Twenty years ago, more than a dozen leaders in child psychiatry received $11 million from the National Institute of Mental Health to study an important question facing families with children with attention deficit hyperactivity disorder: Is the best long-term treatment medication, behavioral therapy or both?
The widely publicized result was not only that medication like Ritalin or Adderall trounced behavioral therapy, but also that combining the two did little beyond what medication could do alone. The finding has become a pillar of pharmaceutical companies' campaigns to market A.D.H.D. drugs, and is used by insurance companies and school systems to argue against therapies that are usually more expensive than pills.
But in retrospect, even some authors of the study -- widely considered the most influential study ever on A.D.H.D. -- worry that the results oversold the benefits of drugs, discouraging important home- and school-focused therapy and ultimately distorting the debate over the most effective (and cost-effective) treatments.
The study was structured to emphasize the reduction of impulsivity and inattention symptoms, for which medication is designed to deliver quick results, several of the researchers said in recent interviews. Less emphasis was placed on improving children's longer-term academic and social skills, which behavioral therapy addresses by teaching children, parents and teachers to create less distracting and more organized learning environments.
1. Irritability: "Complaints of irritability and [emotional] volatility following.
3. Inability to learn
4. Weight gain: People who are underslept seem to have hormone imbalances that are tied to increased appetite, more cravings for high-calorie foods, a greater response to indulgent treats, and a dampened ability to control their impulses -- a very dangerous combination.
5. Poor vision
6. Heart disease
9. Economic risk-taking
10. Overproduction of urine
Not getting enough sleep is a big problem.
Randomized controlled trials show that people who are sleep-deprived can see decreases in their empathy. More than one such study has shown that sleep deprivation can leave people more sensitive to pain. Sleep deprivation can hurt cognition, and it is associated with many, many car accidents.
Sleep for empathy, cognition, and safe driving.
In one TV commercial, a man declared that with Lumosity "decisions come quicker. I'm more productive." The company website stated that brain training could help "patients with brain trauma, chemofog, mild cognitive impairment and more," adding that "healthy people have also used brain training to sharpen their daily lives and ward off cognitive decline."
Earlier this month, the Federal Trade Commission said: No more.
Its complaint charged that the company could not substantiate such marketing claims. "The research it has done falls short because it doesn't show any real-world benefits," said Michelle Rusk, an F.T.C. staff lawyer.
She called the commission's yearlong investigation "part of an effort to crack down on cognitive products, especially when they're targeted to an aging population."
Lumosity agreed to give its one million current subscribers, who pay $14.95 a month or $79.95 annually, a quick way to opt out. It also accepted a $50 million judgment, all but $2 million suspended after the commission reviewed the company's financial records.
Previously: Lumosity lawyer needed ?
A less-than-novel solution -- getting more sleep -- would also help.
The endocannabinoid system is involved in various brain functions, including stress management, immune response and pain modulation. It has even been linked to the "runner's high" that many feel after aerobic exercise. But the new study represents the first time that scientists have found the system to be affected by sleep deprivation, Dr. Hanlon said.
Research suggests that losing sleep slightly increases the body's need for calories, but that people who are sleep deprived often consume far more than they need.
The study comes as Americans are voluntarily curtailing their own sleep, a practice that may correspond to a sharp rise in obesity rates over the last several decades.
Between 2005 and 2007, nearly 30 percent of adults said that they slept six hours or less per day, according to data from the National Health Interview Survey. That's an hour less than the minimum amount of sleep recommended for adults.
Cognitive tests used to assess participants' progress are often so similar to the training games that investigators may be "teaching to the test."
In one TV commercial, a man declared that with Lumosity "decisions come quicker. I'm more productive." The company website stated that brain training could help "patients with brain trauma, chemofog, mild cognitive impairment and more," adding that "healthy people have also used brain training to sharpen their daily lives and ward off cognitive decline."
Earlier this month, the Federal Trade Commission said: No more.
Its complaint charged that the company could not substantiate such marketing claims. "The research it has done falls short because it doesn't show any real-world benefits," said Michelle Rusk, an F.T.C. staff lawyer.
She called the commission's yearlong investigation "part of an effort to crack down on cognitive products, especially when they're targeted to an aging population."
Lumosity agreed to give its one million current subscribers, who pay $14.95 a month or $79.95 annually, a quick way to opt out. It also accepted a $50 million judgment, all but $2 million suspended after the commission reviewed the company's financial records.
The company had already stopped making health and cognition claims, its new chief executive, Steve Berkowitz, said in an interview. But the firm settled because "we came to the realization that the most important thing we could do is focus on the future," Mr. Berkowitz said
Campuses like Trinity's have thick handbooks full of sexual assault resources, filled with pages upon pages of legal definitions and situational scenarios. But that doesn't mean that students necessarily understand the new policies. Yes, "consent" is now emblazoned on T-shirts and posters -- it was the subject of a recent public service initiative at Columbia, "Consent is BAE," that was criticized by students -- but even that does not ensure that students can define it.
"I think it's when two people agree to have sex, yeah?" a young woman, a junior at the Fashion Institute of Technology, said when approached on a recent day in Manhattan and asked if she could define "affirmative consent."
"Isn't that when only yes means yes? But not really?" said another woman, a dance and fashion major at N.Y.U.
"I know what consent is; is this different?" said a young man, a sports management major, also at N.Y.U.
It's the low fat, very high carbohydrate diet that we've been eating for the last 40 years, which raises levels of the hormone insulin and programs fat cells to go into calorie storage overdrive. I like to think of insulin as the ultimate fat cell fertilizer.
When someone with Type 1 diabetes first comes to attention, their blood sugar is high because they can't make enough insulin. They invariably have lost weight. They may be eating 5,000 calories a day, and they're still losing weight. You can't gain weight without insulin. The opposite is also true. If you give someone with diabetes too much insulin, they will inevitably gain weight. Insulin programs the body to store calories, and most of those calories get stored in the fat cells. If you've got too much insulin, you're going to store too many calories. This has been very well established scientifically.
Dr. David Ludwig, an obesity expert and professor of nutrition at the Harvard T.H. Chan School of Public Health
'At the corner of Lougheed Hwy and Willingdon Ave, Burnaby, BC' or 'SOLO' South of Lougheed ?
Included with the first building is a Whole Foods store, which, if history is prologue, bodes well for Solo District and the surrounding area. In the U.S., they call it the Whole Foods effect: wherever the Texas-based organic food chain locates a store, prices for surrounding real estate jump. The debate continues over whether those prices rise because of Whole Foods' presence, or because the chain is good at selecting markets where the future is bright. In any case, no one questions that Whole Foods is a desirable amenity.
Animated illustrations of 48 movements for fitness and health.
RolPal's president, Dièry Prudent, and it's easy to understand the roller's genesis. Mr. Prudent, a personal trainer who lives in a featured-in-interiors-magazines 1870s brownstone in Park Slope, Brooklyn, is the sort of exacting guy who bristles if you refer to the roller as a tool. "Tools are for carpenters," he said. "This is an instrument."
When a reporter arrived for a demonstration breathless, late and sweaty, Mr. Prudent, 53, handed over a glass of water and gestured toward a platter of Paleo-diet-friendly snacks: strips of bresaola, the meat as intricately folded as origami, so uniformly spaced it looked as if a ruler had been involved. "Relax," he said. "This is supposed to be an experience."
Mr. Prudent, who destroyed his right knee playing basketball on Bedford-Stuyvesant blacktop and then as a running back on his high school football team, was always on the hunt for a better rehab tool, ordering everything he could find off the Internet. About 12 years ago, he even concocted his own, made of steel pipes, foam pads and bicycle handlebar grips. It looked like a medieval torture device.
His wife, Mariza Scotch, an accessories designer and the chief creative director at Skagen, a Danish lifestyle brand, was unimpressed. Ms. Scotch can't stand "visual dissonance," he said, so he worried he'd have to rescue it from the trash or the recycling bin, like some of his other projects.
Intact skin is an effective germ barrier, and the skin of the buttocks and legs is relatively thick. It is also less likely to be cracked than the skin of the hands or face because it is normally sheltered from sunlight, dishwashing detergent, tools and other assaults.
An airport lounge once felt rich with possibilities for spontaneous encounters. Even if we did not converse, our attention was free to alight upon one another and linger, or not. We encountered another person, even if in silence. Such encounters are always ambiguous, and their need for interpretation gives rise to a train of imaginings, often erotic. This is what makes cities exciting.
The benefits of silence are off the books. They are not measured in the gross domestic product, yet the availability of silence surely contributes to creativity and innovation. They do not show up explicitly in social statistics such as level of educational achievement, yet one consumes a great deal of silence in the course of becoming educated.
Data showed that those who consumed a moderate amount of coffee, about three to five cups a day, were at the lowest risk for problems.
A systematic review published in 2005 found that regular coffee consumption was associated with a significantly reduced risk of developing Type 2 diabetes, with the lowest relative risks (about a third reduction) seen in those who drank at least six or seven cups a day. The latest study, published in 2014, used updated data and included 28 studies and more than 1.1 million participants. Again, the more coffee you drank, the less likely you were to have diabetes. This included both caffeinated and decaffeinated coffee.
-- Aaron E. Carroll is a professor of pediatrics at Indiana University School of Medicine
Under the ClassPass rules, members can take no more than three classes a month at any single studio, but they can otherwise take an unlimited number of classes at the 450 participating studios in New York. The hope for the studios is that ClassPass members will become sufficiently devoted that they will want to attend more often and will become full-price paying customers.
But the new crowds ClassPass brings are sometimes alienating the regular clientele.
New years' heath goal: Steve Feinberg and YOO-SUN PARK / Speedball
Almond Joy Overnight Oats
4 oz coconut, vanilla or plain yogurt*
2 tablespoons almonds, chopped
1/3 cup rolled oats
1 tablespoon cacao nibs
2 tablespoons unsweetened coconut
1/4 cup unsweetened vanilla almond milk
In U.S. Google searches, the most common word to follow the phrase "Is my husband . . ." is "gay." It is ten times more common than "depressed." It won't be long before Google will be able to provide the answer. Right now, just from your pattern of likes on Facebook (and without relying on status updates or comments), an algorithm can determine with eighty-eight-per-cent accuracy whether you are straight or gay.
Sixty per cent of the time, it can tell whether your parents were divorced before you turned twenty-one. Rudder calls this trove of data "an irresistible sociological opportunity." He writes, "You know the science is headed to undiscovered country when someone can hear your parents fighting in the click-click-click of a mouse."
The Pittsburgh health plan, for instance, has developed prediction models that analyze data like patient claims, prescriptions and census records to determine which members are likely to use the most emergency and urgent care, which can be expensive. Data sets of past health care consumption are fairly standard tools for predicting future use of health services.
But the insurer recently bolstered its forecasting models with details on members' household incomes, education levels, marital status, race or ethnicity, number of children at home, number of cars and so on. One of the sources for the consumer data U.P.M.C. used was Acxiom, a marketing analytics company that obtains consumers' information from both public records and private sources.
With the addition of these household details, the insurer turned up a few unexpected correlations: Mail-order shoppers and Internet users, for example, were likelier than some other members to use more emergency services.
Of course, buying furniture through, say, the Ikea catalog is unlikely to send you to the emergency-room. But it could be a proxy for other factors that do have a bearing on whether you seek urgent care, says Pamela Peele, the chief analytics officer for the U.P.M.C. insurance services division. A hypothetical patient might be a catalog shopper, for instance, because he or she is homebound or doesn't have access to transportation.
"It brings me another layer of vision, of view, that helps me figure out better prediction models and allocate our clinical resources," Dr. Peele said during a recent interview. She added: "If you are going to decrease the costs and improve the quality of care, you have to do something different."
The U.P.M.C. health plan has not yet acted on the correlations it found in the household data. But it already segments its members into different "market baskets," based on analysis of more traditional data sets. Then it assigns care coordinators to certain members flagged as high risk because they have chronic conditions that aren't being properly treated. The goal, Dr. Peel
Cause vs age, via Institute for Health Metrics and Evaluation.
The takeaway of both studies is that it is best, if you wish to perform high-intensity interval training, to stick to what is well documented as effective: a few sessions per week of 30- or 60-second intervals so strenuous you moan, followed by a minute or so of blessed recovery, and a painful repetition or four. Done correctly, such sessions, in my experience, get you out of the gym quickly and inspire truly inventive cursing.
Eating at the wrong times is tied to such profound and negative effects on our bodies
According to Satchidananda Panda of the Salk Institute, "we are very different animals between the day and night."
researchers discovered that the SCN is not the body's only timepiece. Additional oscillators in the peripheral tissues help adjust the daily rhythmic functions of organs. (See illustration here.) In the gut, for instance, intestinal motility and absorption differ depending on the time of day. Like all of the body's clocks, these rhythms are guided by clock genes that operate in a transcriptional feedback loop. Transcription factors such as CLOCK and BMAL1 activate the expression of a large number of genes, including Period and Cryptochrome, whose proteins, in turn, inhibit CLOCK and BMAL1, causing daily oscillations in their expression.
Circadian clocks in the periphery are guided by the SCN, and all of the clocks are vulnerable to the influence of zeitgebers (from the German for "time giver"), environmental stimuli that tell the body what time it is. The SCN's primary zeitgeber is light. Clocks of peripheral tissues, on the other hand, can take their cues from other inputs, such as food consumption.
The most common treatment for OSA is continuous positive airway pressure (CPAP), which reverses upper airway occlusion and improves sleep quality, subsequently reducing daytime sleepiness.
Q. How can you and other researchers publicize the hidden but massive costs imposed by inflexible workplace management so that managers learn to do better by their employees? The short-term emphasis on benchmarks and cutting costs, at the longer-term expense of institutional health, employee well-being, customer service and societal balance is very destructive. -- Dean, U.S.
A. Businesses should be concerned about worker sleep health, as Dean points out, for the many destructive impacts of having a narrow, short-term focus. Coincidentally, this narrowness of focus mirrors the mental state of sleep-deprived individuals. In the United States, being at work but not fully functional because of insomnia (called "presenteeism") has been estimated to cost $63 billion annually. We have evidence of multiple pathways by which the workplace impacts health and wellness.
Management can either be a part of the problem, or be a part of long-term solutions. We need evidence-based solutions that both improve worker health and benefit employers. Stay tuned. We also need a platform for broader conversations, like this Booming blog, than academic journals offer, because in part this is a social problem of cultural norms around balancing work and nonwork, the corporation and the individual.
The well.blogs.nytimes offers conclusions and speculations for next year in fitness intensity matters.
Stigmatizing female promiscuity -- a.k.a. slut-shaming -- has often been blamed on men, who have a Darwinian incentive to discourage their spouses from straying. But they also have a Darwinian incentive to encourage other women to be promiscuous. Dr. Vaillancourt said the experiment and other research suggest the stigma is enforced mainly by women.
"Sex is coveted by men," she said. "Accordingly, women limit access as a way of maintaining advantage in the negotiation of this resource. Women who make sex too readily available compromise the power-holding position of the group, which is why many women are particularly intolerant of women who are, or seem to be, promiscuous."
Indirect aggression can take a psychological toll on women who are ostracized or feel pressured to meet impossible standards, like the vogue of thin bodies in many modern societies. Studies have shown that women's ideal body shape is to be thinner than average -- and thinner than what men consider the ideal shape to be. This pressure is frequently blamed on the ultrathin female role models featured in magazines and on television, but Christopher J. Ferguson and other researchers say that it's mainly the result of competition with their peers, not media images.
"To a large degree the media reflects trends that are going on in society, not creates them," said Dr. Ferguson, a psychologist at Stetson University. He found that women's dissatisfaction with their bodies did not correlate with what they watched on television at home. Nor were they influenced by TV programs shown in laboratory experiments: Watching the svelte actresses on "Scrubs" induced no more feelings of inferiority than watching the not-so-svelte star of "Roseanne."
But he found that women were more likely to feel worse when they compared themselves with peers in their own social circles, or even if they were in a room with a thin stranger, like the assistant to Dr. Ferguson who ran an experiment with female college students. When she wore makeup and sleek business attire, the students were less satisfied with their own bodies than when she wore baggy sweats and no makeup. And they felt still worse when there was an attractive man in the room with her.
The first step is to collect the data in one app, so that the weight you're measuring on the Withings connected scale and the stats on the 30-mile bike ride you tracked using MapMyRide, as well as your blood pressure, all appear in the same app and on the same interface.
Which app or website that should be is still up for grabs. A diverse group of fitness and vital-signs device makers, as well as app developers, are trying to figure it out. And the aggregation of monitoring data has turned into a spider's web of possibilities, with the functions captured on one app or hardware device able to be viewed on scores of others.
So now not only can you track Withings' weight data on Fitbit's app, but you can track Fitbit's activity data on Withings' app.
The MyFitnessPal weight-loss app shares information with Fitbit, Runtastic, BodyMedia, Jawbone and the Withings scale, among others. Fitbit shares its information with over 30 partners, including Lose It!, MapMyRun, and SleepDebt, as well as Withings and MyFitnessPal. Visit the site of your favorite fitness and health device or application, and you'll find similar partnerships.
Earlier that morning at Google headquarters in Mountain View, Calif., Chade-Meng Tan, a veteran engineer, was laughing about the demand for an in-house course he created called "Search Inside Yourself." The seven-week class teaches mindfulness, a loose term that covers an array of attention-training practices. It may mean spending 10 minutes with eyes closed on a gold-threaded pillow every morning or truly listening to your mother-in-law for once. Google naturally sees it as another utility widget for staying ahead. "Whenever we put the class online, it sells out in 30 seconds," Mr. Tan said.
Thich Nhat Hanh, the Vietnamese Buddhist leader who introduced mindfulness to Westerners (Google got first dibs on him as a guest speaker), once said, "The most precious gift we can offer anyone is our attention." Yet for the majority of sentient beings today, simply getting through an episode of "The Big Bang Theory" without tending multiple screens is a quasi-mystical triumph. Naturally, the architects of our electronic age approach the situation as if it were an engineering problem.
At the Wisdom meet-up in September at the Hub, a smiley young man with a nametag that read "Walter Inward" was showing off a new smoking-cessation app he had created for the iPhone. On one wrist, he wore a Buddhist mala bead bracelet; on the other, a high-tech Basis band that uses skin conductivity to record heart rate, sleep and steps.
He turned out to be Walter Roth, 30, chief executive of a tech start-up called Inward Inc. Mr. Roth said he had attended every Wisdom 2.0 event since 2009. Mindfulness has made him more competitive, he said. "Not only do I put fewer things on my to-list but I actually get them done and done well. It's like I've learned that to be more successful and accomplish more, I must first slow down."
With live, one-on-one video, a yoga teacher could instruct a student to hold her arm at a different angle or a lactation consultant could suggest that a mother position her infant in a different way.
Yet for the kind of questions the search engine can't answer, Google already has an alternative: YouTube, where how-to videos, like tying a bow tie or installing a car seat, are one of the most popular types for viewers and advertisers.
Other companies, like Quora, try to connect people with experts to answer questions, and some use video, like Joyus for shopping, American Well for health care and Wello for fitness training.
Helpouts is also part of a trend in tech to bridge offline and online commerce, including Square for payments, TaskRabbit for hiring people and Airbnb for renting homes.
If Helpouts succeeds, Google hopes it will provide experts with a source of income, so retired doctors or guitar players could teach people online. Experts charge a fixed rate or by the minute (a Helpouts session from Kitchit on making Thanksgiving stuffing costs $20). They keep 80 percent and Google takes 20 percent.
Helpouts is an obvious venue for marketers (Sephora is offering free one-on-one make-up tutorials, for instance) and Bridget Dolan, Sephora's vice president for digital marketing, said she could imagine eventually selling products from a Helpouts session.
city, state and federal policies that for more than half a century encouraged suburbanization and car use -- from mortgage lending to road building -- are gradually being diluted or reversed. "They created what I call a culture of 'automobility,' and arguably in the last 5 to 10 years that is dying out," Ms. Sheller said.
New York's new bike-sharing program and its skyrocketing bridge and tunnel tolls reflect those new priorities, as do a proliferation of car-sharing programs across the nation.
A study last year found that driving by young people decreased 23 percent between 2001 and 2009. The millennials don't value cars and car ownership, they value technology -- they care about what kinds of devices you own, Ms. Sheller said. The percentage of young drivers is inversely related to the availability of the Internet, Mr. Sivak's research has found. Why spend an hour driving to work when you could take the bus or train and be online?
From 2007 to 2011, the age group most likely to buy a car shifted from the 35 to 44 group to the 55 to 64 group, he found.
Few in Los Angeles get more joy from walking than the walking activist Alissa Walker (I kid you not). A journalist by trade, she has lived car-free by choice since 2007 and is on the steering committee of Los Angeles Walks, a volunteer organization dedicated to repairing the city's image as a walker's wasteland. "The basic goal is to make people realize you can walk in L.A.," she said. Better sidewalks, signage and city policies are all part of their mission.
I'm starting to think these health articles mainly offer opportunities for readers to write in to boast about their superior life style, habits and knowledge...then they advise the rest of us what we should do, when nobody asked them.....i'm sure their relatives steer clear to avoid their annoying lectures..i find many comments are obnoxious.in these health articles.....
The rise of interest in very brief, high-intensity interval training.
This approach to exercise started to take off in 2006, when Martin Gibala, a physiologist at McMaster University in Ontario, and his colleagues published a study showing that a three-minute sequence on an electronic stationary bicycle -- 30 seconds of punishing, all-out pedaling followed by a brief rest, repeated five or six times -- led to the same muscle-cell adaptations as 90 to 120 minutes of prolonged bike riding.
The study, which was published in The Journal of Physiology, soared to the top of the journal's "most e-mailed" list and stayed there for years.
Since then, Dr. Gibala and his colleagues, as well as other groups of scientists, have been closely parsing the effects of brief bouts of intense exercise, trying to determine just what happens in the body when you work it very hard for a short period of time, and what dosage of such intense effort is likely to be most effective and tolerable for a majority of people.
The most recent research suggests that a few minutes per week of strenuous exercise can improve aerobic fitness, generally more quickly than moderate activity does.
Especially come humid summer days, many women (and complexion-concerned men) rely on just their color cosmetics for their daily dose of SPF. The labels of trendy beauty balm and color control products (a k a BB and CC creams); their close cousins, tinted moisturizers; liquid foundations; and face powders often boast coverage of up to SPF 50. The new F.D.A. rules require that any SPF claiming "broad spectrum protection" must cover both UVA and UVB rays.
¶ So if your makeup offers broad spectrum SPF 15 (the recommended minimum level of protection) or above, you're covered, right?
¶ The short answer: "No,
Molly still feels like a more respectable substance than others.
"I think people are much more aware of where coke comes from and what it does in those countries," said Sarah Nicole Prickett, 27, a writer for Vice and The New Inquiry, a culture and commentary site, who called cocaine a "blood drug." "Molly, if it's pure, it feels good and fun." (Much of it comes from Canada and the Netherlands, Mr. Payne said.)
Ms. Prickett, who moved to New York from Toronto last year, added that she could see why the drug might be taking hold in her new habitat.
"My impression of New York was that everyone just did drugs for work, that everyone was on speed," she said. "Molly makes you feel unplanned, and that's not a common feeling in New York, where everyone knows where they're going all the time and they're going very, very fast."
Rick Doblin, the founder of the Multidisciplinary Association for Psychedelic Studies, which has helped finance MDMA studies since the drug first entered the club scene, put Molly in the context of past drug trends: in the 1960s, he suggested, people searched for deeper spirituality and found LSD; in the '70s, as hippie culture became mainstream, marijuana entered the suburban household; in the '80s, cocaine complemented the extravagance and selfishness of the greed decade; and by the early '90s, youths dropped out of reality, dancing all night on Ecstasy or slumping in the corner on heroin. MDMA, which in addition to acting as a stimulant also promotes feelings of bonding and human connection, just might be what people are looking for right now.
"As we move more and more electronic, people are extremely hungry for the opposite: human interaction on a deeper level where you're not rushing around," Mr. Doblin said. "The rise of Molly is in tune with how people are feeling emotionally."
Exercise and Academic Performance
As schools everywhere strive to improve the academic performance of their students, many have cut physical education and recess periods to leave more time for sedentary classroom instruction. A sensible new report from the Institute of Medicine, a unit of the National Academy of Sciences, shows how shortsighted this trend can be. It found that exercise can significantly improve children's cognitive abilities and their academic performance, as well as their health.
Students who exercise have lower body fat, greater muscular strength, and better cardiovascular and mental health. While admitting that the studies are limited, a panel of experts assembled by the institute says that "a growing body of evidence" suggests children who are more active are better able to focus their attention, are quicker to perform simple tasks, and have better working memories and problem solving skills than less-active children. They also perform better on standardized academic tests.
Academic performance is influenced by factors like parental involvement and socioeconomic status, but the panel reported that active children tended to have stronger performance, especially in reading and mathematics. It believes that the benefits of exercise during the school day outweigh the benefits from increasing class time.
-- NY Times THE EDITORIAL BOARD, May 24, 2013
Consider the lengths to which health scientists go to try to understand the workings of female desire: Using a laboratory gadget that measures vaginal blood flow while women watch varieties of pornography. Having women wear headgear that tracks the precise movement of their pupils, hundreds of times per second, as they gaze at X-rated images.
Studying female hamsters and even arachnids mating as a way to glean insight into women's sexual psyches. Wiring women's necks and forearms to what they are told is a polygraph machine while they fill out surveys about their sex lives, their answers then compared with those of women who aren't wired up -- and compared in turn with the responses of men. These are all attempts to see around or beneath the societal messages and cultural influences that may distort women's sexuality and constrain its expression, even in our seemingly unconstrained times. (Yes, the lie detector had a much bigger effect on the women than the men, greatly increasing the number of partners women said they'd had sex with.)
Serotonin is a molecule of self-control. It instills calm, stability, coherence (and, too, a sense of well-being, which is why S.S.R.I.'s, by bathing the brain in serotonin, can counter depression). Roughly speaking, dopamine is impulse; serotonin is inhibition and organization. And in sexuality, as in other emotional realms, the two have to work in balance. If dopamine is far too dominant, craving can splinter into attentional chaos. If serotonin overwhelms, the rational can displace the randy.
Dancy uses sensors to track his movements. His dog has a sensor to track where it is in the house. Sensors in his home are programmed so the music can be turned on and off during the day. Lights in the house turn on when he walks into the house. He uses IFTTT (If this then that) and Zapier to connect apps that feed into Google Calendar, Evernote and Excel.
Ross Douthat abortion counter:
But a tentative and ambiguous pro-choice trend in public opinion after a long period of pro-life gains does not mean that liberals have won the abortion wars, especially given that the main policy shift of the Obama era has been an uptick in state-level abortion restriction.
Stereotypes link the anti-abortion cause to traditionalist ideas about gender roles -- to the belief that a woman's place is in the home, or at least that her primary identity should be maternal rather than professional. Writing in the Reagan era, the sociologist Kristin Luker argued that this dimension of the debate trumped the question of whether unborn human life has rights: "While on the surface it is the embryo's fate that seems to be at stake, the abortion debate is actually about the meaning of women's lives."
The most outrageous aspects of the show -- its copious nudity, grinding simulations, exceptionally blue language -- tend to overshadow both its social importance and the sweet, rather innocent messages about sex at its core. The revue ran during a time when ideologies from the 1960s sexual revolution were being absorbed into the American mainstream: second-wave feminism and the post-Stonewall gay rights movement both were in full swing.
The sexual revolution, women's liberation and gay activism were all enormously complicated, influential, interconnected movements that meant countless different things to as many different people. Reactions to the changing times ran the gamut from sheer joy on one hand to confusion, anger, and fear on the other.
A friendly, inclusive show like "My People" proved just the ticket for the time. Audiences likely came to the Village Gate to ogle naked actors and guffaw at crude sex jokes, but the show ended up offering much more: surprisingly touching songs and sketches about intimacy, women's rights, gay life, lesbian love, all presented as fun, healthy and just not that big a deal. The show could be enjoyed by those who had unflinchingly embraced the era of sexual liberation, but it proved just as appealing to the many spectators who were tentative -- shyer, conservative, confused -- and yet eager to learn, at a safe distance, what all the fuss was about.
The excesses might have died away, but the 1970s left us with lasting, meaningful change: more rights for women; a better understanding of sexuality; enormous strides in the struggle for gay and lesbian civil rights.
But a part of Ms. Lorri Unumb's job these days is to assist parents with appeals where employers have said no or appear likely to. She has accompanied parents to meetings with their human resources departments all over the country to request that the employer expand coverage for everyone. She has a 115-page presentation that she draws on, pointing out that at its core, autism is a medical condition diagnosed by a doctor, the very thing health insurance is supposed to cover.
At $60,000 or more annually for children with particularly acute treatment needs, the coverage does not come cheaply. But Autism Speaks estimates that that expense, spread over thousands of employees, raises premium costs 31 cents a month.
Ms. Unumb notes that for many autistic children, intensive early intervention can allow them to function in mainstream classrooms and prevent a host of problems there and once they finish school. "You pay for it now or you pay for it later," she said. "And you pay for it a lot more if you choose later, in more ways than just financial."
Autistic children can benefit from an intensive treatment called applied behavior analysis, but many insurance companies haven't wanted to cover what can be a $60,000 or $70,000 annual cost. They claim that the treatment, which can include intensive one-on-one interaction and assistance with both basic and more complex skills, is either too experimental or an educational service that schools should provide. This can be a tricky area for parents to navigate, because it isn't always clear which part of an overall health insurance policy ought to cover various possible treatments.
A law school professor named Lorri Unumb faced a bill that big several years ago when her son Ryan was found to be autistic and she discovered that her insurance would not pay for treatment. After moving to South Carolina and meeting families there who had not been able to afford the therapy, she spent two years persuading state legislators to pass a law that forced insurance companies to pay for the treatment. "I did not really know how to write a bill," she said. "I had watched 'Schoolhouse Rock' before, and that was kind of my inspiration and guidance."
Autism Speaks, a national advocacy organization, saw what she accomplished and hired her to barnstorm the country in an effort to get similar laws passed. There are now 32 states that have them, though there's a crucial catch: they don't apply to the many large employers who pool their own resources in so-called self-funded insurance plans.
If you work in such a company, it may be up to you to lobby your human resources department to cover applied behavioral analysis or whatever mental health therapy you or your child may need. Sometimes a personal appeal will succeed; Mr. Kaplan, the benefits consultant, noted that when a parent called about a child, an employer might be particularly sensitive.
The first thing Truffo told me when I reached her in her Orange County office was that I shouldn't feel bad about my empty hours; nowadays, she said, even established veterans were struggling. Yes, the economy was bad, but the real issue was that psychotherapy had an image problem.
The one thing I enjoyed most was the wide array of cases I saw, I explained to Roth, and if I specialized, I'd be doing too much of the same thing all day. She suggested that if I wasn't ready to commit to a niche, I could add life-coaching services to appeal to "today's consumer looking for quick solutions rather than long-term insight." When I balked -- I couldn't picture "Lori Gottlieb, life coach" -- she assured me that many therapists who prefer deeper, broader work also offer coaching as an adjunct to their practices.
She told me about a therapist named Sandra Bryson. In 2009, Bryson called for help after her successful Oakland-based practice of 25 years lost patients when she stopped taking insurance. According to Truffo, Bryson shared a problem common to therapists: "a blah-sounding message and no angle." Bryson had always done well as a generalist -- treating anything from depression to grief to marital issues -- but Truffo urged her to find a specialty, one that "captured the zeitgeist but didn't feel played out." Bryson mentioned that she liked helping parents and had an affinity for technology, and voilà -- suddenly she had a brand. Not as a clinician addressing typical parenting issues like boundary-setting, which Truffo called "generic and old-school," but as an expert who helps modern families navigate digital media. She also became a sought-after speaker on so-called hot issues like screen time, cyberbullying and sexting, and Bryson told me her practice, which is based on "mostly deep work," had become "more advice-driven." Now her schedule is full, and her income has increased about 15 percent a year.
"Nobody wants to buy therapy anymore," Truffo told me. "They want to buy a solution to a problem." This is something Truffo discovered in her own former private practice of 18 years, during which she saw a shift from people who were unhappy and wanted to understand themselves better to people who would come in "because they wanted someone else or something else to change," she said. "I'd see fewer and fewer people coming in and saying, 'I want to change.' "
From a branding perspective, the fix was simple. At professional-networking events or in newsletters, her pitch went from "I treat people with depression and anxiety" to "Are you having trouble with the difficult people in your life?" Of course, therapy isn't about changing someone else, but that wasn't the point. If she could get people in treatment and help them feel better, she explained, why did it matter how she spun her pitch? Her goals seemed valid, but the idea of pitches and branding still made me uncomfortable.
The doctor knelt at the bedside to perform the time-honored tradition of percussing the heart. "Do it like this," he said, placing his left hand over the man's heart, and tapping its middle finger with the middle finger of his right.
One by one, each trainee took a turn. An X-ray or echocardiogram would do the job more accurately. But Dr. Heineken wanted the students to experience discovering an enlarged heart in a physical exam.
Dr. Heineken fills his teaching days with similar lessons, which can mean struggling upstream against a current of technology. Through his career, he has seen the advent of CT scans, ultrasounds, M.R.I.'s and countless new lab tests. He has watched peers turn their backs on patients while struggling with a new computer system, or rush patients through their appointments while forgetting the most fundamental tools -- their eyes and ears.
For these reasons, he makes a point of requiring something old-fashioned of his trainees.
"I tell them that their first reflex should be to look at the patient, not the computer," Dr. Heineken said. And he tells the team to return to each patient's bedside at day's end. "I say, 'Don't go to a computer; go back to the room, sit down and listen to them. And don't look like you're in a hurry.' "
One reason for this, Dr. Heineken said, is to adjust treatment recommendations based on the patient's own priorities. "Any difficult clinical decision is made easier after discussing it with the patient," he said.
The idea that race or ethnicity might help determine how well people sleep is relatively new among sleep researchers. But in the few short years that epidemiologists, demographers and psychologists have been studying the link, they have repeatedly come to the same conclusion: In the United States, at least, sleep is not colorblind.
Non-Hispanic whites get more and better-quality sleep than people of other races, studies repeatedly show. Blacks are the most likely to get shorter, more restless sleep.
What researchers don't yet know is why.
"We're not at a point where we can say for certain is it nature versus nurture, is it race or is it socioeconomics," said Dr. Michael A. Grandner, a health research associate with the Center for Sleep and Neurobiology at the University of Pennsylvania. But when it comes to sleep, "there is a unique factor of race we're still trying to understand."
Whatever the cause, doctors say that unlocking the secret to racial disparities in sleep could yield insights into why people in some minority groups experience higher rates of high blood pressure, obesity and diabetes. Helping poor or immigrant populations to get more solid sleep, they say, could also help break the cycle of poverty and disadvantage.
"When people aren't sleeping as well during the night, they aren't as productive during the day, and they're not as healthy," said Dr. Mercedes R. Carnethon, associate professor of preventive medicine at Northwestern University Feinberg School of Medicine. "It's a self-perpetuating cycle."
Research that does tease apart weight and fitness -- like a series of studies conducted by Steven Blair at the Cooper Institute in Dallas -- shows that being fat and fit is better, healthwise, than being thin and unfit. Regular aerobic exercise may not lead to weight loss, but it does reduce fat in the liver, where it may do the most metabolic damage, according to a recent study at the University of Sydney.
"More often than not, cardiovascular fitness is a far more important predictor of mortality risk than just knowing what you weigh," said Glenn Gaesser, author of "Big Fat Lies" and director of the Healthy Lifestyles Research Center at Arizona State University.
-- Harriet Brown, author, "Brave Girl Eating: A Family's Struggle with Anorexia."
Nutritional recommendations were born at the end of the 19th century with the discovery that humans need 20 calories per pound of weight each day; 55 to 65 percent of this energy intake ought to come from carbohydrates, a quarter from fats and something over 10 percent from proteins.
These guidelines did not emerge only from scientific inquiry but also from a desire to maximize efficiency. In 1888, the American chemist Wilbur O. Atwater devised a series of formulas that would help people get the most energy from the least food. Economics and physiology would be joined in what he called "the pecuniary economy of food." Atwater pioneered a movement that came to be known as "scientific eating."
The notion appealed to French physicians, who had been looking for ways to improve working-class health and budgets. They believed that these households spent too much on meat and alcohol. Their program of "rational eating" aimed to instruct the poor to keep food expenses within the limits of their (modest) budgets. They urged the substitution of protein-rich legumes for red meat, pasta for sausages, and sugared beverages for wine.
Martin Bruegel, historian at the French National Institute for Agricultural Research, is the editor of "A Cultural History of Food in the Age of Empire."
Indeed, scientists are puzzling out the connections between musical training in childhood and language-based learning -- for instance, reading. Learning to play an instrument may confer some unexpected benefits, recent studies suggest.
We aren't talking here about the "Mozart effect," the claim that listening to classical music can improve people's performance on tests. Instead, these are studies of the effects of active engagement and discipline. This kind of musical training improves the brain's ability to discern the components of sound -- the pitch, the timing and the timbre.
"To learn to read, you need to have good working memory, the ability to disambiguate speech sounds, make sound-to-meaning connections," said Professor Nina Kraus, director of the Auditory Neuroscience Laboratory at Northwestern University. "Each one of these things really seems to be strengthened with active engagement in playing a musical instrument."
Skill in appreciating the subtle qualities of sound, even against a complicated and noisy background, turns out to be important not just for a child learning to understand speech and written language, but also for an elderly person struggling with hearing loss.
In a study of those who do keep playing, published this summer, researchers found that as musicians age, they experience the same decline in peripheral hearing, the functioning of the nerves in their ears, as nonmusicians. But older musicians preserve the brain functions, the central auditory processing skills that can help you understand speech against the background of a noisy environment.
Dr. Szasz argued against coercive treatments, like involuntary confinement, and the use of psychiatric diagnoses in the courts, calling both practices unscientific and unethical. He was soon placed in the company of other prominent critics of psychiatry, including the Canadian sociologist Erving Goffman and the French philosopher Michel Foucault.
Edward Shorter, the author of "A History of Psychiatry: From the Era of the Asylum to the Age of Prozac" (1997), called Dr. Szasz "the biggest of the antipsychiatry intellectuals."
"Together," he added, "they tried their hardest to keep people away from psychiatric treatment on the grounds that if patients did not have actual brain disease, their only real difficulties were 'problems in living.' "
This attack had some merit in the 1950s, Dr. Shorter said, but not later on, when the field began developing more scientific approaches.
To those skeptical of modern psychiatry, however, Dr. Szasz was a foundational figure.
Nowadays, the veil of ignorance is challenged by a powerful but ancient contender: the veil of opulence. While no serious political philosopher actually defends such a device -- the term is my own -- the veil of opulence runs thick in our political discourse. Where the veil of ignorance offers a test for fairness from an impersonal, universal point of view -- "What system would I want if I had no idea who I was going to be, or what talents and resources I was going to have?" -- the veil of opulence offers a test for fairness from the first-person, partial point of view: "What system would I want if I were so-and-so?" These two doctrines of fairness -- the universal view and the first-person view -- are both compelling in their own way, but only one of them offers moral clarity impartial enough to guide our policy decisions.
Those who don the veil of opulence may imagine themselves to be fantastically wealthy movie stars or extremely successful business entrepreneurs. They vote and set policies according to this fantasy. "If I were such and such a wealthy person," they ask, "how would I feel about giving X percentage of my income, or Y real dollars per year, to pay for services that I will never see nor use?" We see this repeatedly in our tax policy discussions, and we have just seen the latest instance of it in the Tax Policy Center's comparison of President Obama's tax plan versus Mitt Romney's tax plan.
Benjamin Hale, assistant professor of philosophy and environmental studies at the University of Colorado, Boulder, and a co-editor of the journal Ethics, Policy & Environment
My family has lived this reality for many years. We have a severely autistic son who has attended private schools which offer intensive behavioral therapy ("Applied Behavior Analysis" or "ABA," which is the only therapeutic methodology for which much evidence of effectiveness exists) with a student-teacher ratio of 1:1, and has also been receiving extensive ABA and other related services after school. Those schools and related services have enabled our son to make what progress he has been able to achieve. They are also necessarily and extremely expensive.
But every single year, we have to "sue" NYC (technically it's not a lawsuit in a court but an impartial hearing as provided under IDEA, but it functions in very similar fashion) to cover the costs of such a school and services when they invariably recommend services far below what is necessary for our son to achieve any educational benefit. We have never lost one of our "suits" yet against NYC, but in the meantime we are required to front the cost of our son's school and services every year and seek eventual reimbursement from NYC. Very, very few families have the financial resources to do so. (And while we have enough resources to front the costs pending reimbursement, we are not nearly rich enough to bear the full costs of our son's school and services - those can exceed $170K per year.) Those that do not either have to move or make do with whatever the system offers, which is often far, far below what is necessary.
It should also be noted that the very malfunctions of large school systems such as NYC make it easier for families such as mine, who have enough resources to go through the battles every year, to obtain eventual public reimbursement for special education services. First, the IEP process described above presupposes intensive consideration of the student's individual educational needs. Large educational bureaucracies, such as NYC's, are not well equipped for that type of individual consideration. This leads to a tendency for the bureaucracies to offer services based on what's convenient and typical rather than what's appropriate for the student. Second, large school bureaucracies are not, to put it mildly, well renowned for their general administrative competence, and the IDEA imposes various elaborate procedural requirements on school districts that are regularly violated. A family can often demonstrate these two facts when necessary to enforce the IDEA against the school district, if they have the time and resources to spare.
Strawberry and Almond Smoothie: A traditional smoothie with a twist of nutty protein.
Coconut Pineapple Pumpkin Seed Smoothie: Ice cubes made with low-fat coconut milk give this blended drink extra flavor and texture.
Carrot, Papaya and Sesame Smoothie: Hazelnuts, pistachios and coconut milk add richness to this nutritious drink.
Seeded Banana Frappe: A simple banana smoothie gains complexity from almonds, a trio of seeds and a little spice.
Melon Pomegranate Almond Smoothie: You can get the ruby-colored pomegranate juice for this drink with a juicer or a citrus press.
While it is reasonable for politicians to shy away from rationing -- especially when voters believe no expense should be spared to save a human life -- if the experience of other countries serves as precedent, they will probably get there sooner or later. In Britain, the National Institute for Health and Clinical Excellence determines what therapies will be covered by the National Health Service. It generally recommends against paying for a therapy that costs more than $31,000 to $47,000 for each year of life gained, adjusted for quality.
Putting a value on life, as it were, is controversial. The National Institute in Britain has denied or limited coverage of expensive drugs for ailments like pancreatic cancer, macular degeneration and Alzheimer's. But in a world of limited budgets, such decisions must be made.
Similar systems exist in many countries, including Australia and New Zealand, where the government decided not to pay for a universal vaccine against pneumococcal disease until its price fell to 25,000 New Zealand dollars (about $20,000) per quality-adjusted life year.
Though this concept may sound foreign, Washington has been putting a price on life since the administration of Ronald Reagan -- who determined that regulations should pass through a strict cost-benefit analysis, with values placed on factors like life and health. The Environmental Protection Agency values a life at about $9 million today. In 2009, the Transportation Department used a price tag of about $6 million. If safety improvements on a road were projected to cost more than the value of the lives expected to be saved by the improvement, the project would be deemed too expensive.
This approach has been contentious. And it has had an impact on Americans' health. In 1991 an appeals court reversed the E.P.A.'s decision to ban asbestos on the ground that it was too costly. The E.P.A., it argued, "would have this court believe that Congress, when it enacted its requirement that the E.P.A. consider the economic impacts of its regulations, thought that spending $200 million to $300 million to save approximately seven lives (approximately $30 million to $40 million per life) over 13 years is reasonable."
Sunscreen and sunblock, not to be forgotten,
T.T.: Your skin is very fair. Do you have a special trick to help get a glow?
Kay Panabaker: It's a struggle having such incredibly fair skin, and when I spend time in the sun, it turns obnoxiously red, instead of getting a pretty glow. I use Jergens Natural Glow Daily facial moisturizer. It not only restores moisture to my face, but it builds up a natural color without giving me that orange, fake-tan look. I'll also use Physicians Formula Bronze Booster on my neck, so I don't get that weird face-is-a-different-color-than-my-neck look!
Eight million men and women in the United States who struggle with binge eating, defined as consuming large amounts of food within a two-hour period at least twice a week without purging, accompanied by a sense of being out of control.
While about 10 percent of patients with anorexia and bulimia are men, binge eating is a problem shared almost equally by both sexes. A study published online in October and then in the March issue of The International Journal of Eating Disorders found that among 46,351 men and women ages 18 to 65, about 11 percent of women and 7.5 percent of men acknowledged some degree of binge eating.
"Binge eating among men is associated with significant levels of emotional distress, obesity, depression and work productivity impairment," said Richard Bedrosian, a study author and director of behavioral health and solution development at Wellness and Prevention Inc., which works with employers and health plans.
But while binge eating is challenging for women who suffer from it, the perils are perhaps greater for men, who rarely seek treatment for what many believe is a "women's disease." Unlike bulimia and anorexia, binge eating does not even have a distinct listing in the current D.S.M., as the diagnostic guide for mental health professionals is known.
"Guys generally don't come forward for any reason," said Ron Saxen, 49, author of "The Good Eater," a memoir of his struggle with binge eating, which began when he was about 11. At his worst, Mr. Saxen was consuming 10,000 to 15,000 calories' worth of Big Macs, French fries, chocolate milkshakes, candy bars, ice cream and M & Ms, often within an hour-and-a-half window.
Those men who do seek treatment often have difficulty finding a facility or therapist to work with them -- even the literature is predominantly female-centric. Before Vic Avon was given a diagnosis of anorexia in 2006, for example, he scoured the Web for information relating to men and eating disorders. "Everything I saw was written for and by women," said Mr. Avon, 29, a building contractor in Brick Township, N.J.
About 30 million children participate in organized sports in the United States; every year, three million to four million of them get injured. Dr. Metzl points to the rising number of young athletes suffering injuries to the anterior cruciate ligament -- the main ligament that stabilizes the knee joint -- as evidence of the need for greater emphasis on strength training in youth sports. Exercises like squats can strengthen the muscles around the knee joints, making them less vulnerable.
"A number of studies show that strengthening the muscles around the knee reduces the risk of A.C.L. injuries," Dr. Metzl said. "Stronger muscles make you a better athlete, but also a safer athlete."
"We want kids to play sports," he added, "but we also want to figure out how to make them safer."
But exactly what constitutes safe and effective strength training for young people? Dr. Metzl says the most important thing to realize is that strength training is not the same as powerlifting. For youngsters, the emphasis should be on low weight and high repetitions. If a child cannot lift a weight for 15 reps, then it's too heavy, Dr. Metzl says. In fact, many of the most useful strengthening exercises for children are full-body movements that do not involve any weights at all.
Many of these movements are demonstrated in a video that Dr. Metzl and the American Academy of Pediatrics released this month for parents and adolescents, called "Home Strength Training for Young Athletes".
The video looks like any other workout series, except the instructor -- a buff Dr. Metzl, who is preparing for an Ironman race -- leads a group of children ages 8 to 16 through a variety of exercises that can be done at home. The only equipment required is a set of light dumbbells.
Many of the exercises involve functional body weight training -- essentially using your own weight for resistance. Dr. Metzl leads his pint-size workout warriors through exercises like jump squats, biceps curls and overhead "presses" with weights (done while balancing on one foot). Some other movements Dr. Metzl teaches his young athletes are push-ups, single-leg squats and a tough, core-building exercise called mountain climbers, as well as burpees, a series of movements executed in rapid succession that develop agility, coordination and strength.
Doing these exercises at home -- in a roughly 45-minute session two or three times a week -- has several advantages, said Dr. Gregory of Vanderbilt Children's. For one, it allows parents to watch or join in on the workout. Many commercial gyms have a minimum age limit that forbids adolescents, and most children would risk injury trying to use machines designed for adults anyway.
In France, the French social anthropologist Claude Fischler theorizes, a meal is considered a kind of communion, an intimate sharing of experience. In the States, he argues, it represents a contract, a negotiation over aversions, allergies and dietary needs.
"It is not looked upon highly, in France, to be on a diet," Valerie Bignon said. "Because, in principle, it's not really necessary." This sentiment surprised me, given that the company she worked for had purchased a diet company for $600 million. She explained to me how easy losing weight should be: "The main course is passed around on a big plate, and you take what you want. So if a French woman takes from the meat dish at all, she takes just a little. It is rather easy to do her diet without mentioning it to anyone." Bignon also serves on the advisory board of the corporate foundation for Nestlé France, a program interested, she explained, in "reviving the French culture of nourishment." She seemed torn between defending her country's food culture and promoting a product that offers a defense against the results of its erosion so far.
As is true in the United States, Jenny Craig clients in France are expected to meet, by phone or in person, once a week with a Jenny Craig consultant. In France, however, the consultants are all dietitians, whereas the American model relies on laypeople trained in the Jenny Craig technique. If the French take their food seriously, they also see dieting as a serious affair, something that could be hazardous to your health without appropriate supervision. The word "diet" has negative enough associations in France that Weight Watchers recently came up with a new marketing campaign there: "Stop the diets. Relearn how to eat."
Agency officials began the electronic monitoring operation on their own.
The software used to track the F.D.A. scientists, sold by SpectorSoft of Vero Beach, Fla., costs as little as $99.95 for individual use, or $2,875 to place the program on 25 computers. It is marketed mainly to employers to monitor their workers and to parents to keep tabs on their children's computer activities.
"Monitor everything they do," says SpectorSoft's Web site. "Catch them red-handed by receiving instant alerts when keywords or phrases are typed or are contained in an e-mail, chat, instant message or Web site."
The F.D.A. program did all of that and more, as its operators analyzed the results from their early e-mail interceptions and used them to search for new "actors," develop new keywords to search and map out future areas of concern.
The intercepted e-mails revealed, for instance, that a few of the scientists under surveillance were drafting a complaint in 2010 that they planned to take to the Office of Special Counsel. A short time later, before the complaint was filed, Dr. Robert C. Smith and another complaining scientist were let go and a third was suspended.
In another case, the intercepted e-mails indicated that Paul T. Hardy, another of the dissident employees, had reapplied for an F.D.A. job "and is being considered for a position." (He did not get it.)
Posted in Health.
Equinox gyms have a new 45-minute class called Indo-Row, which takes students through speed and distance drills on rowers. The gyms are also starting a 30-to-45-minute class in April called Shock Wave that sends students through four stations.
The highlight is the rowing station, where instructors assign up to eight people at a time a distance like 300 meters, which is supposed to take a minute or two to complete. The other students work out at the other stations, using that time to perform exercises like lunges and planks that target different body parts. A set ends when all rowers have completed their distances.
"The point is to work every muscle group intensely in a short amount of time and to surprise students by giving them different distances each time," said Jay Blahnik, a fitness educator and a creator of Shock Wave.
Other options include group classes on weekends at Row New York, a decade-old club based in Long Island City, Queens. There's even a free session for adults with physical and cognitive disabilities.
Anatomically Correct, a personal-training gym in SoHo, has an interactive program called Indoorance created by the owner and trainer Mike Creamer. The gym has three Concept2 rowing machines equipped with 3-D screens that lead rowers through varying workouts on a virtual river.
Randall J. Bateman, director of the DIAN Therapeutic Trials Unit at Washington University School of Medicine in St. Louis, says it is far too soon to admit defeat. He notes that the history of medicine is replete with stories of drugs that were almost abandoned because they were initially studied in the wrong group or were administered in the wrong dose or at the wrong time in the course of a disease. Even penicillin was a failure at first. It was initially tested by dabbing it on skin infections, Bateman says. But the way the drug was applied to the infections and its low dose made it impossible for the drug to cure even an infection that would otherwise respond to it. Finally, when the drug was tested at the right dose in the right patients, it cured eye infections and also pneumonia in people who were certain to have died without it.
"Even something as effective as penicillin can fail unless it is administered properly," Bateman says. He predicts that in the future it will become clear that for Alzheimer's drugs to be effective, they would have to be given earlier.
In 1901, a German psychiatrist, Alois Alzheimer, first noted the disease when he described the case of a 51-year-old woman named Auguste Deter. "She sits on the bed with a helpless expression," Alzheimer wrote. "What is your name? Auguste. Your husband? Ah, my husband. She looks as if she didn't understand the question."
Five years later, when Auguste Deter died, Alzheimer examined her brain. It was the color of sandpaper and the texture of tofu, like every other brain. But there the similarities ended. Deter's brain was shriveled and flecked with tiny particles that stuck to it like barnacles. No one had ever seen such a thing before in any brain.
A shot-glass amount of sunscreen should be applied to all exposed skin, including the ears, back of the neck and top of the feet, which are often forgotten."
In Australia, where skin cancer has long been epidemic, a "no hat, no play" policy as part of a broad-based emphasis on sun protection has made the country one of the first in the world in which skin cancer incidence is declining, Mr. Geller said.
And once children reach their teens, sun protection succumbs to burgeoning feelings of independence and invulnerability, as well as the popular belief among teenagers that they look more attractive when sporting a tan. Few seem worried about the chances of developing wrinkled, leathery, blotchy skin decades later as a result. Fewer still seem to know that they are risking cancer.
Yet childhood is the most critical time for avoiding sun-induced harm later in life. As much as 80 percent of a person's lifetime exposure to skin-damaging ultraviolet rays occurs by age 18. Multiple studies have shown that the more youngsters are exposed to the sun early in life, especially if they suffer serious sunburns, the greater the risk of later developing both superficial skin cancers and deadly melanomas.
But despite their relative success, Skinnerian weight-loss programs have not become the default treatment for obesity the way AA has for alcoholism. One reason, of course, is that most would-be weight-losers can't afford these programs (insurance usually won't cover them) or don't have the time, patience, or motivation to commit to one. At up to $3,500, the six-month Miriam outpatient program is a relatively good deal, especially compared with Canyon Ranch, which offers a well-regarded residential program for about $1,200 a day.
"We know how to get people to eat healthier and exercise," says Steven Blair, an exercise and epidemiology researcher at the University of South Carolina. "The question is how to roll out the needed behavioral strategies to 50 million unfit adults in the U.S. Even if there were enough trained counselors to work with that many people, which there aren't, the cost issues would be overwhelming."
¶In Seattle, the Virginia Mason Medical Center, once deemed a high-cost provider, has conducted rigorous internal reviews to eliminate waste and inefficiency. It says that after doctors were required to click through a computerized checklist of the medical circumstances needed to justify a costly imaging test, CT scans for sinus conditions dropped by 27 percent and M.R.I.'s for headaches by 23 percent. It placed nursing teams and supplies closer to patients, freeing nurses to spend 90 percent of their time on direct patient care, far more than the 35 percent at most hospitals. The time needed to process insurance claims was sharply cut by consolidating steps. In a tough environment for hospitals, Virginia Mason has been reporting margins of 4 to 5 percent.
¶Virginia Mason also collaborated with Starbucks and the company's insurance provider, Aetna, to find better ways to treat patients with uncomplicated back pain, a costly burden to the company. At the start, all patients complaining of back pain typically waited many weeks to see a specialist, who would then prescribe a costly, unnecessary M.R.I. before finally sending them on to a physical therapist. By finding ways to separate out the uncomplicated cases, Virginia Mason was able to send them directly to a therapist on the day the patient requested an appointment, and the vast majority were able to quickly return to work.
What new information did your equation render?
That the conventional wisdom of 3,500 calories less is what it takes to lose a pound of weight is wrong. The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight onto an obese person than on a thinner one.
Also, there's a time constant that's an important factor in weight loss. That's because if you reduce your caloric intake, after a while, your body reaches equilibrium. It actually takes about three years for a dieter to reach their new "steady state." Our model predicts that if you eat 100 calories fewer a day, in three years you will, on average, lose 10 pounds -- if you don't cheat.
Another finding: Huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person's body will respond slowly to the food intake.
Footsteps, sweat, caffeine, memories, stress, even sex and dating habits - it can all be calculated and scored like a baseball batting average. And if there isn't already an app or a device for tracking it, one will probably appear in the next few years.
Over the last weekend of May, in the upstairs of the Computer History Museum in Mountain View, California, in the heart of Silicon Valley, 400 "Quantified-Selfers" from around the globe have gathered to show off their Excel sheets, databases and gadgets.
-- April Dembosky, FT's San Francisco correspondent
AT THE HOTEL Dr. Philip M. Tierno, a microbiologist at the New York University School of Medicine, recommends laying the bedspread aside, because it is washed rarely, and making sure the sheets are crisp and clean; if they are not, request another room. Check the mattress for bed bugs. Wipe down the telephone, night stand, remote control and bathroom with disinfectant. Disinfect the handle on the minibar fridge, and relax.
OUT AND ABOUT Americans traveling to less developed nations should pay special attention to the water, according to Dr. David Schlossberg, a professor of medicine at Temple University who contributed to and edited the book "Infections of Leisure." He recommends drinking only bottled water with a sealed cap, to make sure you're not swallowing dressed-up tap water. Carbonated water is best. Do not use ice (frozen tap water), do not eat salad (washed in tap water) or fruit you can't peel yourself. Use bottled water to brush your teeth. At restaurants, he cautions against eating anything that is room temperature or seems undercooked. "For all the advances in medicine, infectious disease remains the No. 1 killer on the planet," he said.
"What we're finding is, it's everybody," said Mike Indursky, the president of the Bliss chain of spas, which offers a men's Brazilian called the Ultimate He-Wax for $125. "It's the gay community, it's the straight community, it's very conservative guys, it's very liberal guys. All different age groups are coming in. It's much, much bigger than we ever thought."
Men's bikini waxing accounts for around 70 percent of the weekly business at Face to Face, a discreet salon in the Flatiron district of Manhattan with a predominantly male clientele founded eight years ago by Enrique Ramirez. "When I started, I was like, 'Nobody's going to come in and get this done,' and it's just kept growing and growing," Mr. Ramirez said. "In the past two years, it's been crazy."
The salon offers a full Brazilian called South of the Border for $70, along with partial treatments. Also on its menu is something called "pejazzling," in which crystals in patterns like stars and dolphins are affixed on newly defuzzed skin.
Fashion & Style
A He-Wax for Him
By RACHEL FELDER
Published: April 10, 2012
Lately, men's grooming has gone one step farther than a manicure or a facial, into territory previously reserved solely for women: bikini waxing.
The researchers had the volunteers either vigorously ride computerized stationary bicycles or sit quietly for an hour before settling onto the M.R.I. tables. Each volunteer then swapped activities for their second session.
Immediately afterward, they watched a series of photos flash onto computer screens. Some depicted low-fat fruits and vegetables or nourishing grains, while others showcased glistening cheeseburgers, ice cream sundaes and cookies. A few photos that weren't of food were interspersed into the array.
In the volunteers who'd been sitting for an hour, the food-reward system lit up, especially when they sighted high-fat, sugary items.
But if they had worked out for an hour first, those same people displayed much less interest in food, according to their brain scans. Their insula and other portions of the food-reward system remained relatively quiet, even in the face of sundaes.
"Responsiveness to food cues was significantly reduced after exercise," says Todd A. Hagobian, a professor of kinesiology at California Polytechnic who oversaw the study, published last month in The Journal of Applied Physiology. "That reduction was spread across many different regions of the brain," he continues, "including those that affect liking and wanting food, and the motivation to seek out food." Though he didn't follow the volunteers after they'd left the lab to see whether they might have headed to an all-you-can-eat buffet on days they exercised, on questionnaires they indicated feeling much less interested in seeking out food after exercise than after rest.
Those results may not be typical, though. The Cal-Poly subjects uniformly were in their 20s, normal weight and fit enough to ride a bike strenuously for an hour. Many of us are not.
On another table stand a group of newcomers to the Special K family, a brand that is evidently food's answer to "Law & Order," given the number of spinoffs it has generated. Ms. Bath hands over a package of Special K "chocolatey delight" pastry crisps in a shiny white wrapper. (They are not called "chocolate" because they don't meet an F.D.A. definition of chocolate.)
Insurers typically encourage patients to use less expensive drugs by classifying products into tiers with successively higher co-payments, like $10, $30 and $50. Generic drugs are usually in the lowest tier, preferred brand-name drugs in the second tier and other brand-name drugs in the third.
But some insurers are now putting specialty drugs into a fourth tier of their own with extra high co-payments, or even co-insurance, in which the patient pays a percentage of the drug cost.
Patient advocates say that for some diseases, like multiple sclerosis, none of the drugs are inexpensive, making it impossible to avoid the high out-of-pocket costs unless people stop taking their medicine and endanger their health.
That discriminates against people with certain diseases, they say, and contravenes the whole idea of insurance, which is to help people pay for costly medical problems.
Mark Merritt, president of the Pharmaceutical Care Management Association, which represents pharmacy benefit managers, said the real problem was the price of the drugs. The legislation, he said, was an effort by the pharmaceutical industry to "turn a pricing problem into a coverage issue."
Sharon Treat, executive director of the National Legislative Association on Prescription Drug Prices, an organization of state lawmakers, said that was a drawback of the bills. Insulating patients from the cost of their drugs, she said, "gives the drug companies a free ride to charge as much as they want."
The health care mandate was defended as a kind of technocratic marvel -- the only policy capable of preventing the complex machinery of reform from leaking smoke and spitting lug nuts.
But the mandate is actually a more political sort of marvel. In the negotiations over health care reform, it protected the Democratic bill on two fronts at once: buying off some of the most influential interest groups even as it hid the true cost of universal coverage.
The mandate offered the interest groups what all entrenched industries desire: a fresh and captive market for their products. For the insurance companies, it promised enough new business to offset the cost of covering Americans with pre-existing conditions. For the health care sector as a whole, it guaranteed that disposable income currently being spent on other goods and services would be spent on its instead.
This explains why the health care bill was ultimately backed by so many industry lobbying groups, from the Pharmaceutical Research and Manufacturers of America to the American Medical Association. It explains why the big insurers, while opposing the final legislation, never attacked it as vigorously as they did Bill Clinton's ill-fated reform effort.
At the same time, by requiring the private purchase of insurance, the mandate kept the true cost of the health care expansion off the government's books, and largely out of the Congressional debate. As the Cato Institute's Michael Cannon has noted, during the Clinton era the Congressional Budget Office scored an individual mandate as a form of government spending, which pushed the official cost of the Clinton bill into the trillions. But the Obama White House was savvier in its mandate design, and the C.B.O. was more compliant in its scoring. As a result, a bill that might require over $2 trillion in new health care spending -- private as well as public -- over its first decade was sold with a $900 billion price tag.
So the mandate was politically brilliant, in a sense.
Another promising investment: In-room televisions that walk a patient through a doctor's orders - from bed rest to getting prescriptions filled.
"Like while you're in the hospital, they educate you on the TV so that you cannot see your shows until you've gone through the education, and they test you," she says.
It's a bit like not getting dessert until you've had your vegetables. Maybe this all sounds incredibly simplistic, but venture capitalists say one of the trickiest things about this new world of investing is that their returns, in many cases, hinge on humans changing their behavior. And that's a lot harder than building a robot.
His approach was almost free-form: he made us hold poses for a long time but taught no inversions and few classical postures. Throughout the class, he urged us to pay attention to the thresholds of pain. "I make it as hard as possible," he told the group. "It's up to you to make it easy on yourself."
A number of factors have converged to heighten the health risk of practicing yoga. The biggest is the demographic shift in those who study it. Indian practitioners of yoga typically squatted and sat cross-legged in daily life, and yoga poses, or asanas, were an outgrowth of these postures. Now urbanites who sit in chairs all day walk into a studio a couple of times a week and strain to twist themselves into ever-more-difficult postures despite their lack of flexibility and other physical problems. Many come to yoga as a gentle alternative to vigorous sports or for rehabilitation for injuries. But yoga's exploding popularity -- the number of Americans doing yoga has risen from about 4 million in 2001 to what some estimate to be as many as 20 million in 2011 -- means that there is now an abundance of studios where many teachers lack the deeper training necessary to recognize when students are headed toward injury. "Today many schools of yoga are just about pushing people," Black said. "You can't believe what's going on -- teachers jumping on people, pushing and pulling and saying, 'You should be able to do this by now.' It has to do with their egos."
In a 2003 article in Yoga Journal, Carol Krucoff -- a yoga instructor and therapist who works at the Integrative Medicine center at Duke University in North Carolina -- revealed her own struggles. She told of being filmed one day for national television and after being urged to do more, lifting one foot, grabbing her big toe and stretching her leg into the extended-hand-to-big-toe pose. As her leg straightened, she felt a sickening pop in her hamstring. The next day, she could barely walk. Krucoff needed physical therapy and a year of recovery before she could fully extend her leg again.
Joannides, who is 58, made sex education his life's work following the success of his sex manual for older teenagers and adults called, "The Guide to Getting It On." Lauded for its voluminous accuracy and wit, the 900-plus-page paperback took him 15 years to research and write. Joannides argues that pornography can be used as a teaching tool, not a bogeyman, as is apparent in a short Web video he made called "5 Things to Learn About Lovemaking From Porn." "In porn," he affably lectures, "sex happens instantly: camera, action, crotch. . . . In real life, the willingness to ask and learn from your partner is often what separates the good lovers from those who are totally forgettable." (Another of Joannides's assertions is that the best way to reach heterosexual boys -- who he believes are the most neglected in the current environment -- is to play to their desire for "mastery", because by middle school, they've thoroughly absorbed that to be a man is to be a stud.)
He wrestled with the question of how to portray what happens in the private chambers. "Sex scenes in a brothel are so expected that they could be very boring," he said. "I went much more into theater, fetishism, a kind of play." Masks and mirrors are ubiquitous; one prostitute mimics a marionette, while another dresses as a geisha and speaks pidgin Japanese. "These things can tell you more about power relationships than a faked sex scene," he added.
Extending the metaphor of brothel as theater, he likened the madam in "House of Pleasures" to a director committed to putting on a nightly show and consumed by the logistics and economics of doing so. (She is played by the director and actress Noémie Lvovsky, and many of the customers are also played by filmmaker friends, including Xavier Beauvois and Jacques Nolot.)
When testing Abilify, how was it determined that is a placebo is no better than Abilify ?
The box would quantify the benefits and side effects of Abilify used in combination with other antidepressants, drawing on the larger of the two six-week trials that formed the basis of its approval by the F.D.A. First, it would show how the drug scored versus a placebo (in Abilify's case, not much: only three points lower on a 60-point scale, and it resolved depression for only 10 percent of patients -- that is, 25 percent with Abilify versus 15 percent with just the placebo).
Skin cancer and skin damage: summer health alert.
The F.D.A. announced that it was re-examining the safety of the roughly 17 sunscreen agents approved for use in the United States, although it has no information to suggest that they are not safe. Tuesday's announcement will do nothing to speed the approval of more sunscreen agents. There are roughly 28 such agents approved in Europe and 40 in Japan, and some in the industry complain that the best ingredients have yet to reach American shores.
Claims that sunscreen is sweatproof or waterproof are universally false and not allowed.
Dr. Warwick L. Morison, a professor of dermatology at Johns Hopkins University and chairman of the photobiology committee for the Skin Cancer Foundation, said he was disappointed that the F.D.A. failed to ban SPF numbers higher than 50 because such products expose people to more irritating sunscreen ingredients without meaningful added protection.
"It's pointless," Dr. Morison said.
Instead, just re-apply SPF 50 sunscreen every 30 minutes.
Another edition of
but no thank you
I'd rather listen to N Gregory Mankiw.
1 THE VALUE OF COMPETITION Representative Paul D. Ryan, Republican of Wisconsin, has attracted much attention with his plan to reform Medicare. He proposes replacing the current fee-for-service program, in which the government picks up the bill for medical expenses, with a "premium-support" system in which seniors use federal dollars to choose among competing private insurance plans.
Democratic critics of the plan suggest that enacting it would be akin to pushing Grandma over a cliff. But they rarely point out that the premium-support model is in some ways similar to the system set up under President Obama's health care law. If choosing among competing private plans on a government-regulated exchange is a good idea for someone at age 50, why is it so horrific for someone who is 70?
2 THE INSURANCE MANDATE those without insurance will be fined. A mandate is just a financial incentive to have insurance.
What is the Republican alternative for having more people insured? It is unclear what the Republicans would do if they ever succeeded in repealing the health care reform law. However, their last presidential nominee -- Senator John McCain -- proposed a tax credit for buying health insurance. That may seem more palatable than a mandate, because it uses a carrot rather than a stick.
3 TAXING THE RICH Democrats want to increase taxes on the rich to fund the looming fiscal gap, which is driven largely by soaring health costs. Republicans object, saying higher taxes create economic distortions, discourage work and impede growth. Last month, John A. Boehner, the House speaker, said that we should instead consider means-testing Medicare
4 BLINKERED OPTIMISM Democrats and Republicans generally have different approaches to controlling the growth of health care spending. Democrats often favor a top-down approach: a panel of experts set up by the recent health care law will decide which medical procedures are cost-effective and which are wasteful. Republicans tend to prefer a bottom-up approach: empower consumers to make their own choices, they say, and the power of competition among private providers will keep costs down.
One thing that the two parties share, however, is the belief that controlling health care costs is possible.
Brown's stamina and fitness are noted by adversaries and allies alike. "I hope I'm in that good health when I'm 72," Dutton, the 60-year-old Senate Republican leader, said a few weeks before Brown turned 73. Still, Brown acknowledges he has lost a beat. He is bald, which has the effect of sharpening his already hawklike visage, with bushy white eyebrows and a slight stoop that sometimes makes him look like just another state bureaucrat as he wanders the halls of the Capitol. He has a huskiness of voice and a slight stiffness as he gets in and out of a car. "Oh, yeah, I feel the effects of age," he told me as we sat in his office in March. "You're not as acute as you were when you were younger. There's an aging process that I certainly have experienced. I'm in pretty good shape. And I do know more; there's an accumulation. But there's a big difference between 56 and 72. You do age. There are limits to our lives. They come to an end."
He is compulsive about daily workouts: a three-mile jog along the Sacramento River with Anne or lifting weights in a gym. In an otherwise loosely structured existence, exercise is the one constant on his daily schedule. When the governor ran into Anne at the lunch he attended with Beatty in Oakland, the couple could be overheard engaged in this bit of bantering:
"You look great," Brown said to his wife.
"You look great," Anne responded. "Did you work out today?"
"Yes, I did," Brown said. "Did you work out today?"
"Yes I did," Anne said. At that point, Beatty, who is 74, turned in astonishment to Brown. "You did?" he said. "For how long?"
Brown does push-ups, and he has a chin-up bar in his suite of offices. "I am the one who got him to do pull-ups," Anne said. He lost a belly of weight before his most recent campaign, and Anne is always on him to watch his diet. When a waitress asked Brown during our dinner if he wanted more wine, Anne intervened. "He'll have some water first," she said. Brown, who was picking at bread and French fries, was not on the program. "No, I'll have more wine," he said.
D IVERSION safes, of course, are not fire resistant and do not even have locks. Their strength is pretense. They cost $5 to $100, and are designed to look like various household objects: a head of iceberg lettuce, a can of soda and a can of shaving cream. Cans, jars and aerosol containers found in pantries and bathroom cabinets are typical. These stealth safes also come disguised as other kinds of things, like surge protectors and clocks.
"They are great for hiding stuff like money and jewelry," said Annie Blanco, marketing coordinator for homesecuritystore.com, an online retailer of home security systems, based in Riverside, Calif.
But Paul Cromwell, a professor of criminology at the University of South Florida Polytechnic in Lakeland, who has interviewed scores of professional burglars in his research, said he is skeptical about their value. "Burglars are looking online at these kinds of safes, too," he said. "So they know what to look for."
Hiding valuables in coat pockets or shoeboxes, in the freezer or buried in the dirt of potted plants, he added, isn't any better. "You may think you're being clever, but these are the first places burglars look."
Criminologists and law enforcement officials also advise against putting things inside toilet tanks and cereal boxes (where addicts tend to hide illegal drugs) and inside medicine cabinets (where thieves look for prescription drugs with resale value). So the last place you want to hide your diamond necklace or a roll of bills is inside an empty bottle of Oxycontin or Adderall.
Apart from a steel-clad safe, he said, the best place to store valuables is one that would take a thief considerable time and effort to find.
"Burglars want to spend as little time as possible in your home," he said. "The average time a professional burglar will spend there is five minutes."
Good options might include putting what you want to protect in a nondescript box surrounded by a pile of junk in the attic, or tucking it into the stuffing of one of a group of stuffed animals.
Amazing corrections. How could the original have slipped past a science editor ?
This article has been revised to reflect the following correction:
Correction: April 20, 2011
An earlier version of this article misstated the number of microbes relative to the number of cells in the human body. Each person shelters about 100 trillion microbes, not 10 trillion, and is made up of about 10 trillion cells, not one million.
Correction: April 23, 2011
A headline on Thursday with an article about the discovery by a group of scientists that people can be classified by the bacteria in their digestive systems misstated the conclusions of the researchers. They reported finding three ecosystems, each involving a multitude of bacteria species, in the human gut -- not just three types of bacteria.
Nurdle is "a small amount of toothpaste akin to what consumers would use brushing their teeth."
In life, like martial art, you can address a situation in 3 ways:
Rflexes protect us when we have no skill.
Context-specific reactions and
Reactions give tightly-defined, rote skills.
The most appropriate solution comes from the discretion to improvise and adapt as situations unfold.
Beyond flinches and forms, discover flow. Which are you using right now?
Patients were using a card distributed by the maker of an expensive antibiotic used to treat acne, sharply reducing their health insurance co-payments. With their out-of-pocket costs much lower, consumers had switched from generic alternatives to the more expensive drug.
With drug prices rising and many people out of work, pharmaceutical companies are increasingly helping patients with their co-payments. The use of such co-payment cards and coupons and other types of discounts has more than tripled since mid-2006, according to IMS Health, an information company that tracks the pharmaceutical industry.
"It seems the best strategy for a pharmaceutical company is to price their drug as high as they possibly can and offer that co-pay assistance broadly" to insulate consumers, said Joshua Schimmer, biotechnology analyst at Leerink Swann, an investment bank.
Jazz Pharmaceuticals has quadrupled the price of its narcolepsy drug Xyrem, to about $30,000 a year, over the last five years, according to a recent report from the securities firm Jefferies & Company. To cushion patients, the company recently increased its co-pay assistance to as much as $1,200 a month.
hundredpushups is epimonous.
Scientists studying sun safety took multiple readings of ultraviolet radiation at 32 high-altitude ski areas in western North America and interviewed thousands of skiers to find out whether they took precautions against the sun, like wearing hats, sunscreen and goggles, at appropriate times. Their conclusion was: only occasionally.
"There were lots of findings, but the big takeaway is that people do not know when UV is high and do not take precautions," said Peter A. Andersen, a professor of health communications at San Diego State University. "People took precautions not only when it was sunny but when it was warmer, and that's an erroneous calculation in people's minds. There is absolutely no correlation between temperature and UV radiation."
There can also be a lot of exposure to UV radiation on cloudy days, he said.
Daydreaming 'does not make you happy'
Continue reading the main story
The joy of daydreaming
People spend nearly half of their waking hours not thinking about what they are actually doing, according to a US study conducted via the iPhone.
More than 2,200 volunteers downloaded an app which then surveyed them about their thoughts and mood at random times of day and night.
The Science study suggested minds wander, even from demanding tasks, at least 30% of the time.
"Triathlons are much better for the body than long-distance running. With triathlons, when you are injured running, you can still swim and bike."
-- Dr. Michael J. Neely, the medical director at NY Sports Medicine and Physical Therapy, based in Manhattan.
... And leads to branded consumerism:
all the accessories and lifestyle brands that now cater to him and other triathletes. They can now buy TriSwim's shampoo to remove chlorine, and sports drinks like Hammer Nutrition Heed, which is sold on Web sites like One Tri. There are aerodynamic helmets and sunglasses made for triathlons, as well as wet suits and tri-specific running sneakers made by K-Swiss, Asics, Zoots and Newton.
At Placid Planet, a bicycle and triathlon shop in Lake Placid, N.Y., the new must-have accessories are Zipp wheels and compression tights. "Zipp wheels are an aerodynamic carbon wheel that increase speed by reducing drag on the wheel," said Kenny Boettger, the owner. Compression tights and socks, he said, help athletes recirculate oxygen and blood. "This is the big thing right now and it works," he said.
There are also magazines like Lava, which began publishing in August and offers testosterone-fueled articles and profiles that appeal to men who dream about being Ironmen. With page after page of Lycra, equipment reviews and training tips, the magazine is geared for "hardcore triathletes who want to get right inside the fiery molten center of triathlon," according to its mission statement.
Lava's macho-man mantra is simple. "Forty is the new 20," said John Duke, who publishes the monthly magazine in San Diego. "And in triathletes, 40 isn't old. The median age of the sport is 41."
Good thing, too, since triathlons don't come cheap. "Forty-somethings are also the ones who can afford the sport," said Scott Berlinger, the head coach of Full Throttle, a 120-man triathlon team that is based out of the Chelsea Piers in Manhattan. "I tell my athletes everything costs $100 -- shoes, helmets, glasses -- and the big purchase is your bike."
A bicycle -- the tri-world equivalent of the red sports car -- can cost anywhere from several hundred dollars to more than $10,000. After the bike and the chiropractor bills, the biggest item is individual coaching, which can easily run $100 an hour.
"Triathletes are a discerning group of alpha consumers, with $175,000 average salaries," said Erik Vervloet, vice president for sports marketing at K-Swiss, which jumped into the tri-market three years ago. "The average Ironman spends $22,000 a year on the sport."
The high price is an issue, particularly for spouses. "I still argue with the wife about the costs," said Mr. Goodman, the triathlete from Stamford. His gear includes a $5,000 Cervelo bicycle, a $3,000 Pinarello bicycle, Xterra Vector Pro2 wet suits, Izumi Tri Fly 111 bike shoes and a Lazer Tardiz helmet.
But his wife, Amy, eventually came around. "At first it was a bit hard for me to swallow," said Ms. Goodman, 32, who is attending graduate school in the field of public health, "but when I saw that the bike wasn't going to hang on the wall, I thought, in terms of self-indulgences, this is one of the best things he could be doing."
Another reason to ride the trolley (or bus, if need be):
In one such case in Wisconsin, a former physician slammed his S.U.V. into a Honda Accord in April 2008, killing the pregnant driver and her 10-year-old daughter. Prosecutors said the physician, Mark Benson, had high levels of the sleep aid Ambien in his system, as well as Xanax, an anti-anxiety drug, and oxycodone, an opiate painkiller. Mr. Benson was sentenced to 30 years in prison.
Defendants can try to prove that they did not realize their medication would affect their driving, prosecutors said, but that argument may not hold up if the bottle had a warning label.
"Would you go home and start a chain saw and cut down a tree?" said Lt. Col. Thomas C. Hejl, the assistant sheriff in Calvert County, Md. "Why should you get behind the wheel of a vehicle when the same medication has the same side effects?"
Vaseline launches skin-whitening Facebook India app
(AFP) - 15 hours ago
NEW DELHI -- Skincare group Vaseline has introduced a skin-lightening application for Facebook in India, enabling users to make their skin whiter in their profile pictures.
The download is designed to promote Vaseline's range of skin-lightening creams for men, a huge and fast-growing market driven by fashion and a cultural preference for fairer skin.
The widget promises to "transform your face on Facebook with Vaseline Men" in a campaign fronted by Bollywood actor Shahid Kapur, who is depicted with his face divided into dark and fair halves.
"We started campaign advertising (for the application) from the second week of June and the response has been pretty phenomenal," Pankaj Parihar from global advertising firm Omnicom, which designed the campaign, told AFP.
In 2005, Indian cosmetics giant Emani launched the first skin-whitening cream for men, called "Fair and Handsome", 27 years after the first cream for women.
Since then a half dozen foreign brands have piled into the market for men, including Garnier, L'Oreal and Nivea, which promote the seemingly magical lightening qualities of their products in ubiquitous advertising.
In 2009, a poll of nearly 12,000 people by online dating site Shaadi.com, revealed that skin tone was considered the most important criteria when choosing a partner in three northern Indian states.
A member of the Chukchansi tribe in California, Andrews is 6-foot-4 and about 250 pounds, with tattoos of his spirit animals ringing his thick biceps. He doesn't joust because he's attracted to romantic notions of honor and chivalry or because he has an affinity for the medieval period. ("I don't know jack about history, nor do I care," he says.) He does it because he considers jousting one of the most extreme sports ever invented, and he likes doing things that most other people can't or won't do.
"I like violent sports," says Andrews, who also participates in mixed martial arts. "I like hitting you. I like getting hit. I like competing man to man to see who the better man is that day."
The problem is that Andrews and Adams joust in a style they call "full contact," which, while popular in North America, is considered by the rest of the world to be unnecessarily dangerous. It's a reputation that isn't helped by the video on YouTube showing the two men describing their many injuries, including the time a lance bruised Andrews's heart and he nearly died from a pulmonary embolism. (He was back jousting five days after his release from the hospital.)
Over time, modern jousters have learned the lessons of their medieval predecessors -- plate armor protects better than chain mail, and more armor protects better than less. Even so, there are still plenty of injuries: concussions and dislocated shoulders, broken hands, assorted fractures and gashes. In one much-talked-about incident a few years ago, the Australian jouster Rod Walker suffered a partly severed penis when a lance veered south during a match at a Renaissance fair in Michigan -- a targeting failure that might not have happened if both he and his opponent hadn't been competing with broken hands.
It is these incidents that keep European jousters from coming to the U.S. to compete, and has those who have swearing they won't return. European jousters typically use lances with balsa-wood tips, which produce fewer dangerous splinters and deliver a less powerful hit. "Come do our sport and break your bones -- that's not the ideal recruitment poster," says Petter Ellingsen, a Norwegian jouster who has competed in nine countries and been injured badly only twice -- both times when competing in what he calls "the American style." "I don't think it's cool completing a tournament with four broken bones in my hand," he says. "I think it's bad for the sport."
At 57, the newly minted leader of the U.S. efforts in Afghanistan still likes to start his day at sun-up with a five-mile run, blazing out each of those miles in under six minutes. Then it's straight to the weight room, where he ignores all those cushy-seated machines and heads for his torture device of choice: a single iron bar, lag-bolted eight feet overhead. A Petraeus pull-up is nothing as simple as hoisting your own body weight up and down a few dozen times. Instead, he slowly jack-knifes from the hips until his shoelaces are level with his face. After 20 of those babies, he drops to the floor for a crisp 100 or so pushups. And to recover from these self-imposed beatings, the general treats himself to a total of one meal per day and four hours of sleep. This, from a guy who a year ago was being treated for prostate cancer and survived getting shot in the chest when a soldier tripped during a live-fire drill.
Petraeus' rough-riding of his own wrinkling hide is often regarded as an indication that the general is a bit off his rocker, and the court of public opinion was quick to raise a finger and say "Aha!" after Petraeus fainted during a Senate hearing this month. Politics Daily observed that "while the 57-year-old Petraeus has been a lifelong athlete and overall high achiever, his ambitious personality may have pushed his body too far this time."
Boehringer has been trying to lay the consumer groundwork with a promotional campaign about women's low libido, including a Web site, a Twitter feed, a Discovery Channel documentary and a publicity tour by Lisa Rinna, a soap opera star and former Playboy model, who describes herself as someone who has suffered from a disorder that Boehringer refers to as a form of "female sexual dysfunction."
There is no dispute that some women have a depressed level of sexual desire that causes them anguish. Boehringer cites a condition -- hypoactive sexual desire disorder -- that is included in the Diagnostic and Statistical Manual of Mental Disorders, a reference book for psychiatrists and insurers.
But many experts say that unlike sexual dysfunction in men -- which has an obvious physical component -- sexual problems in women are much harder to diagnose. And among doctors and researchers, there is serious medical debate over whether female sexual problems are treatable with drugs. Some doctors advocate psychotherapy or counseling, while others have prescribed hormonal drugs approved for other uses.
There is also debate over how widespread hypoactive sexual desire disorder actually is among women. The medical literature, including articles in the prestigious New England Journal of Medicine, indicate numbers above 10 percent, but such studies have been financed by drug companies.
Critics say Boehringer's market campaign exaggerates the prevalence of the condition and could create anxiety among women, making them think they have a condition that requires medical treatment.
"This is really a classic case of disease branding," said Dr. Adriane Fugh-Berman, an associate professor at Georgetown University's medical school who researches drug marketing and has studied the campaign. "The messages are aimed at medicalizing normal conditions, and also preying on the insecurity of both the clinician and the patient."
California spends more than $40 a day per inmate for health care, including expenses for guards who accompany them on visits to outside doctors. NuPhysicia says that this cost is more than four times the rate in Texas and Georgia, and almost triple that of New Jersey, where telemedicine is used for mental health care and some medical specialties.
"Telemedicine makes total sense in prisons," says Christopher Kosseff, a senior vice president and head of correctional health care at the University of Medicine and Dentistry of New Jersey. "It's a wonderful way of providing ready access to specialty health care while maintaining public safety."
Georgia state prisons save an average of $500 in transportation costs and officers' pay each time a prisoner can be treated by telemedicine, says Dr. Edward Bailey, medical director of Georgia correctional health care.
For lunch, I bypassed the kid-pleasing pizza shops and hamburger joints along the waterfront and found healthier sandwiches and salads at Cafe Metropole, a true traveler's oasis, with patio seating. It's the kind of place anyone who eats vegetables is thrilled to find in a town that mostly caters to tourists, especially boardwalk or seaside destinations that lean heavily toward fried things.
By far the most talked-about diet regimen in New York political circles is that of New York's junior senator, Kirsten E. Gillibrand, who has dropped pounds even faster in recent months than she has would-be election opponents. A spokesman, however, said that Ms. Gillibrand had embarked on her diet -- lean protein with large portions of fruits and vegetables, as prescribed by a nutritionist -- not for the campaign, but to return to her normal weight after having her second child, Henry, who was born in May 2008.
Indeed, an informal survey of lawmakers and candidates turned up fewer women on campaign-season diets, a theory for which was offered by Diane J. Savino, a Democratic state senator from Staten Island.
"Most women are going on a diet whether or not they have a campaign," she said. "Since I hit puberty, there hasn't been a week in my life that I haven't been on a diet. It's kind of like an ever-present condition for me."
By using pretax dollars, you can reduce your overall cost for these items by about 20 percent, estimates Jennifer Calhoun, a principal with Mercer Health and Benefits, a consulting firm.
Another attraction had been the extremely generous list of eligible health expenses -- including deductibles and co-pays, eyeglasses and dental work, over-the-counter cold medicine, sunscreen and vitamins. But under the new law, starting Jan. 1, flex-spend users will no longer be able to submit claims for over- the-counter medicines unless they have been specifically directed to use them by a doctor.
For many consumers, having to start paying for cough drops or Tylenol with after-tax dollars probably is not a big deal. But the change will probably be felt by people with chronic illnesses who depend on drugs that have gone from prescription-only to over-the-counter status, like Claritin or other allergy medicines, or heartburn pills like Pepcid, Ms. Calhoun said.
And there is another big flex-spend change ahead: starting in 2013 the annual limit that any employee may contribute to these plans will be restricted to $2,500. Many companies had allowed much more.
The policy rationale for that change is simple. As the health law ushers in more comprehensive, affordable coverage, Kelly Traw, a principal at Mercer's Washington Resource Group, said the assumption was that employees would have less need for flexible spending accounts. And the revenue the government may get by limiting this tax break is meant to help finance the nation's health care overhaul.
If you look only at the averages, the new cap actually seems more than adequate. Although about 85 percent of companies with 500 or more workers offer health care flexible spending benefits, only 27 percent of eligible employees use them, according to Mercer. And the average account annual account balance is about $1,400 -- far less than even the new limit.
Until now, it has been perfectly legal in most states for companies selling individual health policies -- for people who do not have group coverage through employers -- to engage in "gender rating," that is, charging women more than men for the same coverage, even for policies that do not include maternity care. The rationale was that women used the health care system more than men. But some companies charged women who did not smoke more than men who did, even though smokers have more risks. The differences in premiums, from 4 percent to 48 percent, according to a 2008 analysis by the law center, can add up to hundreds of dollars a year. The individual market is the one that many people turn to when they lose their jobs and their group coverage.
Insurers have also applied gender-rating to group coverage, but laws against sex discrimination in the workplace prevent employers from passing along the higher costs to their employees based on sex. Gender rating has taken a particular toll on smaller or midsize businesses with many women, like home-health care, child care and nonprofits. As a result, some businesses have been unable to offer health coverage or have been able to afford it only by using plans with very high deductibles.
Advocates for women's health said one of the new law's benefits would be to ban the denial of health coverage to women who have had a prior Caesarean section or been victims of domestic violence. Some companies providing individual policies have refused coverage in those circumstances, regarding Caesareans or beatings as pre-existing conditions that were likely to be predictors of higher expenses in the future.
In a statement issued Thursday, Senator Mikulski said: "One of my hearings revealed that a woman was denied coverage because she had a baby with a medically mandated C-section. When she tried to get insurance coverage with another company, she was told she had to be sterilized in order to get health insurance. That will never, ever happen again because of what we did here with health care reform."
The passage, Sec. 1557 on page 368 of the 2,074-page bill, says: "Except as otherwise provided for in this title (or an amendment made by this title), an individual shall not, on the ground prohibited under Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), Title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), the Age Discrimination Act of 1975 (42 U.S.C. 6101 et seq.), or Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity, any part of which is receiving federal financial assistance, including credits, subsidies, or contracts of insurance, or under any program or activity that is administered by an executive agency or any entity established under this title (or amendments)."
What it means, Ms. Greenberger said, is that no organization receiving any federal money at all -- as insurers generally do -- can discriminate on the basis of sex. Gender rating, she said, "is a problem whose days are numbered."
A vivid example of how the legislation manipulates revenues is the provision to have corporations deposit $8 billion in higher estimated tax payments in 2014, thereby meeting fiscal targets for the first five years. But since the corporations' actual taxes would be unchanged, the money would need to be refunded the next year. The net effect is simply to shift dollars from 2015 to 2014.
In addition to this accounting sleight of hand, the legislation would blithely rob Peter to pay Paul. For example, it would use $53 billion in anticipated higher Social Security taxes to offset health care spending. Social Security revenues are expected to rise as employers shift from paying for health insurance to paying higher wages. But if workers have higher wages, they will also qualify for increased Social Security benefits when they retire. So the extra money raised from payroll taxes is already spoken for. (Indeed, it is unlikely to be enough to keep Social Security solvent.) It cannot be used for lowering the deficit.
A government takeover of all federally financed student loans -- which obviously has nothing to do with health care -- is rolled into the bill because it is expected to generate $19 billion in deficit reduction.
Over time I have found that kettlebell workouts strengthen muscles that provide stability and support, essential to everyday life. Lifting kettlebells for as little as 20 minutes per day will burn body fat while at the same time add muscle definition. You don't need to dedicate separate time to weight lifting and cardio!
January 26, 2010
Vital Signs of Health:
Exercise: In Women, Training for a Sharper Mind
Older women who did an hour or two of strength training exercises each week had improved cognitive function a year later, scoring higher on tests of the brain processes responsible for planning and executing tasks, a new study has found.
Researchers in British Columbia randomly assigned 155 women ages 65 to 75 either to strength training with dumbbells and weight machines once or twice a week, or to a comparison group doing balance and toning exercises.
A year later, the women who did strength training had improved their performance on tests of so-called executive function by 10.9 percent to 12.6 percent, while those assigned to balance and toning exercises experienced a slight deterioration -- 0.5 percent. The improvements in the strength training group included an enhanced ability to make decisions, resolve conflicts and focus on subjects without being distracted by competing stimuli.
Older women are generally less likely than others to do strength training, even though it can promote bone health and counteract muscle loss, said Teresa Liu-Ambrose, a researcher at the Center for Hip Health and Mobility at Vancouver General Hospital and the lead author of the paper, which appears in the Jan. 25 issue of Archives of Internal Medicine.
-- RONI CARYN RABIN
Labor leaders are fuming that President Obama has endorsed a tax on high-priced, employer-sponsored health insurance policies as a way to help cover the cost of health care reform. And as Senate and House leaders seek to negotiate a final health care bill, unions are pushing mightily to have that tax dropped from the legislation. Or at the very least, they want the price threshold raised so that the tax would affect fewer workers.
Labor leaders say the tax would hit not only wealthy executives with expensive health benefits, but also many rank-and-file union members who have often settled for lower wage increases in exchange for more generous health benefits.
The tax would affect individual insurance policies with annual premiums above $8,500 and family policies above $23,000, which by one union survey would affect one in four union members.
Take the "individual mandate" bit: The rule that everybody must buy insurance or get fined. That's something both conservatives and liberals hate, though its inclusion may have been the price to pay to get the insurance industry to agree to any reform.
Now, the individual mandate made excellent sense at the beginning of this re-sewing process, because if people were allowed not to buy insurance at all then the low-risk young people would do exactly that. This would have had two bad consequences: First, they would still need charity care if they got sick or hurt in an accident. Second, the average price of insurance would be higher because the lower-risk people would not be contributing towards it.
At least 31 states currently regulate indoor tanning for minors, according to the National Conference of State Legislatures. Just last month, the country's first local ban on indoor tanning for those under the age of 18 was passed in Howard County, Md. And in July, the World Health Organization broadcasted one of its most damning warnings yet about tanning beds, declaring them "carcinogenic," and placed them in the same category as cigarettes and arsenic.
Over the years, such health warnings have gone heard but unheeded by many. But that may have been because, up until quite recently, tan seekers saw no worthy alternative to fake baking. Increasingly, they have another option on the table--or in the booth, that is. Spray-on tanning--when the face and body are misted with nontoxic colored chemicals--is the bright spot for the future of the tanning industry. Even though the service can cost more than three times as much as baking under bulbs, it's considered much safer and, thus, guilt-free. "Growing awareness about the high cancer risk associated with UV tanning beds will invariably diminish market share," George Van Horn, an IBISWorld senior analyst, said in a recent press release. He estimates that sunless tanning accounted for roughly 11 percent of tanning-salon revenues two years ago and may reach as high as 17 percent for 2009. And as technology improves for the spray tan (read: customers exit looking less orange), most industry insiders predict that it will continue to lure customers away from traditional tanning beds.
(See alse Sunscreen SPF.)
Curiously does not mention which medicines are so prevelant.
New federally financed drug research reveals a stark disparity: children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance. And the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts, the data shows.
Children and Antipsychotic Drugs Those findings, by a team from Rutgers and Columbia, are almost certain to add fuel to a long-running debate. Do too many children from poor families receive powerful psychiatric drugs not because they actually need them -- but because it is deemed the most efficient and cost-effective way to control health problems that may be handled much differently for middle-class children?
Blumenthal and Morone's most provocative finding is that presidents who have been most successful in moving the country toward universal health coverage have disregarded or overruled their economic advisers. Plans to expand coverage have consistently drawn cautions or condemnations from economic teams in every administration, from Harry Truman's down to George W. Bush's. An exasperated Lyndon Johnson groused to Ted Kennedy that "the fools had to go to projecting" Medicare costs "down the road five or six years." Such long-term projections meant political headaches. "The first thing, Senator Dick Russell comes running in, says, 'My God, you've got a one billion dollar [estimate] for next year on health. Therefore I'm against any of it now." Johnson rejected his advisers' estimates and intentionally lowballed the cost. "I'll spend the goddamn money." An honest economic forecast would most likely have sunk Medicare.
THE HEART OF POWER: Health and Politics in the Oval Office
By David Blumenthal and James A. Morone
Illustrated. 484 pp. University of California Press. $26.95
Books / Sunday Book Review
By ROBERT B. REICH
Published: September 6, 2009
This history of health policy and the Oval Office shows that the presidents who made the biggest steps in the direction of universal care have acted despite their economic advisers.
Mr. Baucus's plan, expected to cost $850 billion to $900 billion over 10 years, would tax insurance companies on their most expensive health care policies. The hope is that employers would buy cheaper, less generous coverage for employees, thereby reducing the overuse of medical services.
The separate new fee on insurance companies would help raise money to pay for the plan. The fee would raise $6 billion a year starting in 2010, and it would be allocated among insurance companies according to their market shares.
The fees were first proposed by Senators Charles E. Schumer of New York, John D. Rockefeller IV of West Virginia and Debbie Stabenow of Michigan. Until now, Mr. Baucus had not shown interest in the idea.
Mr. Schumer said, "The health insurance industry should pay its fair share of the cost because it stands to gain over 40 million new consumers under health care reform legislation."
Mr. Rockefeller said the fees were justified because insurance companies were "rapaciously, greedily and unstoppably making money by underpaying the patient, by underpaying the provider and by overpaying themselves."
The law also prohibits advertising that products carry a lower health risk than traditional cigarettes without F.D.A. approval, a provision aimed at ensuring that such claims are scientifically valid not only for individual smokers but also for the population as a whole, including nonsmokers who might be enticed to smoke if they thought a cigarette was low-risk.
You don't have to talk about the parts.
But there are limits. Without an endless budget, the N.H.S. does have to ration care, by deciding, for instance, whether drugs that might add a few months to the life of a terminal cancer patient are worth the money. Its hospitals are not always clean. It is bureaucratic. Its doctors and nurses are overworked. Patients sometimes are treated as if they were supplicants (petitioners) rather than consumers. Women in labor are advised to bring their own infant's diapers and their own cleaning products to the hospital. Sick people routinely have to wait for tests or for treatment.
Death Panels are Fiction, The case for, Part I
Right now, the charge that's gaining the most traction is the claim that health care reform will create "death panels" (in Sarah Palin's words) that will shuffle the elderly and others off to an early grave. It's a complete fabrication, of course. The provision requiring that Medicare pay for voluntary end-of-life counseling was introduced by Senator Johnny Isakson, Republican -- yes, Republican -- of Georgia, who says that it's "nuts" to claim that it has anything to do with euthanasia..
And not long ago, some of the most enthusiastic peddlers of the euthanasia smear, including Newt Gingrich, the former speaker of the House, and Mrs. Palin herself, were all for "advance directives" for medical care in the event that you are incapacitated or comatose. That's exactly what was being proposed -- and has now, in the face of all the hysteria, been dropped from the bill.
Yet the smear continues to spread. And as the example of Mr. Gingrich shows, it's not a fringe phenomenon: Senior G.O.P. figures, including so-called moderates, have endorsed the lie.
Senator Chuck Grassley, Republican of Iowa, is one of these supposed moderates
The case for, Part II
Painting the Giacometti-esque Emanuel as a creepy Dr. Death, Palin attacked him on her Facebook page a week ago, complaining that his "Orwellian thinking" could lead to a "death panel" with bureaucrats deciding whether to pull the plug on less hardy Americans. Never mind that Palin herself had endorsed some of the same end-of-life counseling she now depicts as putting Grandma down.
As the Democratic National Committee pointed out, Palin put out a 2008 proclamation for Healthcare Decisions Day "to raise public awareness of the need to plan ahead for healthcare decisions, related to end of life care ... and to encourage the specific use of advance directives to communicate these important healthcare decisions."
Consistency was long ago sent to a death panel in Palin world.
The controversy over "death panels" is just the most extreme manifestation of this debate. Obviously, the Democratic plans wouldn't euthanize your grandmother. But they might limit the procedures that her Medicare will pay for. And conservative lawmakers are using this inconvenient truth to paint the Democrats as enemies of Grandma.
Just begging for a correction:
The pharmacists like to slice and dice our country into red pills and blue pills: red pills for Republicans, blue pills for Democrats. But I've got news for them, too. We get an awesome high on the blue pill, and we don't like federal agents poking around our stash of red pills.
We deal to the little league some blue pills, and, yes, we've got some gay friends hopped up on red pills.
Luntz also wrote: "Healthcare quality = 'getting the treatment you need, when you need it.' That is how Americans define quality, and so should you. The key opportunity here is that this commitment goes beyond what the Democrats can offer. Their plan will deny people treatments they need and make them wait to get the treatments they can actually receive. This is more than just rationing. To most Americans, rationing suggests limits or shortages -- for others. But personalizing it -- 'delaying your tests and denying your treatment' -- is the concept most likely to change the most minds in your favor" [emphasis in original].
On its "Talking Points" page, congressional Republicans similarly stated that Democrats would deny access to medical care and treatments, claiming, "The Democrats' government-takeover of health care will deny access to medical care and life-saving treatments."
Mrs Obama looks strong and healthy.
Looking somehow clinical in her pajamas, Kristen instructed me to answer the questions honestly. No problem, since I'm honest to a fault when I choose to speak to people. For the next two hours, she led me through questions that at times had us both laughing with recognition:
¶Do you often talk about your special interests whether or not others seem interested? Who's not interested in cleaning-product slogans?
¶Do you rock back and forth or side to side for comfort, to calm yourself, when excited or overstimulated? Where's the hidden camera?
¶Do you get frustrated if you can't sit in your favorite seat? Friendships have ended over this.
See also: autism.
But for the profoundly autistic, graduation is perhaps the saddest day in their lives. For those who cannot enter the work force, continue on to more education or find some sheltered workshop environment with adequate staffing, there are few options. Far too few programs and resources are allocated for adults with autism.
For purposes of fund-raising and awareness-raising, autism has been portrayed as a childhood disease. The federal Department of Health and Human Services has characterized it as a "disorder of childhood." There are practical reasons for this: early intervention has been shown to be the most effective therapy. The trend in autism treatment has been to steadily lower the age at which intensive intervention commences -- as early as five months, according to some experts. Yet autism is not a degenerative condition; the vast majority of those 1 in 150 children who are afflicted will survive to adulthood.
During the campaign, Obama talked about the need to control medical costs and mentioned a few ideas for doing so, but he rarely lingered on the topic. He spent more time talking about expanding health-insurance coverage, which would raise the government's bill. After the election, however, when time came to name a budget director, Obama sent a different message. He appointed Peter Orszag, who over the last two years has become one of the country's leading experts on the looming budget mess that is health care.
Their argument happens to be supported by a rich body of economic literature that didn't even make it into the book. More-educated people are healthier, live longer and, of course, make more money. Countries that educate more of their citizens tend to grow faster than similar countries that do not. The same is true of states and regions within this country. Crucially, the income gains tend to come after the education gains. What distinguishes thriving Boston from the other struggling cities of New England? Part of the answer is the relative share of children who graduate from college. The two most affluent immigrant groups in modern America -- Asian-Americans and Jews -- are also the most educated. In recent decades, as the educational attainment of men has stagnated, so have their wages. The median male worker is roughly as educated as he was 30 years ago and makes roughly the same in hourly pay. The median female worker is far more educated than she was 30 years ago and makes 30 percent more than she did then.
Dynamic warm-up series:
2 x 20 reps Kettlebell pass around the waist / lower legs
1 x 10 reps Wall Slides (arms against wall)
1 x 30 second hold Wrist flexion / extension stretch
1 x 20 reps each side Standing trunk rotation
1 x 15 reps each side Hip swings
2 x 15 reps Body Weight Squats
2 x 15 reps Kneeling push-ups
(repeat entire routine 2 to 4 times with a 2 to 3 minute rest interval in between each cycle)
1 x 20 reps Double Arm Swing --> 1 x 20 reps Alternating hands
1 x 16 reps Double Arm Swing with 180 degree Spin
1 x 30 reps Stationary Flip Swing and Catch
1 x 20 reps Double Arm Swing with Lateral Squatting Movement
See also: Kettlebell Workshop with Steve Cotter.
New for 2009: SPF 85
A sunscreen's SPF, or sun protection factor, measures how much the product shields the sun's shorter-wave ultraviolet B rays, known as UVB radiation, which can cause sunburn. It used to be that SPF topped out at 30. No more. These days, a race is on among sunscreen makers to create the highest SPF that R&D can buy.
If adequately applied, sunscreens with sky-high SPFs offer slightly better protection against lobster-red burns than an SPF 30. But they don't necessarily offer stellar protection against the more deeply penetrating ultraviolet A radiation, or so-called aging rays.
The difference in UVB protection between an SPF 100 and SPF 50 is marginal. Far from offering double the blockage, SPF 100 blocks 99 percent of UVB rays, while SPF 50 blocks 98 percent. (SPF 30, that old-timer, holds its own, deflecting 96.7 percent).
A sunscreen's SPF number is calculated by comparing the time needed for a person to burn unprotected with how long it takes for that person to burn wearing sunscreen. So a person who turns red after 20 minutes of unprotected sun exposure is theoretically protected 15 times longer if they adequately apply SPF 15. Because a lot of sunscreens rub off or don't stay put, dermatologists advise reapplication every two hours or after swimming or sweating.
SKIN DEEP Confused by SPF? Take a Number
By CATHERINE SAINT LOUIS
Published: May 14, 2009
The SPF arms race is leading some dermatologists to complain that this is merely a numbers game that confuses consumers.
If public transport and public health could merge, there would be a safe way to get home at night.
The Valley's light rail will soon extend its hours on the weekends.
Currently, the light rail makes its last run at 11 p.m.
However, starting July 1, the trains will leave from both ends of the line at 2 a.m., which means if your stop is somewhere in the middle, the final train will sometimes come past 2 a.m.
On Wednesday, the METRO Board of Directors approved the new hours.
The change was made after getting feedback from passengers and businesses along the light rail route.
Melissa Harrigan, a bartender at Zuma Grill in Tempe, said she thinks the change will be good for business because people will be able to stay longer.
She also said that she feels it will keep the roads safer because a bigger group of people won't be drinking and driving.
According to a METRO news release, the estimated fiscal and maintenance impact for extended weekend service is $254,500 annually to the METRO operating budget.
After six months, the Board will review ridership statistics and costs associated with the service extension to see if the change is cost effective.
He woke as usual at 5 a.m., swam a mile at the Y, read papers and was in the office at 7 for the senior staff meeting at 7:30. There was a meeting in the Situation Room about Afghanistan, a leadership meeting, a conversation with the Senate majority leader, Harry Reid, a meeting with Senator Orrin G. Hatch, budget meetings, several conversations with the president.
He has be equally solicitous of Republicans in Congress (who also have been given access to Mr. Emanuel's private contact information). On days he does not swim, he works out -- and conducts business -- at the House gym: 25 minutes on the bike, 20 minutes on the elliptical, 120 sit-ups, 55 push-ups and many sweaty conversations with his former colleagues.
They found that Web searches for things like headache and chest pain were just as likely or more likely to lead people to pages describing serious conditions as benign ones, even though the serious illnesses are much more rare.
For example, there were just as many results that linked headaches with brain tumors as with caffeine withdrawal, although the chance of having a brain tumor is infinitesimally small.
Would such inference be addressed better by a frequentist or bayesian mindset ?
Kettle bells are a most a versatile type of exercise equipment.
Simple, durable, but versatile. No moving parts of maintenance.
The kettlebell has a potentially important role because it is cost efficient, space efficient, time-efficient and effort efficient -- a whole gym in your hand.
Kettlebells are an ancient Russian weight-training tool shaped like a cannonball with a thick handle. They range in weight from 4kg (9lbs) to 48kg (105lbs), and are quickly becoming the strength tool of choice for athletes, coaches, and trainers. But kettlebells are for more than just the pros and 'hardcore' fitness buffs - everyone and anyone can lift kettlebells and reap muscular strength, endurance, flexibility and cardiovascular benefits with every workout.
I am really grinding my teeth. I am too hyper, too often,
madly jumping from one project to another, making lists with
even more zeal than normal. During a staff meeting in which
I know I am going to be grilled on topics I am extremely familiar
with, I feel like I am going to have a heart attack. Or at least a
panic attack. Are my fingers tingling or shaking or not actually
moving at all? I'm going a little crazy.
I can, for the first time, understand how people who are
heavily medicated feel crazy and out of control and even suicidal..
-- Like the Amazon.com customer reviews of drugs, but much
Bodybuilding emphasizes developing large, well-defined,
well-proportioned muscles. In weightlifting, on the other
hand, the goal is simply increasing muscular strength.
Now, weight training, that's something else entirely.
Weight training builds strength to improve performance
in other athletic activities. You're gonna see a lot of
basketball and football players doing weight training.
-- Glen Tuttle, 41, Glendale, AZ.
In 1970, Laud Humphreys published the groundbreaking dissertation
he wrote as a doctoral candidate at Washington University called
“Tearoom Trade: Impersonal Sex in Public Places.” Because of his
unorthodox methods — he did not get his subjects’ consent, he
tracked down names and addresses through license plate numbers,
he interviewed the men in their homes in disguise and under false
pretenses — “Tearoom Trade” is now taught as a primary example
of unethical social research.
Manhattan dermatologist Dr. Patricia Wexler puts sunscreen between her toes.
But as proof that she is not merely some phobic S.P.F. showboater in
Gandhi clothing, Dr. Wexler explained that her favorite moment comes
when she can finally escape her portable sun shields for an immobile
one truly out of the sun. That would be the 10-by-10-foot Treasure
Garden cantilever umbrellas next to her pool at her house in East
Hampton, N.Y. They are the product of a long, long search.
“Every year I would look for something better than what I had,”
she said. And every year the Atlantic winds knocked over each
new arrival. “So you could never really relax,” she said. “You’re
trying to read, but you’ve always got one eye on the umbrella to
make sure it’s staying put.”
The Treasure Garden umbrella’s base, which when filled with sand
weighs 300 pounds, does just that. “This is the ultimate umbrella,”
she declared, which explains why she bought four, at $1,255 each,
at Hildreth’s in East Hampton. “They’re worth every penny.”
They worked, it turned out, too well, casting her entire patio into
shade. “I have a few friends we’ve had for a long time,” she
said carefully. “They have that real Miami skin — dark, dark tan
and definitely aged. And when they visit, they want to go and
sit by the pool with a drink, just to make sure they get every ray.
They won’t get near the umbrellas.”
Many patients point to another problem with chronic fatigue syndrome:
the name itself, which they say trivializes their condition and has
discouraged researchers, drug companies and government agencies
from taking it seriously. Many patients prefer the older British term,
myalgic encephalomyelitis, which means “muscle pain with inflammation
of the brain and spinal chord,” or a more generic term, myalgic
In a group health plan, the employer typically pays a large
share of the premium, so most employees sign up as
soon as they are eligible, regardless of their health status.
The health plan covers a mix of sick and healthy workers.
By contrast, individuals and independent contractors are
more likely to defer coverage until they need it, so the pool
of people insured is, over all, less healthy. Sick people
consume more health care. As a result, the cost to insure
them is higher.
Janet S. Trautwein, executive vice president of the National Association
of Health Underwriters, which represents insurance agents and brokers.
Do they need to be feminists who like porn or can
they be porny types who are also feminists?
The writing profession has a yo-yo-diet effect on diet.
"Everybody loses weight on hiatus, and everybody gains
weight during the show. You break up the long day by
getting a little ritualistic snack. It's like cigarette breaks
used to be."
"Someone at 'Friends' would get a thing of Gummi Bears
and line them up by color before eating them."
-- Greg Malins, who wrote for "Friends" and "Will and Grace"
and is now a writer and executive producer for "How I Met
"Our room is obsessed with Tim's jalapeño chips and
these salt-and-vinegar chips that Greg has flown
in from Canada.
No kidding. Their salt-and-vinegar-ness is, like,
illegal in the States."
-- Gloria Calderon Kellett, one of Malins's colleagues.
Mexoryl sun screen season is here.
Protect yourself from UVA, UVB.
The protection factor is only part of the story. A product with
an S.P.F. of 30 may have a UVA protection rating of only 2. Your
sunscreen should be a broad-spectrum one that also blocks
UVA radiation. Two ingredients now used in "complete" sunscreens
in cosmetically acceptable micronized forms are titanium dioxide
and zinc oxide.
Two other agents that offer broad-spectrum protection, Mexoryl
and Tinosorb, help to stabilize UVA protection during prolonged
exposures. They are available in Canada and Europe but have not
yet been approved by the Food and Drug Administration here.
Neutrogena, however, has a new product on the American market,
Ultra Sheer, with an S.P.F. of 55, that is said to do the job of Mexoryl.
It is also more affordable and is cosmetically comfortable. The
company uses a patented Helioplex technology to stabilize two
UV blockers, avobenzone and oxybenzone.
If you sleep based on what your body tells you,
you’ll probably be sleeping more than you need
— in many cases a lot more, like 10-15 hours
more per week.
Why get up early?
The main reason is that you’ll have a lot more
time to do things that are more interesting
Trust me, they don't care. I designed gyms for years,
for the bigest in the business. They are after their own
workout experiance, not interested in giving you the
same gym you came from. You can be sure, everything
including, The placement of of the machines, has been
reviewed at corporate, without the Gym's manager's
input or knowledge. There are reasons for everything.
Missing drink machines...= cleaner workout floor, and
drive up the juice bar sales.
No personal TVs at carrdio=, cut down on replacement
overhead (they do break)and quicker turnaround, studies
show people use cardio machines for longer time with
a personal TV station.
This is common stuff in gyms with high peak times.
You will not be tripping over bottles, and waiting for
machines to open up. But if enough people complain
about the TVs they will put them in, but only if the
membersip numbers don't hit target.
When all else fails, the Administration has simply preached:
In February, a hundred CDC researchers on sexually transmitted
diseases were summoned to Washington by HHS deputy secretary
Claude Allen for a daylong affair consisting entirely of speakers
extolling abstinence until marriage. There were no panels or
workshops, just endless testimonials, including one by a
young woman calling herself "a born-again virgin."
Most height and weight restrictions have been thrown out at
major police departments, after lawsuits challenging them
on grounds of gender and race. As for strength and stamina,
a recruit in King County need be able to do only
* 30 situps in a minute; and
* run a mile and a half in less than 14 minutes 31 seconds.
“You don’t have to be Superman,” said Sheriff’s Deputy Kurt
Lange, a 14-year veteran of King County, where the vacation
bonus has led deputies to start recruiting on their own,
looking for friends, relatives or just casual acquaintances
who might want to wear a badge.
George W. Bush runs three back to back 6:45 minute miles.
One Sunday I was driving through Missouri on Interstate 70, letting the
radio scan through the frequencies, and pausing on each station for a
minute. I heard a country station, a news talk station, another country
station, and a religious service. The commentator on the news talk station
was horrified that a grant for AIDS awareness was being used to
talk about sex (in San Francisco). His view now enjoys national influnece.
Scientists who study AIDS and other sexually transmitted diseases say they
have been warned by federal health officials that their research may come
under unusual scrutiny by the Department of Health and Human Services or by
members of Congress, because the topics are politically controversial.
The scientists, who spoke on condition they not be identified, say they have
been advised they can avoid unfavorable attention by keeping certain "key
words" out of their applications for grants from the National Institutes of Health
or the Centers for Disease Control and Prion. Those words include sex
workers, men who sleep with men, anal sex and needle exchange, the
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