A Coffee a Day Keeps Liver Disease at Bay

WASHINGTON — Researchers in the United States have found another good reason to go to the local espresso bar: several cups of coffee a day could halt the progression of liver disease, a study showed Wednesday.

Sufferers of chronic hepatitis C and advanced liver disease who drank three or more cups of coffee per day slashed their risk of the disease progressing by 53 percent compared to patients who drank no coffee, the study led by Neal Freedman of the US National Cancer Institute (NCI) showed.

For the study, 766 participants enrolled in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial -- all of whom had hepatitis C which had not responded to treatment with anti-viral drugs -- were asked to report how many cups of coffee they drank every day.

The patients were seen every three months during the 3.8-year study and liver biopsies were taken at 1.5 and 3.5 five years to determine the progression of liver disease.

"We observed an inverse association between coffee intake and liver disease progression," meaning patients who drank three or more cups of java were less likely to see their liver disease worsen than non-drinkers, wrote the authors of the study, which will be published in the November issue of Hepatology.

Phys Ed: Why Doesn’t Exercise Lead to Weight Loss?

For some time, researchers have been finding that people who exercise don’t necessarily lose weight. A study published online in September in The British Journal of Sports Medicine was the latest to report apparently disappointing slimming results. In the study, 58 obese people completed 12 weeks of supervised aerobic training without changing their diets. The group lost an average of a little more than seven pounds, and many lost barely half that.

How can that be? Exercise, it seems, should make you thin. Activity burns calories. No one doubts that.

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But few people, an overwhelming body of research shows, achieve significant weight loss with exercise alone, not without changing their eating habits. 

Chemicals in Our Food, and Bodies

Your body is probably home to a chemical called bisphenol A, or BPA. It’s a synthetic estrogen that United States factories now use in everything from plastics to epoxies — to the tune of six pounds per American per year. That’s a lot of estrogen.



More than 92 percent of Americans have BPA in their urine, and scientists have linked it — though not conclusively — to everything from breast cancer to obesity, from attention deficit disorder to genital abnormalities in boys and girls alike.
Now it turns out it’s in our food.

Guinea-Bissau, the World's First Narco State

Dealers
The volume of drugs passing through the tiny coastal nation has multiplied many times over since the cartels arrived. The U.N. Office on Drugs and Crime estimates that a quarter of all cocaine consumed in Western Europe — worth $18 billion on the streets — passes through West Africa, most of it via Guinea-Bissau. In this photo, men affiliated with the cartels prepare capsules containing cocaine that will be swallowed and then smuggled into Europe.

Read more: http://www.time.com/time/photogallery/0,29307,1933291_1975618,00.html#ixzz0WCWtnbVr

After Setbacks, Small Successes for Gene Therapy

Not long ago, gene therapy seemed troubled by insurmountable difficulties. After decades of hype and dashed hopes, many who once embraced the idea of correcting genetic disorders by giving people new genes all but gave up the idea.

Enlarge This Image

Dr. Patrick Aubourg

The red areas of four cells got the added gene and are using it to fight a brain disorder.

But scientists say gene therapy may be on the edge of a resurgence. There were three recent, though small, successes — one involving children with a fatal brain disease, one with an eye disease that causes blindness and one with children who have a disease that destroys the immune system

Swine Flu Virus Animation

New Life for the Pariahs

Perhaps the most wretched people on this planet are those suffering obstetric fistulas.

Fred R. Conrad/The New York Times

Nicholas D. Kristof

On the Ground

Nicholas Kristof addresses reader feedback and posts short takes from his travels.

Go to Blog »Go to Columnist Page »

This is a childbirth injury, often suffered by a teenager in Africa or Asia whose pelvis is not fully grown. She suffers obstructed labor, has no access to a C-section, and endures internal injuries that leave her incontinent — steadily trickling urine and sometimes feces through her vagina.
She stinks. She becomes a pariah. She is typically abandoned by her husband and forced to live by herself on the edge of her village. She is scorned, bewildered, humiliated and desolate, often feeling cursed by God.
I’ve met many of these women — or, often, girls of 13, 14, 15 — in half a dozen countries, for there are three million or four million of them around the world. They are the lepers of the 21st century.
Just about the happiest thing that can happen to such a woman is an encounter with Dr. Lewis Wall, an ob-gyn at Washington University in St. Louis. A quiet, self-effacing but relentless man of 59, Dr. Wall has devoted his life to helping these most voiceless of the voiceless, promoting the $300 surgeries that repair fistulas and typically return the patients to full health.

Ill-Conceived Ranking Makes for Unhealthy Debate

In the Wrangle Over Health Care, a Low Rating for the U.S. System Keeps Emerging Despite Evident Shortcomings in Study

During the health-care debate, one damning statistic keeps popping up in newspaper columns and letters, on cable television and in politicians' statements: The U.S. ranks 37th in the world in health care.
The trouble is, the ranking is dated and flawed, and has contributed to misconceptions about the quality of the U.S. medical system.
Among all the numbers bandied about in the health-care debate, this ranking stands out as particularly misleading. It is based on a report released nearly a decade ago by the World Health Organization and relies on statistics that are even older and incomplete.
Few people who cite the ranking are aware that some public-health officials were skeptical of the report from the outset. The ranking was faulted because it judges health-care systems for problems -- cultural, behavioral, economic -- that aren't controlled by health care.

Behind the Scenes: Suffering, Writ Large

Photojournalism that  captures the suffering of women and children in the Congo here.

"The photography in “Congo/Women” — together with essays and video interviews online — explores the systemic violence against women, and the political and economic factors that sustain it. The images are provocative and disturbing: a malnourished child being measured in a clinic; the severed arm of a mother of three, lost while defending her children; a 70-year-old victim of gang rape awaiting couunseling; child soldiers leaning against a fence, machine guns in tow."

Science in Pictures: Honeybees, Artificial Monkeys, and a Rare Crow

Neat images here

Missed Kicks Make Brain See Smaller Goal Post

Flubbing a field goal kick doesn’t just bruise your ego — new research shows it may actually change how your brain sees the goal posts.
In a study of 23 non-football athletes who each kicked 10 field goals, researchers found that players’ performance directly affected their perception of the size of the goal: After a series of missed kicks, athletes perceived the post to be taller and more narrow than before, while successful kicks made the post appear larger-than-life.
Professional athletes have long claimed that their perception changes when they’re playing well — they start hitting baseballs as large as grapefruits, or aiming at golf holes the size of a bucket — but many scientists have been slow to accept that performance can alter visual perception.

Findings About Veracity Of Peripheral Vision Could Lead To Better Robotic Eyes

ScienceDaily (Oct. 18, 2009) — Two Kansas State University psychology researchers have found that although central vision allows our eyes to discern the details of a scene, our peripheral vision is most important for telling us what type of scene we're looking at in the first place, such as whether it is a street, a mountain or a kitchen.

Cold Sore Virus Linked To Alzheimer's Disease: New Treatment, Or Even Vaccine Possible

ScienceDaily (Dec. 7, 2008) — The virus behind cold sores is a major cause of the insoluble protein plaques found in the brains of Alzheimer's disease sufferers, University of Manchester researchers have revealed.

Grand Rounds is up at "Survive the Journey"

Here is the link. The theme is participatory medicine.
It includes this delightful clip from CIO Blogger, Brad Ahier...

Nutrition: Lower Depression Risk Linked to Mediterranean Diet

Eating a Mediterranean-style diet — packed with fruits, vegetables, legumes, nuts, olive oil and fish — is good for your heart, many studies have found. Now scientists are suggesting the diet may be good for your mental health, too.

The Young and the Neuro

In 2001, an Internet search of the phrase “social cognitive neuroscience” yielded 53 hits. Now you get more than a million on Google. Young scholars have been drawn to this field from psychology, economics, political science and beyond in the hopes that by looking into the brain they can help settle some old arguments about how people interact.
These people study the way biology, in the form of genes, influences behavior. But they’re also trying to understand the complementary process of how social behavior changes biology.
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In other words, consciousness is too slow to see what happens inside, but it is possible to change the lenses through which we unconsciously construe the world.
Since I’m not an academic, I’m free to speculate that this work will someday give us new categories, which will replace misleading categories like ‘emotion’ and ‘reason.’ I suspect that the work will take us beyond the obsession with I.Q. and other conscious capacities and give us a firmer understanding of motivation, equilibrium, sensitivity and other unconscious capacities.
The hard sciences are interpenetrating the social sciences. This isn’t dehumanizing. It shines attention on the things poets have traditionally cared about: the power of human attachments. It may even help policy wonks someday see people as they really are.

Award for Humanitarian Leadership

The National Business Aviation Association (NBAA) today announced that the Civil Air Patrol will be presented with the NBAA Al Ueltschi Humanitarian Award in recognition of the organization’s efforts to provide disaster relief for people and communities in times of crisis.
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Al Ueltschi, the award’s namesake, has been widely recognized for his lifetime of dedication to philanthropic causes. He was instrumental in the development of ORBIS, an international non-profit organization dedicated to preventing blindness and saving sight. Ueltschi, who has served as ORBIS’s chairman for more than 20 years, has made a number of significant financial contributions to the organization and has been instrumental in developing many of its most important initiatives.

How to Raise Your Kids—and Maybe Your Company, Too

In addition to NurtureShock’s release, they’re now writing this NurtureShock blog for Newsweek.com. I hope you enjoy this interview about parenting based on NurtureShock (and think a little about this could apply to parenting your company).

Draw a sketch and find a matching photo

PhotoSketch: Internet Image Montage from tao chen on Vimeo.

from Migurski

A Battery Of Tests. For What?

Physician's Ordeal Leads to a Realization

How Ice Can Save Your Life

My brother, who is in charge of lifeflight for the Medical College of Virginia, notes that they have been using hypothermia in cardiac arrests over the past five years...

 

Therapeutic Hypothermia' Can Protect the Brain in the Aftermath of Cardiac Arrest

 

For decades, conventional wisdom in treating patients with cardiac arrest was that if the heart stopped beating for longer than six to 10 minutes, the brain would be dead. Now a new treatment being embraced by a growing number of U.S. hospitals suggests that patients can be brought back to a healthy life even if their heart is stopped for 20 minutes, perhaps longer.
The difference is profound. In recent months around the U.S., doctors and nurses say, cardiac-arrest patients who would previously have been given up for dead have been revived and discharged to return to their families and jobs with all or nearly all of their cognitive abilities intact.

 

Tracing the Origins of Human Empathy

Chimpanzees' Caring Behavior Toward Others Hints at the Emotion's Antiquity; the Mystery of the Contagious Yawn

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Even so, Dr. de Waal contends that empathy, sympathy and compassion are traits shared by every species with a rudimentary capacity for self-awareness. While chimps can be combative and violent, they more often comfort and help each other. Capuchin monkeys enjoy giving to others. Elephants and dolphins aid companions in need. Whales can display something akin to gratitude. Even mice appear to have an ability to sense what their cage-mates are experiencing, says a recent study by researchers at McGill University.

Key cancer spread gene found

Scientists have pinpointed a gene linked to more than half of all breast cancers.

The Consistent Smile of Barack Obama

Obama and First Lady Michelle Obama recently posed for around 135 photographs with UN delegates during a reception that was held at the Metropolitan Museum in New York City. Eric Spiegelman took these photos from the Whitehouse Flickr stream and turned them into a short time-lapse video.
The end-result is fairly interesting. The President has exactly the same smile in every single picture.


Barack Obama's amazingly consistent smile from Eric Spiegelman on Vimeo.

(From Avanish Kaushik via labnol)

E. Coli Path Shows Flaws in Beef Inspection

Vegeterianism anyone? Actually this article highlights the exact reason why some of my friends are strict vegeterians...
uvealblues

Stephanie Smith, a children’s dance instructor, thought she had a stomach virus. The aches and cramping were tolerable that first day, and she finished her classes.

Then her diarrhea turned bloody. Her kidneys shut down. Seizures knocked her unconscious. The convulsions grew so relentless that doctors had to put her in a coma for nine weeks. When she emerged, she could no longer walk. The affliction had ravaged her nervous system and left her paralyzed.
Ms. Smith, 22, was found to have a severe form of food-borne illness caused by E. coli, which Minnesota officials traced to the hamburger that her mother had grilled for their Sunday dinner in early fall 2007.
“I ask myself every day, ‘Why me?’ and ‘Why from a hamburger?’ ”Ms. Smith said.
In the simplest terms, she ran out of luck in a food-safety game of chance whose rules and risks are not widely known.
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Ms. Smith’s reaction to the virulent strain of E. coli was extreme, but tracing the story of her burger, through interviews and government and corporate records obtained by The New York Times, shows why eating ground beef is still a gamble. Neither the system meant to make the meat safe, nor the meat itself, is what consumers have been led to believe.
Ground beef is usually not simply a chunk of meat run through a grinder. Instead, records and interviews show, a single portion of hamburger meat is often an amalgam of various grades of meat from different parts of cows and even from different slaughterhouses. These cuts of meat are particularly vulnerable to E. coli contamination, food experts and officials say. Despite this, there is no federal requirement for grinders to test their ingredients for the pathogen.

You Snooze, You Lose--Weight

Getting enough rest promotes weight loss

The Buzz: Targeting Cancer With Bee Venom

In Animal Studies, Tiny Composite Spheres Deliver Drug Directly to Tumor Sites; 'It's Like an Injection'

A bee sting can be painful, but its venomous payload might hold promise for a beneficial purpose—fighting cancer.
Researchers at Washington University in St. Louis have used an ingredient of bee venom called melittin to shrink or slow the growth of tumors in mice. Melittin's anti-tumor potential has been known for years, but it hasn't been used as a drug because it also attacks healthy cells, including vital red blood cells.
Now the researchers have found a way, using the burgeoning field of nanotechnology, to pinpoint tumors for attack by melittin while largely shielding healthy cells. They do this by attaching the bee-venom ingredient to nanoparticles, which are ultra-tiny, synthetically manufactured spheres. The resultant product, called nanobees, are injected into the blood stream where they circulate until they reach and attack cancerous tumors. The approach also has the potential to avoid some of the toxic side effects seen in older cancer therapies like chemotherapy.

 

Burst of Technology Helps Blind to See

A nice summary of current ophthalmology research here...


Scientists involved in the project, the artificial retina, say they have plans to develop the technology to allow people to read, write and recognize faces.

Advances in technology, genetics, brain science and biology are making a goal that long seemed out of reach — restoring sight — more feasible.

The Claim: Lack of Sleep Increases the Risk of Catching a Cold.

THE BOTTOM LINE Research suggests that poor sleep can increase susceptibility to colds.

With Genetic Gift, 2 Monkeys Are Viewing a More Colorful Worl

Dalton and Sam are male squirrel monkeys, about a foot tall. Their ancestors lived by eating fruit and insects and dodging falcons in the forest canopy of Central and South America. Dalton and Sam lead a more protected life in the laboratory of Jay and Maureen Neitz at theUniversity of Washington, Seattle. Recently, the Neitzes endowed them with a new genetic gift: the ability to see the world with full color vision.

Rx for money woes: Doctors quit medicine

Some physicians, fed up with the costs of their practice, are ready to hang up their stethoscopes and shift careers.

Prosthetic Retina - 'Bionic Eye' Artificial Vision Enhancers Being Put To The Test

In a survey conducted about patients’ expectations of electronic retina prostheses (retina implants) a decade ago, visually impaired or blind patients with degenerative retina conditions stated they would be happy if they were able to regain some mobility and recognize faces and read again.
According to the presentations given at the international symposium “Artificial Vision” September 19th, 2009 at the Wissenschaftszentrum Bonn, that's gotten a lot closer.

7 Solid Health Tips That No Longer Apply

Are you taking a daily aspirin or multivitamin to stay healthy? Avoiding eggs and choosing no-cholesterol margarine over butter? Convinced that jogging will ultimately kill your knees? Advice that was once considered gospel truth among the medical community is now being questioned

Drug-electricity combo makes paralysed rats sprint

Rats with severed spinal cords and no feeling in their hind limbs can walk, run, step sideways and jog backwards without re-growing the nerves between the injured site and the brain, raising the prospect of a treatment for people with spinal injuries.

Touched by Mortality

An excellent essay by Garrison Keiller from the vantage point of being a patient after a stroke...


The doctor who saw me in the E.R. wrote in her report: “nice 67 y.o. male, flat affect, awake, alert and appropriate.” I had appeared with slurred speech and a balloon in my head, had driven myself to United Hospital in St. Paul, Minnesota, parked in No Parking, walked in and was triaged right in to a neurologist who trundled me into the M.R.I. Space-Time Cyclotron for 50 minutes of banging and whanging that produced a picture of the stroke in the front of my brain, so off to the Mayo Clinic I went and the St. Mary’s Hospital Neurology I.C.U. and was wired up to monitors. A large day in a nice 67 y.o. man’s life.
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But when the doctor talks about how you must go on a powerful blood thinner lest a stray clot turn your fine intellect into a cheese omelet, you must now accept being 67 y.o. and do as he says. You had intended to be a natural wonder, an old guy who still runs the high hurdles, but mortality has bitten you in the butt.
I like this hospital. St. Mary’s is a research and teaching hospital so you get to observe troops of young residents go by, trailing close behind Doctor Numero P. Uno, and watch them try to assume the air of authority so useful in the medical trade. The nurses, of course, are fabulous. Like many nice 67 y.o. men, I am even more awake and alert around attractive young women. A dark-haired beauty named Sarah brings me a hypodermic to coach me on self-administered shots of heparin, and without hesitation I plunge it into my belly fat.
No man is a coward in the presence of women.

Americans Have Been Taken Hostage

Dylan Ratigan from MSNBC calling it as he sees it ... 

The American people have been taken hostage to a broken system.
It is a system that remains in place to this day.
A system where bank lobbyists have been spending in record numbers to make sure it stays that way.
A system that corrupts the most basic principles of competition and fair play, principles upon which this country was built.
It is a system that so far has forced the taxpayer to provide the banks with the use of $14 trillion from the Federal Reserve, much of the $7 trillion outstanding at the US Treasury and $2.3 trillion at the FDIC.
A system partially built by the very people who currently advise our President, run our Treasury Department and are charged with its reform.
And most stunningly -- it is a system that no one in our government has yet made any effort to fundamentally change.
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As hostages -- was there any sum of money we wouldn't have given AIG?
Why did we pay Goldman Sachs and all the other banks 100 cents on the dollar for their contracts with AIG, using taxpayer money, while we forced GM and others to take massive payment cuts?
Why hasn't any of the bonus money paid to the CEOs that built this financial nuclear bomb been clawed back?
And more than anything else -- why does the US Congress refuse to outlaw the most anti-competitive structure known to our economy, one summed up as TOO BIG TOO FAIL?
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Why is this? Who does our Government work for? How much longer will we as Americans tolerate it? And what, if anything, can we do about it?
As we approach the anniversary of the bailouts for our banks and insurers -- and watch the multi-trillion taxpayer-funded programs at the Federal Reserve continue to support banks and subsidize their multibillion bonus pools, we must ask if our politicians represent the interests of America? Or those who would rob America of its money and its future?

World's only flying eye hospital

In this BBC news piece there is  a nice video of the inside of the Flying Eye Hospital , narrated by my friend, Hunter Cherwek, who is the medical director  of the  Flying Eye Hospital.
Uvealblues 
On approaching the flying eye hospital, it looks like any of the other passenger jets on the runway waiting to take holidaymakers to exotic destinations.

But this DC-10 jet is exceptional - it houses the only airborne operating theatre for eye treatment in the world.

Its mission is to tackle avoidable sight loss and its charter reaches developing countries where 90% of the world's 45 million blind people live.

Clean Water Laws Are Neglected, at a Cost in Suffering

This is an eye-opening article in the sense of how pervasive the problem is. The article doesn't even touch upon the problems of water contamination by pharmaceuticals, which has been shown to be an issue for Reno (link)..
Uvealblues

The Times obtained hundreds of thousands of water pollution records through Freedom of Information Act requests to every state and the E.P.A., and compiled a national database of water pollution violations that is more comprehensive than those maintained by states or the E.P.A. (For an interactive version, which can show violations in any community, visit www.nytimes.com/toxicwaters.)
In addition, The Times interviewed more than 250 state and federal regulators, water-system managers, environmental advocates and scientists.
That research shows that an estimated one in 10 Americans have been exposed to drinking water that contains dangerous chemicals or fails to meet a federal health benchmark in other ways.

Those exposures include carcinogens in the tap water of major American cities and unsafe chemicals in drinking-water wells. Wells, which are not typically regulated by the Safe Drinking Water Act, are more likely to contain contaminants than municipal water systems.
Because most of today’s water pollution has no scent or taste, many people who consume dangerous chemicals do not realize it, even after they become sick, researchers say.
But an estimated 19.5 million Americans fall ill each year from drinking water contaminated with parasites, bacteria or viruses, according to a study published last year in the scientific journal Reviews of Environmental Contamination and Toxicology. That figure does not include illnesses caused by other chemicals and toxins.
In the nation’s largest dairy states, like Wisconsin and California, farmers have sprayed liquefied animal feces onto fields, where it has seeped into wells, causing severe infections. Tap water in parts of the Farm Belt, including cities in Illinois, Kansas, Missouri and Indiana, has contained pesticides at concentrations that some scientists have linked to birth defects and fertility problems.

In parts of New York, Rhode Island, Ohio, California and other states where sewer systems cannot accommodate heavy rains, untreated human waste has flowed into rivers and washed onto beaches. Drinking water in parts of New Jersey, New York, Arizona and Massachusetts shows some of the highest concentrations of tetrachloroethylene, a dry cleaning solvent that has been linked to kidney damage and cancer. (Specific types of water pollution across the United States will be examined in future Times articles.)
The Times’s research also shows that last year, 40 percent of the nation’s community water systems violated the Safe Drinking Water Act at least once, according to an analysis of E.P.A. data. Those violations ranged from failing to maintain proper paperwork to allowing carcinogens into tap water. More than 23 million people received drinking water from municipal systems that violated a health-based standard.  

Life Hacks For Doctors

Check out this SlideShare Presentation by Joshua Schwimmer of efficient MD:
The ophthalmologists especially will appreciate the 'scleral icterus" example

Life Hacks For Doctors

View more documents from Joshua Schwimmer.

Now this is a workout!!!

Man vs. God

Karen Armstrong says we need God to grasp the wonder of our existence

Richard Dawkins has been right all along, of course—at least in one important respect. Evolution has indeed dealt a blow to the idea of a benign creator, literally conceived. It tells us that there is no Intelligence controlling the cosmos, and that life itself is the result of a blind process of natural selection, in which innumerable species failed to survive. The fossil record reveals a natural history of pain, death and racial extinction, so if there was a divine plan, it was cruel, callously prodigal and wasteful. Human beings were not the pinnacle of a purposeful creation; like everything else, they evolved by trial and error and God had no direct hand in their making. No wonder so many fundamentalist Christians find their faith shaken to the core.

But Darwin may have done religion—and God—a favor by revealing a flaw in modern Western faith. Despite our scientific and technological brilliance, our understanding of God is often remarkably undeveloped—even primitive. In the past, many of the most influential Jewish, Christian and Muslim thinkers understood that what we call "God" is merely a symbol that points beyond itself to an indescribable transcendence, whose existence cannot be proved but is only intuited by means of spiritual exercises and a compassionate lifestyle that enable us to cultivate new capacities of mind and heart.

Obama's Speech

This is an absolutely brilliant, humorous, and insightful post about the U.S. Healthcare system by Doc Gurley....Link here. 

I’ve been watching the healthcare reform debate from a distance, like all doctors. It was a brilliant stroke of genius on the part of both Republicans and Democrats (when they undertook the job of changing all of healthcare) to do so without the input of any practicing physicians. I’m very glad about this – it makes the discussion so much more “out of the box” and “process oriented” and only rarely causes “patient death.”
Besides, I’m waiting for my chance to participate when we overhaul the legal system and exclude all the lawyers. Or maybe I’ll hold out for the Plumbing Reformation Act – I’ve got some deep insights (so to speak) on the whole butt-crack issue.

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So you see, this whole healthcare reform thing doesn’t really affect me. Any more than it does you. Sure, I’ve heard tall tales from the rocking-on-a-porch old-timers, those myths about the prehistoric days when dinosaur doctors ruled the earth – when you could throw your primary care massive weight around and decide for yourself how to treat a patient, who you would see and how long to spend. Hell, I even heard there are Jurassic-Park-like pockets where such a thing still exists. Exotic, tribal locales with primitive, rudimentary, non-capitalistic approaches to healthcare. Places like London and Paris and Stockholm. Shudder. Thank God we don’t have to live in fear like those people must.

Rule out Testing

Another great post from the Happy Hospitalist on rule out testing  here.. 
The post really needs to be read in its entirety at the link.

(As an aside one of the frustrating things about the insurance "game" is that the doctor will not be given approval to do a test for a diagnosis according to current CMS rules if the diagnosis is "rule out..."so in the middle ofspending time and effort with regard to the patient's diagnosis one has to creatively pursue a diagnosis for which the insurance company will agree to pay)

A 17 year old female is seen in the emergency room with a chief complaint of shortness of breath. Thus begins the rule out testing.

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This is where rule out testing feels so good.

Do you send the patient home with a diagnosis of panic attack and follow up with her doctor? Or do you pursue further testing for pulmonary embolism? That is the million dollar question. And let me answer it for you. Our current system is set up to pursue the diagnosis of exclusion without regards to cost. And here's why. Doctors act out of fear. Patients respond out of the comfort of knowing. And in both situations, neither is personally held responsible for for the cost of their desires. We pay for it through higher premiums. We will pay for it through higher taxes. The patient is immune from the immediate cost of feel good medicine. The doctor is immune from the fear of not knowing. A fear that is driven to spend other peoples money to prevent a bad outcome.

Look at my four box theory on Testing vs Outcomes. The physician will always want to stay on the top line. Because that's where the lawyers work for food. (Bold lettering mine...check out the "Testing vs Outcomes link for further elaboration from the Happy Hospitalist). That's where they feel good. And that's where the patients feel good. That's why rule out testing feels so good.

Is Doctors' Income the cause of health care inflation?

Moving Meat dissects the role of physician income in health care inflation in a counterpoint to an article by Ezra Klein of the Washington Post...Please read the whole post here.


Ezra has an interesting post in which he posits that the problem in health care economics is that the rate of inflation of health care persistently exceeds the general rate of inflation.  Fine; I do not think anybody is in disagreement on that point any more.  He goes a bit further, wrongly, I think, in implying that the solution is just to pay doctors less. 


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But that ignores the fact that much of physician's revenue does not go to that physician's income.  Most doctors (ER docs being an exception) have offices to maintain, nurses and assistants to pay, healthcare premiums for this employees, in addition to the malpractice insurance and billing expenses.   Medicine is not a low-overhead game any more!  My gut feeling was that physician income has been stagnant-to-declining over the last decade.

So I went to the Bureau of Labor Statistics and I manually pulled the data on physician income over the 1999-2008 timeframe, and the inflation rate for the same time span and saw that I was more or less right:

Note that for the first six years, physician income was less than inflation, and 2006-7 was only a little bit above the overall inflation rate.  Also note that for two years physician income was actually negative.   2008 was the only year in which physician income increased faster than inflation.

Food Habits More Important In Obesity Than Obesity Gene

You may know that correlation studies have shown that the risk of becoming obese is 2.5 times higher for those who have double copies of the best known risk gene for being overweight or obese, the FTO gene (fat mass and obesity associated).

New discoveries of that sort have led to a resurgence in concern that we may be slaves to our genes, but is that the case?  No, in every study obesity still required high calorie consumption, especially fat.

Kids' Smiles Predict Their Future Marriage Success

Pictures of grinning kids may reveal more than childhood happiness: a study from DePauw University shows that how intensely people smile in childhood photographs, as indicated by crow’s feet around the eyes, predicts their adult marriage success.

Lush Land Dries Up, Withering Kenya’s Hopes

LOKORI, Kenya — The sun somehow feels closer here, more intense, more personal. As Philip Lolua waits under a tree for a scoop of food, heat waves dance up from the desert floor, blurring the dead animal carcasses sprawled in front of him.

So much of his green pasture land has turned to dust. His once mighty herd of goats, sheep and camels have died of thirst. He says his 3-year-old son recently died of hunger. And Mr. Lolua does not look to be far off from death himself.

“If nobody comes to help us, I will die here, right here,” he said, emphatically patting the earth with a cracked, ancient-looking hand.

A devastating drought is sweeping across Kenya, killing livestock, crops and children. It is stirring up tensions in the ramshackle slums where the water taps have run dry, and spawning ethnic conflict in the hinterland as communities fight over the last remaining pieces of fertile grazing land.

Why I Get Angry

Please read this excellent post by one of the best medical bloggers out there, Dr. Rob.
Uvealblues
Something touched a nerve yesterday. I kind of lost my composure when someone tried to defend the insurance industry and responded out of emotion – perhaps putting aside some reason in the process.
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I have health insurance. I do understand why it needs to exist, but I also see how harmful the current state can be to my patients. I get frustrated with Medicare and Medicaid as well, but that is not my point. Just because government run insurance has problems doesn’t do anything to change the problems with private insurance. The fact that you can be killed by firing squad doesn’t make the gallows any better.

My Problems with the Business of Medicine

This post by "Topher" seems to hit the proverbial nail on the head...
uvealblues

The value of having access to a physician (let’s say you have diabetes) that can take an active role in your care, help you correct some mistakes that are leading to uncontrolled glucose levels, and not only extend your life but help you extend it without the complications of the disease is incredible! But as only one man, the number of people for whom he can do this is limited. His service is not scalable.
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Only he’s trapped. In the interim of dropping his Medicare patients, seeing to it that his billing is changed and that no new claims are filled in the next two years, and educating his patients about the changes, his malpractice insurance premiums continue to consume what’s left and he has no chance for air. Gulliver himself couldn’t escape the net of obligations that are binding him to this system and taking away his freedom. In the time it takes to change, he’ll be bankrupt anyway. He closes the money-sink that was once his shining creation. He locks the door on his practice.

Right now, this is what medicine looks like to me. Terrifying, right? I have hopes on hopes that I am wrong and that there is a way to avoid Dr. A’s fate (maybe I’m awfulizing). And I know that there are plenty of doctors running practices, making money, and living comfortably but unless they are completely free of the forces that took down Dr. A in my example, they’re just the last line before the firing squad. Even if I manage to escape it (as physicians do by having concierge or cash-only practices from the start), I don’t want any other physicians to have to deal with it. It’s unjust.

Beyond the Biopsy: A Tiny Monitor for Cancer

DOCTORS doing a needle biopsy to analyze tissue for cancer may one day add a second step to the procedure: depositing a tiny device at the site to report on growth of a tumor — and even the effects of chemotherapy.

Researchers at the Massachusetts Institute of Technology have created prototypes for cancer monitors the size of a grain of rice, small enough to fit easily into the bore of a biopsy needle. Tiny coated particles inside the devices can bind with molecules linked to cancer at the site, creating minuscule clumps that can be detected by a non-invasive scan like an M.R.I., said Michael J. Cima, a professor of materials science and engineering at M.I.T. and leader of the team that created the devices.

Increase Your Happiness With These Six Scientifically Proven Strategies

In recent years there has been an explosion of research on happiness, optimism, positive emotions and healthy character traits. While psychology has traditionally concerned itself with what ails the human mind--such as anxiety, depression, neurosis, obsessions, paranoia, and delusions--, a new branch of psychology, aptly named “positive psychology”, asks the question: "What are the enabling conditions that make human beings flourish?" That is, the goal of positive psychology is to study what actively makes people feel fulfilled, engaged, and happy.

In addition, neuroscientists are studying how the brain can be rewired in such a way that makes happiness more likely. Below you’ll find six strategies from the fields of positive psychology and neuroscience that will help you increase your current level of happiness.

There Are More Slaves Today Than at Any Time in Human History

One writer spent four years inside the world of modern-day slavery; an industry that produces huge profits and countless wasted lives.

The world suffers global recession, enormous inequity, hunger, deforestation, pollution, climate change, nuclear weapons, terrorism, etc. To those who say we’re not really making progress, many might point to the fact that at least we’ve eliminated slavery.

But sadly that is not the truth.

How Different Groups Spend Their Day

The American Time Use Survey asks thousands of American residents to recall every minute of a day. Here is how people over age 15 spent their time in 2008. Related article

Check out the link for the interactive graphic--quite interesting indeed...

Genocide From the Inside

Tracy Kidder's previous book, "Mountains Beyond Mountains," documenting the life of Dr. Paul Farmer is one of my favorites. This seems that this will be a worthwhile read as well...The description below of the hollow, caved in skills with empty eyeholes staring at you, imploring you....accurately describes my feelings as well when I was at the Holocaust Museum in Rwanda last year around this time..

Tracy Kidder asks how a traumatized African becomes an American.

We have preserved the massacre site. We have preserved the death," the young Rwandan man said to me with a bewildering smile. He was leading me briskly through a school where a decade earlier, hundreds of men, women, and children had been hacked to death. Pools of dried blood made the floor sticky. In one corridor, old bits of skull and bone made it crunchy. And then we came to the bodies.

The dead were covered in some kind of greenish preservative and laid out in long rows on the floor. A child—frozen forever at 4 or 5—had her skull split open in one clear blow. A woman's stomach had been hacked, and the contents must have spilled out somewhere: She was empty now. I would like to be able to say the faces of the hundreds of bodies I marched past had an accusatory stare that asked: How could you let this happen to us? But, in reality, they were glassy-eyed and gone.

What happens when you travel in a single 12-hour flight from the splattered heart of this genocide to the streets of New York City? That's what happened to Deogratias Niyizonkiza, a 24-year-old man who had narrowly survived a genocide in two countries and suddenly in 1994 found himself on a flight to a place he had only heard of—America.
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Deogratias fled across a river already beginning to choke with Tutsi corpses into the forests. After days hiding out in the woods—to echoed screams—he realized he had to get out of Burundi. He thought he had an option for safety—to make his way across the border to Rwanda. He nearly didn't make it. He was stumbling from one catastrophe to another—straight into the heart of the Rwandan genocide. The president there was murdered, too, and the extermination of nearly 1 million people—mostly by machete, wielded at high speed–erupted. It took 100 days. "Before the end of the night, the cockroaches are not going to wake up again," the mobs would sing on their killing frenzies.

And suddenly Deogratias was standing in an American airport, with $200 in his pocket and trauma cluttering his head, claiming he had work to do in New York City. A friend had pointed him toward Burundi's airport and urged him to get as far away as he could. He slept in boarded-up buildings and in Central Park and marvelled: "Almost everyone looked happy. Or at least no one looked alarmed. And no one looked terrified. These were people just going about their business, greeting their friends and their families, as if they didn't know there were places where dogs were trotting about with human heads in their mouths. But how could they not know?"

Kidder's descriptions of Deogratias seeing New York for the first time are some of the best in the book. He was so shocked by people wearing their pants low and strolling oddly that he became convinced America was afflicted by an epidemic of broken hips. When he stumbled into Central Park one day, he exclaimed: "My God, I just discovered a forest!"

Why is the African continent poor?

The desolate, dusty town of Pibor on South Sudan's border with Ethiopia has no running water, no electricity and little but mud huts for the population to live in.

You would be hard put to find a poorer place anywhere on earth.

I went there as part of a journey across Africa to ask the question "Why is Africa poor?" for a BBC radio documentary series.

Pictures of the Day

Many great pictures here...

The Women’s Crusade

IN THE 19TH CENTURY, the paramount moral challenge was slavery. In the 20th century, it was totalitarianism. In this century, it is the brutality inflicted on so many women and girls around the globe: sex trafficking, acid attacks, bride burnings and mass rape.

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There’s a growing recognition among everyone from the World Bank to the U.S. military’s Joint Chiefs of Staff to aid organizations like CARE that focusing on women and girls is the most effective way to fight global poverty and extremism. That’s why foreign aid is increasingly directed to women. The world is awakening to a powerful truth: Women and girls aren’t the problem; they’re the solution.

Sunrise At Nudgee Beach in Australia

What a beautiful photo taken by Christolakis at Flickr...

Fatty Foods Affect Memory and Exercise

Eating fatty food appears to take an almost immediate toll on both short-term memory and exercise performance, according to new research on rats and people.

It’s already known that long-term consumption of a high-fat diet is associated with weight gain, heart disease and declines in cognitive function. But the new research shows how indulging in fatty foods over the course of a few days can affect the brain and body long before the extra pounds show up.

Why Exercise Won't Make You Thin

The conventional wisdom that exercise is essential for shedding pounds is actually fairly new. As recently as the 1960s, doctors routinely advised against rigorous exercise, particularly for older adults who could injure themselves. Today doctors encourage even their oldest patients to exercise, which is sound advice for many reasons: People who regularly exercise are at significantly lower risk for all manner of diseases — those of the heart in particular. They less often develop cancer, diabetes and many other illnesses. But the past few years of obesity research show that the role of exercise in weight loss has been wildly overstated.

"In general, for weight loss, exercise is pretty useless," says Eric Ravussin, chair in diabetes and metabolism at Louisiana State University and a prominent exercise researcher. Many recent studies have found that exercise isn't as important in helping people lose weight as you hear so regularly in gym advertisements or on shows like The Biggest Loser — or, for that matter, from magazines like this one.

The basic problem is that while it's true that exercise burns calories and that you must burn calories to lose weight, exercise has another effect: it can stimulate hunger. That causes us to eat more, which in turn can negate the weight-loss benefits we just accrued. Exercise, in other words, isn't necessarily helping us lose weight. It may even be making it harder.

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Could pushing people to exercise more actually be contributing to our obesity problem? In some respects, yes. Because exercise depletes not just the body's muscles but the brain's self-control "muscle" as well, many of us will feel greater entitlement to eat a bag of chips during that lazy time after we get back from the gym.
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Closing the Energy Gap
The problem ultimately is about not exercise itself but the way we've come to define it. Many obesity researchers now believe that very frequent, low-level physical activity — the kind humans did for tens of thousands of years before the leaf blower was invented — may actually work better for us than the occasional bouts of exercise you get as a gym rat. "You cannot sit still all day long and then have 30 minutes of exercise without producing stress on the muscles,"
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There's also growing evidence that when it comes to preventing certain diseases, losing weight may be more important than improving cardiovascular health. In June, Northwestern University researchers released the results of the longest observational study ever to investigate the relationship between aerobic fitness and the development of diabetes. The results? Being aerobically fit was far less important than having a normal body mass index in preventing the disease. And as we have seen, exercise often does little to help heavy people reach a normal weight.

Phys Ed: Can Running Actually Help Your Knees?

An article in Skeletal Radiology, a well-respected journal, created something of a sensation in Europe last year. It reported that researchers from Danube Hospital in Austria examined the knees of marathon runners using M.R.I. imaging, before and after the 1997 Vienna marathon. Ten years later, they scanned the same runners’ knees again. The results were striking. “No major new internal damage in the knee joints of marathon runners was found after a 10-year interval,”
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Instead, recent evidence suggests that running may actually shield somewhat against arthritis, in part because the knee develops a kind of motion groove. A group of engineers and doctors at Stanford published a study in the February issue of The Journal of Bone and Joint Surgery that showed that by moving and loading your knee joint, as you do when walking or running, you “condition” your cartilage to the load. It grows accustomed to those particular movements. You can run for miles, decades, a lifetime, without harming it. But if this exquisite balance is disturbed, usually by an injury, the loading mechanisms shift, the moving parts of the knee are no longer in their accustomed alignment and a “degenerative pathway” seems to open. The cartilage, like an unbalanced tire, wears away. Pain, tissue disintegration and, eventually, arthritis can follow.

Pro-Democracy Leader in Myanmar Is Convicted

How sad--for a Nobel Peace Prize winner who had won 92% of the popular vote in a national election...

BANGKOK — Daw Aung San Suu Kyi, the Burmese pro-democracy leader, was sentenced Tuesday to three years of hard labor for violating the terms of her house arrest, but her sentence was quickly commuted to a new term of house arrest of up to 18 months.
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“The outcome of this trial has never been in doubt,” Jared Genser, her international counsel in Washington, said Tuesday after the verdict was announced. “The real question is how the international community will react — will it do more than simply condemn this latest injustice?”

The charge against Mrs. Aung San Suu Kyi was prompted by a strange incident in early May when an American intruder swam across a lake in central Yangon, Myanmar’s main city, and spent two nights in her villa, saying he wanted to save her from assassins.

The intruder, John Yettaw, 53, of Falcon, Mo., was given a seven-year sentence on Tuesday, including four years of hard labor, for abetting Mrs. Aung San Suu Kyi’s actions and for violating immigration law and local ordinances, according to diplomats reached by telephone in Yangon.

8 totally awesome natural phenomena you probably didn’t know about

When you hear a name like maelstrom, you just know it’s about something wicked. Introduced in English by Edgar Allan Poe from the Nordic languages, from which it came from the Dutch word maelstrom (maalstroom in modern spelling), it literally means crushing current, which is quite a very good description.

Genome Sequencing Gets 99.9833% Price Cut

Dr. Quake of Stanford University only needed $50,000 and a month's time to complete a genome sequencing process which previously took $300 million, over 250 people, and several years. How cheap would Windows 7 be with this guy's cost-cutting?

Fungus Makes Zombie Ants Do All the Work

A tropical fungus has adapted to infect ants and force them to chomp, with surprising specificity, into perfectly located leaves before killing them and taking over their bodies.

Fire risk 'super' ants discovered

Ants believed to have a "kamikaze attraction" to electricity have been discovered in one of England's finest National Trust gardens.
(..)They are naturally drawn to electrical currents so can pose a fire risk.
The species was first identified in Budapest 20 years ago. The ants look like a common black garden variety.
English Heritage and the National Trust carried out investigations into infestations within the Hidcote estate to identify them as lasius neglectus.

Their compulsion to follow electricity is stronger than their need for food or drink.

Top websites

PC magazine names the top 100 websites of 2009 here.

How to Sign Documents Electronically - No Ink or Paper Required

Amit Agarwal has one of the best tech blogs on the web. Here is an excellent post on digital signatures..

Cheese and Burger Society

Strictly for carnivores, here is a link to a variety of burger recipes...

Just When Africa’s Luck Was Changing

TWO years ago, when Dubai World said it would invest $230 million in Rwandan tourism, officials here rejoiced.

Among the many projects the company trumpeted were a sprawling luxury hotel on the 18-hole golf course here and an ecolodge in the Akagera National Park, a swampy grassland further northeast where herds of elephants and water buffalo roam.

In an interview at his offices in Kigali last fall, Rwanda’s president, Paul Kagame, cited the Dubai investment as one of many that his small east African country had managed to attract in its effort to reduce its dependence on aid in favor of private investments.

But just last month, Dubai World ratcheted back its ambitious investment plans, its coffers strained by the global financial crisis. The company says it will go forward with only two of the eight projects it had planned in Rwanda, and the Kigali hotel and Akagera ecolodge didn’t make the cut.
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Continentwide figures for foreign direct investment so far this year are not available. But in the sub-Saharan African countries, the International Monetary Fund estimates, foreign direct investment will drop roughly 18 percent in 2009 from about $30 billion in 2008.

“The decline in investment will reduce the ability of African governments to fund health, education, infrastructure and nutrition programs,” said Léonce Ndikumana, director of the development research department at the African Development Bank.

Organizations like the development bank have stepped up their efforts to limit the impact of the credit crisis. But many fear that the moves will not be enough. The World Bank said recently that international financial institutions by themselves could not currently cover the shortfall in capital and investments to emerging-market countries.

According to the Organization for Economic Cooperation and Development, the amount of private investment going to Africa had begun to outpace aid. M. Nathaniel Barnes, Liberia’s ambassador to the United States and the country’s former finance minister, says that while foreign aid is still crucial for African countries, it usually focuses on humanitarian issues like emergency food and shelter or medical supplies. In contrast, he said, foreign investment provides long-term sustainability and growth.

“Instead of talking to Usaid, I’d rather be talking to a company like Nike,” Mr. Barnes said. “Having a partner like that means jobs and economic growth, and you just don’t get that from aid.”

An Easy Way to Increase Creativity

Creativity is commonly thought of as a personality trait that resides within the individual. We count on creative people to produce the songs, movies, and books we love; to invent the new gadgets that can change our lives; and to discover the new scientific theories and philosophies that can change the way we view the world. Over the past several years, however, social psychologists have discovered that creativity is not only a characteristic of the individual, but may also change depending on the situation and context. The question, of course, is what those situations are: what makes us more creative at times and less creative at others?

One answer is psychological distance.

This research has important practical implications. It suggests that there are several simple steps we can all take to increase creativity, such as traveling to faraway places (or even just thinking about such places), thinking about the distant future, communicating with people who are dissimilar to us, and considering unlikely alternatives to reality. Perhaps the modern environment, with its increased access to people, sights, music, and food from faraway places, helps us become more creative not only by exposing us to a variety of styles and ideas, but also by allowing us to think more abstractly. So the next time you’re stuck on a problem that seems impossible don’t give up. Instead, try to gain a little psychological distance, and pretend the problem came from somewhere very far away.

Rural Medical Camp Tackles Health Care Gaps

It was a Third World scene with an American setting. Hundreds of tired and desperate people crowded around an aid worker with a bullhorn, straining to hear the instructions and worried they might be left out.

Some had arrived at the Wise County Fairgrounds in Wise, Va., two days before. They slept in cars, tents and the beds of pickup trucks, hoping to be among the first in line when the gate opened Friday before dawn. They drove in from 16 states, anxious to relieve pain, diagnose aches and see and hear better.

ORBIS 2009 Nairobi Program

Professional photographer, Kelvin Young, has nicely captured the spirit of the Orbis trip to Kenya in June here. It is worth checking out the original version on youtube as you can watch it in high-def.

On Assignment: Afghanistan

The photography here from Mr. Guttenfelder, 40, the chief Asia photographer for The Associated Presis incredible.

Here is one letter writer (from stretchphotography.com) speaking of the images:

"There are so many remarkable images here, I don’t know which one will stay with me longest. The guy bent over from the weight of his pack, in a photo made just before Independence Day, should be humbling for any American; we owe these guys so much, and we will never be able to repay their sacrifice. The momentarily deceptive shot of the young men asleep in holes in the ground is at first frightening, then humorous, and, finally tender. Thank you, David Guttenfelder, for bringing these moments to us."



“For photographers, there’s really no other way to tell the story but in the micro way, the intimate level,” he (Guttenfelder) said. “The closer you can get to the company or platoon or squad level, to a few individuals out in the field, the better the work will end up. They allow you in. That’s the only way for a photographer to get down and as close to the ground as possible.”

Not a Victim, but a Hero

After being kidnapped at the age of 16 by a group of thugs and enduring a year of rapes and beatings, Assiya Rafiq was delivered to the police and thought her problems were over.

Then, she said, four police officers took turns raping her.

The next step for Assiya was obvious: She should commit suicide. That’s the customary escape in rural Pakistan for a raped woman, as the only way to cleanse the disgrace to her entire family.

Instead, Assiya summoned the unimaginable courage to go public and fight back. She is seeking to prosecute both her kidnappers and the police, despite threats against her and her younger sisters. This is a kid who left me awed and biting my lip; this isn’t a tale of victimization but of valor, empowerment and uncommon heroism.

“I decided to prosecute because I don’t want the same thing to happen to anybody else,” she said firmly.

Top 10 Travel Gadgets Under $50

Here is a list of the 10 gadgets, all under $50, that I either own or have been lusting after.

An Amazon Culture Withers as Food Dries Up

XINGU NATIONAL PARK, Brazil — As the naked, painted young men of the Kamayurá tribe prepare for the ritualized war games of a festival, they end their haunting fireside chant with a blowing sound — “whoosh, whoosh” — a symbolic attempt to eliminate the scent of fish so they will not be detected by enemies. For centuries, fish from jungle lakes and rivers have been a staple of the Kamayurá diet, the tribe’s primary source of protein.

But fish smells are not a problem for the warriors anymore. Deforestation and, some scientists contend, global climate change are making the Amazon region drier and hotter, decimating fish stocks in this area and imperiling the Kamayurá’s very existence. Like other small indigenous cultures around the world with little money or capacity to move, they are struggling to adapt to the changes.

The Stories Behind 29 U2 Songs

The name didn't last, but more than 30 years and 22 Grammys later, the band, which would eventually be called U2, has proven it has what it takes to stay on top.

The keys to U2's longevity include respect for each other and their fans; the ability to continuously reinvent themselves and their musical style; and powerful music with a message.

But the meanings of most U2 songs are subject to interpretation. Bono is a genius at writing ambiguous lyrics, allowing listeners to decide what each song means to them. Read on to take a musical journey with the band that Time magazine once named "Rock's Hottest Ticket."

Strange Eye-Shaped Galaxy Has Black-Hole Iris

Coiled Creature of the Night

Not to be outdone by the 10th anniversary of its sibling, the Chandra X-Ray Observatory, NASA’s Spitzer Space Telescope delivered this crazy looking eye-shaped galaxy image.

The iris of the eye is actually a ring of stars surrounding the area around an enormous, invisible black hole that is around 100 million times the mass of the sun and far larger than our galaxy’s central black hole. The stars show up white and the space around the black hole is blue in this color-coded infrared image.

Human echolocation and blind mountain biking

Another cool post from mindhacks.com

Psychologist Lawrence Rosenblum has written an excellent short article about a remarkable group of blind mountain bikers who apparently use echolocation to avoid obstacles by making loud click sounds as they ride.

Vision shift glasses alter time perception:

There's an intriguing study about to be published in Psychological Science finding that people wearing prism glasses that shift everything to the right overestimate the passage of time, while people wearing left-shift glasses underestimate it.

A Death in Burundi

Burundi is a small, ancient, landlocked, mountainous nation that exports excellent tea and coffee and not much else, a country with a rich and, in modern times, a tragic history, tragic in large part because of European colonialism. It is a history intimately connected with the history of Rwanda, its neighbor to the north. In the post-colonial era, Rwanda and Burundi accentuated each other’s path toward mass violence. Most Americans surely remember hearing news of Rwanda’s infamous genocide, which began in 1994. But many know little or nothing of Burundi’s related catastrophe, an ethnic civil war that began in October 1993, lasted 13 long years and killed, it is estimated, about 300,000 Burundians.

The country now has a democratically elected government, but it receives considerably less aid than Rwanda, and is in desperate shape.

Faber: Next Stimulus Will Be Worse

I subscribe to Mark's Faber newsletter and recommend it...there is a good video interview at the link...
uvealblues

Some economists think that another bubble is what’s needed to get the economy moving again.

Gloom, Boom and Doom publisher Marc Faber said this is ridiculous, and that the Federal Reserve — which he holds responsible for creating the housing bubble — wants to do it all over again.

Microbes ‘R’ Us

The typical human is home to a vast array of microbes. If you were to count them, you’d find that microbial cells outnumber your own by a factor of 10. On a cell-by-cell basis, then, you are only 10 percent human. For the rest, you are microbial.
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Even on your skin, the diversity of bacteria is prodigious. If you were to have your hands sampled, you’d probably find that each fingertip has a distinct set of residents; your palms probably also differ markedly from each other, each home to more than 150 species, but with fewer than 20 percent of the species the same. And if you’re a woman, odds are you’ll have more species than the man next to you. Why should this be? So far, no one knows.

But it’s the bacteria in the digestive tract, especially the gut, that intrigue me most.

Jason Becker: The Amazing Musician with ALS Who Composes with His Eyes

By the age of 20, Jason Becker was already a guitar legend—but after being diagnosed with ALS, he lost his mobility and was told he would have just several year to live. 20 years after that awful diagnosis, this inspiring man is still going strong and creating beautiful music.
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Although Becker still has extremely limited motor function, he has long since surpassed his estimated death date, and plans to keep on going for many years to come. His positive spirit, relationship with his friends and family, his spirituality, and his love of music all keep him from giving up on his life. “I guess I still have a point or a purpose for being here,” he said. “I don’t really know why, but I am grateful.”

Becker knows that even though it’s become far more difficult for him to express himself, he can still send messages through his music, and is determined to make a difference in the world.

“Not being able to play guitar anymore has made me focus more on beautiful melodies and soul stirring stuff,” he told Guitar World. “Now I want people to feel something so deep that they can’t help but reflect and make positive changes in themselves.”

Better Vision, With a Telescope Inside the Eye

A TINY glass telescope, the size of a pea, has been successfully implanted in the eyes of people with severely damaged retinas, helping them to read, watch television and better see familiar faces.

The new device is for people with an irreversible, advanced form of macular degeneration in which a blind spot develops in the central vision of both eyes.

A New View, After Diagnosis

Experimental Group Therapy Aims to Help Cancer Patients Find Meaning in Face of Mortality.

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Dr. Breitbart based his program in part on the writings of Viktor Frankl, the Austrian psychiatrist who survived Auschwitz with the conviction that people can endure any suffering if they know their life has meaning. The eight-week program helps patients with Stage 3 or 4 cancer reconnect with the many sources of meaning in life—love, work, history, family relationships—and teaches them that when cancer produces an obstacle in one, they can find meaning in another.

“We help cancer patients understand that they are not dead yet,” says Dr. Breitbart. “The months or years of life that remain can be times of extraordinary growth.”

In fact, anyone can benefit from reflecting on what’s most meaningful in life, he says. “Every human being wrestles with the question: How can you live knowing that you’re going to die? “Most of us are too distracted to think about it. But ask yourself, ‘What accomplishments are you most proud of? What do you want your legacy to be?’ It’s never too late,” he says.

Making the iPhone Icons Speak

You’d never suspect that the iPhone 3GS, which has no physical keys at all, is one of the easiest smartphones in the world for a blind person to use. But now it’s true, thanks to VoiceOver.

Catching The Gold Bug

A quick primer on gold investment...

More and more investors are acquiring physical gold, or bullion, in the form of small bars the size of iPhones or coins like American Eagles and South African Krugerrands. Individuals’ bullion purchases almost doubled last year, amid apocalyptic panic over the financial system, to 862 metric tons.

Lately, that panic-driven demand has given way to a more subdued, yet still potent, fear that stocks will suffer as the recession grinds on for a long time, so gold makes sense. At the same time, there’s a rising anxiety about inflation among people like Dr. Van Steyn, resulting from the Obama administration’s massive stimulus spending.

Clean, Sexy Water

So many people in poor countries desperately need assistance. So many people in rich countries would like to help but fear their donations would line the pocket of a corrupt official or be lost in an aid bureaucracy. The result is a short circuit, leaving both sides unfulfilled.

That’s where Scott Harrison comes in.

Five years ago, Mr. Harrison was a nightclub promoter in Manhattan who spent his nights surrounded by friends in a blur of alcohol, cocaine and marijuana. He lived in a luxurious apartment and drove a BMW — but then on a vacation in South America he underwent a spiritual crisis.

“I realized I was the most selfish, sycophantic and miserable human being,” he recalled. “I was the worst person I knew.”

Mr. Harrison, now 33, found an aid organization that would accept him as a volunteer photographer — if he paid $500 a month to cover expenses. And so he did. The organization was Mercy Ships, a Christian aid group that performs surgeries in poor countries with volunteer doctors.
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Mercy Ships transformed Mr. Harrison as much as it did Alfred. Mr. Harrison returned to New York two years later with a plan: he would form a charity to provide clean water to save lives in poor countries. But by then, he was broke and sleeping on a friend’s couch.

Armed with nothing but a natural gift for promotion, and for wheedling donations from people, Mr. Harrison started his group, called charity: water — and it has been stunningly successful. In three years, he says, his group has raised $10 million (most of that last year alone) from 50,000 individual donors, providing clean water to nearly one million people in Africa and Asia.

Let Sleeping Hypertensives Lie

From Doc Gurley's blog, aptly entitled "Posts from an Insane Healthcare System"...

A well-designed recent study showed just how important sleep is to your blood pressure. Other studies in the past have revealed an association between time-spent-sleeping, and high blood pressure, but none of those studies actually measured a person’s sleep (they were, instead, based on self-report) and almost none looked at blood pressure over time

This recent study did both – and found some eye-opening (so to speak) results:

• Every hour LESS you sleep, you increase your risk of high blood pressure by 37%

Saving a Kashmiri Village After Remaking His Life

This Mr. Shea is quite an inspirational person, "being the change that he wants to see in the world..."

CHIKAR, Pakistan — The lone hospital in this Kashmiri mountain town was on the eve of hosting one of the year’s biggest social gatherings, a health fair for several hundred villagers, and Todd Shea was not happy.

The hospital’s founder, Mr. Shea, an American who resembles a football coach more than a health worker, was outraged because one of the employees had failed to purchase enough hygiene kits — freebies the villagers had come to expect at the fair.

If Mr. Shea, 42, had a résumé, it would by his own admission reveal far more experience as a cocaine addict than as a medical professional. But with his take-charge demeanor, he has transformed primary health care here in this mountain town in Kashmir, where government services are mostly invisible.

“Others are more qualified, but I’m the one who’s here,” he said.

When Our Brains Short-Circuit

Evidence is accumulating that the human brain systematically misjudges certain kinds of risks. In effect, evolution has programmed us to be alert for snakes and enemies with clubs, but we aren’t well prepared to respond to dangers that require forethought.