For Traumatized Caregivers, Therapy Helps - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">I recently wrote about <a href="http://newoldage.blogs.nytimes.com/2013/01/30/for-some-caregivers-the-trauma-lingers/" style="color: rgb(0, 0, 102); text-decoration: none; ">caregivers who experienced symptoms of traumatic-like stress</a>, and readers responded with heart-rending stories. Many described being haunted by distress long after a relative died.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Especially painful, readers said, was witnessing a loved one's suffering and feeling helpless to do anything about it.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The therapists I spoke with said they often encountered symptoms among caregivers similar to those shown by people with post-traumatic stress — intrusive thoughts, disabling anxiety, hyper-vigilance, avoidance behaviors and more — even though research documenting this reaction is scarce. Improvement with treatment is possible, they say, although a sense of loss may never disappear completely.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">I asked these professionals for stories about patients to illustrate the therapeutic process. Read them below and you'll notice common themes. Recovery depends on unearthing the source of psychological distress and facing it directly rather than pushing it away. Learning new ways of thinking can change the tenor of caregiving, in real time or in retrospect, and help someone recover a sense of emotional balance.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Barry Jacobs, a clinical psychologist and author of "The Emotional Survival Guide for Caregivers" (Guilford Press, 2006), was careful to distinguish normal grief associated with caregiving from a traumatic-style response.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"Nightmares, lingering bereavement or the mild re-experiencing of events that doesn't send a person into a panic every time is normal" and often resolves with time, he said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Contrast that with one of his patients, a Greek-American woman who assisted her elderly parents daily until her father, a retired firefighter, went to the hospital for what doctors thought would be a minor procedure and died there of a heart attack in the middle of the night.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Every night afterward, at exactly 3 a.m., this patient awoke in a panic from a dream in which a phone was ringing. Unable to go back to sleep for hours, she agonized about her father dying alone at that hour.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The guilt was so overwhelming, the woman couldn't bear to see her mother, talk with her sisters or concentrate at work or at home. Sleep deprived and troubled by anxiety, she went to see her doctor, who works in the same clinic as Dr. Jacobs and referred her to therapy.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The first thing Dr. Jacobs did was to "identify what happened to this patient as traumatic, and tell her acute anxiety was an understandable response." Then he asked her to "grieve her father's death" by reaching out to her siblings and her mother and openly expressing her sadness.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Dr. Jacobs also suggested that this patient set aside a time every day to think about her father — not just the end of his life, but also all the things she had loved about him and the good times they'd had together as a family.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Don't expect your night time awakenings to go away immediately, the psychologist told his patient. Instead, plan for how you're going to respond when these occur.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Seven months later, the patient reported her panic at a "3 or 4" level instead of a "10" (the highest possible number), Dr. Jacobs said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"She'll say, 'oh, there's the nightmare again,' and she can now go back to sleep fairly quickly," he continued. "Research about anxiety tells us that the more we face what we fear, the quicker we are to extinguish our fear response and the better able we are to tolerate it."</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><a href="http://www.uccs.edu/psych/people/faculty/sara-qualls.html" style="color: rgb(0, 0, 102); text-decoration: none; ">Sara Qualls</a>, a professor of psychology at the University of Colorado in Colorado Springs, said it's natural for caregivers to be disgusted by some of what they have to do — toileting a loved one, for instance — and to be profoundly conflicted when they try to reconcile this feeling with a feeling of devotion. In some circumstances, traumatic-like responses can result.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Her work entails naming the emotion the caregiver is experiencing, letting the person know it's normal, and trying to identify the trigger.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">For instance, an older man may come in saying he's failed his wife with dementia by not doing enough for her. Addressing this man's guilt, Dr. Qualls may find that he can't stand being exposed to urine or feces but has to help his wife go to the bathroom. Instead of facing his true feelings, he's beating up on himself psychologically — a diversion.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Once a conflict of this kind is identified, Dr. Qualls said she can help a person deal with the trigger by using relaxation exercises and problem-solving techniques, or by arranging for someone else to do a task that he or she simply can't tolerate.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Asked for an example, Dr. Qualls described a woman who traveled to another state to see her mother, only to find her in a profound disheveled, chaotic state. Her mother said that she didn't want help, and her brother responded with disbelief. Soon, the woman's blood pressure rose, and she began having nightmares.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">In therapy, Dr. Qualls reassured the patient that her fear for her mother's safety was reasonable and guided her toward practical solutions. Gradually, she was able to enlist her brother's help and change her mother's living situation, and her sense of isolation and helplessness dissipated.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"I think that a piece of the trauma reaction that is so devastating is the intense privacy of it," Dr. Qualls said. "Our work helps people moderate their emotional reactivity through human contact, sharing and learning strategies to manage their responsiveness."</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><a href="http://med.stanford.edu/profiles/Dolores_Thompson/" style="color: rgb(0, 0, 102); text-decoration: none; ">Dolores Gallagher-Thompson</a>, a professor of psychiatry at Stanford University School of Medicine in California, noted that stress can accumulate during caregiving and reach a tipping point where someone's ability to cope is overwhelmed.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">She tells of a vibrant, active woman in her 60s caring for an older husband who declined rapidly from dementia. "She'd get used to one set of losses, and then a new loss would occur," Dr. Gallagher-Thompson said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The tipping point came when the husband began running away from home and was picked up by the police several times. The woman dropped everything else and became vigilant, feeling as if she had to watch her husband day and night. Still, he would sneak away and became more and more difficult.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Both husband and wife had come from Jewish families caught up in the Holocaust during World War II, and the feeling of "complete and utter helplessness and hopelessness" that descended on this older woman was intolerable, Dr. Gallagher-Thompson said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Therapy was targeted toward helping the patient articulate thoughts and feelings that weren't immediately at the surface of her consciousness, like, for example, her terror at the prospect of abandonment. "I'd ask her 'what are you afraid of? If you visualize your husband in a nursing home or assisted living, what do you see?'" Dr. Gallagher-Thompson said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Then the conversation would turn to the choices the older woman had. Go and look at some long-term care places and see what you think, her psychologist suggested. You can decide how often you want to visit. "This isn't an either-or — either you're miserable 24/7 or you don't love him," she advised.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The older man went to assisted living, where he died not long afterward of pneumonia that wasn't diagnosed right away. The wife fell into a depression, preoccupied with the thought that it was all her fault.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">Another six months of therapy convinced her that she had done what she could for her husband. Today she works closely with her local Alzheimer's Association chapter, "helping other caregivers learn how to deal with these kinds of issues in support groups," Dr. Gallagher-Thompson said.</div></div><a href="http://newoldage.blogs.nytimes.com/2013/02/22/for-traumatized-caregivers-therapy-helps/?src=recg&pagewanted=print">http://newoldage.blogs.nytimes.com/2013/02/22/for-traumatized-caregivers-therapy-helps/?src=recg&pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

For Traumatized Caregivers, Therapy Helps - NYTimes.com

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Getting Patients to Think About Costs - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div id="well" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; "><div align="left"><div class="entry-content"><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">A colleague and I recently got into a heated discussion over health care spending. It wasn't that he disagreed with me about the need to rein in costs; but he said he was frustrated every time he tried to do so.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Earlier that week, for example, he had tried to avoid ordering a costly M.R.I. scan for a patient who had been suffering from headaches. After a thorough examination, my colleague was convinced the headaches were the result of stress.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">But the patient was not.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">"She wouldn't leave until she got that M.R.I.," my colleague said. Even after he had explained his conclusions several times, proposed a return visit in a month to reassess the situation and ran so far overtime that his office nurse knocked on the door to make sure nothing had gone awry, the patient continued to insist on getting the expensive study.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">When my colleague finally evoked cost – telling the woman that while an M.R.I. might ferret out rare causes, it didn't make sense to spend the enormous fee on something of such marginal benefit – the woman became belligerent. "She yelled that this was her head we were talking about," he recalled. "And expensive tests like this were the reason she had health insurance."</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Face flushed, he paused to take a deep breath. "Yeah, I may be all for controlling costs," he finally said. "But are our patients?"</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">According to a <a href="http://content.healthaffairs.org/content/32/2/338.abstract" style="color: rgb(0, 0, 102); text-decoration: none; ">new study in the journal Health Affairs</a>, his concern about patients may not be far off the mark.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">A growing number of initiatives aimed at controlling spiraling health care costs have been championed in recent years, aiming to replace the current model in which doctors are reimbursed for every office visit, test or procedure performed. These <a href="http://www.nejm.org/doi/full/10.1056/NEJMp0804658" style="color: rgb(0, 0, 102); text-decoration: none; ">programs range from pay-for-performance,</a> where doctors can earn more money by meeting predetermined quality "goals" like controlling patients' blood sugar or high blood pressure, to <a href="http://www.nejm.org/doi/full/10.1056/NEJMp1009380" style="color: rgb(0, 0, 102); text-decoration: none; ">accountable care organizations</a>, where clinicians and hospitals in partnership are paid a lump sum to cover all care.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Their uninspired monikers aside, all of these plans share one defining feature: doctors are to be the key agents of change. Whether linked with quality measures, bundled payments or satisfaction scores, it is the doctors' behavior and choice of treatments that result in savings, goes the thinking.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">But as the new study reveals, doctors need to take into account more than just symptoms and diseases when deciding what to prescribe and offer. They must also consider their patients' opinions and willingness to be cost conscious when it comes to their own care.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">The researchers conducted more than 20 patient focus groups and asked the participants to imagine themselves with various symptoms and a choice of diagnostic and treatment options that varied only slightly in effectiveness but significantly in cost. They were asked, for example, to choose between an M.R.I. or a CT scan for a severe long-standing headache, with the M.R.I. being much more expensive but also more likely to catch some extremely rare problems.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">When it came to their own treatment, "patients for the most part did not want cost to play any role in decision-making," said Dr. Susan Dorr Goold, one of the study authors and a professor of internal medicine and health management and policy at the University of Michigan in Ann Arbor. Most did not want their doctors to take expenditures into account, and many made it clear that they would ask for the significantly more expensive medications, procedures or diagnostic studies, even if those options were only slightly better than the cheaper alternatives. "That puts doctors, whose primary responsibility is to their individual patients, in a very difficult position."</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">A majority of the participants refused to consider the expenses borne by insurers or by society as a whole when making their choices. Some doubted that one individual's efforts would have any real overall impact and so gave up considering cost-savings altogether. Others said they would go out of their way to choose the more expensive options, viewing such decisions as acts of defiance and a kind of well-deserved "payback" after years of paying insurance premiums.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Underlying all of these comments was the belief that cost was synonymous with quality. Even when the focus group leaders reminded participants that the differences between proposed options were nearly negligible, participants continued to choose the more expensive options as if it were beyond question that they must be more efficacious or foolproof.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">The study's findings are disheartening. But Dr. Goold and her co-investigators believe that public beliefs and attitudes about cost and quality can be changed. They cite the dramatic transformation in attitudes about end-of-life care as an example of how initiatives to improve understanding can lead people to make higher quality and more cost-effective decisions, like choosing hospices over hospitals.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">"We need to begin to talk about these issues in a way that doesn't turn it into a discussion pitting money against life, and we need to find ways of getting people to think about not spending money on things that offer marginal benefit" Dr. Goold said. "Because it's going to be tough otherwise trying to implement any cost-saving measures, if patients don't accept them."</div></div></div></div></div><a href="http://well.blogs.nytimes.com/2013/02/21/getting-patients-to-think-about-costs/?pagewanted=print">http://well.blogs.nytimes.com/2013/02/21/getting-patients-to-think-about-costs/?pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Getting Patients to Think About Costs - NYTimes.com

A colleague and I recently got into a heated discussion over health care spending. It wasn't that he disagreed with me about the need to...

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Doctor Groups Issue List of Overused Medical Tests - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">In an effort to change entrenched medical practices, 17 major medical specialty groups recommended on Thursday that doctors greatly reduce their use of 90 widely used but largely unnecessary tests and treatments.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">This list of "don'ts" builds on 45 recommendations <a href="http://www.nytimes.com/2012/04/04/health/doctor-panels-urge-fewer-routine-tests.html" style="color: rgb(0, 0, 102); text-decoration: none; ">made last April</a>, under a broad initiative by the American Board of Internal Medicine Foundation, in partnership with the magazine Consumer Reports.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"As you look through the lists, a lot of these were mea culpas," said Dr. Eric Topol, chief academic officer of Scripps Health, a health care provider in San Diego. Dr. Topol was not involved in creating the new recommendations. "The literature had supported these recommendations, but until now they were not sanctioned as no-no's by the professional groups," he said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Some of <a href="http://www.choosingwisely.org/doctor-patient-lists/" style="color: rgb(0, 0, 102); text-decoration: none; ">the recommendations</a> reinforce existing guidelines, but others aggressively go after procedures that have little evidence of benefit and may cause harm, yet are still practiced on a daily basis.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">For example, the American Society of Echocardiography recommended against using echocardiograms before or during surgery for patients with no history or symptoms of heart disease; doctors routinely perform this test. The Society of Nuclear Medicine and Molecular Imaging urged physicians not to perform routine annual stress testing using a nuclear heart scan after coronary artery surgery. This is also a routine test, and it exposes the patient to radiation equivalent to 2,000 chest X-rays.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"Many of these tests are wasteful, and they could put patients in danger of harm without any benefits," said Daniel Wolfson, executive vice president of the American Board of Internal Medicine Foundation. "The goal is to begin to change attitudes both from the public side and the physician side that sometimes less is better."</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Each medical specialty society participating in the foundation's initiative has offered up five procedures that patients should question. "That's a key point. I don't think they'll have any impact unless patients get activated," Dr. Topol said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The new list includes recommendations against inducing labor or performing a Caesarean section before a woman's 39th week of pregnancy, unless it is medically necessary. Scheduled Caesareans and inductions are commonly performed for convenience, but delivery before 39 weeks is associated with increased risk of learning disabilities, respiratory problems and other risks to the baby.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The American Academy of Pediatrics urged doctors not to automatically use computed tomography, or CT scans to evaluate children's minor head injuries. According to the report, approximately 50 percent of children who visit hospital emergency departments with head injuries undergo a CT scan, exposing them to radiation. Other groups also called for reductions in the use of CT, PET and M.R.I. scans for a variety of ailments.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Several physician groups recommended against prescribing antibiotics for common respiratory illnesses, including sinusitis, sore throat and bronchitis. The vast majority of these illnesses are caused by viruses, not bacteria, making antibiotics pointless. The pediatrics group also said not to treat children under 4 years of age with cough and cold medicines. Studies have shown that these products have little benefit and may cause serious side effects in children.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The American Geriatrics Society recommended against using feeding tubes in patients with advanced dementia. These patients should be fed orally. Tube feeding is associated with agitation, increased use of physical and chemical restraints and pressure ulcers.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Other notable recommendations include:</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">· Don't use opioid or butalbital treatment for migraine except as a last resort. Frequent use of these drugs can worsen headaches.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">· Don't routinely treat acid reflux in infants with anti-reflux therapy. There is emerging evidence that it may be harmful to infants in certain situations.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">· Avoid routine preoperative testing for low-risk surgeries without a clinical indication. Most pre-op tests turn up nothing unusual and don't lead to better outcomes.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">· Avoid using medications to achieve tight control of glucose levels in most adults aged 65 and older with Type 2 diabetes. Moderate control is generally better.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">· Don't use benzodiazepines or other sedative hypnotics in older adults as a first choice for insomnia, agitation or delirium. Studies consistently show a doubling of risk of car accidents, falls and hip fractures in older adults taking these medications.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-left; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">· Don't perform annual Pap tests in women 30 to 65 years of age who are not at high risk for cervical cancer. The Pap test should be performed every three years in women aged 21 to 30, and every three to five years for women aged 30 to 65.</div></div><a href="http://well.blogs.nytimes.com/2013/02/21/doctor-groups-issue-list-of-overused-medical-tests/?pagewanted=print">http://well.blogs.nytimes.com/2013/02/21/doctor-groups-issue-list-of-overused-medical-tests/?pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Doctor Groups Issue List of Overused Medical Tests - NYTimes.com

In an effort to change entrenched medical practices, 17 major medical specialty groups recommended on Thursday that doctors greatly reduce t...

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Qualifications versus duties: Why knowing the difference matters

<b style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 12px; text-align: left;"><span id="cbArticle_lblByLine">Justin Thompson, CareerBuilder Writer</span></b><br /><b style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 12px; text-align: left;"><span><br /></span></b><br /><div class="ArticleHeadline" style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin-top: -30px; text-align: left;"><div class="cbmsnArticleImage" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img alt="" src="http://emj.cbdr.com/artieimages/j8/ar5l2pj6t1v4d54xw9j8.gif?time=3/5/2012%202:25:15%20pm" /></div></div><br style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 12px; text-align: left;" /><div class="ArticleContent" style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 12px; text-align: left;">Some job seekers have problems selling their skills. They list their basic duties, which most job seekers have in common. You can stand out in a job search by positioning those skills so they set you apart.<br /><br />Think of how a <a href="http://msn.careerbuilder.com/jobs/keyword/sales/" style="color: #666666; font-family: Arial; text-decoration: none;">salesperson</a> sells a car. He doesn't tout the fact that the car has four wheels, windows and functioning lights, because you'd expect that from every car. Instead, he sells the unique points of the car -- design, safety, mileage -- all of which make the car appealing to a potential buyer.<br />Job seekers need to do the same when selling their qualifications. Instead of saying you've used Microsoft Excel, tell the employer how you've solved problems or increased efficiency by creating a basic accounting process through<b> </b>Microsoft Excel.<br /><br />Kyra Mancine, a professional <a href="http://msn.careerbuilder.com/jobs/keyword/copywriter/" style="color: #666666; font-family: Arial; text-decoration: none;">copywriter</a> with a career development background, says a list of job responsibilities is her biggest résumé pet peeve. "The key is to take a simple job duty and expand it to match the [job posting] with quantitative evidence of accomplishments," Mancine says. "It may take some thought and creativity, but it can be done for any job, no matter what the level. I don't care if you're a <a href="http://msn.careerbuilder.com/jobs/keyword/sanitation/" style="color: #666666; font-family: Arial; text-decoration: none;">sanitation worker</a>, <a href="http://msn.careerbuilder.com/jobs/keyword/ceo/" style="color: #666666; font-family: Arial; text-decoration: none;">CEO</a> or <a href="http://msn.careerbuilder.com/jobs/keyword/seamstress/" style="color: #666666; font-family: Arial; text-decoration: none;">seamstress</a>; anyone can do this."<br /><br />By adding numbers, statistics and adjectives applicable to the posting, job seekers can set themselves apart from others who have submitted more generic résumés.<br /><br /><b>How to quantify accomplishments</b><br />To give an example, here's a real job posting from <a href="http://msn.careerbuilder.com/jobs/keyword/banking/" style="color: #666666; font-family: Arial; text-decoration: none;">a bank</a> looking for a call-center representative:<br /><ul style="margin-bottom: 5px; margin-left: 15px; margin-right: 0px; margin-top: 5px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" type="disc"><br /><li>Serves as first-line response for incoming customer calls.​</li><br /><li>Accurately and expediently answers inquiries from customers on all types of new and existing products and services, drawing on a detailed knowledge base of bank products, services, policies and procedures.​</li><br /><li>Sells and cross-sells bank products and services to new and existing customers who have contacted the bank by telephone.​</li><br /><li>Efficiently performs routine follow-up work and initiates requests for detailed follow-up work.​</li><br /><li>Relies on excellent verbal and written communication skills to fulfill customer requests and to ensure customer satisfaction.​</li></ul><br />If you're applying for this job and all you've listed on your résumé is that you answered phone calls in a call center, you probably won't get an interview, Mancine says. Instead, she suggests rewriting your résumé to match the bullets listed in the job posting, quantifying your successes. Mancine shares this example of how an applicant could restructure her résumé to address the posting above:<br /><br />Primary call-center contact for a high volume of customer service inquiries, ranging from orders to returns.<br /><ul style="margin-bottom: 5px; margin-left: 15px; margin-right: 0px; margin-top: 5px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" type="disc"><br /><li>Successfully handled hundreds of incoming consumer calls daily from across the country.</li><br /><li>Received recognition for product upsells, resulting in a 5 percent increase in weekly sales.</li><br /><li>Tapped into strong base of product knowledge on thousands of product stock-keeping units, quickly and courteously relaying product information to existing and new customers.</li><br /><li>Consistently acknowledged for speed, accuracy to details and follow-through on catalog requests, Web order processing, batches and data entry.</li><br /><li>Committed to going above and beyond to ensure customer satisfaction, resulting in being named Employee of the Month for June 2011.</li></ul><br />Here's another test that can help determine if you've listed qualifications or just duties: Look at each bullet point on your résumé and ask yourself, "So what?" If you're not impressed, why would a recruiter be?<br /><br /><b>Don't neglect the cover letter</b><br />"Cover letters are most often left out or even sent as generic notes with résumés," says Tiffani Murray, a résumé writer and <a href="http://msn.careerbuilder.com/jobs/keyword/career+coach/" style="color: #666666; font-family: Arial; text-decoration: none;">career coach</a>. She says that the cover letter is a great place to sell your personality and breathe life into your application.<br /><br />"If a job posting specifically asks for a cover letter, this is a great opportunity to match up your skills and experiences with the requirements of the job," Murray says. "Make sure to detail how you can perform the tasks of the job you are applying for, but also add to the company, team or overall business with your knowledge and success in similar roles."<br /><br /><i>Justin Thompson is a writer and blogger for CareerBuilder.com and its job blog, </i><a href="http://www.theworkbuzz.com/" style="color: #666666; font-family: Arial; text-decoration: none;" target="_blank"><i>The Work Buzz</i></a><i>. He researches and writes about job search strategy, career management, hiring trends and workplace issues.</i></div>

Qualifications versus duties: Why knowing the difference matters

Justin Thompson, CareerBuilder Writer Some job seekers have problems selling their skills. They list their basic duties, which most job seek...

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NBA trade deadline: Winners and losers

<div dir="ltr" style="text-align: left;" trbidi="on"><img alt="Thomas Robinson was the big winner of the 2013 NBA trade deadline. (Ronald Martinez/Getty Images)" src="http://sinbapointforward.files.wordpress.com/2013/02/thomas-robinson-kings-trade.jpg?w=610&h=430" /><br /><span style="background-color: #c52e1b; color: white; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 12px;">Thomas Robinson was the big winner of the 2013 NBA trade deadline. (Ronald Martinez/Getty Images)</span><br /><br /><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">By <a href="http://nba.si.com/author/benjamingolliver/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; font-weight: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">Ben Golliver</a></strong></div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Thursday’s NBA trade deadline passed without a splashy move to rival the James Harden and Rudy Gay trades from earlier this season. J.J. Redick was the biggest name dealt. High-profile players who are set to become free agents such as Josh Smith, Al Jefferson and Paul Millsap stayed put. None of the stars mentioned in rumors — Kevin Garnett, Paul Pierce, Rajon Rondo, Monta Ellis, Pau Gasol and Dwight Howard among them — actually changed zip codes.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Still, plenty of business was done, as 12 trades involving 18 teams and more than 20 players were completed in the final 24 hours before the 3 p.m. ET deadline.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Let’s take a look at the winners and losers from the deals that went down at the deadline. (The Point Forward will address the deals that <em style="border: 0px; font-family: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">weren’t</em> made on Friday.)</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><span id="more-35553" style="border: 0px; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"></span></div><h3 style="background-color: white; border: 0px; color: #221f20; font-family: Helvetica, Arial, sans-serif; font-size: 22px; margin: 0px 0px 10px; outline: 0px; padding: 0px; vertical-align: baseline;">Winners: Teams</h3><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Houston Rockets:</strong> A vast majority of deadline moves were subtle deals that involved fringe rotation members or financial considerations. Not Houston’s trade. General manager Daryl Morey <a href="http://nba.si.com/2013/02/20/thomas-robinson-trade-kings-rockets/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">acquired the No. 5 pick in the 2012 draft</a>, Thomas Robinson, in a six-player deal that didn’t require the Rockets to part with an A-list asset (player or pick), meaningfully compromise their cap space this summer or receive a dead-weight contract in return. This was as clean a pilfering as you will see in the modern NBA, as if Morey helicoptered in to pluck Robinson off of the roof as flames engulfed the Sleep Train Arena.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Robinson has the most untapped potential and upside of any player traded this week. The Rockets look like a fairly solid playoff team this season, but their window is just opening around a young core that includes Harden, Jeremy Lin, Chandler Parsons, Omer Asik and now Robinson. Parting with the serviceable Patrick Patterson — who has one more year left on his rookie contract after this season — is a small price to pay for the chance to see whether Robinson can blossom into the game-changer some believed he would be coming out of Kansas.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Oklahoma City Thunder:</strong> Delicate is the word to describe Thunder GM Sam Presti. Oklahoma City pulled off two moves on Thursday, <a href="http://nba.si.com/2013/02/21/eric-maynor-trade-thunder-blazers-giorgio-printezis/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">dealing reserve point guard Eric Maynor</a> to the Trail Blazers for a trade exception and acquiring guard/forward <a href="http://nba.si.com/2013/02/21/ronnie-brewer-trade-knicks-thunder/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">Ronnie Brewer from the Knicks</a> for a 2014 second-round pick and cash.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">The Thunder boast one of the league’s deepest rosters, but the two moves provides just a touch of improved balance. Maynor was not having his best year after a major knee injury that cost him most of the 2011-12 season. The more athletic Reggie Jackson was emerging as Russell Westbrook’s backup and there just aren’t that many minutes to go around when the All-Star starter plays 36 per game. Brewer gives coach Scott Brooks one more experienced, defensive-minded body to add to a wing mix that includes Kevin Durant, Thabo Sefolosha and Kevin Martin. Brewer, a strong defender, can be used when OKC goes to smaller lineups or in certain matchups that might not be as favorable for Martin. He also provides an added degree of injury protection for Sefolosha.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Presti also shaved more than $1 million off of his books this season. That’s delicate defined: improving the bench’s positional balance while cutting payroll.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Golden State Warriors:</strong> The Warriors’ owners are deep-pocketed, so money isn’t the end-all, be-all. But the new collective bargaining agreement strongly encourages teams to dip into the luxury tax waters carefully rather than make a habit of swimming in those waters year after year. Where the luxury tax zone was once an annoyance, now it can be a true impediment to team-building and a costly one at that.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">The Warriors <a href="http://nba.si.com/2013/02/21/jeremy-tyler-charles-jenkins-trade-golden-state-warriors-trade/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">dumped 2011 second-round picks Jeremy Tyler and Charles Jenkins</a> to move under the $70.8 million luxury tax line. This year’s luxury tax payments would have been minuscule, but the fact the Warriors are now recipients of luxury tax money rather than payers is a nice bonus. The bigger deal: Staying under the luxury tax line prevents the Warriors from taking a strike in the new “repeater” system, which promises escalating fines for teams that are regularly taxpayers. With big dollars committed to Andrew Bogut, David Lee and Stephen Curry, plus expensive players options for Richard Jefferson and Andris Biedrens in 2013-14, the Warriors will be headed to the luxury tax vicinity again next year. These moves, while very predictable, kept them from being behind the financial eight ball down the road.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Portland Trail Blazers:</strong> The Blazers’ backup point guard position has been one of the NBA’s biggest disasters this season. Few teams fall off as hard when one player checks out as the Blazers do when Rookie of the Year front-runner Damian Lillard hits the bench. Obtaining a new backup has been a glaring need since training camp opened, and Portland finally <a href="http://nba.si.com/2013/02/21/eric-maynor-trade-thunder-blazers-giorgio-printezis/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">plugged that hole</a> by acquiring Maynor for nothing more than the draft rights to Greek forward Georgios Printezis. To make room for Maynor, the Blazers released veteran guard Ronnie Price.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Maynor is in the final year of his rookie contract, so this amounts, first and foremost, to a rental tryout. He’s struggled this season, particularly with his shot (he’s shooting a career-low 31.3 percent), and he’s only a little more than a year removed from suffering an ACL injury. With the weakest bench in the league and a need for a longer-term option to back up Lillard, the Blazers were smart to take a “buy low” flier on a game-managing point guard with some playoff experience who can spell Lillard or potentially play alongside him.  If he works out, they’ve added one piece to a bench that needs three or four more of them. If not, no assets were expended in the trial.</div><h3 style="background-color: white; border: 0px; color: #221f20; font-family: Helvetica, Arial, sans-serif; font-size: 22px; margin: 0px 0px 10px; outline: 0px; padding: 0px; vertical-align: baseline;">Losers: Teams</h3><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Sacramento Kings: </strong>Trading a top-five pick like Robinson just nine months after selecting him without ever giving him a true shot at major minutes reflects failure in so many aspects of the management process. One: Certainly the pick could have been used more effectively. Two: A loose leash, or at least some level of patience, should have come into play in managing his role. Three: This was the best they could get as far as a return package?</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://nba.si.com/2013/02/20/thomas-robinson-trade-kings-rockets/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">The move</a> also reflects an obvious desire to cut costs as an ownership transfer from the Maloofs to a Seattle-based group unfolds. Dealing Robinson to the Rockets reportedly netted the Kings $1 million, along with an additional $1 million-plus in salary savings. Is tossing away Robinson’s potential really worth that little? If Sacramento’s fans hadn’t been through so much in recent years, this would have prompted unadulterated outrage. Instead, it joins a long line of blood-boiling, pathetic decisions.</div><div class="wp-caption aligncenter" id="attachment_35567" style="background-color: #c52e1b; border: 0px; clear: both; font-family: verdana, arial, helvetica, sans-serif; font-size: 12px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; width: 620px;"><a href="http://nba.si.com/2013/02/21/nba-trade-deadline-winners-and-losers/jordan-crawford-wizards-2/" rel="attachment wp-att-35567" style="border: 0px; color: #003c68; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><img alt="Jordan Crawford was traded to the Celtics" class="size-full wp-image-35567" height="425" src="http://sinbapointforward.files.wordpress.com/2013/02/jordan-crawford-wizards1.jpg?w=610&h=425" style="border: 0px; font-family: inherit; font-style: inherit; margin: 5px; outline: 0px; padding: 0px 0px 5px; vertical-align: baseline;" width="610" /></a><div class="wp-caption-text" style="border: 0px; color: white; font-family: verdana, arial, sans-serif; font-size: 10px; font-style: inherit; line-height: 12px; margin: 5px; outline: 0px; padding: 0px 0px 6px; vertical-align: baseline;">The Wizards received a puzzling package in return for Jordan Crawford. (Ned Dishman/NBAE via Getty Images)</div></div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Washington Wizards:</strong> Dealing Jordan Crawford for Leandro Barbosa and Jason Collins is <a href="http://nba.si.com/2013/02/21/jordan-crawford-trade-leandro-barbosa-wizards-celtics/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">just a mess</a>. How exactly do you move a rotation player on a rookie deal for a journeyman center and a player with a season-ending injury without receiving any other assets and take on money (albeit only a few hundred thousand) in the process? Who cares how inefficient Crawford is or disgruntled he might be; how does this move benefit Washington in the slightest? Shedding his $2.2 million contract for next season would seem to be of little concern when, by comparison, the twin powerless towers of Emeka Okafor/Nene pull in a combined $27 million.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">There really wasn’t a second-round pick to be found for Crawford? It really wouldn’t make more sense to just wait until the summer and try to move him then?</div><h3 style="background-color: white; border: 0px; color: #221f20; font-family: Helvetica, Arial, sans-serif; font-size: 22px; margin: 0px 0px 10px; outline: 0px; padding: 0px; vertical-align: baseline;">Winners: Players</h3><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Thomas Robinson, Rockets:</strong> It’s hard to improve your lot in life <a href="http://nba.si.com/2013/02/20/thomas-robinson-trade-kings-rockets/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">more than Robinson did this week</a>. He goes from not playing much for a lottery-bound franchise loaded with question marks and distractions to a young, fun-and-gun team on the rise that promises to commit real minutes to him and is likely headed to the playoffs.  He goes from backing up a veteran in Jason Thompson to being penciled in as an every-night starter on a fast-paced team that can put his athleticism to full use. He goes from a me-first squad that has the second-worst assist rate in the league to a Houston team that moves the ball with slightly better than average regularity.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Tobias Harris, Magic:</strong> If there’s one totally under-the-radar player moved on Thursday who can emerge into a real player by shifting locales and being given a larger opportunity, it would be Harris. Included as <a href="http://nba.si.com/2013/02/21/j-j-redick-trade-magic-bucks-beno-udrih/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">one of the pieces Milwaukee sent to Orlando</a> in exchange for Redick, Harris has good size for a wing and posted decent per-minute numbers in a limited role for the Bucks. Milwaukee simply had too many veteran options in front of the 20-year-old, who was the 19th pick in 2011. In Orlando, coach Jacque Vaughn should be delighted to give Harris the opportunity to showcase his talents.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Eric Maynor, Blazers:</strong> After fighting — and mostly losing — a battle with Reggie Jackson for scant backup minutes in Oklahoma City, Maynor has the opportunity to <a href="http://nba.si.com/2013/02/21/eric-maynor-trade-thunder-blazers-giorgio-printezis/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">start a second chapter to his NBA career in Portland</a>. The Blazers are fading fast, having lost six straight games, and Maynor could very well see at least 20 minutes a game consistently as the season winds down. Missing out on a possible Finals run this year will be a bitter pill to swallow, but he has more immediate concerns, such as shoring up his future in the league.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Jordan Crawford, Celtics:</strong> It’s not every day that players stuck on atrocious teams <a href="http://nba.si.com/2013/02/21/jordan-crawford-trade-leandro-barbosa-wizards-celtics/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">exit that situation as cleanly as Crawford</a>. He moves to the Celtics, a team that is actually playing for something, and plugs into an injury-ravaged backcourt that will need him to provide minutes.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Sebastian Telfair, Raptors:</strong> Much like Crawford, Telfair just saw <a href="http://nba.si.com/2013/02/21/sebastian-telfair-trade-suns-raptors-hamed-haddadi/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">the rest of his season become relevant again</a>. Rather than watching his playing time erode in favor of rookie Kendall Marshall as the Suns limp to the lottery, Telfair moves into the backup point guard hole created when the Raptors shipped Jose Calderon to the Pistons in the deal that netted Rudy Gay. While Toronto has some serious ground to make up to get to the No. 8 seed in the East, that uphill climb is far better for a vet like Telfair than Phoenix’s trudge toward a top-five pick.</div><div class="wp-caption aligncenter" id="attachment_35570" style="background-color: #c52e1b; border: 0px; clear: both; font-family: verdana, arial, helvetica, sans-serif; font-size: 12px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; width: 620px;"><a href="http://nba.si.com/2013/02/21/nba-trade-deadline-winners-and-losers/morris-twins/" rel="attachment wp-att-35570" style="border: 0px; color: #003c68; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><img alt="Marcus Morris, Markieff Morris" class="size-full wp-image-35570" height="425" src="http://sinbapointforward.files.wordpress.com/2013/02/morris-twins.jpg?w=610&h=425" style="border: 0px; font-family: inherit; font-style: inherit; margin: 5px; outline: 0px; padding: 0px 0px 5px; vertical-align: baseline;" width="610" /></a><div class="wp-caption-text" style="border: 0px; color: white; font-family: verdana, arial, sans-serif; font-size: 10px; font-style: inherit; line-height: 12px; margin: 5px; outline: 0px; padding: 0px 0px 6px; vertical-align: baseline;">Twins Marcus (left) and Markieff Morris will play alongside each other in Phoenix. (Bill Baptist/NBAE via Getty Images)</div></div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Marcus Morris, Suns:</strong> Marcus and twin brother Markieff, famously inseparable, are <a href="http://nba.si.com/2013/02/20/thomas-robinson-trade-kings-rockets/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">now reunited in Phoenix</a>. If you must play for one of the NBA’s worst teams, you might as well have your best friend alongside you.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Kenyon Martin, Knicks:</strong> After essentially begging for a job, Martin finally got one, <a href="http://nba.si.com/2013/02/21/kenyon-martin-new-york-knicks-10-day-deal/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">agreeing to a 10-day contract</a> after the Knicks opened a roster spot by moving Brewer. This is a good spot for Martin: a veteran-laden team with championship aspirations that includes a number of his former teammates from the Nuggets days, including Carmelo Anthony and J.R. Smith. Will he make the most of it?</div><h3 style="background-color: white; border: 0px; color: #221f20; font-family: Helvetica, Arial, sans-serif; font-size: 22px; margin: 0px 0px 10px; outline: 0px; padding: 0px; vertical-align: baseline;">Losers: Players</h3><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">J.J. Redick, Bucks:</strong> It seemed like the whole NBA world wanted Redick’s services these past few weeks, and for good reason. He’s a great teammate and great shooter and has developed into a solid all-around player. Given his expiring contract, he was the ideal trade target for a contender to add in an attempt to push itself over the top. Instead, the Bucks, the No. 8 seed in the Eastern Conference at 26-27, <a href="http://nba.si.com/2013/02/21/j-j-redick-trade-magic-bucks-beno-udrih/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">added Redick</a> in an attempt to prevent a slide back into the lottery. Redick’s reward for suffering through months of rumors and being one of the most coveted trade deadline targets could very well be a four-game sweep in the first round at the hands of the Heat before he undergoes the madness and uncertainty of free agency. He will surely take it all in stride, but you can’t help but feel sympathy for him.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Hakim Warrick, Magic:</strong> How many times can one man be traded? Since signing a four-year contract with the Suns in July 2010, Warrick has been traded from Phoenix to New Orleans to Charlotte and<a href="http://nba.si.com/2013/02/21/josh-mcroberts-hakim-warrick-trade-magic-bobcats/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">now to Orlando</a>, where he will be bought out. Perhaps all that traveling might be worth it if he finds a playoff team to hook on with for the stretch run.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Ronnie Price, Blazers:</strong> The Maynor trade came just before the buzzer and it was a bit of a surprise, as Blazers management had been promising a quiet trade deadline. The <a href="http://nba.si.com/2013/02/21/eric-maynor-trade-thunder-blazers-giorgio-printezis/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">move cost Price his job</a> and unfairly so, given that he’s played better this season than 2010 first-round pick Nolan Smith. Blazers GM Neil Olshey said the franchise felt an “organizational responsibility” to continue developing Smith, but that responsibility didn’t extend to picking up Smith’s rookie option for next year. Price is left watching a less deserving player keep a roster spot that should have been his.</div><div style="background-color: white; border: 0px; font-family: verdana, arial, sans-serif; font-size: 12px; line-height: 20px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; color: #221f20; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Luke Zeller, Suns:</strong> Zeller was <a href="http://nba.si.com/2013/02/20/thomas-robinson-trade-kings-rockets/" style="border: 0px; color: #ec2c21; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">released to make room for Marcus Morris</a>. The undrafted free agent must now find his next job, a tall task with just 58 minutes of playing time to show for his rookie season.</div><div class="sharedaddy sd-like-enabled sd-sharing-enabled" id="jp-post-flair" style="background-color: white; border-bottom-left-radius: 0px !important; border-bottom-right-radius: 0px !important; border-top-left-radius: 0px !important; border-top-right-radius: 0px !important; border: 0px; clear: both; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 12px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; zoom: 1;"><div class="sharedaddy sd-sharing-enabled" style="border-bottom-left-radius: 0px !important; border-bottom-right-radius: 0px !important; border-top-left-radius: 0px !important; border-top-right-radius: 0px !important; border: 0px; clear: both; font-style: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; zoom: 1;"><div class="robots-nocontent sd-block sd-social sd-social-icon-text sd-sharing" style="border-bottom-left-radius: 0px !important; border-bottom-right-radius: 0px !important; border-top-color: rgba(0, 0, 0, 0.129412); border-top-left-radius: 0px !important; border-top-right-radius: 0px !important; border-top-style: solid; border-width: 1px 0px 0px; font-family: inherit; font-style: inherit; margin: 0px; outline: 0px; padding: 10px 0px 5px; vertical-align: baseline; width: 648px; zoom: 1;"></div></div></div></div>

NBA trade deadline NBA trade deadline: Winners and losers

Thomas Robinson was the big winner of the 2013 NBA trade deadline. (Ronald Martinez/Getty Images) By  Ben Golliver Thursday’s NBA trade dead...

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Amber Rose Shares First Picture of Wiz Khalifa Holding Baby Bash

<div dir="ltr" style="text-align: left;" trbidi="on"><img alt="Wiz Khalifa" src="http://www.usmagazine.com/uploads/assets/articles/60457-amber-rose-shares-first-picture-of-wiz-khalifa-holding-baby-bash/1361542388_wiz-khalifa-467.jpg" /><br /><br /><div data-action="Zoom" data-category="Article" data-label="0" id="article-image" style="border: 0px; float: left; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin: 0px 19px 17px 0px; outline: 0px; padding: 0px; vertical-align: baseline; width: 240px;"><span class="caption" style="border: 0px; clear: both; color: #999999; display: block; font-size: 10px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Wiz Khalifa</span><span class="caption" style="border: 0px; clear: both; color: #999999; display: block; font-size: 10px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Credit: instagram.com</span></div><div data-action="Contextual" data-category="Article" data-track-tags="a" id="article-body" style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">Frame it! <a href="http://www.usmagazine.com/celebrities/amber-rose" style="border: 0px; color: #009bd5; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank"><strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Amber Rose</strong></a> shared a touching photo of <strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Wiz Khalifa</strong> holding their first child together, son Sebastian "The Bash" Taylor Thomaz, after giving birth Thursday, Feb. 22.</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">"Best daddy ever," the new mom, 29, captioned the <a href="http://instagram.com/p/WB19oMQvL-/" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">beautiful shot</a>. "Up with the baby so Muva can go back to sleep."</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.usmagazine.com/celebrity-moms/pictures/hollywoods-new-star-dads-2011265/15119" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">PHOTOS: Hollywood's new star dads</a></div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">Khalifa, 25, alerted his <a href="https://twitter.com/wizkhalifa" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">Twitter</a> followers that Rose was about to give birth on Thursday by writing "daddy time" with a picture of himself wearing scrubs. The couple, who became engaged in March 2012, announced baby Bash's birth on Twitter shortly after by wishing him happy birthday.</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">"I'm so happy you guys. I fell in love all over again," Rose <a href="https://twitter.com/DaRealAmberRose" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">said</a>. The rapper added, "Everyone welcome this perfect young man into the world."</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div class="assetContainer imageStandard floatLt" style="border: 0px; margin: 0px auto 10px; outline: 0px; padding: 0px; vertical-align: baseline; width: 467px;"><img alt="Wiz Khalifa" src="http://www.usmagazine.com/uploads/assets/article_photos/wiz-khalifa-inline.jpg" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;" width="467" /><div class="imageCaption" style="border: 0px; color: #8b8b8b; font-size: 10px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline; width: 465px;">Wiz Khalifa<br />Credit: instagram.com</div></div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.usmagazine.com/celebrity-moms/pictures/pregnant-models-2009218/1994" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">PHOTOS: Pregnant models</a></div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">Khalifa is now focused on taking good care of his son and future wife. "My wife said she just wants a Jack & coke, a cheesesteak, and a cigarette," he shared early Friday morning. "That's why I'm marrying that woman!"</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">"Thanx for all the love guys," he added to his fans. "Bash took his first poop, had a good meal, now he's peacin."</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.usmagazine.com/celebrity-moms/pictures/dads-on-duty-20091811/5130" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">PHOTOS: Dads on duty</a></div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">The new parents have received many well wishes from their friends including <a href="http://www.usmagazine.com/celebrities/rihanna" style="border: 0px; color: #009bd5; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank"><strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Rihanna</strong></a> and <strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Snoop Dogg</strong>.</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">"Congratulations to my fam Wiz and Amber! Welcome baby Bash! You're born in an exquisite month," the "Diamonds" singer, who celebrated her 25th birthday on Wednesday, <a href="https://twitter.com/rihanna" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">tweeted</a>. "Baby Pisces."</div><div style="border: 0px; font-size: 14px; line-height: 18px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">"Welcome to fatherhood Wiz! Congrats to you and Amber on your new son -- he got the same Cday as Cordell Broadus!" Snoop Dogg (real name: Calvin Cordozar Broadus, Jr.), a father of three, <a href="https://twitter.com/SnoopDogg" style="border: 0px; color: #009bd5; font-size: 1.1em; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">wrote </a>about his son. "Bless up."</div></div><span style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><br /><br />Read more: <a href="http://www.usmagazine.com/celebrity-moms/news/amber-rose-shares-first-picture-of-wiz-khalifa-holding-baby-bash-2013222#ixzz2Le57lJ3l" style="border: 0px; color: #003399; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;">http://www.usmagazine.com/celebrity-moms/news/amber-rose-shares-first-picture-of-wiz-khalifa-holding-baby-bash-2013222#ixzz2Le57lJ3l</a><br />Follow us: <a href="http://ec.tynt.com/b/rw?id=dFNQGSbkCr4AEwacwqm_6r&u=usweekly" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">@usweekly on Twitter</a> | <a href="http://ec.tynt.com/b/rf?id=dFNQGSbkCr4AEwacwqm_6r&u=usweekly" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">usweekly on Facebook</a></span></div>

Amber Rose Amber Rose Shares First Picture of Wiz Khalifa Holding Baby Bash

Wiz Khalifa Credit: instagram.com Frame it!  Amber Rose  shared a touching photo of  Wiz Khalifa  holding their first child together, son Se...

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NASCAR: Kevin Harvick secures 3rd spot behind Danica Patrick, Jeff Gordon in Daytona 500

<div dir="ltr" style="text-align: left;" trbidi="on"><br /><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><span class="loc" style="border-right-color: rgb(196, 196, 196); border-right-style: solid; border-width: 0px 1px 0px 0px; float: left; font-family: nimbus-sans, Helvetica, Arial, sans-serif; font-size: 0.7em; font-style: inherit; font-weight: 900; height: 16px; letter-spacing: 0.07em; line-height: 1.6em; margin: 2px 10px 0px 0px; outline: 0px; padding: 0px 10px 0px 0px; text-transform: uppercase; vertical-align: baseline;">DAYTONA BEACH, FLORIDA</span>Kevin Harvick claimed the first of two qualifying races Thursday to secure third spot on the starting grid for the Daytona 500 and establish himself as favorite to win Sunday's NASCAR Sprint Cup season opener.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><a data-assetid="50141519" data-assettypeid="14" data-nodeid="400" data-overlay="1" data-overlayenabled="true" href="http://www.cbsnews.com/video/watch/?id=50141519n" style="background-color: white; border: 0px; color: #b12124; cursor: pointer; font-family: Helvetica, Arial, sans-serif; font-size: 15px; margin: 0px; outline: none; padding: 0px; text-decoration: none; vertical-align: baseline;"><div class="storyEmbed" style="border-bottom-color: rgb(222, 222, 222); border-bottom-style: solid; border-width: 0px 0px 1px; clear: left; float: left; font-family: inherit; font-size: inherit; font-style: inherit; margin: 4px 20px 20px 0px; outline: 0px; padding: 0px; vertical-align: baseline; width: 220px; zoom: 1;"><figure class="video" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; margin: 0px 0px -32px; outline: 0px; padding: 0px 0px 40px; position: relative; vertical-align: baseline; width: 220px;"><img class="image220" src="http://i.i.com.com/cnwk.1d/i/tim/2013/02/21/en_0221_danicapatrick_220x157.jpg" style="border: 0px; display: block; font-family: inherit; font-size: inherit; font-style: inherit; height: 140px; margin: 0px; outline: 0px; padding: 0px; position: relative; vertical-align: baseline; width: 220px;" /></figure><div class="meta" style="border: 0px; color: #666666; font-family: Georgia, 'Time New Roman', serif; font-size: 0.85em; font-style: italic; line-height: 22px; margin-top: 4px; outline: 0px; padding: 0px; position: relative; vertical-align: baseline; width: 220px; z-index: 11;">Play <span style="border: 0px; color: #b12124; font-family: nimbus-sans, Helvetica, Arial, sans-serif; font-size: 12px; font-style: normal; font-weight: 700; margin: 0px; outline: 0px; padding: 0px 0px 0px 2px; text-transform: uppercase; vertical-align: baseline;">VIDEO</span></div><h3 style="-webkit-font-smoothing: subpixel-antialiased; border-bottom-width: 0px; border-left-width: 0px; border-right-width: 0px; border-top-style: none; color: #202022; font-family: nimbus-sans, Helvetica, Arial, sans-serif; font-size: 1.4em; font-style: inherit; letter-spacing: -0.07em; line-height: 1em; margin: 0px; outline: 0px; padding: 5px 0px 10px; vertical-align: baseline; width: 220px;">Danica Patrick on Daytona 500, NASCAR gender barrier</h3></div></a><span style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 15px;"></span><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">With Danica Patrick and Jeff Gordon having claimed the top two spots in initial qualifying last weekend, Thursday's two races set the rest of the grid for the season's showpiece event.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Only nine of Daytona's 54 previous pole winners have gone on to take the checkered flag -- about one in five, <a href="http://www.cbsnews.com/8301-18563_162-57570634/danica-patrick-set-to-make-history-at-daytona" style="border: 0px; color: #b12124; cursor: pointer; font-family: inherit; font-size: inherit; font-style: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; vertical-align: baseline;">CBS News correspondent Mark Strassmann reports</a>.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Harvick also won an exhibition race at Daytona last weekend and his strong performances give him a favorites tag for Sunday's race that he'd rather be without.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">"We like to be the lame-duck underdog. That's what we're shooting for," Harvick said.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">"If it's meant to be, it's meant to be. We definitely have the car and team to be in contention to do that."</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><ul class="arrows gray" style="background-color: white; border: 0px; font-family: Helvetica, Arial, sans-serif; font-size: 15px; list-style: none; margin: 0px 0px 15px; outline: 0px; padding: 0px; vertical-align: baseline;"><li style="background-image: url(http://asset2.cbsistatic.com/cnwk.1d/i/cbs/generic/genericSprite.png); background-position: -15px -911px; background-repeat: no-repeat no-repeat; border: 0px; font-family: Georgia, 'Times New Roman'; font-size: 1.1em; font-style: inherit; margin: 0px; outline: 0px; padding: 0px 0px 0px 40px; text-align: left; vertical-align: baseline;"><a href="http://www.cbsnews.com/8301-18563_162-57570634/danica-patrick-set-to-make-history-at-daytona/" style="border: 0px; color: #b12124; cursor: pointer; font-family: inherit; font-size: inherit; font-style: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; vertical-align: baseline;">Danica Patrick set to make history at Daytona</a></li></ul><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">But nobody is quite sure what the 500 will look like with NASCAR's new Gen-6 race car. Sunday's race will go off with a full 43-car field, double the amount of cars that ran in Thursday's qualifying races. There were 19 cars in last Saturday's exhibition.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Kyle Busch, winner of the second qualifying duel Thursday and fourth spot on the grid, believes more cars on the track will create a much more dynamic race than is usual for season openers, when drivers are becoming accustomed to new cars.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><a data-assetid="50141496" data-assettypeid="14" data-nodeid="400" data-overlay="1" data-overlayenabled="true" href="http://www.cbsnews.com/video/watch/?id=50141496n" style="background-color: white; border: 0px; color: #b12124; cursor: pointer; font-family: Helvetica, Arial, sans-serif; font-size: 15px; margin: 0px; outline: none; padding: 0px; text-decoration: none; vertical-align: baseline;"><div class="storyEmbed" style="border-bottom-color: rgb(222, 222, 222); border-bottom-style: solid; border-width: 0px 0px 1px; clear: left; float: left; font-family: inherit; font-size: inherit; font-style: inherit; margin: 4px 20px 20px 0px; outline: 0px; padding: 0px; vertical-align: baseline; width: 220px; zoom: 1;"><figure class="video" style="border: 0px; font-family: inherit; font-size: inherit; font-style: inherit; margin: 0px 0px -32px; outline: 0px; padding: 0px 0px 40px; position: relative; vertical-align: baseline; width: 220px;"><img class="image220" src="http://i.i.com.com/cnwk.1d/i/tim/2013/02/21/en_0220_PREVIEW_220x157.jpg" style="border: 0px; display: block; font-family: inherit; font-size: inherit; font-style: inherit; height: 140px; margin: 0px; outline: 0px; padding: 0px; position: relative; vertical-align: baseline; width: 220px;" /></figure><div class="meta" style="border: 0px; color: #666666; font-family: Georgia, 'Time New Roman', serif; font-size: 0.85em; font-style: italic; line-height: 22px; margin-top: 4px; outline: 0px; padding: 0px; position: relative; vertical-align: baseline; width: 220px; z-index: 11;">Play <span style="border: 0px; color: #b12124; font-family: nimbus-sans, Helvetica, Arial, sans-serif; font-size: 12px; font-style: normal; font-weight: 700; margin: 0px; outline: 0px; padding: 0px 0px 0px 2px; text-transform: uppercase; vertical-align: baseline;">VIDEO</span></div><h3 style="-webkit-font-smoothing: subpixel-antialiased; border-bottom-width: 0px; border-left-width: 0px; border-right-width: 0px; border-top-style: none; color: #202022; font-family: nimbus-sans, Helvetica, Arial, sans-serif; font-size: 1.4em; font-style: inherit; letter-spacing: -0.07em; line-height: 1em; margin: 0px; outline: 0px; padding: 5px 0px 10px; vertical-align: baseline; width: 220px;">Danica Patrick: NASCAR embraced "my difference"</h3></div></a><span style="background-color: white; font-family: Helvetica, Arial, sans-serif; font-size: 15px;"></span><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">"With more cars out there, we might see it be a little bit different come Sunday," Busch said. "There's going to be twice as many good cars, twice as many middle of the pack cars, twice as many back of the pack cars. If you can get your car handling, driving, feeling good, you'll be able to be one of the guys that's up front."</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">Kasey Kahne, who settled for second behind Busch, said timing will be critical and nobody is sure just yet what move will be needed to win the Daytona 500.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">"It's tough because you don't know when you get that push. You don't know when it plays into your time," said Kahne. "You need to be ready at any time to get to the front, to second, to third, try to move up. I don't think waiting till the last lap is a ticket the way things are right now."</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">And Kahne wasn't ready to give Harvick the win in the big race, either.</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">"He can be beat, yeah. There's a few of us in the second race who had really good cars, and I could move around really well, similar to what Harvick did in the first race."</div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;"></div><div style="background-color: white; border: 0px; color: #202022; font-family: Georgia, 'Time New Roman', serif; font-size: 1.1em; line-height: 22px; margin-bottom: 15px; outline: 0px; padding: 0px; vertical-align: baseline;">In the first race, Harvick held off Greg Biffle over a four-lap sprint to win. Harvick and Biffle also went 1-2 in last Saturday's exhibition race.</div></div>

NASCAR NASCAR: Kevin Harvick secures 3rd spot behind Danica Patrick, Jeff Gordon in Daytona 500

DAYTONA BEACH, FLORIDA Kevin Harvick claimed the first of two qualifying races Thursday to secure third spot on the starting grid for the Da...

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