A Genetic Test for Exercise - 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; ">Research <a href="http://well.blogs.nytimes.com/2010/11/17/phys-ed-the-workout-enigma/" style="color: rgb(0, 0, 102); text-decoration: none; ">has confirmed</a> that people's physiological responses to exercise vary wildly. Now a new genetic test promises to tell you whether you are likely to benefit aerobically from exercise. The science behind the test is promising, but is this information any of us really needs to know?</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 new test, which is being sold by a British company called <a href="http://www.xrgenomics.co.uk/" style="color: rgb(0, 0, 102); text-decoration: none; ">XRGenomics</a>, is available to anyone through the company's Web site and involves rubbing inside your cheek with a supplied swab and returning the tissue sample to the company. Results are then available within a few weeks. It is based on a body of research led by James Timmons, a professor of systems biology at Loughborough University in England, and colleagues at the Pennington Biomedical Research Center in Louisiana and other institutions.</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; ">That original research, published in a <a href="http://www.ncbi.nlm.nih.gov/pubmed/20133430" style="color: rgb(0, 0, 102); text-decoration: none; ">landmark 2010 study,</a> looked into the genetics of why some people respond to endurance exercise so robustly, while others do not. Some lucky men and women take up jogging, for example, and quickly become much more aerobically fit. Others complete the same program and develop little if any additional endurance, as measured by increases in their VO₁2 max, or their body's ability to consume and distribute oxygen to laboring muscles.</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; ">For the 2010 study, Dr. Timmons and his colleagues genotyped muscle tissue from several groups of volunteers who had completed 6 to 20 weeks of endurance training. They found that about 30 variations in how genes were expressed had a significant effect on how fit people became. The new test looks for those genetic markers in people's DNA.</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 idea is to help people to understand why" they might be progressing more slowly in an exercise program than their training partners are, says Dr. Timmons, one of the founders of XRGenomics.</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; ">After he appeared on a BBC science program last year, in the course of which the host was revealed to be a "low" responder, according to his gene profile, Dr. Timmons was inundated with e-mails and calls requesting the test, he says. At that point, he and several colleagues filed a patent (still pending) for the gene markers and brought the test to market.</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; ">It joins other, less-sophisticated exercise-related gene test kits already available over the counter. These tests, which are not monitored by the Food and Drug Administration, typically rely on a single gene marker and claim to be able to predict whether you - or your child - will have success as a distance runner, say, or as a power-based athlete, like a sprinter.</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 actual predictive value, based on the best currently available genetic science, "is approximately zero," says Claude Bouchard, a professor of genetics at Pennington, who was the senior author of the 2010 study with Dr. Timmons, but has no involvement with XRGenomics. (He is a paid consultant for another company, Pathway Genomics, that offers gene tests only through physicians.)</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 new test is almost certainly more reliable, with "a much stronger scientific basis than any of the previous exercise-related DNA test kits," says Tuomo Rankinen, a professor of genetics at Pennington, who, like Dr. Bouchard, was an author of the original gene study but has no involvement with XRGenomics. But, he adds, it relies on VO¹2 max, just one measure of how someone responds to exercise, so it has severe limits.</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 new test will not tell you, for example, how exercise might affect your blood pressure over the long haul, Dr. Rankinen says, or whether your insulin sensitivity might change, or whether you'll lose weight. The genetic markers related to these health responses to exercise are quite different from those related to VO₁2 max, he says.</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; ">In other words, the scientific understanding of how our DNA affects our overall bodily response to exercise is in its infancy.</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; ">Which does not mean that anyone curious - and deep-pocketed - enough to take the test should refrain from doing so. At present the basic test kit costs about $318 (199 British pounds) for genotyping and a brief accompanying report. For about $478, you receive a more extensive explanation of the findings, along with customized exercise recommendations from the company's scientific advisory board. The report might suggest, Dr. Timmons says, that if you are a "low" responder to endurance exercise, you should concentrate on resistance training or otherwise refocus your training.</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; ">"What we hope," he says, is that the test and report "will encourage people to keep exercising" who might otherwise have quit when running or swimming didn't make them more fit.</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; ">On the other hand, some people might look on the news that they are a "low" responder to endurance training as a license to quit working out altogether, he acknowledges.</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 Dr. Bouchard says that that would be the worst message to take from any gene testing. "This is a good test, as far as it goes," he says. But genes will never be destiny.</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; ">In the original 2010 gene study, the authors concluded that the gene profile they'd uncovered accounted for at least 23 percent of the variation in how people responded to endurance training, which, in genetic terms, is a hefty contribution. That leaves perhaps 77 percent of how you respond to exercise consciously up to you.</div></div></div></div></div><a href="http://well.blogs.nytimes.com/2012/10/10/are-you-likely-to-respond-to-exercise/?src=mv&ref=general&pagewanted=print">http://well.blogs.nytimes.com/2012/10/10/are-you-likely-to-respond-to-exercise/?src=mv&ref=general&pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

A Genetic Test for Exercise - NYTimes.com

Research  has confirmed  that people's physiological responses to exercise vary wildly. Now a new genetic test promises to tell you whet...

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Today's archidose #625

Here are some photos of the Basque Culinary Center in San Sebastián, Spain, by <a href="http://www.vaumm.com/">VAUMM</a> (2011), photographed by <a href="http://www.flickr.com/photos/dwape/">Pawel Paniczko</a>.<br /><br /><a href="http://www.flickr.com/photos/dwape/8059426157/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8174/8059426157_e4df37cc06_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/dwape/8059415295/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8449/8059415295_7b2f8d0a7c_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/dwape/8059433875/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8458/8059433875_9cbf300269_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/dwape/8059543704/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8321/8059543704_38c6e16a1f_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/dwape/8059456414/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8321/8059456414_27f467d681_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/dwape/8059476329/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8307/8059476329_250ee14a04_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/dwape/8059491551/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8169/8059491551_1b3c13f885_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/dwape/8059505334/" title="Basque Culinary Center by Pawel Paniczko, on Flickr"><img alt="Basque Culinary Center" height="427" src="http://farm9.staticflickr.com/8037/8059505334_7eda5f9503_z.jpg" width="640" /></a><br /><br />To contribute your Flickr images for consideration, just:<br /><blockquote>:: Join and add photos to the <a href="http://www.flickr.com/groups/archi-dose/">archidose pool</a>, and/or<br />:: Tag your photos <span style="font-style: italic;"><a href="http://www.flickr.com/photos/tags/archidose/">archidose</a></span></blockquote>

Today's archidose #625

Here are some photos of the Basque Culinary Center in San Sebastián, Spain, by VAUMM (2011), photographed by Pawel Paniczko . To contribute...

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After Losing St. Vincent’s Hospital, Manhattan Sees Rise in Clinic Care - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><nyt_text style="color: rgb(51, 51, 51); 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 id="articleBody"><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The demise of <a title="Articles on St. Vincent's demise" href="http://www.nytimes.com/2010/02/03/nyregion/03vincents.html" style="color: rgb(102, 102, 153); text-decoration: none; ">St. Vincent's Hospital</a> in Greenwich Village two years ago has led to a struggle for health care supremacy in some of New York's most distinctive neighborhoods, offering a glimpse, in the process, at what might be the future of urban medicine.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Without building a hospital, one large chain, <a title="Continuum Web site" href="http://www.wehealnewyork.org/" style="color: rgb(102, 102, 153); text-decoration: none; ">Continuum Health Partners</a>, is establishing a beachhead in Chelsea and the Village by connecting with outpatient clinics, trying to dominate the market and create a feeder network for its hospitals in other neighborhoods. It is joining forces not just with traditional clinics but also with newer experiments like doctors working out of drugstores. A competitor, <a title="NYU Langone Web site" href="http://www.med.nyu.edu/" style="color: rgb(102, 102, 153); text-decoration: none; ">NYU Langone Medical Center</a>, is expanding its physician practices downtown, and like Continuum, it has hired dozens of stranded St. Vincent's doctors.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Several walk-in "urgent care" centers have also rushed into the vacuum left by St. Vincent's in Lower Manhattan, hoping to show that they are more efficient and consumer-friendly than a hospital-based system, but some have already begun to form relationships with the hospitals.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"We are still trying to figure out if we are a threat or an asset to each other, and we are probably both," said Dr. Alicia Salzer, co-founder of <a title="Medhattan Web site" href="http://www.medhattan.com/" style="color: rgb(102, 102, 153); text-decoration: none; ">Medhattan</a>, an urgent care center that opened in 2011 near ground zero at Liberty Street and Trinity Place.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The immediate fight is to win market share, the loyalty and business of the area's many affluent and well-insured residents. But the demise of St. Vincent's has also turned Lower Manhattan into a laboratory for health care reform. The new clinics and the maneuvering by large chains are anticipating an expansion of the number of people with insurance and changes in the way that health care is delivered and paid for. And they are testing the notion, long held by health planners, that the city can survive with fewer hospitals.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Many doctors and some Village residents were dismayed when St. Vincent's went bankrupt and closed, and consider the new health care choices in the area to be less than adequate.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"As a physician and general internist, other than a <a href="http://health.nytimes.com/health/guides/injury/cuts-and-puncture-wounds/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Cuts and puncture wounds." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">laceration</a>, I would never send a patient to the urgent care center," said Dr. David Kaufman, who trained at St. Vincent's and spent more than 30 years working there.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">But in its waning days, St. Vincent's was filling far fewer beds than it did during the <a href="http://health.nytimes.com/health/guides/disease/aids/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about AIDS/H.I.V.." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">AIDS</a> crisis, and as is the case at other hospitals, many patients using its emergency room did not need emergency care, driving up costs.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">While it is impossible to know whether local residents are worse off without the hospital, <a title="Rand 2009 study" href="http://www.rand.org/news/press/2009/08/31.html" style="color: rgb(102, 102, 153); text-decoration: none; ">one 2009 study by analysts for the RAND Corporation</a> found no adverse impact on quality, and significant cost savings, in the newer models of care.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The study looked at patients in a large Minnesota health plan who received care for sore throats, ear infections and urinary tract infections — common complaints at retail clinics like the ones in drugstores. It found that the cost of care was 30 percent to 40 percent lower in those clinics than in physician's offices and urgent care centers, and 80 percent lower than in emergency departments, mainly because of lower reimbursement rates and less laboratory testing. It found that the rate of preventive care and overall quality of care was actually worse for patients who patronized emergency rooms for those ailments.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The researchers did raise concerns that the proliferation of urgent and retail care might lead people who otherwise would nurse minor illnesses at home to seek medical attention, raising the costs of health care to society. And they suggested that without good communication between different types of care, the health system might become even more fragmented.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"So you have more cooks over the pot, and that lack of continuity is a real frustration," said Dr. Ateev Mehrotra, a policy analyst at RAND, an associate professor at the University of Pittsburgh School of Medicine and the lead author of the study, published in the Annals of Internal Medicine.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">As for worries that urgent care or retail clinics might miss serious diseases like <a href="http://health.nytimes.com/health/guides/disease/cancer/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Cancer." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">cancer</a>, Dr. Mehrotra said that the rarity of complications made that concern hard to assess, but that "there would be a lot of malpractice suits, and we haven't seen that."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Executives at Continuum, which runs five hospitals in New York City, say they expect their expansion into the community to form the foundation of an accountable care organization, a new model of care supported by the federal law that seeks to move patients out of hospitals as much as possible, and to reward health care organizations for working together to improve quality and cut costs.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">From Eighth Street in the Village to 26th Street in Chelsea, between Ninth Avenue and Union Square, a patient can now choose from a dozen clinics or medical practices that have been opened or expanded by Continuum or are affiliated with it.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Continuum has also taken over the former St. Vincent's cancer center on 15th Street, and it has established a clinic with a focus on H.I.V. patients on 17th Street, renovating several floors and filling them with colorful pop art. Half of the doctors at the clinic, called the Center for Comprehensive Care, were hired from the old St. Vincent's H.I.V. program.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"Urgent care centers are opening at the pace of Starbucks, and we are affiliating with as many of them as we can," said Adam Henick, senior vice president of Ambulatory Care and Medical Enterprise for Continuum.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Continuum has also become affiliated with doctors practicing out of 13 Duane Reade drugstores in Manhattan and Brooklyn, and has a contract to expand to 20 within the next year or so, and to 50 within four years, said Dr. James A. D'Orta, chairman and chief executive of Consumer Health Services, which manages the practices in the pharmacies.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">No money changes hands in the Duane Reade affiliations, Mr. Henick said, but there are indirect benefits for both sides. The hospital system checks doctors' credentials and provides — and bills for — laboratory, radiology and imaging services prescribed by the Duane Reade doctors. The system also gets a potential trove of patients referred by the clinics. The Duane Reade clinics earn the cachet of being associated with major hospitals, and as with other affiliated practices, the Duane Reade patients are given expedited access to Continuum specialists and direct access to hospital admission if needed.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">While one goal of the federal health care overhaul is to move nonemergency patients from hospitals to cheaper outpatient care, there is significant cost variation among clinics, even among those that are part of Continuum's loose network. In a byzantine patchwork of state and federal law, some specialized clinics — especially those treating H.I.V. or geriatric patients — can be reimbursed several times as much for a patient visit as are private practices and urgent care centers.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Officials at NYU Langone Medical Center on the East Side said that they, too, were trying to expand their downtown market.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"Everything is intensely competitive and everyone is everywhere," said Dr. Andrew W. Brotman, its senior vice president and vice dean for clinical affairs and strategy.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The hospital system with perhaps the most to lose from the competition is the North Shore-Long Island Jewish Health System. It is <a title="Article on North Shore-LIJ plans" href="http://www.nytimes.com/2012/03/15/nyregion/deal-reached-for-former-site-of-st-vincents.html" style="color: rgb(102, 102, 153); text-decoration: none; ">renovating the 160,000-square-foot O'Toole building</a>, across from the old St. Vincent's, as a free-standing emergency room, which expects to handle 50,000 visits a year. It will operate as an extension of Lenox Hill Hospital, a North Shore affiliate on the Upper East Side.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">But the emergency room is not scheduled to open until 2014. Over the summer, North Shore was forced to close an interim clinic it had opened in Chelsea with a $9.4 million state grant. The clinic attracted an average of only two patients a day, which a hospital spokesman, Terry Lynam, attributed to its limited hours and "the proliferation of urgent care" in the neighborhood.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Michael J. Dowling, chief executive of North Shore, said he believed there was room to work collaboratively with Continuum and other health care providers in the neighborhood.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"Good hospitals are important, but you don't need more than you need," Mr. Dowling said. "In many cases, we've been addicted to inpatient beds. We can't be addicted to them in the future."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Word of the new options is trickling out, and some patients say they are not mourning St. Vincent's.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Michelle McKenzie, a social worker, said going to the St. Vincent's emergency room often meant hours of waiting and, in recent years, run-down facilities. She found Medhattan, the urgent care center, advertised on the bulletin board at Public School 3, where her 7-year-old son, Ian Etheridge, is a student. She has gone there to be treated for an allergic breakout of <a href="http://health.nytimes.com/health/guides/disease/hives/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Hives." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">hives</a>, and her husband took their son there a few months ago when he cut his forehead on the playground and needed stitches.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"I was seen immediately," Ms. McKenzie said. "It wasn't crazy chaotic like St. Vincent's was. I only had to tell my story once, and I was treated by the same physician I told my story to."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Dr. Charles Carpati, former chief of intensive care at St. Vincent's, now at Lenox Hill Hospital, said the community seemed to be coping without the old hospital.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"It's been very hard to show that people are dying because St. Vincent's is no longer there," Dr. Carpati said.</p><nyt_correction_bottom><div class="articleCorrection" style="margin-bottom: 2.8em; "></div></nyt_correction_bottom><nyt_update_bottom></nyt_update_bottom></div></nyt_text><span style="color: rgb(51, 51, 51); 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; background-color: rgb(255, 255, 255); display: inline !important; float: none; "></span></div><a href="http://www.nytimes.com/2012/10/10/nyregion/after-losing-st-vincents-hospital-manhattan-sees-rise-in-clinic-care.html?">http://www.nytimes.com/2012/10/10/nyregion/after-losing-st-vincents-hospital-manhattan-sees-rise-in-clinic-care.html?</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

After Losing St. Vincent’s Hospital, Manhattan Sees Rise in Clinic Care - NYTimes.com

The demise of  St. Vincent's Hospital  in Greenwich Village two years ago has led to a struggle for health care supremacy in some of New...

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The teacher is not always right (at least not about this Nobel Prize winner)

The teacher is not always right. Take this report card for a troubled science student in 1949.<br /><br /><blockquote class="tr_bq">"It has been a disastrous half. His work has been far from satisfactory. His prepared stuff has been badly learnt, and several of his test pieces have been torn over; one of such pieces of prepard work scored 2 marks out of a possible 50. His other work has been equally bad, and several times he has been in trouble, because he will not listen, but will insist on doing his work in his own way. I believe he has ideas about becoming a scientist; on his present showing this is quite ridiculous, if he can't learn simple Biological facts he would have no chance to find the work of a a Specialist, and it would be sheer waste of time, both on his part, and of those who have to teach him."</blockquote><br />This is taken from the report card of <a href="http://www.boston.com/news/world/europe/2012/10/09/nobel-prize-winner-got-poor-marks-science/V4Ac8ByiebdB2DiVCmglBJ/story.html" target="_blank">John Gurdon</a>, by a teacher at Eton College in 1949.<br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="http://c.o0bc.com/rf/image_539o215/Boston/2011-2020/Wires/2012/10/09/Boston.com/APOnlineImages/2012-10-09/fb79fcb979ed7d1c1d0f6a706700fa9b.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="247" src="http://c.o0bc.com/rf/image_539o215/Boston/2011-2020/Wires/2012/10/09/Boston.com/APOnlineImages/2012-10-09/fb79fcb979ed7d1c1d0f6a706700fa9b.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><a href="http://www.boston.com/news/world/europe/2012/10/09/nobel-prize-winner-got-poor-marks-science/V4Ac8ByiebdB2DiVCmglBJ/story.html" target="_blank">Boston.com </a>- AP News - Nobel Prize winner gets poor marks in science.</td></tr></tbody></table><br /><br />Gurdon has just <a href="http://www.independent.co.uk/news/science/britains-sir-john-gurdon-wins-nobel-prize-in-medicine-for-his-pioneering-work-in-cloning-and-stem-cells-8202243.html" target="_blank">won the Nobel prize</a> for science. I find it ironic how quickly this paper surfaced. I would wonder if Gurdon kept it as fuel for his passion, kind of like I recall those in my class who told me that I'd never be anything because I had no common sense.<br /><br />I am going to show this to my students today. The fact is that passion cannot be held back and that teachers aren't always right.<br /><br />It is also true, that sometimes we learn the most from our worst teachers... or those we get along with the worst... that -- "if it is to be, it is up to me."<br /><br />Ponder this one today. Remember your noble calling, teacher, but also that you are not omnipotent.<br /><br /><br /> <div class="zemanta-pixie" style="height: 15px; margin-top: 10px;"><a class="zemanta-pixie-a" href="http://www.zemanta.com/?px" title="Enhanced by Zemanta"><img alt="Enhanced by Zemanta" class="zemanta-pixie-img" src="http://img.zemanta.com/zemified_c.png?x-id=1d960674-2922-4df1-8dc4-038e365cf696" style="border: none; float: right;" /></a></div>

John Gurdon Teaching The teacher is not always right (at least not about this Nobel Prize winner)

The teacher is not always right. Take this report card for a troubled science student in 1949. "It has been a disastrous half. His work...

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Gleanings from the Google Teacher Academy in New York, October 3rd and 4th

<div dir="ltr" style="text-align: left;" trbidi="on"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixEIKRjL97U6HTVe_zBf-a_i1Lp7UF-Wjhwk6T1dm7T61Sc71g4K_AQmqjlG9-Szp_5Mg3uiHKbcSlhFYkNVwlPTjJ2kBA7bKVXBEqdqtp_7xP9ilBw34Nrvp4t-EaPGqb45cd_LcOdiw/s1600/google-graphics.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="105" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixEIKRjL97U6HTVe_zBf-a_i1Lp7UF-Wjhwk6T1dm7T61Sc71g4K_AQmqjlG9-Szp_5Mg3uiHKbcSlhFYkNVwlPTjJ2kBA7bKVXBEqdqtp_7xP9ilBw34Nrvp4t-EaPGqb45cd_LcOdiw/s200/google-graphics.JPG" width="200" /></a></div><span style="font-size: x-small;"></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">In my post yesterday I wrote<span style="background-color: white;"> <a href="http://e-blogschool.blogspot.com/2012/10/reflections-on-google-teacher-academy.html" target="_blank">a reflection </a></span><a href="http://e-blogschool.blogspot.com/2012/10/reflections-on-google-teacher-academy.html" target="_blank">on the latest Google Teacher Academy</a> in New York. The more I think about it, it was a mind blowing experience! We absorbed so much useful information both informally through networking and sharing, and formally from the various talented presenters. Today’s post will mention but a <b>FEW</b> of my take aways from the GTA experience</span></span><br /><br /><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: large;"><b>Something interesting about Google</b></span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b><br /></b>When you are there walking through different parts of the huge building you see all these young (so it seemed) men and women working intensely at their computers and you know that things are happening ‘out there’ in the Internet. There is a large emphasis on creativity and the 400-800 employees at that particular office are encouraged to relax in various ways after an intense session. Good, healthy food is in plentiful supply and Google provides breakfast, lunch and dinner to its employees. I was interested in their 20% time principle, best explained as “<i>Google gives its workers ‘20 percent time’ so that they can work on projects that they are passionate about. ‘20 percent time’ has been used to develop Gmail, Google Talk, Adsense, Orkut and a few other features that would never have seen the light of day unless this philosophy existed within Google”</i>. (<a href="http://www.ictsteps.com/2011/20-time-your-own-learning-time/%5C" target="_blank"><span style="background-color: white;">Kevin Mclaughlin</span></a>) </span></span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: large;">Tips and tricks from Google </span></span></b></span></span><br /><ul><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>Google Chatbot for translation.</b> This is INCREDIBLE for collaboration with those who don’t speak your language. You simply add the chatbot to your chat list as a ‘friend’ and then you create a chat between yourself, the chat bot and the foreign friend. <i>e.g. someone from China</i>. You type in English and he/she will see your words in Chinese and vice versa! Amazing! Read more <a href="http://support.google.com/chat/bin/answer.py?hl=en&answer=172257" target="_blank">here</a>. </span></span></li><li> <span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>Google dashboard</b>. Did you know that you can log in to <br /><a href="http://www.google.com/dashboard">http://www.google.com/dashboard</a></span> <span style="font-size: small;"> and see all things you have done or created in Google?</span></span><br /> </li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>Google Lesson plans</b> for students can be found at <a href="http://www.google.com/insidesearch/searcheducation/lessons.html" title="http://www.google.com/insidesearch/searcheducation/lessons.html">http://www.google.com/insidesearch/searcheducation/lessons.html</a></span></span></li></ul><br /><div class="separator" style="clear: both; text-align: center;"><span style="font-size: x-small;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3LrJgFph0iIzVyHPGC-_DKv8_3YUTkqkiY6W43JMJphqPiytboSH2BMvrSObR2tq4ILhLMlEjsaZqv87LI0HyNFXl62BR_bHHf8maY0eVSmku5iFJMbBiM-VARrZvhSh_nE-0IVRQi5k/s1600-h/image7.png" style="margin-left: 1em; margin-right: 1em;"><img alt="image" border="0" height="137" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhS19axXrha8uHccrPAjoWsLfbsuDx1h6xCwCiq6dveZlpNPFbPNOLfl97QIpyuhZ5YvXm297X311pZoiLoOc4X6ojtOmSY3-rnOEfG5laeIrZNQQHWGticiDS0zcbamTTcNjWpyUOG2MY/?imgmax=800" style="background-image: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="240" /></a></span></div><span style="font-size: x-small;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3LrJgFph0iIzVyHPGC-_DKv8_3YUTkqkiY6W43JMJphqPiytboSH2BMvrSObR2tq4ILhLMlEjsaZqv87LI0HyNFXl62BR_bHHf8maY0eVSmku5iFJMbBiM-VARrZvhSh_nE-0IVRQi5k/s1600-h/image7.png"></a><br /><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: large;"><b>There’s so much you can do with YouTube</b></span></span></span> <br /><ul><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>YouTube Search</b> - shared by James Sanders<br />You can tailor your search by adding keywords and commas. For example:<br />[puppies, HD, short, partners, new] will get you the newest puppy videos in HD, that are short from partner groups.</span></span><br /> </li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>YouTube Crea</b>te <a href="http://youtube.com/create">http://youtube.com/create</a> <br />It is quite amazing how many online tools you can now combine with your YouTube account to create videos with your class. Just take a look.</span></span><br /> </li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>YouTube Editor</b> <a href="http://youtube.com/editor">http://youtube.com/editor</a><br />You can edit and use YouTube videos right from YouTube! The first thing to do is see that they are uploaded with the Creative Commons license. </span></span> <ul><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">You can add text, transitions, and audio files<b></b></span></span> </li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">You can also upload your own video with Creative Commons and tag them.  Once tagged you can have your students find and use them for editing</span></span></li></ul></li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>Video Manager</b> features to check out in You Tube</span></span> <ul><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">You can blur faces, <b></b></span></span> </li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">You can add annotations and use these to create links to other videos</span></span> </li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">You can add captions. To do this upload a .txt file and YouTube will do its best to add captioning.</span></span></li></ul></li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Take a look at this inspiring presentation '<b>Ten ways to use You Tube in the classroom</b>' <a href="http://t.co/PYtHgOKR">http://goo.gl/qs26z </a>created by James Sanders one of the Lead Learners.</span></span> </li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>Google Search stories</b> created by a Google Certified Teacher Karen Mensing is an inspiring example of how  the search feature of Google can be used with success in Google. Take a look at her channel.  <a href="http://www.youtube.com/user/SearchStories">http://www.youtube.com/user/SearchStories</a></span></span><span style="font-size: x-small;"><span style="color: #4d4d4d;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">  </span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Take </span></span></span><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">a look at this example from Caroline, an amateur astronomer, who became the youngest person to  discover a supernova: <a href="http://www.youtube.com/watch?v=x9-F6dbCIHw">Supernova Video</a> </span></span></span><span style="font-size: x-small;"><b></b></span></li></ul><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNlIRjr0Vuc-GebqPQpN8stdfclxk8tQZAyNczydQee0xrkWdXSdQHCSVcWf6szdPjyIgKeSd_ZmlvlSMya6cUtv0gqutiY4gV1WhGYy__se-4XxEnwmEvRrKGFWsHerqoEO5gDa1Ii7k/s1600-h/image3.png" style="margin-left: 1em; margin-right: 1em;"><img alt="image" border="0" height="93" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjmK14ScNsI1891zoeNKYGBVBerQl6xsze4DgRhJrDcTfUrabQMTWnfHg9sCH4HWYQeBM7kL7mLEbH_NLaK1zbvbRkvtjbqWbWStUISH108SMnsG78Q0TTQSlNKRV3i6bmux-TgTx40n0c/?imgmax=800" style="background-image: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="240" /></a></div><br /><br /><span style="font-size: x-small;"><b><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: large;">Google Chrome extensions</span></span></b><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><br /><br />This needs a paragraph all to itself! If you have never used Google Chrome, please give it  try. It is FAST and there are all sorts of amazing free extensions that you can add to your browser bar so that you don’t have to leave your browser to do certain things. Here are a few examaples:</span></span></span><br /><ul><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b>The ChromeVox screen reader</b> is an extension to Chrome that brings the speed, versatility, and security of Chrome to visually impaired users. Find out more <a href="https://chrome.google.com/webstore/detail/chromevox/kgejglhpjiefppelpmljglcjbhoiplfn#detail/chromevox/kgejglhpjiefppelpmljglcjbhoiplfn" target="_blank">here</a>.</span></span></li><li><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Read <b>5 Best Chrome Extensions for Educators</b> by Amy Mayer (one of the Lead Learners at the GTANY)<br /><a href="http://www.friedtechnology.com/2012/08/5-best-chrome-extensions-for-educators.html">http://www.friedtechnology.com/2012/08/5-best-chrome-extensions-for-educators.html</a>  </span></span></li></ul><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: x-small;"><span style="font-size: small;">Well, I can see the post could go on forever - there is just so much to share! These are just a few gleanings, but future blog posts will contain more highlights.</span> </span></span></div>

google Gleanings from the Google Teacher Academy in New York, October 3rd and 4th

In my post yesterday I wrote a reflection on the latest Google Teacher Academy in New York. The more I think about it, it was a mind blowi...

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9.79* Reflection

If ESPN is doing one thing right, it has to be their <i>30 for 30 </i>documentary film series. 30 films on 30 different subjects by 30 different directors. Each documentary that I have watched has been very compelling and informative, and I highly recommend watching them when you can.<br /><br />Tonight's doc featured the eight athletes who participated in the 100m final at the Seoul Olympics in 1988. This was the race that featured Ben Johnson's unprecedented demolishing of the world record and subsequent gold medal. It also brought on the most thorough and media-scrutinized doping scandal in the days following, also featuring Johnson.<br /><br />The <i>30 for 30</i> film interviewed all eight athletes, and each of them got into the sport in their own way. But each of them (except Johnson, who has already admitted to doping) talked about training "clean," even though half of them had been implicated in doping either in 1988 or following.<br /><br />It was a little disheartening, as an Olympics fan, to see how blatant the cheating had been in the track and field circles. I'm sure that even now, athletes in every sport are taking something to try to get better. More athletes take them because they don't want to get left behind...the doping athletes are winning, while the "clean" athletes can't get ahead.<br /><br />There was also tons of finger pointing. Carl Lewis, who was awarded the gold medal in the days after the race, kept to the high ground while looking down on Johnson. Johnson was equally critical of Lewis, claiming that one of Lewis' friends, Andre Jackson, spiked his beer before he took the test, and had done it many times before.<br /><br />Considering I was very young when this all took place originally, this was a very new story to me. I had known about Johnson being stripped of his gold medal, but didn't know the whole story. I don't think anyone really "knows" the whole story, unfortunately. Even now, twenty-four years later, facts are shady.<br /><br />And that will remain with any athlete that competes. We'll hail them for their accomplishments, and then feel wronged when we find out they were cheating. In third grade Reading basals that I use, there is a story about the Olympics. One of the supplemental stories is about how wonderful Marion Jones is as a track athlete. Do I teach my students that this story is false? That Jones actually was caught cheating and stripped of her medals? Or do I allow them to watch a documentary twenty years from now on Jones, and have them learn the whole story in the same manner I did?<br /><br />It's all in the perspective. And this documentary, although excellently and thoroughly produced, still allows the viewer to make their own opinion about how they are going to take the information given. Do they shun the sports and athletes they love - or do they choose to hide it and move on?<br /><br />What will you do?

9.79* Reflection

If ESPN is doing one thing right, it has to be their 30 for 30 documentary film series. 30 films on 30 different subjects by 30 different di...

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What's in Jay's Wallet?

<div dir="ltr" style="text-align: left;" trbidi="on">Hola curious bitches! I bet you lose sleep every night just lying there wondering "What the hell does Jay have in his wallet?" Well, wonder no more my friends cause I'm getting ready to show ya! And, I'm doing it Vlogging style. Woo-Hoooo!<br /><br />The video isn't all that great. I look stupid and the audio sucks balls. But, it was like the 87th try so screw it, I'm posting it the same way I sold that 1992 Plymouth Sundance two door: "As Is Bitches!"<br /><br /><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="allowfullscreen" frameborder="0" height="266" mozallowfullscreen="mozallowfullscreen" src="https://www.youtube.com/embed/M2qTVscMwlI?feature=player_embedded" webkitallowfullscreen="webkitallowfullscreen" width="320"></iframe></div><br /></div>

What's in Jay's Wallet?

Hola curious bitches! I bet you lose sleep every night just lying there wondering "What the hell does Jay have in his wallet?" Wel...

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Reflecting on the Google Teacher Academy experience – you MUST try to attend one!

<div dir="ltr" style="text-align: left;" trbidi="on"><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipzOCRMnpJ8rgPnXIKfIZqmmTUqs7VCZyAGu2jM7yc06ZMy8ZOxgHFNwlqXF6KEq7JDvcpp6urH6mRNOk6sMDxXZ1LRP1g61IwohC_TzlMjMsu1OX9OtfHebqzw_rxWqTzVdqFFfsdtck/s1600-h/image%25255B3%25255D.png" style="margin-left: 1em; margin-right: 1em;"><img alt="image" border="0" height="102" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhV2Ds1osbVH3wqUzeLoFt0B9Ffc7Af9UDZ5dLsavP22L7W6DxOFURSo_rqZ19jaQxPrrhtKzPtiQPWXSy-HFn6kM2NR5URe7e4H6vfdTZh6AwB3fJ7PecdsZtnt2rN7Cfp00I1wnBjt1Y/?imgmax=800" style="background-image: none; border-color: -moz-use-text-color; border-style: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="240" /></a></div><i>Submitted by Fiona Beal</i><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">A Google Teacher Academy (GTA) is definitely something that every teacher interested in technology integration should strive to attend at some stage of their teaching career. I have just been privileged to attend one in New York and have come back somewhat exhilarated and enthused, and quite amazed at the enormous amount of learning that happened in that short whirlwind of time.</span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"> </span></span> <br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b><span style="font-size: large;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">So what exactly is a Google Teacher Academy? </span></span></b> </span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Google holds these popular events consisting of two days of professional development  twice or so a year in different locations, and normally accepts 50 participants from the vast number of applications that are received. Sometimes the Academies are open to the whole world and sometimes they are limited to a particular country or region. An application consists of filling in a detailed online form and then making a one minute video about oneself based on one of the the titles that Google provides. Find out mor<span style="background-color: white;">e</span><span style="background-color: yellow;"><span style="background-color: white;"> </span><span style="background-color: white;">about the GTA <a href="http://www.google.com/edu/teachers/google-teacher-academy.html#" target="_blank">here</a></span></span><span style="background-color: white;">.</span> </span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"> </span></span> <br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwDgXXi198NaaFprEBikIgI4ClqTTxTQltUcYwC_2XpKvuH48j3M-tQ6tyBfH8iqulSRbGdGOFbUdWMM6Z76on5u4hiXYFuVrZTKGzliewsLsJTz27TSwibKOZZ25vhd5E6ZojN6tTE1M/s1600-h/image%25255B6%25255D.png" style="margin-left: auto; margin-right: auto;"><img alt="image" border="0" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEii_X8ePf_VGOVgpoqfuWOryRy9Sm3KUXlNTkTpA7OkbPCaWCPtlDjCmnLdqhzfsAxFDaxAcPMhxM9FiD1Qsbtp9HFgUqL-Zz4dntAgkwn4Hs1P1_SjDI33g40EpOjXA17f27iPWQutDPc/?imgmax=800" style="background-image: none; border-color: -moz-use-text-color; border-style: none; border-width: 0px; display: inline; margin: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="244" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">The Google Teacher Academy team</td></tr></tbody></table><br /><b><span style="font-size: x-small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: large;">A great sense of community was fostered</span></span></span><u><span style="font-size: x-small;"><br /></span></u></b><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">The most exciting aspect was the<span style="background-color: white;"> sense of community that de</span>veloped among the 50+ educators attending. It showed me that the best learning takes place when there is collaboration, sharing, and networking. There were quite a number of technology integration facilitators from around the USA and elsewhere, and it seemed, in my estimation, that they are mostly having an enormous amount of success with their methodologies. However a number of them shared informally the challenges that go with leading change revolving around technology integration.  Many of them have technology blogs which I am keen to delve into. There were also several media specialists at the Academy who are taking on a new role and making their libraries a vital part of the technology happenings in a school. </span></span><br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJps3X3bwGANM1DzUtVtongg6I_LXWyZ5tegaYQoJV9N1YyjfL7rdBdrnnQ8JM3tIP2twS6DsqTtzESlaPCA5eCK-8AAOg4ZLy-wBo7cd2BhBYSch9zPmGozzs6oESk3_nbmIJtzX-X_o/s1600-h/image%25255B9%25255D.png" style="margin-left: auto; margin-right: auto;"><img alt="image" border="0" height="183" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiRmb7wPs9SePxlJ3DEFdJYYs7lw_KHhCSjiLsE-cwsvRXp_r9vhdb9pd-30ODVdupRjgPhArw80DR70ZBJlMjs7MK-KDzyhUpa9fbat-iOKo5EgKHPx41g-PlWwfJqpScAstwq4Tv6d0c/?imgmax=800" style="background-image: none; border-color: -moz-use-text-color; border-style: none; border-width: 0px; display: inline; margin: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="244" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">This is our team, Team Diesel</td></tr></tbody></table><br /><b><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: large;">So how did we prepare for the Academy?</span></span></span><u><span style="font-size: small;"><br /></span></u></b><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Before the Academy we joined Google + which I hadn't yet fully grasped, and we were placed in groups of six with a leader so that we could get to know each other via a Google hangout. This was an awesome experience and as a result I can see many uses for  Hangouts </span></span><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">(a free video conferencing tool for ten people at a time)</span></span> in education. We also wrote bios about ourselves so that we could read up about everyone before we started. And of course, there were the technology legends that we already knew about and followed on Twitter. So basically, by the time we started the Academy we had got to know 6 others plus legends and we had the potential of finding out about all the other attendees. The night before at the informal Google dinner at John's Pizzararia in New York we had great fun putting names to faces. Funnily enough when I say <i>names</i> - we always introduced ourselves by our Twitter handles - shows the power and popularity of  Twitter!</span></span><br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2SKRGeNr0Ku2xCxGntPRLp3ykD6oWuMNBjEFNu8cxJWlTthCBTvh8GI7_iDuJ09zgrDE0_4LgcSlNJMTPng_fPfwJCRKd724rcdSlP6Oy0pbq0YJvfwhEUiv8cU1OQnesVrNzGsRoh18/s1600-h/image%25255B13%25255D.png" style="margin-left: auto; margin-right: auto;"><img alt="image" border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhUZeVpb1MYk6LEy1i2eT3bM1sFEhhmhSwQhq4V6ax5qcP_Dyqjha-MwOtINWA7k_FioWqbYq4Nx5YnLhozvPIaYXW3bXW8SVemtYz7sP6-1pb9tcu954Xbc_-evst9FT29fZLbTmnk8E/?imgmax=800" style="background-image: none; border-color: -moz-use-text-color; border-style: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="242" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Team Diesel on a pre-Academy hangout </td></tr></tbody></table><br /><span style="font-size: x-small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b><span style="font-size: large;">The big day!</span></b></span></span><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"> </span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">On the first day we excitedly made our way to the massive Google building just opposite the Chelsea Market in NYC - all very eager to see what Google actually looked like inside, and not knowing what to expect from the day… </span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"> </span></span> <br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwgrgTf988H5hWchZDt60USuLeWH07h4ktCTZyOi_v1Y0BDfqMBCIoGeT1Xty8xt3ergqLINvftvkMwIYdZmtYJrzGH1MqMtLeApoghjArem2qvvufBkygyEARPc5PZJYINGSe37cJ5QQ/s1600-h/image%25255B16%25255D.png" style="margin-left: auto; margin-right: auto;"><img alt="image" border="0" height="173" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHFCQa583r9NGzjesNAyACDG4Uag-fKzmL-oXYkkWuwAeJaR4ZG2EuyTC_hOPt6_NtaPC7tYvBEf2qNc3uORWqVrQiqi5Q9lA2j2GW-5QTkk9fNfWEQS93IAmgbslpT3hV4DRq0WrGZiw/?imgmax=800" style="background-image: none; border-color: -moz-use-text-color; border-style: none; border-width: 0px; display: inline; margin: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="244" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Google is HUGE!</td></tr></tbody></table><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Of course, I don’t want to give too much of the two days away for the sake of future attendees, but they were action-packed, collaborative and great fun to say the least, and we were afforded the most amazing presentations from dynamic presenters.<span style="background-color: white;"> The exchange of ideas was incredible.As JR Ginex-</span>Orinion (one of the attendees) said ‘<i>The quality of educators and leaders in the room was at times intimidating, and yet unbelievably inspiring at the same time.</i>”  I'll be writing blogposts about some of the things I learned at this Academy in the days to follow. One of the things I really enjoyed was hearing from some of the designers of Google products, such as Google Drive etc. Another highlight was hearing from some of the Lead Learners as they are called (those leading the teams). One of them was <a href="https://twitter.com/kernkelley">Kern Kelly </a>who shared his perspective and thoughts about allowing students to lead the process, take ownership of their learning and also help the teachers learn about technology. He brought along several of his students to share their experiences with the rest of us. </span></span><br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi16LKIciidPExpYvy-x9y8RvSqC0XYYMnsVPm3F9BcKlYatyeNg5FQY4Bujwa3JoBwns_JhZQ94HqQIsT5T4vKzeVyEDPFUNyTBiczLNzFMJRmSMQvo31j9UeGYQ5bwEc1LnoR5OmfvEk/s1600/kERN.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="179" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi16LKIciidPExpYvy-x9y8RvSqC0XYYMnsVPm3F9BcKlYatyeNg5FQY4Bujwa3JoBwns_JhZQ94HqQIsT5T4vKzeVyEDPFUNyTBiczLNzFMJRmSMQvo31j9UeGYQ5bwEc1LnoR5OmfvEk/s320/kERN.JPG" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Kern Kelly and some of his students</td></tr></tbody></table><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">So the event continued till our brains boggled (and googled!)...but we didn't want it all to end. It was too absorbing and captivating, too engaging…</span></span><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;"> </span></span> <br /><span style="font-size: x-small;"><b><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: large;">Graduation time</span></span><u><br /></u></b></span><span style="font-size: small;"><span style="font-family: Arial,Helvetica,sans-serif;">At our ‘graduation’ we were presented with our Google Certified Teacher badges, and certificates. We were officially welcomed into the Google Certified Teachers’ Google group which now has about 750 educators in it. We were also tasked with developing a ‘Personal Action Plan’  outlining a project that we will complete in the days to come, with given deadlines. As far as I am aware I am, to date, only the second South African to have attended a Google Academy, the first being Ariellah Rosenberg from Ort (@Ariellah). I am hoping that statistic will change in the future.  </span></span><br /><br /><table border="0" cellpadding="2" cellspacing="0" style="width: 400px;"> <tbody><tr> <td valign="top" width="133"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdkcA6jFDjnyFqxO1TzCjalOs7O87QfwVtLtD6QP4FvXHrlBxuKNdCCm6VEhDgVzA70L8lJtTInLKYtPfny1nHjJD_EOC0P-lhDQxOl9xpe6BCGtg_ksvQi1QauwQIxyDYi0-KzWdCnSg/s1600-h/image%25255B21%25255D.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img alt="image" border="0" height="170" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEilrLg_4wXiIoWhmZVZDA8Q-h3x_gCChDZ8AiX_jLrtpUT59jLfJNe20WWVxc_a6Ab-K9CWkc77A4RtCPPvFYS4m8WFzY0sFm5j6IfujWMTn4c6VqbDOxqmLGm4OF48miK4MhnmDPcEjWo/?imgmax=800" style="background-image: none; border-color: -moz-use-text-color; border-style: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="242" /></a></td> <td valign="top" width="10"></td> <td valign="top" width="256"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwEFKb_BshAn_Avp41QiPt4QUKeV1tvWNeBQv4tetCXi3EuHK7i0Mp_5LI_Sajtppyg3-8M2BUK60X1Vb0bJyBFbMgKMxVQHpy5jlozWNb1F6DRba3t9kEkPi0OmEYIyiwYkTJTKeuPGE/s1600-h/image%25255B26%25255D.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img alt="image" border="0" height="172" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhP2LGVAlPRtG_2UiC3M27wzC2UqsDkXH78hWGc8-_RFyMV7BPwKsmWxFd8Er2BbpzoLISdGE80jiSkDKc4DCNVQqkLP4TSxSpVDyifZiGGTp9Zi3hcijV5Z4tMdFco6Gc0Gcp1zy9T8zQ/?imgmax=800" style="background-image: none; border-color: -moz-use-text-color; border-style: none; border-width: 0px; display: inline; padding-left: 0px; padding-right: 0px; padding-top: 0px;" title="image" width="224" /></a></td></tr></tbody></table><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Well, in order to keep this post at a reasonable length I will be writing a separate post outlining a few of the ideas that I walked away with from the rich sharing that took place at the Google Teacher Academy in New York, in October 2012.</span></span><br /><br /><span style="font-family: Arial,Helvetica,sans-serif;"><span style="font-size: small;">Also read <a href="http://e-blogschool.blogspot.com/2012/10/gleanings-from-google-teacher-academy.html" target="_blank">Gleanings from the Google Teacher Academy in <span style="font-size: small;">N</span>ew York</a>.  </span></span> </div>

google Reflecting on the Google Teacher Academy experience – you MUST try to attend one!

Submitted by Fiona Beal A Google Teacher Academy (GTA) is definitely something that every teacher interested in technology integration shoul...

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School Library Media Specialist - Niantic Center School

<strong>School Library Media Specialist - </strong><strong><span style="color: #48286d;">Niantic Center School </span></strong>(Elementary). FTE. (CT 062). Strong background in instructional technology preferred. Open until filled. All internal and external candidates should apply online through AppliTrack at <a href="http://www.applitrack.com/eastlyme/onlineapp">www.applitrack.com/eastlyme/onlineapp</a>. A link to AppliTrack can also be found on the Human Resource page of our district website at <a href="http://www.eastlymeschools.org/">www.eastlymeschools.org</a>. It is the policy of the East Lyme Board of Education not to discriminate on the basis of race, color, religious creed, age, physical disability, national origin, ancestry, marital status, sexual orientation or mental disorder in any of its educational activities or employment policies.

School Library Media Specialist - Niantic Center School

School Library Media Specialist - Niantic Center School (Elementary). FTE. (CT 062). Strong background in instructional technology preferre...

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School Library Media Specialist - East Lyme Middle School

<strong>School Library Media Specialist - </strong><strong><span style="color: #48286d;">East Lyme Middle School</span></strong>. FTE Long Term Substitute (CT 062). Strong background in instructional technology preferred, assignment begins on or about January 28, 2013 through on or about end of the 2012-2013 school year. All internal and external candidates should apply online through AppliTrack at <a href="http://www.applitrack.com/eastlyme/onlineapp">www.applitrack.com/eastlyme/onlineapp</a>. A link to AppliTrack can also be found on the Human Resource page of our district website at <a href="http://www.eastlymeschools.org/">www.eastlymeschools.org</a>. It is the policy of the East Lyme Board of Education not to discriminate on the basis of race, color, religious creed, age, physical disability, national origin, ancestry, marital status, sexual orientation or mental disorder in any of its educational activities or employment policies.

School Library Media Specialist - East Lyme Middle School

School Library Media Specialist - East Lyme Middle School . FTE Long Term Substitute (CT 062). Strong background in instructional technolo...

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Library Circulation Assistant - Lyme Public Library

<strong>Library Circulation Assistant -</strong> <span style="color: #48286d;"><strong>Lyme Public Library</strong></span>. 13 hours per week - Tuesday & Thursday evenings and Saturdays for small public library. Opportunity to work additional hours substituting for other staff as needed. Responsibilities include working circulation desk and assisting both adult and juvenile patrons with reference and reader’s advisory. Must possess good customer service and computer skills. Starting wage $11.00/hr. Position open until filled. Send résumé, cover letter, and names, addresses, and phone numbers of three references to: Theresa Conley, Lyme Public Library, 482 Hamburg Road, Lyme, CT 06371-3110 or email to <a _fcksavedurl="mailto:tconley@lymepl.org" href="mailto:tconley@lymepl.org">tconley@lymepl.org</a>. EOE.

Library Circulation Assistant - Lyme Public Library

Library Circulation Assistant - Lyme Public Library . 13 hours per week - Tuesday & Thursday evenings and Saturdays for small public ...

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Bayer aspirin: How a struggling painkiller was reborn as a heart medicine and earned billions for Bayer. - Slate Magazine

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">Say you have a headache. Your fever's rising. Your back is aching. What do you take? Probably ibuprofen (<a href="http://www.amazon.com/gp/product/B000O7UBGC/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B000O7UBGC&linkCode=as2&tag=slatmaga-20" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Motrin</a>, <a href="http://www.amazon.com/gp/product/B00475J0YQ/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B00475J0YQ&linkCode=as2&tag=slatmaga-20" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Advil</a>), maybe acetaminophen (<a href="http://www.amazon.com/gp/product/B003D7KPJI/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B003D7KPJI&linkCode=as2&tag=slatmaga-20" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Tylenol</a>), possibly naproxen (<a href="http://www.amazon.com/gp/product/B00008PW1R/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B00008PW1R&linkCode=as2&tag=slatmaga-20" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Aleve</a>). Together, those drugs comprise nearly four-fifths of the $2 billion-plus over-the-counter pain relief market, prospering from aggressive ad campaigns and cheap manufacturing costs.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">But say you're having a heart attack. What do you take now?</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">If you've been listening to the advice of medical professionals for the past few decades, you'll pop an aspirin while you wait for the ambulance. And if you've been listening closely, you've already been taking it every day. Aspirin's benefit to heart-attack victims is common knowledge these days, while its effectiveness as a painkiller, or analgesic, is increasingly overlooked.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">That's no problem for <a href="http://www.amazon.com/gp/product/B001LFG0OI/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=B001LFG0OI&linkCode=as2&tag=slatmaga-20" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Bayer</a>, aspirin's first modern manufacturer, which has rebranded its product as a "<a href="http://www.wonderdrug.com/" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Wonder Drug</a>" and made it a staple for aging baby boomers across the Western world. The rebranding triggered a remarkable resurgence for the company whose signature product once appeared doomed.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">Aspirin as a painkiller is old news. The ancient Egyptians wrote of the medical benefits of willow in the <a href="http://en.wikipedia.org/wiki/Ebers_Papyrus" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Ebers Papyrus</a>, a text sold to an American antiques dealer by grave robbers in 1862. Willow contains salicylate, a key aspirin component, and the Egyptians had probably learned to use it as a salve and a tonic (although their preferred pain relief method was getting drunk). A few thousand years later in the mid-18th century, the English Rev. Edward Stone rediscovered willow's healing powers but failed to bring his finding to a wider audience. It wasn't until the late 1890s that a small German drug and dye factory called Bayer properly synthesized aspirin's various ingredients into a single drug. (Bayer faced stiff competition from another extremely popular new pain reliever called heroin.)</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">Eventually Bayer secured international patents for aspirin, shipping the product across the globe and turning a massive profit. But their patents were dissolved in Britain and Australia during World War I, opening up the market to a glut of generic competitors. This wasn't the only challenge posed to aspirin by the war, as Diarmuid Jeffreys recounts in <em style="margin: 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; font-style: italic; "><a href="http://www.amazon.com/gp/product/1582346003/ref=as_li_ss_tl?ie=UTF8&camp=1789&creative=390957&creativeASIN=1582346003&linkCode=as2&tag=slatmaga-20" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Aspirin: The Remarkable Story of a Wonder Drug</a></em>. Facing a British embargo of phenol, a necessary ingredient of aspirin, Bayer nearly ceased production of aspirin in its German factories. Confronting pharmaceutical catastrophe, the German government covertly deployed a former Bayer employee to the United States to buy surplus phenol from the country's most prolific producer of the chemical, Thomas Edison. The <a href="http://en.wikipedia.org/wiki/Great_Phenol_Plot" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">Great Phenol Plot</a> was exposed and the brand's reputation was ruined in America. Soon after, the U.S. government snatched Bayer's American holdings, nullified its patents and trademarks, and sold everything to Sterling Products, who owned the company's American branch until 1994.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">The German branch of Bayer, Bayer AG, survived the war only to be bought up by the mega-corporation IG Farben in 1925. The corporation was dissolved in 1952 after many of its leaders were convicted of war crimes. Its factories—run by slave laborers—had produced the Zyklon B used to kill Jews in concentration camps. Bayer AG endured the dissolution of its parent company only to find itself steadily losing its market shares to new painkillers acetaminophen and ibuprofen. After surviving two world wars, the brand faced death at the hands of the free market.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">Then a small miracle occurred: In the late 1960s, two British medical researchers, John O'Brien and Peter Elwood, uncovered studies by John Vane and Harvey Weiss suggesting that aspirin could improve heart health. Intrigued, O'Brien and Peter developed a theory that aspirin could prevent blood platelets from clumping up around the heart. These clumps are liable to burst, allowing blood clots to form and prevent blood flow to heart, causing a heart attack. By preventing these clots from forming, O'Brien and Elwood postulated, aspirin enables blood flow to the heart to remain steady, seriously reducing the risk of heart attack. In several medical trials, the researchers proved that a daily dose of aspirin taken by a heart attack survivor significantly decreases his risk of a second attack, confirming their hypothesis.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">The small sample size of their study cast doubt on its conclusions. In 1980, however, a British statistician named Richard Peto published a meta-analysis with apparently irrefutable evidence that aspirin had a positive effect on the heart, at least in male patients.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">Bayer took note. By this point, Bayer Aspirin's pain relief market share was hovering at around 6 percent, a precipitous drop from its former dominance. Bayer's parent company in the United States, Sterling Products, jumped at the chance to rebrand its product as a vital tool in the fight against heart attacks. In 1983, Sterling lobbied the FDA for the ability to advertise aspirin's cardiovascular benefits on the product's labels. The company won the battle and soon began to rebrand its product as a life saver. Soon after, a slew of studies suggested that an aspirin a day could prevent the first occurrence of a heart attack—not only a second—and that an aspirin taken during a heart attack increases the victim's chance of survival. Other researchers demonstrated aspirin's effectiveness in preventing strokes, inhibiting blood clots from blocking blood to the brain. Aspirin was no longer limited to the pain relief market. It had become a market all its own.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">Bayer's profits have risen accordingly. In 1994, the German branch of Bayer bought back its American holdings from Sterling Products for $1 billion, uniting the company for the first time since World War I. In 2011, the company <a href="http://economictimes.indiatimes.com/news/international-business/bayer-confident-after-nearly-doubling-profits-in-2011/articleshow/12068402.cms" target="_blank" style="color: rgb(86, 129, 140); text-decoration: none; ">doubled its profits</a> from the previous year, to $3.3 billion.</div></div><div class="text parbase section" style="margin: 1.5em 0px; padding: 0px; border: 0px; font-size: 12px; font: inherit; vertical-align: baseline; color: rgb(0, 0, 0); font-family: verdana, sans-serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; 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 style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-style: initial; border-color: initial; font-size: 12px; font: inherit; vertical-align: baseline; ">For a company nearly left for dead three times in a century, that's an impressive comeback.</div></div></div><a href="http://www.slate.com/articles/business/the_pivot/2012/10/bayer_aspirin_how_a_struggling_painkiller_was_reborn_as_a_heart_medicine_and_earned_billions_for_bayer_.html?">http://www.slate.com/articles/business/the_pivot/2012/10/bayer_aspirin_how_a_struggling_painkiller_was_reborn_as_a_heart_medicine_and_earned_billions_for_bayer_.html?</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Bayer aspirin: How a struggling painkiller was reborn as a heart medicine and earned billions for Bayer. - Slate Magazine

Say you have a headache. Your fever's rising. Your back is aching. What do you take? Probably ibuprofen ( Motrin ,  Advil ), maybe aceta...

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Institute for Healthcare Improvement

The Institute for Healthcare Improvement (IHI) believes that everyone deserves safe and effective health care, and we have been working with health care providers and leaders throughout the world to fulfill that promise.<br /><br> <br /><br>An independent not-for-profit organization based in Cambridge, Massachusetts, IHI focuses on motivating and building the will for change; identifying and testing new models of care in partnership with both patients and health care professionals; and ensuring the broadest possible adoption of best practices and effective innovations.<br /><br> <br /><br><a href="http://www.ihi.org/Pages/default.aspx">http://www.ihi.org/Pages/default.aspx</a>

Institute for Healthcare Improvement

The Institute for Healthcare Improvement (IHI) believes that everyone deserves safe and effective health care, and we have been working with...

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Institute of Medicine - National Academy of Sciences

The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. <br /><br><br /><br>The IOM asks and answers the nation's most pressing questions about health and health care.<br /><br><br /><br>Our aim is to help those in government and the private sector make informed health decisions by providing evidence upon which they can rely. Each year, more than 2,000 individuals, members, and nonmembers volunteer their time, knowledge, and expertise to advance the nation's health through the work of the IOM.<br /><br><br /><br>Many of the studies that the IOM undertakes begin as specific mandates from Congress; still others are requested by federal agencies and independent organizations. While our expert, consensus committees are vital to our advisory role, the IOM also convenes a series of forums, roundtables, and standing committees, as well as other activities, to facilitate discussion, discovery, and critical, cross-disciplinary thinking.<br /><br><br /><br><a href="http://www.iom.edu/">http://www.iom.edu/</a>

Institute of Medicine - National Academy of Sciences

The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authorita...

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The Things We Carried, Then and Now - 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"><h3 class="entry-title" style="color: rgb(0, 0, 0); margin: 0px 0px 12px; padding: 0px; font-size: 16px; ">The Doctor's Bag for the New Millennium</h3><address class="byline author vcard" style="font-weight: bold; font-size: 0.829em; margin-bottom: 12px; display: block; font-family: arial, helvetica, sans-serif; ">By <a href="http://well.blogs.nytimes.com/author/abraham-verghese/" class="url fn" title="See all posts by ABRAHAM VERGHESE" style="color: rgb(0, 0, 102); text-decoration: none; text-transform: uppercase; ">ABRAHAM VERGHESE</a></address><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; ">When I was a medical student in Madras, India, in the late 1970s, my uncle, a retired physician, still made occasional house calls. In his early years he delivered babies in dimly lighted huts, often resorting to high forceps on the head - something that is rarely done now. His compounder - the man who would compound his prescription of mistura carminativa and dispense it in corked glass bottles - carried my uncle's medical bag. It was almost like a trunk - a mobile office. The compounder became so experienced from watching my uncle that he secretly began a practice of his own, delivering babies and even applying forceps.</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; ">My uncle's doctor's bag from his halcyon days was long gone by the time I was a medical student staying in his house; it had been replaced by a newish model, a small tan suitcase with square corners and latches on the top. When it was opened, two shelves magically unfolded. The medicinal odor that emanated was so powerful it could deliver a buzz.</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; ">One shelf held the sterilized syringes, needles, cotton swabs and alcohol that were the bread and butter of a doctor's trade in India - every patient wanted an injection, and doctors were destined to disappoint if they didn't oblige. The other shelf held ampules of adrenaline, Coramine, theophylline and other emergency medications as well as rows of bright orange vitamin B12 ampules - a dramatic injectable placebo.</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 bottom of the bag was stuffed with bottled medications, a blood pressure cuff and instruments that my uncle rarely used: Foley catheters, hemostats and the like. I had carried that bag for him more than once and been there when he jabbed adrenaline into a desperately wheezing patient and produced immense relief.</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 few years later, when I was an intern in Tennessee, my attending physician and mentor, Steven Berk, carried a leather doctor's bag, one he had toted around since his medical school days. His bag, unlike my uncle's, was small - the size of a loaf of bread, or perhaps a bit bigger - just enough to carry his ophthalmoscope, blood pressure cuff, reflex hammer and a few other things. It was well worn.</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 bag became a fetish for me. It embodied all the qualities I admired about the man: He was a careful listener, and he examined patients thoroughly and well. In the Mountain Home Veterans Hospital in Tennessee, which had a large domiciliary and nursing home population, he made original observations about pneumonia in the elderly and became a pioneer in the field.</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 I became Dr. Berk's chief resident, three years later, I bought a similar bag even though it was prohibitively expensive on a resident's salary. Mine was stiff, and despite lots of rubbing with neatsfoot oil it remained hard and unyielding.</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 year later, in 1983, I was a fellow in infectious diseases at Dr. Berk's alma mater, Boston University and Boston City Hospital. I noticed that in Boston the doctors who carried bags were a shrinking minority - often older, and often the best physicians. Neurologists favored them - more tools to carry, I presumed. Medical students were no longer routinely buying doctor's bags. I stopped carrying mine; my white coat held most of what I needed, and now that ophthalmoscopes came in penlight size, or were mounted on walls, I had eliminated the bulkiest item I needed to carry.</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; ">I never got rid of my doctor's bag. Inventorying its contents recently, it was as if I were gazing into a diorama from the early '80s: eye drops to dilate the pupil, prescription pads, a pocket EKG book and EKG calipers, pens, measuring tape, penlights, laminated cards with algorithms on them for various conditions - and everything, of course, with a pharmaceutical company logo on it; no one felt compromised by that sort of stuff.</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; ">As the years have passed, I now find myself in a minority of physicians who wear white coats. For those who do, the coat is not a repository of instruments, but a ceremonial robe.</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; ">Not so for me; my coat bulges with what I carry: a Queen Square reflex hammer with a bamboo stem (given to me by the widow of my medical school professor who read something I wrote in Granta about her late husband and the way he brandished that hammer; she arranged to meet in a London train station to present it to me), a stethoscope (a bulky, three-headed monster made by Tycos that I love), a tuning fork (frequency of 128 to test vibration), a magnifying glass (to study nail fold capillaries), an Optyse pocket ophthalmoscope, a penlight, a pocket Snellen eye chart, tongue depressors, hand gel, triplicate prescriptions, laminated billing and coding guides, packets of chewing gum....</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 coat must weigh at least five pounds. But as a believer, I must walk the talk, carry the tools. I believe that a good bedside examination of a hospitalized patient has a high diagnostic yield: It can reveal the more obvious diagnoses and can guide judicious use of subsequent blood and imaging tests. But the exam also is a ritual, an important one, which when done well validates the patient's complaints and places its locus on the body, and not on a computer screen.</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; ">Recently, two of my colleagues at Stanford, John Kugler and Errol Ozdalga, who work with me in what we call the "bedside medicine group," persuaded me to add three tools to my armamentarium.</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; ">Dr. Kugler taught me to use a Vscan: a pocket ultrasound machine, which allows a great view of the heart, and adds volumes to what the stethoscope can discern. Dr. Ozdalga taught me to use the PanOptic ophthalmoscope, an instrument that looks a bit like a large revolver; it allows a beautiful view of the retina, and especially its blood vessels, far better than my conventional ophthalmoscope. One look in an eye and I have a sense of the status of the arteries in the kidney, the heart. The PanOptic can also be hooked up to an iPhone to take great pictures.</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 third tool I carry around is an iPad: It is a great way to demonstrate anatomy to patients, to take pictures and to pull up videos on <a href="http://stanfordmedicine25.stanford.edu/" style="color: rgb(0, 0, 102); text-decoration: none; ">a Web site that Dr. Ozdalga has developed,</a> which teaches and reinforces for residents and students specific techniques for examining patients: <a href="http://stanfordmedicine25.stanford.edu/" style="color: rgb(0, 0, 102); text-decoration: none; ">http://stanfordmedicine25.stanford.edu</a>.</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; ">Carrying these three new additions can cramp my fingers, and it is not always easy to find a place to set these down when examining a patient.</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; ">Dr. Kugler showed me his modified messenger bag in which he carries his instruments. I've seen similar models made by Chrome, Vega and Eagle Creek - and I've just placed my order. I will soon be able to unburden my coat pockets.</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; ">As technology advances and gets more portable, I see us bringing more tools to the bedside, and therefore spending more time with patients, instead of sending them hither and thither to diagnostic suites. The more time with the patient, the 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; ">This is how you will know us, the doctors of the next millennium: by the things we carry.</div></div></div></div></div><a href="http://well.blogs.nytimes.com/2012/10/08/the-doctors-bag-for-the-new-millennium/">http://well.blogs.nytimes.com/2012/10/08/the-doctors-bag-for-the-new-millennium/</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

The Things We Carried, Then and Now - NYTimes.com

The Doctor's Bag for the New Millennium By  ABRAHAM VERGHESE When I was a medical student in Madras, India, in the late 1970s, my uncle,...

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