill would have inflicted on the sick and vulnerable, there were at least a few clear winners. With the Better Care Reconciliation Act, not so much.

But the individual market is a bit of a sideshow. It’s where around 22 million people get their health insurance today. The real issue is Medicaid—which covers about 62 million individuals, or almost one-fifth of Americans, and 39 percent of children. Both the House and Senate would make historic, devastating changes to the program that would leave millions uninsured. But the Senate’s are more extreme. Where Paul Ryan would take a hatchet to Medicaid, Mitch McConnell would break out the Black & Decker.

Both bills would roll back Obamacare’s Medicaid expansion. The Senate would go about it more slowly—a big priority of the chamber’s moderates, who supposedly didn’t want to “pull the rug out” from anybody—but the end result is the same. Both bills would also cap federal Medicaid spending for the first time, giving each state a fixed chunk of change each year to help pay for each enrollee. But after 2024, the Senate bill would increase that funding much more slowly by tying it to a lower measure of inflation. That tiny, technical-sounding change would cause Medicaid’s purchasing power to rapidly wither.

To be specific: The House bill would increase Medicaid funding based on the medical component of the Consumer Price Index. (Spending for some groups, like the elderly and disabled, would based on the M-CPI plus 1 percent.) This sounds reasonable, until you realize that the M-CPI, as it’s called, mostly tracks items that families pay for out of pocket—glasses and Tylenol rather than hip-replacement surgery. Hitching Medicaid to the index would drag the program’s budget growth, making it nearly impossible for states to continue offering enrollees the same level of care they receive today. Statehouses would be forced to choose between reducing the number of services Medicaid covers, reducing payments to doctors, or even cutting the program’s rolls.

The Senate prefers an even more severe approach. After 2024, it would adjust Medicaid based on the normal Consumer Price Index, which tracks things like food, clothing, and electronics, trailing far behind medical inflation. There is no real policy justification for this other than budget-cutting.

How bad could the damage be? Well, the House bill would have slashed about a quarter of Medicaid’s future funding over a decade. The Senate plan cuts much deeper. Over time, this approach could easily drain hundreds of billions more from Medicaid, leaving the program a shadow of its former self as its budget fails to keep up with ever-climbing costs.

Medicaid is bedrock piece of the American health care system, larger by enrollment than Medicare. Both the House and Senate would cut it back. Either approach would signal a generational disaster for the American welfare state. But Mitch McConnell’s bill would bring on the travesty even more quickly. So, yeah, you could say his bill is meaner.


          Is This the End for Tommy John Surgery, It Is in Texas, with More States to Follow        

Dallas Clinic Eliminates Need For Tommy John Surgery in 95% of All Cases. Is Tommy John Surgery About To Become Extinct? You Can Avoid Tommy John Surgery

Dallas, TX -- (SBWIRE) -- 10/13/2014 -- Dallas Peak Performance and Rehab (www.PeakPerformanceAndRehab.com) has been making waves in the sports medical community ever since they began successfully treating Ulnar Collateral Ligament (UCL) and torn labrum injuries and in the process not only saving players seasons, but in some cases their careers. Most surprising to the players, coaches and parents, however, has been the rapid pace at which these results have occurred, allowing players to get back on the field in 12-14 days fully recovered and pain free, as opposed to 6-8+ months with other therapy programs, and still not fully healed. These incredible results and accelerated pace of recovery have opened many eyes, drawn praise from parents, coaches and players alike but has also initiated skepticism in others at first. One such skeptic was Lynn University head baseball coach, Rudy Garbalosa, (2009 NCAA DII Champion, and All Time Winningest Baseball Coach in Lynn's history). Upon hearing about the technology and Dallas Peak Performance's (DPP) success, he invited DPP's Managing Director Mark McClure to the team's facilities to demo the protocols on one of their pitchers suffering from UCL issues.

"The pitcher had been having elbow pain throughout the season and was clearly inflamed. Rest, stim, nothing worked. Prior to the treatment he had a pain level of 7 when he did a throwing motion. At the end of the session, his pain was zero. Nothing. He immediately went into the program and is now pain free, injury free and the elbow issue that he had for a year is gone. Completely. This is the real deal. If you're a pitcher with elbow, shoulder and overall arm issues, you need to check this out first. We were so impressed by the results we are using this on our entire pitching staff. This is a game changer for baseball", Garbalosa stated.

Like Garbalosa, Dr. Jason Bongi of Atlanta Spine and Sport was also a skeptic, having been a sports chiropractic physician for many pro athletes throughout North America as well as work with the NHL's Buffalo Sabres on a team level.

"When I heard the results Dallas Peak Performance was getting for their baseball clientele, I mean literally taking pitchers slated to be out months or even a season due to UCL issues and torn labrums, and then getting them back in under 3 weeks stronger than they were before the injury, I was skeptical. Mark McClure came to Atlanta and demonstrated on a patient with severe elbow pain, a level 10 when he started. At the end of the treatment the patient was at a pain level of zero, and subsequently went into the program. That patient is now pain free and symptom free for the first time in 5 years. The ARP Wave and Dallas Peak Performance's Tommy John elimination program is one of kind. Stim, Ultrasound, Laser and the rest cannot hold a candle to this technology. And from a UCL pain elimination standpoint? Not even close", Bongi ended.

The testimonials from the players themselves are pretty strong also. Ty Sullivan, former collegiate pitcher and now expert pitching instructor with The ARMory, one of Florida's premiere pitching academies, made this statement in a recent video interview;

"We did a baseline test on the radar gun and I got to 78 MPH with medial elbow pain I had been struggling with for 2 and half years now. Being a skeptic and scientist myself along with my father we did one session. And after that one session I was able to get up to 89MPH on the radar gun, with no pain and never dropped below 85MPH. That's close a 12MPH increase in under 15 minutes," Sullivan stated. Sullivan went into the ARP Wave program and by 20 sessions was pain free, hitting 90MPH consistently and the UCL issue eliminated.

So is Tommy John surgery an "epidemic" that can be eliminated?

The American Sports Medicine Institute has stated that Tommy John Surgery has increased 20% each and every year from 2004-2011, and that number has continued to climb ever since. So if Dallas Peak Performance and Rehab is the answer to this epidemic, why isn't every team, player, parent and coach in America rushing to them? The results are clearly there, what's holding back the masses?

"Ignorance and old school thinking is what is holding them back. Rest, ice, compression and elevation, or what is referred to as RICE in the sports medicine field does not work for UCL issues, labrum issues or any issue for that matter. Never has and never will. What people need to realize is where you feel pain or are injured is not where it is coming from, ever. Somewhere a muscle or muscles are not absorbing force like they were meant to do and this arises from a neurological disconnect. OK, so what's that mean? It means that the signal being sent by the brain for that muscle to turn on fast enough to absorb force and create force is not getting through, and this is due to sodium potassium leakage and where there is sodium potassium leakage there is scar tissue and absolutely zero neurological communication. When this occurs that force is then sent to areas of the body not meant to absorb force, hence causing damage to the ulnar collateral ligament. Until the muscles meant to absorb this force are treated, all the Tommy John surgeries in the world will not fix the problem because that force will STILL be sent to the ulnar collateral ligament. Sure, they now have a new ligament and the surgeon did his job to perfection, but the shocks still are not working, the force is still going to the UCL and only a matter of time until the problem arises again. Strength training, rest, corrective exercises are useless until the origin of what is causing the problem is fixed. With the ARP Wave system and proprietary protocols developed by Denis Thompson and Jay Schroeder, we are able to pinpoint this neurological disconnect, treat it, turn the muscle back on so to speak so it is now absorbing and creating force, transfer the force away from the ligament to the muscle and in the process vastly accelerate healing. To the point our players are back in 21 days or less as opposed to 6+ months. Thus the reason for our success in eliminating the need for Tommy John Surgery in 95% of the cases that we see", Dallas Peak Performance, Managing Partner Mark McClure stated.

While DPP has become the "go to" facility for eliminating the need for Tommy John surgery, with players flying in from all over the country to be treated by head therapist and ARP Wave expert Paula Wallem, the clinic has seen their business explode by treating a lot of the players remotely as well.

"Not everyone can fly in and be treated by us at our facility. Most are at college or it's during the season and they can't get away long enough for the 20 sessions needed, which is the case for our minor leaguers and Major Leaguers. So we simply ship out the ARP Wave device and treat them via Skype or FaceTime with our 30 Day "In Home" Program. This has worked extremely well. Not only do we treat them and neurologically strengthen them back to a level they probably haven't been at in 5 plus years. But they also get to sleep with the ARP Wave system, reinforcing everything we do and continuing to supply blood flow to the UCL region and in our shoulder patients, the labrum region, accelerating the rehab process even further. It's been amazing to see a player start the first session at a pain level of 7 to 10 with only 5 pitches or so, and by session 5 they are throwing at full velocity and by the 20th session they are pain free, symptom free and in most cases throwing harder than they ever have," Paula Wallem stated.

So what has been the long term success with Dallas Peak Performance's "Tommy John Surgery Elimination" program? FOX 4 DALLAS NEWS sports reporter, Edward Egros, did a story recently on Tommy John Surgery and Dallas Peak Performance's success in eliminating it, and caught up with former Denton Ryan, Texas pitcher Sam Watson for an interview..Watson was scheduled for Tommy John surgery in 2012 but came to Dallas Peak Performance beforehand to see if he could avoid it all together.

"Prior to the first session, she (Paula Wallem) made me do some exercises that really hurt so we could see a "before and after". At the end of this initial session there was no pain whatsoever. After 10 sessions I was pain free. She saved my career for sure!"

Watson went into the full 20 session program almost 2 years ago, got back a clean MRI and is still pain free, throwing maximum velocity and is as strong if not stronger than before the injury. Watson is now pitching for Western OK State.

Could this be the end of Tommy John surgery, as Dallas Peak Performance and ARP Wave pave the way for a new, proven way to eliminate UCL pain and injury?

"Not the end per se, but certainly a huge reduction. Look, sometimes surgery is absolutely warranted, especially if the ligament is cut in half or off the bone. No amount of what we do or what anyone else does will fix that. Plain and simple. However, if it's a partial tear or extreme inflammation we can reverse that symptom at an accelerated pace and when we are done, the result is permanent. Period." McClure ended.

Due to the rapid rise of DPP's Tommy John Surgery elimination program in Texas, they have decided to expand into Florida at the end of November, opening clinics in Boca Raton and Miami respectively, with California to follow. They intend on establishing 50 or more clinics in the next 24 months than expand nationally from there.

So, is Tommy John surgery on the endangered species list? Only time will tell. With a track record of over 600 NFL Players and more than 2,000 of the world's most elite professional athletes trusting their multi-million careers to this patented system of rehab, it's a very, very strong possibility.

For more information on Dallas Peak Performance & Rehab's "Tommy John Surgery Elimination" program, you can call them at 469-513-4200 or visit them at www.PeakPerformanceAndRehab.com

About Peak Performance & Rehab
The leading Tommy John surgery rehab and elimination clinic in the United States. In addition, Dallas Peak Performance and Rehab has a rapid ACL Rehab recovery program, as well as rapid rehab from torn labrums, knee, back, hip, elbow and shoulder issues, with a client base that includes top NFL, MLB and Division 1 NCAA players.

For more information on this press release visit: http://www.sbwire.com/press-releases/is-this-the-end-for-tommy-john-surgery-it-is-in-texas-with-more-states-to-follow-553204.htm

Media Relations Contact

Mark McClure
Peak Performance and Rehab
Telephone: 214-417-1218
Email: Click to Email Mark McClure
Web: http://peakperformanceandrehab.com/


          Comment on Hibernate Batch Processing – Why you may not be using it. (Even if you think you are) by adventuremateblog.ampblogs.com        
There are many medical complications associated with it. It does exist, it's actually nnot a lie, however it generally seems too work just on laboratory animals. Chitosan is often a natural substance (which has a structure that appears like cellulose) often known as "the fat magnet" as a consequence of its ability to become a lipid binder wijth the rate in order to 5 too 10 x its weight. http://adventuremateblog.ampblogs.com/Guideline-for-Choosing-a-Weight-Loss-Product-4098925
          Blue Flowers Org’s Prostate Cancer Care 360™ Summit        
Title: Blue Flowers Org’s Prostate Cancer Care 360™ Summit
Venue: Commerce Club / Atlanta
Category: Charity Event
Date: Sep 15, 2017
Time:
Description:

 

Partners in business, politics and the medical community will come together for ONE DAY to advance prostate cancer awareness in the community: 

Blue Flowers Org’s Prostate Cancer Care 360™ Summit

Date: Friday, September 15, 2017

Time: 9AM-5PM

Place: Commerce Club, 191 Peachtree Street NE, 49th Floor

Atlanta, GA 30303

Reception: 5-7PM

We invite women and the men in their lives, to attend with their partners, son's, brothers, father's, friends and family. Receive information on early detection for those that have not been impacted by prostate cancer, and vital information for those that have including patients and their families, caregivers, prostate cancer survivors, and physicians- all members of the public are invited to attend.

Physicians have an opportunity to earn continuing medical education (CME) credits.

Also, enjoy an exclusive sneak peek of the documentary:

“Silent Killer: Prostate Cancer in African American Men” by Blue Child Entertainment.

Visit www.blueflowers.org/summit for schedule and registration.

 

 


                  
Having an addiction still carries an unfortunate stigma to it. Though much has been improved in the way the medical community views addiction, as it is now considered a disease just like any other disease, there are still those in society who view addiction as a choice, a weakness, and some sort of moral failing. […]
          An Answer to "Retire Where?"        

Chris DeMuth Jr. recent published an article in Seeking Alpha titled “RetireWhere?” in which he suggested three fairly typical locations for retirement: Wyoming, Puerto Rico, and Dominica. He justified those choices largely in economic terms. Unfortunately he completely ignores the vast array of "soft" quality of life factors as well as a number of very real issues that older persons, retired or not, must must deal with.

East Passyunk, Philadelphia, PA

What? Inner city Philadelphia? You bet. We’re fairly young (about to be) retirees.  East Passyunk and the Passyunk Square area are the closest things this side of Paris to pure bliss for us. Why? Let me enumerate the ways:

Walkability

Living in a city comes with absolutely free walkability. There’s no need to own a car, pay for gas, insurance, maintenance, and so forth. This alone is an enormous financial advantage. If a place is too far to walk, Philadelphia has a very good public transit system. In the rare instance we happen to need larger or more flexible transport we can use ZipCar or a similar service.

Dining

We’re both avid “foodies” and East Passyunk is a nationally recognized hotbed of high quality eats. Some of our favorites in the area include Le Virtu and Brigantessa, Laurel, P’unk Burger, and Stargazy a recently opened authentic English pie shop (complete with eels). Bing Bin Dim Sum is a high concept “dim sum” joint serving innovative dishes you’ll never see in an actual Chinese restaurant. You can read more about the area restaurants in this recent article: http://www.philly.com/philly/neighborhoods/east-passyunk?&betaPreview=redesign

If we’re willing to walk a little further we come to Philadelphia’s Italian Market and the really wonderful Monzu cooking up great Sicilian style food. A few blocks away is Pho 75, a great Vietnamese joint. A short bus ride brings us east to City Tavern, Zahav, the original Han Dynasty location, Morimoto’s first restaurant, and many more.

We can take the Broad Street Line a couple stops north for Vetri, Jose Garces’ Volver and many more. Two more stops north and we’re in Chinatown. Another stop brings us to Spring Garden and the excellent restaurants in that area including  Osteria, Alla Spina, and many more.

And heck, let’s not forget Pat’s and Geno’s, the great Cheese Steak emporiums facing each other across E. Passyunk Ave.  I’m pretty sure you can’t get a real cheese steak in Puerto Rico.

The Arts

At this point it should come as no surprise that we also happen to enjoy the arts. Nearly everyone has heard of the Philadelphia Museum of Art (if only from Rocky). Then there’s the Rodin Museum, The Barnes Foundation, The University of Pennsylvania Museum of Archaeology and Anthropology are the most well known. On Bloomsday (or any other day) we can wander over to the Rosenbach Museum and Library to O.D. on everything Joyce. All are a short bus or subway ride from East Passyunk.

What’s that? You’re interested in music? Well, there’s the Kimmel Center, home of the Philadelphia Orchestra, The Curtis Institute, The Wilma Theater. and The Academy of Music all within about 3 blocks on Broad Street. Over on Chestnut there’s the Prince Music Theater and on Walnut Forrest Theater and Walnut Street Theater, the oldest playhouse in America. For those interested in something louder, The Trocadero and the Electric Factory present wildly varied acts.  And those are just the big names!

Movies? Yes, we have movie theaters here in Philadelphia. We like to go to the Cinemark theaters near the Penn campus because there are also a bunch of good restaurants in the area including another Han Dynasty. 

Travel

Philadelphia is located in the middle of Amtrak’s Northeast Corridor so we have frequent and reasonably fast train access to Washington DC, Baltimore, New York, Providence and Boston. We can take a SEPTA train to PHL for direct flights to places we like to visit like Paris, Rome, and Las Vegas.

If you live in Wyoming and want to visit Paris, well, first you have to drive to CPR, then fly to DEN, then to a real airport like ORD, EWR, or IAD and finally to CDG – 16+ grueling hours. Me? I can hop the train to PHL for the 7h 25m flight to CDG.

Shopping

For groceries we’ve got Chinatown, Reading Terminal Market, Italian Market, several chain grocery stores, and a number of seasonal farmer’s markets within walking distance or a short transit ride. Then there are the specialty shops like Czerw’s for all kinds of Polish sausages, several traditional bakers, local cheese makers and so forth. Craft Beer? We got it all over the place. And we also happen to have Philadelphia Distilling, makers of Bluecoat Gin, arguably the best made in the US. (Plus you get a $3 credit when you bring back your empty bottle.)

Of course we’re living in a major city, so we’ve got department stores like Macy’s and all the national chains. Wherever we happen to shop we’ll be a few steps from great dining.

Health Care

Philadelphia is a regional hub for health care. We’ve got the University of Pennsylvania medical complex, Thomas Jefferson University Hospital, Hahnemann University Hospital, Temple University Hospital… all minutes away. In Dominica you’ll have to make your way to Princess Margaret Hospital in Goodwill, Roseau at the south west side of the island.

OK. So what’s It Cost?

The houses we’re looking at are in the area of 1,100-1,300 sq. feet with prices for a fully renovated home in the $250,000 to $300,000 range. Many have roof decks with great views of the city skyline. We’ll have about $100,000 in equity from our current house (in the first ring suburb made famous by Kobe Bryant) so we’ll be financing a relatively small amount. We expect to have monthly PITI payments in the $1300-$1500 range. This number isn’t random; if we have no other income than our two social security checks and small annuity Mrs. C. is vested in, we’ll still be able to live comfortably (though international travel will require considerable planning).

As for utilities mid-block row houses are extremely inexpensive to operate with combined gas and electric bills in the $125/month range (less than half what we’re paying now) and water/sewer about $40.

Maintenance consists principally of keeping an eye on your roof every 20 years and occasionally shoveling a little snow off your 15 feet of sidewalk. East Passyunk has several very active civic associations that sponsor recycling clean outs, home tours, community gardens, zoning hearings and so forth.

Where does Pennsylvania actually end up on the retiree tax chart? Quite high. According to this infographic from Kiplinger's Pennsylvania is number 11 on the list of "15 Most Tax Friendly States For Retirees":


My Conclusion

There’s simply no way we could even consider living someplace like Wyoming. Puerto Rico and Dominica are probably great places to visit, but live there? Not a chance. We want to have all the cultural offerings of a major city steps from our front door, friendly neighbors who are active in the community, and easy access to the rest of the world. If (when) we become ill, we want to get to the hospital quickly and get world-class care once we arrive.  

          Alternative Medicine - The Best Healing Methods        
The world is so brainwashed by the medical community, Big Pharma and even our government about the best methods for curing our ailments that it is truly frustrating. America will never solve the serious condition of our health problems until they decide to educate people how to become healthy and stay healthy instead of being dependent on prescription drugs to do it.
          Conventional Medicine is a Hoax        
The conventional medical community and Big Pharma (Drug industry) has brainwashed the general population into believing that their way is the way to correct your health problems. Now there are some credible doctors in America who really have the correct methods for curing your ailments and diseases but they are not among the conventional or traditional medical community. These doctors are the holistic doctors, the naturopaths, the osteopathic and even the chiropractors.
          Impact of Case Order on Laparoscopic Sacrocolpopexy: Do Surgeons Need a Warm-Up?        
imageObjectives: Warm-up is defined as a preparatory activity or procedure. Using case order as a surrogate for surgeon warm-up, first cases were compared with second or later cases for intraoperative complications, operative time, and length of stay (LOS) among women undergoing laparoscopic sacrocolpopexy. Methods: This is a retrospective study of laparoscopic sacrocolpopexies performed from 2009 through 2014 at a large academic center. Any surgery preceding laparoscopic sacrocolpopexy was considered a surrogate for surgeon warm-up. Logistic and linear regression analyses were used to identify predictors of complications, operative time, and LOS. Results: Of 480 procedures, 192 (40%) were first cases and 288 (60%) were second or later. Baseline characteristics were similar between groups. Intraoperative complication rate was not different between groups (6.3% vs 3.1%, P = 0.50) even after controlling for risk factors. Operative times were comparable on initial analysis (231.2 ± 55.2 vs 225.9 ± 51.2 minutes, P = 0.28l), but a small difference was detected after adjusting for confounding factors (body mass index, menopausal status, surgeon experience, intraoperative complications, and concomitant hysterectomy or midurethral sling; adjusted β = 8.44 minutes, P = 0.037). Length of stay was longer for first case patients (1.44 ± 0.67 vs 1.24 ± 0.50 days, P < 0.001) even after adjusting for age, medical comorbidities, operative time, conversion to laparotomy, ileus/bowel obstruction, and postoperative urinary retention (adjusted β = 0.183 days, P = 0.001) as well as after accounting for delayed start time of second or later cases. Conclusions: Laparoscopic sacrocolpopexy performed first case of the day without preoperative surgeon warm-up conferred no significant increase in intraoperative complications. Second or later cases were associated with small decreases in operative time and in LOS.
          Still Rough Around The Edges        

Many gamers were disappointed when Square Enix revealed that Deus Ex would miss its original March 2011 release date. However, if what I saw at E3 is any indication, the game needs the extra time in development.

The demo involved protagonist Adam Jensen sneaking into a medical facility, showcasing more stealth scenarios than combat. This means that he spent a lot of time avoiding detection and looking for ways into places, so the demo had a heavy emphasis on the ways the players' choices will affect which options are available.

For instance, Jensen appears to run into a dead end when the only way to proceed is by falling down a long shaft. Because he has invested in a special ability, he can fall the distance without getting hurt. However, if he had not bought that upgrade, he'd have to turn around and find another way in. Another example surfaces when Jensen needs to cross into a new area, but the path is blocked by electricity. While an upgrade exists that allows him to traverse it, he didn't have it in this scenario, so instead he picked up a nearby vending machine and used it to jump up to another section of the facility.

Along the way, Jensen ran into a few patrolling guards, but he generally took them out quietly to avoid attracting attention. This was another puzzling aspect, though; performing takedowns on guards requires you to use one "charge" from an energy meter (which only had four charges in this demo). Once you've used them all, only the first charge regenerates, which means that after the initial expenditure, players could spend a lot of time waiting for their one charge to come back. Maybe it would make more sense if Jensen were using some awesome ability, but you can grab people and snap their necks without cybernetic augmentation...why does it require energy?

While Deus Ex successfully showed that there several ways to attain your objective in the medical compound, the trick with providing multiple options is that they should all be compelling. Otherwise, it feels you're just like walking through different doors that all lead to the same room, and it seemed like Deus Ex leans more toward providing lots of options rather than adding depth to them.

Maybe the stealth-focused demo just doesn't show off the things Deus Ex does best, but as a fan of RPGs and stealth games, I walked out of the demo feeling like the gameplay was culled from the last generation and dressed up with current-gen graphics.


          

Trans people react to the opening of a new clinic for trans kids and teens.

   
     

Life-saving and life-changing health care.


A new clinic geared toward St. Louis transgender teens hopes to be a sort of one-stop shop for supporting trans youth.

After opening the first week of August, St. Louis' Transgender Center of Excellence is already booked through mid-September. It's one location complete with mental health, hormones, and other essential services, and it's getting rave reviews from patients already.

"Having support and acceptance is extremely important for this patient population," Dr. Christopher Lewis, physician and founder of the clinic, told WGN News. "Transgender patients already deal with harassment and discrimination within the medical community and that is a barrier to them accessing care."

A supportive medical environment is a big win for trans kids — take it from others, like myself, who wish those resources existed when we were growing up.

On Twitter, I reached out to my trans followers to find out what this type of clinic would have meant to them when they were younger. A few common themes emerged.

For many, it would have meant help and support for themselves and their parents.

Others remarked on how a supportive environment would have encouraged them to stop hiding, sidestepping some traumatic early-life experiences.

It would have provided a sense of identity for those who felt alone and isolated, who never saw accurate reflections of themselves in the media.

Then, the emails started rolling in. "If I'd had the words, if I'd known the concepts, if I had a supportive and professional environment to turn to. I would have been able to live without a dysphoria that came close to killing me, repeatedly," writes Alvhild Sand, a trans woman from Norway, about what a difference a resource like this would have made for her.

"It would have been fantastic if such a place had existed," writes Gwyn Ciesla, another trans woman, who grew up in a "highly Catholic town in the 1980s" where she was "not exposed to LGBTQ ideas or openly LGBTQ people."

"The only tools available were in the context of education, religion, and mental health, and were ineffective because they were incomplete," Ciesla explains. "If I had known then what I know now, and a clinic like this had been available, it would have been life-changing."

"Given what I did and didn't know at the time, I might not have been able to get to the point where I could take advantage of the clinic's services," Ciesla admits, expressing hope that "the presence of the clinic might have at least increased the information available to me and helped me to understand and begin to accept myself years earlier."

"I only survived my youth by a narrow margin, and I think this clinic might have widened that margin a lot. I hope this clinic can do that for youth now and in the future."

The new clinic in St. Louis joins a handful of other trans-specific children's medical programs across the country.

One of the most notable is the gender development services at Lurie Children's Hospital in Chicago. The sad fact is that even though the Affordable Care Act effectively banned discriminating against people on the basis of their gender identity, many trans people continue to face either discrimination or confusion from their health care providers.

According to the National Center for Transgender Equality's 2015 U.S. Transgender Survey, 33% of trans people who saw a health care provider in the previous year had at least one negative experience, were denied care, or had to actually teach their provider about trans patients. In other words, there's a lot of work to be done, and taking steps to ensure trans people have competent, knowledgeable medical care is a work in progress.

The new clinic in St. Louis is a big step in the right direction, providing care and benefits for years to come.



          IGF-1, Heart Health and Bodybuilding        
  By Thomas O’Connor, MD     1/02/17   I’ve stayed away from writing about Human Growth Hormone- HGH and  any of the related agents such as IGF-1, IGF-1 Lr3 and IGF-1 DES simply because these agents have not been used or discussed in the main-stream medical community. Anabolic Androgenic Steroids- AAS...
          Big Brains in the British Medical Community        
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          Nature's Wonderland Fenugreek Seed Herbal Supplement Capsules, 800 mg, 60-Count Bottles (Pack of 3) Immediately        
I had to supplement my son in the hospital because of medical complications, and when we got him home I decided that I wanted to breast feed solely, so I started taking Fenugreek to build up my supply. It worked, and I was producing enough that I could feed him and then pump and start to stock up. I know for a fact that it was this product that helped boost my supply because, stupidly, I stopped taking it, thinking that I would stay at the current production rate. Within days I went from producing 4 ounces every 3 hours to producing 1 ounce if I was lucky. I'm a bigger Mom so I take 4 pills three times a day. It took me almost a week to get my supply back up, but we are back to normal now. It also works well in conjunction with Blessed Thistle Nature's Herbs Blessed Thistle, 360 mg, Capsules, 100 capsules (Pack of 4). I started taking the Blessed Thistle to jump start my body back into production and take 3 pills three times a day. You will notice that your urine and sweat start to smell like the Fenugreek. Some say it smells like maple syrup, and there might be a hint of that, but to me it just smells herby and it isn't all that pleasant, which is why I decided to stop taking it. A good deodorant will solve the problem, and it's worth the smell if you are having production issues. Get more detail about Nature's Wonderland Fenugreek Seed Herbal Supplement Capsules, 800 mg, 60-Count Bottles (Pack of 3).

          Sciatica Symptoms, Causes, Treatments        

Back pain is one of the most common conditions that people suffer from today. But,Sciatica pain relief with massage therapywhen you’re talking about experiencing sciatica pain that shoots from your lower back into your glute area and legs, it can be difficult to sit, stand and move around to accomplish your daily tasks. Sciatica pain is becoming so well known that studies show up to 43 percent of people experience this painful condition at some point in their lives. (http://www.massagetherapy.com/articles/index.php/article_id/2064/Assessing-Sciatic-Pain) If you suffer from excruciating pain in your lower back and body area, it’s important to identify the symptoms and causes of your condition so that you can take the appropriate path to treatment. 

Sciatica or Piriformis Syndrome: The Symptoms May Be Similar

The sciatic nerve is the largest nerve in the body that starts in the lower back and runs down both legs. Sciatica pain occurs as the result of a spine or disc condition that compresses part of the nerve, causing inflammation, extreme pain and even numbness from the low back down throughout the leg. The most common symptoms of sciatica pain include weakness, numbness and tingling in the low back that radiates down the side of one of your legs. The pain is rarely experienced in both legs and it’s described as a sharp, shooting type of pain, explains Edi Woods, massage therapist at Elements Indianapolis North.

While many people seek relief from sciatica pain symptoms as described above, many may actually be suffering more from a muscular issue, rather than a true sciatic nerve condition. In Woods’ experience, the muscular condition of piriformis syndrome is often more common in people, but may not always be accurately detected, as it can compress the sciatic nerve and imitate pain similar to sciatica.

“I see clients with sciatica-like symptoms frequently in my practice”, explains Woods. “But, from a muscular standard it’s usually more of a piriformis muscle issue than true sciatica. The piriformis muscle is one of our deep lateral hip rotators that extend into the glute area. It can get inflamed, contracted and can compress the sciatic nerve as well. When this happens, it mimics the sciatica condition, which people are more commonly aware of. So, a lot of people may come in saying they have sciatica, but in reality more times than not it’s piriformis syndrome.”

Causes Range from Health Conditions to Activity Induced

True sciatica pain can happen to anyone since any of us can develop a disc disorder like herniation or degeneration. The cause in these long-term conditions could be hereditary or the result of a lifestyle event like an accident or injury that creates prolonged compression on the sciatic nerve. Pregnant women also have a tendency to develop a temporary sciatica condition as the weight from carrying a baby either pinches or puts extra pressure on the sciatic nerve.

But, for the majority of the people that Woods treats who seek relief from what they call sciatica pain, the cause tends to be muscle overuse from runners, walkers, cyclists, etc. who push their bodies through a constant forward leg motion. When this happens, a trigger point develops in the piriformis muscles, which can compress on the sciatic nerve and cause similar sciatica-type symptoms.

“When I have clients who are coming to me with sciatica-type symptoms, I don’t treat the nerves, but rather the muscles that are compressing on the nerve,” explains Woods. “To work on someone with sciatica symptoms, I’m going to first focus on the piriformis muscles, which are located in the middle of each glute, and then move on to the gluteus muscles, hamstrings and sacrum. I prefer to use a mix of trigger point therapy and a stretching routine in all of these areas because everything is connected and pulling on each other.”

Alternative Treatments May Help with Addressing Pain

Since true sciatica is typically the result of a herniated or degenerative disc, the medical community recommends surgery as the number one way to remedy the condition, says Woods. However, there are other ways to address the pain before you get to the surgical table. Woods suggests a mix of heat, ice, pain medications, physical therapy, stretching and regular massage therapy as possible alternative solutions to help alleviate the pain associated with both sciatica and piriformis syndrome. And, contrary to what you might expect, Woods also advises her clients suffering from sciatica symptoms to stay active, continue exercising and stretching. If you stop all activity, the area is more prone to locking up muscularly, compressing on the nerve more and increasing your level of discomfort.

“A lot of people think that they have to have surgery right away if they feel sciatica-type symptoms,” explains Woods. “But, what they’re feeling could actually just be the result of tight piriformis muscles that can be treated by massage therapy sessions that focus on the glutes and lower back areas. Their symptoms can be relieved and they won’t have to have surgery.”

“It’s important for people to realize that sciatica symptoms are something that can be treated with massage in cases when the cause isn’t really a disc issue, but is rather tight piriformis muscles,” concludes Wood.

If you’re experiencing sciatica-like symptoms in your lower back and glute areas, seek the advice of a medical professional to determine whether your symptoms are true sciatica or piriformis syndrome. In both cases, massage therapy can help alleviate pain in both the long-term and short-term. Just realize that you have options when it comes to treatment and make sure to explore all possible diagnosis and treatment plans, advises Woods. 


          Sciatica Symptoms, Causes, Treatments        

Back pain is one of the most common conditions that people suffer from today. But, when you’re talking about experiencing sciatica pain that shoots from your lower back into your glute area and legs, it can be difficult to sit, stand and move around to accomplish your daily tasks. Sciatica pain is becoming so well known that studies show up to 43 percent of people experience this painful condition at some point in their lives. (http://www.massagetherapy.com/articles/index.php/article_id/2064/Assessing-Sciatic-Pain) If you suffer from excruciating pain in your lower back and body area, it’s important to identify the symptoms and causes of your condition so that you can take the appropriate path to treatment. 

Sciatica or Piriformis Syndrome: The Symptoms May Be Similar

The sciatic nerve is the largest nerve in the body that starts in the lower back and runs down both legs. Sciatica pain occurs as the result of a spine or disc condition that compresses part of the nerve, causing inflammation, extreme pain and even numbness from the low back down throughout the leg. The most common symptoms of sciatica pain include weakness, numbness and tingling in the low back that radiates down the side of one of your legs. The pain is rarely experienced in both legs and it’s described as a sharp, shooting type of pain, explains Edi Woods, massage therapist at Elements Indianapolis North.

While many people seek relief from sciatica pain symptoms as described above, many may actually be suffering more from a muscular issue, rather than a true sciatic nerve condition. In Woods’ experience, the muscular condition of piriformis syndrome is often more common in people, but may not always be accurately detected, as it can compress the sciatic nerve and imitate pain similar to sciatica.

“I see clients with sciatica-like symptoms frequently in my practice”, explains Woods. “But, from a muscular standard it’s usually more of a piriformis muscle issue than true sciatica. The piriformis muscle is one of our deep lateral hip rotators that extend into the glute area. It can get inflamed, contracted and can compress the sciatic nerve as well. When this happens, it mimics the sciatica condition, which people are more commonly aware of. So, a lot of people may come in saying they have sciatica, but in reality more times than not it’s piriformis syndrome.”

Causes Range from Health Conditions to Activity Induced

True sciatica pain can happen to anyone since any of us can develop a disc disorder like herniation or degeneration. The cause in these long-term conditions could be hereditary or the result of a lifestyle event like an accident or injury that creates prolonged compression on the sciatic nerve. Pregnant women also have a tendency to develop a temporary sciatica condition as the weight from carrying a baby either pinches or puts extra pressure on the sciatic nerve.

But, for the majority of the people that Woods treats who seek relief from what they call sciatica pain, the cause tends to be muscle overuse from runners, walkers, cyclists, etc. who push their bodies through a constant forward leg motion. When this happens, a trigger point develops in the piriformis muscles, which can compress on the sciatic nerve and cause similar sciatica-type symptoms.

“When I have clients who are coming to me with sciatica-type symptoms, I don’t treat the nerves, but rather the muscles that are compressing on the nerve,” explains Woods. “To work on someone with sciatica symptoms, I’m going to first focus on the piriformis muscles, which are located in the middle of each glute, and then move on to the gluteus muscles, hamstrings and sacrum. I prefer to use a mix of trigger point therapy and a stretching routine in all of these areas because everything is connected and pulling on each other.”

Alternative Treatments May Help with Addressing Pain

Since true sciatica is typically the result of a herniated or degenerative disc, the medical community recommends surgery as the number one way to remedy the condition, says Woods. However, there are other ways to address the pain before you get to the surgical table. Woods suggests a mix of heat, ice, pain medications, physical therapy, stretching and regular massage therapy as possible alternative solutions to help alleviate the pain associated with both sciatica and piriformis syndrome. And, contrary to what you might expect, Woods also advises her clients suffering from sciatica symptoms to stay active, continue exercising and stretching. If you stop all activity, the area is more prone to locking up muscularly, compressing on the nerve more and increasing your level of discomfort.

“A lot of people think that they have to have surgery right away if they feel sciatica-type symptoms,” explains Woods. “But, what they’re feeling could actually just be the result of tight piriformis muscles that can be treated by massage therapy sessions that focus on the glutes and lower back areas. Their symptoms can be relieved and they won’t have to have surgery.”

“It’s important for people to realize that sciatica symptoms are something that can be treated with massage in cases when the cause isn’t really a disc issue, but is rather tight piriformis muscles,” concludes Wood.

If you’re experiencing sciatica-like symptoms in your lower back and glute areas, seek the advice of a medical professional to determine whether your symptoms are true sciatica or piriformis syndrome. In both cases, massage therapy can help alleviate pain in both the long-term and short-term. Just realize that you have options when it comes to treatment and make sure to explore all possible diagnosis and treatment plans, advises Woods. 


          Massage in the 21st Century        

The path of massage therapy has been long, with roots dating back thousands of years. However, the practice in Western culture and specifically in the United States is relatively young, with many miles left to evolve and transform the industry. To truly appreciate the journey of massage therapy, it’s important to take a step back in time to where massage began, as well as look ahead to where massage is going in the future of healing, relaxing and rejuvenating the American population.

Relaxation and Rejuvenation Have Ancient History

The art and science of healing with massage therapy has references in writings from China, Japan, India, Egypt, Greece and Rome. Hippocrates even wrote of the many advantages of rubbing techniques to bind and loosen joints, as well as defined medicine as “the art of rubbing."

While the popularity of massage has risen and fallen throughout the years, it is steadily increasing as a viable complementary and alternative medicine and is used in conventional settings as well. Most recently, the 2007 National Health Interview Survey estimated that 18 million U.S adults and 700,000 children had received massage therapy in the previous year. Today, Swedish massage continues to be the cornerstone of mainstream massage; however, there are various modalities practiced in the United States.

“Swedish is the foundation of all massage modalities and approaches,” says Colleen O'Connor, massage therapist and studio owner at Elements Louisville East. “We use all of the original Swedish techniques in any massage that we do, but as massage therapists we continue to evolve every day. We become better as we see new conditions and we adapt to find techniques and approaches that will help alleviate our clients’ pain and make them feel better.”

Mainstream Meets Massage

Over the last decade, O’Connor has seen the massage industry take off by leaps and bounds. In the past, many shared the attitude that massage was a luxury that people couldn’t afford or it was something that people who were in a high degree of pain used as a last resort to try to experience some relief. Today, with the emergence of retail massage and an increased knowledge from the public about the benefits of massage, its modalities and practices have become more of a widely utilized form of healthcare, relaxation and luxury that millions of people are using on a daily basis.

Some of the turning points that O’Connor attributes to the recent explosion in popularity and acceptance of massage by the American population include:

  • The weaving of traditional medicine with massage techniques. Nurses in the past and present have used the power of touch and massage in hospitals to help in healing patients. Specifically, nurses have used touch techniques in premature babies to help them thrive.
  • The on-camera presence of therapists at the Olympics. The world was exposed to the power of massage therapy when they saw Olympic athletes traveling with their therapists, as well as use massage techniques to prepare for and recover from their Olympic event.
  • The emergence of retail massage locations nationwide. More accessible massage studios have increased acceptance of massage therapy by the majority of the population as it is becoming seen as more of a necessity rather than a luxury. These locations and monthly wellness programs allow you to easily carve time out of your busy schedule to take care of yourself on a routine basis.
  • The introduction of industry licenses and therapist training. Massage has become more of a serious business over the past few years as many states require therapists to have initial and continuing education, as well as hold licenses to practice massage therapy. The industry also has added national oversight that plays an active role in defining how massage is delivered and how therapists are trained.

“There are a lot of these moments that have happened that make people realize that they can relate with using massage in their daily lives,” reflects O’Connor. “I think the acceptable images of massage therapy being embraced by the medical community and athletes have made it more mainstream.”

Benefits and Acceptance Continue to Cross Gender, Generation Lines

In our society of diminished downtime and escalating responsibilities, the need and demand for massage therapy continues to rise. The sandwich generation, in particular, is turning to massage for relief and relaxation to combat the increased responsibilities and stress associated with taking care of the people who have raised them, as well as raising their own children.

O’Connor also is seeing an influx of male clients in her studio who are golfers, heads of businesses, dads and retirees who are turning to massage to maintain their mental and physical health. And, parents are paving the way for their children to become comfortable with and appreciate the benefits of massage when they bring them in for a session to relieve repetitive motion issues from sports and other activities.

“In the next five to 10 years, I foresee more people in the future who will start looking at massage not as an alternative medicine or last resort, but as a way to take care of themselves as they progress through their life,” O’Connor said.

The evolution of massage continues to move forward at a rapid pace as the mental and physical benefits of the practice become more accepted among the American public. Take a total mind and body approach to health and wellness by including the power of massage therapy into your way of life.


          NEET, Exit Test, No DNB: Read How Scrapping of MCI Will Affect Doctors        

Most of the readers must have been reading many things about changes in Medical Council of India (MCI), conduction of National Eligibility cum Entrance Test (NEET), National Exit Test (NEXT) and much other news. We doctors have been hearing and knowing about Medical Council of India (MCI) since many years but now this is changing. MCI as per IMC Act, 1956 is going to be replaced with the National Medical Commission (NMC) Act, 2016 as soon as the draft rules are confirmed by the parliament of India. I am dividing this article into 3 parts, in 1st part I will describe in short the changes which are going to happen because of replacement of MCI with NMC, in 2nd part I will describe these changes in much more details for interested readers and in 3rd part I will be writing some comments by myself which are going to affect all the medical students and doctors in India. Short description of changes in National Medical Commission (NMC) MCI and all its functions will be replaced by the same by National Medical Commission (NMC). So MCI will be no more after this act comes into effect. All India Postgraduate Medical Entrance Exam (AIPGMEE) will be replaced with National Eligibility Cum entrance  Test (NEET) for admission into both undergraduate (UG) and Postgraduate (PG) Medical courses. There will be a National Exit Test (NEXT) also known as a Common Licentiate Examination, which UG medical students have to pass to get themselves registered in National Medical Register or State Medical Register and thus practice. So without passing the exit test, no students passing out after the introduction of this act will be able to practice in India. Common Licentiate Exam will come into effect within 3 years of the passing of this NMC Act. Common Licentiate Examination will also serve as NEET for PG medical admission. National Board of Examinations (NBE) will be merged into NMC. So even NBE will not exist after this act comes into effect. MD/MS by MCI and Diplomate National Board (DNB) by the National Board of Examination (NBE) will be merged into a single course. No more MCI inspection for Medical college and courses recognition. If a medical college fails to meet the minimum standards, a fine can be levied on it and it will be allowed to explain the reasons. If a college is derecognized it will be asked to maintain the facilities till the last admitted batch of students passes out. Currently, only not-for-profit organisations are allowed to set up medical colleges but this act will allow for-profit organisations as well to establish medical colleges. Under-Graduate Medical Education Board (UGMEB) will oversee UG medical courses Post-Graduate Medical Education Board (PGMEB) will oversee PG and super speciality medical courses Medical Assessment and Rating Board (MARB) will oversee assessment and rating of medical education institutions. So students will be able to see the rating of medical colleges before admission to see the quality of education in the same. Board for Medical Registration (BMR) will be Maintaining the National Register (NR). Any person having a foreign medical degree will not be able to practice in India i.e. will not have their names registered in NR unless they qualify National Licentiate Examination. All students studying degree, diploma or certificate course before the NMC act coming into effect, can continue the same courses and institutions have to maintain the standards and conduct the examinations as per the standards before the act comes into effect. Detailed description of changes in National Medical Commission (NMC) Indian Medical Council (IMC) Act came into effect in 1956. After which it has been amended multiple times by central governments for a variety of reasons. Recent ones being due to allegations of corruption by MCI officials in allowing medical colleges to function and recognition of medical courses. Ordinances included Indian Medical Council (Amendment) Ordinance, 2010 for one year with a newly constituted Board of Governors (BoG) taking over the functions of the MCI. IMC (Amendment) Act, 2010 for reconstituted of MCI within three years which was again amended in 2012 and 2013. IMC (Amendment) Second Ordinance 2013, led to the reconstitution of the MCI while also allowing the latter to continue the work done by the BoG. Parliamentary Standing Committee on Health and Family Welfare submitted Report 92 to the Rajya Sabha on 8th March 2016 after detailed discussions, wide consultations with various stakeholders and review of published articles and written submissions by experts, it. The report offers a critical assessment of medical education in India and offers recommendations for reforming it. “The Committee observes that the Medical Council of India as the regulator of medical education in the country has repeatedly failed on all its mandates over the decades”. It mentions the failure of MCI like failure to create curriculum, maintain a uniform standard, devaluation of merit in admission, no transparent system and a heavy focus on infrastructure and human staff during MCI inspections but no substantial evaluation of the quality of teaching, training and imparting of skills. Recommendation were made by expert committee led by (late) Prof. Ranjit Roy Chaudhury which asked for creation of NMC and four verticals like (i) UG Board of Medical Education and Training, (ii) PG Board of Medical Education and Training (iii) National Assessment and Accreditation Board and (iv) National Board for Medical Registration. Also, Hon’ble Supreme Court has reinforced the sentiment expressed by the Parliamentary Standing Committee Report in the Judgement dated 2nd May 2016 in the Civil Appeal No. 4060 of 2009. Details of changes recommended by the committee are as follows: The National Medical Commission (NMC) will be the policy-making body for medical education and shall comprise a Chairperson, nine ex-officio Members and ten part-time members. There will be a creation of four mutually independent and autonomous Boards whose activities will be coordinated through the NMC. Each board will have a separate president. NMC will be supported by a professionally equipped permanent Secretariat. Statutory basis for conducting a common entrance examination for admissions to undergraduate and post-graduate courses in Medical institutions will be provided so that there will be a transparent admissions process based on merit rather than the ability to pay capitation fee. There will be an all-India National Eligibility cum Entrance Test (NEET) for admission into UG and PG medical courses. Statutory basis will be provided for a Common Licentiate Examination for practice by medical professionals after completion of the undergraduate medical degree. Central Government may also prescribe skill tests as necessary, as part of Licentiate examinations to ensure medical professionals have appropriate knowledge, skills and attitudes for providing health care as per societal needs. Passing the Common Licentiate Exam will be mandatory to get a license to practice in India and for registration of the doctor in the Indian medical register. This examination will also serve as the NEET for admission to the PG courses in Medical Educational Institutions. Common Licentiate Exam will come into effect within 3 years of the passing of this NMC Act and it would ensure common standards of knowledge and skills for Doctors on a Nationwide basis. Committee also deliberated on enabling statutory provision of a similar licentiate examination in the PG and other Super-Speciality Courses but did not recommend the same for reasons like diversity of courses and in the practices across states, as PG and super-specialty doctors have already appeared for NEET or Common Licentiate Exam their quality is ensured and as NBE is merged with Post Graduate Medical Education Board (PGMEB) it can could continue conducting the system of voluntary examinations with those institutions/ candidates who are willing to voluntarily take part in such a process. Committee also discussed on adding an additional enabling provision of voluntary recertification/ renewal of license exam once every ten years which is done in many countries but it concluded that it is desirable but this is not the right time for such radical step. NMC should not engage in fee regulation of Private Colleges as there is already a merit-based admission process via NEET and NMC may be empowered to fix norms for regulating fees for a proportion of seats (not exceeding 40% of the total seats) in private medical colleges. Currently, only not-for-profit organisations are allowed to set up medical colleges but this act will allow for-profit organisations as well to establish medical colleges. Enough time will be given for transition from MCI into NMC. Once the NMC bill becomes an act, rules will be notified for the same. Under-Graduate Medical Education Board (UGMEB) for undergraduate courses and Post-Graduate Medical Education Board (PGMEB) for postgraduate and super speciality courses will oversee medical education, competency-based dynamic curriculum (including assessment), prescribe guidelines for setting up medical institutions, prescribe guidelines for medical courses, infrastructure, faculty and quality of education, development/training for the faculty, facilitate research and for compulsory annual disclosure, electronically and otherwise, by medical institutions in all aspects related to their functioning. Medical Assessment and Rating Board (MARB) will do Assessment and Rating of Medical Educational Institutions as per the standards laid down by the UGMEB or PGMEB, hire credible third party agencies or to appoint such visitors and personnel as it may consider necessary to carry out inspections of the Medical Educational Institutions and  levy penalties on institutions for not meeting the minimum standards. The penalty will only be levied after giving a reasonable opportunity to institutions for explaining the reasons failures. Even after this if Medical Educational Institution fails to take the necessary corrective actions after three monetary penalties, MARB shall recommend to the NMC to initiate proceedings for derecognizing the degree/ degrees awarded by the Institution as per the procedure prescribed in section 36. No medical college can be established without permission of MARB. The board will take 6 months to accept or reject the request of setting up a medical college and if not done institution is free to make a second appeal to the Government in case no decision is received within one year from the date of his submission or the scheme is disapproved. The MARB or the Commission or the Government should approve or disapprove medical college set up request after looking into the financial resource of the institution, adequacy of academic faculty and hospital facilities. Board for Medical Registration (BMR) will be Maintaining the National Register (NR) will which will contain the name, address, date of birth, Aadhaar ID of and all qualifications recognised by UGMEB and PGMEB possessed by the licensed practitioner. National Register and State Medical register will be in sync. If the name of a doctor is removed from state medical register, they can appeal in front of BMR for the same. A person who is a citizen of India and obtains medical qualification granted by any medical institution in any country outside India recognised as medical practitioner in that country after such date as may be specified, shall not be entitled to be enrolled in the National Register unless he qualifies the National Licentiate Examination and such foreign medical qualification after such person qualifies the National Licentiate Examination shall be deemed to be recognised medical qualification for the purposes of this Act for that person. A person who is a citizen of India and obtains medical qualification by medical institution outside India recognised as medical practitioner in that country after such date as may be specified, shall not be entitled to be enrolled in the National Register unless he qualifies the National Licentiate Examination and such foreign medical qualification after such person qualifies the National Licentiate Examination shall be deemed to be recognised medical qualification for the purposes of this Act for that person. If the name of a person is not there in NR, they will not be allowed to practice medicine or testify in the court of law as a medical expert. Schedule I, II, III and IV of the IMC Act, 1956 shall be incorporated automatically in Schedule I, II, III and IV of NMC Act. All the medical institutions will have to maintain a website and display all the information as per NMC. “Any student of medical institution who, immediately before the commencement of this Act was studying for a degree, diploma or certificate in any such institution shall continue and complete his course for that degree, diploma or certificate, as the case may be, and such institutions shall provide for the instruction and examination for such student in accordance with syllabus and studies as existed before commencement of this Act and shall be deemed to have completed his course of study and awarded degree, diploma, as the case may be, under this Act.” “The medical institution in the lapse of its recognition whether by efflux of time or by its voluntary surrender or for any other reason whatsoever shall continue to maintain and provide the minimum standards approved by the Commission until such time that all the candidates are able to complete their study in such institutions.” All the assets and liabilities of the Indian Medical Council will be transferred to the National Medical Commission. Educational standards, requirements and other provisions of the Indian Medical Council Act, 1956 and the rules and regulations made thereunder will continue to be in force and operate till new standards are specified under NMC Act or the rules and regulations made. The National Board of Examinations (NBE) will be merged with the PGMEB. Also, all such courses and the qualifications by the NBE shall be subsumed and added as the courses conducted by and qualifications awarded by the PGMEB and any reference to the existing National Board of Examinations in any law or rule or contract other than this Act shall be deemed as a reference to PGMEB after NMC act comes into effect. If NMC fails or neglects to comply with any order within the specified period, the Central Government may make the regulations or amend or revoke the regulations made by the Commission, as the case may be, in such manner as the Central Government thinks fit. NMC will be funded by the National Medical Commission Fund by the central government and will be audited by the Comptroller and Auditor-General of India (CAG). If any difficulties arise due to NMC act, the central government may provide order to remove such difficulties. Comments by the Author It is a good initiative by the government to conduct NEET so that merit plays an important role in medical admission and students who come from the wealthy background will not get admission into the medical colleges just by paying capitation fees Common Licentiate Exam is being opposed by many students and doctors in social media but this exam will ensure that only good quality doctors pass out of the medical colleges and thus reducing the risk to the life of the patients. As Common Licentiate Exam will also serve as NEET, students do not have to wait for years studying for PG medical exams and many precious years of young doctors of India will be saved. Common Licentiate Exam is similar to USMLE in The United States and will have to be cleared by the foreign medical degree holders which is a good news. As there will be no more MCI inspections, the issue of recognition of medical degrees will no longer be an issue and students can safely take up medical course of their liking NEET, Common Licentiate Exam and MCI inspection removal will significantly reduce corruption in medical colleges which is good for students, doctors and the country. Although Common Licentiate Examination is in line with USMLE of USA, there should be Objective Structured Clinical Examinations (OSCE) to test the ability of the students. Also, OSCE has less scope for subjectivity as a candidate faces multiple examiners in one exam. Thus bias of the examiners towards the students is minimised. Readers can comment below and share their opinion these drastic reforms of medical education in India. Also, readers can submit their suggestions to NITI Aayog (Government of India) as done by (Dr Jayaprakash Narayan, Dr.Siva Reddy, Dr.Praveen) Foundation for Democratic Reforms – LOKSATTA, comments can be found here. Source

The post NEET, Exit Test, No DNB: Read How Scrapping of MCI Will Affect Doctors written by Dr. Paresh Koli appeared first on Desi Medicos.


          Feasibility Study for BioLEIR        
The biomedical community asked CERN to investigate the possibility to transform the Low Energy Ion Ring (LEIR) accelerator into a multidisciplinary, biomedical research facil- ity (BioLEIR) that could provide ample, high-quality beams of a range of light ions suitable for clinically oriented fundamental research on cell cultures and for radiation instrumenta- tion development. BioLEIR would be operated when LEIR is not providing heavy ions for the CERN physics programme. The study group was mandated to write a Feasibility Study Report, using high-level engineering estimates based on previous experience, with the aim to: – collect the requirements for such a facility from the biomedical community in close collaboration with the International Strategy Committee for CERN Medical Applica- tions; – determine a coherent set of beam parameters, based on the requirements; – explore whether the beam requirements can be met throughout the facility, from the source to the biomedical end-stations; – perform a feasibility study of the facility, taking into consideration the overall CERN schedules and programmes; – favour simplicity and robustness of the facility design, while minimizing the cost of maintenance and operation; – establish a high-level costing of material and personnel needed for project implemen- tation; – describe the preferred installation scenario; – perform a high-level risk analysis for the project; – identify the areas of potential difficulty, and the required R&D; should the study go ahead and become a project. The study found no technical show-stopper for the BioLEIR facility. BioLEIR could be operational in 2021, after CERN Long Shutdown 2 (LS2), provided a decision is taken without delay and the required, experienced personnel and funds are made available by mid-2017 at the latest. A minimum of 3.5 years are necessary to design, procure, test, install and commission all elements required for first beam to BioLEIR. Should we miss the LS2 window of opportunity, and on the basis of the current CERN schedule, the BioLEIR facility could only become operational after LS3 in 2026.
          Greater insight into basic biology of pain will reveal non-addictive remedies        
The medical community needs a better understanding of the biology of pain and how it plays out in individuals to be able to combat the national epidemic of addiction to painkillers. This is especially urgent given no analgesic drugs directed at novel targets have been approved in the past five years. The authors call for a public-private partnership to create a $10 billion research fund administered by the NIH.
          USARAF physician assistant receives Army surgeon general's top honor        
VICENZA, Italy -- Maj. P. Jason Auchincloss, the U.S. Army Africa - Southern European Task Force Headquarters and Headquarters Battalion senior physician assistant, was recently selected as the recipient of the Surgeon General's Physician Assistant Recognition Award. The annual award honors the Army PA considered to have made the most significant contributions to military medicine within the year. The award's selection panel included Lt. Gen. Nadja Y. West, the U.S. Army surgeon general and commanding general of U.S. Army Medical Command.
          US Soldiers share skills, expertise during medical exercise in Gabon        
LIBREVILLE, Gabon - "Charlotte! Charlotte!" called the Gabonese doctor. "Oui, madam!" said Spc. Charlotte McGuckin, a health care specialist with the 212th Combat Support Hospital, as she responds in French to Gabonese Commandant Igoho Christel-Iris. McGuckin and 11 other Soldiers from 212th CSH, out of Germany, and four support Soldiers from the 3rd Medical Command (Deployment Support), partnered with Gabonese medical counterparts at the Hopital D'Instruction Des Armees in Libreville, Gabon, during a medical readiness training exercise from May 22 to June 10.
          The Philosophy of Herbalism        
Herbalists, or practitioners of herbal medicine, believe in the use of herbal medicines to treat common medical complaints. This is not to say that herbalists do not use, or believe in the use of, conventional pharmaceutical medications.
          Prescription Drug Rehab To Go or Not to Go Herbal that is the Question        
Many people nowadays are turning to “organics” and “naturals” otherwise known as herbals. The rising popularity of herbal supplements has created a new fad if not a new health lifestyle. But before you join the bandwagon, here are some things you need to know about this mean, “green” dietary supplementing machine.

What is the difference between a drug and a dietary supplement?

According to the definition set by food and drug administrations in different countries, drugs are chemicals that can prevent, prolong the life, treat other effects of a health condition, improve the quality of life, and/or cure ailments and diseases, or alter the function of any part or chemicals inside the body. These drugs have approved therapeutic claims. For example, paracetamol is a drug given to bring down the body temperature in fever. Ascorbic acid is indicated for the treatment of scurvy. Iron supplements are given to treat mild cases of anemia.

Herbal supplements are not classified as drugs but as dietary supplements. The main difference is that they do not have approved therapeutic claims unlike in the case of drugs. Moreover, dietary supplements could either contain vitamins, minerals, herbals, or amino acids, all aimed to add to or supplement the diet of an individual. They are not intended to be taken alone as a substitute to any food or medicine.

Most of the manufactured medicines we now have once came from animals and plants. Through the years, chemists isolated the life-saving or life-curing components and separated them from the harmful ones. This lead to the further drug research and drug development that lead to the production of a different variety of drugs for many ailments and conditions from synthetic sources. But still we have semi-synthetic drugs, as well as drug that more or less approximate more natural composition. Since herbal supplements are made from a mixture of crude herbs reduced into powder or gel form, and later on packaged as tablets and capsules, there is a possibility that life-threatening or at least body chemistry-altering components are still present, thus the expression of concern from the medical community.

Is there a growing concern with the use of herbal supplements?

Yes. With the rising popularity of using and consuming anything herbal or organic is the proliferation of fake herbal supplements that threaten to endanger lives. If that’s the case, then why are herbal supplements given drug administration approvals? One way of ensuring the safety of the people is to have all candidate drugs, food, drinks, and dietary supplements registered with the proper authority. Otherwise, they would pose more risk with these things being sold in the black market for a hefty sum. We could ensure the quality and safety of herbal supplements if they get proper classification with the food and drug administration. Moreover, people may be able to file the proper complaints in the event a worsening of health condition is proven to be linked to the use of a particular herbal supplement.

Is using herbal supplements worth the risk?

Yes. It cannot be discounted that many who have tried herbal supplements experienced an improvement in their health—whether this is due to the herbals themselves or due to a placebo effect, as long as they do not worsen the condition of an individual, then using them is worth the risk. But of course, certain things must be considered before taking those herbal supplements:

Your doctor knows best.

First of all, clear your condition with your doctor. Ask him/her if taking a particular herbal supplement is safe given your health condition. People with heart, liver, or kidney trouble or malfunction, are usually not advised to take these, or at the minimum is to take these herbals in minimum amounts. All substances pass through the liver and kidney to be processed and filtered respectively. Kava, which is used to relieve people from stress, has been pulled out from the Canadian, Singaporean, and German markets because it contains substances that cause liver damage. Certain herbals such as Ephedra used for losing weight, contains chemicals with heart-inducing effects that can increase heart rate, which in turn can exhaust the heart and cause heart attacks in several documented cases by the American Medical Association.

Follow the directions for use.

Never take more herbal supplements than what is directed by the doctor or as instructed on the bottle. Each individual reacts differently to the components of herbal supplements. While it is perfectly safe for one individual to take in a supplement of primrose oil capsules, another person may be allergic to it. So, do not even think about downing one bottle of

It has no approved curative effect.

No matter how the product pamphlet or the label of the bottle sounds about how it has been found to be helpful in certain health conditions, these herbal supplements are not therapeutic. So do not substitute these for the medications prescribed by your doctor for the treatment of certain diseases, or for the maintenance of blood pressure, lowering of blood sugar and cholesterol, and fight off infections.
The Alternative To Meds Center Program is a prescription drug rehab and drug detox center
          Hastening Death: A Biased Account of Tea as Medicine in Europe, 1607-1657        
by Steven D. Owyoung

in honor of Corax and in celebration of the fifth anniversary of CHA DAO

By the time it was imported to the West, tea had already been used in China as a medicinal herb for over three thousand years. Reports of tea reached Europe through the ancient overland trade in spices and drugs, but only a fraction of the knowledge about its role in Asian medicine ever reached the West. As the curative power of the plant and leaf acquired testimony from European diplomats and missionaries traveling in the East during the late sixteenth century, tea attracted the interest of herb merchants, physicians, and apothecaries.

Soon, small quantities of the costly dried leaf and powder were available at European pharmacies serving the aristocracy and wealthy. Founded on novelty and curiosity, the Western reception of tea warmed among enthusiasts who became habituated to the herb’s stimulating effects, both as a beverage and the object of extravagant ostentation.

Tea arrived in Europe during the early decades of the seventeenth century. In 1607, the Dutch East India Company acquired tea from Chinese merchants at Macao for transport to Batam in western Java, the first known shipment of the leaf by a European carrier. A transfer of tea from Hirado in western Japan to Bantam was made by the Dutch before sailing to Holland for its debut in Amsterdam in 1610. The Dutch initially carried only small shipments of tea from the Indies. The herb was not even mentioned in official Company correspondence until 1637 when the directors, sensing a small but growing taste for the leaf, expressed to their governor-general at Batavia that “As tea begins to come into use by some of the people, we expect some jars of Chinese as well as Japanese tea with each ship.”

Company records from late 1650 reveal a shipment of less than 30 pounds of “Japanese Thia, in five boxes.” In 1651 and 1652, similar parcels of tea were sold at auction in Amsterdam.

The reason behind such minimal amounts of tea was market and price. Even in Japan, good tea was costly, and only the wealthy few bought the herb. Like Chinese rhubarb, tea was treated in Europe as a precious and exotic drug, bought in minute amounts at great expense from apothecaries. Circa 1643, the French Jesuit Alexander Rhodes commented on the exorbitant price of ordinary tea: “the Dutch, who bring it from China…sell it at Paris at 30 francs the pound, which they have bought in that country for 8 or 10 sols [sous].”

Fifty years later, the finest tea was even more expensive. Pierre Pomet, apothecary to the French throne, kept a pharmacy and spice shop on Rue des Lombards where he sold “true Japanese tea for no less than one hundred fifty to two hundred francs per pound.” Despite its cost, the drinking of tea as a physic and beverage was prevalent enough among wealthy French, Dutch, Germans, and Danes to provoke their doctors.

The aristocratic courts of Denmark contended with sharply conflicting views of tea throughout much of the seventeenth century. In Schleswig, the ducal court of Holstein-Gottorp read the first-hand observations of the noted scholar Adam Olearius and the enthusiastic accounts from Persia of the adventurer Johann Albrecht von Mandelslo who praised tea as a healthful beverage and an effective medicine. In Copenhagen, the royal court endured the gratuitous and derogatory remarks of the king’s physician who devoted his medical and scientific career to undermining tea as drink and drug. Among the skeptics, the uncertain botanical identity of tea drew suspicion early on, fomenting speculation and debate. Moreover, the exorbitant price of the herb and the remarkable, nigh insupportable claims of its medicinal efficacy struck a nerve in the European medical community. Negative reaction was direct and vociferous. The first among the opposing physicians was the young German doctor Simon Pauli.

In 1635, Pauli wrote Commentarius de Abusu Tabaci et Herbae Thee, a work that three centuries later was called “a medical tract full of terrifying alarms” about tea. Throughout his long career as a doctor of medicine, university professor, botanist, and physician to the Danish throne, Pauli was the most vocal and adamant opponent of caffeine, executing an ongoing harangue against tea that lasted over forty years until his death in 1680. In addition to Commentarius, he wrote A Treatise on Tobacco, Tea, Coffee, and Chocolate thirty years later in 1665. Exhibiting symptoms of xenophobia, he condemned the use of all four substances as foreign and collectively characterized their users as “idle, prodigal, barren, impotent, or effeminate,” emphasizing the latter. His criticism of tea, influential and enduring, was also quite defamatory, and he accused the Chinese of “fulsome Exaggeration” in attributing health and longevity to the herb. Moreover, he viewed himself as a defender of the West against an insidious “oriental” incursion: “As Hippocrates spared no Pains to remove and root out the Athenian Plague, so I have use the utmost of my Endeavors to destroy the raging epidemical Madness of importing Tea into Europe from China.” Regarding the merits of tea, Pauli was obdurate and unforgiving, and his escalating rhetoric, damning:
As to the virtues they attribute to it, it may be admitted that it does possess them in the Orient, but it loses them in our climate, where it becomes, on the contrary, very dangerous to use. It hastens the death of those who drink it, especially if they have passed the age of forty years.
Skeptical of the medicinal value of tea and convinced of its mortal toxicity, he then attacked the quality of the leaf, claiming that tea deteriorated to an ineffective state after prolonged periods of shipping, storage, and exposure to the European climate. As for the botanical identification of the plant, he wrote:
But if any one should ask my Sentiments of Tea, which some Years ago began to be imported from Asia, and the Eastern Countries ... I answer, that no satisfactory Reply can be made, till we know the Genus and Species of Tea, and to what Species of European Herbs it may be referred or compared ... but we give no Name of any of our Plants to Tea: Nay, it is not known, whether Tea is what the Greeks call ... an Herb, or ... a Shrub ....
He then shrilly demanded to know “Of what Kind and Species the Herb Tea is? ... Whether Tea is only the Produce of Asia, and whether it is ever found in Europe, or not? And ... Which of the European Herbs may be most properly used in its Stead?” He was at the ready with answers. To seal his argument and the ultimate fate of tea, Pauli asserted that the plant and leaves were nothing more than common myrtle.

Actually, the identification of tea with myrtle was nothing new. Before Pauli, several Catholic writers had already noted the superficial resemblance of tea leaves to those of Myrtus communis. However, he took their casual but unscientific observations to heart and concluded his investigation “by opening some Tea leaves.” Based on his findings, Pauli insisted that tea was specifically Myrica gale, the ordinary bog myrtle, known as sweet gale and Dutch myrtle, a commodity that was plentiful and cheap and indigenous to Northern Europe. He then posed the question why one should bother importing tea at great expense and distance and at such a diminution in quality, when myrtle was already and copiously available at home. Paradoxically, the lethality of tea was no longer at issue.

In his writings, Pauli credited his contemporary Alexander Rhodes for indicating the beneficial effects of tea, paraphrasing the priest and calling the Frenchman by his Latin name: “The first of which, according to Rhodius, is, that it alleviates Pains of the Head, and represses Vapors: The second, that it corroborates the Stomach: And, the third, that it expels the Stone and Gravel from the Kidneys.” The positive tea writings by Rhodes and other tea drinking Jesuits ironically provided the primary sources for Pauli’s negative campaign against the herb. Pauli’s attacks constituted a perverse, inverted twist on the Jesuits’ optimistic view of tea and the habitual use of and dependence by the priests on the herb. Based on his reputation as a medical doctor and botanist, Pauli was appointed physician to King Frederic III of Denmark, who was quite fond of tea. Perhaps it was the chilling effect of the doctor’s inexorable lectures on the evils of tea to the gullible aristocrats of his court that disturbed the Danish king, or perhaps Pauli said one direct word too many to his royal patron, but one day Frederic could no longer suffer the doctor’s criticism of his favorite drink and responded in Latin: “Credo te non esse sanum,” i.e. “I do believe you to be insane!”

Among the scientific community, Pauli’s hard position on caffeine often obscured and distracted scientific research, hindering sound and sober judgment on the identity, properties, and efficacy and defects of tea. It took over a decade for European botanists to overthrow Pauli’s claim that tea was bog myrtle. Andreas Cleyer, a German doctor in the service of the Dutch East India Company at Deshima, sent a specimen of the tea plant to the court of the Great Elector Friedrich Wilhelm I in Berlin where the German botanist and sinologist Christian Mentzel refuted Pauli in 1682 with the publication of the Universal Index of Plant Names. In the annals of European tea, Pauli was thereafter slighted as a “medical terrorist” for his stubborn assertion that deadly tea was gentle myrtle in disguise. Contempt for his botanical view of tea was such that innocent Myrica gale came to bear the sarcastic pseudonym “Thé du Simon Pauli.” In contrast to the Danes, the Dutch possessed no qualms about tea. Holland not only brought the leaf to the West, but also actively promoted its use as both philter and physic. In 1627, the physician Jacob de Bondt, who was stationed in Batavia as surgeon and apothecary to the Dutch East India Company, recommended tea as a remedy for respiratory and digestive ailments. Nikolas Dirx, better known as Nicolaes Tulp, the mayor of Amsterdam, was an eminent burgher and successful physician. Trained at Leyden University, Dirx was an anatomist and botanist who was effusive in his praise of tea:
Nothing is comparable to this plant. Those who use it are for that reason, alone, exempt from all maladies and reach an extreme old age. Not only does it procure great vigor in their bodies, but it preserves them from gravel and gallstones, headaches, colds, ophthalmia, catarrh, asthma, sluggishness of the stomach and intestinal troubles. It has great additional merit of preventing sleep and facilitating vigils, which makes it a great help to persons desiring to spend their nights writing or meditating.
In nearby Antwerp, Jan Baptist van Helmont, the Belgian chemist, taught that “tea had the same effect on the system as bloodletting or laxatives, and should be used instead.” His Dutch students and followers like Stephen Blankaart became noted physicians, many of whom “recommended enormous quantities of the newly imported novelties, coffee and tea, as panaceas for acidity and blood-purifiers.” The idea that tea was an effective replacement for standard if not antiquated therapies gave grave pause to the conservative medical establishment in France. In 1648, the French physician Gui Patin, known for his stylish and witty letters, dismissed tea as an “impertinent novelty of the century” in a mocking review of the burning of a thesis on tea by members of the faculty of medicine in Paris. Patin, who later became dean of the Faculty of Medicine and Professor of the College of France, was hostile to the use of drugs and herbs, continuing to ridicule tea as late as 1657 when he scoffed that Cardinal Mazarin, the French chief minister, “takes thé as a preventative of gout.” He quickly changed tunes after an encounter with the influential chancellor of France, Pierre Séguier. The chancellor was a learned and sophisticated man who created a library second only to the royal collection and who was the official patron of the prestigious French Academy. Séguier was also an advocate and habitual drinker of tea, and he often entertained the heights of society with elegant tea parties at his literary salons.

In 1657, he formally accepted a College dissertation on tea written in his honor by a doctor, the son of the noted surgeon Pierre Cressy. Gui Patin, in one of his famously sarcastic letters, wrote: “Thursday next, we have a thesis on the subject of tea, dedicated to M. le Chancellor, who has promised to be present. The portrait of the above-mentioned gentleman will be there.” To everyone’s surprise, Séguier displaced his likeness by actually attending the morning-long lecture, bringing in tow an entourage of members of the royal privy council and adding the intimidating presence of officialdom to the gathering. By lunchtime, the dissertation was successfully defended, and tea was accepted as a remedy for gout and sundry ailments. Succumbing to logic, reason, and the palpable pressure of Séguier, the medical Faculty stood in ovation, allowing Patin to nimbly exchange his sly jibes for easy praise of tea.

It is unknown whether or not the eminent botanist and physician Denis Joncquet was with Séguier and present on the day of the 1657 meeting. But sometime during that same year, Joncquet displayed a gift for literary expression when -- like a Chinese sage -- he compared tea to “ambrosia” and praised the shrub as the “divine plant.” From the mid-1600s on, tea continued to find critics within and without the medical profession in Europe. And although the cast of characters and the science have changed over the centuries, the debate on the therapeutic efficacy of tea endures to this day.
          Homeopathic Tinnitus Treatment - Advice For Those Seeking Tinnitus Cure        
If you do enough research on the subject of tinnitus treatment you'll soon discover that there really is no typical cure available. It is a longtime fact that the medical fraternity and the scientific community has therefore far been not able to come up with a successful remedy using typical drugs and medicines. Even though it is recognized that using vitamin and herbal therapies do help with tinnitus relief, this particular cure does not address the first root of the tinnitus problem and is thus not especially an enduring solution.
Masking Treatments
That being recounted, there are many cures available that help with this condition and make it more OK. This involves masking the tinnitus with other sounds like recordings of running water, music or white noise.

Homeopathic Treatments

Natural treatments would include diet, homeopathy, herbal treatment, relaxation and meditation and reflexology. Homeopathic treatments are most certainly the safest and gentlest of all natural remedies for tinnitus. With natural cures, there's a bigger opportunity to discover a treatment that is perfectly suited for your sort of tinnitus since all the symptoms are taken into consideration and almost all sorts of tinnitus have a working homeopathic treatment. Though the medical community has had little success with a cure, many victims report excellent results have been obtained using homeopathic tinnitus treatments plus herbal or vitamin based therapies to alleviate tinnitus.

Medical Treatments

Before hospital therapy is started, a doctor has to pinpoint the root cause of the tinnitus and to make certain there are no significant medical problems that are responsible. However, some people with tinnitus may require surgical treatment. Benzodiazipines (valium, xanax, etc) are the only medically licensed tinnitus treatment for this condition, and it should be noted that several of the listed medical treatments may have serious side-effects.

Homeopathic Tinnitus Remedies - Tips For Those Seeking Tinnitus Reduction
          The Umbrella Kid        
Well they do say when it rains it pours.  In my house umbrellas aren't just for preventing rain from soaking you.  We live under the umbrella of diagnoses in our home.  It's part of the joys of living with a medically complex kiddo.

Cary Lynn is a medical enigma.  She delights in 3 am solos, her stuffed animals, and keeping doctors scratching their heads.

An umbrella diagnosis is where they take a whole bunch of problems, group them all together, and say voila!!  Here you go, take a whack a doodle at that!  I kid you not.  I sometimes think the way they come up with these things involve a dart board, stiff rounds of expensive scotch, and a parker brother's Ouija board.  They sit together, take some shots, consult the position of the stars, and make lots of notes in Latin so it looks like they know what they are talking about.  Then they have meetings, press conferences, and write it down in big medical journals.  Which are passed on to doctors and nurses who present the information to us while they try to look like they perfectly understand what is going on with my child.

Cary Lynn has many, many, many diagnoses.  I kid you not.  Last time her chart was updated she was up to 30.  Some are little and frankly not worth the space they take up on paper.  But some are bigger.

Three of her biggies are umbrella diagnoses.  Cerebral Palsy is considered an umbrella diagnosis.  CP is a large disability category.   For some people in the CP umbrella the only trace of it you see is they hold a pencil a little funny.  On the other end of the umbrella you have children like my daughter who cannot roll, sit, or do a lot independently.

The other one is CVI.  This one is also a big big umbrella.  From children who function so well visually that you would never know to children who are very visually impaired.  Cary Lynn falls right about in the middle of this one.

The last one is a new diagnosis that we just got official confirmation of last week.  Dysautonomia. It's a big word, but once again I'm stuck in umbrella land.  If you look up the definition you will even see in several places that it is defined as an umbrella term where the autonomic nervous system malfunctions.  It can range from mild issues like gi track problems to Parkinson's disease.  I sat down with neurology and had a very long and fun filled round of what type might Cary Lynn have. Because there is a really big difference.  There is the kind that you treat the symptoms and go on slogging or there is progressive.  In the case of the latter it's not a good prognosis.  At this point the medical community is still consulting the dartboard and the Ouija to figure out what category Cary Lynn is in.

I hate being grumpy and disgruntled.  But in a way I really am.  To me an umbrella diagnosis isn't a real diagnosis.  I am the type of person who really wants a clear cut answer.  So I know what to do to fix or at least stabilize the problem.  Instead I get a lot of running around the bush and unhelpful handouts.  And the run of the mill advice like, keep doing therapy.  To me that is the equivalent of patting a small child on the head and sending them off with a lolly pop in hopes that they have pacified the child and made them forget the problem at large.  So it makes me kind of mad that the same old tired things keep getting trotted out.

But the other part of me knows that they really don't know.  Cary Lynn lived.  She defied medical odds at 24 weeks.  She defied medical odds when she first came to live with us.  Every day she lives she defies another odd.  Everything that she does that they told me she would never do.  From the day she grabbed a toy to the day she took simple steps with support she continues to remind me that I dwell with a miracle.  The doctors are by and large clueless about my child and so many other children like her.

So while I'm not overly thrilled that I have to endure another umbrella diagnosis and I'm not going to give up hope that someday we may have better answers than darts and scotch can provide I'm going to take it one day at a time and watch my little odd buster continue to blaze new trails and set the world on fire.



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Amy Fields is a wife, mother of two special needs kids, and very late putting a post up!  You can follow her on her blog Many Kinds of Families
          Need to Focus on Core Competencies Driving Market for Healthcare CMOs        
Hoping to achieve improved efficiency in capacity, time to market, quality, and cost, a number of pharmaceutical and medical companies have been outsourcing manufacturing operations to third party contract manufacturers. This trend of outsourcing also enables companies to gain expertise in specific business areas they might not be specialized in or services that are not available in-house. The demand for outsourcing certain operations is also spurred by cost benefits, the need to focus on one’s core capabilities, the increase in cost pressure, and the growing focus on marketing and research and development. By reducing the time spent on manufacturing operations, companies can focus solely on its core competencies. As a result, the global contract manufacturing market has been exhibiting remarkable potential. This market is fueled by the growth of the medical device industry, the rise in regulatory concerns, and the surging demand from emerging countries.  Lucrative Growth Opportunities for Medical Device Contract Manufacturing The global health care contract manufacturing organization market offers a host of services such as medical device contract manufacturing and pharmaceutical contract manufacturing. The segment of pharmaceutical contract manufacturing comprises manufacturing of active pharmaceutical ingredients, manufacturing of final dose formulations, and packaging. Among these, final dose formulation manufacturing is anticipated to witness the strongest growth in the coming years.  The manufacturing of pharmaceutical ingredients holds immense opportunities for growth owing to the impending expiration of patent of leading drugs. This has propelled manufacturers of generic drugs to the front of the pharmaceutical industry. The demand for generic drugs, as a result, is projected to rise substantially over the next few years, leading to a surge in research and development investments from life science companies. The market for health care contract manufacturing organizations is anticipated to gain impetus by 2019, expanding at a healthy 14.30 per cent compound annual growth rate. 

Original Post Need to Focus on Core Competencies Driving Market for Healthcare CMOs source Twease
          Global Healthcare Companies Advance to Tap Indian Market        
For almost two years, Parkway Pantai has been delaying the opening of its 450-bedded hospital in India. The Singapore based medical company’s pursuit to leverage opportunities in one of the fastest growing healthcare markets has been waiting for necessary pursuits. Parkway, which is a unit of the second largest healthcare group in the world plans to use acquisitions in pursuit for fast expansion in India. The private hospital market in India is estimated to be valued at US$55 bn each year, but companies need to obtain almost 70 clearances from local and federal authorities for the launch of a new facility. The head of Parkway’s operations head in the Middle East and South Asia commented that Greenfields is not on the agenda of the healthcare group. He further commented on a telephonic interview that Greenfield is a company that would need eternal wait to tap into, as a result the company has decided to tap it inorganically. It is only a matter of shorter runway. In Mumbai, garbage festers in the proximity of Parkway have already built Gleneagles Khubchandani hospital. The hospital was expected for an opening in 2012. The head of operations of Parkway commented that the India hospital is scheduled to open in 2016. The healthcare group currently expanding through acquisitions is becoming the first choice of hospital operators in pursuit to expand speedily in India. The demand for private healthcare is mushrooming in India thanks to the overburdened public healthcare system. As per data from the Global Research h firm states that BofA-ML, private hospital market is expected to grow at 16% each year to be valued at US$120 bn by 2020, which will be double the size of the healthcare market in China. The expansion strategy, although will not address the severe shortage of beds or bring down healthcare costs in any way. 

Original Post Global Healthcare Companies Advance to Tap Indian Market source Twease
          IBM Announces US$1 Bn Acquisition of Merge Healthcare        
In an attempt to expand its global presence in the health care industry, IBM has been getting rather aggressive. The company on Thursday morning announced the US$ 1 billion acquisition of medical imaging leader Merge Healthcare. This is the third such acquisition since the setting up of Watson Health in April, IBM’s new unit based on the innovative Watson technology. This move is likely to help the company redirect its core strength to one of the biggest industries of the US economy. Watson has already begun teaming up with health care bigwigs such as Cleveland Clinic and Memorial Sloan Kettering to becoming a system that learns from its evaluation of situations in the past. Combining Watson’s commanding cognitive computing engine as well as the massive amount of cloud based health care data and Merge Healthcare’s superior technology platform for the exchange of medical images such as mammographies and CAT scans, Watson will be able to help doctors in making effective and efficient decisions.  Senior vice president of IBM Research and Solutions Portfolio John Kelly said on Thursday that as a leader that has proven itself in delivering health care solutions for the last 20 years and more, Merge Healthcare is an incredible addition to the Watson Health platform.  Health care will turn out to be one of the biggest growth areas of IBM over the next decade. This is the main reason, John Kelly said, that the company has been making key investments to fuel industry transformation and to encourage a more improved quality of patient care.  The analytical and cognitive capabilities of Watson, Merge, and other acquisitions of the company have helped IBM in partnering with research institutions, health care providers, insurers, biomedical companies, and other organizations who are dedicated to transforming the nature of health care in the 21st century. 

Original Post IBM Announces US$1 Bn Acquisition of Merge Healthcare source Twease
          Contego Medical Completes the US$5.6 Million Worth Financing Round of Series B        
Contego Medical, which happens to the sole and the very first provider of Integrated Embolic Protection based filter technology for stent delivery catheters and angioplasty balloons has recently declared the end of the financing round worth US$5.6 million from the Hatteras Venture Partners. Hatteras Venture Partners is a new venture firm that mostly focuses on diagnostics, biopharmaceuticals, medical devices, and other aspects of human medicine.  Medical Mutual, Lookout Capital, and Mountain Group Partners were also included in the round. This development of angioplasty balloons by Contego Medical happens to be a major breakthrough in medical technology that researchers believe will lead to lower incidence of procedural complexities and strokes. The funds that the company will be utilizing will mostly be directed towards the engineering teams, sales teams, and the area of leadership.  The main rationale is to develop and come up with innovative products for the upcoming next-gen platform for Integrated Embolic Protection. The various devices including Paladin device that are at present still going through development mostly address the highly lucrative market and industry. These devices exhibit the capabilities for becoming the standards of medical care in the particular areas of target treatment since most combination devices aim at simplifying the procedures offer cost efficient solutions, and even improve the outcomes. The CEO and founder of Contego Medical has expressed that the company is all geared up for partnering with Hatteras Venture Partners for commercialization and expansion of their company portfolio. 

Original Post Contego Medical Completes the US$5.6 Million Worth Financing Round of Series B source Twease
          Multiple Sclerosis Diet Therapy - Does Diet Really Make a Difference?        
Multiple Sclerosis is considered to be one of the most devastating physical diseases to affect mankind. As an autoimmune disorder the effects of this disease are different in each person it affects. Until recently very little thought has been given towards the possibility of our diets having any effect on this disease in the medical community. Recent studies involving multiple sclerosis and diet therapy are beginning to show results that are finally being taken notice of in the scientific community.
          Can a Raw Food Diet Help With Multiple Sclerosis        
In recent years there has been a lot of talk about multiple sclerosis and raw food diets. There is still a large percentage of the medical community that refuses to see the connection between eating a healthy diet and reduced or eliminated symptoms of MS. However, in recent years far more research is being conducted in the areas of diet and nutrition as a way to improve the overall health of the multiple sclerosis patient and alleviate their symptoms.
          MS Diet and Exercise - Can They Really Help?        
Over the years there has been much said about MS, diet and exercise. There are many in the medical community that still refuse to believe that anyone can find relief from there multiple sclerosis symptoms simply by changing the way they eat and becoming involved in a regular exercise program. This makes no sense as the number of patients taking control of the MS in exactly this way is rising every day.
          Recognizing Multiple Sclerosis Symptoms and Signs        
Although the first recording of multiple sclerosis symptoms and signs occurred in 1868 by Jean-Martin Charcot, the medical community still has no real idea what causes one person to have this potentially devastating disease and not another. It is thought by many to be a disease of the autoimmune system in which the body actually attacks itself creating lesions and plaque that attack the spinal cord and brain.
          What Should You Do for MS Pain Management?        
If you were to ask anyone who has multiple sclerosis what the hardest thing to deal with on a daily basis was they would most likely tell you it was the pain. Only in the last 25 years or so has MS pain management been something that the medical community has taken any interest in. Prior to this most doctors did not consider pain as a part of this disease. Anyone who has MS will tell you a very different story as pain is something that they have become accustomed to living with.
          Types of MS Pain - The Most Common Types        
While the medical community has only just begun to take an active interest in the different types of MS pain, the average person with multiple sclerosis would do just about anything to have relief. The problem is that of all the symptoms associated with MS, pain can be the hardest to find a treatment for. Accordingly there are three main types of MS pain that can be either acute or chronic in nature depending on the location of the pain and the stage of the disease the patient is at.
          Relieving the Pain Symptoms of MS        
Pain as symptoms of MS has only been recognized in the last two or three decades. The average person who has been diagnosed with multiple sclerosis is likely to have an issue with this statement as many of them spend a large percentage of their lives in pain that can be chronic or acute. In many cases they can end up dealing with both at the same time. The problem is not so much that the medical community did not see that the person was in pain, only that they were not willing to associate the pain with the disease.
          Relieving MS Pain in the Arms        
At one point in time the medical community thought of multiple sclerosis as a relatively painless disease. Today it is estimated that at least half of all people with this disease endure some level of pain that can become chronic over time. MS and pain in arms and legs go together as the extremities are often the most commonly affected areas of the body and over time without proper therapy and treatment can become disabled.
          Multiple Sclerosis Symptoms and Pain        
For those who have been diagnosed with MS there are many problems that must faced. One of the biggest is the number of multiple sclerosis symptoms and pain. Despite the number of years that the medical community refused to see that the pain many patients went through as a symptom of the disease, there is no doubt in the minds of the patients that it actually exists. For many it can be hours, days or weeks of chronic pain, for other instantaneous acute pains that come and go in minutes or hours.
          Multiple Sclerosis - A New Treatment on the Way        
The results in the early testing phase of patients with multiple sclerosis and Fingolimod when compared to those given Avonex showed a 52% reduction in the number of annual relapses. This is a very promising number and has caught the attention of many people, not only those in the medical community but patients as well.
          MS Diagnosis Criteria - What Do Doctors Look For When Diagnosing MS?        
It can be very difficult for any physician to diagnose a patient with the disease multiple sclerosis. The type of damage that the disease does to the central nervous system can cause symptoms that can be reminiscent of many other neurological problems. In order to make it easier to present such a diagnosis the medical community has developed a set of MS diagnosis criteria that gives physicians the highest chance of detecting the disease at the earliest possible stage.
          Multiple Sclerosis Tingling - Why Do I Get This Tingling Feeling?        
Of all the different symptoms of multiple sclerosis, tingling and numbness are two of the most commonly reported. Known as paresthesia to the medical community, you will find that the vast majority of MS patients will have experienced this symptom multiple times and may in fact be one of the symptoms that led them to seek a diagnosis in the first place.
           Cognition and schizophrenia: improving real life function         
Morgan, Kevin D., David, Anthony S., Murray, Robin M. and Eberhard, Jonas, eds. (2006) Cognition and schizophrenia: improving real life function. Cambridge Medical Communication, Cambridge, UK. ISBN 9780955130212
           Insight and cognition         
Morgan, Kevin D. (2006) Insight and cognition. In: Cognition and schizophrenia: improving real life function. Cambridge Medical Communication, Cambridge, UK, pp. 37-43. ISBN 9780955130212
          Evolution and medicine        
Catriona MacCallum, an editor at PLoS Biology has posted the following essay (being PLoS, it is available to everybody) about medicine and evolution.

According to the article, physicians do not get much of a training in evolution as a method to study the origin of diseases. That is because most of the training of physicists is not to make them good scientists but to make them good at treating patients. Quoting the article: "does a mechanic need to understand the origins, history and technological advances that have gone into the modern motor vehicle in order to fix it?".

This approach is not entirely wrong and once can treat things that are the result of an evolutionary process without having to spend too much time studying evolution. A different thing is when the disease is not a result of evolution but they are evolution itself. They never mention cancer in the article but cancer and infectious diseases are clear cases of diseases in which evolution should be dealt with if the disease is to be cured or even contained. Without an understanding of evolution a physician will be unable to understand how the bacteria or cancer cells will react and evolve when a treatment is used or what phenotypical traits are more likely to be evolved and thus cause problems to or be exploited by the medical community.
          Video: Pee Wee Football Team Stands Up For Bullied Kid        
From last year, a video that will warm your heart.  We hear so many horror stories about kids these days,  it's wonderful to see that there are plenty of good ones out there still.

Danny Keefe is the cutest kid ever.  He's only six, but ever since his parents bought him a black velvet jacket and tie for Christmas, he started wearing one every day to school, along with a very cool hat. Unfortunately, his penchant for dressing dapper, and his speech disorder (childhood Apraxia), Danny was often the target of bullies, so much so, he no longer wanted to go to school. That is, until his football buddies (he's water coach for the Bridgewater Badgers) decided to come to his defense by wearing suits to school one day.

What Danimal's Army have to say about their friend and bullying is truly inspirational, as is Danny himself.

Danny was a preemie and the medical community did not have much hope for him.  He has proved them wrong.



          Chris Lee receives 2011 NBCR Summer Institute Scholarship        
In August, Chris will attend the sixth National Biomedical Computation Resource (NBCR) Summer Institute (SI) in San Diego, CA on the campuses of University of California, San Diego (UCSD) and The Scripps Research Institute (TSRI). The Goal is to provide significant training opportunities for the biomedical research community members in computational multiscale biomedical research. Training includes hands-on sessions […]
          Iraq Shiite leader Hakim dies in Tehran hospital        

Tehran: The leader of Iraq`s largest Shiite party, Abdel Aziz al-Hakim, died in a Tehran hospital today aged 60 after a long battle with lung
cancer, five months ahead of key parliamentary elections.
"He died a few minutes ago after battling cancer for 28 months," his son Mohsen Hakim told agencies. He and his brother Ammar had been at their father`s bedside.

Hakim, a cleric who helped establish an opposition movement in exile in Iran in 1982 to battle Saddam Hussein`s Sunni-dominated regime, returned to Iraq after the US-led invasion of 2003.

His Supreme Iraqi Islamic Council swept Shiite areas in first provincial elections after the invasion but in new elections this January the party suffered major losses to the rival list of Prime Minister Nuri al-Maliki.

"The body of the head of the SIIC will be transferred to Najaf and the details of the mourning ceremony will be announced in due course," Mohsen Hakim told Iran`s Fars news agency, referring to the central Iraqi shrine city where Shiites from around the world are traditionally brought for burial.

Hakim, a former heavy smoker, was admitted to hospital on Saturday after he developed a "medical complication", the son told AFP on Monday.

The cleric, who had been in Tehran for treatment for more than four months, had undergone frequent medical check-ups in the Iranian capital in the past and even visited the United States to see lung cancer specialists.

Bureau Report

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          BABY-LED APPROACH TO EATING SOLIDS        
It is always interesting to read about parenting trends where parents are influenced by popular books or non-traditional ideas. The level of parental passion determines the speed and magnitude with which trends spread—often globally. What is equally interesting is how fast, or more often how slowly, the medical community catch up with whatever is trending. […]
          CDC Meeting Explores Community Strategies to Reduce Impact of Pandemic Influenza        
The impact of pandemic influenza extends well beyond health and medical communities into many segments of society. Developing a pandemic influenza vaccine could take several months....
          True that        

In reply to I asked today

I had a bit of culture clash with the medical community when it came to terms, CURE vs CURATIVE vs PALLAIVE. The best I could coax from my team is they are seeking curative therapy in hope it may cure the disease. They could never come to say I would be cured.

I do think if we have this discussion or those who crossed the five year post treatment milestone, probably have a few stories where their practitioners will loosen up and say you have been "cured" of this cancer incident. whoi knows LOL


          (USA-CT-RIDGEFIELD) Clinical Compliance Vendor Liaison        
Boehringer Ingelheim is an equal opportunity global employer who takes pride in maintaining a diverse and inclusive culture. We embrace diversity of perspectives and strive for an inclusive environment which benefits our employees, patients and communities. **Description:** To provide quality management and compliance oversight for US BI (BIPI) clinical trials involving the outsourcing of BI internal functions, and in select cases for the sourcing of specialized services as well. The Medical Compliance Vendor Liaison function will assist in building in quality oversight and effective vendor management principles into Medicine including tracking of CRO Key Performance Indicators across trials to ensure appropriate and timely corrective and preventative plans are implemented and carried through to resolution. This position will be a resource to clinical/ project teams conducting such trials as well as the holder of associated clinical processes. This position will liaise with Local Global Sourcing Medical (LGSM) and Clinical Trial Contracting Management (CTCM) as needed, as well with Global Vendor Management functional team in business functions and Quality Medicine, to ensure quality management and compliance is maintained and supported throughout the contracting process. This function will support the ongoing interactions between clinical/project teams to address quality and compliance issues. In addition this position will serve as a resource to the clinical/project teams in facilitating the development of Corrective and Preventative Action Plans (CAPA) in the event non-compliance issues arise for specific trials. As an employee of Boehringer Ingelheim, you will actively contribute to the discovery, development and delivery of our products to our patients and customers. Our global presence provides opportunity for all employees to collaborate internationally, offering visibility and opportunity to directly contribute to the companies' success. We realize that our strength and competitive advantage lie with our people. We support our employees in a number of ways to foster a healthy working environment, meaningful work, diversity and inclusion, mobility, networking and work-life balance. Our competitive compensation and benefit programs reflect Boehringer Ingelheim's high regard for our employees **Duties & Responsibilities:** + Lead the development of establishing a robust end-to-end quality oversight model and effective vendor managements and principles. Drive the activities and projects in Quality Medicine under the direct supervision of the Head of Medical Compliance. + In collaboration with Corporate and local GSM personnel assure adherence to applicable Corporate and local SOPs, BI Quality Manual, WIs, policies, guidelines and regulations. + Drive the root cause analysis on vendor quality events (as well its follow up) by closely interacting with vendors partners to address adequate corrective and preventive actions on CAPA Plans. + Develop, implement and maintain internal processes within BIPI Medicine & QRPE to standardize and support activities to ensure compliance when outsourcing BI internal(core) functions as well as sourcing of specialized (i.e. non-core function)needs. Processes may involve review and approval of trial outsourcing plans, the documentation of transfer of regulatory obligations, vendor compliance and pre-qualification assessments, project governance plans, definition and description of process interfaces across impacted functions, budget review and vendor evaluations. + Act as a vendor management SME by attending departmental, staff and any other meeting where vendor compliance (including performance) input is advisable. In addition, prepare and present selected topics identified as trends, critical and major vendor quality events, information sharing, processes updates, etc. Act as an Inspection coordinator for health authority inspections at BIPI, facilitating the interactions between inspector, vendor representative (if applicable) and BI. Provide feedback and guidance on inspection preparation activities where vendor is involved. + Lead the assessment of activities pertaining to contracting with niche vendors to support Digital Health /Medicine efforts. Provide training to BIPI Medicine as needed regarding outsourcing processes and best practices especially in the areas of quality management and regulatory compliance. + Develop tools to manage and report specific information regarding the outsourcing and outside vendor requests and ongoing vendor-related activities of all clinical trials/projects conducted at BIPI as well as in support of departmental outsourcing as agreed by management. + Assure that mechanisms are in place to secure compliance and that tracking mechanisms are in place, including use of KPIs, to address issues that may arise assuring that corrective actions have been implemented and reported. Coordinate, perform and report Vendor Quality Visits utilizing a risk based approach coordinated with CQA Vendor Auditing, Project Teams and management as appropriate. **Requirements:** + Bachelor’s Degree from an accredited institution with five to seven (5-7) years of experience in clinical trial operations and GxP Compliance required. + Ability to understand/interpret/coordinate quality and performance improvement activities, perform data collection and reporting, and support compliance and risk management activities. + Ability to construct a quality management vendor oversight model which encompasses vendor assessment, qualification, performance and issue management through KPI/KQIs measures. + Ability to operate independently of functional groups and provide critical independent assessments and advise to senior management. + Strong analytical skills as well as demonstrated strength in agility while demonstrating initiative and ability to develop and implement a new process. + Exclusivity of responsibility, strategic and operational processes conceptual/analytical thinking, internal accountability, organizational design, initiative and self-motivation. **Desired Skills, Experience and Abilities:** + Master’s Degree from an accredited institution preferred. **Eligibility Requirements:** + Must be legally authorized to work in the United States without restriction. + Must be willing to take a drug test and post-offer physical (if required) + Must be 18 years of age or older **Our Culture:** Boehringer Ingelheim is one of the world’s top 20 pharmaceutical companies and operates globally with approximately 50,000 employees. Since our founding in 1885, the company has remained family-owned and today we are committed to creating value through innovation in three business areas including human pharmaceuticals, animal health and biopharmaceutical contract manufacturing. Since we are privately held, we have the ability to take an innovative, long-term view. Our focus is on scientific discoveries and the introduction of truly novel medicines that improve lives and provide valuable services and support to patients and their families. Employees are challenged to take initiative and achieve outstanding results. Ultimately, our culture and drive allows us to maintain one of the highest levels of excellence in our industry. We are also deeply committed to our communities and our employees create and engage in programs that strengthen the neighborhoods where we live and work. Boehringer Ingelheim, including Boehringer Ingelheim Pharmaceuticals, Inc., Boehringer Ingelheim USA, Boehringer Ingelheim Animal Health USA, Inc., Merial Barceloneta, LLC and Boehringer Ingelheim Fremont, Inc. is an equal opportunity and affirmative action employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender identity or expression; affectional or sexual orientation; disability; veteran or military status, including protected veteran status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. Boehringer Ingelheim is firmly committed to ensuring a safe, healthy, productive and efficient work environment for our employees, partners and customers. As part of that commitment, Boehringer Ingelheim conducts pre-employment verifications and drug screenings. *LI-DS1 *I-DS1 **Organization:** _US-BI Pharma/BI USA_ **Title:** _Clinical Compliance Vendor Liaison_ **Location:** _Americas-United States-CT-Ridgefield_ **Requisition ID:** _176816_
          (USA-CT-RIDGEFIELD) Clinical Compliance Lead (Senior Associate Director) 2 Openings)        
Boehringer Ingelheim is an equal opportunity global employer who takes pride in maintaining a diverse and inclusive culture. We embrace diversity of perspectives and strive for an inclusive environment which benefits our employees, patients and communities. **Boehringer Ingelheim is currently hiring two** **(2) Clinical Compliance Leads** **to join the Quality Management Team.** **Description:** The Clinical Compliance Lead is a lead role, proficient in GCP/ICH requirements, key risks within Quality Management System as well as processes related to Medicine functions. This position will be responsible for identifying risk and failure points within a system and process, establish a solution, and the conduct of error analysis. In addition, this position would lead solutions and recommendations across Medicine in risk mitigation and drive sustainability solutions. This position will also support the implementation of Quality Management principles (Quality by Design - QbD, Quality Risk Management - QRM- and Quality Management System- QMS) within BIPI Medicine and should work together with business professionals to embed QbD in clinical development and clinical trials execution from study planning through completion. As an employee of Boehringer Ingelheim, you will actively contribute to the discovery, development and delivery of our products to our patients and customers. Our global presence provides opportunity for all employees to collaborate internationally, offering visibility and opportunity to directly contribute to the companies' success. We realize that our strength and competitive advantage lie with our people. We support our employees in a number of ways to foster a healthy working environment, meaningful work, diversity and inclusion, mobility, networking and work-life balance. Our competitive compensation and benefit programs reflect Boehringer Ingelheim's high regard for our employees **Duties & Responsibilities:** + Lead US QM Compliance associates, tasks and support the activities and projects in Quality Medicine assigned and under the direct supervision of the Head of US Medical Compliance. Act as a deputy of the Head of US Medical Compliance when required. + Serve as the point of escalation within QM functions (e.g.: auditing team) and business partners to assure compliance with process and systems. Serve as a leader by assisting BIPI with consultancy on quality/regulatory issues. + Develop and lead the implementation of Key performance indicators (KPIs) and Key Quality indicators (KQIs) based on initiatives and process improvements efforts. Analyze continuously trends, thresholds and risk impact of quality events that are escalated to QM and provide reports on a frequency to be stipulated. Lead and contribute to Quality Management activities and projects such as the development, implementation, training and maintenance of Quality Improvement plans based on audit reports, priorities and CAPA investigations and follow up to identify areas of improvement and compliance risk. + Lead cross functional quality projects with complete autonomy. + Serve as inspection lead/coordinator for USA FDA /health authority inspections at BIPI, facilitating the interactions between inspector and BI. Provide feedback and guidance on inspection preparation activities. Serve as Primary Contact Person (PCP) an all inspections preparations activities. + Serve as a primary contact to Medicine Leadership Team (MLT) and Senior BIPI leaders related to inspection updates, debriefs, Health Authorities responses, etc. + Serve as a US Compliance SME by attending departmental, staff and any other meetings where clinical compliance input is advisable and supported by Quality Management principles. The interaction with BI Therapeutic areas is expected with full understanding on target diseases, pipeline and protocol design. In addition, prepare and proactively present on selected topics identified as trends, critical and major quality events, information sharing, processes updates at management meetings within Medicine. + Lead the interpretation of trends associated with key therapeutic areas responsibility. Analyze continuously trends, thresholds and risk impact of quality events that are escalated to QM by using QbD and QRM approach by employing analytical and risk-management methodology. Lead and contribute to Quality Management systems and projects such as the development, implementation, training and maintenance of Quality Improvement plans based on audit reports, priorities and CAPA investigations and follow up that identify areas of improvement and compliance risk. + Demonstrate strong knowledge and understanding of BI Quality Manual, Standard Operating Procedures, applicable regulatory requirements (FDA, ICH & country specific), and current industry standards and practices. + Serve as a US Compliance Lead on investigations by closely interacting with key stake holders in developing and delivering against corrective and preventive actions. Provide expert guidance to BIPI Business functions and Therapeutic areas on root cause analysis. + Perform external visits (if necessary) to assure adherence on GCP and FDA regulatory requirements including visits to strategic alliance partners. **Requirements:** + BS degree in scientific or health related field or equivalent field of study (MS preferred) + A minimum of eight (8) years progressive in clinical regulatory compliance experience including a broad range of GCP auditing and/or clinical compliance experience/demonstrated experience in a senior advisory role. + Leadership and analytical skills, ability to change, adaptability, self-motivation, lateral thinking and Initiative. + Requires exclusivity of responsibility, strategic and operational processes conceptual/analytical thinking, internal accountability and organizational design. **Desired Skills, Experience and Abilities:** + Master’s degree from an accredited institution preferred. **Eligibility Requirements:** + Must be legally authorized to work in the United States without restriction. + Must be willing to take a drug test and post-offer physical (if required) + Must be 18 years of age or older **Our Culture:** Boehringer Ingelheim is one of the world’s top 20 pharmaceutical companies and operates globally with approximately 50,000 employees. Since our founding in 1885, the company has remained family-owned and today we are committed to creating value through innovation in three business areas including human pharmaceuticals, animal health and biopharmaceutical contract manufacturing. Since we are privately held, we have the ability to take an innovative, long-term view. Our focus is on scientific discoveries and the introduction of truly novel medicines that improve lives and provide valuable services and support to patients and their families. Employees are challenged to take initiative and achieve outstanding results. Ultimately, our culture and drive allows us to maintain one of the highest levels of excellence in our industry. We are also deeply committed to our communities and our employees create and engage in programs that strengthen the neighborhoods where we live and work. Boehringer Ingelheim, including Boehringer Ingelheim Pharmaceuticals, Inc., Boehringer Ingelheim USA, Boehringer Ingelheim Animal Health USA, Inc., Merial Barceloneta, LLC and Boehringer Ingelheim Fremont, Inc. is an equal opportunity and affirmative action employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender identity or expression; affectional or sexual orientation; disability; veteran or military status, including protected veteran status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. Boehringer Ingelheim is firmly committed to ensuring a safe, healthy, productive and efficient work environment for our employees, partners and customers. As part of that commitment, Boehringer Ingelheim conducts pre-employment verifications and drug screenings. *LI-DS1 *I-DS1 **Organization:** _US-BI Pharma/BI USA_ **Title:** _Clinical Compliance Lead (Senior Associate Director) 2 Openings)_ **Location:** _Americas-United States-CT-Ridgefield_ **Requisition ID:** _176821_
          (USA-CT-RIDGEFIELD) Clinical Compliance Expert (Associate Director)        
Boehringer Ingelheim is an equal opportunity global employer who takes pride in maintaining a diverse and inclusive culture. We embrace diversity of perspectives and strive for an inclusive environment which benefits our employees, patients and communities. **Description:** This position should be considered an expert with regards to GXP (specifically in the GCP area. The US Medical Compliance Expert serve as a lead in ensuring improvement and maintenance of Clinical Compliance processes within BIPI Medicine and clinical research activities in compliance with GCP, ICH guidelines, FDA regulations and internal processes. The US Clinical Compliance Expert also leads the investigation related to quality events with the ability to analyze data, understand Root Cause Analysis, CAPA processes and outcomes, and drive continuous process improvement related to issue management. This position will also lead the implementation of Quality Management principles (QdB, QRM and QMS) within BIPI Medicine and should work together with business professionals to embed QbD in clinical development and clinical trials execution from study planning through completion. As an employee of Boehringer Ingelheim, you will actively contribute to the discovery, development and delivery of our products to our patients and customers. Our global presence provides opportunity for all employees to collaborate internationally, offering visibility and opportunity to directly contribute to the companies' success. We realize that our strength and competitive advantage lie with our people. We support our employees in a number of ways to foster a healthy working environment, meaningful work, diversity and inclusion, mobility, networking and work-life balance. Our competitive compensation and benefit programs reflect Boehringer Ingelheim's high regard for our employees **Duties & Responsibilities:** + Serve as a lead in driving activities and projects involving US Compliance in Quality Medicine aligned with the scope of the project. + Demonstrate strong knowledge and understanding of BI Quality Manual, Standard Operating Procedures, applicable regulatory requirements (FDA, ICH & country specific), and current industry standards and practices. + Serve as a US Compliance Lead on investigations by closely interacting with key stake holders in developing and delivering against corrective and preventive actions. Provide expert guidance to BIPI Business functions and Therapeutic areas on root cause analysis. + Serve as inspection coordinator for USA FDA /health authority inspections at BIPI, facilitating the interactions between inspector and BI. Provide feedback and guidance on inspection preparation activities. + Serve as Primary Contact Person (PCP) an all inspections preparations activities. + Serve as a primary contact to Medicine Leadership Team (MLT) and Senior BIPI leaders related to inspection updates, debriefs, Health Authorities responses, etc. + Serve as a US Compliance SME by attending departmental, staff and any other meetings where clinical compliance input is advisable and supported by Quality Management principles. The interaction with BI Therapeutic areas is expected with full understanding on target diseases, pipeline and protocol design. In addition, prepare and proactively present on selected topics identified as trends, critical and major quality events, information sharing, processes updates at management meetings within Medicine. + Lead the interpretation of trends associated with key therapeutic areas responsibility. Analyze continuously trends, thresholds and risk impact of quality events that are escalated to QM by using QbD and QRM approach by employing analytical and risk-management methodology. Lead and contribute to Quality Management systems and projects such as the development, implementation, training and maintenance of Quality Improvement plans based on audit reports, priorities and CAPA investigations and follow up that identify areas of improvement and compliance risk. + Perform external visits (if necessary) to assure adherence on GCP and FDA regulatory requirements including visits to strategic alliance partners. + Serve as liaison to across sub-functions and business partners to assure compliance with process and systems. **Requirements:** + BS degree in scientific or health related field or equivalent field of study (MS preferred) + Ability to understand/interpret/coordinate quality and performance improvement activities, perform data collection and reporting, and support compliance and risk management activities. + This position requires an innovative and strategic leader to drive the implementation of new processes across QM and Medicine functions. + A minimum of five to seven (5-7) years progressive clinical regulatory compliance experience including a broad range of GCP auditing and/or clinical compliance experience/demonstrated experience in a senior advisory role. + Expertise in regulatory requirements in the area of GCP, ICH guidelines and FDA regulations. + Ability to operate independently of functional groups and provide critical independent assessments and advise to senior management. + Strong analytical skills as well as demonstrated strength in agility while demonstrating initiative and ability to develop and implement a new process. + Exclusivity of responsibility, strategic and operational processes conceptual/analytical thinking, internal accountability, organizational design, initiative and self-motivation. **Desired Skills, Experience and Abilities:** + Master’s Degree from an accredited institution preferred. **Eligibility Requirements:** + Must be legally authorized to work in the United States without restriction. + Must be willing to take a drug test and post-offer physical (if required) + Must be 18 years of age or older **Our Culture:** Boehringer Ingelheim is one of the world’s top 20 pharmaceutical companies and operates globally with approximately 50,000 employees. Since our founding in 1885, the company has remained family-owned and today we are committed to creating value through innovation in three business areas including human pharmaceuticals, animal health and biopharmaceutical contract manufacturing. Since we are privately held, we have the ability to take an innovative, long-term view. Our focus is on scientific discoveries and the introduction of truly novel medicines that improve lives and provide valuable services and support to patients and their families. Employees are challenged to take initiative and achieve outstanding results. Ultimately, our culture and drive allows us to maintain one of the highest levels of excellence in our industry. We are also deeply committed to our communities and our employees create and engage in programs that strengthen the neighborhoods where we live and work. Boehringer Ingelheim, including Boehringer Ingelheim Pharmaceuticals, Inc., Boehringer Ingelheim USA, Boehringer Ingelheim Animal Health USA, Inc., Merial Barceloneta, LLC and Boehringer Ingelheim Fremont, Inc. is an equal opportunity and affirmative action employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender identity or expression; affectional or sexual orientation; disability; veteran or military status, including protected veteran status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. Boehringer Ingelheim is firmly committed to ensuring a safe, healthy, productive and efficient work environment for our employees, partners and customers. As part of that commitment, Boehringer Ingelheim conducts pre-employment verifications and drug screenings. *LI-DS1 *I-DS1 **Organization:** _US-BI Pharma/BI USA_ **Title:** _Clinical Compliance Expert (Associate Director)_ **Location:** _Americas-United States-CT-Ridgefield_ **Requisition ID:** _176817_
          Breast health center gives TGen new research opportunities        

TGen partners with John C. Lincoln Health Network to prevent breast cancer



PHOENIX, Ariz. – May 4, 2009 – Today's opening of a new breast health center next to John C. Lincoln Deer Valley Hospital will provide significant research opportunities for the Translational Genomics Research Institute (TGen).


The 9,000-square-foot Breast Health and Research Center will include a tumor biorepository for TGen that will aid the non-profit research institute in discovering new ways to diagnose and treat breast cancer, which affects 1 in every 8 American women.


"What this partnership means is that breast cancer research at TGen will be significantly accelerated, specifically in development of more accurate diagnostic tests and smarter treatment options for newly-diagnosed breast cancer patients,'' said Dr. Heather Cunliffe, head of TGen's Breast & Ovarian Cancer Research Unit.



The new center is located in John C. Lincoln's Medical Offices 3, 19646 N. 27th Ave., just southwest of Interstate 17 and Loop 101, in northwest Phoenix.


"Our new state-of-the-art medical equipment allows the earliest possible detection of breast cancers when survival rates are highest and treatment is less invasive," said Sherry Gage, Clinical Director of John C. Lincoln's new center.


"But, our staff also knows the key component of the care they offer is their personalized and genuine concern for their patients. We're not just here to give the diagnosis, we're here to help patients at all stages," said Gage, a Registered Radiologic Technologist.


Breast cancer patients at the new center who agree to donate their tumor tissues will boost TGen's abilities to use genomic and proteomic research toward development of new ways to combat breast cancer.


TGen's role at the new center will be for research; not for TGen clinical trials.


"We are thrilled that JCL and TGen have developed a strong strategic partnership to benefit breast cancer patients,'' said Dr. Cunliffe, who also is an Investigator in TGen's Computational Biology Division.



The new center provides TGen with yet another avenue of assisting local hospital and research networks, including Arizona's three major universities, St. Joseph's Hospital and Medical Center, Banner Health and Scottsdale Healthcare.


"This is another example of how Arizona is forging new ground through fostering broadly the alignment of clinical centers of excellence, such as John C. Lincoln, with biomedical research organizations, such as TGen. The ultimate beneficiaries are of course our patients who have cancer and other debilitating diseases," said Dr. Jeffrey Trent, TGen's President and Research Director.


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About TGen

The Translational Genomics Research Institute (TGen) is a Phoenix-based non-profit organization dedicated to conducting groundbreaking research with life changing results. Research at TGen is focused on helping patients with diseases such as cancer, neurological disorders and diabetes. TGen is on the cutting edge of translational research where investigators are able to unravel the genetic components of common and complex diseases. Working with collaborators in the scientific and medical communities, TGen believes it can make a substantial contribution to the efficiency and effectiveness of the translational process. TGen is affiliated with the Van Andel Research Institute in Grand Rapids, Michigan. For more information, visit: www.tgen.org.


About John C. Lincoln

John C. Lincoln Health Network is an acclaimed not-for-profit system of hospitals, physician practices and community outreach programs. Honored for excellence by independent experts, John C. Lincoln doctors use advanced medical technology to deliver superior health care every day. Its focus on quality has earned John C. Lincoln Health Network the trust and respect of the patients and community members it serves. For more information visit JCL.com.


          Comment on Beijing Medical beauty commerce by Noori        
Hi to whom it may concern. You can remove this post as Beijing Medical commerce has made contact as reading my complaints. They promised to assist and help me from here on in the future.
          As Legitimate Market for Execution Drugs Dries Up, States' Secret Execution Practices Become Increasingly Questionable        

Pfizer's recent announcement that it was tightening controls against what it calls the misuse of its medicines in executions highlights an on-going struggle between states desperate for execution drugs and a medical community that believes its involvement in the lethal injection process violates its medical and corporate missions and the ethical standards of the pharmaceutical and health professions. As Pfizer and nearly two dozen other pharmaceutical companies have ended open market access to drugs potentially used in executions, states have responded by increasingly shrouding the execution process in secrecy. The states "are mainly concerned about losing their providers of lethal-injection drugs should the companies’ names become public," says Linc Caplan in a recent article in The New Yorker. Otherwise, "companies that do not want their products associated with executions will know that their drugs are being used." He reports that since the Supreme Court upheld Kentucky's execution protocol in 2008, 20 states have responded to drug shortages by abandoning protocols that had been substantially similar to Kentucky’s, making "unfettered substitutions" to their protocols in "desperate attempts to adhere to their execution schedules.” Caplan reports that States "have also been increasingly misleading in their efforts to obtain drugs for executions." He cites documents showing that one Ohio official urged state drug purchasers to identify themselves as from the Department of Mental Health and warned they should "not mention anything about corrections in the phone call or what we use the drug for." Louisiana similarly obtained execution drugs from a local hospital, which mistakenly assumed they were needed for medical use. Last week, an Oklahoma grand jury report described that state's secrecy practices as producing a "paranoia" that "clouded [prison officials'] judgment and caused administrators to blatantly violate their own policies." An article by Chris McDaniel in BuzzFeed after the release of that report documented that the same secrecy and lack of oversight criticized by the Oklahoma grand jury is common in other states, and has contributed to execution problems in Missouri, Georgia, and Ohio. Arizona and Missouri paid executioners in cash, and Missouri's mismanagement of that fund likely violated federal income tax law. Missouri's secrecy, McDaniels writes, also "allowed it to purchase execution drugs from a pharmacy in Tulsa, Oklahoma, that was not licensed in Missouri and had questionable pharmaceutical practices." Other states, like Texas and Arizona "have used the secrecy to purchase drugs illegally," he reports. 

In The New Yorker, Caplan concludes, "In the five years between Hospira’s decision to stop making sodium thiopental and Pfizer’s decision to stop supplying drugs for executions, the unsuccessful effort, by one state after another, to carry out lethal injections in a manner that meets standards of fairness and reliability has made it increasingly clear that states cannot constitutionally perform these types of executions."

(L. Caplan, "THE END OF THE OPEN MARKET FOR LETHAL-INJECTION DRUGS," The New Yorker, May 21, 2016; C. McDaniel, "Scathing Oklahoma Grand Jury Report Showcased Issues Common In Death Penalty States," BuzzFeed, May 20, 2016.) See Lethal Injection.


          TS EAMCET 2017 Key| TS EAMCET 2017 Question Paper        
TS EAMCET 2017 exam for Engineering (E) stream held on 12.05.2017, 10:00 AM to 01:00 PM.TS EAMCET 2017 exam for Agriculture and Medical (AM) stream held on 12.05.2017, 02:30 PM to 05:30 PM. TS EAMCET 2017 (Engineering) A Common Entrance Test designated as “Engineering, Agriculture& Medical Common Entrance Test” (TS EAMCET–2017) will be conducted by […]
          Why You Want Heart Sync Pads for Your AEDs        

We provide AED's and other wholesale medical supplies.We know that you have a choice when it comes to what AEDs and consumables you purchase for your medical facility. Pacific West Medical offers a variety of choice in our online site to ensure that our customers have the options they want. If you aren't sure which AED or consumable product is right for you, you can always ask a member of our team. They'll help guide you to the right choice for your facility, based on your needs, budget, and usage. 

One of the products we often recommend to our customers are the Heart Sync AED Pads. Heart Sync has been in the medical industry for over 22 years, and their reputation in the medical community is one of quality. These AED pads offer the longest lead wire in the industry, so your medical teams have more flexibility in the placement and usage of the pads. The pads have a 36-month shelf life, too, which means less waste for your facility. Their products are made in the USA, so you can be proud of your purchase.

Read more about these AED consumable on our website. You'll be impressed with Heart Sync's commitment to designing quality AED pads that offer the features your team needs when working in high-pressure life or death situations. Place an order for AEDs and AED consumables on our website or give us a call to ask a question or place an order over the phone. Pacific West Medical will help you get the equipment you need right away! 


          Home health services help maintain senior independence        

(BPT) - Staying healthy and out of the hospital is a top priority for the majority of seniors. However, as you age, you may need additional care to meet your medical needs after an illness, injury or exacerbation of a chronic health problem. Fortunately, this doesn't necessarily mean a long hospital or rehab stay, thanks to home health service options.

For Yoko and Kenneth Gilbert, both age 84, home health services provided important care when they needed it the most. After an injury caused by a fall Yoko needed nursing care for her wounds. She also needed physical therapy to regain her ability to get around. Her husband's help could only go so far, but he could not provide the professional care that she required, so at her doctor's advice, she decided to get home health services.

What is home health care?

According to Medicare.gov, "Home health care is a wide range of health care services that can be given in your home for an illness or injury. Home health care is usually less expensive, more convenient and just as effective as care you get in a hospital or skilled nursing facility (SNF)."

Every home health plan of care is individualized based on the person's unique medical needs and abilities. The goal is to treat the person's medical condition at home so that he or she can enjoy a high quality of life while receiving professional services designed to restore health, self-sufficiency and independence.

For Yoko, this gave her important peace of mind. She decided to work with Brookdale Home Health for her specific needs. "They came every week, changed my dressing and catheter," she says. "Everything was just great."

When are home health services used?

For seniors residing at home or in a senior living community, both medical and non-medical home care are options. The people most likely to need home health services are those recently diagnosed with a new illness, those who have been injured in a fall or other event, and those who have experienced a major change in health condition such as the worsening of a chronic disease process.

To provide these services, a health care professional will come to your place of residence. This may include a nurse, a physical therapist, an occupational therapist, a speech therapist, a home health aide or a medical social worker. Because these professionals come to you, you're able to remain in the comfort and security of your own home. Receiving care at home enhances your physical and mental well-being and promotes dignity and independence.

For Yoko, part of her home health care services were provided by a physical therapist named Barbara. “Barbara was wonderful," she says. "She took care of me, she pushed me and because of her I can move around better.”

Yoko's husband, Kenneth, says the services were more than just health care. “Brookdale Home Health helped her a lot. Her therapists really lifted her spirits," he adds.

How can you get home health services?

Before Yoko could receive home health care, she got a referral from her doctor. A doctor is in charge of determining whether you are a candidate for home health services. If you think you are a candidate, it's important to have an honest conversation with your physician to see if home health is the right option for you.

If your doctor decides that home health is right for you, begin to research options in your area. With a doctor's prescription, the Brookdale Home Health team of experts can provide care based upon your unique medical needs in the privacy of your home. Learn more by visiting www.brookdale.com.

Is home health covered by insurance?

Home health services are often covered by health insurance, but you should verify the details with your particular plan provider. Many plans offer 100 percent coverage if certain conditions are met. For example, Brookdale Home Health services may be covered by 100 percent of your Medicare Part A benefit if your doctor determines that you are homebound and that home health services are medically necessary to treat your illness, injury or change in medical condition.

Yoko saw great improvements in her condition through home health services. However, she eventually experienced additional medical complications that require 24 hour care. Her husband could not keep up with the demands and sought respite care in a Brookdale community. After receiving respite services, they have decided to move in to a Brookdale Senior Living community full-time.

“My wife got sick and there was no way I could take care of her," says Kenneth. "We moved into a Brookdale community on Valentine’s Day and we’ve been here ever since.”

Today they are permanent residents of Patriot Heights in San Antonio, Texas, where they receive the full-time care they need, enjoy a full social calendar and have made many new friends.


          About my story "Our State Fair"        

Folks who've read my recent story "Our State Fair" may be interested in some of the background information that I, uh, fictionalized. As one commenter on my story has noted, a uterine transplant was apparently performed in Turkey last year. The medical communities of several countries are, in fact, vying to be the first to perform viable uterine transplants; I thought I'd make it easy on them by having the transplant occur between siblings. But now let's talk about food ...

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          I will not debate the usefulness of spec scans for...        
I will not debate the usefulness of spec scans for diagnosis, even though they are highly questioned within the medical community. I will focus my review on the other aspects of my experience.
Even though they charge a huge amount of money, their "premium" services only includes one meeting with the doctor. Any further meetings or phone calls will be made with the doctor's assistant and not the doctor himself. After diagnosis, they asked me to start taking all sorts of different supplements for a total of 26 pills per day and charged me thousands of dollars for those supplements.
Bear in mind that I didn´t take a single pill before visiting Amen. 3 weeks after I started taking the pills I still had no change regarding my state of mind and I felt physically bad because of the amount of pills I was having to digest.
Finally I decided to start working with one of the most brilliant psychiatrist in my country instead. Unlike Amen where the doctor was never available, I was able to contact my psychiatrist at any time of the day via email and expect a response within a day. After 2 weeks of treatment I was feeling a lot better, and 1 month later I´m feeling better that what I´ve ever felt before. And what did I have to do? Take 1 pill of 20mg Prozac a day, the lowest dose available for adults. And my psychiatrist tells me it´s only temporary and I could even stop taking it after a year or two. Also, I met with the psychiatrist 3 times, for a total cost of $400 plus one box of Prozac a month, which is quite cheap. Amen charged me about $3500, plus travelling expenses, plus $2000 in supplements for just 6 months.
Amen Clinics did not help my anxiety, they made it far worse. So I strongly recommend to avoid them and look for a clinic or a doctor that cares more about you than about making money of you.

          Senior Web & User Interface Ruby Developer - Palo Alto        
Stanford University, one of Silicon Valley's largest and unique employers, has an immediate opening for a Web & UI Designer within the School of Medicine. Stanford's mission is to educate future leaders and promote interdisciplinary, world-class research and teaching. This passion makes Stanford an intensely creative and rewarding place to work. Much of the technology that powers the Web and its many applications were initially developed at Stanford. The Senior Web & UI Ruby Developer will be involved in an exciting new project; we are creating a national biomedical computing infrastructure to accelerate biomedical discoveries using a Web-based portal to scientific knowledge residing in a diversity of online resources. Our group is collaborating with a consortium of world-class international researchers. This is an opportunity to play an integral and creative role in a highly visible, national project. Your skills will be critical in our ability to both visualize and provide easy access to the vast biomedical data being generated today. Responsibilities: * Understand user needs and design and implement user interfaces for the Web portal and present the information in different ways to different users. * Design and create web-based applications as well as manage the website for our center. * Serve as a member of a small internal development team and work with collaborators from other sites in developing this resource. * Maintain ongoing contact with users. Required Qualifications: * Bachelors degree or higher and a minimum of 5 years applicable experience or an equivalent combination of education and experience in Web design and UI design. * Extensive experience in front end design; specifically UI and Web application development. * Strong knowledge of human-computer interface design principles required. * Familiarity with Web server frameworks. * At least 3 years experience with Ruby on rails development. * Experience with back-end technology and implementing them in conjunction with the front end. * Excellent communication skills are essential, including the ability to write well. It is also essential to have experience working in an interdisciplinary environment. Preferred Qualifications: * MS in Computer Science or related degree. * Experience with cross-platform development and technologies such as CSS, DHTML, XML/XSLT, Photoshop, and Illustrator. * Knowledge of Java, Swing, JavaScript, JSP, JDBC and related technologies. * Experience with system and database administration, knowledge bases, the Semantic Web, and familiarity with the biomedical domain. * Experience with J2EE web application front end programming * Extensive experience with Ruby on rails application development * Experience with AJAX, and other dynamic, rapid development front end technologies.
          Mitzvah Schmitzva        
My life is turning in to a George Carlin routine about stuff. I love George Carlin, but we are simply running out of room. In reaction to the onslaught of stuff that made its way into our house this past holiday season, I have put a moratorium on acquisitions until late March when Little turns six.
I revisited the whole "Mitzvah Birthday" idea again-where the party guests donate to a charity of Little's choosing in lieu of gifts- but I had forgotten it was kind of a bust when we tried it when Big turned six a few years back.
A mitzvah, if you don't know, is the word used to describe a good deed in the Jewish faith. It is something that both kids have been steeped in since we started going to our amazing Jewish school five years ago.
The idea for a Mitzvah Birthday began a two years ago on one particularly tedious weekday afternoon, just before Big was going to turn six. I was making dinner and after a series of games, some wrestling, some fighting, both of my incredibly well attended (if not over indulged) children declared themselves bored. I heard them whining and told them to go play outside.They ignored me. I reminded them that boredom wasn't an option, as long as they live in this house, in this city, in this country.
They persisted, so I cut to the chase:
I told them that they should be thanking their lucky stars that they weren't born somewhere in an Indian slum where they might be sifting through piles of dirty medical waste all day every day instead of complaining that their pasta didn't have enough cheese. I had read an article about it in the paper a few days before. Big pricked up her ears and wanted to know more. Little buried her head in some stuffed animals. I explained that there were parts of the world where little girls didn't spend their days fighting over one of eleven nude Barbie dolls, painting outside, going to school, or hosting fancy birthday parties. No, those little girls, sometimes as young as four, sat in a disgusting fly infested,maggoty garbage dump from sun up to sundown with no sandwiches with the crusts cut off and picked hypodermic needles out of a large pile of trash to sell back to the medical communities in their town. The poor kids often got stuck by the needles and many contracted terrible illnesses and died because of it. I explained that those children had no pretty clean room to mess up or drawers full of clothes to throw on the ground when they weren't satisfied with their Mother's choice of wardrobe.
They were both silent for a second. Little wandered off (which made me wonder how the Indians got the four year olds to sift through the garbage in the first place), but Big was mesmerized. She nodded passionately as I spoke, hanging on every word. She asked how we could help them, and I broached the subject of her having a Mitzvah Birthday, assuring her that she would still receive numerous gifts from her large, generous family. After I explained the part about the needles a few more times, she decided that this would be her charity of choice for her birthday party. I found a link to a wonderful organization called Ragpickers Education and Development Scheme or REDS. They have drop in centers in and around the areas where most of the kids are scavenging and they spend time encouraging  the parents to let their kids get educated and have a childhood instead of be ragpickers.
I encouraged the Mitzvah Birthday for two reasons- 1) to forgo the bazillion Chinese made plastic twenty dollar well meaning gifts from her eighteen guests ( no offense but how many more My Little Pony set or Pet Shop or Polly Pocket or Disney Princess phones,"computers", dress up shoes, tiaras, tutus, do we really need to have?) and 2) So she could learn that giving is actually pretty cool, even on your birthday.

I completed the Evite and pressed send, feeling very proud of my kid.

Two hours later, I ran into a mom whose child from another school was invited to the party. We were both in line at Trader Joe's. She was impeccably dressed, in full make up with her buttery blonde hair swept up into a perfect French twist. It was a Tuesday, and she was grabbing a quick lunch between broker open houses. She looked up from her phone and asked what sort of gift Big might like. I smiled and began to explain the Mitzvah Birthday concept to her. As soon as the word "ragpickers" left my lips, her eyes glazed over, as if I had handed her The Watchtower pamphlet and parked myself on her doorstep. As I spoke, she became a slow motion montage of eye rolling, sighing and checking her phone. I kept talking while she nodded over my words, her eyes wandering.  By the time I had finished my twenty second explanation, she had paid for her salad was gone, leaving behind a cloud of perfume and some unintelligible remark about liking to buy stuff. I watched her go, pretty sure I saw her shake her head in disbelief. 
I stood there in my goto unbelievably comfortable faded black yoga pants and a waffle knit hoodie, my hair a messy after thought, feeling like a squishy, flabby, smelly, stubble-covered, unwaxed, caterpillar-browed, braless, yellow toothed,"natural", placenta eating, braid wearing, vegetarian, reusable bag carrying, liberal cliche that should be milking goats in Oregon and not attempting to make a home in Hollywood. God, did I even brush my teeth today?

She managed to make me feel bad about trying to save starving needle pricked children in India.

While I waited to check out, I noticed a hole in the arm of my waffle hoodie, likely sewn by the very same Indian slave child that my daughter wanted to help. I walked to my car, feeling very squinty and conflicted, and fished around for the lipstick that had been rolling around on the floor for the last year.
It was a MAC named Meltdown. Perfect.
I drove home asking myself when encouraging your child to consider other people became such a yawn worthy concept. I know that many five year olds have their own Mini Ipads and all, but when did empathy go out of style?  It isn't as if I was going to deny Big birthday gifts. She couldn't go without gifts if she tried to since both kids have a small army- four grandmas, three grandfathers, a two grand aunts, three great grandmas,two aunts, two uncles, several cousins and their adoring parents-that routinely showers them with gifts.
As I unloaded the car, I questioned my own motivation for the whole mitzvah thing. First, it's the stuff.I am done with too much stuff. Second, it's the entitlement. I do not want to raise entitled children. It is my worst fear, that all of our attempts to give our kids everything they need will  make them heartless insatiable little assholes. So far, not the case, but we've had our moments. I barely survived Little's Horrendous Performance at Department Stores Phase that lasted almost seven months, where Mommy specifically said every single time we went to a store "you each get one thing", WELL before entering the store, only to have Little persist relentlessly in wanting two things. I never gave in, but the HPDS phase aged me rapidly and brought me closer to child abuse than almost anything else has before or since.  I rarely take them to stores at all anymore: HPDS induced PTSD is a bitch.
I look around our house and see all the stuff they have-LOTS and lots of toys, clothes, stuffed animals, games, piles of gifts from birthday after birthday. All of it represents how much they are loved by their family and friends, but most days, I  wonder if we should give it all away. Just let them pick some of what they actually play with, which is maybe twenty percent of what they have. Unfortunately for me, I married someone who hates that idea with a passion and has vowed to replace each item I discreetly place in the Goodwill bag tenfold. I believe him. He has an irritating yet astonishing sixth sense about the toys that have been culled and will ask suspiciously about a random brown squeaky cow from a bath set he bought them at the Phoenix airport three years ago. If it can't be produced, he vows to buy more, "just to teach you not to toss their stuff, their memories", no matter how useless and ignored it might be. I should mention here that he is an excellent father and has instituted the "word of the month" in our house. He and the kids pick a meaningful word (determination, respect and courage are some of the previous choices). They define it, write it on a piece of paper and stick it on the wall for the month. How awesome is that?

I voted for "frugal" for February.

He also enjoys buying them stuff immensely. He took Little to the toy store for her birthday last year and offered her anything in the store. Really, a five year old was told to "pick anything". She looked at all of it over the course of thirty minutes and chose a twenty dollar sale item. I was thrilled because I might have insisted he return the thousand dollar mini Hummer in hot  pink if she had chosen it. Call me a killjoy, but I believe in limits, even on your birthday.
Two days before Big's party, with the linen closet  packed with gifts from family as promised, and I had not received a single notification of a donation sent to REDS, the ragpicker charity. Then a Paypal notification came- yes! Someone had actually read the Evite details. The day of the party came- a luau theme-  and the first two guests brought gifts. They were received with a little confusion by Big, so I put out a box next to the leis that said "Donations Here". After some clarification that the donations were not meant to purchase leis,  a few more guests put in their donations and, all told, seven out of sixteen people brought gifts and four people donated that I know of.  I guess that electronic communication isn't the most personal and most people probably just read the Evite to get the basic facts, but it was a huge disappointment for Big. Perhaps we will try it again in a few years, provided we haven't drowned in our own excess.
However, having momentarily convinced Little to go the same Mitzvah Birthday route in a few weeks, I am kind of relieved that she changed her mind. She wants her friends to bring her gifts, and that is okay. Especially because her charity of choice was, inexplicably, "to help people in Colorado". I wanted to tell her that they have legalized marijuana now, and that there are other more uptight states that could use the help-any needy folks in Connecticut?

          CBM Book Reviews gave 5 stars to: I'm Sorry, Oliver        

CBM Book Reviews reviewed:

I'm Sorry, Oliver by Alison M. Tomlinson
5.0 out of 5 stars An Amazingly Unique Christian Fiction, April 17, 2017
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This review is from: I'm Sorry, Oliver (Paperback)
I’m Sorry, Oliver by Alison M. Tomlinson is based on the true-life events of the author. Offering insight into the spiritual realm, the author writes an amazingly unique Christian fiction filled with insight into the spiritual realm as she depicts the Scripture based on John 10:10 (NIV), “The thief comes only to steal, kill and destroy; I have come that they may have life, and have it to the full.” Depicting the suffering she faced through her battle to good health, the birth and death of her handicapped son and Heaven’s intervention upon her behalf, faith, miracles, angels and the demonic realm reveal to readers a story that is not only heartbreaking, infuriating, and intriguing, but gives hope as Sylvie finds new life in revived health and a deep resolute faith in God as her Healer and Savior.

Born premature, Oliver, is sickly from birth. After several weeks, it is discovered that Oliver has severe physical and mental handicaps that cut his life short at the age of 10. Sylvie and her husband, Neil, are devastated when they discover that an asthma drug given to Sylvie during pregnancy could have caused Oliver’s condition.

Through fiction, Alison presents her years of struggle with her own health and that of her severely handicapped son, Timothy. Capturing a mother’s loving heart and complete devotion to her son, the author sheds light into deception into the medical industry, unveiling that it is not the “cure-all” that people believe it to be.

From a nutritional perspective the author learns her sensitivity to gluten, and that the human body is designed to heal itself – with the right nutrients. This is a moving and compassionate story, offering readers elements of surprise, intrigue, suspense, real-life drama, the Big Pharma industry, and deception within the medical community that make for a surprising, yet unforgettable drama that is thought-provoking and challenging, yet transformational and inspiring, leading people to the truth of Jesus, the Bible and God’s healing power and wisdom. ~ A highly recommended read for Christians and non-believers alike!

          Invokana FDA Warning        
The FDA safety communication issued a warning to the general public and the medical community that the agency is monitoring the side effects of SGLT2 inhibitors to determine whether changes need to be made in the prescribing protocol of the drug.
          Pneumonia risk higher with breast cancer treatments, personalized treatment protocols may help reduce pneumonia mortality        

pneumonia risk in breast cancer patientsPneumonia risk has been found to be higher in patients undergoing breast cancer treatment. There has been a consensus among the medical community that pneumonia in cancer patients was a result of a weakened immune system and exposure to multiresistant …

The post Pneumonia risk higher with breast cancer treatments, personalized treatment protocols may help reduce pneumonia mortality appeared first on Bel Marra Health - Breaking Health News and Health Information.


          ~*Are Medically Complex Children Bad for Siblings?*~         
While we have been supported so wholeheartedly through this challenging medical season, there is a stirring in my heart that I think I need address. 

Why do this? 
Why put our other children through this?
Isn't it unfair to them?

Oh my, where do I begin? 

If you had a child born with some unexpected ailment, condition, or disease would you not move heaven and earth to see that your beautiful baby had the best care in the world? 

Of course, for the vast majority of my audience the answer is a resounding *YES*! You would never give up on that child until you had answers! 

When we chose to adopt we knew that we were adopting children that were a medical mystery. We said the same exact, YES, that you have said every time you added a homegrown kiddo to your family.

Yes, our China blessings are medically complex and the further we dig into the care they need the bigger the mystery seems to get. They are filled with fun and not so fun surprises. 

If I would not reject a homegrown babe why would I reject a heartgrown babe on the possibility of medical surprises?


The concept that this is unfair to our other children is just bogus.  This journey has taught our children invaluable lessons of compassion, attentiveness, true love and acceptance, how to advocate for needs and how to navigate the medical community.

Those character qualities and skills are invaluable. Setting aside all generic discussions here, we firmly believe that teaching all of our children the value of life, the value of *each* life, is a precious gift.

 No matter how desperate the situation, no matter how deep the pile of medical equipment, no matter how intricate the special need, each and every life is valuable. 

Luke 12:7
Indeed, the very hairs of your head are all numbered. Don’t be afraid; you are worth more than many sparrows.

#writeandrun31
Day 1 (3.1 miles complete)

          How industrial farming techniques can breed superbugs        

Watch Video | Listen to the Audio

Find all of the stories in our series Stopping Superbugs

JUDY WOODRUFF: But first: our special series Stopping Superbugs.

This week science correspondent, Miles O’Brien and economics correspondent Paul Solman tag-team again for a look at how the use of antibiotics in livestock can lead to unhealthy, even dangerous outcomes.

Miles begins at a Missouri pig farm, as part of our weekly science series, Leading Edge.

MILES O’BRIEN: Pig farmer Russ Kremer is up early, tending to his herd, talking to the animals.

RUSSIANS KREMER, Heritage Foods: I have the ability to interact with pigs. I think that they are the smartest, most social animals. I tell people that, if you like kids, you love pigs.

MILES O’BRIEN: He is the fifth generation in the Kremer clan to farm this plot of land in Frankenstein, Missouri. He introduced me to the newest residents.

RUSS KREMER: Everything that we do on this farm as far as feeding, and as far as production, as far as genetics, that all has to do with keeping them healthy.

MILES O’BRIEN: Russ Kremer is obsessed with keeping his pigs healthy, because he knows firsthand that his own health depends on it.

RUSS KREMER: That’s about as good as it’s going to get.

MILES O’BRIEN: Thirty years ago, the farmer from Frankenstein created a monster after he adopted industrial farming techniques to increase his pig production.

RUSS KREMER: My pigs were unhealthy. I would go through my pigpens three times a day, injecting them with antibiotics to cure some sort of chronic diseases that I had on my place.

And, in fact, I was actually growing superbugs in this farm and didn’t know it.

MILES O’BRIEN: How he found out nearly killed him. He was gored in the leg by a boar, and the wound became infected. His doctor told him not to worry, antibiotics were the cure. But it wasn’t that simple.

RUSS KREMER: We tried two different tetracyclines. We tried streptomycin. We tried erythromycin, amoxicillin, seven different antibiotics in total, to no avail.

MILES O’BRIEN: So he checked the reports from his veterinarian to see what infections his pigs had and what antibiotics worked for them.

RUSS KREMER: It came back, resistant, resistant, resistant, resistant. And finally, aha, there was one antibiotic at that time that had some effect on that disease. They treated me, and thank God there were this new-generation drug. And so that transformed my life.

MILES O’BRIEN: Molecular microbiologist Lance Price also grew up on a farm, a cattle ranch. He watched firsthand as a neighboring dairy went from a small-scale family operation to an high-density, industrial-scale farm.

They are called concentrated animal feeding operations. Lance Price says they are fertile breeding grounds for disease.

LANCE PRICE, George Washington University: You pack them together, snout to tail in the case of pigs, and beak to feather in the case of chickens and turkeys, they’re going to share bacteria.

So we have engineered a system that makes them sick. Rather than change that system, we actually just add low doses of antibiotics to try to prevent infections.

MILES O’BRIEN: Price and his team at George Washington University conduct large epidemiological studies of meat that is sold in grocery stores. They culture the bacteria found on the meat and test to see how they react to disks saturated with antibiotics. He is hunting for superbugs.

LANCE PRICE: If they’re susceptible, that is, not resistant, to the antibiotic, they will be inhibited. They won’t grow near the disk. But when they grow right up to the disk, like all of these, that means that that bacteria is resistant to all those antibiotics. You don’t want to get infected with one of these.

And these are bacteria that we actually isolated from the food supply.

MILES O’BRIEN: He sequences the genomes of E. coli from food and from people, comparing them to a database of 7,000 distinct types of the bacteria.

LANCE PRICE: We’re trying to figure out, hey, did this urinary tract infection come from the E. coli from animals or from food?

MILES O’BRIEN: He says there is a strong case linking the use of antibiotics in livestock to the spread of drug-resistant bacteria in humans.

LANCE PRICE: So, on every grocery store shelf in this country, I guarantee you you’re going to find drug-resistant bacteria on the meats of those shelves. And then they get in our guts when we consume the meat from those animals.

Most of the time, that’s a dead end, right? We will eventually get rid of those bacteria. We will shed them away. But, sometimes, they will take hold.

MILES O’BRIEN: In the 1950s, farmers discovered feeding livestock steady, low doses of antibiotics made them grow faster. But this so-called subtherapeutic use of these precious drugs raised concern in the medical community and the government.

In 1977, the U.S. Food and Drug Administration proposed a ban on subtherapeutic uses of penicillin and tetracycline in animal production. But the rule was never enacted. And the problem worsened.

In 1989, human and livestock usage of antibiotics was about equal. Today, agriculture accounts for about three-quarters of all the antibiotics used in the United States.

MAE WU, Natural Resources Defense Council: We have to stop now. We have to stop abusing them now, so that we can slow this problem down.

MILES O’BRIEN: Mae Wu is a senior attorney at the Natural Resources Defense Council.

MAE WU: Using antibiotics and misusing them just to make animals get fatter or so you can cram more together and have more stressful conditions and feed them worse diets is the worst way to be using these incredibly important drugs.

MILES O’BRIEN: In 2010, the NRDC, sued the FDA to force it adopt its own rule. Instead, it released new regulations limiting the use of medically important antibiotics in animals to when it is necessary for assuring animal health and with veterinary oversight and/or consultation.

Liz Wagstrom is the chief veterinarian at the National Pork Producers Council.

LIZ WAGSTROM, National Pork Producers Council: The pork industry believes that the most judicious uses of antibiotics are those for treatment, control and prevention of diseases.

MILES O’BRIEN: Wagstrom says the pork industry will follow the FDA guidance, but she says pork producers will continue to use antibiotics as a routine disease-prevention tool even if there are no illnesses detected in their livestock.

LIZ WAGSTROM: It is a judicious and responsible use of antibiotics to go ahead and prophylactically treat some of those animals when we know they’re exposed, we know that it’s a specific disease, and we’re going to use that antibiotic for a defined duration of use.

MILES O’BRIEN: This is a huge loophole, as my colleague Paul Solman discovered in his conversation with Johns Hopkins University environmental health scientist Ellen Silbergeld.

ELLEN SILBERGELD, Johns Hopkins University: What has been stated as the recommendations, not enforceable policy, by the FDA is that agriculture shouldn’t use antibiotics for growth promotion anymore, but they are still permitted to use the exact same amounts of antibiotics in feeds for prevention. So, I think the category of prevention now has blown up.

MILES O’BRIEN: No need to worry about this at Russ Kremer’s farm in Frankenstein, Missouri. His pigs do not spend their life confined indoors cheek to jowl. They have much more space, easy access to pastures, even a wooded area Kremer calls his pig park.

He is trying to mimic what pigs would find in nature.

RUSS KREMER: This is the best place in America to raise pigs, in my mind.

MILES O’BRIEN: Right here?

RUSS KREMER: Right here.

MILES O’BRIEN: He rarely uses antibiotics at all, and then only if an animal is sick. Antibiotics saved Russ Kremer’s life 30 years ago. Today, he’s doing all he can to return the favor.

RUSS KREMER: They’re lifesavers. And what we have to ingrained into people’s mind, in society’s mind is we have to do everything we can to preserve them. It’s the most important, the most critical health issue in the world. And I’m here to do whatever I can.

MILES O’BRIEN: After I got back from Frankenstein, I sat down with Paul Solman to share some anecdotes from Russ Kremer’s bucolic pig farm.

So, Russ Kremer was ahead of his time, but the market has kind of caught up to what he is doing. It’s still a small piece of the big pie. Just a few thousand are raised in the way Russ does.

So, the question is, is it scalable?

PAUL SOLMAN: Well, in chickens, producers claim that 30 percent of the market or something like that, the chickens are raised antibiotics-free.

So, that’s where we’re going next, actually. That’s our next story.

For the PBS NewsHour, I’m economics correspondent Paul Solman.

MILES O’BRIEN: And I am science correspondent Miles O’Brien.

The post How industrial farming techniques can breed superbugs appeared first on PBS NewsHour.


          Think Tank Medical Combats Future DOJ & RAC Investigations of Hospitals for Improper ICD Implantation Procedures        

In a continued effort to ensure ICD Compliance within CMS Guidelines, Think Tank Medical now offers hospitals a private, dedicated version of the CMS ICD Application to distribute to all doctors, cardiologists and electrophysiologists within their facilities.

(PRWeb January 29, 2013)

Read the full story at http://www.prweb.com/releases/2013/1/prweb10371500.htm


          Flowers for Algernon by Daniel Keyes        

Joe's comments:

The book that inspired the movie “Charly” is a truly heartbreaking piece of 20th century American literature. The book is basically a set of progress reports told by the main character, Charlie Gordon, as he sets out on a journey to live a second life. Charlie is a mentally retarded adult who works in a bakery. He suffices day-to-day but is offered a chance to essentially get a new brain by a group of scientists.

Charlie elects to go through with the surgery, which has first been performed on a lab mouse named Algernon. Both Charlie and Algernon both begin learning at a monumental rate to the point where people once shunned Charlie now fear his intelligence. The news is broken to Charlie that he might revert back to his former state, though, and his world begins to crumble.

Like “One Flew Over The Cuckoo’s Nest” and other books of the time period, the story is a critique of mid-20th century medical science and the way the medical community (and society in general) treated the mentally impaired. 


          The Straight Dope about Homoeopathy        
This week, the Georgia Straight published an article by the daughter of the publisher of the paper espousing the benefits of homoeopathic remedies for the H1N1 influenza virus due to hit North America in full force this fall. After a round of pillory by the Canadian skeptics calling the author out on her assertions, the publishers included an article detailing a new study about the rate of medical errors in Canada in hospitals. While the 23000 deaths in 2000 attributed to medical errors is very disturbing, this defence of homoeopathy is one big red herring. Here is the comment I left on the article - which may or may not be published..we will see

"The chance of making a medical error looms over every health professional's head. Especially when you are applying treatments that have large inherent risks, like surgery or anaesthesia. What this article does not address is the much larger number of Canadians who are helped by or cured by modern medicine - which surely numbers in the millions every year; let alone those whose lives are extended by drugs treating their chronic conditions.

The way the medical and skeptical community raises its voice is by doing SCIENCE. To uncover problems in our therapies and interventions, publishing them so the public and our peers can see the problem, and then trying to abate it. When was the last study done by homoeopaths of this kind? I see you did not cite any study like this.

The reason homoeopathy has no side effects is because it has no effects, outside the placebo effect. The danger in using homoeopathy to prevent the flu is that you are avoiding real treatment - and this will surely do some harm. We have already seen outbreaks of measles (a serious disease that can kill your child) in the US and the UK because of the lessoning of vaccination. The regular flu kills 36000 people in the US every year - and this is less virulent than the H1N1 strain.

We have to lower the death-from-error rate, no doubt, but it surely sits below 1 percent now. Digging up this red herring of medical errors does not lesson the argument against homoeopathic flu medicine - it just muddies the waters some more and confuses the issue. The flu vaccine is safe and effective at preventing flu. Homoeopathic medicine is safe but not effective at preventing the flu. I know which one I will choose.
"


The debate over the flu vaccine seems to be one of competing fears. The two major arguments are as follows:

Medical Community:

The H1N1 influenza virus is a novel virus for which we have no immunity. It is more virulent than the normal seasonal flu, if not more deadly. To prevent serious complications in target populations (young people, pregnant people, health care workers) you should get vaccinated.

Vaccine-denial Community:

The H1N1 influenza virus is not nearly as bad as the medical community says it is. It is just a ploy by big pharma to sell more vaccines. These vaccines have not been proven safe and will cause more harm than good.

We have evidence for the former position:
http://www.cdc.gov/h1n1flu/vaccination/acip.htm
http://www.cdc.gov/h1n1flu/pubs/
http://www.who.int/wer/2009/wer8436.pdf
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2691743&tool=pmcentrez

Evidence for the Latter Position:
http://swinefluswindle.com/
http://www.rense.com/general86/dngers.htm (please check out the home page - it is one big ad for conspiracy and health products - dubious ones)

The latter is just s sample of the conspiracies out on the web. Most use news articles as their source, or other like-minded blog posts. The former uses science.

Here is an article by Dr. Harriet Hall talking about all of the myths surrounding the Swine Flu. If you read nothing else, this will be a great guide through the jungle of swine flu fears.
          Significant Advances For The Treatment of Fibromyalgia        
significant-advances-for-the-treatment-of-fibromyalgiaFibromyalgia affects millions of Americans – predominantly women – and is often misunderstood by the medical community.

In recent years, however, significant advances have occurred in our understanding of the condition.

Dr. Murray J. McAllister is a health psychologist who currently serves as the Clinical Director of Pain Services for Courage Kenny Rehabilitation Institute.

He talks to us today about this elusive illness and how best to treat it.
          Treat Cancer With Traditional Chinese Medicine (TCM), Acupuncture And Ancient Herbs – Studies        
The conventional medical community have accepted acupuncture and Chinese herbs, the ancient Chinese system of medicine known as TCM, as a credible treatment for alleviating some of the symptoms of cancer and the side effects of chemo and radiotherapy; however, little is known about its true potential to treat the disease itself. Acupuncture is one […]
          It's been a month        
Pejam celik, pejam celik..
Eh, it's been a month!
Maksudnya, dah sebulan bertukar angin ke bumi Pahang..
Dah sebulan juga menggalas tanggungjawab sebagai seorang pendidik..

Things were hard at the beginning.
Tapi, bila go through everything step by step, everything will be alright..

What I did the whole month?
Telling myself to fall in love with coding!
Ya! Both basic c and java.



I told myself to start being friend with coding.

Few years back, I did learned programming technique and object oriented programming. But, thinking that I'm not going to use them in the future, I started ignoring them. Enough if I can learn for exam and mini project!

That's what I've been thinking before. Because science computer is not my main stream. I though I would be someone who work at one of the biomedical company that will deal more with medical instrumentation, human fisiology and etc. 

Sometime, I though I would be an academic staff and researcher at any university and teach student on electric and electronic subject. Telling the student what capasitor that you need to use and etc.

We thought we will do what we like to do..And we ignore things that we don't like to do..
And somehow, we might end up to do the things we don't like for the next upcoming years! Who knows future better than HIM?

It's been a month.
And I think, I'm getting in love with coding.
It's fun! 

So, Wish me luck!




          Predisposing Characteristics of Adjacent Segment Disease After Lumbar Fusion        
imageStudy Design. Retrospective Review. Objective. The aim of this study was to determine medical, radiographic, and surgical risk factors for the development of adjacent segment disease (ASD) after lumbar fusion. Summary of Background Data. ASD is a recognized outcome of spinal fusion that leads to increased costs and debilitating symptoms for patients. However, a comprehensive understanding of risk factors for the development of this surgical outcome does not exist. Methods. The medical records of patients who received their first lumbar fusion for any indication were retrospectively examined for preoperative medical comorbidities and medications, as well as surgical approach and perioperative complications. A blinded reviewer assessed radiographs for each patient to examine sagittal alignment after fusion. Multivariable logistic regression was used to model the risk of developing ASD on the basis of one or more predictors. Results. A total of 137 patients fit the inclusion criteria; 9% required a follow-up operation for degeneration at segments adjacent to the fusion. The ASD group had a mean follow-up of 21.1 months prior to revision surgery and an overall follow-up of 41.0 months. The average follow-up in the control group was 14.0 months. Statistically significant independent predictors of developing ASD included antidepressant use [odds ratio (OR) = 5.4], diagnosis of degenerative scoliosis (OR = 34.2), fusion of L4-S1 (OR = 56.5), having no decompressions adjacent to the fusion, and low sacral slope (OR = 0.9). No patient who developed ASD received a decompression adjacent to the fusion such that an OR could not be generated for this independent predictor. Conclusion. This study is the first to use a combination of medical, surgical, and postoperative sagittal balance as risk factors for the development of adjacent segment disease after lumbar fusion. The awareness of these risk factors may allow for better patient selection and surgical technique to decrease the probability of acquiring this adverse outcome. Level of Evidence: 4
          What You Need To Know About Losing Weight        
The epidemic of obesity is steadily increasing in the United States and worldwide. This is nothing new, we hear about it frequently on the news and from the medical community. Over the last 70 years, each generation has grown increasingly heavier than the generation before them, and that trend does not seem to be changing.
          Drug companies aren’t making new antibiotics. Is there an economic cure?        

Watch Video | Listen to the Audio

Find all of our stories in this series, Stopping Superbugs

JUDY WOODRUFF: Now to our series on the hunt for new antibiotics, as superbugs and bacteria are building more resistance to the current line of drugs.

It is a joint project from our correspondents Paul Solman and Miles O’Brien.

Last night, Paul looked at why the market for developing new drugs is simply no longer working. But, as one expert warned, antibiotics are a class of drugs that could be lost for treatment if there’s no new investment.

As part of his series Making Sense, Paul looks at some new options for solving that problem.

PAUL SOLMAN: Northeastern University biologist Slava Epstein has traveled the world on the hunt for hitherto undiscovered microbes. Some trips are shorter than others.

MILES O’BRIEN: We are five minutes from your lab, right in the heart of Boston, and this soil is as good as any?

DR. SLAVA EPSTEIN, Co-founder, Novobiotic Pharmaceuticals: This soil is as good as any.

PAUL SOLMAN: As Professor Epstein told my NewsHour counterpart on the science beat, Miles O’Brien, just about any handful of soil contains tens of thousands of different microbial species, 99 percent of which remain utterly unexamined, in part because they refuse to grow in petri dishes.

Epstein’s breakthrough was figuring out how to cultivate them, inventing a gizmo that isolates individual bacteria, then grows them back into teeming colonies.

So, you can kind of see through them there.

AMY SPOERING, Research Director, NovoBiotic Pharmaceuticals: That’s right. So, in each one of those individual holes, in theory, there is a single cell. And by capturing single cells and putting them back out into the environment that they came from, you can cultivate microorganisms no one has ever cultured before.

PAUL SOLMAN: Amy Spoering is research director at NovoBiotic, the company Slava Epstein co-founded to study newfound bacteria, now up to 60,000 strains, and counting, as potential sources of new antibiotics. And how does that work?

SLAVA EPSTEIN: Antibiotics are produced by microorganisms to kill their neighbors, so the enemies, the competitors. This is an exercise that the microorganisms have been going through for the past four billion years.

PAUL SOLMAN: And that humans have exploited for the past century or so, with chemicals from microorganisms like penicillium, the mold that makes penicillin.

The trick is finding chemicals that kill infections in people without killing the people too.

So, I don’t mind interviewing movers and shakers, but it’s actually making me slightly dizzy, so I’m just going to look at you.

AMY SPOERING: Just look at me. That’s fine.

PAUL SOLMAN: So, what is this?

AMY SPOERING: So, what this is, is, this is where we grow all of the novel microorganisms that we cultivate. They need a large amount of air in order to grow well, in order to produce the antibiotics.

PAUL SOLMAN: So you’re aerating them?

AMY SPOERING: That’s right. That’s why they’re shaking.

PAUL SOLMAN: So far, they have identified 33 novel compounds here, one of which may be a breakthrough: a new antibiotic that kills bacteria in two completely different ways, making resistance much less likely.

AMY SPOERING: So, this is making our lead compound, teixobactin.

PAUL SOLMAN: And the cost, if all goes well, of eventually getting it to market?

AMY SPOERING: That’s big money.

PAUL SOLMAN: Big money that investors would be tripping over one another to provide, right, to get in on the ground floor of the next Z-Pak.

AMY SPOERING: The payout will be huge, if we are successful.

PAUL SOLMAN: But it’s a long lug, says Spoering, between bug and drug.

AMY SPOERING: This is 30 liters of it growing to produce the compound that we need to do the next set of pre-clinical tests.

PAUL SOLMAN: And then, after you have done those animal trials, the toxicology trials…

AMY SPOERING: Yes.

PAUL SOLMAN: … then, and only then, do you do trials on humans?

AMY SPOERING: First, an initial set of studies that is just for safety, and then you move on to the efficacy studies, which is phase two, and then much larger efficacy studies, which are phase three, clinical trials.

DALLAS HUGHES, President, NovoBiotic Pharmaceuticals: Drug discovery is a very long process.

PAUL SOLMAN: Dallas Hughes is NovoBiotic’s president.

DALLAS HUGHES: We are talking with venture capitalists now, but venture capitalists aren’t going to become interested until we discover a compound like teixobactin and move it forward a bit farther than it is now. And we’re hoping to raise some financing soon.

PAUL SOLMAN: But, for now, they’re relying on government and foundation grants.

SLAVA EPSTEIN: Promising something that may or may not happen 10 years from now doesn’t make people as excited as if you were promising the results like here.

PAUL SOLMAN: But, hey, every drug costs a fortune to bring to market. That can’t be the reason antibiotic firms like this one have such a tough time raising private capital.

So, what’s the story? As we explained in a prior report, there just isn’t enough profit soon enough. You buy a week’s worth of an antibiotic, not three months, say, of Harvoni for hepatitis C.

NARRATOR: That’s one pill, once a day, for 12 weeks.

PAUL SOLMAN: And it costs about $30,000 a month.

Moreover, when a company comes up with a new superbug slayer, the medical community wants to keep it off the market as long as possible to delay toxic microorganisms developing resistance to it. Meanwhile, the patent runs out. Small wonder that even big pharma has said no mas.

DR. JOHN REX, Former Pharmaceutical Industry Executive: Most of the companies that were really doing the large-scale development work backed away from the area.

PAUL SOLMAN: Like AstraZeneca, where infectious disease Dr. John Rex used to head antibiotic development. What did he learn from his tenure?

DR. JOHN REX: It’s a good way to destroy $50 million to $100 million worth of net present value after 30 years of really hard work.

PAUL SOLMAN: But ever-hopeful startups like this one, Tetraphase, outside Boston, have popped up. And a new public-private partnership called CARB-X has stepped in to help fund their trek from test tube to clinical trials.

KEVIN OUTTERSON, Executive Director, CARB-X: We have, at CARB-X, $455 million over the next five years, but what we need globally across all countries is about $2 billion per year for antibiotic R&D, supported by public and charitable funds.

PAUL SOLMAN: So, says executive director Kevin Outterson.

KEVIN OUTTERSON: This is an infrastructure investment that has to be made in order to keep this drug class alive. I think antibiotics is the most valuable drug class in human history. It’s done more to save lives than any other drug class. It’s incredibly powerful. But it’s the only one that, if you don’t keep investing, you lose it.

Every other invention of modern medical science is still going to work in 100 years. Antibiotics, we know they won’t.

PAUL SOLMAN: Because bugs resistant to the antibiotic will evolve. But what cure can economics possibly come up with, when the market itself fails?

KEVIN OUTTERSON: The model that people are coalescing around is some sort of a significant prize, a significant billion-dollar payment, that rewards them for the innovation, and then we can still use that antibiotic sparingly for the next 10 or 20 years.

PAUL SOLMAN: Rich prizes, they have motivated everything from discovering a way to determine longitude at sea, to Charles Lindbergh’s transatlantic solo flight in 1927, to private space flight today.

DR. PETER DIAMANDIS, XPRIZE Foundation: We have got $50 million of prizes on the table right now, and $200 million of prizes in development at different stages in the pipeline.

DANIEL BERMAN, Longitude Prize: Prizes can be the answer when you’re trying to motivate people beyond the normal suspects.

PAUL SOLMAN: Daniel Berman is in charge of today’s so-called longitude prize, 10 million British pounds for a quickie test to see if you need antibiotics at all.

NARRATOR: One of the main reasons why drug resistant infections occur is that antibiotics are used inappropriately, such as people taking the wrong ones or not needing them in the first place.

DANIEL BERMAN: We need a rapid diagnostic test because we need to make sure that we don’t burn through the few antibiotics that are left. And when new antibiotics come on, we have to make sure that we dramatically use them in a more rational way.

PAUL SOLMAN: Without such a test, doctors are under constant pressure to prescribe.

DR. LINDSEY BADEN, Brigham and Women’s Hospital: Often, acute infections are viral, and without the ability to specifically diagnose you at the point that you’re in the office, it’s very hard to know that an antibiotic won’t help.

PAUL SOLMAN: Boston infectious disease expert Lindsey Baden.

But to just distinguish between a virus and a bacterium, that would be a big deal.

DR. LINDSEY BADEN: A virus and bacterium would be very important.

PAUL SOLMAN: And even more so in developing nations.

DANIEL BERMAN: For example, in India, you can still purchase antibiotics without a prescription in a lot of places. And people are dying because, for some pathologies, there are simply no antibiotics that work anymore.

PAUL SOLMAN: But look, says Slava Epstein:

SLAVA EPSTEIN: Can you use antibiotics smarter? Absolutely. But that will not prevent antimicrobial resistance. It will delay it.

PAUL SOLMAN: That’s why, he says, we must ramp up the efforts and investments in new ones.

This is economics correspondent Paul Solman, reporting for the PBS NewsHour.

JUDY WOODRUFF: And I’m still dizzy from the shaking.

Join us next week as Paul and Miles continue their series.

The post Drug companies aren’t making new antibiotics. Is there an economic cure? appeared first on PBS NewsHour.


          How Can I Come Back to the Practice of Law after Leaving for Several Years?        
Question: I graduated from a top law school a few years ago. I accepted an offer from the firm that I worked at during my second summer and began working in the fall after my law school graduation. I left the firm a little over a year later due to medical complications related to my pregnancy. Now, after being home with my child for several years, I wish to return to work. How hopeless is my situation, and what should I do?
          Alternative Health Care Tips        
You probably already know that you’re supposed to finish all of your medication when prescribed and get plenty of exercise in order to stay healthy, but did you know that many of the best kept secrets in the medical community Read More ...
          Black Ops Hypnosis Try Peachy And Sensational Complimentary Health        
Alternative medicine has been around for thousands of years. Regions around India and China show been using alternative medicine techniques these as visualization and vitality transfer for thousands of years. The practice of acupuncture has long been one of the leading forms of alternative medicine, but has come into mainstream use within the medical community in the last 20 years. While better forms of alternative medicine are not endorsed by numerous medical associations, some places like splendid Britain and the United States generally show alternative medicine specialists residing in practice with more traditional and mainstream disciplines.




Naturopathy has at its parentage the belief that every one of human ailments can be solved by the combination of a healthy diet and using wholly natural ingredients and remedies. Using herbs, spices, and other medicinal plants, practitioners believe that they may solve all bodily illness. The use of cutting-edge medical techniques including invasive surgery and the use of medical scans are frowned upon as unnecessary in the naturopathic community. Ayurveda was originally conceived in India, and remains in widespread use centuries later. Ayurvedic remedies include those that the practitioner creates using natural, healthy ingredients, and that proper digestion is the key to health.




Traditional Chinese Medicine, more commonly famous as TCM in the medical community, is one of the oldest of the alternative medicine groups. TCM remains one of the largest-used forms of medical treatment in Asia, while being relegated to secondary or alternative care in greater of Europe and America. Herbal remedies, as well as acupuncture, are two of the prevailing tenets of TCM practitioners. Massage therapy and strict dietary help are also prevailing ideals of TCM. Traditional Chinese Medicine traces its origins to nearly 3,000 B.C.E. And is similar in its design and implementation to Taoism. Acupuncture is widely used in Traditional Chinese Medicine.




There are a wide divergency of alternative treatments, including Yoga, chiropractic, homeopathy, and hypnosis. Hypnosis encompasses treating the patient's subconscious. The hypnotist implants an idea in the patient's mind to help them quit smoking, lose weight, or exercise more. Homeopathy is a term used to describe any treatment done without the use of modernized medicine.

With Yoga, the individual learns how to focus their mind, while also working their body. The stretches done in Yoga help the individual improve their posture and lose weight, but it also works their mind. It takes in relaxation techniques and a calming spirit. There are also chiropractic treatments, which are used on patients with back problems. The individual works the patient's back and joints, but isn't a doctor.




Though many of the alternative medicine disciplines pre-date up-to-date medical practices by thousands of years, coincident medicine is still reluctant to accept alternative medicine as a viable course of treatment. While contemporary medicine produces results that are able to be reproduced inside of a controlled environment, alternative medicine methods are more individualized. What works for one patient will fail completely for anyone else. Because of the lack of reproducibility, coincident physicians and the medical community at immense are hesitant to accept it as a viable form of treatment.




Alternative medicine is a term that refers to any specimen of treatment offered that falls clashing with the world of western medicine. The followers and proponents of these options believe that ailments can be treated by using home remedies and focusing on the mind. While it's viewed with scepticism from outsiders, there are myriads humans who believe in it.

The focus in larger of these practices is on treating the entire body. It's considered that by taking all natural herbs and other products, the disease or condition will be cured. There's also a focus on using the mind and positive thinking to superior the individual.


black ops hypnosis: covert hypnotism

black ops hypnosis: covert hypnosis

          April's Passing Milestones        

April is an interesting month. It is the month in which both of my parents died. My father died on April 13, 1961, when I was 11 years old. We all expect our parents to die at some point, but to have that happen at so young an age is not the norm. However, I vividly remember several other elementary school friends who lost parents in 1961 and 1962 so maybe it was the norm back then.


If I am thankful for one memory of my dad - it was the memory I have of him the night before he died. We had the best time that night. He left for work early in the morning at 4:30 a.m. six days a week (before we awoke for the day so we didn’t get to see him until he returned in the early evening). He and his brother owned a poultry business on Maine Avenue in Washington, DC. Occasionally we would take a “field trip” to visit him at the warehouse. It was so cold there (and I guess he was used to that temperature because he would sleep in one of the bedrooms with an air conditioner set to around 50 degrees). I remember lots of chickens and turkeys (on occasion) strutting around the warehouse. It never really occurred to me what happened to the chickens after we left – but I remember eating lots of chicken while I was growing up.


On Sundays, he would drop my sister and I off at church (back then I was a Methodist) and after church he would pick us up and take us to visit his mother, our dear grandmother. She lived in an apartment about 20 minutes from our house, with her spinster sister as my grandfather had died several years before. On the way to grandmother’s house, my dad would sing songs to us, and he didn’t have the gift of music that I was fortunate enough to have inherited. He sang off key on the entire ride to her house. It was always a fun time for me.


My grandmother always had a bowl of vanilla ice cream with Nabisco Brown Edged Wafers for us when we visited. She was a very gentile Virginia woman and I loved our weekly visits with her. I used to feed the squirrels outside of her apartment each week. They would come right up to me to get the peanuts my grandmother would buy for the squirrels.


Anyway, the evening before he died was so much fun. We laughed and joked around all evening. I remember something about one of the Marlboro Man commercials on TV that we laughed about. We had such a great night and when I woke up the next morning, my aunt was at the house. I thought that was strange and she said that my mom had taken my dad to the hospital in the middle of the night because he wasn’t feeling well.


A short time later, my mother came in the door and asked my sister and I to come with her to her bedroom. There she told us that our dad had died. She said he had a “small heart attack” at home and the ambulance came and took him to the hospital. It was at the hospital that he had a second massive heart attack which killed him. I remember thinking what a great night we had just 12 hours earlier and how everything had changed in the morning.


The next several days were busy with funeral preparations, relatives, friends and neighbors visiting the house and bringing food, and lots of phone calls. I also remember discussing the funeral arrangements with my mother and making the decision not to attend the funeral. Fifty years later, I have never regretted that decision. I have such wonderful memories of my dad from the evening before and that is how I will always remember him.


My grandmother died about eleven years later and I did go to the funeral – she was 97 years old and although she looked like she was sleeping, I still remember her in the casket. Her poor body gave out, but she was an amazing person with wonderful memories to share with everyone, even up to the end of her life. She was alive for the first Wright Brothers plane flight and the first walk on the moon  - what a time period she lived through.


Fast forward to April 26, 1986 – the day, twenty five years ago, my mother died. My mom had been sick for awhile and was in need of a heart transplant, however, with her medical complications and her age, that wasn’t an option. I spoke to her the night before she died. Our local neighborhood group was participating in our city parade the next morning. Each family in our group represented a different decade, beginning with the Gay 90s through the turbulent 60s. We had great costumes and even won a monetary award from the city. When I got home, there was a message on the answering machine – my cousin said to call him. I knew when I heard that message that my mom was dead and sure enough, when he answered the phone, he didn’t have to say anything – I said, “I know, she’s dead.” My sister had stopped by to see her and found her dead in her condo. Once again, going from a “natural high” from the parade to a “natural low” from the news of her death.


I was 36 when she died. My children were 12, 10 and 6. I indicated that I didn’t want an open casket at the funeral home. Instead we had lots of photos of my mother throughout the room. I remember how many comments we received that evening about all the photos – people thought it was a great idea and they were able to remember my mom as she was – with a smile on her face, throughout many decades with clothing to reflect those decades. We had a graveside service for her as she joined my dad in the cemetery (with my grandparents) in the same area. Since then my aunt and uncle were buried near them so it’s kind of like a family reunion to visit the cemetery.


When I look at the calendar, I marvel that their death dates were within two weeks of each other, in the same month, although 25 years apart. And now it’s been 25 years since my mom died and 50 years since my dad died. I’m so grateful that my children have had a totally different experience with their parents and hope we will be around for many more years to come. For some reason, those numbers really struck me this year.


I know that losing my dad at such a young age taught me a lot of things and made me grow up faster than if he had died when most parents die – in his seventies or eighties. I have a painting in my house that my mom had commissioned from a photo of my dad and he has a small grin on his face in the painting. I can totally remember him looking like that when I was a little child. I sometimes wonder what life would have been like if my dad hadn’t died, but then I remember we all are given situations we have to learn to live with and that, in the end, makes us who we are. I am just so grateful for the childhood memories of that wonderful night before he died. I think he would have been proud of the woman, wife and parent I became.
          Nitin Chhoda Releases New Information on Ways to Accelerate Better Patient Care        

Nitin Chhoda, a licensed physical therapist and an EMR expert has been among the first in the medical community to provide practitioners with information about the many advantages of an EMR. He is now sharing to clinicians new information on ways to improve the quality of care for patients.

(PRWeb December 23, 2013)

Read the full story at http://www.prweb.com/releases/PT-software/EMR/prweb11441933.htm


           People should eat more salt, new book suggests – experts say not so fast         
A New York cardiovascular scientist has caused an uproar in the medical community after claiming people should eat more salt.
          Ciencia y espiritualidad        
Salud, pseudociencia y escepticismo

"No hay ninguna razón para que la ciencia se autolimite a los métodos considerados ortodoxos. No hay ninguna razón para que renuncie a problemas como amor, creatividad, valor, belleza, imaginación, moral y alegría, dejándolos del todo en manos de los no-científicos, poetas, profetas, clérigos, dramaturgos, artistas o diplomáticos". Lo escribía Abraham Maslow en "El hombre autorrealizado" y en el siglo XXI, el debate sigue de plena vigencia.

Claudio Naranjo explica en esta entrevista que dejó la ciencia al sentir "que la filosofía y la psicología afrontaban mejor el dolor de la infelicidad". Este médico psiquiatra cambió de rumbo "para ejercer como psicoterapeuta" porque "vi que la medicina farmacológica abordaba síntomas, pero no la raíz del problema del paciente". Mónica Felipe-Larralde se hace eco de la reflexión sobre ciencia, salud y enfermedad al abordar los determinantes sociales de la salud en su blog.

¿Mueve montañas la fe del escéptico, tal y como titula Pablo Linde este artículo? Redes abordó el caso de los científicos malditos por la religión y la ciencia en un programa que encontré al hilo del artículo sobre Wilhelm Reich "In Defense of Wilhelm Reich: An Open Response to Nature and the Scientific /Medical Community", que la revista Nature (Glaussiusz 2012) presenta como un "desgraciado ejemplo de la influencia del escepticismo de algunos medios de comunicación para la correcta evaluación de hallazgos científicos".

Por su parte, Jane Risen analiza en un articulo en Psychological Review porqué personas adultas, inteligentes y emocionalmente estables que no se consideran supersticiosas se dejan llevar por pensamientos irracionales que influencian su manera de pensar, sentir y comportarse. "La intuición mágica predomina” porque "detectar un pensamiento irracional y corregir este error son dos procesos separados", según afirma esta profesora asociada de la Universidad Chicago Booth School of Business en "Believing What We Don't Believe: Acquiescence to Superstitious Beliefs and Other Powerful Intuitions".

El ilusionista James Randi está convencido de que "la gente que cree en pseudociencias no es idiota", sino que "le falta información" y reclama más escepticismo. ‘Pseudociencia’ es el cómic de Darryl Cunningham sobre fraudes y timos, del que se hace eco Magonia. Los escépticos critican, no sin razón, nuestra falta de cultura científica y el recurrente "yo lo vi, yo lo viví".

Este interesante artículo trata de desentrañar las entrañas de la ciencia, la pseudociencia, el “pensamiento mágico científico” y el â€œescepticismo científico”. Mientras según este otro la telepatía está comprobada científicamente, el psiquiatra Ian Stevenson asegura que sus investigaciones demuestran que la reencarnación humana es un hecho¿Estás ahí? El espiritismo ante la ciencia es un documental en el que, sin embargo, el divulgador Miguel Ángel Sabadell utiliza el método científico para demostrar que no se puede hablar con los espíritus.

¿Podremos llegar a integrar alguna vez ciencia y metafísica? La clave está en la pregunta de Lourdes Martos, que yo también me hago: Â¿la ciencia al servicio del hombre o el hombre al servicio de la ciencia?. Este extenso artículo publicado en Misterios de la astrofísica analiza este cambio de paradigma y el consiguiente nuevo modelo científico.

          Why Are Men Shying Away From Buying Penis Enlargement?        
Despite increasing medical proof that increasing your penis length is attainable, penis enlargement is still regarded by some with scepticism.

The main problem is the number of fake devices on the market. With no clinical trials or backing to prove their credibility, these devices have infiltrated many facets of the industry and as a result have further encouraged the mythology surrounding penis enlargement.

Yet this is far from the truth.

Look a little closer and you'll find a number of different traction devices that have got the recommendations, the backing and the clinical proof that natural penis enlargement is possible.

SizeGenetics - who are they?

Made from medical type 1 materials, the SizeGenetics device is arguably one of the leading penis stretching devices on the market today, and one of the first to get genuine medical recognition. The medically endorsed penis traction device has been clinically proven to increase penis lengths by 30%; correct penile curvatures and erectile dysfunction, and improve general sexual intercourse.

Yet their recognition as a proven penis enlargement device extends far beyond the medical field. SizeGenetics have also been featured in GQ magazine and on Channel 4's 'Extreme Male Beauty' for its ability to help men attain natural penis enlargement.

"It just grows and grows. The device clearly works but I'm not sure I want it to continue.

Interested in answering the age old question of whether natural penis enlargement is possible, Channel 4 reporter Tim Shaw decided to give a number of different buy penis enlargement methods a try on national television to see if they worked.

Testing each method over a period of 2 weeks - Tim took a cast of his penis both before and after the experiment, and discovered that he managed to acquire a natural penis growth of half an inch.

An increase that has remained with him long after the show has ended.

Learn more about Tim's fantastic enlargement gains on Extreme Male Beauty

Medical backing and endorsements

Alongside SizeGenetics increasing recognition within the media for its buy penis enlargement capabilities, SizeGenetics has developed a strong standing within the medical community itself.

Having undergone numerous clinical studies since its creation in 1994, SizeGenetics is now medically endorsed by over 13 doctors who all commend it for its ability to encourage safe natural lengthening and growth.

"The patients who were treated with the device without previous surgical lengthening achieved an average lengthening of the penis at erection of 2.8cm (range 1.5 - 5.0cm)" - Dr. Jorn Ege Siana, M.D., Specialist in General and Plastic Surgery

The Results

Having already helped over 13,000 of their customers to increase their penis length by 2-3 inches, SizeGenetics have translated these successes onto their website by providing their consumers with penis enlargement testimonials.

Here SizeGenetics have provided visual proof that their device does work by showing 'before' and 'after' shots of all their case studies. Photographs that clearly demonstrate an increase in length through the application of their device.

Combine all these facets together - GQ Magazine, Channel 4 and their medical endorsements - and SizeGenetics is a clear example that increasing your penis length is possible with the right device.

For more information about the SizeGenetics device, please visit the official home page at www.sizegenetics.com


          HBO's Getting On has just the right prescription for a medical comedy        
none
          Video games for surgeons        
Once a pastime relegated to teenage boys in suburban cul-de-sacs, video games have come a long way. In recent years, the power of the video game has been harnessed for health, from inspiring exercise to raising awareness of HIV among teens. Now Stanford researchers are turning those techniques on the medical community itself, with a new web-based
          Developmental Disabilities Update for the Medical Community at UCSF        
  Informed health care for people with developmental disabilities UCSF’s 16th Annual Developmental Disabilities Conference (read about the history of the conference HERE) is coming up March 2 and 3 in San Francisco. The conference,  presented by the UCSF School of Medicine and the UCSF School of Nursing, is an invaluable opportunity for multidisciplinary dialogue among experts in the care and future of 
          333: Lauran Star: The Bus Driver Takes The World On The Ultimate Journey        
Todays guest has a wonderful tale of how she got to her point of success today. Starting probably as far away as she could from the motivational, success fuelled powerhouse she is today, who inspires ladies across the world to stop surviving and start thriving in life and business. She started her own personal journey in the Military, where she did nearly ten years working for Uncle Sam with the 309th Field Medical Company. And we see this time and time again, that although a million miles from the corporate route, it actually sets amazing foundations and organizational skills that can be used to maximum effect when becoming a civilian again. And this certainly seems the case for todays guest, as from this point onwards you can see the dots joining up big-time, as she built up her confidence and talents by working in multiple roles within the sales, training, and leadership areas, and even performing roles on and off Broadway. She is the CEO of LS Consulting and an International Speaker, and in her spare time the international host of "Empowering Women - with Lauran Star " She believes that we all have the skills and talents inside us to literally create the life of our dreams. We just have to start tapping into our personal power and blast our way to the gold. We need to find the time that we actually have in abundance, but are using the wrong way. So does she look at her time in the military as the perfect grounding to where she is now? Or would she have liked to have the extra ten years, now she has really found her thing and is blasting forward on a daily basis? Well lets find out as we bring onto the show to start joining up dots, with the one and only Lauran Star
          November is Prematurity Awareness Month        
November is when we focus the nation’s attention on the impact premature birth has on babies and families, and on the opportunities for prevention.
Today more than 1,400 babies in the U.S. will be born prematurely. Many will be too small and too sick to go home.
Instead, they face weeks or even months in the intensive care unit. (NICU). These babies face an increased risk of serious medical complication, and death; however, most eventually will go home.
In honor of Prematurity Awareness Month, please go to http://www.marchofdimes.com/padpetition/index.aspx?a=1&z=1&c=1&l=en
to sign the petition to urge the federal government to increase support for prematurity-related research.
          200: Sean Swarner: A Man Who Inspires The World Every Single Day        
Todays guest for the milestone 200th episode is the only man that I wanted for the job......in fact I held back from recording this show so he could appear. And why did I feel that way? Well after 199 episodes of Join Up Dots, hopefully you will feel like I do that they are motivational, inspiring, challenging and the kind of content that makes you believe that everything is possible. But if this is the first show that you have listened to then...believe me, just hearing about this guys story will leave you feeling exactly the same way. When he was a young man at ages 13 and 16 he received news that would knock most people off their feet. He had cancer and not just one type but two completely different types, which left him listening to his last rights and waiting to die. He was given only fourteen days grace, but instead of passing on as expected he astounded the medical community when he survived both these brutal diseases and also  a medically-induced coma for a year. This courage to beat the odds and take on a challenge that many deemed as impossible left him with the realisation that no challenge would ever be too great or any peak too high. He proved this theory when he crested the peak of the highest point in the world (Mount Everest) with only partial use of his lungs. As the first cancer survivor to do so, he then decided to continue climbing and has since topped the highest peaks in Africa, Europe, South America, Australia, Antarctica, and North America. But this isn't a story about a man with super human strength or support, this is a story of total belief in himself and what he can achieve. Inspiring us all to dream bigger and go for the impossible. He is voted one of the top eight most inspirational people of all time, so it with great delight to bring onto the show to start joining up dots, the one and only Sean Swarner
          Intro        
DISCLAIMER: I am not a doctor, and this is blog is not intended to diagnose, treat, or cure any condition. My intention here is simple: after going through hell for 2 years with mitral valve prolapse syndrome (MVPS), as opposed to merely mitral valve prolapse (MVP), largely left to discover the causes and effects empirically, I want to benefit other suffers by sharing what I've learned. Use it as a launchpad for your own research, and to suggest questions for your cardiologist, neurologist, or other medical expert. Above all, I would like to share some practical suggests for symptom management, if not improvement in the underlying pathology.

Bear in mind that MVPS is still a hotly debated syndrome, with some doctors questioning its mere existence. Herein, from firsthand experience, I will present my own definition. Eventually, I suspect that the medical community will define which symptoms are and are not associated with this condition.

By the way, some research has indicated that MVP may be inherited or spontaneous. However, according to Scordo (see book references below), it does not appear in babies at all, and thus develops as one's genome interacts with the environment over time. Perhaps this implies that MVPS follows the same pattern, although this is uncertain due to ambiguity in its definition.

So call me Mitral Mike. In 2006, I was diagnosed with mitral valve prolapse using an echocardiography, which essentially means that I have leaky heart valve.

The events leading up to this diagnosis, and following it for about a year, constituted the hardest and most terrifying part of my life. Perhaps I'll tell you my story later, but right now, I'd rather focus on helping you get well.

Let me begin by telling you the bottom line: In April, 2007, I ended up on the floor of my apartment, hyperventilating intensely for probably half an hour, with my vision gradually going blurry at the periphery, and tightness in my chest. I could hardly breathe. I could hardly move. Waves of terror radiated through my brain, each one passing like a suffocating wave. I clawed my way across the floor to my cell phone, and struggled to dial my friend's number.

Now, in January 2009, I live profoundly free of fear, in a way which I never imagined humanly possible even before my diagnosis; and the symptoms of my MVPS are rare and fleeting, and though they may startle me, do not result in persistent panic. I can tell you how I accomplished the first part, but you probably won't believe me, so let's just focus on the clinical stuff that we can address empirically, which I hope will help you manage your symptoms.

Consider the following books as essential supplemental reading. I'd suggest reading the Scordo book before the Hendricks book. Jointly, they started me on the path to wellness, which I have gradually augmented with my own symptom management techniques, often based on tips from discussion sites on the internet. (Not everything on the Web is junk, you know. You have to experiment and research carefully for yourself.)

Suggested Reading


1. Taking Control: Living with the Mitral Valve Prolapse Syndrome by Dr. Kristine A. Scordo

2. Conscious Breathing: Breathwork for Health, Stress Release, and Personal Mastery by Gay Hendricks, PhD


Because MVP is comparatively well-defined and understood, this blog is mostly about MVPS. In my view, MVP is one of many symptoms of MVPS. However, because heart valves are easy to analyze scientifically, compared to "panic attacks" or the other subjective symptoms of the latter, the former was deemed the disease, and the latter, one of its side effects . In reality, I think that a small set of genes is the cause, and the heart valve anomaly just happens to be the most obvious effect. Frankly, I would not be surprised if it turned out that decades of heart-pounding adrenaline attacks characteristic of MVPS contributed to the heart valve pathology that is MVP. (However, MVPS cannot be the entire cause of MVP, as we do know that MVP is also associated with a connective tissue disorder, which would at least partly explain the infirmity of the valve leaflets, and thus perhaps their susceptibility to damage by adrenaline-induced heartrate acceleration.)

As this article from Emedicine puts it:

"Besides the symptoms attributable to the MR, various neuroendocrine and autonomic disturbances occur in some patients with mitral valve prolapse. In these patients, prolapse may be an epiphenomenon of the underlying autonomic or neurohumoral illness. The term mitral valve prolapse syndrome is often used to refer to the collection of these manifestations. However, in a significant proportion of patients, the mitral valve prolapse is trivial, and no such associated manifestations are present. In these patients, mitral valve prolapse constitutes an essentially benign condition."

Common MVPS Symptoms


1. MVP.

You can have all the other symptoms of MVPS, and not have MVP. Or occasionally, the reverse may be true. This is further evidence that there is a common genetic cause to most aspects of MVPS, including MVP; MVP does not cause MVPS and visa-versa, perhaps with exception of adrenaline-induced valve pathology, about which I conjectured above.

2. "Head spins" and "mental resets".

Sudden disorientation, lasting about a second, and directly pursuant to
premature ventricular contractions
(PVCs).

I am not talking about syncope (fainting), although this does occur in a minority of patients. When these events occur, I get the sensation that time has skipped a fraction of a second, and perhaps the room is spinning for this brief moment. The spinning is not persistent, as would be the case with vertigo. Most likely, the "time skippage" is due to the brain reacting to a very unexpected sudden alteration in the heart rhythm, which has the side effect of temporarily suppressing conscious thought. (After all, it's well known that our thought processes largely switch off in emergencies; to the uneducated brain stem, a change in heart rhythm is definitely an emergency.) The more severe PVCs, when I used to get them (I get only little ones now), could jolt my brain so hard that I'd forget the last few seconds of thoughts.

I'm not kidding about this. One night, when I was having massive and frequent PVCs, I did a little experiment: I would think of several words, and imagine corresponding images in my mind. For example, I would think "apple" and simultaneously see an apple in my mind's eye. Then, as soon as I realized that I had suffered a PVC, I would go back and try to remember the last 5 words. Again and again, I would remember only the first 3 or 4; it was always the last word(s) that were missing -- those which I was thinking about at the time of the PVC. It would appear that these head spins have the effect of hitting the reset button on shortterm memory, which would certainly explain the perception of "time skippage".

If you're wondering whether these events are due to something else, I've had 3 full brain MRIs. Except for a spot which was tracked by 3 neurologists and found to be benign (perhaps the result of a bicycle accident when I was younger), no pathology is evident, such as an arteriorvascular malformation, which might otherwise explain the above. And these events are 100% correlated to a time period of about 5 seconds after the sensation of a PVC in my chest. Case closed.

I've also considered that, because PVCs are preceded by "weak beats", i.e. the heart beats once very hard in order to compensate for the previous beat being too weak, it's possible that the head spins are actually due to temporary brain hypoxia. While you can hold your breath for much longer, and still think clearly, it's possible that the temporarily reduced blood pressure associated with a PVC causes brain hypoxia much more rapidly, resulting in the perceptions described above. But as I mentioned above, I think there is a second mechanism at work, which is the brain stem's obsession with perfect heartbeat: the strange sensations are partly due to the brain stem briefly switching into panic mode, then (usually) back out of it, in response to an unexpected irregular heart beat. Occasionally, particularly with larger PVCs, the brain stem fails to exit panic mode, in which case cognitive thought processes remain suppressed, and a full-fledged panic attack (discussed below) may ensue. In any event, PVCs are merely one of many causes of MVPS panic attacks, the latter being discussed more below.

3. Orthostatic hypotension (or more generally, low blood volume).

If you feel light-headed when you stand up quickly, you may simply have too little blood in your system to keep your brain fully oxygenated during this exercise. Your heart may beat more rapidly (tachycardia) in order to compensate, but it may be unable to do so quickly enough due to the leaky valve. In some sense, this is a desirable condition, since it may imply that you have low blood pressure (which I think is a better problem than high blood pressure).

There are a few easy measures you can take to mitigate this problem:

(1) As you rise from your chair or bed, inhale over the course of the rise. This creates increased pressure in your chest, which tends to sustain higher blood pressure. Actually, fighter pilots use a similar technique to maintain consciousness during high-G-force manoeuvers: they wear "G pants", which squeeze their legs at the proper time in order to prevent their blood from draining from their heads to their feet. Thus, by inhaling over the course of a few seconds as you stand up, the increased blood pressure will help keep blood in your brain.

(2) Stand more slowly. If 2 seconds is too fast, take 3. Or 5.

(3) Keep hydrated. For one thing, this means that you always have sufficient liquid in your body for optimal performance. As a result, your blood volume is larger, which means that the pressure will be slightly higher, allowing you to more easily maintain brain oxygenation as you stand. But make no mistake: hydration isn't just about water! You need salt (and, in my opinion, a proper balance of all required trace minerals). You also need sugar. (For all the bad press that it has received since Dr. Atkin's diet, sugar not only keeps you alive, it induces insulin to open your cell membranes, allowing nutrients to go where they are needed. For this reason, I think it's better to eat superfruits like berries, followed by your morning workout; than complex carbs like beans, followed by you sitting at a desk, or worse, going to bed. I also think caloric restriction is superior to a calorically unrestricted low-carb diet. Anyway, remind me if I forget to post my Atkins rant!) For now, just remember: hydration is critical to the management of orthostatic hypotenion and MVP itself, but hydration does not mean binging on distilled water!

4. Intermittant and migratory chest pain.

If you have any sort of chest pain, you need to identify the cause immediately in order to rule out life-threatening conditions. Just because your chest pain is characteristic of MVPS does not mean that it's due to MVPS.

Anyway, MVPS chest pain seems to focus on certain areas -- in my case, the upper right pectoral muscle, and occasionally the right side of the sternum -- but grow, shrink, and move from time to time.

Most doctors seem to be convinced that MVPS chest pain does not come from MVP. Indeed, there is a small (but in my opinion, still meaningful) statistical significance to the number of MVP sufferers reporting chest pain, compared to non-MVP-sufferers. (See Scordo's book, and of course Google, for the numbers.)

I would say, incontrovertably from my own experience, that chest pain can indeed result from MVPS. I say "incontrovertably" due to the evidence of precise time correlation: my chest pain would be worst immediately following an adrenaline burst. Think about it: an MVPS-induced adrenaline burst is associated with an increase in sympathetic nervous system activity, which results in an increase in pain sensitivity (i.e. never take caffeine before a visit to your dentist); second, adrenaline bursts pound on the cardiac and respiratory system, rather like flooring the accelerator of one's car, inevitably resulting in aches in the chest.

Most doctors say that MVP does not cause chest pain. There is some evidence that MVP does cause chest pain under certain pathological conditions, potentially due to mechanical stress on the valve or the heart's attempt to compensate for lower efficiency. Nonetheless, I think that most MVP sufferers who experience chest pain do so due to MVPS-related hyperadrenalization, and not MVP.

In my case, the evidence could hardly be more compelling: when the adrenaline burst occurs, the pain flares up; both usually subside within a minute. This is a clear correlation between the MVPS-induced adrenaline bursts and chest pain. But the relationship goes deeper than that:

Sometimes, however, post-burst pain would remain for hours, occasionally giving rise to the sensation of a heart attack. Why? In my case, which is no doubt not unique in this regard, it would persist because I had consumed large doses of inflammatory foods the same day: sugar, simple carbs, or (especially) cheeses (including cottage cheese).

Cheeses, in particular, seem not only to cause more lasting chest pain, but also an increased incidence of PVCs. The lasting pain may result from the high omega-6 content in cheese, which is proinflammatory. Cottage cheese contains more protein and less omega-6, but it causes increased PVCs as well, if not extended chest pain. I could be wrong about the omega-6 theory. But test it yourself: cheese of any type will result in increased PVCs within 6 to 12 hours (or if you already eat it, cut it out for a few days and monitor the effect). There's something in these dairy products which causes this. To a lesser degree, the same happens with milk. Omega-9-rich olive oil, and omega-3-rich fish and flaxseed oil, do not have this effect. Coconut milk, which is rich in saturated fat but is not a dairy product, seems to produce little or no increase in PVCs. Thus, perhaps, it's something else. Lactose? I don't know, but the effect is unmistakable.

Frankly, it might not be a chemical issue so much as a blood thickness issue: eating dairy products may increase blood viscosity, in particular by raising plasma triglycerides. Thicker blood puts more hydrodynamic drag on the valve leaflets. This is the main reason why boats move more slowly than airplanes: water is much more viscous than air. So axe the cheese from your diet, and closely monitor the effect on PVC number and severity. Cutting out cottage cheese, milk, and coconut milk may also help to some extent, but potentially to the detriment of your calcium and protein intake. (I take "Tums" as a supplement after breakfast, but no dairy products or coconut milk, and hardly ever have PVCs anymore.)

Interestingly, when I eat organic peanut butter, I do not experience an increase in PVCs, despite the obvious high viscosity and high omega-6 content of this food. This may be due to: (1) the fact that I pour off all the peanut oil into the trash before eating the "dry" butter, (2) the fact that it's rich in niacin, which is good for the heart, and (3) its high vitamin E content, which is antiinflammatory. By the way, organic peanut butter contains large amounts of the antioxidant, p-coumaric acid, which is actually increased by the otherwise oxidative roasting process used to produced roasted peanut butter.

Superdark (85%+) chocolate bars also do not cause me increased PVCs, despite having a high saturated and omega-6 fat content. This is consistent with the generally accepted principle that the moderate consumption of dark chocolate (particularly the nonalkalized variety) is conducive to cardiac health. But this would appear to contradict my theory that PVC intensity and frequency relate primarily to blood viscosity. However, superdark chocolate probably does not significantly increase plasma tryglycerides. Hmm... maybe my "Triglyceride-Induced PVC" theory is true.

My worst bout of chest pains ever, followed by a horrendous hyperventilating panic attack, was preceded by a night of gorging on pizza cheese without the crust. (What do you do when you're on a low-carb diet, and you're out with the guys, who have nothing to offer you but pizza? Smart answer: starve. Dumb answer: gorge on mozerrella, and flirt with disaster.)

5. Panic attacks.

These events are characteristically preceded by the sensation of a wave or cloth washing through the entire head for about a second, most perceptible on the face, and may or may not have an obvious environmental cause.

Many doctors (who no doubt do not have MVPS themselves) think that the panic attacks associated with MVPS are somehow indirectly due to the patient becoming anxious about his/her newly identified "heart problem". While such a discovery, however benign, might make anyone anxious, I can tell you from deeply personal, visceral experience that the "bad" news is not the cause of the panic attacks. Having analyzed myself under conditions of sudden extreme terror (which I assure you, is possible, albeit difficult), they result largely from one of the following causes:

(1) a PVC which temporarily interrupts normal blood rhythm to the brain, triggering some sort of massive sympathetic nervous system response in the brain stem, as suggested by the recent discovery that the brain monitors the heart rhythm with a level of diligence hidden to our conscious mind, to which I alluded in the above discussion of head spins;

(2) a sudden change in electrolyte balance, as by ingesting a large dose of potassium (e.g. low-sodium vegetable juice or several bananas) or highly bioavailable iron (e.g. eating a vitamin pill on an empty stomach, or eating more than 100g of dark chocolate in a day);

(3) a sudden change in body fluid volume (and probably therefore blood pressure and electrolyte concentration), as by urinating or donating blood;

(4) a very light wind which cools and tingles the skin, and thus mimics, to the unconscious mind, certain perceptions of electrolyte imbalance;

(5) the memory of any of the foregoing;

(6) the consumption of large amounts of chocolate (especially dark or organic) or walnuts, both of which produce migraine with aura in sensitive individuals, triggering fear and panic, and entirely separate from the bioavailable iron panic pathway related to the former.

6. Unusually flexible joints.

This is most obvious in the fingers. This is the connective tissue anomaly so often mentioned in MVPS literature. In the presence of chronic stress, it probably aids the gradual deformation of the valve, which ultimately manifests as MVP. According to Scordo's book, essentially no one is born with MVP; it develops as one ages. My theory is that when one combines the frequent adrenaline bursts of MVPS with overly stretchable connective tissue, then the result is eventually a floppy valve that doesn't quite snap shut. It's kind of like stretching a rubber band too many times; eventually, it becomes less inclined to snap back into its original shape.

It would be interesting to study whether teaching children with MVPS to suppress excessive adrenaline releases would manifest in a lower rate of MVP later in life. I guess the medical community must first decide on a clinical definition of MVPS!

More on adrenaline bursts below.

7. A depressed or indented sternum -- a "breast bone valley".

8. Scoliosis.

9. A straight spine, which I take from the literature to mean a spine without concavity at the base.

10. Electrolyte hypersensitivity.

Sensitivities to sudden changes in electrolytes, particularly involving potassium or iron, as discussed above. Critically, if you have MVPS, do not donate blood before speaking to your doctor. If you have the low blood volume typical of many MVPS sufferers, it could cause you to faint in response to blood donation. (It happened to me in 2004, at a blood drive at work. I wondered, at the time, why I couldn't tolerate the process as well as much much less fit colleauges!)

My first bout with electrolyte sensitivity was in around 1998. I had just had a visit to the dentist. During this particular visit, the dentist removed a number of mercury-silver fillings. Even today, dentists continue to use mercury-silver amalgum in fillings because they assert that they leach only trivial amounts of mercury. I might agree, but when they're heated and aerosolized during removal, I think it's possible that a dangerous amount of mercury is released.

Now, I knew about this threat, and knew that it might be preempted by injesting a vitamin pill (to thwart further mineral absorption) and vitamin C (which chealates heavy metals). However, I forgot to take either before the appointment. So immediately afterward, I headed to the nearest drug store and bought a bottle of vitamin pills, as I was on the way to work, and had no time to return home.

When I arrived at work, I ingested 3 vitamin pills in rapid succession. (DO NOT do this.) Worse, on account of the dental appointment, my stomach was empty. So an hour or so later later, I had something like 300% RDA of iron (beyond the tolerable upper intake level) flowing around in my blood.

Rapidly, my skin became numb at the surface, causing a "pins-and-needles" sensation. Though I may have made some slight progress in inhibiting the blood plasma uptake of mercury from the intestines, I had given myself some level of iron poisoning. I spent the next hour or so slowly and carefully sipping water, and urinating myself back to homeostasis.

Nowdays, I keep a 7-day pill organizer full with all my supplements, including multivitamins, to ensure that I get sufficient but not excessive nutrition. I even break my vitamins into a couple pieces for ingestion at different times of day, in order to maintain more stable plasma electrolyte levels and systemic hydration.

11. Chest tightness.

Diffuse but possibly intense, often mistaken for anxiety-related chest tightness, but persistent for days at a time, and only marginally relieved by sleep.

This tightness is constricting, rather like wearing a sweater that is much too small. However, it is distinct from the migratory chest pain described above.

This was one of the worst symptoms of my MVPS. I think, in my case, it related to the onset of sleep apnea which went undiagnosed for years, for which I have since received corrective surgery. It would not surprise me if there were a correlation between MVP, MVPS, and sleep apnea, as the latter increases adrenaline stress on the heart, and contributes to panic disorder, on account of terrifying hypoxic episodes.

Here's how I fixed my chest tightness, which at times was so intense that I could hardly get enough air to walk (this, after being a near-Olympian just days prior to the hyperventilation attack in April, 2007 that started the tightness): I tried all manner of foods -- eating more or eating less -- trying to discover a cause or find relief. Finally, after months of work, I discovered that salmon, milk, and shiitake mushrooms -- and nothing else in my diet -- relieved the condition to some extent; milk was the fastest. Truly perplexed by how these radically different foods were acting in a common way, I did some homework.

But first, I sought professional help. I had several doctors tell me that it was all just stress-related. In a sense, they were correct: MVPS was stressing out my autonomic nervous system, resulting in this problem. But in the sense of anxiety, they were wrong. I felt happy most of the time. In fact, I could generally breathe better when I was angry, perhaps due to improved respiratory function under the influence of adrenaline. On the other hand, I could be perfectly content with life, and the tightness would be there. The severity was mostly dependent on whether or not I was asleep, and on how recently I had had one of these "magic foods". It was also somewhat better in the morning than the evening. The worst tightness was immediately after exercise, suggesting that it had something to do with hydration, blood pressure, and electrolyte balance.

It turns out that the magic foods are all excellent sources of vitamin D (as D2 or D3), which is otherwise very hard to obtain (except from solar exposure). Somehow, vitamin D was allowing me to get some degree of chest tightness relief. Not surprisingly, I was subsequently diagnosed with a vitamin D defficiency (18, where optimal is something like 40-60, depending which study you read). (Just in case you think the docs always have the answers, I was the one who suggested the test, based on my empirical analysis. Sure enough, I was short on vitamin D.)

Using 800IU daily supplements, I cured the defficiency over a period of months. However, the tightness persisted to some extent. That's when my friend introduced me to Hendrick's book about breathing, noted above. Combined with yoga, it completely fixed the problem. My chest is so relaxed now that I no longer practice yoga, but I probably should. In fact, for a while, I was so relaxed that I had to encourage myself to adrenalize a bit on the highway, for safety reasons. As far as I can tell, these focussed exercises allowed me to reprogram my breathing rhythm, reducing the tightness.

The final piece of the solution was getting surgery to alleviate sleep apnea. With a wider airway, I was no longer struggling to breathe during the daytime, and my chest tightness has never returned since.

12. Adrenaline bursts.

These events occur seemingly without cause, manifesting in a pounding heart, as though you is about to crash your car, when in fact you may be relaxing on the beach. If you have these, check with your endocrinologist for other rare conditions such as adrenal tumors. But likely as not, this is just MVPS. I used to have these, until intensive self-monitoring allowed me to intervene and arrest them before they could occur.

Everyone gets adrenaline bursts when they're nervous. They are an important part of our fight-or-flight mechanism: if a tiger is about to eat you, it's time to run! Psychologists have long known that this ancient wiring causes stress reactions in our bodies today, despite the fact that we don't need to run from a dentist, or use super strength to invest in a crazy stock market. In short, our wiring has not kept pace with the shift in the nature of our threats, from physical to psychological.

The adrenaline bursts characteristic of MVPS are similar to anxiety-related adrenaline releases, but they are overexpressed. And typically, many more occur per day than one's stress load would otherwise suggest. For example, I would get terrifying heart poundings every time the phone rang. I would, of course, calm down, but not before slamming my heart valve and respiratory system for this completely unjustifiable reason. At my worst, I had probably a thousand perceptible spikes per day, which on average is one every several seconds for many hours.

Low-carb diets are often touted as a solution to such hyperadrenalization. In my case, it only made things worse. The reason, I think, is that hydration is difficult with these diets because the high fat content inhibits the absorption of water-soluble nutrients, particularly in the absence of sugar. At the time, I didn't realize this. As a result, no doubt, my electrolyte concentrations varied much more throughout the day than they should have, which no doubt contributed to the problem.

Positive imaging is commonly suggested as a solution: psychologists often tell us to imagine a beautiful beach scene when we're under immense stress. I think this only causes more stress, as it reminds us that we might not survive long enough to get there! In my case, it offered no help at all.

One of the most significant improvements came with medical hypnosis. I went to a medical hypnotist who, believe it or not, was recommended by my endocrinologist who did the vitamin D test. After a single session, I experienced approximately a 75% reduction in daily adrenaline spike count. It cost $300, but in my case, was highly effective. Part of the reason for my success is that I knew that the spikes were almost never justifiable, and thus had an irrational basis of activation, likely related to subconscious activity in the brain stem. Because I knew that the response was irrational, it was easier to combat with the help of a hypnotist; otherwise, I am virtually immune to hypnosis. After yoga and certain mental focus exercises, my adrenalization dropped so low that, as I mentioned above with regards to chest tightness, I had to struggle to adrenalize enough to avoid traffic accidents!

One other technique for minimizing adrenaline bursts may be to eat garlic or garlic gelcaps. There is ample evidence that they lower blood pressure, and seem to promote mood stability, perhaps via seretonin regulation. I haven't done much research on this, but I've read enough on reputable websites to recommend that you research it. At the very least, it might make your dinner taste better.

13. Plasma magnesium defficiency

According to this 1997 study, some cases of MVP are caused by plasma magnesium defficiency. Though magnesium defficiency as examined in the study is strictly a cause of MVP and not MVPS, I suspect that it also relates to the latter, as magnesium is critical for neurological function, implying that defficiency may contribute to the hyperadrenergic symptoms observed in MVPS sufferers. Note that the study does not say "insufficient dietary intake of magnesium", but rather refers to plasma (blood) levels of the element. So while you may get sufficient magnesium in your diet, it may or may not end up in your blood, depending on how well it is absorbed with the rest of the food that you eat.

My magnesium level is normal. However, I didn't test it until long after I had started occasional supplementation. So I don't know whether it was one of the causes of my MVPS.

Back in 2007 or so, I found a nurse on an MVPS discussion board who recommended magnesium glycinate as an MVPS treatment. Intrigued, I tried some.

For me, this stuff kills palpitations within an hour. It's incredible. In particular, I took a 200mg dose, which is 1 tablet. (The bottle says "400", but the serving size is 2 tables. Is this dangerous, or what?)

However, before you try this yourself, I would suggest that you try my other suggestions for eliminating palpitations, including cardiovascular exercise as recommended by your cardiologist. The reason is that we were not evolved to ingest pure concentrated minerals. Therefore, these tablets are hard on the kidneys, which are responsible for electrolyte balance. Also, like other magnesium supplements, they tend to cause mental confusion if used in sufficiently high doses for sufficiently many days in a row. The effect seems stronger than with magnesium oxide, which is likely due to the glycinate component: I believe that the glycinate allows the magnesium to penetrate neurons, including those in the brain, much more easily. For this reason, it may be equivalent, in a neurological sense, to a much higher dose of magnesium oxide.

Here's what the National Institutes of Health has to say about magnesium. In particular, see their comments on excess intake. Again, I think magnesium glycinate may be neurologically equivalent to several times as much magnesium oxide.

From my perspective, it beats the side effects of beta blockers. Therefore, on the rare occasion that I have palpitations, I take one of these.


          This just in!        
The American Medical Association declared its unflinching support yesterday for bans on trans fat use by restaurants and bakeries. Equally progressive stances were no doubt taken on dinosaur bites and something called fire.

Sure, it must take time to fill out all those insurance forms. But where has the group been for the last two years? At this stage, trans-fat bans are about as controversial—and necessary—as bar signs warning pregnant women not to knock back drinks.

If this group is the voice of the medical community, you can only hope it gets up to speed before the dialogue starts on universal health care.

Well, I better get back on AMA watch. It could issue its revised policy on battery licking at any second.
          Associate-Asia Business Development & Regulatory Consulting        
MD-Bethesda, Pacific Bridge Medical (PBM) is an international medical consulting firm focused on Asia (www.pacificbridgemedical.com).  PBM assists medical companies with business development and regulatory issues in Asia.  PBM is currently seeking recent college graduates or graduates with (1-3 years of work experience) who are interested in Asian business issues. This is an outstanding opportunity to be a key
           Ken Jeong Lands Pilot Deal For Semi-autobiographical Medical Comedy         
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          Dr. Who and the Orthodic Alien Burrito        

A Doctor Who Short story Written as my wife's mothers day card.  Picture the 11th doctor (Matt Pond)

Dr. Who and the Orthodic Alien Burrito
On a random Sunday at an unspecified relatively unimportant moment in the history of the Universe, an antique, blue, and extremely British Police Box Apperated (the official Harry Potter word for disappearing from one location and appearing elsewhere as a method of transportation) in front of a decidedly weird and busy pink doughnut shop in what appeared to be a city of some sort.  Despite a slight rain, a large line of people were lined up outside. 

            “OOOO, Shock, awe, well, this isn’t Andy Warhol’s Factory in the 1970s,” said the Doctor quite loudly to no one in particular.  He confidently stepped out of the box in a bowtie and tattered suit.  “Excuse me, Flannel-Beard-Guy and Pierced-Tattooed-High-Wasted-Bike-Short Woman, where and when am I?”
           
            “Portland, Mother’s Day, 2015,” said Beard Guy as the doughnut line continued to snake around the newly present Police Box without stopping or moving at all in response to the new arrival. 

            “No response, no shock, no surprise.  Come on people, random man, British accent, appearing a Pacific Northwest Street,” said the exasperated time-traveler with a hint of disappointment.

            “The Time Based art event is in a few months but that effect was pretty cool,” said Pierced-Tattooed-High-Wasted-Bike-Short Woman.  “you should totally enter it.”

            “Well, um yes, that’s why I’m here.  Art installation on the impact of emergency medical communication with a British accent.  Carry on…or first…”
Fifteen Minutes later, the Doctor was riding down the Portland streets in the rain on a fixed gear bicycle, loudly singing Oasis songs for no apparent reason, eating a doughnut made of bacon and maple syrup. 

            The Doctor road around the town for a while getting soaked by the slow, constant downpour but didn’t appear bothered, “the traffic’s better than London, but the weather’s the same…” he said again to no one in particular. 

 It must’ve been around 5pm when the doctor heard someone yell, “nice bow-tie” from the sidewalk.  It was an overweight man with impressive sideburns pushing a stroller near what could only be a delicious Mexican Restaurant.  Inside was a small and loquacious human around 2- years-old or approximately 2/968ths of the Doctor’s age.  The Doctor thought this was as good of a place to stop as any.  His travel companions were visiting family and there was no Dalek invasion, so a burrito sounded fantastic. 

As the Doctor tried to stop, he realized the bike he had found in a long lost Tardis closet had no functioning breaks, so he frantically waved the sonic screwdriver at the wheel as he slammed the curb toppled over.  “Are you ok” said the side-burned man as he reached down to help the doctor off of the bike. 
“Ok” parroted the small human, followed by, “gah do wahh bah noon p.”

“Right as rain little one, Peri right.  Sir, your daughter here is a very important person.  I believe I just met the greatest novelist of the 21st century and founder of the Human/Alien Art Exchange.  It’ll make more sense in, oh 30 years or so.  Sorry, spoilers, must’ve hit my head.  I speak baby.  Time to have burrito,” rambled the doctor.

As he adjusted his suit and straightend his wet bowtie, the sideburned man, waved down an approaching well-dressed woman.  “Honey,” he said, “this man who just crashed his bike, says our daughter is going to be a novelist and share art with aliens.”
“By the way, what is your name, I’m Bob and this is my wife Morgan, and daughter who’s name your creepily know.”
“Sir, we will call the cops,” said the wife.  In this couple, thought the Doctor, this woman is the one who means business.

“Sorry, I’m the Doctor, a time-traveling alien.  I think I’m here to buy you dinner and give you some advice.  Bob, judging from you Star Wars shoes, this may be your perfect evening.  Shall we.”

“Go ahead Bob,” said Morgan, “might as well see where this leads, besides, Pablo at the bar will take care of him if he tries anything fishy.  Don’t forget your daughter.”

Bob grabbed the toddler who was nearly out of the stroller and pushed through the door behind the Doctor and Morgan who were already at the bar ordering Margaritas and Burritos. 

“Well, you aren’t surprised to be talking to me.  No one in this town seems to care.  So disappointing.  I like making and entrance,” said the doctor while he and Morgan waited for Bob to order.  Peri ran and gave her mother a giant hug.  “Seriously, it’s like this is common place.”

“Doctor, Portland is weird.  There’s a unicycling bagpiper and multiple adult marching bands that can sell out concerts.  I think at this point we all just take things as they come,” explained Morgan.

They all sat down around a table.  Peri slid from her mother and climbed on the Doctor’s lap.  Bob seemed anxious but Morgan seemed not to mind at all.  “Babies like me,” said the Doctor, “but I think this one pooped.”  Bob grabbed the small one from the Doctor and headed towards the bathroom.

“Morgan,” said the Doctor, “you’re the one I’m actually here to see.  In about  20 years from now on a linear timeline , I travel with your daughter.  She asked that I come back here and tell you that you’re amazing and you do an amazing job.  Peri told me to tell you that you taught her how to be strong and sensitive and human and that it might help for you to hear it from a well-dressed stranger.”  As he said this a tear came to Morgan’s eye.  “Also, spoilers, enjoy the Cirque de Solei.”

            “Of course, I’m also here to stop the alien monster living inside your foot from taking over the world…the creature in the orthotic.  Kind of forgot about that fact when I grabbed my doughnut.”

            Morgan’s foot began to twitch.  She fell on her back but her leg was whipping around in the air.  “Bartender, Pablo right, can you get me a Gin and Tequila in a diet coke with a maraschino garnish, quickly please.  Kind of wrestling a possessed leg here.”  The patrons in the restaurant barely looked up.  Their food was good and they didn’t want to disturb this dinner theater that they would blog cynically about later. 

            Pablo brought the doctor the drink as a double tall in a pint glass.  The doctor quickly dumped it on the Morgan’s shoe.  Her leg stopped shaking as her shoe slipped itself of her foot, wiggled its way to the corner and began snoring.  Pablo and the doctor helped Morgan up and sat her down shaking.  “Morgan, I have to take this shoe back to it’s home planet, NIKEA but don’t forget my message, and thanks for dinner.  Peri says happy Mother’s Day, from the future”  The Doctor left just as Bob and Peri came out of the bathroom.  Peri was in new pants. 

            Morgan walked over, picked up Peri and gave her a big hug.  Bob was confused, but that was his normal state of being.  Peri knowingly looked out the window and waved to the raggedy bow-tied man getting in a blue box outside.  The Doctor gave her a wink and mouthed, “call me!” and disappeared.


          Death by caffeine? Dangers of caffeine dissected after teen’s death        

Death by caffeine: an eye-catching headline when a coroner recently declared a South Carolina teen died from excessive caffeine consumption. In the span of two hours, according to reports, the 16 year-old drank a large Diet Mountain Dew, a cafe latte from McDonald’s and an energy drink, causing a “caffeine-induced cardiac event” leading to a probable arrhythmia.

The news surprised many experts in the medical community, including Joseph Garry, M.D., associate professor in the Department of Family Medicine and …Read more

The post Death by caffeine? Dangers of caffeine dissected after teen’s death appeared first on Health Talk.


          HPC-centric Research Software Engineering role within RSE Sheffield        
A job opportunity within the RSE Sheffield group is available under the job title of “Research Software Engineer in High Performance Computing (HPC) enabled Multi-Scale Modelling”. This is a EU funded position with a focus on supporting the biomedical computing community within the INSIGNEO institute. We are looking for people who can both write good […]
          Medication and Diet OMG! Why ADD ADHD is so Misunderstood        
It’s a sad reality. Most people don’t understand ADHD. And, quite frankly, many do not want to. Unfortunately, too many are intolerant or ignorant. ADHD is an excuse, they say. Some go further than that, as you will soon read, and blame ADHD on pharmaceutical companies who, as you know, created ADHD so they can sell their over-priced medications. They have that power, apparently. Those reasons and more are why ADD ADHD is so misunderstood . It truly is amazing what some people believe or want to believe, isn’t it? Today I want to call your attention to an article published by Jaqui Karr. “Destroying Children with the Cloak of ADHD: Parents Need to Pay Attention” Karr states unequivocally: The problems AND answers lie in food. Sadly the pharmaceutical companies will do everything in their power to get the “experts” and medical community to say otherwise. Even sadder is that for the […]
          American model and comedian Jenny McCarthy Beautiful pictures,Jenny McCarthy profile        
Jenny McCarthy profile

Jennifer Ann “Jenny” McCarthy (born November 1, 1972) is an American model, comedian, actress, author, activist, and game show host.

Jennifer Ann “Jenny” McCarthy began her career in 1993 as a nude model for Playboy magazine and was later named their Playmate of the Year. Jennifer Ann “Jenny” McCarthy then parlayed her Playboyfame into a successful television and film acting career. Most recently, Jennifer Ann has written books about parenting, and has become an activist promoting the claims that vaccines cause autism and that chelation therapy helps cure it—both claims are considered unsubstantiated by the medical community. McCarthy was born in Evergreen Park, Illinois to a middle-class Catholic family of Polish and Irish descent. She lived in the West Elsdon neighborhood of Chicago. Jennifer McCarthy  is the second of four daughters; her sisters are named Lynette, Joanne and Amy. Her cousin is actress Melissa McCarthy ofBridesmaids and Mike and Molly fame. McCarthy’s mother, Linda, was a housewife and courtroom custodian, and her father, Dan McCarthy, was a steel mill foreman. Jennifer McCarthy attended St. Turibius Grade School on Chicago’s South Side.  As a teenager, McCarthy attended Mother McAuley Liberal Arts High School (whose school sweater she donned in the pages of Playboy) and was a cheerleader at both Brother Rice High School and St. Laurence High Schools, although she has referred to herself as an “outcast” at her school and has described how she was repeatedly bullied by classmates. After McCarthy graduated from high school, she attended Southern Illinois University Carbondale to study nursing. She needed money to pay for college, so she decided to submit her picture to Playboy magazine to make money. Jennifer McCarthy was accepted and became a model.


















          Victoria Advocate January 4, 2016        

Farenthold brings VA paperwork training for medical community Congressman Blake Farenthold, R-Texas, partnered with Port Lavaca Memorial Hospital to bring training Tuesday to assist the medical community in dealing with paperwork to get promptly reimbursed through the Department of Veterans Affairs.

The post Victoria Advocate January 4, 2016 appeared first on .


          The History of Cleaning Products and Why We Use Them        
Why we use cleaning products is obvious-for personal cleanliness and health. From the very beginning of washing off dirt and mud with water, to the start of the Middle Ages, most cleaning compounds were made from mixes of ashes, animal or plant fats, and oils used for cleanliness and health. The fall of the Roman Empire prior to the Middle Ages led to reduced cleanliness and catastrophic diseases. By the 17th Century, bathing and cleanliness experienced a renewal.



Over later centuries, soap was considered to be a luxury item, and was taxed. When it became affordable, the general public began to benefit again from the use of soaps. During the early to middle 1800's, soap chemistry was studied and improved. Costs were reduced, and soaps were even more affordable to all increasing usage.



The availability of washing machines in the early 1900's helped increase the use and popularity of soaps and led to modern developments in soap chemistry. Following World War II, detergents gained in popularity over soaps, and are now used liberally. The importance of soap and cleanliness for disease prevention is another reason for educating the public about using soap products.



Today's cleaning products not only are safer for public use, but also for the natural environment. Current chemical research has led to the development of modern detergents and cleaners used in janitorial and cleaning services worldwide.



There is an abundance of new cleaning products for every purpose at home or in commercial use. Soaps and cleaners are used in bathrooms, kitchens, and public businesses to help assure safety and disease control. People are aware of the dangers of germs every time a major disease occurs, or an epidemic is threatening a population.



Medical advisers recommend frequent hand washing as the first step in preventing flu, colds, and other commonly found diseases. Hand washing is the number one step taken in the medical community to avoid spreading germs around hospitals, clinics, and industrial locations.



Safer chemical products are available that have less impact on the environment and that are eco-friendly. Low suds, cold water, and fragrance free products help the green movement, and address some allergenic problems people may have.



Obtaining the vast array of new cleaning products has never been easier, thanks to the Internet and easy access to large cleaning and janitorial product service companies. Delivery is fast and affordable, saving time and money for all who order online.



Today is the best time in history to be able to use and enjoy safer, healthier cleaning products. Research continues to bring improvements to the marketplace, and new uses for cleaning products are found every day, everywhere. Through the development of cleaning supplies throughout history, there is now a cleaning product available for every use and every need, but no matter how the history has changed, the cleaning products are all still used for cleanliness and health.


Browse cleaning products distributed by CleanItSupply.

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          E-Cigarette Market on Fire While Scientists Wage Heated Debate        

Electronic cigarette use is skyrocketing, revenue has reached the billions of dollars, legislators are talking about — and enacting — regulations, and more and more research is published every month.

Toronto, ON -- (SBWIRE) -- 11/10/2014 -- But the jury is still out on their safety, and whether they are a gateway to smoking.

Earlier this week, the New York Times highlighted a growing concern that the tobacco industry is taking over the business and targeting kids with flavours that sound like candy as well as advertisements featuring cartoon characters or celebrities.

Meanwhile, the less reliable Daily Mirror in Britain focussed on the danger of explosions when e-cigarettes are plugged into the wrong charger, citing half a dozen examples to back up its worries.

For those not up on this newest trend, an e-cigarette includes a battery, heating coil and a cartridge containing e-juice. That's the liquid that may or may not contain nicotine and which gets vaporized when the battery powers the coil to heat up the liquid.

The vapor gets drawn up by the wick when someone inhales, and there is no smoke, so it's called vaping.

The pros and cons of vaping are hotly debated by scientists, and there is a wide range of experience among those who have tried it.

Vaping may increase smoking

For some, like Anna Camara, it may even lead to increased smoking.

Last year, an acquaintance she would see at the off-leash area for dogs in a Toronto park persuaded Camara, an eight-cigarette-a-day smoker, to follow her example and abandon smoking for vaping.

Camara invested $80 in the technology and the e-juice, with nicotine, but felt that vaping wasn't delivering enough nicotine to satisfy her need. So she would also smoke a cigarette.

She calculated that vaping would be cheaper than smoking, but it didn't help her to quit, and it also irritated her throat. (She had tried to quit before by using a nicotine patch, but found it too strong.)

In the end, she blames the vaping experience for doubling the number of cigarettes she smokes to about 16 a day.

On the other hand

E-cigarette proponents claim that because the physical act of vaping more closely resembles smoking, and because the nicotine intake can be adjusted, it should be a better tool to help a smoker quit the habit.

That's what Winnipegger Matt Clinch found. He says e-cigarettes are "fantastic."

In 20 years of puffing, he was up to a pack a day. But then he tried e-cigarettes and hasn't had a smoke in seven weeks.

He says he feels better, he isn't out of breath as much as he was and food is starting to taste better.

"It's as close to smoking as you can get without lighting up and smelling like an ashtray."

He says the battery charge lasts him until dinner time and then he has to charge the unit for four hours, which he calls "a good thing, because it keeps me from over-using it."

Cheaper than cigarettes

Clinch also likes the fact that the juice comes in a variety of flavours and levels of nicotine, because "it makes cutting back your nicotine intake easier, without really realizing that you're cutting back."

He estimates the start-up costs of vaping as equivalent to a carton of cigarettes. But now he's down from spending $17 a day on cigarettes to 75-80 per cent less buying e-juice.

Nick Cooke, a Canadian living in Nicaragua, is discovering the same thing.

He has been using a vaporizer for a little more than a year and says vaping is "way less worse for me than the 30 to 40 cigarettes I used to smoke each day.

"It's odourless and smokeless for the people around me, so it's no problem to have a puff in a restaurant or bar or airport boarding lounge."

Cooke also can have just one or two drags on the e-cigarette and then set it aside.

He says that even in Nicaragua, where cigarettes are cheap ($1.75 for a pack of 20), he's saving money by vaping.

"The only disadvantage is not always having a lighter in my pocket, which comes in handy during power outages."

Doubts about safety

In Canada, selling e-cigarettes with nicotine or those with a health claim is not authorized, though selling e-cigarettes or e-juice without nicotine is legal.

In an email to CBC News, Health Canada said, "To date there is not sufficient evidence that the potential benefits of e-cigarettes in helping Canadians quit smoking outweigh the potential risks."

In order to get a vaping product authorized, Health Canada requires a company "to provide evidence of safety, quality and effectiveness" - a regulatory hurdle that is "among the most restrictive in the world," according to an editorial last year in the Canadian Medical Association Journal. (It wants e-cigarettes to be regulated as pharmaceutical rather than tobacco products.)

Winnipeg-based Theravape Inc. is one of about a dozen established juice-makers in Canada.

It is just Eden Sorrell and two friends working there and they manufacture and sell wholesale at least 13 different flavours of e-juice.

Their best sellers include lychee, menthol and tobacco. Sorrel describes the tobacco flavor as "transitional."

All their flavours can come with or without nicotine, and the nicotine can come in different strengths. Theravape e-juice sells for about $1 a millilitre.

Asked about Health Canada's policy, Sorrel explains that e-cigarettes with nicotine are "not authorized for sale but not prohibited. It's a grey market item."

He says his company doesn't get hassled by Health Canada "because it's actually marketed as a chemical consumer product, not as a health-care product."

Sorrel, who also works as a nurse, and is a non-smoker, explains that "it takes longer for nicotine to hit your bloodstream from a vape than it does from a cigarette, because it's being absorbed through the mucous membranes in the mouth, not within the lungs."

Tobacco industry dominates

One of the issues under debate among scientists is whether vaping could serve as a so-called gateway to smoking.

Sorrel says Theravape is "not here to start new habits" and he is unaware of any non-smokers trying their product.

Nevertheless a concern in the medical community is that e-cigarettes will be "a Trojan horse that will allow the tobacco industry to reverse decades of global progress in reducing smoking prevalence," says the CMAJ editorial.

"The tobacco industry sees a future where e-cigarettes accompany and perpetuate, rather than supplant tobacco use," the editorial adds.

The tobacco industry dominates the e-cigarette industry. In the U.S., a company called Blu eCigs accounts for almost half of all e-cigarettes sold, and it is in the process of being acquired by Imperial Tobacco.

The tobacco industry also dominates the e-cigarette industry in Europe, where vaping is more popular.

In the British documentary, "The Rise of the E-cigarette," Kingsley Wheaton, a director at British American Tobacco (which sells Vype e-cigarettes), says e-cigarettes "provide a substantially safer alternative to smoking a traditional cigarette."

Although that may sound like a good reason to stop smoking, there is intense debate among scientists around the world about whether vaping will lead to smoking cessation.

In May, 53 public health specialists wrote to the World Health Organization, arguing that e-cigarettes could provide what they called tobacco harm reduction because, in vaping, nicotine is consumed in a low-risk, non-combustible form and doesn't draw tar and toxic gases into the lungs the way smoking tobacco does.

That started a vigorous scientific exchange, starting with a rebuttal from 129 other public health and medical authorities, then a reply from the first group.

Reading those three letters gives an understanding of the debate, and its intensity.

The points in contention include the safety of the liquid, the safety of the second-hand vapor, and whether e-cigarettes are just another way of perpetuating smoking.

They don't debate the harms of the nicotine. By now that's pretty well understood.

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          Dr Josh Axe: Vitamin B17 Controversy: Poison or Cancer Treatment?        
Excerpt:

"Banned by the FDA in the 1980s but touted by some alternative medicine practitioners as a treatment for cancer, the controversy over the innocently named vitamin B17 rages on. Once labeled and marketed as a vitamin, its appearance practically disappeared without a trace within the mainstream medical community.
Today, however, a simple Web search pulls multiple blogs and articles either generously supporting this nutrient as a miracle cure or vilifying it as a hoax.
Vitamin B17, also called amygdalin or laetrile, is a glycoside nutrient linked with cancerprevention in alternative medicine practices — and there are anecdotal claims that it’s actually cured cancer. Vitamin B17 is derived from natural food sources and most abundant in seeds of plants of the prunasin family, such as apricots and apples.
Vitamin B17 interacts with other antioxidants â€” including vitamin Avitamin C and vitamin E â€” along with pancreatic enzymes to break down and eliminate harmful cells from the body. This makes it beneficial for detox support, immunity and potentially even various forms of disease prevention.
Vitamin B17, which has the scientific name mandelonitrile beta-D-gentiobioside, is considered a nitriloside, a natural cyanide-containing substance. Laetrile, the extract form of vitamin B17, is most well-known for potentially helping prevent cancer development through the production of hydrogen cyanide.
This beneficial compound is released into the body’s tissues and targets and destroys mutated cells. Although more formal research is still needed to prove vitamin B17’s effectiveness, many alternative medicine practitioners use vitamin B17 to increase immunity. Cyanide is thought to be the main anti-cancer component of vitamin B17 but is not fully proven in clinical settings as of today.

Vitamin B17’s Potentially Big Benefits

1. May Help Protect Against Cancer

Overall, study results investigating the anti-cancer effects of vitamin B17 are mixed. Some show that vitamin B17 is beneficial in avoiding cancer and keeping the spread of existing cancer cells to a minimum, while others show no effects of vitamin B17 on cancerous cells. While many practitioners believe that vitamin B17 laetrile is a very good cancer treatment, most agree that it shouldn’t be the primary cancer treatment for any patient — instead, they recommend that it be used as an effective add-on supplement.
Vitamin B17, specifically in the form of D-amygdalin, may help with the regression and growth of cancerous cells and tumors because it exhibits selective killing effects on mutated cells, also called apoptosis. Apoptosis is a mechanism of “programmed cell death” and considered an important part of cancer treatment. Vitamin B17 compounds have the important ability to kill cancer cells more readily than killing normal, healthy cells.
In a study by the Department of Physiology at Kyung Hee University in South Korea, when amygdalin extract was combined with cancerous human prostate cells, the extract helped significantly induce apotosis in the prostate cancer cells. The researchers conclude that amygdalin may offer a valuable, natural option for treating prostate cancer. (1)
Other animal studies show that vitamin B17 amygdalin is effective at killing cancerous bladder and brain cells under certain conditions, especially when combined with other antibody-enzyme complexes. (2)
On the other hand, other studies using human lung and breast cancer cells show no effects of vitamin B17 on stunting tumor growth. Therefore, in the medical community, there still isn’t agreement at this time as to whether vitamin B17 should be used as an anti-cancer treatment.

2. Boosts Immunity

Vitamin B17 contains special properties that slow down the spread of illness throughout the body by killing harmful cells, but the exact way that vitamin B17 does this isn’t well-understood.
A study published in the International Journal of Radiation and Biology found that vitamin B17 amygdalin stimulated the immune system by causing a statistically significant increase in the ability of a patient’s white blood cells to attack harmful cells. (3) One theory of vitamin B17’s effects suggests that transformation of normal cells into dangerous cells that can cause disease is normally prevented by beneficial enzymes produced within the pancreas. So vitamin B17 may help increase the production of pancreatic enzymes that destroy harmful properties within the body.
Vitamin B17 is also thought to help the body experience enhanced detox effects by supporting liver function. This boosts immune function by ridding the body of toxins, malignant cells and other potentially harmful substances before they cause illness or serious chronic diseases. Another explanation of vitamin B17 mechanisms is that when vitamin B17 releases cyanide, it increases the acid content of tumors and leads to the destruction of harmful cells within the tumors, arresting their growth.

3. Reduces Pain

In a case series published in 1962, when patients were treated with a wide range of doses of intravenous vitamin B17 laetrile, pain relief was the primary benefit reported. Some of the patients’ responses included decreased adenopathy (swollen lymph nodes) and decreased tumor size.
However, patients weren’t followed long term to determine whether or not the benefits continued after treatment stopped, so it’s hard to tell whether vitamin B17 could act as a natural pain reliever for other conditions, such as arthritis. (4)

4. Lowers High Blood Pressure

Vitamin B17 may cause a low blood pressure reaction due to formation of thiocyanate, a powerful blood pressure–lowering agent. However, it’s unknown if this is an effective treatment long-term or if the effects are mostly temporary.
Once metabolized, vitamin B17 causes enzyme beta-glucosidase production that interacts with intestinal bacteria to detox the body and lower blood pressure. This normally isn’t a danger for most people and may be beneficial for some, but it’s important not to use vitamin B17 in this way if you already take blood pressure-lowering medication.
If you have any existing heart issues that could become complicated if you experienced a sudden drop in blood pressure, you should avoid taking vitamin B17."
Also mentioned in the article:

Is Vitamin B17 Safe?

Best Sources of Vitamin B17

Is Vitamin B17 Treatment New?

Recommended Intake of Vitamin B17

Types of Vitamin B17 Supplements

Vitamin B17 Recipes

Vitamin B17 Side Effects and Interactions


Link

          ACR Appropriateness Criteria® Early-Stage Non–Small–Cell Lung Cancer        
imageEarly-stage non–small–cell lung cancer (NSCLC) is diagnosed in about 15% to 20% of lung cancer patients at presentation. In order to provide clinicians with guidance in decision making for early-stage NSCLC patients, the American College of Radiology Appropriateness Criteria Lung Cancer Panel was recently charged with a review of the current published literature to generate up-to-date management recommendations for this clinical scenario. For patients with localized, mediastinal lymph node-negative NSCLC, optimal management should be determined by an expert multidisciplinary team. For medically operable patients, surgical resection is the standard of care, with generally no role for adjuvant therapies thereafter. For patients with medical comorbidities making them at high risk for surgery, there is emerging evidence demonstrating the availability of low toxicity curative therapies, such as stereotactic body radiotherapy, for their care. As a general statement, the American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
          Massage Therapy Is Putting Touch Back into Health Care        
massage therapy July 13, 2017 An interest in health and wellness, a solid understanding of how the human body works and a desire to help people are the perfect combination for a successful career in massage therapy.

An interest in health and wellness, a solid understanding of how the human body works and a desire to help people are the perfect combination for a successful career in massage therapy.

And right now, massage therapy is one of the fastest growing career fields in the nation.

“Massage therapists provide maintenance in a world that is structured for stress,” said Michelle Liggett, massage therapy program director and instructor.  “We provide a release, both mentally and physically.”

In the recent past, massage therapy has served as a stepping stone into other medical fields for some students. Liggett said that today, more students are going into massage as a primary occupation.

Recognition of massage therapy as an ancillary treatment and preventive measure by the broader medical community is growing. Medical practitioners from dentists and doctors, to chiropractors and surgeons are now employing massage therapists or referring their patients to therapists for everything from temporomandibular joint disorder to carpal tunnel syndrome.

Liggett said, “Massage therapy is more than just a Swedish massage these days. It requires you to know how movement occurs so rehabilitation can take place. This means therapists are also pain managers and must understand muscles, their origin, insertion, and action.”

PTC students learn more than just a therapeutic stroke. They must learn basic pharmacology, anatomy and physiology, kinesiology, pathology, and medical terminology so that they can critically determine what the best course of treatment is for each client.

Completion of a certificate in massage therapy at PTC prepares students to sit for testing through the National Certification Board for Therapeutic Massage and Bodywork.

For more information on the massage therapy program, contact Michelle Liggett at liggett.m@ptc.edu or go to www.ptc.edu/massage. 

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          LOGAN for the Pirkle family — AL        
Taylor and Sarah Pirkle have been married for 6 years. Together they have 6 biological children, yours, mine and ours. Caden-13, Blake-12, Kati-10, Alyssa-9, Tatum-5 and Brooks-3. Taylor is an IT specialist with a medical company while Sarah is a nurse at a home health agency. Their children are active in school and extracurricular activities. […]
          A 'serious and urgent' American warning        
What would you think if the medical community were regularly injecting a chemical compound into millions of Americans that medical scientists are now saying that the “potential toxicity associated” with it should be “seriously and urgently considered”? In my last couple columns, I’ve discussed how my wife, Gena, and others across our nation and around [...]
          Greatest medical cover-up and Ponzi scheme        
By Chuck Norris, Gena Norris and Marcie Jacobs (This following column is a combination of my own commentary and research materials from our friend, Marcie Jacobs, who has given Gena and me permission to use her content.) One would think that underhanded parts of the medical community and government agencies that oversee them have taken [...]
          Fewer Women Need To Undergo Repeat Surgery After Lumpectomy        
For more than a decade, the number of women choosing bilateral mastectomy to treat breast cancer has been on the rise. That's the case even for women with early stage breast cancer, cancer in only one breast or non-invasive breast cancer, which has raised concerns that women are getting more surgery than they need. Now a study suggests that trend may be turning around. Repeat surgeries including mastectomies declined by 16 percent from 2013 to 2015, after medical groups recommended a smaller cancer-free margin around tumors removed by lumpectomy. The results were published Monday in JAMA Oncology. It's important to consider the history here. Before the recommendations were published in 2014, there was disagreement in the medical community about how wide the margin of cancer free-tissue removed along with the cancer should be. Some doctors wanted 2 millimeters or more of normal tissue beyond the edge of the cancer. Other doctors believed that 1 millimeter of healthy tissue was fine.
          No Doctors, No Drugs, Lots of Critics        
Recently in a discussion about birth, I was asked why I "dog" modern medicine, especially when I could run into breech births, cord pinching, wrapping , bleeding out etc. and what my game plan was.

When one decides to do a home birth, we aren’t rejecting modern medicine. We have made educated decisions to know when and where such things are needed and which procedures we can do ourselves. This applies to all of our medical needs. Self-reliance is important to us and self-reliance begins with education. Whether its a simple head cold or  postpartum hemorrhaging, I have done my best to prepare myself for such things, and I have the information and supplies needed to first prevent, and if needed, to treat such things. And more importantly, to know when to ask for help. Education is important. Ignorance makes you helpless.

I find it terribly sad when I hear women comment negatively about birth. I wonder what could have been done differently so that they had a positive outlook on childbirth. I know its not just luck that I have had 8 wonderful births. That can't be coincidence. And with my 9th childbirth experience just around the corner I find it more important to dispel the fears others have of childbirth. Its impossible to have the good support system one needs when so many are fearful and undereducated.


Why do I "dog" modern medicine? I know that many childbirth complications stem from unnecessary intervention. And this is not just my opinion. Inductions are common. Induction greatly intensifies contractions increasing the mother’s pain and fetal distress. Then we have the introduction of epidural. While these relieve the mother of the intense pain temporarily, they prohibit her from birthing naturally. She is usually at this point forced into a non-productive birth position.  This increases her chances of tearing, prevents the baby from descending into the birth canal properly and causes fetal distress. In many cases, had the women been left to start labor on her own and was given the education and support to labor without such drugs, the birth would have gone smoothly. The WHO and other organizations state that the rate of necessary intervention in birth should only be around 10%. Our c-section rate alone is near 50% in some hospitals. These do not stem from natural birth complications rather human interference in a natural process. This is one of my biggest issues with the way we give birth.

One thing that caught my attention was this comment
 "but my obgyn put it plainly when he said we don't perform surgeries or give stitches without some form of anesthetic why should you pop out babies without it."

This points out exactly what is wrong with the way we view birth in America. Birth is not a medical event. It is not surgery. It is a process that Heavenly Father has blessed us with. I have a separate blog post that goes into detail about that. But the idea that babies cannot be born safely without the assistance of a medical professional is a self-destructive thought process. Why should we follow the medical community with blind faith. Why must we take such a beautiful and natural process and make it a frightening medical event. Why do we refuse to take the time and energy to learn as much as we can when it comes to the birth of our most precious gifts. People spend more time ( and money)  and research shopping for a car then they do when it comes to the birth process of their own child.

The first thing any woman who is preparing for children needs to do is take control of her health. Many birth complications can be prevented. Its is the mothers responsibility to make sure she is in the best health possible during her pregnancy. Proper nutrition is key. Prepare your body not only to grow a baby, but to prepare for labor. Keeping your diet balanced can greatly reduce if not eliminate hypertension. Hypertension contributes to about 10% of labor inductions. A high iron diet esp late in pregnancy can help reduce the risks of hemorrhage. Why wouldn't you do all you can to insure the safest delivery possible, even before it begins.

Childbirth in any setting is not without risks. And many will say, well why not just birth in a hospital, just in case. Well,not everyone is comfortable in a hospital. I am one of those people. One thing we need to remember is that babies sometimes die in birth. It doesn't matter where the mother births, its a tragic fact of life. The concern is that if she is at home, it will be blamed on the fact that she home birthed. If she is in a hospital, its just one of those things.

So I want to address common "birth complications". How they usually arise and what my course of action as a home birther is.

Fetal position and cords. Breech presentation as well as posterior and transverse are all normal fetal presentations. These usually only became "complications" when the doctors put women on their backs to birth. The lithomy position hinders the ability to deliver these babies successfully. If a baby begins to present itself in a non-productive position, the mother is advised to change positions to see if the baby can turn. The most ideal position for birth is squatting or hands and knees. As an example, a full face presentation delivery, in most cases depends on if the baby is facing up ( sunny side up--chin towards moms belly button) or not. Sunny side up, or Angel Faces as some call them, can be safely born. If the baby is posterior face first, a safe vaginal delivery is unlikely. This is extremely rare. I would try an inversion to see if the baby could turn its head. If after a few minutes this does not look like a deliverable position, you would then prepare for transfer.

One of the most common birth complications I hear is " the baby's cord was wrapped". I have done alot of research on this one. It sounds terrible to someone who has little or incorrect information on umbilical cords. The umbilical cord is an amazing thing. Heavenly Father knew babies would enjoy the water bubble he created for them and know they would move, twist and turn and even play with their cord. They get it wrapped around their hands, feet, neck. This is all normal. A cord can even stand pinches and knots. A little bit of research on nuchal cords will provide more than enough information to show that it is not a complication, rather a normal part of birth.
From the March of Dimes
What is a nuchal cord?
About 25 percent of babies are born with a nuchal cord (the umbilical cord wrapped around the baby's neck) (1). A nuchal cord, also called nuchal loops, rarely causes any problems. Babies with a nuchal cord are generally healthy. 
 
Sometimes fetal monitoring shows heart rate abnormalities during labor and delivery in babies with a nuchal cord. This may reflect pressure on the cord. However, the pressure is rarely serious enough to cause death or any lasting problems, although occasionally a cesarean delivery may be needed. 
Less frequently, the umbilical cord becomes wrapped around other parts of the baby's body, such as a foot or hand. Generally, this doesn't harm the baby.
There are two concerns with cords. One being a "True knot" these are often quite rare. This can be delivered safely and often, the calmer the delivery, they better for mom and baby.  The biggest concern with cords is prolapse. There are two schools of thought on this. One is that a c-section is the only option. The other is to one push the cord back inside and try to deliver the baby quickly. Again, an inversion would be my first solution. Even if you do decide to transfer, hold the cord inside and sit with your bottom elevated. One way to avoid this is to delay breaking of waters. Most hospitals will rupture waters as a way to "move the birth along". I strongly advise against this.

Hemorrhage. Prevention of hemorrhaging begins during pregnancy. But the risk is increased by interventions in labor. DO NOT FORCE OR RUSH THE PLACENTA! This is a very common reason for hemorrhaging. Forcing a mother to push a baby when her body is not ready or forcing birth by pulling on the baby can increase risk of hemorrhage. ( this is more common in hospitals where the L&D staff are in a hurry) After birth a mother is encouraged to nurse. This is not only beneficial to the baby, but to mother as well. Nursing stimulates painful but, ESSENTIAL uterine contractions. There are occasions where the bleeding is severe. This was the case with my 6th delivery. I bled heavily an hour after birth. The reason for this was due to my neglect to use my better judgment when it came to pain pills for a dental problem I had a week prior to delivery. Fortunately my body recovered on its own, most likely from the intense nursing Olivia did after her birth. In most cases a compressing massage of the uterus and emptying of the bladder will reduce the bleeding. ( that’s why they tell you to pee after birth!!) If needed, most midwives carry Pitocin for this treatment but consumption of the placenta will have a similar result. It is very rare a blood transfusion would be needed. In this case a call to the hospital to prep would be done and they would be ready by the time we got there.

Baby not breathing.  While its ideal the infant take its first breaths right after birth, they do have a few min window. The first thing I do when my babies are born is I hold them with their head lower than their body. You can see here with Ezra. We also delay cord clamping. This gives them the opportunity to have all the oxygen rich blood supplied by the placenta. We clamp the cord when it turns white. Laying the infant skin to skin in mother’s chest and rubbing their back will help stimulate breathing. If you can have oxygen on hand, but if you don't, you can stimulate breathing with your own breaths. I urge every parent, not just home birth parents to know CPR and resuscitation. Kangaroo care has proven to work, even in cases where medical interventions did not.

Neonatal Complications. The "fire drill" procedure they do with a newborn actually creates problems. They grab the newborn, cut the cord asap ( cutting off oxygen) then give the baby oxygen, they put the baby naked alone on a scale and measure and weigh etc. Then they rush to get the newborns temperature back up. To me this system is cruel. It is much more important that my newborn nurses and feels my touch immediately after birth than it is to know how much he weighs or how long she is. As soon as the baby is born they are placed on my chest, skin to skin, cord intact. If the infant needs anything, it should be done while on the mothers chest. Suctioning etc should not be a standard procedure. All of this trauma can interfere with bonding, nursing, etc. Not to mention, that its pretty harsh to do to a newborn.

I know there are more "What ifs"..  These were the most common, so they are the ones I addressed.

I do want to say that I had a wonderful hospital birth with my first. It was wonderful because I had a midwife and a birth friendly hospital. While I was aware of a few things I didn't want done, I  was also ignorant to a few procedures. Ignorance is bliss. I then went on to have 3 midwife attended home births. With our 5th child we decided to go unassisted, or unattended. It was just a decision we decided was best for us. We didn't feel the need for a midwife. And we continued that with our other births.

 We choose home birth for two reasons. First, a hospital does not provide the setting that is conducive to a peaceful birth. Especially if the mothers labor is a long one. A 2-3 or more day labor isn't usually allowed in a hospital, and if it was do you really want to spend that long there. It also doesn't provide the freedom one has at home. At home you can walk around dressed how every you feel comfortable, you can lay in bed, you can lounge on the couch, you can raid the fridge, you can take a hot shower or bath.  We all feel most comforted at home. The more relaxed you can be, the easier labor becomes.

The second reason is intervention. Whether it be someone just touching me or telling me what position I need to be in, or trying to use medical procedures, I don't want to be bothered unless I ask you. I prefer a hands off method for both me and my child unless there is a need.

 I do not expect everyone to choose a home birth, but I want to dispell the myths and fears that surround it. There are so many who cringe at the thought of a homebirth, and they do it based on false information. Most people who who tell me how dangerous it is haven't done any research on the safety factors of home-birth vs hospital birth. The have this preconceived idea that home birth is risky and dangerous and the safest place to be is in a hospital. My first question is why would childbirth, being so vital to the plan of salvation, and the continuance of the human race, be so inherently dangerous that it would be contingent on the interventions of modern medicine? And if so, how did we possibly get to the point we are at? Its no wonder more and more women are choosing to have fewer children, if they have them at all. Its because birth is feared, not revered.

We as women are being told that we are not capable of bearing children on our own. That our one divine and biological duty, and we just aren't good enough to even accomplish that. How insulting it must be to be told that you cant give birth on your own, but your dog sits there with 9 puppies she delivered in the quiet of the night.

Birth is an experience, not a medical event. We shouldn't fear birth. We need to put faith in God. We need to put our faith back into ourselves. Doctors don’t deliver babies. Women give birth.

          The truth about childbirth        
Its understandable to be bombarded with questions after having a baby, esp one who was born at home with absolutely no outside medical intervention. I will try to answer as many as I can.

First let me say there is no better way to introduce a child into the world. The calm serene environment a home provides is ideal for such an event. Not only is the mother in a comfortable location and can move about freely, to make her delivery easier, the newborn is reprieved of all the prodding the medical community deems necessary and is justified in doing to the most delicate of humans. The first thing a newborn needs is skin to skin contact with mother. Nursing as soon as baby is ready is very important. I think many adults forget that the baby also went thru an incredible ordeal.. They have just been born. They have exerted energy and have wiggled their way out into our cold stark world. They also need a bit of quiet downtime. It just seems cruel to do it any other way.


I know not all women can birth at home. Many midwives offer birthing centers closely designed to a home like environment. These have become increasingly popular. And of course for women who are high risk, hospital births are advised. My only concern is what is truly considered "high risk". For my local hospital, anyone who has had a previous cesarean birth WILL have another one here. They do not encourage vbacs at all.. Take a trip 45 min  north and you will find many Dr's to encourage vbacs. There are many many testimonies to vbac homebirths on the web. This, among other "risk" factors, are pre decided by a medical community, not on a case by case basis, as it should be.

I had my first child in a hospital with a midwife. It was a great experience and I was pleased with the results. The hospital was a midwife friendly place and everything was done in the same room. I also admit I didnt know as much as I do now. When I was pregnant with my second I was in another state and it was easy to find a midwife to birth at home. She attended that birth and the 2 others that followed. It wasnt till the 5th child we decided to go unassisted. We felt confident to do so. We took the time to do some extra studying and we researched the "what ifs".



 Childbirth comes with risks. Life comes with risks.Whether you are in a hospital, at home or a taxi cab in between, the potential for tragedy is there. Childbirth is not math. There is generally more than one answer and several ways to get to it. Some common concerns about homebirth are as follows: Cord wrapped around the neck~ this has occurred with two of ours. Its actually so common its considered normal. The first time a midwife was present and the second time was not. In both instances the cord was adjusted as to allow the baby to be born as normal. This not something to panic over. True knots can be dangerous as they cut off supply to the baby, but are also extremely rare.  Umbilical cords are meant to be stretched bent and twisted.Again, this is completely normal and can be corrected quite easily. Breech, transverse, posterior positioned babies. ~ The difference between the woman who delivers these types of babies and the women who have them "rescued" by a surgeon lies on many factors. How empowered the mother is, her trust in her own body and her faith in God, whomever that may be to her. I agree in some cases medical intervention is necessary, but by taking away a woman's empowerment and her faith, medical intervention becomes even more necessary. Spend 20-30 min on you tube watching "natural breech births". Its pretty fascinating... well for me it is :). Homebirth also allows for a woman to regulate her movement. Being able to move freely is important to help the baby move down the birth canal. Laying on your back is the worst position for childbirth as it reduces the pelvic opening and causes many babies to become "stuck". Yet most hospitals restrict a womans movement. Heart rate dropping~ The idea of constant fetal monitoring seems to helping attorneys, not physicians. Consistently watching fetal heart rate can actually cause an increase in the mothers heartrate and inturn the baby's. Again we have to remember the baby is also feeling every contraction. Group B Strep~ Along with antibiotic treatment, Garlic, Vitiamin C, Echinasia can be taken to remedy GBS during pregnancy. The reduction of vaginal exams, esp duing labor, decreases the chance of the baby getting an infection. Preventative measures~ when you are preparing for a homebirth you are not only more inclined to educate yourself on birthing issues, but you are also more likely to care for yourself better. Not just simple nutrition but ways to avoid birth complications such as pre-eclampsia. Education plus preparedness will help guide you to the birth you desire. We must first take responsibility for our bodies, and in turn, the body growing inside of us.

Another area of question is pain management: This is a key word for childbirth. To have a successful childbirth you have to admit to yourself that childbirth is painful. The kind of pain you never imagined. Then you have to learn how to manage it. You have to have control over it, or you succumb to it.The techniques for each woman is different and can differ from delivery to delivery.I prefer the use of  hot showers and baths. Hip movement and walking around is also helpful. There are several birth positions that can be used. The traditional lithotomy position ( on your back) actually creates problems ( and pain) and is generally only used in hospitals for the convenience of the doctors. Think about it.. when you are 9 mos pregnant, does laying on you back EVER feel comfortable? It also cuts off blood flow.. not a good idea. Its also reduces the pelvic area as I addressed above. Crawling, squatting, kneeling, even standing can make a huge difference in pain management. I know for myself, going from an upright position to laying down is impossible in the laters stages of labor. The pain is unmanageable at that point. Its no wonder so many women rely on epidurals. Those types of birth positions also encourage the baby to descend into and out of the birth canal. Its like some supernatural being had it all planned out ;)

As soon as our babies are born I hold them as close to me as possible and clean the airways. I gently rub the babies skin as well, observe activity and watch for signs of rooting. As soon as the baby is ready we nurse. We wait for the placenta before we do anything else. Once the placenta is delivered we clamp the cord and wait a few min before cutting. Our oldest had had the opportunity to cut twice. Daddy begins clean up ( I know how awesome is that!) While mom, baby and siblings bond. Then we rest.

Childbirth has been occurring since the beginning of time.. Hombirth was the only option untill the earyl 1900's when hospitals became more accessible and homebirths were encouraged to be phased out. In the 1950's the creation of Obstetrical organizations created a greater decline in homebirths and midwifery. Recently the desire to homebirth has come back but is now labeled "trendy" or " dangerous" depending on ones outlook. Talk Show Celeb Ricki Lake brought nationwide awareness the "new trend" of freebirthing, aka unassisted homebirth. I find the media reference to this being "trendy new idea" amusing. I didnt realize Eve was such a trend setter.

When it comes to prenatal care that is something we do on a limited basis. I last saw a midwife in the beginning of my second trimester with my 7th child. I had just wanted a basic check up appt so we made one. I am not opposed to prenatal care, nor do I see anything wrong with it. I just use it on a needs be basis. If I have a concern I have it looked into. We do not do sonograms either unless we have a concern. I did with my first after suffering two prior miscarriages, I had to see the strong heartbeat!! I also had one with #3 and #4 as we needed to be sure of the EDD. I do not screen for disabilities. They have been wrongly diagnosed in the past and I want to enjoy my pregnancy. If I have a child with a disability then I have a child with a disability. There is no other option for me.


What it boils down to is there are no guarantees in life. Childbirth is a beautiful natural process which sometimes has casualties. There is nothing man can do to change that. While we have taken great medical measures to reduce those casualties and injuries, we have seemed to go full circle and our mortality and injury rates are increasing. I feel that every mother to be should be educated in all aspects of birth. I feel saddened when I hear of a mothers traumatic birth story that has made hear fear another. Especially when, in many of those cases, unnecessary intervention caused it. We can spend our days doing the "what ifs". Once you are educated on an issue it comes down to what is the best option for you. Unfortunately for most women they are not educated, they are being made fearful of childbirth.

*originally posted 4/8/10

          USM to buy Care Medical’s rehab, repair divisions        
11/07/2012
HME News Staff

HAZELWOOD, Mo. – United Seating & Mobility (USM) has reached an agreement to purchase the rehab and repair divisions of Portland, Ore.­–based Care Medical Equipment, according to multiple reports. As part of the transaction, USM will add locations in Seattle, Olympia and Vancouver, Wash. Terms of the deal, expected to be completed Nov. 30, were not disclosed. The purchase of Care Medical comes on the heels of two recent acquisitions by USM: the Nov. 2 purchase of JeffQuip in Upper Chichester, Pa., and the September purchase of Glass Seating & Mobility in Huntsville, Ala. 


          Quantum Well Infrared Photodetectors (QWIP)        
Year: 
Inducted Individuals: 
Dr. Sumith Bandara
Clyde Bethea
Dr. Kwong-Kit Choi
Dwight Duston
Dr. Sarath Gunapala
Theodore Hoelter
Dr. Murzy Jhabvala
Dr. Carl Kukkonen
Dr. Barry Levine
John Liu
Dr. Kathrine Manizade
Technology Description: 

Understanding climate changes and the parameters influencing the climate is very important. Infrared imaging is an important technology for gathering useful information however, prior to 1990, no photodetector arrays had been fabricated that would operate at infrared wavelengths necessary for detecting these changes in ecosystems. In a unique collaboration between the Goddard Space Flight Center, and ATT/Bell Labs the first quantum well photodetector array capable of operating in the far infrared was developed and incorporated into a camera system that successfully performed airborne imaging. Dr. Sarath Gunapala of the Jet Propulsion Laboratory (JPL), while working with Dr. Barry Levine at Bell Labs, helped developed the QWIP technology that could be used in imaging systems. 

Bell Labs decided that this novel technology did not fit their commercial directions. However, technical visionaries at NASA JPL saw its potential for producing enhanced space-based imaging systems and acquired the technology as well as several technical people including Dr. Gunapala. At JPL he and his colleagues have perfected the QWIP technology and have produced cameras that are capable of operating at infrared wavelengths that were not previously possible with existing technology. Use of this technology is enabling NASA to enhance substantially its earth? observation capability. The QWIP technology is a complicated solid-state detector that involves sandwiching gallium arsenide chips between silicon wafers and connected them with indium connectors. The technology can be designed to operate at longer infrared wavelengths and can be produced at lower costs making it is superior to any existing technology. A new company, QWIP Technologies, was formed to obtain a license from JPL to produce focal plane cameras using the QWIP technology. 

OmniCorder, a biomedical company, recognized the potential of using QWIP technology for medical purposes. They obtained an exclusive, worldwide license from NASA to use the technology for biological applications, including breast cancer detection. Recent medical research studies have shown that cancer cells exude nitric oxide. This causes changes in blood flow and concomitantly the temperature in tissue surrounding cancer. The OmniCorder BioScan System, which incorporates the QWIP technology, is able to reliably detect these minute temperature changes. The system, which has received FDA approval, uses no ionizing radiation and permits a hazard-free non-invasive assessment of abnormal tissue.


          Strange Fruit #155: How Do Doctors Treat Transgender Kids?        
We're lucky enough to live in a time when more and more parents of transgender kids are accepting, loving, and trying to help their children be their authentic selves. And the medical community is developing new ways for trans kids to achieve their physical goals, but experts disagree on what the treatment protocol should be — and how early they should start. That's the subject of an article in this month's issue of Scientific American Mind, and the author of that article, Francine Russo, joins us this week to talk about it. Russo says drugs known as puberty blockers can essentially put the brakes on a child's sexual development while they and their doctors determine what to do next. The officially-accepted standard of care is to start puberty blockers at the first sign of puberty, then start cross-sex hormones at age 16. "And that's where the controversy in the field is," Russo explains. "Some doctors feel if the child is so clearly trans, and has been for a very long time - what they say in the field is the child has been 'insistent, persistent, and consistent' over time - those children, some doctors feel, should get cross-sex hormones and start going through puberty as early as 14 or 15, although the professional standards say don't do it before 16." We also asked Russo about a sidebar in her story about brain imaging studies done on trans people. Early results of these studies seem to show differences in the brains of trans people and cisgender people, and also hint that sometimes a trans woman's brain, for example, reacts to stimuli in ways that a cis woman's brain would — not in ways that a cis gender man's brain would. In Juicy Fruit this week, we remember David Bowie, specifically in terms of his championing of black people and his lovely longtime marriage to Iman.

          Thomas Cook: 25 years with a transplanted heart        

Actually endorsed her new heart at the same time when surgeons transplanted into his chest 25 years ago.

" Your body and heart have become one ," says Steven Boyce, surgical director at MedStar Heart Institute at MedStar Washington Hospital Center , where he transplanted the heart to Thomas Cook on February 1, 1989 . " We do not know why. 's Pretty unusual for the body to accept a new body and recognize it as their own. But his body took the body from the start and never caused rejection."

Thomas Cook , 50 , is one of the longest transplanted survived a heart transplant in history. Note that Cook has never experienced significant episodes of rejection or other common major medical complications following a heart transplant . He takes medication to prevent rejection , all transplant patients do.

"I have done nothing but live life ," says Cook. "I've had ups and downs but I am enjoying the feeling of being alive. "

On February 19 , when Cook arrived at the hospital for his annual checkup , doctors , nurses and other personnel involved in monitoring, as well as the mother of the donor of his heart, he was caught with 25 red heart shaped balloons , a cake heart shaped dishes with heart-shaped biscuits and a crystal heart shaped engraved wearing "25 years strong . "

While most people are afraid to grow old , Cook thanks you and says "I grow old , I hope to be here to celebrate 50 years of transplantation. "


          Almirall expands its international presence to Canada        

The Canadian subsidiary will focus primarily on therapeutic solutions for respiratory and skin diseases .

According to the CEO of Almirall Canada, Ed Dybka : " We are at a very important moment for Almirall , advances in research projects , key regulatory milestones and new partnerships will be the foundation for a sustained period of international growth , where we have an important role and underlines our commitment to the U.S. pharmaceutical market . "

Headquartered in Mississauga , the new subsidiary will support the launch of new products in the local market Almirall , including an innovative new treatment for chronic obstructive pulmonary disease (COPD ) : Tudorza ® Genuair ® , which is marketed in the fall.

Almirall fourteenth Canada is the subsidiary of the pharmaceutical company joins existing in Europe and Mexico .

Considering the milestones achieved by Almirall in Europe throughout its history, the General Manager of Almirall Canada has stated : "We want to stand out for being a pharmaceutical company in which they can develop new lines of business as well as continue our commitment to collaborate with the medical community to improve the quality of life of Canadian patients , "said Dybka .

Research and development

Research has been a fundamental part to create , for more than 40 years , the DNA of Almirall . In 2012 , Almirall reinvested more than 23% of its sales in R & D - an increase of 10 % over the previous year . This was the largest investment in research and development in the Spanish pharmaceutical sector and the third in the ranking of all companies.

In late 2012 , 20% of all staff of the company is dedicated to R & D. In total, more than 500 people , including scientists and experts play an essential role in all stages of research and product development for applications for marketing authorization record .

corporate Values

Almirall , corporate values ​​reflect our attitude : how we work and how we interact daily professional and personal level , both within and outside our organization.

Our four core values ​​: trust , innovation , teamwork and personal leadership , define the company and help us to improve our performance and create value . The results of the company are the sum of individual efforts dedicated to the fulfillment of our vision , objectives and goals.

Almirall

Almirall is a pharmaceutical company committed to providing valuable drugs through its efforts in R & D , which exceeded 23% of its sales in 2012 , along with external agreements , licenses and collaborations. Through the search for innovative medicines, we aim to become a leading company in the areas of respiratory disease and dermatology , with a high interest in gastrointestinal and pain. With more than 3,000 employees in 22 countries , Almirall has generated total revenues of 900 million euros in 2012 .

The company was founded in 1943 and its headquarters are located in Barcelona ( Spain ) . Almirall shares traded on the Spanish Stock Exchange ( ticker : ALM ) .

For more information, visit the website: www.almirall.com


          USAW Secures More IWF Leadership Positions        
USAW family earns slots on Executive Board, Coaching, and Medical Committees at IWF Electoral Congress
          Early antibiotic treatment of severe sepsis        

Infectious disease specialists have advocated the early use of highly active antibacterial antibiotics to reduce the number of deaths caused by severe sepsis in the scientific session entitled "Facing the dilemma of mortality and resistance in Gram-positive infections" organized by Novartis under XXIII European Congress of the European Society for Microbiology and Infectious Diseases (ESCMID). This disease, which is often confused with 'blood poisoning', is one of the leading causes of mortality in the world 4, which could be significantly reduced with the use of drugs active against Gram + from Time 0 in which active sepsis5 code.

Sepsis or sepsis is the body's response to infection, either extra-or hospital, more frequent due to the immune status of patients and increased invasive techniques, intravenous catheters, prostheses and implants intravasculares1, 6. It is a disease whose incidence increases 2% annually and that records 18 million cases per year worldwide. Only in Spain are detected daily one to two new cases of severe sepsis per 100,000 inhabitants. Has a mortality rate of 50% 2 in case of septic shock, being superior to that of prostate cancer, breast cancer and HIV / AIDS juntos3.

To reduce these numbers, Dr Alex Soriano, Infectious Diseases Unit of the Hospital Clinic of Barcelona, ​​argued in his paper "Saving your patient: the importance of early treatment" the importance of early antibiotic therapy in the treatment of serious infections "to reduce mortality, length of hospitalization and possible relapse."

Although this is an increasingly common protocol, the usual tendency is to start with a classic less potent antibiotic and increase it if necessary. The consumption of antibiotics has been linked to the selection of resistant organisms, but for Dr. Soriano "the problem is not that you use a strong antibiotic from the beginning, but that the patient take for many days as necessary. The initiation of treatment should not be delayed unnecessarily and discontinued or adjusted according to the results of the microbiology laboratory. "

In your opinion, was suspected severe sepsis is better not to take risks, as it is in the patient's life threatening. "It is true that following this protocol is possible that people who do not need treatment so strong end up getting it but it does not pose a risk to the patient," said the doctor.

Area Director Integrated Hospital Care at Novartis, Begoña Gómez, highlights the importance of efforts devoted to R & D to address issues such as sepsis. "The health and quality of life of patients is our top concern, so that our work is focused on the development of drugs that allow us to care for and heal people, not forgetting to publicize the progress made in this regard between the medical community. " Sample this commitment, Novartis has held in the Congress of the symposium on ESCMID positive infections.

This release contains certain forward-looking statements relating to the business of the Company. There are factors that could modify the current results.

About Novartis

Novartis AG (NYSE: NVS) provides solutions for health care consistent with the needs of patients and societies. Focused exclusively to the area of ​​healthcare, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, eye care, high quality generic drugs that help save cost, preventive vaccines and diagnostic tools, OTC; and Animal Health. Novartis is the only company that has achieved a leadership position in these areas. In 2012, the Group achieved net sales of 56,700 million USD and invested approximately U.S. $ 9,300 million (9,100 million excluding asset impairment depreciation and amortization) in R & D. Headquartered in Basel, Switzerland, the Novartis Group companies employ approximately 129,000 associates and operate in more than 140 countries worldwide. For more information, please visit the websites http://www.novartis.com y http://www.novartis.es.

 

Referencias
1 http://www.news-medical.net/health/What-is-Sepsis-%28Spanish%29.aspx
2 http://www.intramed.net/sitios/librovirtual1/pdf/librovirtual1_52.pdf
3 http://www.cec.health.nsw.gov.au/__documents/programs/sepsis/world-sepsis-day/1_2_wsd_factsheet_english.pdf
4 http://www.biomerieux.com.mx/upload/SPANISH_Fact_Sheet_Sepsis-1.pdf
5 http://www.juntadeandalucia.es/salud/export/sites/csalud/galerias/documentos/p_3_p_3_procesos_asistenciales_integrados/sepsis_grave/sepsis_grave.pdf
6 http://www.intramed.net/sitios/librovirtual1/pdf/librovirtual1_52.pdf


Fotografía By Credit: Rocky Mountain Laboratories, NIAID, NIH [Public domain], via Wikimedia Commons


          Evening of Health Journalism        

The Novartis Institute for Biomedical Communications (INCB) honored last night at the 12th Evening Health Journalism, Leonor Rodriguez, Director of the journal The Physician and Physician Interactive.

This evening is an initiative that aims to bring together annually to journalists specializing in health information in order to exchange, share experiences and recognize the extensive experience of a professional in the field of health.

12 Health Journalism Evening of "The Evening of Health Journalism, is an ideal meeting your company to enjoy and share with all of you who have been part of our project called Novartis, our more than 100 years in Spain. Thank you, because you are an encouragement to us to continue to make history, "said Montserrat Tarrés, Communications Director of the Novartis Group in Spain, who was responsible for presenting the event.

The conclusion of this evening is part of the April 23, Sant Jordi Day and World Book Day, when we commemorate the death of Miguel de Cervantes and the birth or death of other famous international writers. Therefore, this meeting also is a tribute to literature and the world of literature in general.

In previous evenings Bank is honored Celia (2002), Flor de Colmenares (2003), Ramón Sánchez Ocaña (2004), Milagros Pérez Oliva (2005), Jesus Infiesta (2006) and Fernando Mugarza (2007). In 2008 he paid tribute to Jose Maria Catalan, Ramón Sánchez-Ocaña, José Luis de la Serna and Manuel Torreiglesias, journalists that during that year had the privilege of receiving the Civil Order of the Ministry of Health in recognition of his extensive career in the field of health information. In the eighth Evening Health Journalism journalist was honored Leonor Garcia-Alvarez, TVE, in the ninth to Javier López Iglesias, Carlos del Aguila and Mark Lopez and Javier Olave tenth. Last year, the award was to Sergio Alonso.

Novartis Institute for Biomedical Communications
The Institute was founded in 2001 with a vocation to work for excellence in communication and act as a common forum and meeting point between Institutions, Scientific Community, Media and related groups and stakeholders in the biomedical and health. The exchange, transfer and interaction between them are the factors that have consolidated their existence and achievements.

According Montserrat Tarrés, "one of the priorities of the INCB is to promote both the formation of communication professionals, foster and conduct outreach programs and health content, increasingly demanded by patients and society in general . This is an important step in helping to raise awareness of the value and sustainability of health systems and its real dimension for users ".


          Sciatica Symptoms, Causes, Treatments        

Back pain is one of the most common conditions that people suffer from today. But, when you’re talking about experiencing sciatica pain that shoots from your lower back into your glute area and legs, it can be difficult to sit, stand and move around to accomplish your daily tasks. Sciatica pain is becoming so well known that studies show up to 43 percent of people experience this painful condition at some point in their lives. (http://www.massagetherapy.com/articles/index.php/article_id/2064/Assessing-Sciatic-Pain) If you suffer from excruciating pain in your lower back and body area, it’s important to identify the symptoms and causes of your condition so that you can take the appropriate path to treatment. 

Sciatica or Piriformis Syndrome: The Symptoms May Be Similar

The sciatic nerve is the largest nerve in the body that starts in the lower back and runs down both legs. Sciatica pain occurs as the result of a spine or disc condition that compresses part of the nerve, causing inflammation, extreme pain and even numbness from the low back down throughout the leg. The most common symptoms of sciatica pain include weakness, numbness and tingling in the low back that radiates down the side of one of your legs. The pain is rarely experienced in both legs and it’s described as a sharp, shooting type of pain, explains Edi Woods, massage therapist at Elements Indianapolis North.

While many people seek relief from sciatica pain symptoms as described above, many may actually be suffering more from a muscular issue, rather than a true sciatic nerve condition. In Woods’ experience, the muscular condition of piriformis syndrome is often more common in people, but may not always be accurately detected, as it can compress the sciatic nerve and imitate pain similar to sciatica.

“I see clients with sciatica-like symptoms frequently in my practice”, explains Woods. “But, from a muscular standard it’s usually more of a piriformis muscle issue than true sciatica. The piriformis muscle is one of our deep lateral hip rotators that extend into the glute area. It can get inflamed, contracted and can compress the sciatic nerve as well. When this happens, it mimics the sciatica condition, which people are more commonly aware of. So, a lot of people may come in saying they have sciatica, but in reality more times than not it’s piriformis syndrome.”

Causes Range from Health Conditions to Activity Induced

True sciatica pain can happen to anyone since any of us can develop a disc disorder like herniation or degeneration. The cause in these long-term conditions could be hereditary or the result of a lifestyle event like an accident or injury that creates prolonged compression on the sciatic nerve. Pregnant women also have a tendency to develop a temporary sciatica condition as the weight from carrying a baby either pinches or puts extra pressure on the sciatic nerve.

But, for the majority of the people that Woods treats who seek relief from what they call sciatica pain, the cause tends to be muscle overuse from runners, walkers, cyclists, etc. who push their bodies through a constant forward leg motion. When this happens, a trigger point develops in the piriformis muscles, which can compress on the sciatic nerve and cause similar sciatica-type symptoms.

“When I have clients who are coming to me with sciatica-type symptoms, I don’t treat the nerves, but rather the muscles that are compressing on the nerve,” explains Woods. “To work on someone with sciatica symptoms, I’m going to first focus on the piriformis muscles, which are located in the middle of each glute, and then move on to the gluteus muscles, hamstrings and sacrum. I prefer to use a mix of trigger point therapy and a stretching routine in all of these areas because everything is connected and pulling on each other.”

Alternative Treatments May Help with Addressing Pain

Since true sciatica is typically the result of a herniated or degenerative disc, the medical community recommends surgery as the number one way to remedy the condition, says Woods. However, there are other ways to address the pain before you get to the surgical table. Woods suggests a mix of heat, ice, pain medications, physical therapy, stretching and regular massage therapy as possible alternative solutions to help alleviate the pain associated with both sciatica and piriformis syndrome. And, contrary to what you might expect, Woods also advises her clients suffering from sciatica symptoms to stay active, continue exercising and stretching. If you stop all activity, the area is more prone to locking up muscularly, compressing on the nerve more and increasing your level of discomfort.

“A lot of people think that they have to have surgery right away if they feel sciatica-type symptoms,” explains Woods. “But, what they’re feeling could actually just be the result of tight piriformis muscles that can be treated by massage therapy sessions that focus on the glutes and lower back areas. Their symptoms can be relieved and they won’t have to have surgery.”

“It’s important for people to realize that sciatica symptoms are something that can be treated with massage in cases when the cause isn’t really a disc issue, but is rather tight piriformis muscles,” concludes Wood.

If you’re experiencing sciatica-like symptoms in your lower back and glute areas, seek the advice of a medical professional to determine whether your symptoms are true sciatica or piriformis syndrome. In both cases, massage therapy can help alleviate pain in both the long-term and short-term. Just realize that you have options when it comes to treatment and make sure to explore all possible diagnosis and treatment plans, advises Woods. 


          Before You Interview for a Medical Job - Job Interview Tips for Medical Job Seekers        
One of the most critical stages of the job search process is the interview. Whether you’re interviewing for an entry level, hourly wage job, a high-paying hospital executive role, or a clinical role such as nursing or physician jobs, below are a few key steps you can take to assure that you’re prepared for your interview.

Thorough preparation prior to your job interview will help ensure your success in getting the offer, or at least getting to the next step of the job interview process. An interview is a sales presentation, and the product is you.

Research the Potential Employer

Do your homework about your potential employer. This can include internet research and word-of-mouth. If you know someone who works there, spend a few minutes discussing their experience and observations of the company, including corporate culture, values, and any recent business developments. If you don’t know someone who works at the company, try to network your way to a direct connection with someone who does.

If you're interviewing for a hospital job, research its financial stability, and potential growth. Also, what is the reputation of the hospital in the general community and the medical community?

Know the Interview Process for the Position You Want

Knowing the interview process is important not only for your success, but also for your peace of mind during the interview process. If you know what to expect, you’ll be able to more easily gauge the potential employer’s interest level in you as a candidate. Ask the recruiter how many interviews are involved, who are the decision makers at each step of the interview, and what is the anticipated time-frame for hiring and on-boarding someone for this role.

If you're aware that the interview process is two interviews, or five, you won’t be alarmed when you don’t receive an offer after the first interview, for example.

Have Solid References Ready

Now that you know what to expect in the interview process, you know when to expect the background check and referencing stage. You should have a minimum of three professional references, including direct supervisors from your current and most recent jobs. (It is acceptable to ask that your current employer not be contacted until you've received an offer.) You should have the name, title, dates and company where you worked for this person, and contact numbers and email address of each person who is on your reference list. Ideally, you should be aware of what these references are going to say about you as well.

Plan Your Route and Know Where You're Going

Confirm the time and location of the interview the day before. Managers can get busy or pulled into last minute meetings, so be sure everyone is on the same page and planning to meet at the originally designated time.

If possible, drive by the interview location to be sure you know how to get there. If this isn’t possible, allow extra drive time on the way to your interview in case you get turned around or miss a turn.

Plan Your Attire

You should be dressed professionally for an interview. This is going to vary based on the type of position for which you’re applying. However, you can never go wrong with a business suit in a conservative color. A few days before your interview, select your attire and be sure it has been cleaned and pressed and you’re ready to shine! This gives you time to make a run to the drycleaners, or to make any repairs (hems, buttons, etc) or purchase missing accessories if needed.

Anticipate Job Interview Questions and Rehearse Your Best Answers

This is one of the most important things you can do prior to your interview. Most interview questions, although worded differently, seek to identify the same basic traits:
  • What can you contribute to the organization?
  • How well do you work with others and get along as part of a team?
  • Why should we hire you over the other candidates?
  • Why do you want to work here and would you be motivated to stay here?

You need to show (not tell) the interviewer that you can efficiently and effectively do your job. You can illustrate by sharing past accomplishments and achievements: quantifiable, verifiable contributions to the bottom line.

Prepare to Sell Your Strengths and Sell Around Your Weaknesses

Put together a list of specific examples of how you have improved your current and previous employers’ organizations by increasing revenue, decreasing operating costs, or a combination of both. Know your strengths and be able to sell them; know your weaknesses and be able to sell around them. How can you improve on weaker areas? How do your strengths compensate for any weak areas?

Be prepared to succintly describe two or more significant contributions you made to each employer, particularly the action you took that impacted the bottom-line of your employer. You can work these examples into multiple interview answers.

Prepare a List of Intelligent Questions for the Interviewer

The questions you ask in an interview also say a lot about you as a candidate. Therefore, your questions should focus on professional development, long-term goals for the role, and company initiatives. This is not the time to pick apart the work schedule, compensation plan, or vacation allowance. Ask questions that show the interviewer that you've researched the company. For example: "I saw on your website that (insert factoid here)...How do you think that will impact long-term growth?"

Okay, you're ready to go get that job offer! Print a few extra copies of your CV, (or resume') grab your notebook, portfolio, and go!


          Corporatisation of Diagnostic Services        


 

Part I General Review

Introduction

During the 20th century imaging, diagnostic laboratory tests, and pharmacology moved to centre stage in medicine. Few episodes of medical care occur which do not involve one of these. Experts in these fields may not make the clinical decisions but their input can be crucial to these decisions. These services gravitate to hospitals, and to the centres where doctors work.

Jun 2001 Reliance on diagnostic testing

Modern medicine increasingly depends on sophisticated testing, involving wider use of clever but expensive diagnostic equipment, to provide safer and better ways of assessing and preventing disease. In Australia, radiology is the largest category of Medicare expenditure after general practice, closely followed by pathology. Of the total Medicare expenditure of $6.9 billion last financial year, radiology accounted for $1.1 billion and pathology was $1 billion. Total Medicare money paid to general practitioners in 1999-2000 was $2.4 billion.
The Uncanny X-ray Men Business Review Weekly June 22, 2001


Radiology and pathology both require very costly equipment and, because of the rapid changes in the technology they employ, frequent upgrades are needed. To cover costs larger fees and a high turnover are required. Because of this the businesses are very profitable once the breakeven point is passed.

Mar 2005 Huge overheads

Given the huge overheads in running a laboratory (a new lab can cost $20 million to set up) and the cost of keeping pace with regulations, Dixon says many smaller players are happy to sell up and move on. "It's almost impossible for the smaller players to keep up with the corporates as you get huge economies of scale by acquiring a number of big labs," he says. He points out it's a win-win both ways.
RICH PICKINGS THE PEOPLE WHO GET RICH AS YOU GROW OLD Australian Financial Review March 19, 2005

Sep 2005 Costs of equipment

SKG (Subsidiary of Sonic Healthcare) is buying three 64-slice computerised tomography (CT) scanners, with each unit costing about $1.3 million.

This followed the installation last month of a state-of-the-art magnetic resonance imaging scanner at Hollywood, at a cost of about $2.5 million.

In addition, the company has a positron emission tomography scanner at the Subiaco hospital, installed at a cost of more than $3.5 million.
SKG spends on scanners WA Business News September 22, 2005


Both pathology and radiology have consequently become key areas for consolidation and rationalisation to ensure the most efficient use of the equipment. In our world this means that the mechanism used is corporatisation. Corporations can painlessly raise capital and there are opportunities to generate large profits for shareholders. Privately run professional services are unable to compete. They are offered large payments for their practices. Only a few privately owned and run services remain.

Mar 1989 Pathology corporatisation starts

Since that report (Government Review in 1985), the trend towards large groups grabbing the major proportion of business has continued, reflecting the need for pathology laboratories to achieve high-volume throughput.

The trend has been assisted by the widespread rationalisation in the industry, seen recently with Regional Pathology in Victoria going into receivership and its later purchase by the second largest pathology group in South Australia, Gribble.
NEW STARTER IN PATHOLOGY STAKES Australian Financial Review March 20, 1989

Jun 2001 Rapid corporatisation

With the radiology market worth $2billion and the pathology market not far behind, these have been particularly attractive to companies and have been quickly corporatised.
Firms fight for $2.7bn in doctors' fees The Weekend Australian June 16, 2001

Sep 2005 Some did much better than others

Health is a booming segment of the economy and Sonic Healthcare has positioned itself perfectly to reap the benefits of this momentum.
Overseas venture fuels Sonic boom Australian Financial Review September 7, 2005


I have always been privileged to have radiologists and pathologists I knew well "across the passage" so that I could walk over with their reports to discuss X-rays or histological findings. Diagnoses have been revised as a result. Some corporate groups have had the insight to preserve some of this professional collegiality and it has been profitable for them. Others have sought to bind their services to the doctors who use them in other ways.

One of the consequences of corporatisation, mechanisation, centralisation and an emphasis on efficiency is that the laboratory and imaging experts are removed from the clinical setting and from close contact with their clinical colleagues. Decisions are increasingly made on the basis of reports rather than consultation. While tele-radiology greatly improves the service to peripheral practitioners it can impact on collegiality.

Aug 2000 The promise of tele-radiology

Many of these benefits will be achieved through tele-radiology - the digitisation of images which can then be transferred to off-site specialists. Southernex is a market leader in the use of tele-radiology.
Development Capital Of Australia Limited (DVC.AX) DCA Expands with Healthcare Acquisition. Australian Stock Exchange Company Announcements August 9, 2000

Aug 2005 Collegiality - a US company which survived against corporate might for years

"It was just the fact that physicians know physicians doing the interpretation," Jupe said. "They talk. It's more of a close, collegial practice of medicine."
From a small medical practice a big lab grew and grew; Newly sold Clinical Pathology Labs' next test: Stay successful, independent Austin American-Statesman August 30, 2005



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Pathology generates better results from corporatisation than radiology because the expensive facilities can be centralised and the machines automated. Multiple collection centres in medical complexes and hospitals around the country can funnel specimens through these high turnover centres. The number of employees can be reduced and the costly highly trained pathologists anchored and used for maximum benefit.

It is still necessary to carry out some urgent tests on site so this centralisation must be balanced. Some facilities are required in hospitals.

Sonic Healthcare adopted this strategy very successfully setting up only a few major centres around Australia. Gribbles group had multiple scattered laboratories which did not carry out a full range of tests so benefited less. Reports indicate that they became a second tier provider and eventually came unstuck.

Jan 2002 Centralising laboratories

Automation, however, lends itself well to pathology. Effectively the unitary processing fee is the same whether a sample is examined manually as if it is one of a batch of 100 processed automatically. As a result, the Commonwealth Government and the Association of Pathology have set price and volume quotas to regulate the industry. Because volume growth per practice is limited to 5 per cent per annum, acquisition, automation and networking are the main earnings multipliers.

Pathology also lends itself well to a satellitic operating structure where a centralised lab supports numerous sample collecting outlets over a broad geographic region. What's more, the increased emphasis on cervical cancer and diabetes in the May Federal Budget should increase overall levels of pathological testing.
Predators And Prey : Gribbles in a healthy position Shares Magazine January 1, 2002

Mar 2004 Sonic's success

Diagnostic testing company Sonic has consistently delivered better margins than market rivals such as Gribbles Group , Mayne Group and MIA Group .
Consistent Performers Humming Along Australian Financial Review March 17, 2004

Aug 2000 Looking at the market's potential

What has brought about corporatisation of the pathology industry? Diagnostic testing generally has enormous potential for growth as the population ages and new technology enables more sophisticated tests, which doctors say will help in the diagnosis and treatment of illness. Increasing litigation means that doctors are likely to request more tests to protect themselves against allegations of inadequate care. With the genetics field opening up, pathologists have an increasing range of DNA and other genetically based tests, which will add new dimensions to the business.
Sonic's Boom Comes At A Cost, Business Review Weekly August 18, 2000



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Radiology in contrast is people intensive. Trained staff must operate the machines and they need oversight by radiologists. The images need skilled interpretation and the reports are not generated automatically. To get the referrals the machines must be taken to the referring doctors and their patients. The most expensive and less routinely used are usually centralised. As a consequence machines and staff are located in multiple hospitals and medical centres. As a consequence the corporatisation of radiology lagged behind that of pathology.

Dec 2000 Radiology lags behind

The trend towards listed players buying up smaller practices is mirrored in the pathology sector. Radiology is not as yet as such an advanced stage of rationalisation.
MARGIN CALL : Radiology raid ONE to watch The Australian December 1, 2000

May 2001 The companies buying radiology

Listed companies that are actively buying radiology and pathology practices include Mayne (formerly Mayne Nickless), Sonic Healthcare and Medical Care Services. The investment group DCA owns I-Med group, which on May 1 bought a radiology practice with three clinics in Queensland, adding to three other deals with radiology groups in March. Sonic announced a merger with a Queensland radiology group in March.
Taft Joins A Bigger Picture Business Review Weekly May 11, 2001

Jun 2001 Radiology compared with pathology

Macintosh (from MIA) admits that consolidating radiology practices does not reduce costs as much as in the pathology sector. Pathology labs can be automated, but radiology is a hands-on business that requires individual doctors to conduct and analyse the tests.

However, he says consolidation brings other benefits. In a business that relies on expensive technology with defined life expectancies, good management of capital expenditure and efficient use of equipment are vital. In the December half-year, MIA's capital expenditure was $7.5 million (nearly 8% of sales) and depreciation was $6 million. Macintosh says that the centralising of administration, IT and equipment purchases brings efficiencies to the group. It has recently bought software to centralise patient booking.
The Uncanny X-ray Men Business Review Weekly June 22, 2001



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Referral patterns. Fees in both radiology and pathology are set by government and overall standards are generally good. Referral of work is consequently mainly geographic to the nearest or most convenient centre - ie in the same centre or hospital. It is simply not practical to have more than one spacious radiology or pathology unit in a hospital or clinic although this can happen with pathology collection centres.

While there is much talk of competition this is primarily related to securing advantageous geographic locations, size and leverage, as well as maintaining the sort of relationships with doctors which keeps their business, and controversially might encourage increased usage. Kickbacks have been a particular problem in pathology. Person to person referrals have become less common. Companies have varied in their success in securing GP referrals to their laboratories. Primary Healthcare has been particularly successful.

Jul 2004 Primary Health's successful model

The Model
The PRY model is similar to a shopping centre business model. PRY provides a centralised medical centre for GP's to operate in. The GP's like retail tenants are charged a fee of 45 to 50% of gross revenue for operating in the facility. Other services are charged at a fixed rental fee. The leverage for PRY is to increase attendances and generate repeat visits. GP's cannot be financially induced to refer patients to internal partner service providers.

The pairing of GP facilities with related services such as pathology and radiology in the same building fosters such relationships. The convenience of in house services and connectivity of computer systems insures the majority of referral business is in house. The medical centres are run 24 hours a day, every day, offering bulk billing facilities with a policy of not giving medical test results over the phone. A patient who receives a blood test requires two visits to the GP, the first to get a referral for a blood test and the second to receive the results effectively increasing the level of billable attendances. The strategy is to lease buildings then spend $3 to $5m in converting to a medical centre which once fully operational aim to be cash flow positive within 6 to 12 months.
PRIMARY HEALTHCARE (PRY) $5.70 Smaller Companies Guide July 7, 2004


 
 

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Integrating with Referring Doctors
Avoiding Competition

There are clearly many benefits for the patient and for the health system from integrating multiple health services. The problem with integration by corporate for profit companies is that it is integration for the benefit of the shareholder rather than the patient and the system. The two interests are often very different.

The object of integrating pathology and radiology with referring doctors is to obtain their custom. If we are to adopt the sort of market principles advocated by the coalition government in 1996 or the model advocated by Graeme Samuel in 2000 then the diagnostic companies should be competing for referrals from GPs on a level and strictly regulated playing field based on the quality of service and its cost. Integrating these generaol practice services with them is essentially anti-competitive. The claimed benefits of competition will not be recognised.

It is not that the integration model is bad but that the self interested competitive framework within which integration is placed is inappropriate and dysfunctional for the health system - something which by its very nature is cooperative and humanitarian.

Integration is a profitable way of playing pass the parcel and so squeezing and stripping off as much profit from each patient parcel as possible. Work can be directed to team players - ie. those who follow practices which are profitable for the company.

These are not always the best clinicians. They can be problem doctors and even incompetent. The company typically promotes them to the public and protects them from their critics. Profitability rather than clinical competence becomes the basis for status and credibility. Spectacular examples like the unnecessary hospitalisation of large numbers of normal children and bypass surgery on normal hearts are likely to be symptomatic of a broader problem across the corporate health care sector.

Mar 2002 Opportunities to pass the parcel

Market players Mayne and Primary both follow a more vertically integrated model, where revenue is earned at each stage of a patient's treatment.

"Primary's model is a bit more vertically integrated. They do their own pathology, radiology and earn revenue through the whole process," Mr Suleski said.
Foundation rebuilds WA Business News March 21, 2002


Integration for profitability provides endless opportunities for coercing or tempting doctors to play the game - and put the interests of the company ahead of those of their patients. A policy of integration has been a key part of the success of many US health care corporations. Allegations of business arrangements which when they were uncovered were considered to be kickbacks to doctors have formed a significant component of almost all US fraud settlements.

Corporate for profit integration has consequently not worked well or consistently for patients or the health system - nor surprisingly financially for many companies in Australia. Those who have concentrated on one or two core businesses have done better. Integration for the benefits of patients and the health system is almost impossible within a corporate context as the paradigms within which the two patterns of integration operate are contradictory.

In the 1980’s and 1990s kickbacks of borderline legality to referring doctors were a major problem in pathology in Australia. Sustained regulatory pressure and a lack of support by the majority of the pathology profession resulted in most of those responsible going out of business. Instead pathology and general practice groups have adopted a policy of owning the doctors. They have integrated the services to which doctors refer their patients and which the company owns into the doctors work environment.

General practitioners act as gatekeepers and control the referral to all other services. Once they are located in corporate owned centres strategies can be developed to induce them to use those services exclusively and maximally.

Sep 2000 Reason's for GP corporatisation

If general practitioners are not great profit makers in their own right, their purchasing power is considerable. Under the current Federal Government model, general practitioners are the gatekeepers of the medical system and directly control the buying of specialist services.

"The required returns for the investor must therefore come from the centre tenants, from negotiated arrangements with other service suppliers and/or cross-subsidies from other businesses (for example, pathology and radiology) owned partially or wholly by the investor," KPMG said.
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If a medical centre has, for example, 10 full-time general practitioners, each generating $200,000 of Medicare income a year, they are also generating on average $3.2 million a year in downstream specialist billings. If a substantial part of that is picked up by businesses or specialists who work in the same corporate group, it is a good income stream.
Corporate Medicine Business Review Weekly September 29, 2000

Oct 2001 More about reasons and Foundation Health care

The main reason general practices have been bought by companies such as Foundation is their powerful role in the health system. General practitioners are the gatekeepers who control the purchasing of lucrative downstream health services, including pathology, radiology and other specialist treatments. According to a report by the accounting and consulting group KPMG last year, for every $1 in Medicare revenue paid into a general practice, the practitioner is writing out $1.60 in referrals. If Foundation earns $80 million a year in Medicare revenue, in theory, it is recording about $128 million in specialist medical services. The founder and biggest shareholder of Foundation is Michael Boyd, who is also the biggest shareholder in the pathology and radiology company Sonic Healthcare. Sonic owns 10% of Foundation.
Health's Changing Landscape Business Review Weekly October 25, 2001


One strand has been the ownership of general practices by Diagnostic groups. Another has been the ownership of laboratories, diagnostic services, as well as other ancillary services by general practice companies. In each instance the objective has been to secure the allegiance and the referrals from the general practitioners as well as profit from those referrals. General practice is person and time expensive and is seldom profitable itself.

While paying doctors kickbacks for referrals is illegal, geographic positioning is legal and is very effective in securing referrals. All of the integrated groups have built medical centres in which the general practitioners practice and which specialists visit to consult. In the same building are housed the company's radiology, pathology, physiotherapy and multiple other services which the patients or their doctors might be induced to utilise. If they do not own a service they can profitably let space to pharmacies and other groups with which they are associated and who benefit from the location.

Pathology and radiology group Sonic Healthcare was ethically opposed to owning General Practices and so competing with other general practices which referred to them. They were faced with a dilemma. If they failed to buy up General Practices then competitors would buy the doctors on whose referrals they depended and they would lose business.

Sonic resolved this problem when their major shareholder and founder, Michael Boyd, set up a separate company Foundation Healthcare in which Sonic had only a 10% holding. They made an arrangement which gave Sonic exclusive rights in Foundation’s medical centres. This was essentially deceptive as the profits from the referrals went to profitable Sonic while Foundation itself struggled. Sonic was forced to prop up the company and then buy it when a competitor launched a takeover bid. Foundation was profitable for Sonic but not to its other share holders.

There is a long tradition of owning and running general practices as a corporate business. This goes back to controversial medical entrepreneurs, Edelsten and McGoldrick in the 1980s, and to Primary Healthcare in the 1980s and 1990s. It was only in 2000 that the market enthusiasm for wringing profits from general practice and its referrals exploded. By the end of 2002 the bubble had burst. The press extracts give the flavour of what happened.

May 2000 Edelsten's views

One person who clearly understands corporatisation is medical entrepreneur Dr Geoffrey Edelsten, who reportedly told BRW last year: "The success of Ed Bateman's Primary Health Care has demonstrated the enormous economies of scale that can be reaped by merging solo practices ... If you can then vertically integrate it with pathology and radiology and visiting specialists, and have day-care and in-patient care hospital facilities, then the profitability is extraordinary.''
Big Business Targets GPs In National Buying Spree Australian Financial Review May 23, 2000

May 2000 Vertical integration

Under the vertically integrated structures rapidly being set up by companies across Australia, GPs and the services they refer to, such as pathology or radiology, are being aggregated under the one corporate roof. An obvious concern is that there may be pressure to refer patients to in-house services, potentially impinging on doctors' autonomy and perhaps draining money from Medicare.
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If Sonic stays exclusively in pathology, increasing numbers of the doctors who refer to it will be bought out by other corporates, such as Ed Bateman's Primary Health Care, buying up both medical centres and pathology companies. In an interview with the AFR, Goldschmidt (Sonic’s CEO) was extremely candid about his company's dilemma.
Owning The Whole Kit And Caboodle Australian Financial Review May 24, 2000

Aug 2000 Response when Foundation's claim to independence was challenged

"We are talking about fully integrated medical centres so they will have supporting them pharmacy, radiology, pathology and physiotherapy.''

Jones says that Foundation has "developed an alliance'' with Sonic to provide pathology services to patients at the centres.

"We don't have a commercial interest in Sonic and we don't achieve a commercial reward by our patients' use of Sonic,'' he says.

But questioned about Sonic's 10 per cent ownership of Foundation, Jones said: ``[Foundation] as a general practice provider don't have an investment in Sonic, so we receive nothing back from pathology providers.''

Asked if Boyd was a major investor in both Sonic and Foundation, he said: "He is, yes. He is a passive investor in Sonic.''
GPs Inc - Profits Or Patients Sydney Morning Herald August 10, 2000

Aug 2000 The consequence of geography and owning shares

Pathology companies compete on service, not price, and increasing the share of business you do is based on providing a quality service."

Making this more difficult is the recent trend to integration in the health sector. General practitioners order 70% of all pathology paid for by Medicare. But in the past 12-18 months, entrepreneurial health groups have been buying general practices, bringing the doctors into a corporate structure that includes a pathology business. Although the general practitioners can, in principle, send their pathology tests wherever they like, in practice they will mostly use the pathologist that is linked with their company.
Sonic's Boom Comes At A Cost, Business Review Weekly August 18, 2000

Oct 2000 A dramatic development

By far the most dramatic development is the recent growth of medical empires that have brought in general practitioners, pathology, radiology and other specialty services under the one corporate umbrella.
The Painful Opt-out Option Australian Financial Review October 11, 2000

2001 Another reason for corporatising

Another force is the race for scale economies. With continuing cuts in federal government rebates on pathology and imaging, some health care companies are seeking to lock in revenues for their pathology and imaging laboratories by owning a group of in-house referring doctors.
Health Risks For Packer And Smedley Australian Financial Review March 10, 2001

Apr 2001 General Practice corps hungry to buy diagnostic services

Nor are they making any secret of their hunger to acquire lucrative diagnostic businesses; the pathology labs, X-ray and imaging centres that rake in another $2.5billion a year, mostly through referrals from local doctors.
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Endeavour has investments in general practice, pathology, X-ray, occupational health and medicine in NSW, Victoria, SA and WA.
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Medical Care Services: Perth-based public company providing a back-door listing for Gribbles Pathology Group. MCS subsidiary Total Care Services has 15 general practice medical centres in Perth and its own radiology assets.
Medical Corporates Sing A Siren Song To Harassed Doctors The Age April 7, 2001

Jun 2001 The recipe for success

Primary Healthcare has been doing this for about 15 years and has become a sharemarket favourite because of its success in getting GPs and their patients under its banner and then selling them a huge range of services - everything from psychiatry and dermatology to dentists and plastic surgeons. It's the ultimate one-stop-shop model.
Firms fight for $2.7bn in doctors' fees The Weekend Australian June 16, 2001

Jun 2001 Some see this as managed care

With 75 per cent of the pathology industry and 40 per cent of the radiology sector in corporate hands -- not to mention 15 per cent of GPs nationwide now working within corporate structures -- some say it's only a matter of joining the dots to see managed care working here.
Script for a profit; The Weekend Australian June 23, 2001,

Nov 2001 Corporate response to criticisms

Michael Boyd dismissed Deeble's (architect of Australia's Medicare system) concerns about the pathology industry, saying the world was a vastly different place from when Medibank was set up in the 1970s. "Nowadays, people want convenience ... and the one-stop shop for medicine and health services,'' he says.
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In Boyd's case, pathology giant Sonic has formed a strategic alliance with another Boyd company called Foundation, which has almost 1,000 GPs under its corporate roof and is currently putting together medical centres across Australia.
The Rise And Rise Of Medicare Millionaires Australian Financial Review November 20, 2001


As in the USA the enthusiasm for general practice corporatisation soon came unstuck. Only Primary Healthcare was profitable for its shareholders and it went from strength to strength. The reasons for this are not clear to me. All of the others stopped buying general practices in 2002 and were soon running at a loss or just breaking even. After a period of consolidation they were either closed, sold to Primary or Foundation, or kept by a pathology company for their referrals. Sonic later purchased Foundation.

Pathology and Radiology remain very profitable.

Mar 2004 Unable to sell GP businesses

Gribbles had been searching for a buyer for the loss-making division (General Practice) for months and the sale capped its attempt to create a vertically integrated health company.
Primary A Picture Of Good Health Australian Financial Review March 5, 2004


 
 

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Over-servicing

With so much pressure directed towards profitability it seems likely that there would be over-servicing. Concerns about this go back many years and have increased since corporatisation. Kickbacks are sometimes blamed. Gribbles and Macquarie Health are the two most often accused but they have denied this and have never been convicted. This is very difficult to quantify because of the complexity of the tests and the many and varied reasons for performing them. There are other pressures such as fear of litigation. While there has been and still is anxiety about this, little hard evidence is available.

There are currently increasing concerns that the corporatisation of GP's is increasing overservicing.

Jul 1994 Kickbacks and overservicing

But one pathologist last week estimated that up to two thirds of high ordering was "induced'' - by a range of bribes and kickbacks to doctors. He said HIC figures showed that about 14 doctors a week "are being seduced, or encouraged or are naturally falling into becoming high ordering'' - that is, ordering more than $10,000 of tests per quarter.

Many of these doctors tended to cluster around certain pathology laboratories, he said. One practice allegedly got 87 per cent of its work from high-ordering GPs.
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HIC figures, based on audits of all Australian GPs and laboratories, show that in some cases, when doctors switched to an unethical pathology lab, their test bills rose to three or five times their previous levels.
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In October 1991, the HIC began its "feedback strategy'', sending letters to every GP in Australia, outlining the level of their pathology ordering. The strategy - with follow-up letters every three months - had an immediate effect of slashing referrals by high ordering GPs - from $61.5million in the second quarter of 1991 to $42million in the second quarter of last year.
Bleeding The System Sunday Age July 31, 1994

Nov 2004 There is increasing utilisation for many reasons

With payments for pathology and radiology up sharply, the big beneficiaries of this increased spending are the listed pathology and radiology companies, including Mayne, Sonic Healthcare, DCA Group and Gribbles Group, which is now the subject of a take-over bid by Healthscope.
Medicare cuts an artery Business Review Weekly November 11, 2004

Jan 2006 Signs that GP corporatisation results in overservicing - hardly surprising

THE Medicare watchdog, Tony Webber, is concerned that big medical centres have the potential to exploit Medicare's $9 billion a year in benefit payouts.

Evidence is emerging that doctors working for corporatised medical chains have geared their software and patient management systems to maximise returns from Medicare. There is evidence that some of their services, including pathology and radiology, are "inappropriate", he says.
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Dr Webber said it appeared that medical centres were automatically initiating regular "health assessments" for patients over the age of 75, whether or not they were needed. The Medicare benefit for this service is $232.
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"My concern is that where corporate medicine is having a strong influence on doctors, it raises suspicions that there is a lot of [Medicare] money potentially being wasted," he said. "Medicare benefits are not designed to give a doctor a reasonable income and give corporates a 20 per cent return on investment without compromise to standards of care.
Watchdog sees signs of overservicing Sydney Morning Herald January 12, 2006


 
 

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Medicare Payment and Medicare Millionaires

The vast bulk of the funding for doctors' consultations, imaging and laboratory testing comes from Medicare. This is a steady gravy train for the corporations, but there is always the danger that government may exercise its power to reduce fees. If companies are too greedy it will do so. Government’s ability to do so effectively is limited. Its weakness is that it has no choice but to fund these services. It can reduce funding for a while but is soon put under pressure. The voting public will be vocal if services are compromised and corporations are adept at exploiting this pressure point.

Entrepreneurs looking for opportunity have not been slow to recognise the potential of this system of funding and there are now a number of Medicare Millionaires. With wealth has come credibility and influence. The percentage of funding from Medicare has increased steadily over the last 20 years. It was estimated in 2001 that up to 90% of funding for GP, pathology and radiology services came from the taxpayer.

Oct 2001 Medicare income

Listed medical companies receive a big part of their income from Medicare benefits. An estimated 75% of the $1.2 billion the Government paid in Medicare pathology benefits last year, and an estimated 60% of the $1.2 billion for radiology work, went to corporatised medical practices. In addition, about 10% of the $2.3 billion in Medicare benefits paid to general practitioners went to companies that were listed or were planning to be listed. Overall, at least 25% of the $7.5 billion-plus that will be paid in Medicare benefits this year will go to listed companies.
Health's Changing Landscape Business Review Weekly October 25, 2001


A new breed of medical entrepreneur is quietly becoming extremely influential and wealthy, with three Australian health-care businessmen now worth more than $100 million each.
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Shy Perth accountant Michael Boyd now boasts more than $200 million through holdings in the giant Sonic Healthcare, which like all pathology companies has its revenue underwritten by growing Medicare referrals from local GPs.

Similarly, Melbourne barrister Wallace Cameron controls a $150 million stake in Gribbles Group, another highly profitable national pathology company.

In Sydney, the family interests of Dr Edmund Bateman amount to more than $110 million through his share of the medical centre and pathology business Primary Health Care.

With all three, personal fortune has come through a major holding in a listed health-care company that relies on Medicare for the bulk of its revenue.
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A recent report from brokers Burdett Buckeridge Young entitled "Making a Living From Medicare'' suggests the $55 billion Australian health-care system provides "revenue certainty'' and "comfort for investors''. It says that up to 90 per cent of pathology and general practice revenue flows from taxpayer dollars.

Medicare architect Professor John Deeble says that when universal health insurance was set up in Australia in the 1970s, large medical corporations did not exist. "When Medibank was introduced, pathology was still a medical practice ... now it's nothing like that. The regulation of this sector must change. Medical corporates must be treated as businesses, not as medical practices.''

- - - - - - - - - Deeble is concerned that despite the recently introduced caps, now extended to radiology as well, the costs of diagnostic services are out of control. In his view, "owning a pathology business has been a licence to print money''.
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As with pathology and radiology, most general practice revenue comes straight from the public purse. From its inception, Medicare has strongly subsidised the private income of individual doctors. But since the late 1990s, it has been increasingly subsidising shareholder returns as well.
The Rise And Rise Of Medicare Millionaires Australian Financial Review November 20, 2001

Apr 2004 Medicare pays for corporate pathology

In the case of pathology - the most highly corporatised of all the health sectors - only a few independent laboratories remain, and almost four out of every five dollars paid by Medicare for private pathology services goes to one of three public companies.
Grey Expectations Business Review Weekly April 1, 2004


One of the characteristics of health care entrepreneurs has been their supreme self confidence and their faith in the market solutions they espouse. They usually shield themselves from challenge by avoiding publicity and interviews. At the same time they have tended to drive their busineses wth a ruthless single mindedness. They can be very aggressive towards their critics threatening litigation. They have aggressively challenged regulators in the courts. Australian entrepreneurs are no different to their US counterparts and are variously described as publicity shire, private etc.

Nov 2001 Aggressive legal challenges

While personally shunning publicity, Bateman and Cameron have both been aggressive in their dealings with the health authorities. Both have been involved in extended legal tussles with government medical bodies often in cases initiated by the entrepreneurs themselves.
The Rise And Rise Of Medicare Millionaires Australian Financial Review November 20, 2001


The Australian Medical Association was concerned about corporatisation, particularly of General Practice. They were vigorously attacked and criticised when they resisted political and corporate pressures. When they criticised corporate practices libel actions were commenced. As a subscription based professional organizations they simply did not have the resources to take on the industry.

The AMA attempted to negotiate and to set up a code of practice to limit the consequences of corporatisation. This was voluntary and it is worth noting that those GP corporations that signed it have not been profitable.

Aug 2000 AMA comment

"What we are worried about is ... where you have a structure with GPs feeding onto the more lucrative tertiary and secondary services, the diagnostic services like pathology and radiology ...

"I can't name the areas because we have already been successfully sued ... for criticising some of them.''
GPs Inc - Profits Or Patients Sydney Morning Herald August 10, 2000


 
 

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Government and Corporatisation

Government Drives the Process

The process of consolidation had commenced some time before corporatisation. Because of the overheads, the need for staff, and the increasing specialisation pathology and radiology specialists had formed quite large partnerships to provide services - sometimes over a large area.

A number of medical and other entrepreneurs saw the potential for large profits from Medicare through corporate consolidation . They could raise the capital to buy practices and new equipment from the share market. Pathology was the first target and radiology followed a few years later.

As in the USA the relationship with government is ambivalent. On the one hand the steady funding and potential profitability engaged corporate enthusiasts. On the other the dependence on evanescent elected governments with unpredictable policies, and the regulatory strictures imposed to contain abuses, both caused periodic misgivings and concern.

The labour government in power during the late 1980s and early 1990s was not averse to market consolidation which promised to reduce costs. The coalition government elected in 1996 was ideologically disposed to corporatisation and went out of its way to encourage this. The system was fragmented and inefficient, needing change. Methods of accomplishing this were never fully debated n public. A corporatised market system was introduced and government applied pressure to accomplish this.

Fees for services were drastically reduced after a government review in 1985 and a cap was placed on increasing fees. Increased profitability could only come from mechanisation and the consolidation of services into large units which were maximally used. Government in effect wielded a heavy stick to drive the process of corporatisation.

The situation and the many points of view are reflected in press reports over the years.

Mar 1989 Impact of price cuts

Meanwhile, the industry claims it is still reeling from the 25 per cent cut in schedule fees and benefits for pathology in 1986.
NEW STARTER IN PATHOLOGY STAKES Australian Financial Review March 20, 1989

Aug 2000 Nevertheless a good income stream

Pathology businesses are also in the enviable position of having their main source of income underwritten by Medicare. Although the Federal Government has for some years put a cap on its pathology expenditure, it still allows for a 5% annual increase in its total pathology outlays.
Sonic's Boom Comes At A Cost, Business Review Weekly August 18, 2000

          Massage in the 21st Century        

The path of massage therapy has been long, with roots dating back thousands of years. However, the practice in Western culture and specifically in the United States is relatively young, with many miles left to evolve and transform the industry. To truly appreciate the journey of massage therapy, it’s important to take a step back in time to where massage began, as well as look ahead to where massage is going in the future of healing, relaxing and rejuvenating the American population.

Relaxation and Rejuvenation Have Ancient History

The art and science of healing with massage therapy has references in writings from China, Japan, India, Egypt, Greece and Rome. Hippocrates even wrote of the many advantages of rubbing techniques to bind and loosen joints, as well as defined medicine as “the art of rubbing."

While the popularity of massage has risen and fallen throughout the years, it is steadily increasing as a viable complementary and alternative medicine and is used in conventional settings as well. Most recently, the 2007 National Health Interview Survey estimated that 18 million U.S adults and 700,000 children had received massage therapy in the previous year. Today, Swedish massage continues to be the cornerstone of mainstream massage; however, there are various modalities practiced in the United States.

“Swedish is the foundation of all massage modalities and approaches,” says Colleen O'Connor, massage therapist and studio owner at Elements Louisville East. “We use all of the original Swedish techniques in any massage that we do, but as massage therapists we continue to evolve every day. We become better as we see new conditions and we adapt to find techniques and approaches that will help alleviate our clients’ pain and make them feel better.”

Mainstream Meets Massage

Over the last decade, O’Connor has seen the massage industry take off by leaps and bounds. In the past, many shared the attitude that massage was a luxury that people couldn’t afford or it was something that people who were in a high degree of pain used as a last resort to try to experience some relief. Today, with the emergence of retail massage and an increased knowledge from the public about the benefits of massage, its modalities and practices have become more of a widely utilized form of healthcare, relaxation and luxury that millions of people are using on a daily basis.

Some of the turning points that O’Connor attributes to the recent explosion in popularity and acceptance of massage by the American population include:

  • The weaving of traditional medicine with massage techniques. Nurses in the past and present have used the power of touch and massage in hospitals to help in healing patients. Specifically, nurses have used touch techniques in premature babies to help them thrive.
  • The on-camera presence of therapists at the Olympics. The world was exposed to the power of massage therapy when they saw Olympic athletes traveling with their therapists, as well as use massage techniques to prepare for and recover from their Olympic event.
  • The emergence of retail massage locations nationwide. More accessible massage studios have increased acceptance of massage therapy by the majority of the population as it is becoming seen as more of a necessity rather than a luxury. These locations and monthly wellness programs allow you to easily carve time out of your busy schedule to take care of yourself on a routine basis.
  • The introduction of industry licenses and therapist training. Massage has become more of a serious business over the past few years as many states require therapists to have initial and continuing education, as well as hold licenses to practice massage therapy. The industry also has added national oversight that plays an active role in defining how massage is delivered and how therapists are trained.

“There are a lot of these moments that have happened that make people realize that they can relate with using massage in their daily lives,” reflects O’Connor. “I think the acceptable images of massage therapy being embraced by the medical community and athletes have made it more mainstream.”

Benefits and Acceptance Continue to Cross Gender, Generation Lines

In our society of diminished downtime and escalating responsibilities, the need and demand for massage therapy continues to rise. The sandwich generation, in particular, is turning to massage for relief and relaxation to combat the increased responsibilities and stress associated with taking care of the people who have raised them, as well as raising their own children.

O’Connor also is seeing an influx of male clients in her studio who are golfers, heads of businesses, dads and retirees who are turning to massage to maintain their mental and physical health. And, parents are paving the way for their children to become comfortable with and appreciate the benefits of massage when they bring them in for a session to relieve repetitive motion issues from sports and other activities.

“In the next five to 10 years, I foresee more people in the future who will start looking at massage not as an alternative medicine or last resort, but as a way to take care of themselves as they progress through their life,” O’Connor said.

The evolution of massage continues to move forward at a rapid pace as the mental and physical benefits of the practice become more accepted among the American public. Take a total mind and body approach to health and wellness by including the power of massage therapy into your way of life.


          2017 NFL Pro Bowl Concussion Symposium and Health Screening        
The 2017 NFL Pro Bowl is a tradition that stems back to its inception in 1938. While the teams have changed drastically since then, the NFL Pro Bowl has become a tradition of competitive fun and entertainment for players, NFL front offices and fans. 2017 was the first year since 1980 (minus 2009) that the game was held within the continental United States. This venue change hoped to bring more fans, more attention and enhanced exposure of the game itself.

One of the attention grabbers for me during the Pro Bowl weekend occurred off the field. This year, The University of Central Florida (UCF) hosted the 2017 Pro Bowl Concussion Symposium and Health Screening. The purpose of this symposium was two-fold. First, retired NFL players were invited to partake in health screenings for free to help identify any neurological, cardiovascular or other issues plaguing them due to their playing time in the league. Second, the NFL Players Association partnered with the UCF Psychology Department to present all of the latest research and treatment options related to concussions in the world of sports, and more specifically, the game of football.

Here are a few of the highlights:

Following the U.S. Supreme Court settlement regarding previous NFL players and head injuries, the science has gained a significant amount of traction. As new empirical data emerges and technology continues to develop, more funding is becoming available to allow athletes to have increased access to neurological assessment and professional evaluation following head trauma. Interestingly, the Supreme Court settlement included a 65-year plan that will give retired NFL players and their families financial support if they experience symptoms of amyotrophic lateral sclerosis (ALS), dementia or any other life-altering behaviors or symptoms that may arise secondary to traumatic brain injury.

Furthermore, baseline testing is being made available to all retired NFL players and will be done immediately upon retirement. This will allow the players’ medical teams to identify any behavioral, cognitive or neurological changes that may arise over the remainder of the individual’s life.

The overarching goal is to have every college, high school and middle school offer some form of baseline testing in at least one sport for all student athletes. We are slowly, but surely, making our way towards that goal. However, there still remains room for improvement when it comes to baseline testing.

The areas of deficiency that were identified was a lack of baseline testing within recreational sports and ease of administration within middle schools and high schools. If we want to ensure the safety of all athletes, we must do what we can to have concussion education, a concussion protocol and return to play protocol in place.

At the academic levels, we must also ensure that we have a return to learn protocol in place. The question that acts as a defense for medical professionals responsible for the return to play decision is, “If you cannot learn new information, should you be returning to play?”

Emerging Technology

To this point, there are 2 questions that remain: 1) How do we diagnose Chronic Traumatic Encephalopathy prior to death, and 2) How do we avoid the high cost of imaging when it comes to concussion diagnostics?

There is by no means an answer to the first question as of yet, but I am hopeful due to the emergence of Diffuse Tensor Imaging (DTI). DTI has been around for roughly 20 years and has been mainly used in the diagnosis of strokes and other ischemic disorders of the brain.1 Within the past 10 years, research has shown that DTI can also be used to assess the integrity of the white matter in the brain.2 The goal of physicians at the symposium was to make DTI more streamlined and allow patients access to this form of diagnostic following head trauma.

In the image below, the varying colors represent the orientation of various white matter within the brain. In the second image, neurological specialists have the ability to zoom in on a specific location and can visualize a physical abnormality or disruption in neuronal activation due to a disturbance in neuronal integrity.


Images Obtained from Journal of Neuroradiology

So how do we lower the cost of imaging?

We start by locating private medical companies that offer this type of imaging. There were several speakers at the symposium who owned businesses that focused on the neurological diagnosis and treatment of individuals who suffered traumatic head injuries. The businesses offer consultations and diagnostics at a fraction of the cost of normal imagining techniques.

Cognitive and Behavioral Effects of Head Trauma

Neuropsychologists want to make one thing very clear to all health practitioners: There is no such thing as the average TBI patient. While there are several concussion treatment protocols, it is paramount that each case be treated on an individual basis according to the needs of the patient and the underlying symptoms present. Cognitive changes following head trauma occur on a varying spectrum, and can include, but are not limited to: changes in vigilance, reaction time, mental tracking, verbal retrieval, mood and information processing.

Common symptoms that can be seen are the emergence of anxiety, depression, inability to focus and difficulty sleeping. Each symptom can lead to frustration, impatience and social disconnect. There is one congruity with all of these cognitive and behavioral changes: a concussion is a physiologic injury of the brain, where normal cerebral flow has been altered and the normal “algorithm” of information input and output has been compromised.

Unfortunately, head injuries cannot be cured; however, there is hope for individuals seeking refuge from this life-alerting injury. There are many clinics that exist, such as the UCF Psychology Clinic that can help patients learn to cope with the inhibiting effects of head trauma. Treatments include consultations with neuropsychologists, who walk patients through cognitive rehabilitative exercises and various forms of talk therapy. These treatments can help an individual compensate for the mental, emotional or physical deficiency that has arisen. The goal of treatment is to help the individual learn how to live within this new reality, and how to improve their overall quality of life.

The central message of the symposium is concussion research and concussion management are constantly changing. Unfortunately, policy change happens at an even slower rate. Due to this constant evolution, this is a topic All medical, fitness and cognitive specialists need to stay up to date on this topic due emerging information and the constant evolution of the topic. This can be accomplished by staying up to date on the latest research and emerging trends, in order to be able to follow “best practices” and avoid liability.

Resources

1. Hagmann, P., Jonasson, L., Maeder, P., Thiran, J. P., Wedeen, V. J., & Meuli, R. (2006). Understanding diffusion MR imaging techniques: from scalar diffusion-weighted imaging to diffusion tensor imaging and beyond 1. Radiographics, 26(suppl_1), S205-S223.

2. Le Bihan, D., Urayama, S. I., Aso, T., Hanakawa, T., & Fukuyama, H. (2006). Direct and fast detection of neuronal activation in the human brain with diffusion MRI. Proceedings of the National Academy of Sciences, 103(21), 8263-8268.

3. Rutgers, D. R., Toulgoat, F., Cazejust, J., Fillard, P., Lasjaunias, P., & Ducreux, D. (2008). White matter abnormalities in mild traumatic brain injury: a diffusion tensor imaging study. American Journal of Neuroradiology, 29(3), 514-519.


          Black Ops Hypnosis Try Admirable And Intriguing Alternative Health        
Complimentary health has been around for thousands of years. Regions around India and China show been using complimentary health techniques these as visualization and energy transfer for thousands of years. The practice of acupuncture has long been one of the leading forms of alternative health, but has come into mainstream use within the medical community in the last 20 years. While greater forms of alternative medicine are not endorsed by legions medical associations, some locations like famed Britain and the United States repeatedly have complimentary medicine specialists residing in practice with more traditional and mainstream disciplines.




Ayurveda is viewed as an complimentary health because it doesn't rely on science or doctors. Notwithstanding, in India where it originated, it's viewed as a convention of life. It treats not just one disorder, but also the entire body. Followers believe that the body is made of five divergent sectors, and each ailment or disorder is related to one of those areas.

Naturopathy is a category of alternative health that puts the focus on the body and its capabilities. Followers believe that every human being has the ability to heal themselves from diseases and conditions. They believe that focusing the body's zest and taking certain herbs will cure any disease.




Like legions other forms of complimentary medicine, Traditional Chinese Medicine focuses on using herbs and meditation as the main form of treatment. Multitudinous traditional Chinese shops in urban centres keep medicinal solutions on hand, since Traditional Chinese Medicine is so prevalent in primarily Chinese urban centres. Multitudinous Chinese immigrants prefer the traditional remedies over more scientifically proven cures. One of the larger widespread and mainstream forms of Traditional Chinese Medicinal cures is Acupuncture. Acupuncture practitioners believe that the body's ailments are caused primarily by imbalances in the body's go flow, and the specially dreamt up needles used by Acupuncturists are created to release and redirect blocked efficacy channels, leading to a identified decrease in symptoms.




Chinese and Indian traditions are a mammoth part of alternative medicine, but there are other treatments and therapy that are highly regarded nowadays. Yoga is the art of exercising utmost personal and mental discipline, which will surely help your daily lives. Chiropractic therapy approaches health and wellness through massage and body comfort. Hypnosis is another form of therapy that focuses on controlling our minds to motivate ourselves to adopt a healthier lifestyle.



Legions say that the scepticism and the argument against complimentary medicine are getting thinner by the day. The extensive opponents of alternative medicine are career practitioners of western medicine. Numerous professionals suggest that alternative medicines are sufficient only as a supplementary treatment. In addition, legions say that complimentary health is loosely regulated compared to modernized western medicine, and that there are no standards or protocols to protect folk when something goes wrong. Better complimentary medicine treatments show no therapeutic claim.

Sceptics of alternative medicine believe that not everyone should be qualified to practice without certified training. The call for more regulations has hounded proponents of alternative health in the old lang syne. In spite of, more and more disciplines of alternative medicines are organised and institutionalised in the U.K., Europe, and the United States.



It's unknown whether alternative medicine practices will ever be accepted by the medical community as a whole. Legions physicians won't offer referrals to complimentary medicine practitioners, even as a supplement to their own treatments. As a culminate, legions humans in the Western world don't access complimentary health treatments as readily as those in other parts of the world. Insurance providers again and again won't cover alternative medicine, even though the NHS has a number of hospitals with a homeopathic focus.


black ops hypnosis: covert hypnosis

black ops hypnosis: covert hypnosis


          The elusive “potential” of integrative medicine        
  UPDATE: Dr. Katz has responded to this post in his usual venue, The Huffington Post. Alternative medicine was all about “potential” from the get go: In 1991, the Senate Appropriations Committee responsible for funding the National Institutes of Health (NIH) declared itself “not satisfied that the conventional medical community as symbolized at the NIH has fully explored the potential that exists in […]
          Getting Real        
With just over two weeks until the big day, I am starting to feel it sinking in. I just got another call for more preop testing. The next two weeks will be busy. I have two different appointments on the morning of June 4. Both in the same medical complex. I think with all the testing it is really hitting home that this is happening! I am so ready, I feel the anxiety of excitement setting in. I can hardly believe the ways that my life is going to change so dramatically!

So what is going to happen at these appointments? To be honest I'm not 100% sure. I know I need to bring my ID, insurance card, and list of medications. I know we will be going over my pre-op and post op diet, and follow up appointments. I'm expecting some blood work too. Wow! I will continue to keep you posted.

I am sitting here looking at before and after photos of people who had the gastric sleeve procedure. Amazing! This is the great hope! I want to cry just thinking about it! This time next year will be very different for me. Even this time next month!

Example of woman about my age and size.


          Sciatica Symptoms, Causes, Treatments        

Back pain is one of the most common conditions that people suffer from today. But, when you’re talking about experiencing sciatica pain that shoots from your lower back into your glute area and legs, it can be difficult to sit, stand and move around to accomplish your daily tasks. Sciatica pain is becoming so well known that studies show up to 43 percent of people experience this painful condition at some point in their lives. (http://www.massagetherapy.com/articles/index.php/article_id/2064/Assessing-Sciatic-Pain) If you suffer from excruciating pain in your lower back and body area, it’s important to identify the symptoms and causes of your condition so that you can take the appropriate path to treatment. 

Sciatica or Piriformis Syndrome: The Symptoms May Be Similar

The sciatic nerve is the largest nerve in the body that starts in the lower back and runs down both legs. Sciatica pain occurs as the result of a spine or disc condition that compresses part of the nerve, causing inflammation, extreme pain and even numbness from the low back down throughout the leg. The most common symptoms of sciatica pain include weakness, numbness and tingling in the low back that radiates down the side of one of your legs. The pain is rarely experienced in both legs and it’s described as a sharp, shooting type of pain, explains Edi Woods, massage therapist at Elements Indianapolis North.

While many people seek relief from sciatica pain symptoms as described above, many may actually be suffering more from a muscular issue, rather than a true sciatic nerve condition. In Woods’ experience, the muscular condition of piriformis syndrome is often more common in people, but may not always be accurately detected, as it can compress the sciatic nerve and imitate pain similar to sciatica.

“I see clients with sciatica-like symptoms frequently in my practice”, explains Woods. “But, from a muscular standard it’s usually more of a piriformis muscle issue than true sciatica. The piriformis muscle is one of our deep lateral hip rotators that extend into the glute area. It can get inflamed, contracted and can compress the sciatic nerve as well. When this happens, it mimics the sciatica condition, which people are more commonly aware of. So, a lot of people may come in saying they have sciatica, but in reality more times than not it’s piriformis syndrome.”

Causes Range from Health Conditions to Activity Induced

True sciatica pain can happen to anyone since any of us can develop a disc disorder like herniation or degeneration. The cause in these long-term conditions could be hereditary or the result of a lifestyle event like an accident or injury that creates prolonged compression on the sciatic nerve. Pregnant women also have a tendency to develop a temporary sciatica condition as the weight from carrying a baby either pinches or puts extra pressure on the sciatic nerve.

But, for the majority of the people that Woods treats who seek relief from what they call sciatica pain, the cause tends to be muscle overuse from runners, walkers, cyclists, etc. who push their bodies through a constant forward leg motion. When this happens, a trigger point develops in the piriformis muscles, which can compress on the sciatic nerve and cause similar sciatica-type symptoms.

“When I have clients who are coming to me with sciatica-type symptoms, I don’t treat the nerves, but rather the muscles that are compressing on the nerve,” explains Woods. “To work on someone with sciatica symptoms, I’m going to first focus on the piriformis muscles, which are located in the middle of each glute, and then move on to the gluteus muscles, hamstrings and sacrum. I prefer to use a mix of trigger point therapy and a stretching routine in all of these areas because everything is connected and pulling on each other.”

Alternative Treatments May Help with Addressing Pain

Since true sciatica is typically the result of a herniated or degenerative disc, the medical community recommends surgery as the number one way to remedy the condition, says Woods. However, there are other ways to address the pain before you get to the surgical table. Woods suggests a mix of heat, ice, pain medications, physical therapy, stretching and regular massage therapy as possible alternative solutions to help alleviate the pain associated with both sciatica and piriformis syndrome. And, contrary to what you might expect, Woods also advises her clients suffering from sciatica symptoms to stay active, continue exercising and stretching. If you stop all activity, the area is more prone to locking up muscularly, compressing on the nerve more and increasing your level of discomfort.

“A lot of people think that they have to have surgery right away if they feel sciatica-type symptoms,” explains Woods. “But, what they’re feeling could actually just be the result of tight piriformis muscles that can be treated by massage therapy sessions that focus on the glutes and lower back areas. Their symptoms can be relieved and they won’t have to have surgery.”

“It’s important for people to realize that sciatica symptoms are something that can be treated with massage in cases when the cause isn’t really a disc issue, but is rather tight piriformis muscles,” concludes Wood.

If you’re experiencing sciatica-like symptoms in your lower back and glute areas, seek the advice of a medical professional to determine whether your symptoms are true sciatica or piriformis syndrome. In both cases, massage therapy can help alleviate pain in both the long-term and short-term. Just realize that you have options when it comes to treatment and make sure to explore all possible diagnosis and treatment plans, advises Woods. 


          Massage in the 21st Century        

The path of massage therapy has been long, with roots dating back thousands of years. However, the practice in Western culture and specifically in the United States is relatively young, with many miles left to evolve and transform the industry. To truly appreciate the journey of massage therapy, it’s important to take a step back in time to where massage began, as well as look ahead to where massage is going in the future of healing, relaxing and rejuvenating the American population.

Relaxation and Rejuvenation Have Ancient History

The art and science of healing with massage therapy has references in writings from China, Japan, India, Egypt, Greece and Rome. Hippocrates even wrote of the many advantages of rubbing techniques to bind and loosen joints, as well as defined medicine as “the art of rubbing."

While the popularity of massage has risen and fallen throughout the years, it is steadily increasing as a viable complementary and alternative medicine and is used in conventional settings as well. Most recently, the 2007 National Health Interview Survey estimated that 18 million U.S adults and 700,000 children had received massage therapy in the previous year. Today, Swedish massage continues to be the cornerstone of mainstream massage; however, there are various modalities practiced in the United States.

“Swedish is the foundation of all massage modalities and approaches,” says Colleen O'Connor, massage therapist and studio owner at Elements Louisville East. “We use all of the original Swedish techniques in any massage that we do, but as massage therapists we continue to evolve every day. We become better as we see new conditions and we adapt to find techniques and approaches that will help alleviate our clients’ pain and make them feel better.”

Mainstream Meets Massage

Over the last decade, O’Connor has seen the massage industry take off by leaps and bounds. In the past, many shared the attitude that massage was a luxury that people couldn’t afford or it was something that people who were in a high degree of pain used as a last resort to try to experience some relief. Today, with the emergence of retail massage and an increased knowledge from the public about the benefits of massage, its modalities and practices have become more of a widely utilized form of healthcare, relaxation and luxury that millions of people are using on a daily basis.

Some of the turning points that O’Connor attributes to the recent explosion in popularity and acceptance of massage by the American population include:

  • The weaving of traditional medicine with massage techniques. Nurses in the past and present have used the power of touch and massage in hospitals to help in healing patients. Specifically, nurses have used touch techniques in premature babies to help them thrive.
  • The on-camera presence of therapists at the Olympics. The world was exposed to the power of massage therapy when they saw Olympic athletes traveling with their therapists, as well as use massage techniques to prepare for and recover from their Olympic event.
  • The emergence of retail massage locations nationwide. More accessible massage studios have increased acceptance of massage therapy by the majority of the population as it is becoming seen as more of a necessity rather than a luxury. These locations and monthly wellness programs allow you to easily carve time out of your busy schedule to take care of yourself on a routine basis.
  • The introduction of industry licenses and therapist training. Massage has become more of a serious business over the past few years as many states require therapists to have initial and continuing education, as well as hold licenses to practice massage therapy. The industry also has added national oversight that plays an active role in defining how massage is delivered and how therapists are trained.

“There are a lot of these moments that have happened that make people realize that they can relate with using massage in their daily lives,” reflects O’Connor. “I think the acceptable images of massage therapy being embraced by the medical community and athletes have made it more mainstream.”

Benefits and Acceptance Continue to Cross Gender, Generation Lines

In our society of diminished downtime and escalating responsibilities, the need and demand for massage therapy continues to rise. The sandwich generation, in particular, is turning to massage for relief and relaxation to combat the increased responsibilities and stress associated with taking care of the people who have raised them, as well as raising their own children.

O’Connor also is seeing an influx of male clients in her studio who are golfers, heads of businesses, dads and retirees who are turning to massage to maintain their mental and physical health. And, parents are paving the way for their children to become comfortable with and appreciate the benefits of massage when they bring them in for a session to relieve repetitive motion issues from sports and other activities.

“In the next five to 10 years, I foresee more people in the future who will start looking at massage not as an alternative medicine or last resort, but as a way to take care of themselves as they progress through their life,” O’Connor said.

The evolution of massage continues to move forward at a rapid pace as the mental and physical benefits of the practice become more accepted among the American public. Take a total mind and body approach to health and wellness by including the power of massage therapy into your way of life.


          Advanced Medical Awarded Recertification by the Joint Commission        

The country’s most respected “all therapy” travel company achieves the Gold Seal of Approval for health staffing services. Advanced Medical proudly announces its earning of recertification for the Gold Seal of Approval by the Joint Commission. The Commission recognizes the Advanced Medical commitment to maintaining the highest standards in Healthcare Staffing.

(PRWeb November 20, 2011)

Read the full story at http://www.prweb.com/releases/travel-therapy-company/2011/prweb8978168.htm


          San Antonio’s CellRight Sells to U.K. Medical Company Tissue Regenix        
San Antonio — CellRight Technologies, a maker of bone and tissue grafts derived from cadavers, has been purchased by a British company that also uses a process of removing DNA and cells from human and animal tissue so the products can be used in healthcare. CellRight was sold for as much as to U.K.-based regenerative medicine […]
          Reply to Cleveland Medical Director Attacked for Questioning Vaccine Safety on Tue, 10 Jan 2017 21:46:38 GMT        
Last week Medical Director and Chief Operating Officer Dr. Daniel Neides of the Cleveland Clinic decided to post an op-ed article titled “Make 2017 the Year to Avoid Toxins (good luck) and Master Your Domain: Words on Wellness." Half of the article is dedicated to the known and well-documented fact that the public in the U.S. is exposed to an unprecedented toxic burden. The other half of the piece is dedicated to raising questions for the public and the medical community to consider regarding vaccines and the current vaccination program in the United States, a program that has seen over $3 billion in injury and death payouts; $114 million in 2015 alone. As Dr. Neides, like his recent free thinking medical peers Dr. Daniel Kalb and Dr. Robert Sears, quickly found out, you don’t get to question or challenge vaccines or environmental toxins publicly when you belong to establishment medicine…period. The corporate media machine— funded primarily by the pharmaceutical industry — groaned to life and bellowed out tired propaganda in unison to counter the traitor within the tightly controlled medical establishment’s ranks. Forbes weighed in with the article title “Cleveland Clinic Doctor Goes Full Anti-Vaccine” while local ABC News 5 Cleveland ran with the title and video investigation “Cleveland Clinic Doctor Faces Discipline After Bashing Vaccines in Blog.” Many other mainstream media outlets followed suit. Yet the majority of the article titles have one thing in common: they are sensational and wrong.
          First of All - Do No Harm        
I'm switching that to "do know harm?".  Do you know the harm of what you're doing?

In ancient Egypt the tombs were prepared for the god-king pharaohs.  Every organ was removed and placed in to beuatifully carved vessels.  During the process of preserving evetything that was important they shoved a stick up through the nose; into the brain; stirred it up and poured into the sewer system.
Imagine, these tomb preparers were so dumb, they didn't know the value of the 2-3 pound organ in the skull.  That sort of reminds me of the medical community not knowing the importance of the 2-3 pounds of gut flora living in our digestive tract.  This flora out numbers the human cells in your body 10 to 1.

All humans are 99.9% similar in genetic make-up but the gut flora is so diverse, no two people have more than a 40% overlap.   The majority of your immune system resides in the gut biomass.  90% of chronic conditions are a result of gut biome mismatch or insufficiency.  Your food cravings, nutritional needs, mood, heart, skin, brain health are all dependent on the health of the old friends you carry in your gut.  The figure below gives a snapshot of some conditions that you'd be afflicted with if you lack sufficient breadth and depth of gut biome diversity.



People are born without bacteria, and acquire a gut biomass in the first few years of life. Babies get their first dose of microbes as they're passing through their mother's birth canal. Babies born by caesarean section don't acquire their microbes this way. In fact, studies show that C-section babies have a markedly different microbiota from vaginal birth babies, and may be at higher risk for certain types of allergies and obesity.  The gut biomass in C-section babies more resembles skin bacteria strains, and can take a lifetime to normalize.  While the gut biome is initially forming a baby's metabolic, immune, cognitive, and reproductive systems are undergoing extensive development.

Since the 1950s, it is well known that feeding livestock antibiotics makes them gain weight like crazy.  It was first this weight gain - THEN farmers noticed with their newfound artificial disease resistance animals could be packed closer together.     

Western medicine is the greatest development for acute or traumatic conditions.  But just by the ignorance surrounding the conditions that stem from the gut is shockingly sad.  The existential fallacy in logic is: an argument has a universal context and a particular solution.  The premise that bacteria is bad so anything that fights bacterial growth is good is wrecking our health.  Destroying the gut biome is doing harm.  Do not take an anti-biotic 'just in case'.  Never deprive antibiotics from someone very sick, but realize that most childhood colds, ear infections, sore throats just go away on their own.  You have no idea the damage you're doing to the majority of your cells.  

Now our health food stores are packed with probiotics sometimes containing 'many' strains of bacteria.  The odds of a store bought probiotic helping your gut flora is liken to winning the lottery.  It's depth, breadth and biodiversity that makes a healthy gut.  The science is not out yet on what externalities may help cultivate a healthy biomass.  Sadly, science is just now getting to the point of quanitfying the many issues that can result from having a weak gut biome.  Exchanging poop is much more likely to help you, or simply eat real food.  I KNOW thats a bridge too far for many.  





          Brain power        
The physical effects of what we eat and drink and how often we exercise have been studied ad infinitum by the American medical community, with these factors being linked to conditions such as obesity, high cholesterol and heart disease. But as physicians across Fairfield County noted, many contemporary studies are beginning to suggest that these lifestyle choices also have a profound impact on the well-being of our brains.

"We are in the infancy of looking at the effects of diet and exercise on brain health," said Louise Resor, director of neurology at Stamford Hospital, "But there are many studies that suggest brain health is dependent on traditional medical factors."

Read More.......


          Providers voice opposition to healthcare cuts        
Members of the local medical community Thursday said cuts to the federal Affordable Care Act would leave patients uninsured, increase emergency room use and harm innovative efforts to address the roots of health problems and control costs. U.S. Sen. Ron Wyden, D-Ore., visited La Clinica in Medford to hear from a roundtable of providers as […]
          The Mental Myth        


 


How often do we come across the term 'mental illness'? These days, almost constantly; it's on the news and in Eastenders; it saturates reports on social statistics and psychological well-being; someone we know will have suffered one, if we haven't suffered one ourselves. And yet, most mental illness, as we are commonly taught to understand it, does not really exist. 


This is not to say that the devastating symptoms of the conditions identified as mental illnesses do not exist, of course and sadly they do  â€“ it is to state that these symptoms are not indicative of any organic defect; in short, their sufferers are not ‘ill’.

[Please note, I am referring to common, ‘everyday’ mental illnesses, such as depression, panic / anxiety disorders, self-harming, eating disorders, substance abuse, and so on – I am not referring to severe psychiatric complaints such as schizophrenia and violent psychopathologies.]

By labelling something as an illness, we are seeking to state that there is something going wrong with the person suffering the symptoms – that there is malfunction, disorder and disease, where there should be functionality, balance and health.  In short, that the body has failed to produce the appropriate response - and the purpose of medical science is to ensure the correct bodily response take place.  Correct reactions and functions are of paramount importance to the healthy person.

So, imagine one was witness, over many, many years, to terrible suffering and pain. Imagine one was forced to watch people being abused, hurt and violated, again and again. Imagine one had endured some of these terrible atrocities oneself.

How would one feel? One would feel deep trauma and distress. One would suffer panic and anxiety, guilt and despair, hopelessness and grief. 


But would one be ill?  Surely grief and pain are the correct responses to traumatic situations. Surely these responses – while by no means pleasant – are the correct and thereby healthy reactions to have. And surely, having the correct responses to situations is the essence of empathy, of emotion, of being human.        

Not according to modern psychiatry. Read paragraph four again. Panic and anxiety; guilt and despair; hopelessness and grief. These are all classic, text-book symptoms of the alleged medical malady,  ‘depression’. They also tend to feature heavily in the diagnostic criteria of every other commonly diagnosed ‘mental  illness’.

Now read paragraph three again. Imagine being witness to terrible suffering and pain? Imagine this going on for years and years? None of us need to imagine. It’s happening everywhere, all the time, and to everyone.

We are constantly deluged with statistics on mental health issues to corroborate this - estimates suggest one in five people suffer from depression at some point in their lifetime (1); 400 in every 100,000 people in the UK self-harm (2);  â€˜at least’ 1.1 million people in the UK suffer from an eating disorder (3); and one in four people will experience ‘some kind of mental health problem’ over the course of a year (2).

Anti-depressants are commonly prescribed to treat all of these conditions - in fact, anti-depressants are routinely used to treat conditions including, but not limited to: depression, generalized anxiety disorder, agitation, obsessive compulsive disorders (OCD), manic-depressive disorders, childhood enuresis (bedwetting), major depressive disorder, diabetic peripheral neuropathic pain, neuropathic pain, social anxiety disorder, posttraumatic stress disorder (PTSD) etc. Some off- label uses of antidepressants include, but are not limited to: fibromyalgia, chronic urticaria (hives), hot flashes, hyperhidrosis (drug-induced), pruritus (itching), premenstrual symptoms, bulimia nervosa, Tourette syndrome, binge eating disorder, etc.

Below is a graph to illustrate the levels of anti-depressant prescriptions between 1991 and 2006.


There are two possible explanations for these incredible figures and their astonishing increases year upon year:- one, that humanity has spontaneously devolved to create a generation of people with deep neurological and chemical malfunctions – i.e. ‘illnesses’ - on an extraordinary, (42) endemic scale never before seen in any other society; or two, it is our society, and not the people in it, that is sick - the people are merely reacting to this societal sickness, and to its deeply damaging nature, in the logical and appropriate way.  Having extreme negative reactions to damaging environments, to what is dangerous and what is toxic, is not a sign of illness; it is a vital survival mechanism.  

Current society is desperately dangerous and toxically ill - therefore, the deeming of ‘depression’, and other related conditions, as ‘illnesses’ is no more rational or accurate than the deeming of the excruciating pain from crunching a limb in a metal vice as ‘illness’ – and treating it by doping the patient with enough drugs that they don’t feel the pain anymore, rather than removing the limb from the source of its agony.

By treating a vital psychological mechanism that is intrinsic to human survival as an illness, physicians and psychiatrists are simply seeking to sustain and profit the sick society, rather than to restore or install any degree of wellness – they drug those who suffer the consequences, but they don’t fix the problem.

This happens because – despite the fact treating a healthy psychological response as malfunction is incredibly dangerous to the individual - it is enormously profitable to society. Firstly, and in the most obvious way, anti-depressants are very profitable - they make pharmaceutical companies a lot of money. Over 31 million prescriptions were written for antidepressants in 2007 in the UK alone - a 6 per cent rise since 2005 (1).   No company wants to lose 31 million customers, regardless of what they’re producing, or how necessary or even effective their product is – and drug giant GlaxoSmithKline themselves admit that “a majority of drugs only work in 30 to 50 percent of people” (1). Oher estimates and studies are even less optimistic than that. A 2010 study published by researchers from the University of Pennsylvania found that antidepressants do not work for people with mild to moderate depression – the majority of depression cases. Only in isolated cases of "very severe" depression do antidepressants exhibit any perceived benefits at all, and, even then, they come with so many serious side effects that they are hardly worth the risk (5).   


However, further than creating profit for the pharmaceutical companies who know perfectly well how dangerous and unnecessary their products are, the practice of pathologising the person to sustain the societal sickness persists simply to maximize economic output. People who are engulfed in feelings of grief, hopelessness, and despair are not generally very productive or lucrative assets to the workplace. Therefore, the primary goal of a capitalist, consumerist society, and the hugely lucrative pharmaceutical cartels that conspire to sustain it, is to get people, not “fit”, but “fit for work”. Drugging the unhelpful feelings into submission makes this possible, in at least enough cases to make it worthwhile – in the same way that providing a strong enough painkiller for a broken bone would enable someone to keep on using the limb. However, if they took the painkillers for long enough without ever treating the problem, then when they finally withdrew from the drug , the limb would be horribly mangled and dysfunctional – twisted beyond repair.

The aftermath of antidepressants is not too dissimilar - according to one researcher “it is well known among antidepressant manufacturers that their products permanently damage or destroy the emotional existence of those who take them, even after years of being off the drugs.” (6). Antidepressants, like recreational drugs, can cause severe and intense withdrawal symptoms, which, unlike recreational drugs, can last for months, years, or indefinitely - often leaving their users completely incapacitated, and experiencing symptoms far more sinister than those produced by the original complaint (7).

So, in short, although taking antidepressants is overwhelmingly more likely to create illness than it is to treat it, well over 30 million people every year are prescribed them anyway.

Of course, when it comes to dealing with mental ‘illness’, there are also the ‘talking therapies’, but this article does not concentrate on them, as they are almost never the first treatment prescribed by GPs, if they are prescribed at all, and their efficacy is very difficult to measure. Moreover, while a talking therapy is unlikely to have any harmful effects, there is no credible evidence to suggest they have any beneficial effects, either - because, while they avoid the more toxic consequences of drug treatments, they still don’t treat the problem – which is the society, and not the person. They may equip the person with some psychological tools to enable them deal with that society in a way that causes them less pain, but this is not a solution to the problem – indeed, it is merely another way of perpetuating it.

All this leads to the obvious question of why our social and medical systems have been set up this way – why would a sick society producing sick people be created at all, let alone maintained and bankrolled at such colossal human costs? The answer is simple – to benefit the ruling, powerful, financial elite, that control the banks, big businesses and financial institutions that, in turn, control us. Capitalist, free-market economies such as ours are driven by powerful corporations, and powerful corporations are, by their very nature, psychopathic – their only ‘moral imperative’ is to maximize profit, as was clearly demonstrated in Joel Bakan’s award-winning 2003 documentary ‘The Corporation’ 8, which tackled the question of “what would our society be like if it were run by ruthless psychopaths” – concluding that our society is run by them, and so it is like this.

One of the problems of a society run by ‘ruthless psychopaths’ is that their main goal – the maximizing of profit and power – is not and does not reflect human needs, quite the contrary – the concentration and aggressive pursuit of these things by one minority group entails, without exception, the oppression, exploitation and enslavement of the rest of the society they operate in.

Recognising that, and the fact that explicitly oppressive regimes always crumble through opposition and revolution, 20th century Western world controllers realised that, in order to keep hold of their wealth and power, they needed to control covertly; in other words, they needed to carefully guide, programme and manipulate people to be blind to their own oppression and enslavement, and to instead, become entirely complicit in it. As author and philosopher Johann Wolfgang von Goethe (1749-1832) put it, "none are more hopelessly enslaved than those who falsely believe they are free."


This analysis, however, one that points to a malevolent unseen force as the root of all societal problems, is rejected by most people – even when they are in the deepest throws of anguish and pain because of it – as they believe they could never possibly be controlled in this way, nor would such a thing be allowed to happen in a ‘civilised’ society. They believe they live in a liberated, liberal society, where they are free and able to make their own choices and choose their own lives. But they believe this simply because - as with most other false beliefs our fabricated society is founded on - they have been told to believe it. If this were true, if people had real freedom of choice and personal liberty, then why would so many be choosing lives that are making them so unhappy?

Everybody in developed nations is indoctrinated and brainwashed from birth to believe in the myth of freedom and choice. They are bombarded with mind-bending propaganda from the mass media, from advertising, from popular culture, political ideologies, government messages and more, all of which are there to ensure people think and behave in the way societal rulers want them to. As stated in the book ‘The Age of Manipulation’ (Key, Madison Books, 1992; p95):

“We have been manipulated, and continue to be so… We think we are free, but only because we have been conditioned to think so. We believe that we think freely, but the parameters have been defined by other than ourselves.

[People] are, generally, unaware of the extent to which they are manipulated, managed, and conditioned by media, governments, leaders, and institutions that serve the vested interests of their political-social-economic systems.

Remarkably, virtually everyone in developed countries desperately tries to believe that they are immune to indoctrination. They think they think for themselves and readily know the difference between truth and falsity, fantasy and reality, superstition and science, fact and fiction. Technologically sophisticated cultures are conditioned to accept belief systems, behaviors, and values that would have been rejected out of hand by their stone-age predecessors. Primitives would instantly sense the obvious threats to survival and adjustment, or simple nonsense, inherent in many of the treasured beliefs of modern society.”   

Then consider this paragraph from the 1958 preface to Aldous Huxley’s ominously prophetic Brave New World:

“Impersonal forces over which we have almost no control seem to be pushing us all in the direction of the Brave New Worldian nightmare; and this impersonal pushing is being consciously accelerated by representatives of commercial and political organizations who have developed a number of new techniques for manipulating, in the interest of some minority, the thoughts and feelings of the masses."

Huxley’s worst fears have been confirmed by numerous powerful authority figures for decades. Walter Lippmann, an American intellectual, writer and two-time Pulitzer Prize winner brought forth one of the first works concerning the usage of mass media in the developed world. In Public Opinion (1922), Lippmann
compared the masses to a "great beast" and a "bewildered herd" that needed to be guided by a governing class. He described the ruling elite as "a specialized class whose interests reach beyond the locality." The ”bewildered
herd" has its function: to be "the interested spectators of action," i.e. not participants. Participation is the duty of "the responsible man", which is not the regular citizen.

Mass media and propaganda are therefore tools that must be used by the elite to rule the public without physical coercion. One important concept presented by Lippmann is the "manufacture of consent", which is, in short, the manipulation of public opinion to accept the elite's agenda – to repeat von Goethe, “none are more hopelessly enslaved than those who falsely believe they are free."


 It is worth noting that Lippmann is one of the founding fathers of the Council on Foreign Relations (CFR), the most influential foreign policy think tank in the world.  Some current members include: Barack Obama, Dick Cheney, Hilary Clinton, David Rockefeller, and the CEOs of major corporations, such as Nike, Coca-Cola and Visa.  (9)



To give some perspective on just how powerful, distorting, and controlling media messages can be, consider the case of Fiji. Fiji was a nation that traditionally had little exposure to Western culture (it didn’t even have electricity until 1985), where the fuller figure was celebrated. The preference for the build of both sexes was a robust, well-muscled body. Slim women were seen as weak, nobody dieted, and eating disorders were unheard of.

In 1995, television arrived. The Fijians had just one television station, which broadcasted programmes from the UK, US and New Zealand, such as Seinfeld, ER, Melrose Place and Xena: Warrior Princess.

By 1998 – just 38 months later - Anne Becker, a Harvard anthropologist who has studied Fijian eating habits since 1988, found that there had been an extraordinary rise in disordered eating patterns. Now, 74% of teenage girls now felt they were “too big or too fat”, 15% reported vomiting to control weight, and while "nobody was dieting in Fiji 10 years ago, an alarmingly high percentage of adolescents are dieting now." (10)

If one station via one medium can have this impact in as little as three years, imagine the potential impact of hundreds of stations and countless mediums over a whole lifetime.  


These mediums have been able to so effectively dominate and manipulate Western thought because there has been a simultaneous dismantling of all the traditional systems that had previously guided and influenced people. For example, while 50 years ago, over half of people regularly went to Church, now that figure stands at less than 5% (11). While communities used to be integrated and social, now more than 50 per cent of people don't talk to their neighbours and 40 per cent wouldn't even recognise them if they saw them in the street (12). Household sizes have declined year on year, from an average of nearly five people in 1900, to just over two-and-a-half by 2000 (13), with single-occupancy households increasing massively to number 6.8million in 2006 - and projected to reach 10.9million in 2031. By this time, single household occupancy will outnumber any other kind of household in Britain (14).

This trampling and dismantling of the home, the family, the community and the Church as places to seek advice, gain knowledge, and generally socialize and interact, has left the way clear for mass media programmers to dominate people’s thoughts, value systems and behaviours. By doing this, they simultaneously destroy people’s traditional, stable social roles and identities – instead turning them into individualist consumer addicts: addicted to money, goods, clothes, TV, cars, houses, holidays, cosmetics, cosmetic surgeries, alcohol, drugs, whatever, doesn’t really matter, as long as they spend, spend, spend. The wealthy elite cannot, after all, make money if people do not keep buying things - and they cannot control people’s spending power without harnessing and manipulating their needs.

However, people do not need to buy things – much less be addicted to them - to satisfy any of their true needs. Needs with a price are manufactured by the people who set that price - human beings are quite capable of creating everything they need to live well and productively without buying a thing; they’ve managed it for thousands of years.

Therefore, to ensure people willingly abandon productive, fulfilling, communal lives, and become addicted individualist consumers instead, they have had to be re-programmed – in other words, separated from their real needs and the (free) ways of satisfying them, and then aggressively offered false, fake alternatives instead – which cost money. To make that money, they have to enter the privatized workforce (even the public sector is private in this sense), where they work for the corporations and cynical systems that have already enslaved them, thus further contributing to the success and profit of the ruling elite while simultaneously destroying their own power.

The modern, urbanized, privatized world we currently inhabit is an anomaly and a catastrophe. Historically and across all cultures and civilizations, people have lived and worked together in relatively small, integrated, functional groups – families, communities, places of worship and so on, that were, to a large extent, self-sustaining and self-regulating. These provided people with a sense of belonging, direction, stability, a moral code, a clear place and function and value, and everything else that humanity needs to thrive. Then, in the latter half of the twentieth century, a so-called ‘social revolution’ took place, and families, communities, and religions all broke down at once and irretrievably - taking most social and moral codes with them.

In her social history “Farewell to the East End”, Jennifer Worth recounts how the rapid social changes of the 1960s were “life shattering” for many, as they had to   endure the tearing apart of the extended families and communities that had “provided the unity and been the strength of life for generations.” (Orion Books, 2009; p312)

During this time, traditional roles and values were quickly stigmatized as being deeply oppressive – renowned 1960s author and revolutionary feminist Betty Friedan called the family “a comfortable concentration camp” (http://www.wendymcelroy.com/sexcor/marr.html). Thus, people were encouraged to abandon traditional family lives and family-orientated communities, and seek completely new, unknown ways of living instead – something that they did with dizzying speed. Jennifer Worth notes that, during her career as an East End midwife, births per month dropped from around 100 in the 1950s to just four or five by 1964.  People everywhere were subject to inordinate pressures to leave the families and communities they had been born into in order to ‘succeed’ – that is, in order to become money-controlled consumer addicts instead; profitable, taxable and controllable quantities.      

Major challenges to this intended dysfunctional dystopia would have come from the strong, functional units of the old society - the family, the wider community and the Church, units that had always and indelibly shaped and sustained people - therefore, these had to be broken down and discredited, systematically and irrevocably removed from mainstream existence. This was achieved with quick and brutal efficiency, thus creating deep instability, terrible emptiness and desperate psychological need in all people – which consumer giants were only too eager to fill with goods, gadgets, cars, houses, holidays, clothes, cosmetics, alcohol, and so on; quantities all embedded with the glittering promises that they would fill the gaping psychological chasms left by the devastating and total maceration of society.

Everyone fell for this very quickly, because human need is intense, emptiness is unbearable, and consumerism is addictive – so, rather than a society full of integrated, functional adults living productive and fulfilling lives, we now have a society of stunted, isolated, brainwashed addicts, hopelessly enslaved to their manufactured needs and completely unable to so much as identify their real ones, much less meet them.

Unsurprisingly, severing people from what they really need, and forcing them to clamour for things they don’t, has had catastrophic effects on human wellbeing. Despite what we have been led to believe regarding the benefits of prosperity and affluence, study after study has shown that, far from material wealth making people happier, or even maintaining the status quo, it progressively makes them unhappier. Past a certain point, the richer a country and its individual people become, the unhappier they get.  A Gallup poll has shown that Britain is less happy than in the 1950s – despite the fact we are three times richer. The amount of people claiming to be “very happy” has fallen from 52% in 1957, to just 36% by 2005 (15).

The United States is the richest nation on Earth, and below is a graph from the Washington Post, illustrating happiness trends from 1970 to 2000:

 

Although there is a slight incline in the mid-nineties, the facts are clear: the populations of the richest, most developed nations on earth are unhappy and becoming unhappier. As the BBC puts it, “the story of wealth failing to translate into extra happiness is the story of the Western world” (16). This is why so many who live in West start to sense that, far from their feelings of unhappiness and dissatisfaction being a bit of a blip or a temporary malaise, there is something much bigger, and much darker, going on. Many start to feel increasing feelings of panic, or anxiety, or hopelessness, or despair – at which point, they are promptly told by their GP that they are ‘ill’ and need to be ‘treated’.

This response from the medical community and from society at large is a necessity to maintain the current social (dis)order: in other words, to maintain the control and agenda of the very wealthy, very powerful people, who demand our unquestioning and lifelong servitude; and will label us ill and drug us into compliance if they don’t get it.

To really understand what is going on in any given situation it is always useful and often imperative to ask the question – who benefits? Clearly, what is going on in current Western societies it not benefitting the huge majority of people who live in them; the only strata of society that truly benefits from the current social order is the wealthy elite of the world; the bankers, the financiers, and the big business owners who dominate the world’s resources and therefore run the show. They orchestrate the rest of society to serve their own ends, and for no other purpose. That is why they label dissent from these ends as ‘illness’.

It seems pertinent to mention at this point that, of these engineered and inevitable mental ‘illnesses’, those who suffer them most are women, as illustrated by the below graph:
 



This is no coincidence or unexplained anomaly – as, fundamental to the bankers’ dismantling of society was the dismantling of the family – which meant the complete dismantling and re-engineering, of women, who had, until forty years ago, devoted themselves entirely to the family - and had done so for the whole of human history.

Therefore, women had to be powerfully re-programmed to believe that their traditional roles in society as vital lynchpins of families and communities had actually been horrendously ‘oppressive’, and that the only way they could achieve the ‘empowerment’ they so desperately needed was by abandoning all traditional values and aggressively pursuing a career instead (i.e. by becoming money-controlled consumer slaves).  This has, within less than two generations, led to a society ravaged by unprecedented social disorder and interpersonal chaos - endemic divorce, one-parent families, mass abortions, rampant STDs, dysfunctional children, and an enormous incline in mental ‘illnesses’ – amongst women particularly. This was always the obvious consequence of ‘feminism’ and ‘women’s lib’, as, as Dr. Henry Makow, author of “Cruel Hoax: Feminism and the New World Order” (Silas Green, 2007) has stated:

“[m]odern women are the victim of a monstrous hoax perpetrated by the bankers and their lackeys in media, government and education.


Women have been defrauded of a secure and essential social role, that of wife and mother. In exchange they have accepted the role of sex objects and worker drones.

Feminism was promoted for the purpose of de stabilizing society, and creating dysfunctional people. Stunted people can be brainwashed and manipulated. Feminism masquerades as a movement for women's rights, [but] in reality, feminism is ruthlessly opposed to femininity, masculinity, heterosexuality, the nuclear family and children.

The result of feminism is massive social and psychological dysfunction.”
(17)



This is not to ‘blame’ women for all social ills, nor to suggest that women shouldn’t have careers if they want them, or indeed that men aren’t suffering enormously too (the above graph demonstrates that they are hardly immune) – it is simply to state that, from the perspective of diagnosed mental ‘illnesses’, women are suffering most, when this has not always been the case. A report by B P Dohrenwend in the American Journal of Sociology shows that while, prior to 1950, for every 7 men diagnosed as mentally ill, only 2 women were similarly diagnosed, after 1950, the ratio changed to 22 women for every 2 men (18).

This fact that this catastrophic reversal of mental health statistics correlates so precisely with the rise of ‘women’s liberation’ in the West cannot be ignored when evaluating their current position, and why they are now so unhappy. And they are unhappy – according to a study published in the American Economic Journal in 2009: “More than 1.3 million men and women have been surveyed over the last 40 years, both here and in the U.S. and in developed countries around the world. Wherever researchers have been able to collect reliable data on happiness, the finding is always the same: greater educational, political, and employment opportunities have corresponded to decreases in life happiness for women, as compared to men. “(19) The UK Guardian published an article on this same subject in 2009, stating that “according to several significant studies, women's happiness relative to men's has declined in the last 25 years. This includes women of all age groups, and it is evident in many countries, particularly in the US and the UK.” (20)

This, of course, goes against the grain of every single politically correct notion and understanding of life we are indoctrinated to believe from birth, but as the research clearly shows – the findings are always the same. So why?  Why are women, in light of all their modern opportunities and ‘liberations’, now so much unhappier than they once were?  This answer is simple - they are unhappy because women’s ‘liberation’ is a nonsense and a lie.

Women, for the most part, have been ‘liberated’ to become replaceable workers and exchangeable sexual commodities. They have forfeited the deeply respected traditional roles that guaranteed them a lifetime of stability, identity, and social worth, in exchange for becoming, mostly low-level, worker drones (since, irrespective of their qualifications, women everywhere are concentrated in entry- and middle-level positions (21))), while their personal lives reflect the carnage strewn chaos of modern life - in 2009, 195,743 women had abortions (22), meaning that, of viable pregnancies that year, nearly 30% concluded in abortion (23).

In that same year, some 383,349 women were newly diagnosed with STDs – not including HIV - a 38% increase from the year 2000 (24), with Britain having overall the highest proportion of single mothers in the European Union (25).

Despite the politically correct rhetoric, being a single mother has been shown to be disastrous for women and children. A report in the journal Psychological Medicine showed that lone mothers have rates of depressive episodes three times higher than any other group; that poverty, social stress and depressive disorders cluster in the lone mothers’ group; and concluded that “[as] lone mothers are increasing in number… their high rates of material disadvantage and depressive disorder may have considerable implications for psychiatric and social policy.” (‘Lone Mothers, Social Exclusion and Depression’, Targosz et al, 2003). The fact that such environments are damaging to children is obvious, but the reality is that they are catastrophic. Reports show that: 63% of all youth suicides, 70% of all teen pregnancies, 71% of all adolescent chemical/substance abusers, 80% of all prison inmates, and 90% of all homeless and runaway children, come from single mother homes (B. Bennett; The Index of Leading Cultural Indicators; New York, Broadway Books, 1994). A 1998 paper entitled ‘Father Absence and Youth Incarceration’ showed that the strongest predictor of whether a person will end up in prison is if they were raised by a single parent (Harper and McLanahan, 1998). In short, the scales are weighed against children of single mothers from the day that they are born - according to a report by the National Office of Statistics published in 1999, babies born to single mothers are even more likely to die. (40)

Daughters of single mothers are, unsurprisingly, overwhelmingly more likely to become single mothers themselves – and thus the cycle begins again.

All in all, women’s ability to achieve a sense of contentment and fulfillment with their lives is being eroded with terrifying and bewildering force, and these forces are taking control earlier and earlier – a study of 15-year-olds conducted in Scotland in 1987, 1999 and 2006 recorded concern at the 1999 results, which showed that the incidence of common mental disorders such as anxiety, depression, panic attacks and anhedonia (loss of capacity to experience pleasure) had significantly increased for girls from 19% to 32%. The increase for boys was much smaller, at only 2%. But the 2006 set of results were even more dramatic - girls by then were at a staggering rate of 44%, or nearly one in two  (West and Sweeting, 2006).

To sum, women are gradually shattering as functional, fulfilled people. Where they were once indispensable, they are now expendable; where they were once respected and valued, they are now objectified and discarded; a dire situation they embrace and perpetuate, even as it destroys them, as they are told they don’t ‘need’ men anymore – that men are oppressive / unreliable / unnecessary etc, and, instead, they should seek fulfillment in career, friends, booze and shoes - because these things make them ‘autonomous’, ‘independent’, ‘empowered’, and all the other nothing buzz-words that have been successfully used to market women’s own destruction to them in just a couple of generations.
 Men, meanwhile, are told they don't 'need' to commit to women either, given the mass availability of casual sex; where a lifelong commitment was once required for access to sex, now a conversation is not always a prerequisite. The sex industry is rampant, pornography is everywhere, and a study quoted in Newsweek concluded that "the burgeoning demand for porn and prostitutes is warping personal relationships and endangering women and girls." (26) This demand has led to a dizzying proliferation of services so commonplace that many men don't see strip clubs or lap dances as forms of prostitution. "The more the commercial sex industry normalises this behaviour, the more of this behaviour you get," says Norma Ramos, exeuctive director of the Coalition Against Trafficking in Women (CATW).

 

Perhaps most destructively of all, however, is that men are taught that, in the long-term, women don’t ‘need’ them anymore anyway - because women can make their own money, have their own homes, and even produce their own children; an idea perpetuated by many phenomenally successful ‘independent women’ throughout the fashionable media (27), with the press saturated with similar such headlines:  “Men could be completely sidelined,” according to the Daily Mail.
“Women to Self Create,” blared a headline in Australia’s Daily Telegraph. 
“Men beware!” began a story on one U.S. news Web site (28) – and so on.


This situation is disastrous for both sexes, and for any children their unstable unions may produce, as it makes the sexes untenable to each other as long-term partners, and unreliable as committed co-parents to their children. Marriage rates in 2008 were at their lowest since records began (29), 135,994 divorces took place (30), and nearly one in two children were born outside of marriage (31). While some couples may claim cohabitation is a sufficient statement of commitment, the report ‘Cohabitation in the 21st Century” (Hayward and Brandon, 2007) has shown that cohabitation is fragile and generally short-lived; less than 25% of cohabiting couples last five years, with almost half separating by two years. Where children are concerned, cohabiting couples are more than ten times as likely to split up than married couples before their child is 16; just 7% of them are still together by that stage (32).

If cohabiting couples do go on to marry, the report shows they are 60% more likely to divorce than couples that have not lived together, with the marriages lasting for less time. Between 1960 and 2000, the divorce rate rose by 502%. (33)

The dire effects of this instability and breakdown show themselves most severely upon the children – a study by the Department of Health in 2008 showed that children from broken homes are five times more likely to suffer from mental difficulties than those whose parents stay together, and are more likely to do badly at school, suffer poor health, and fall into crime, addiction and poverty as adults; this is across all social groups and at all levels of parental affluence - the findings say that whether parents stay together is as or more important than whether the home is poor, workless, has bad health, or has no one with any educational qualifications. (34)
A 1988 study found that, when compared to children from homes disrupted by death, children from divorced homes have more psychological problems. (35)

To sum, and as Willia
          Going Digital: Pros and Cons of Electronic Medical Records        

Information Technology is revolutionizing the healthcare industry. Digital records provide exciting opportunities to speed patient care, improve the quality of care, increase patient safety, enrich research, and enhance public health efforts. But there is concern in the medical community that increasing reliance on information technology will weaken the human connection that is the cornerstone of U.S. patient care, and particularly nursing care.

The tenth annual survey of America’s 100 [...]

          Denialism         

Hi Michael,

First, let me say it has been a pleasure to read Denialism, a book I've wanted to dig into ever since you came to speak about it to our Knight Science Journalism Fellows seminar at MIT. It's heartening to see another author beating the drum about America's dysfunctional relationship with science, and making the point so vividly and memorably. Your narrative about vaccine skeptics' attacks on an unassuming and rigorous scientist like Harvard's Marie McCormick—whom I have also interviewed—made me so angry I wanted to hurl the book across the room (and that's a good thing!).

What's more, your book looks past some of the more obvious cases of "denialism"—of climate change, HIV/AIDS, evolution, and so forth—to lesser known realms like personalized medicine and synthetic biology, where our qualms about where science is taking us are likely to manifest next. You don't deny the older and more famous instances of anti-science sentiment, but you smartly move along to the ones we're going to be dealing with for years to come.

That's not to say I agree with everything in Denialism; I think there are some aspects of the big picture that you haven't painted quite right. Take, for instance, the baffling fact that despite all of our irrationality on topics like vaccination, Americans aren't actually "anti-science" in any meaningful sense of the term.

According to the latest compilation of data (PDF) on the relationship between the public and science issued by the National Science Foundation, Americans have more confidence in the leaders of the scientific and medical communities than in the leaders of any other major societal institution other than the military. (We journalists, in contrast, are considered even slimier than members of Congress.) These data also show that most Americans agree that science makes our lives better and has far more benefits than costs. So when you write that Americans "fear science at least as fully as we embrace it," I don't really agree with you. To me, the real question is how to understand the paradox that even as we say all these wonderful things about science in surveys, we betray that sentiment on a regular basis. We're not an anti-science country, just an inconsistent one.

This leads into the main question I had as I read the book—for while I agree with almost every substantive point you make about cases in which science is abused or ignored, I found myself wondering about the root causes of these phenomena. Take, for example, the turn toward unproven "alternative" medical remedies or the closely related retreat from vaccination, both of which you discuss at chapter-length. Yes, the folks who follow these fads aren't listening to accurate science; often, they are in utter denial about it. And yes, they are wasting their money, possibly placing themselves at risk, and, in the case of vaccination skeptics, posing a threat to all of us. Yet I can't help wondering if deep down, the real source of this irrational behavior lies not in public ignorance but rather in an understandable reaction against the problems with our health care system and the documented abuses and profiteering of some pharmaceutical companies.

Your thoughtful and nuanced exposition does not neglect these underlying factors. But I wonder whether their existence might point to something more radical. Perhaps the cure for denialism is not a greater infusion of scientific thinking or rationality but rather a solution to the underlying issues that drive people toward homeopathic placebos or worse. Would people flee so readily into the arms of Andrew Weil if they had more time with caring doctors whose services they could actually afford and if they didn't hear so many horror stories about medical errors committed at hospitals?

Here's another question: I agree with you that in some sense, things are getting worsewhen it comes to our broad public irrationality—but what do you think is driving this trend?

You drop some hints about the role the Internet is playing here; you note how it has been a boon to vaccine skeptics in particular. Let me take that one step further: For all these problems to exist, there has to be something structurally deficient about the way scientific information gets transferred from our hallowed research institutions and peer-reviewed journals into the public sphere. I believe the key factor is that this now occurs in a context of more professed "experts" than ever before at think tanks, at advocacy groups, and on the Web—even as there are fewer and fewer filters and gatekeepers in the world of media and publishing to ensure quality control and analytical rigor.

In other words, we have a game set up where misinformation is likely to thrive and good information has a harder and harder time competing. Mainstream science journalists across the country are losing their jobs. For every accurate science blogger, there is an extremely popular anti-science blogger or Web site. And all the interest groups in Washington and beyond know they need to use "science" to make their case.

As a consequence, real science is constantly abused, and the most credible experts can barely keep up with all the nonsense, much less refute it. Your book is a great contribution to the latter task—but at the same time, it implies that what we really need to do is re-engineer the way our media and political systems handle scientific information. That's a Herculean task, no doubt. Do you think there's any hope of success?

Sincerely,
Chris


          MedidataVoice: How To Drive Value-based Healthcare For Pharma, Hospitals And Insurance        
Healthcare in the U.S. is marching toward a value-based system, away from the fee-for-service model. Yet low cost, high quality healthcare is an ambitious goal, especially given the divergent objectives in the medical community. How will value-based healthcare be reflected in the pharma, medical and insurance industries? Pharma Companies Last year, Novartis [...]
          MedidataVoice: Apple's ResearchKit Shows Promising Early Results        
In the approximately nine months since Apple first announced ResearchKit, the medical community has been paying close attention to the adoption and usage of the open-source platform in clinical research. With massive media exposure and the potential to reach millions of participants, there was a lot of anticipation as to [...]
          [19] The Cut Podcast: The Psychological Consequences of Circumcision        

Eliyahu Ungar-Sargon conversed with Dr. Ronald Goldman, a psychologist and published Intactivist, about the psychological consequences surrounding the practice of circumcision. Here is the recording.

Transcript
(slightly modified)

Eliyahu Ungar-Sargon

From the White Letter Productions studios in Los Angeles, California, I'm [Eliyahu] Ungar-Sargon, and this is The Cut Podcast.

Welcome to another special edition of The Cut Podcast; I'm very happy to be sitting here with Ronald Goldman, and we're going to be having a conversation today about some of the psychological aspects of infant male circumcision.

This is a field [into which] I've been a little wary to wade; I think when I talk to people who don't necessarily agree with my position on this subject, I find it much easier to talk about things like Meissner's corpuscles—the hard scientific stuff [to which] I can just sort of point, [and for which] we have hard data; my impressions—and I would love to get your reaction and your opinion about this—is that when it comes to the psychological data, just by virtue of where we are in our understanding of the human brain and the human mind, it's a little trickier to get hard data on these questions. Is that right? or is this a misperception [that I have]?

Ronald Goldman

Well, I agree with you; part of the problem is there's a resistance to doing these kinds of [study]. Most of the researchers who do the studies on circumcision are looking for benefits, not potential harm. They happen to be medical doctors for the most part, so they're starting with what they're familiar with, which is the physical body. Studying behavior is a lot more complicated. You can't so much put it in a box and put it under a microscope [to examine] it that way. So, human behavior requires a different kind of research, and we haven't had the will to do that for the most part.

Eliyahu Ungar-Sargon

If you could talk a little bit about your professional qualifications [and] your academic background. Where are you are coming from on this issue?

Ronald Goldman

I have a Ph.D in psychology. I've written 2 books on circumcision:

These books have been very well received by professionals in the field. The first book is endorsed by dozens of professionals in mental health medicine and social science. The second book is endorsed by 5 rabbis, among others.

Eliyahu Ungar-Sargon

Let's kick off our conversation by having you share with our audience how it is that you came to this subject in the first place; this is a taboo subject to a large extent, [so] I'm always interested in learning how people first came to thinking about this critically. So, what [is] your story?

Ronald Goldman

In the 1980s, I attended a [relative's] ritual Jewish circumcision in a home. I was reluctant to go; I felt uncomfortable with this kind of procedure. When I was there, I felt extremely uncomfortable during the circumcision: The infant cried I would think at the top of his lungs for over 20 minutes; I felt distressed; I wanted to get away. I noticed other people feeling very uncomfortable. The parents were crying—

Eliyahu Ungar-Sargon

Was this the first bris you had ever attended, or was there something about this particular bris that made it memorable or traumatic or difficult for you?

Ronald Goldman

It was the first, and it was the last. I vowed to myself [that] I will never attend one of these [again], because I felt like a silent accomplice to this circumcision, and I didn't like that feeling, and I don't want to be part of this—and as I learned more about [circumcision], my feeling of wanting to raise awareness about circumcision became stronger, and I will never attend another bris.

Eliyahu Ungar-Sargon

I'd like to come back to the Jewish side of your activism a little later, but first I want to deal with what I see as the fundamental core issues related to the psychological [impact] of circumcision.

Is there any evidence that infant circumcision has psychological effects on the person being circumcised, and if so, what are these effects, and where does this data come from?

Ronald Goldman

There [are 2] answers:

  • The [immediate] effects on the infant.
  • The long-term effects on the adult [whom the infant becomes].

There have been studies on behavioral changes in infants; we can't ask infants “What are you feeling now?”, but they're pretty good at expressing themselves or withdrawing, as the case may be. So, there have been studies that show [behavioral] changes for infants who have been circumcised as compared to infants who have not been circumcised.

The medical journals [frequently] use the term irritability; I think that's a [euphemism] for “Hey, they're upset!”—a little more than “irritable” [as we might] use the term in descriptions of adult behavior.

There's also anecdotal evidence. I've talked to many mothers of circumcised infants [who] report, for example, [that] their infants were calm and content before the circumcision, [yet] after the circumcision, they would cry for hours every day for months. [On the other hand], sometimes the infants become quieter and withdrawn after the circumcision [for a significant period of time]. My interpretation of that: It took them that much time to work out the trauma of the circumcision experience. Again that's the response of some infants, but not necessarily all infants.

There's also information based on studies that showed changes in mother–infant interaction after circumcision: The observed changes include less eye contact from the infant with the mother, and also difficulty in feeding. So, again, this is something that has been observed [by] comparing infants who [were] circumcised and infants who [were] not circumcised.

[These things] affect the bond between the mother and child.

I will also say that in talking with mothers of circumcised boys, some mothers are very distressed either from having witnessed the circumcision or learning [more] about it later, or just dealing with the infant's behavior after circumcision. This is something that's very much overlooked. I'm not aware of any studies on this, but I hear about this a lot from individual mothers: [Mothers] can become very distressed about having to deal with a baby [who is] crying hours at a time every day. Their own emotional state can be affected; they can have doubts about [whether] they are [being good mothers]. This [infant] behavior is labeled “colic” by some pediatricians, and that diagnosis [entails] a lot of misunderstanding and a lack of [knowledge on] how to treat it; [pediatricians are] really guessing at what causes this kind of behavior.

There was a significant study that showed changes in pain response of infants [up to at least six months after circumcision] when they were [being] vaccinated; [the researchers] found that the circumcised infants had a stronger response to pain during vaccination than the infants who [had not been] circumcised, and the investigators concluded that this [is] a sign of lasting neurological effects. They also believe that this was a symptom of early trauma—post-traumatic stress disorder (changes in behavior 6 months after the event).

Eliyahu Ungar-Sargon

Can you talk a little bit more about this idea of the pain response, because I see this in the literature, and I'm not entirely certain—and I don't know that our audience is clear on what [it means]. What does it mean that there's an increased pain response, and what are the consequences of that?

Ronald Goldman

The pain response to the vaccination refers to the [behavioral] response of the infants when they are vaccinated; circumcised infants cried longer and louder. So, from the same stimulus, they found a significant difference in the 2 groups:

  • Circumcised
  • Not circumcised

They actually measured the cry and how long they cried, and they found that the difference between the 2 groups [suggests] a relationship with the circumcision status—

Eliyahu Ungar-Sargon

How does that work? What mechanism is at play here—

Ronald Goldman

What the investigators were concluding is [that] the original trauma—the circumcision—changed the neurological [response] of the infant; in other words, it changed the way pain gets transmitted and [processed]. As a result, [less signficant] trauma [becomes] overwhelming.

The way we deal with [trauma] is sometimes [behavioral] (withdrawal, for example) and [sometimes] physical (neurologically speaking); so, [in circumcised boys] that physical change became permanent—at least lasted 6 months. Because of the change in the neurological structure in the infants [who were] circumcised, they were more sensitive to pain later on.

Eliyahu Ungar-Sargon

We touched on this a little bit, but [let's] go a little more in depth into the psychological effects of this practice on the parents, and is there variability [among parents] at all?

Ronald Goldman

Well, there is variability; some parents simply want to believe that they did the right thing, and that's a defense against feeling the discomfort and emotional pain of recognizing that maybe they made a mistake in judgment here ([a judgment] based on either not enough information or misinformation). So, [there is] the denial aspect:

  • It's OK.
  • We did what was best.
  • There are potential health benefits.

The other side of the response is regret. Sometimes, if [circumcision of an infant] is a ritual that's observed, then the parents are actually seeing what's being done to the infant and how the infant responds; observing the infant's response can be very distressing, particularly for the mother. I've talked to mothers who wanted to stop it, [but] were just frozen—couldn't respond—either by saying something or doing something; they were just frozen and in some sort of shock from witnessing what was happening to their [babies].

Eliyahu Ungar-Sargon

[Let's] talk a little bit about the people who perform circumcisions, and the ways in which they allow themselves to do this.

One of the things that I've noticed—and you see in my film actually, very clearly: Dr. Phyllis Marx (who's the mohelette) talks about circumcision at the beginning:

You know, it's not the circumcision that causes the baby pain; it's the mucking. Anything I can do to reduce the mucking helps.

and then, of course, at the end of the film, you see she's doing the circumcision and the baby is completely calm until she starts [cutting], and then the baby is screaming. What occurs to me is that—and I think Dr. Paul Fleiss has talked about this a little bit—[it] is remarkable that the people performing the circumcisions may literally not hear the baby's crying.

Can you address this? How does that happen? What [psychological] mechanisms are at play here?

Ronald Goldman

I've heard that also, and that's part of the defense mechanisms of practitioners—to protect [themselves] against the conflicting feelings and the recognition that they are causing harm. So, some of these feelings are so strong that they require equivalent strength in the defense mechanism to protect the [practitioner] from having these strong feelings.

So, for example, denial can prevent an individual from hearing what everyone else might hear, seeing whatever everyone else might see, and recognizing what might be obvious—particularly to parents—that this infant is in severe distress, and sometimes even the language [practitioners] use [is very telling]: In the [medical] literature, they are very unlikely to describe the infant's response to the stress of circumcision as "trauma". So, the language tends to minimize the effect of this practice on the infant [and thus on the practitioner].

I've spoken to doctors who [have told] me about when they were in medical school and they [did] their first circumcision[s], and there is a lot of pressure on them to comply with this training and do what they're being told to do. So, [while] they may have an instinct not to do a circumcision, they're required to do this (for the most part), [and] they have to protect themselves psychologically so [that] they can follow through with what's being asked of them. That protection gets to be sort of habitual in the way they recognize what they're doing and what's happening as a result of that.

The other thing is they want to [perform] the best circumcision they can—this is a very delicate procedure, of course—so, their attention is focused on doing the procedure; their attention is ignoring what the baby is experiencing; with that focused attention, they're less likely to recognize what's going on.

I spoke to one doctor who did not recognize the infant's response, and then he watched someone else do a circumcision, and he was horrified at what he was seeing with the infant's vocal [and] behavioral response[s]—obviously in agony—and he decided he would not do anymore circumcisions and he would not have his own son circumcised. So, these are very powerful psychological mechanisms that protect people from recognizing what's going on.

Eliyahu Ungar-Sargon

I think also one of the things that I've seen—and I often say that this is one of the most bizarre points of this sordid tale, to me—is this belief that took root in the medical community—and I think [that] to a large extent, some doctors [still] honestly believe this—that babies don't feel pain. This myth—that anyone in possession of sense could very easily disprove by just observing a baby being circumcised—is actually deeply believed.

Then, the sort of corollary to this is that if you give [these babies] a little sugar-infused water, somehow that would have some kind of anesthetic effect.

These beliefs seem to be to me without any foundation in either just direct experience or—even at this point—in the scientific literature.

Ronald Goldman

That's less common now than it used to be, but it's still out there. That's another indicator of a defense mechanism to prevent individuals from recognizing what's really happening. So, what happens with [this psychological] defense is that people will adopt beliefs to support their defensive belief that [they're not causing harm].

This [was] addressed directly back in 1987 when some parents were discovering that major surgery was being done on their young infants without pain medication, and they complained to the medical profession about this, and as a result of a series of complaints about this, a couple of investigators decided to go through the literature on newborn infant pain and write a review article that got published in the New England journal of Medicine, in which they concluded quite clearly that newborn infants not only feel pain at least as much as adults, but probably more so—[there is] lots of data and research to back up that conclusion.

[However], that's a huge shift in what was common belief and practice for decades preceding. So, some doctors who have been doing circumcisions for decades had a difficult time accepting [it]. Again, denial comes in: They would not believe that result, or have a little difficulty in adapting their own belief to [it]. For a long time, circumcisions continued to be done without pain medication. Then, back in the 1990s, there was more research [into] the best form of pain medication to give an infant [during circumcision], and one of the options they were testing was [indeed] sugar water, passifiers—sure, if you put a passifier in a baby's mouth, it's a lot more difficult [for that baby] to cry!

Some of the researchers have a bias going into their research; they're looking for a particular result. This is a great problem on this topic. What they concluded in a lot of this research was that injecting pain medication into 2 spots on the penile shaft was the most effective way of reducing the pain experienced by the infant, but it did not eliminate the pain, and occasionally it was not effective at all, either because the way the practitioner did the injection or some other factor, so there is no guarantee that any pain medication today [would] eliminate the pain [experienced by] an infant during circumcision.

Eliyahu Ungar-Sargon

Of course, in addition to the pain of the actual procedure itself, once that anesthetic has worn off, there's pain for at least a week after—

Ronald Goldman

That's true. It takes at least that much time to heal, and anesthetic wears off after hours.

Eliyahu Ungar-Sargon

[Let's] move onto talking about some of the psychological mechanisms involved in preventing men from dealing with this issue. Let's actually talk about the long-term effects [of circumcision]. Are there any consequences that extend beyond infancy or beyond childhood even? What evidence do we have of this?

Ronald Goldman

Well, again, there's little research on this. To do this kind of research requires a will and resources; we're in short supply of both in mainstream medicine and psychology.

There was just a study that was published in the International Journal of Men's Studies [in which] the investigators conducted a survey of 300 men who were self-selected (something was posted on a couple of websites, inviting men to take [a questionnaire on their feelings]), and [researchers] found a significant difference between the circumcised group and the non-circumcised group: The circumcised men had greater difficulty identifying their feelings and expressing their feelings.

This is consistent with what I wrote about in my book Circumcision: The Hidden Trauma, particularly in the chapter on post-traumatic stress disorder and long-term psychological effects; a common long-term effect of trauma [in general] is [a] reduced [ability for] emotional expression; this is a way individuals can defend against the pain of the earlier trauma: They become less responsive emotionally; if they're more sensitive emotionally, then they're more likely to connect with feelings that go back to their early trauma, [which] is extremely painful.

So, it's a defense [mechaninism that is psychological and physical]. The tension of repressing these feelings [affects] the body and affects personality. In a way, with circumcision being so common here in the United States, some behavioral traits of men like having difficulty expressing feelings are assumed to be normal male behavior. Here, at least, we have a preliminary study that shows that there is some connection between a lack of emotional expression and having been circumcised.

[Feelings expressed by men] who are dissatisfied [with having been] circumcised, include:

Those are some of the feelings that are very common among men who are dissatisfied [with having been] circumcised. How do they become dissatisfied when other men are not dissatisfied?—

Eliyahu Ungar-Sargon

Exactly—

Ronald Goldman

That's the significant question.

Well, it's based on individual experience:

  • I talk to [these upset] men, and they say [something like]:

    Well, when I was 4 years old, I was playing with a friend of mine—a peer—and we were examining the genitals of each other, and I saw that he had this skin over his penis and I didn't, and I've been upset about that ever since—the rest of my life; later on, I asked about it and I found out that this was cut off of me, and I could never understand that!

    So, when they're aware that they are missing something, they feel inadequate, and this can be part of [their feelings of] shame, and it can affect their self-esteem.

  • For another man, it might have been an incident when he was in the showers in junior high-school, looking around and seeing boys who have foreskins—whose penises looked different [from] his—and very often, boys don't talk about this; it's uncomfortable for them. Maybe they don't want to hear what the answer is going to be. No one has ever talked to them about it, so they adapt to the silence that goes on around them in the culture: This is something that people don't talk about—“circumcision”, “penises”, etc. So, they're left with not understanding:

    Why am I missing this piece of skin [from] the end of my penis?

    So, there's a silent denial going on here.

  • Other men maybe don't have such experiences or ignore [them]—again, they have to come up with their own ideas and beliefs. If they see somebody with foreskin, they may [think]:

    That kid's gotta strange looking penis! There must be something wrong with him! I'm the one's who is OK.

    Then, if they see that [a large number of their peers were] circumcised, they think [the minority of] guys who [weren't] circumcised [are the ones] who have the problem.

Boys and young men come up with different beliefs to explain some kind of experience—either it helps to protect them from feeling discomfort, or triggers the discomfort that never goes away.

Eliyahu Ungar-Sargon

In our culture (which is largely a circumcising culture), I think a lot of people listening to this—and I encounter this on a regular basis—[we look] at someone who complains about [his] circumcision as if there is something wrong with [him]. Because it's such a pervasive practice, and because there are so few people who speak out about this, I think there's a sense that there's something psychologically wrong with the people who do speak out about it. So, could you address that perspective a little bit?

Ronald Goldman

That's true, and that's the way the majority defends its own belief that circumcision is OK. If somebody is going to threaten that belief, someone who has believed that deeply for decades is going to defend that belief, so that's where the conflict comes in.

It's going to be painful for somebody who believes in [the goodness of] circumcision to question [it]. If it's a man, then he may be questioning his own circumcision status, which is likely to be painful if he hasn't questioned it before, because for a man to recognize that he's missing part of his penis is very significant—it's a realization that can completely change his feeling about himself and his sexuality. What man wants that psychological disturbance? So, rather than have to deal with that, most men just deny, and defend [circumcision].

There's also the factor of conformity here—being like what you see around you. People are much more comfortable conforming to their culture and what they observe to be normal. People are less comfortable questioning what they observe to be normal behavior and appearance. So, understandably, there's going to be some defenses here to protect the status quo, the cultural belief, the cultural bias that circumcision is OK.

Eliyahu Ungar-Sargon

I think, also, there's a spectrum of response among men when they're exposed to information about circumcision, [which] sort of goes all the way from complete denial [on one end] to apathy [in the middle] to feeling that they've been harmed [at the other end].

I don't know how one would answer this question, but what is it that [makes these differences]? Are there personality types that come into play here? [Are] certain personality types more prone to apathy, and [others] more prone to denial, and [yet others] more prone to feel the trauma that was [imposed] on them? How does that play out?

Also, [for] the people who do really feel harmed by [having been circumcised], what do you think characterizes them as group? Is there anything that sort of connects them as a group?

Ronald Goldman

I think what is going on here is individual differences—lots of psychological aspects. Some people are more open to feelings—[as in] the result of the study [to which] I referred [earlier]. Some people have difficulty with feelings, and some people are more open to them. So, if people are more strongly [defensive psychologically], [have] less emotional expression, [are] suffering from more or stronger symptoms of post-traumati