Coffee Lens Mug Review

<div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqJrHL41j9XnzaxF49KQKBTnfJrhr0RZ6uMqgocWD9ulrnqXVa2e5hy7kZp8e3_CuTFndcbapwzgWlBCYphLN43rgo-T1d92ETMUMm_55sS88PaLmZf6wscxDlcMU-0fuRI6x1tazQfYo/s1600/camera+cup.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqJrHL41j9XnzaxF49KQKBTnfJrhr0RZ6uMqgocWD9ulrnqXVa2e5hy7kZp8e3_CuTFndcbapwzgWlBCYphLN43rgo-T1d92ETMUMm_55sS88PaLmZf6wscxDlcMU-0fuRI6x1tazQfYo/s320/camera+cup.jpg" width="320" /></a></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: 'Trebuchet MS', sans-serif;">Tired of those little Styrofoam</span><span style="font-family: 'Trebuchet MS', sans-serif;"> </span><span style="font-family: 'Trebuchet MS', sans-serif;">cups always making a mess when spilled?</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">Now you can drink your coffee in style with this creative camera lens cup from <a href="https://www.mobstub.com/">Mob Stub</a>.</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">I know what you are thinking huh what?!</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: 'Trebuchet MS', sans-serif;">Is it a camera or is it a coffee cup?</span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfnAPmRVGzQsiqZTnNghCJouIZp7bs8d3tloK-nkMdlc1K7I8orV-b_bvfvqS6QHdmx89LB3bW6IuiCtgckuyX_2YLG7M8f9G4-XXU-R_V46hsU7itAP8ki0L4p5U_sSo1HZS7bwNQt-A/s1600/camera+lens+cup.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfnAPmRVGzQsiqZTnNghCJouIZp7bs8d3tloK-nkMdlc1K7I8orV-b_bvfvqS6QHdmx89LB3bW6IuiCtgckuyX_2YLG7M8f9G4-XXU-R_V46hsU7itAP8ki0L4p5U_sSo1HZS7bwNQt-A/s320/camera+lens+cup.jpg" width="320" /></a></div><div style="text-align: center;"><span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span><span style="font-family: 'Trebuchet MS', sans-serif;">I sure do love coffee as well as taking photos.</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">Ever since I can remember I would always have a camera strapped on me whether it was around my hand or in my bag.</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">I am blown away at how it really does look like a real camera, it even has a lens cap with rubber grip focus!</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">It's actually a camera lens coffee cup, no it's not a real camera but it sure does look like one!</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">It's easy to clean and you can reuse it!</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">You can even put tea or ice cream in it too as well as hot coffee!</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: 'Trebuchet MS', sans-serif;"><br /></span><span style="font-family: 'Trebuchet MS', sans-serif;">Check out their other cool products they offer on their site!</span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;">Like their page and follow them on Twitter! </span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><a href="https://www.mobstub.com/">https://www.mobstub.com/</a></span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><a href="https://www.facebook.com/MobStub">https://www.facebook.com/MobStub</a></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><a href="https://twitter.com/mobstub"><span style="font-family: Verdana, sans-serif;">https://twitter.com/mobstub</span></a></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><a href="http://pinterest.com/mobstub/">http://pinterest.com/mobstub/</a></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Trebuchet MS, sans-serif;"><br /></span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div>

Coffee Lens Mug Review

Tired of those little Styrofoam   cups always making a mess when spilled? Now you can drink your coffee in style with this creative camera l...

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Today's archidose #652

Here are a few photos I took of the <a href="https://www.som.com/project/greenwich-academy-upper-school">Greenwich Academy - Upper School</a> in Greenwich, Connecticut, designed by SOM (2002). The glass entrance structure features <a href="http://payload.cargocollective.com/1/0/8367/80332/Picture-1_2048.jpg">a light installation by James Turrell</a>.<br /><br /><a href="http://www.flickr.com/photos/archidose/8500665305/" title="Greenwich Academy by archidose, on Flickr"><img alt="Greenwich Academy" height="480" src="http://farm9.staticflickr.com/8108/8500665305_3d789ac711_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8501769016/" title="Greenwich Academy by archidose, on Flickr"><img alt="Greenwich Academy" height="480" src="http://farm9.staticflickr.com/8377/8501769016_0b6731c84c_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8500662563/" title="Greenwich Academy by archidose, on Flickr"><img alt="Greenwich Academy" height="423" src="http://farm9.staticflickr.com/8106/8500662563_c15494ae6c_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8501771678/" title="Greenwich Academy by archidose, on Flickr"><img alt="Greenwich Academy" height="480" src="http://farm9.staticflickr.com/8367/8501771678_9b7792a00a_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8500664855/" title="Greenwich Academy by archidose, on Flickr"><img alt="Greenwich Academy" height="853" src="http://farm9.staticflickr.com/8087/8500664855_48b01910ae_o.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8501770318/" title="Greenwich Academy by archidose, on Flickr"><img alt="Greenwich Academy" height="399" src="http://farm9.staticflickr.com/8231/8501770318_604ac2cfa5_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8501771010/" title="Greenwich Academy by archidose, on Flickr"><img alt="Greenwich Academy" height="480" src="http://farm9.staticflickr.com/8382/8501771010_4d29f96580_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 #652

Here are a few photos I took of the Greenwich Academy - Upper School in Greenwich, Connecticut, designed by SOM (2002). The glass entrance ...

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The Robot Will See You Now - Jonathan Cohn - The Atlantic

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div class="articleHead" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: normal; font-style: normal; font-size: 16px; font-family: Georgia, 'Times New Roman', Times, serif; vertical-align: baseline; color: rgb(0, 0, 0); font-variant: normal; letter-spacing: normal; line-height: 24px; 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); "><p class="blurb" style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 11px; font-family: inherit; vertical-align: baseline; text-transform: uppercase; letter-spacing: 1pt; ">IBM'S WATSON—THE SAME MACHINE THAT BEAT KEN JENNINGS AT <em>JEOPARDY</em>—IS NOW CHURNING THROUGH CASE HISTORIES AT MEMORIAL SLOAN-KETTERING, LEARNING TO MAKE DIAGNOSES AND TREATMENT RECOMMENDATIONS. THIS IS ONE IN A SERIES OF DEVELOPMENTS SUGGESTING THAT TECHNOLOGY MAY BE ABOUT TO DISRUPT HEALTH CARE IN THE SAME WAY IT HAS DISRUPTED SO MANY OTHER INDUSTRIES. ARE DOCTORS NECESSARY? JUST HOW FAR MIGHT THE AUTOMATION OF MEDICINE GO?</p><h5 class="author" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: italic; font-size: 16px; font-family: inherit; vertical-align: baseline; color: rgb(0, 0, 0); ">By <span class="authors" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; "><span class="author" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: italic; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Jonathan Cohn</span></span></h5></div><div class="articleText" 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; outline-width: 0px; outline-style: initial; outline-color: initial; font-weight: normal; font-style: normal; font-size: 16px; font-family: Georgia, 'Times New Roman', Times, serif; vertical-align: baseline; color: rgb(0, 0, 0); font-variant: normal; letter-spacing: normal; line-height: 24px; 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); position: static; z-index: auto; "><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; "><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Charley lukov didn't </span><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">need</span> a miracle. He just needed the right diagnosis. Lukov, a 62-year-old from central New Jersey, had stopped smoking 10 years earlier—fulfilling a promise he'd made to his daughter, after she gave birth to his first grandchild. But decades of cigarettes had taken their toll. Lukov had adenocarcinoma, a common cancer of the lung, and it had spread to his liver. The oncologist ordered a biopsy, testing a surgically removed sample of the tumor to search for particular "driver" mutations. A driver mutation is a specific genetic defect that causes cells to reproduce uncontrollably, interfering with bodily functions and devouring organs. Think of an on/off switch stuck in the "on" direction. With lung cancer, doctors typically test for mutations called EGFR and ALK, in part because those two respond well to specially targeted treatments. But the tests are a long shot: although EGFR and ALK are the two driver mutations doctors typically see with lung cancer, even they are relatively uncommon. When Lukov's cancer tested negative for both, the oncologist prepared to start a standard chemotherapy regimen—even though it meant the side effects would be worse and the prospects of success slimmer than might be expected using a targeted agent.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">But Lukov's true medical condition wasn't quite so grim. The tumor did have a driver—a third mutation few oncologists test for in this type of case. It's called KRAS. Researchers have known about KRAS for a long time, but only recently have they realized that it can be the driver mutation in metastatic lung cancer—and that, in those cases, it responds to the same drugs that turn it off in other tumors. A doctor familiar with both Lukov's specific medical history and the very latest research might know to make the connection—to add one more biomarker test, for KRAS, and then to find a clinical trial testing the efficacy of KRAS treatments on lung cancer. But the national treatment guidelines for lung cancer don't recommend such action, and few physicians, however conscientious, would think to do these things.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Did Lukov ultimately get the right treatment? Did his oncologist make the connection between KRAS and his condition, and order the test? He might have, if Lukov were a real patient and the oncologist were a real doctor. They're not. They are fictional composites developed by researchers at the Memorial Sloan-Kettering Cancer Center in New York, in order to help train—and demonstrate the skills of—IBM's Watson supercomputer. Yes, this is the same Watson that famously went on<i>Jeopardy</i> and beat two previous human champions. But IBM didn't build Watson to win game shows. The company is developing Watson to help professionals with complex decision making, like the kind that occurs in oncologists' offices—and to point out clinical nuances that health professionals might miss on their own.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Information technology that helps doctors and patients make decisions has been around for a long time. Crude online tools like WebMD get millions of visitors a day. But Watson is a different beast. According to IBM, it can digest information and make recommendations much more quickly, and more intelligently, than perhaps any machine before it—processing up to 60 million pages of text per second, even when that text is in the form of plain old prose, or what scientists call "natural language."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">That's no small thing, because something like 80 percent of all information is "unstructured." In medicine, it consists of physician notes dictated into medical records, long-winded sentences published in academic journals, and raw numbers stored online by public-health departments. At least in theory, Watson can make sense of it all. It can sit in on patient examinations, silently listening. And over time, it can learn. Just as Watson got better at <i>Jeopardy</i> the longer it played, so it gets better at figuring out medical problems and ways of treating them the more it interacts with real cases. Watson even has the ability to convey doubt. When it makes diagnoses and recommends treatments, it usually issues a series of possibilities, each with its own level of confidence attached.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Medicine has never before had a tool quite like this. And at an unofficial coming-out party in Las Vegas last year, during the annual meeting of the Healthcare Information and Management Systems Society, more than 1,000 professionals packed a large hotel conference hall, and an overflow room nearby, to hear a presentation by Marty Kohn, an emergency-room physician and a clinical leader of the IBM team training Watson for health care. Standing before a video screen that dwarfed his large frame, Kohn described in his husky voice how Watson could be a game changer—not just in highly specialized fields like oncology but also in primary care, given that all doctors can make mistakes that lead to costly, sometimes dangerous, treatment errors.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Drawing on his own clinical experience and on academic studies, Kohn explained that about one-third of these errors appear to be products of misdiagnosis, one cause of which is "anchoring bias": human beings' tendency to rely too heavily on a single piece of information. This happens all the time in doctors' offices, clinics, and emergency rooms. A physician hears about two or three symptoms, seizes on a diagnosis consistent with those, and subconsciously discounts evidence that points to something else. Or a physician hits upon the right diagnosis, but fails to realize that it's incomplete, and ends up treating just one condition when the patient is, in fact, suffering from several. Tools like Watson are less prone to those failings. As such, Kohn believes, they may eventually become as ubiquitous in doctors' offices as the stethoscope.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">"Watson fills in for some human limitations," Kohn told me in an interview. "Studies show that humans are good at taking a relatively limited list of possibilities and using that list, but are far less adept at using huge volumes of information. That's where Watson shines: taking a huge list of information and winnowing it down."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Watson has gotten some media hype already, including articles in <i>Wired</i> and <i>Fast Company</i>. Still, you probably shouldn't expect to see it the next time you visit your doctor's office. Before the computer can make real-life clinical recommendations, it must learn to understand and analyze medical information, just as it once learned to ask the right questions on <i>Jeopardy</i>. That's where Memorial Sloan-Kettering comes in. The famed cancer institute has signed up to be Watson's tutor, feeding it clinical information extracted from real cases and then teaching it how to make sense of the data. "The process of pulling out two key facts from a <i>Jeopardy</i> clue is totally different from pulling out all the relevant information, and its relationships, from a medical case," says Ari Caroline, Sloan-Kettering's director of quantitative analysis and strategic initiatives. "Sometimes there is conflicting information. People phrase things different ways." But Caroline, who approached IBM about the research collaboration, nonetheless predicts that Watson will prove "very valuable"—particularly in a field like cancer treatment, in which the explosion of knowledge is already overwhelming. "If you're looking down the road, there are going to be many more clinical options, many more subtleties around biomarkers … There will be nuances not just in interpreting the case but also in treating the case," Caroline says. "You're going to need a tool like Watson because the complexity and scale of information will be such that a typical decision tool couldn't possibly handle it all."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">The Cleveland Clinic is also helping to develop Watson, first as a tool for training young physicians and then, possibly, as a tool at the bedside itself. James Young, the executive dean of the Cleveland Clinic medical school, told <i>The Plain Dealer</i>, "If we can get Watson to give us information in the health-care arena like we've seen with more-general sorts of knowledge information, I think it's going to be an extraordinary tool for clinicians and a huge advancement." And WellPoint, the insurance company, has already begun testing Watson as a support tool for nurses who make treatment-approval decisions.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Whether these experiments show real, quantifiable improvements in the quality or efficiency of care remains to be seen. If Watson tells physicians only what they already know, or if they end up ordering many more tests for no good reason, Watson could turn out to be more hindrance than help. But plenty of serious people in the fields of medicine, engineering, and business think Watson will work (IBM says that it could be widely available within a few years). And many of these same people believe that this is only the beginning—that whether or not Watson itself succeeds, it is emblematic of a quantum shift in health care that's just now getting under way.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; "><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">When we think </span>of breakthroughs in medicine, we conjure up images of new drugs or new surgeries. When we think of changes to the health-care system, byzantine legislation comes to mind. But according to a growing number of observers, the next big thing to hit medical care will be new ways of accumulating, processing, and applying data—revolutionizing medical care the same way Billy Beane and his minions turned baseball into "moneyball." Many of the people who think this way—entrepreneurs from Silicon Valley, young researchers from prestigious health systems and universities, and salespeople of every possible variety—spoke at the conference in Las Vegas, proselytizing to the tens of thousands of physicians and administrators in attendance. They say a range of innovations, from new software to new devices, will transform the way all of us interact with the health-care system—making it easier for us to stay healthy and, when we do get sick, making it easier for medical professionals to treat us. They also imagine the transformation reverberating through the rest of the economy, in ways that may be even more revolutionary. </p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Health care already represents one-sixth of America's gross domestic product. And that share is growing, placing an ever-larger strain on paychecks, corporate profits, and government resources. Figuring out how to manage this cost growth—how to meet the aging population's medical needs without bankrupting the country—has become the central economic-policy challenge of our time. These technology enthusiasts think they can succeed where generations of politicians, business leaders, and medical professionals have failed.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Specifically, they imagine the application of data as a "disruptive" force, upending health care in the same way it has upended almost every other part of the economy—changing not just <i>how</i> medicine is practiced but <i>who</i> is practicing it. In Silicon Valley and other centers of innovation, investors and engineers talk casually about machines' taking the place of doctors, serving as diagnosticians and even surgeons—doing the same work, with better results, for a lot less money. The idea, they say, is no more fanciful than the notion of self-driving cars, experimental versions of which are already cruising California streets. "A world mostly without doctors (at least average ones) is not only reasonable, but also more likely than not," wrote Vinod Khosla, a venture capitalist and co-founder of Sun Microsystems, in a 2012 TechCrunch article titled "Do We Need Doctors or Algorithms?" He even put a number on his prediction: someday, he said, computers and robots would replace four out of five physicians in the United States.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Statements like that provoke skepticism, derision, and anger—and not only from hidebound doctors who curse every time they have to turn on a computer. Bijan Salehizadeh, a trained physician and a venture capitalist, responded to reports of Khosla's premonition and similar predictions with a tweet: "Getting nauseated reading the anti-doctor rantings of the silicon valley tech crowd." Physicians, after all, do more than process data. They attend at patients' bedsides and counsel families. They grasp nuance and learn to master uncertainty. For their part, the innovators at IBM make a point of presenting Watson as a tool that can help health-care professionals, rather than replace them. Think Dr. McCoy using his tricorder to diagnose a phaser injury on <i>Star Trek</i>, not the droid fitting Luke Skywalker with a robotic hand in <i>Star Wars</i>. To most experts, that's a more realistic picture of what medicine will look like, at least for the foreseeable future.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">But even if data technology does nothing more than arm health-care professionals with tablet computers that help them make decisions, the effect could still be profound. Harvey Fineberg, the former dean of the Harvard School of Public Health and now the president of the Institute of Medicine, wrote of IT's rising promise last year in <i>The New England Journal of Medicine</i>, describing a health-care system that might be transformed by artificial intelligence, robotics, bioinformatics, and other advances. Tools like Watson could enhance the abilities of professionals at every level, from highly specialized surgeons to medical assistants. As a result, physicians wouldn't need to do as much, and each class of professionals beneath them could take on greater responsibility—creating a financially sustainable way to meet the aging population's growing need for more health care.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">As an incidental benefit, job opportunities for people with no graduate degree, and in some cases no four-year-college degree, would grow substantially. For the past few decades, as IT has disrupted other industries, from manufacturing to banking, millions of well-paying middle-class jobs—those easily routinized—have vanished. In health care, this disruption could have the opposite effect. It wouldn't be merely a win-win, but a win-win-win. It all sounds far too good to be true—except that a growing number of engineers, investors, and physicians insist that it isn't.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; "><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">O</span><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">ne of these </span><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">enthusiasts</span> is Daniel Kraft, age 44, whose career trajectory tracks the way medicine itself is evolving. Kraft is a physician with a traditional educational pedigree: an undergraduate degree from Brown and a medical degree from Stanford. He trained in pediatrics and internal medicine at Harvard-affiliated hospitals in Boston. Then he returned to the West Coast, to Stanford University Hospital, to complete fellowships in hematology and oncology.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">But Kraft always had a flair for entrepreneurship and a taste for technology: While in medical school, he started his own online bookstore, selling texts to his classmates at a discount. (He later sold the business, for considerable profit.) At Stanford, Kraft says he used his knowledge of social media to develop a better method for communication among doctors, allowing them to exchange pertinent information while making rounds, for instance, rather than simply texting phone numbers for callbacks. "Here we are at Stanford, heart of Silicon Valley, and all we had were basic SMS text pagers—they could only do phone numbers," Kraft recalls. "So I hacked into a Yahoo Groups thing, so we could send actual text messages through servers. Then it spread to the rest of the hospital."  </p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Thus began Kraft's second, parallel career as an inventor, an entrepreneur, and a professional visionary. He audited classes in bio-design and business, hanging out with computer nerds as much as doctors. Today he holds several patents, including one for the MarrowMiner, a device that allows bone marrow to be harvested faster and less painfully. (Kraft is the chief medical officer for a company that plans to develop it commercially.) Kraft is also the chairman of the medical track at Singularity University, a think tank and educational institution in Silicon Valley. Initially, Kraft's primary role at Singularity was to offer a few hours of instruction on medicine. But Kraft says he quickly realized that "a lot of people, in gaming, IT, Big Data, devices, virtual reality, psychology—they were all converging on health care, and interested in applying their skills to health care." That led Singularity to establish FutureMed, an annual conference on medical innovation that brings together financiers, physicians, and engineers from around the world. Kraft is the director.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Exponential improvements in the ability of computers to process more and more data, faster and faster, are part of what has drawn this diverse crew to medicine—a field of such complexity that large parts of it have, until recently, stood outside the reach of advanced information technology. But just as significant, Kraft and his fellow travelers say, is the explosion of data available for these tools to manipulate. The Human Genome Project completed its detailed schematic of human DNA in 2003, and for the past several years, companies have provided personal genetic mapping to people with the means to pay for it. Now the price, once prohibitive, is within reach for most people and insurance plans. Researchers have only just begun figuring out how genes translate into most aspects of health, but they already know a great deal about how certain genetic sequences predispose people to conditions like heart disease and breast cancer. Many experts think we will soon enter an era of "personalized" medicine, in which physicians tailor treatments—not just for cancer, but also for conditions like diabetes and heart disease—to an individual patient's genetic idiosyncrasies.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">A potentially larger—and, in the short run, more consequential—data explosion involves the collection, transmission, and screening of relatively simple medical data on a much more frequent basis, enabling clinicians to make smarter, quicker decisions about their patients. The catalyst is a device most patients already have: the smartphone. Companies are developing, and in some cases already selling, sensors that attach to phones, to collect all sorts of biological data. The companies Withings and iHealth, for example, already offer blood-pressure cuffs that connect to an iPhone; the phone can then send the data to health-care professionals via e‑mail, or in some cases, automatically enter them into online medical records. The Withings device sells for $129; iHealth's for $99. Other firms sell devices that diabetics can use to measure glucose levels. In the U.K., a consortium has been developing a smartphone app paired with a device that will allow users to test themselves for sexually transmitted diseases. (The test will apparently involve urinating onto a chip attached to the phone.)</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">AliveCor, a San Francisco–based firm, has developed an app and a thin, unobtrusive smartphone attachment that can take electrocardiogram readings. The FDA approved it for use in the U.S. in December. While the device was still in its trial phase, Eric Topol, the chief academic officer at Scripps Health in San Diego and a well-known technology enthusiast, used a prototype of the device to diagnose an incipient heart attack in a passenger on a transcontinental flight from Washington, D.C., to San Diego. The plane made an emergency landing near Cincinnati and the man survived.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">As sensors shrink and improve, they will increasingly allow health to be tracked constantly and discreetly—helping people to get over illnesses faster and more reliably—and in the best of cases, to avoid getting sick in the first place. One group of researchers, based at Emory University and Georgia Tech, developed a prototype for one such device called StealthVest, which—as the name implies—embeds sensors in a vest that people could wear under their regular clothing. The group designed the vest for teenagers with chronic disease (asthma, diabetes, even sickle-cell anemia) because, by their nature, teenagers are less likely to comply with physician instructions about taking readings or medications. But the same technology can work for everyone. For instance, as Sloan-Kettering's Ari Caroline notes, right now it's hard for oncologists to get the detailed patient feedback they need in order to serve their patients best. "Think about prostate surgery," he says. "You really want to check patients' urinary and sexual function on a regular basis, and you don't get that when they come in once every three or four months to the clinic—they'll just say generally 'good' or 'bad.' The data will only get collected when people are inputting it on a regular basis and it captures their daily lives."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">As more and more data are captured, and as computers become better and faster at processing them autonomously, the possibilities keep expanding. One medical-data start-up getting some buzz is a company called Predictive Medical Technologies, based in San Francisco. It is developing a program that sucks in all the data generated in a hospital's intensive-care unit, plugs the information into an algorithm, and then identifies which patients are likely to experience a heart attack or other forms of distress—providing up to 24 hours of warning. A trial is under way at the University of Utah's hospital in Salt Lake City. The eventual goal is to expand the program's capabilities, so that it can monitor conditions throughout the hospital. "You don't just want more data," Kraft says. "You want actual information in a form you can use. You need to be able to make sense of this stuff. That's what companies like Predictive Medical do."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; "><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">So how would </span>all these innovations fit together? How would the health-care system be different—and how, from a patient's standpoint, would it <i>feel</i> different—from the one we have today? Imagine you're an adult with a chronic condition like high blood pressure. Today, your contact with the health-care system would be largely episodic: You'd have regular checkups, at which a doctor or maybe a nurse-practitioner would check your blood pressure and ask about recent behavior—diet, exercise, and whatnot. Maybe you'd give an accurate account, maybe you wouldn't. If you started experiencing pain or had some other sign of trouble, you'd make an appointment and come in—but by then, the symptom might well have subsided, making it hard to figure out what was going on.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">In the future as the innovators imagine it—"Health 2.0," as some people have started calling it—you would be in constant contact with the health-care system, although you'd hardly be aware of it. The goal would be to keep you healthy—and any time you were in danger of becoming unhealthy, to ensure you received attention right away. You might wear a bracelet that monitors your blood pressure, or a pedometer that logs movement and exercise. You could opt for a monitoring system that makes sure you take your prescribed medication, at the prescribed intervals. All of these devices would transmit information back to your provider of basic medical care, dumping data directly into an electronic medical record.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">And the provider wouldn't be one doctor, but rather a team of professionals, available at all hours and heavily armed with technology to guide and assist them as they made decisions. If, say, your blood pressure suddenly spiked, data-processing tools would warn them that you might be in trouble, and some sort of clinician—a nurse, perhaps—would reach out to you immediately, to check on your condition and arrange treatment as necessary. You could reach the team just as easily, with something as simple as a text message or an e-mail. You'd be in touch with them more frequently, most likely, but for much shorter durations—and, for the most part, with less urgency.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Sometimes, of course, office or hospital visits would be necessary, but that experience would be different, too—starting with the hassle of dealing with insurance companies. Watson has a button for submitting treatment proposals to managed-care companies, for near-instant approval, reducing the time and hassle involved in gaining payment authorization. The transformation of the clinical experience could be more profound, although you might not detect it: someone in a white coat or blue scrubs would still examine you, perform tests, prescribe treatment. But that person might have a different background than he'd have today. And as the two of you talked, your exam information would be uploaded and cross-referenced against your medical record (including the data from all those wireless monitors you've been toting around), your DNA, and untold pages of clinical literature.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">The evolution toward a more connected system of care has already begun at some large organizations that use team models of care. One such institution is the Group Health Cooperative of Puget Sound, a nonprofit, multi-specialty group practice. Matt Handley, the medical director for quality and informatics, says that about two-thirds of Group Health's patients now use some form of electronic communication, and that these methods account for about half of all "touches" between patients and the group's doctors or nurses. "They set up their own appointments … They don't need to call somebody and ask when I'm free," Handley says. "They send messages to doctors; look up lab tests and radiology results; and order refills … The fascinating thing is that people of all ages are using it … I have people in their 90s who secure-message me."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">It's a long way from Group Health to Health 2.0, and Handley is among those who are wary of the hype. Sure, the demos for products like Watson look great. They always do. But can such tools really winnow down information in a way that physicians will find useful? Can they effectively scour new medical literature—some 30,000 articles a month, by Handley's reckoning—and make appropriate use of new evidence? Will they actually improve medicine? "While Watson could sometimes be helpful, it may actually drive up the cost of care," Handley says, by introducing more possible diagnoses for each patient—diagnoses that clinicians will inevitably want to investigate with a bevy of expensive tests. A study in the journal <i>Health Affairs</i>, published in March 2012, found that physicians with instant electronic access to test results tended to order more tests—perhaps because they knew they could see and use the results quickly. It's the same basic principle Handley has identified: if new tools allow providers to process far more information than they do now, providers might respond by trying to gather even more information.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Another reason for skepticism is the widespread lack of good electronic medical records, or EMRs, the foundation on which so many promising innovations rest. Creating EMRs has been a frustratingly slow process, spanning at least the past two decades. And even today the project is a mess: more than 400 separate vendors offer EMRs, and the government is still trying to establish a common language so that they can all "speak" to one another. "Our doctors have state-of-the-art electronic health-record systems," says Brian Ahier, the health‑IT evangelist (yes, that is his real title) at the Mid-Columbia Medical Center, in northern Oregon, and a widely read writer on medical innovation. "But for clinical communication" outside the medical center, "they have to print it out, fax it, and then scan" what they get back.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">But despite these risks and stumbling blocks, there are reasons to think the next wave of innovations might really stick. One is legislation enacted by the Obama administration. The 2009 Recovery Act—the $800 billion stimulus designed to end the economic crisis—set aside funds for the creation of a uniform standard for electronic medical records. It also made changes to Medicare, so reimbursement to doctors and hospitals now depends partly on whether they adopt EMRs and put them to "meaningful use." The incentives seem to be working: according to a September 2012 survey by the consulting firm CapSite, nearly seven in 10 doctors now use EMRs. The trade publication<i>InformationWeek</i> called this tally a "tipping point."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Under the Affordable Care Act, a k a "Obamacare," Medicare will also begin rewarding providers who form integrated organizations, like Group Health Cooperative of Puget Sound, and groups that accept "bundled" payments, so that they are paid based on the number of patients in their care rather than for each service rendered. In theory, this financing scheme should encourage medical practices and hospitals to keep patients healthier over the long term, even if that means spending money up front on technology in order to reduce the frequency of patient visits or procedures. In other words, the new, digital model for health care should eventually become more economically viable.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; "><span class="smallcaps" style="margin: 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">One sign that </span>medical care is in the midst of a massive transformation, or at least on the cusp of one, is the extraordinary rise in demand for information-technology workers within the health-care sector. All over the country, hospitals are on a hiring binge, desperate for people who can develop and install new information systems—and then manage them or train existing workers to do so. According to one government survey, online advertisements for health-IT jobs tripled from 2009 to 2010. And the growth is likely to continue. The Bureau of Labor Statistics estimates that in this decade, the health-IT workforce will grow by 20 percent. Most experts believe that such growth still won't be nearly enough to fill the demand. But it's the data revolution's ability to <i>change</i> jobs within health care—to alter the daily workflow of medical assistants, nurses, doctors, and care managers—that might have the most far-reaching effects not just on medicine, but also on the economy.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Economists like to say that health care suffers from a phenomenon called "Baumol's disease," or "the Baumol effect," first described half a century ago by the economist William Baumol, in collaboration with a fellow economist named William Bowen. In most occupations, wages rise only when productivity improves. If factory workers get an extra dollar an hour, it's because they can produce extra value, thanks to better training or equipment. Baumol and Bowen observed that certain labor-intensive occupations don't operate by the same principle: job productivity doesn't rise much, but wages go up anyway, because employers need to keep paying workers more in order to stop them from pursuing other lines of work, in other sectors where productivity is rising quickly. That forces the employers to keep raising prices, just to provide the same level of service.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Over time, industries afflicted with Baumol's disease tend to consume a larger and larger proportion of a nation's income, because their cost, relative to everything else, climbs ever upward. The health-care industry has a textbook case of Baumol's disease, and so far, technology hasn't made much of an impact. Just as it still takes five string players to play a Mozart quintet (Baumol's famous example), so it still takes a highly trained surgeon to operate on somebody. "We do now have robots performing surgery, but the robot is under constant supervision of the surgeon during the process," Baumol told a reporter from <i>The New York Times</i> two years ago. "You haven't saved labor. You have done other good things, but it isn't a way of cheapening the process." Likewise, a doctor in a clinic still sees patients individually, listens to their problems, orders tests, makes diagnoses—in the classic economic sense, the process of an office visit is no more efficient than it was 10, 30, or 50 years ago.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Now technology could actually change that process, not by making the exam faster but by enabling somebody else to conduct it—or to perform the test, or carry out the procedure. The idea of robots performing surgery or more-routine medical tasks with less supervision is something many experts take seriously—in part because, in the developing world, burgeoning demand for care is already pushing medicine in this direction. As part of an experimental program in Tanzania, rural health workers, many of whom have relatively little medical training, have access to a "decision-support tool" that can help them diagnose and treat illness based on symptoms. And thanks to an initiative called the Maternal Health Reporter, similar caregivers in India can submit patient information to a central data bank, then receive regular reminders about care for pregnant women.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">"In Brazil and India, machines are already starting to do primary care, because there's no labor to do it," says Robert Kocher, an internist, a veteran of McKinsey consulting, and a former adviser to the Obama administration. He's now a partner at Venrock, a New York venture-capital firm that invests in emerging technologies, including health-care technology. "They may be better than doctors. Mathematically, they will follow evidence—and they're much more likely to be right." In the United States, Kocher believes, advanced decision-support tools could quickly find a home in so-called minute clinics—the storefront medical offices that drugstores and other companies are setting up in pharmacies and malls. There, the machines could help nonphysician clinicians take care of routine medical needs, like diagnosing strep throat—and could potentially dispense the diagnoses to patients more or less autonomously. Years from now, he says, other machines could end up doing "vascular surgery, fistulas, eye surgery, microsurgery. Machines can actually be more precise than human hands."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Nobody (including Kocher) expects American physicians to turn the keys of their practices over to robots. And nobody would expect American patients accustomed to treatment from live human beings to tolerate such a sudden shift for much of their care, mall-based minute clinics notwithstanding. But because of a unique set of circumstances, the health-care workforce could nonetheless undergo enormous change, without threatening the people already working in it.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Between the aging of the population and the expansion of health-insurance coverage under Obamacare, many more people will seek medical attention in the coming years—whether it's basic primary care or ongoing care for chronic conditions. But we don't have nearly enough primary-care doctors—in practice today or in training—to provide this care. And even if we trained more, we wouldn't have enough money to pay them. With the help of decision-support tools and robotics, health-care professionals at every level would be able to handle more-complicated and more-challenging tasks, helping to shoulder part of the load. And finding enough nurses or technicians or assistants would be a lot easier than finding enough doctors. They don't need as many years to train, and they don't cost as much to pay once their training is finished. According to the Bureau of Labor Statistics, doctors' median annual salary is $166,400, while nurses' is $64,690 and medical assistants' is $28,860. </p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Health professionals at all levels tend to guard their turf ferociously, lobbying state officials to prevent encroachments from other providers. But the severe shortage of professionals to provide primary care means there should be plenty of work to go around. Already today, there's a push within health-care-policy circles to more consistently allow providers to "practice at the top of their licenses"—that is, to let the people at each level of training do as much as their training could possibly allow them to do. That would enable higher-wage, more-highly-skilled professionals to focus on work that's truly commensurate with their education. It would also reduce the cost of care. Watson and its ilk could help us take this concept further, by augmenting the capabilities of workers at every skill level. Physicians could lead large teams of mid- and low-level providers, delegating less complicated and more routine tasks. "Having nurses, with the assistance of these artificial-intelligence tools, [do more] frees physicians to perform the higher-level interventions, allowing everyone to practice at the top of their license," Brian Ahier says.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">That model actually isn't so different from the collaborative approach that institutions like Group Health have been deploying with such success. "We focus on developing teams—teams of several doctors, physician assistants, nurse-practitioners, and/or nurses," Matt Handley says. "Every day starts with a huddle: the team talks about the day and reviews a couple of topics and cases, figures out who is going to need what, from which provider, and so on."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">The providers with less medical training can be more technologically adept, anyway. "The doctor or clinician of course has the high analytic skills, makes the judgment calls, the diagnoses, prescribes medications," says Catherine Dower, an associate director at UC San Francisco's Center for the Health Professions. "But the medical assistants are frequently the ones who can actually use this new technology really well, including tele-health—they can get bio-feeds from patients sitting at home, they can tap insulin and cardiac rates. And then, as this information is fed into a central site, the medical assistant can read and make a decision on which patient should come in and be seen by the doctor, and which one needs some minor modification"—whether that means adjusting medication or scheduling a visit to discuss more-significant changes in treatment or therapy.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">For the health-care system as a whole, the efficiencies from the data revolution could amount to substantial savings. One estimate, from the McKinsey Global Institute, suggested that the data revolution could yield onetime heath-care savings of up to $220 billion, followed by a slower rate of growth in health-care costs. Total health-care spending in the U.S. last year was $2.7 trillion, so that would be roughly the equivalent of reducing health-care spending by 7.5 percent up front. That's the best reason to believe that the data revolution will make a difference, even if it never lives up to the hype of its most enthusiastic proponents. The health-care system is so massive, so full of waste, so full of failure, that even a marginal change for the better could save billions of dollars, not to mention quite a few lives.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">And, in a small way, it could help us begin to fill the hole that's developed in the middle class. David Autor, an economist at MIT, has noted that for the past generation, technological change in the U.S. has tended to favor highly skilled workers at the expense of those with mid-level skills. Routine clerical functions, for instance, have been automated, contributing to the hollowing-out of the middle class. But in the coming years, health care may prove a large and important exception to that general rule—effectively turning the rule on its head. "Look at physician-assistant positions," Dower says. "They don't require college or a bachelor's degree, just a technical program." And once you're certified, "you come out with a pretty good salary, up in the $75,000-to-$80,000 range." If technological aids allow us to push more care down to people with less training and fewer skills, more middle-class jobs will be created along the way.</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">"I don't think physicians will be seeing patients as much in the future," says David Lee Scher, a former cardiac electrophysiologist and the president of DLS Healthcare Consulting, which advises health-care organizations and developers of digital health-care technologies. "I think they are transitioning into what I see as super-quality-control officers, overseeing physician assistants, nurses, nurse-practitioners, etc., who are really going to be the ones who see the patients." Scher recognizes the economic logic of this transition, but he's also deeply ambivalent about it, noting that something may be lost—because there are still some things that technology cannot do, and cannot enable humans to do. "Patients appreciate nonphysician providers because they tend to spend more time with them and get more humanistic hand-holding care. However, while I personally have dealt with some excellent mid-level providers, they generally do not manage complex diseases as well as physicians. Technology-assisted algorithms might contribute to narrowing this divide."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Even Watson, which has generated so much positive buzz in medicine and engineering, has its doubters. "Watson would be a potent and clever companion as we made our rounds," wrote Abraham Verghese, a Stanford physician and an author, in <i>The New York Times</i>. "But the complaints I hear from patients, family and friends are never about the dearth of technology but about its excesses."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Marty Kohn, from the Watson team, understands such skepticism, and frequently warns enthusiasts not to overpromise what the machine can do. "When people say IT can be transformative, I get a little anxious," he told me. Partly that's because he thinks technology can't change an industry, or a culture, if the professionals themselves aren't committed to such a transformation—Watson won't change medicine, in other words, if the people who practice medicine don't want it to change. As a physician, Kohn is careful to describe Watson as a "clinical support" tool rather than a "decision making" tool—to emphasize that it's a machine that can help health-care professionals, rather than replace them. "Some technologies are truly transforming health care, providing therapies that never existed before. I don't view IT that way. I view IT as an enabler."</p><p style="margin: 10px 0px; padding: 0px; border: 0px; outline: 0px; font-weight: inherit; font-style: inherit; font-size: 16px; font-family: inherit; vertical-align: baseline; ">Still, Kohn has reconciled himself to hearing people talk about Watson as if it were a person—he says he's now used to answering the question "Who is Watson?" rather than "What is Watson?" He also likes to tell a story about a speech he gave in Canada, one that, like the Las Vegas presentation, attracted more people than the room could hold. That evening he called his wife, to tell her about the enthusiasm. "That's really great, Marty," he recalls her saying. "Just remember, they were there to meet Watson, not you."</p></div></div><a href="http://www.theatlantic.com/magazine/archive/2013/03/the-robot-will-see-you-now/309216/?single_page=true">http://www.theatlantic.com/magazine/archive/2013/03/the-robot-will-see-you-now/309216/?single_page=true</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

The Robot Will See You Now - Jonathan Cohn - The Atlantic

IBM'S WATSON—THE SAME MACHINE THAT BEAT KEN JENNINGS AT  JEOPARDY —IS NOW CHURNING THROUGH CASE HISTORIES AT MEMORIAL SLOAN-KETTERING, L...

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Italian breakfast

<p>After dropping Bones in to<a href="http://www.muttugly.com/"> Mutt Ugly</a> for his groom we went to <a href="http://m.yelp.ie/biz/er-buchetto-dublin">Er Buchetto</a> for breakfast.  I had milky porridge with honey while Ciaran chose the full Irish minus the eggs.</p><p>This is a tiny little cafe.  It was not busy this morning - possibly because it is so cold out with a little sleet.</p><p>We chilled out over breakfast while reading the Irish Times.  Normally we have the dog tied up outside so it was nice not to have to keep looking out the window to see that he was safe.</p><div class='separator' style='clear: both; text-align: center;'> <a href='https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyzEqpwR5f8etya_e3zkOGUrnkrGMaTkpWGFPzVKfIRRjfvAjJAGivy3iwW6LHN_Oz2XZs5Is-VVy5oxdY6RxYdVrQ9KmZyxXMbM_EKsIvx4dF7Nn0QWjCCurscziDlWSeG4ZfC_xm_9i_/s1600/20130223_101407.jpg' imageanchor='1' style='margin-left: 1em; margin-right: 1em;'> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyzEqpwR5f8etya_e3zkOGUrnkrGMaTkpWGFPzVKfIRRjfvAjJAGivy3iwW6LHN_Oz2XZs5Is-VVy5oxdY6RxYdVrQ9KmZyxXMbM_EKsIvx4dF7Nn0QWjCCurscziDlWSeG4ZfC_xm_9i_/s400/20130223_101407.jpg" /> </a> </div><div class='separator' style='clear: both; text-align: center;'> <a href='https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhlnSq2xyFIXfb-yHKh8cRE5qtLM1ezMUZvXA0Yn8Aqq0OSClJaVlecehRbs8MGoJAZaf1SPy9wLrHFwjv27zFqZX7r7G4rD3rm8bOvb0LRpDM55Je2rGThV12YEznnr45T_T8DmbgJ0eob/s1600/20130223_103748.jpg' imageanchor='1' style='margin-left: 1em; margin-right: 1em;'> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhlnSq2xyFIXfb-yHKh8cRE5qtLM1ezMUZvXA0Yn8Aqq0OSClJaVlecehRbs8MGoJAZaf1SPy9wLrHFwjv27zFqZX7r7G4rD3rm8bOvb0LRpDM55Je2rGThV12YEznnr45T_T8DmbgJ0eob/s400/20130223_103748.jpg" /> </a> </div><div class='separator' style='clear: both; text-align: center;'> <a href='https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7A8uN7LJwCWhDaE9V1Bvsp10FwhQ0aGQg_I4a5fLwEJMCe0M4Vud9iHtpE7usS-9DSNQ6VTIW6eicrVnuaGo9pzPTJiuAdQUd5YVp3JaDOFAcQLCKojH6n9VNc7rOezg3lhzuzVHbYzMd/s1600/20130223_103244.jpg' imageanchor='1' style='margin-left: 1em; margin-right: 1em;'> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7A8uN7LJwCWhDaE9V1Bvsp10FwhQ0aGQg_I4a5fLwEJMCe0M4Vud9iHtpE7usS-9DSNQ6VTIW6eicrVnuaGo9pzPTJiuAdQUd5YVp3JaDOFAcQLCKojH6n9VNc7rOezg3lhzuzVHbYzMd/s400/20130223_103244.jpg" /> </a> </div><div class='separator' style='clear: both; text-align: center;'> <a href='https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVwrjwfIRzmO7cr-PypruLAgqiH1xvxV7vNuX2NN-ep5JzREUkCaTf6rsArDB3YWpygne2XlfemzncbXeLkou3icu6x3GwVttv586txPL_9yQnDNA9AvYhnUjEBSdk8dS6f28hjtCkTu4y/s1600/20130223_101517.jpg' imageanchor='1' style='margin-left: 1em; margin-right: 1em;'> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVwrjwfIRzmO7cr-PypruLAgqiH1xvxV7vNuX2NN-ep5JzREUkCaTf6rsArDB3YWpygne2XlfemzncbXeLkou3icu6x3GwVttv586txPL_9yQnDNA9AvYhnUjEBSdk8dS6f28hjtCkTu4y/s400/20130223_101517.jpg" /> </a> </div>

Italian breakfast

After dropping Bones in to Mutt Ugly for his groom we went to Er Buchetto for breakfast.  I had milky porridge with honey while Ciaran ch...

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Daily Education and Technology News for Schools 02/23/2013

<ul class="diigo-linkroll"> <li> <p class="diigo-link"> <a href="https://docs.google.com/spreadsheet/viewform?formkey=dGc4aFVlRy1RczNLNDc0OEtCSXZxd3c6MA#gid=0">Virtual Participants for Flat Classroom Conference 2013 Japan - Sign up Here</a> </p> <p class="diigo-description">The Flat Classroom conference is coming up March 7-10. We have an option for receiving credit (if you're international) and also for full participation. Virtual participants are an important part of our face to face conference as we seek to create experiences that flatten the conference as we collaborate in a problem-based environment. You'll have a team and work with them to create a project that can be brought to the world based upon principles that WORK. Click on this link to learn more about how you can participate in the conference remotely FOR FREE. ;-) We want you.</p> <p class="diigo-tags"> <span>tags:</span> <a href="https://www.diigo.com/user/coolcatteacher/news">news</a> <a href="https://www.diigo.com/user/coolcatteacher/teaching">teaching</a> <a href="https://www.diigo.com/user/coolcatteacher/education">education</a> <a href="https://www.diigo.com/user/coolcatteacher/flatclassroomconference">flatclassroomconference</a> <a href="https://www.diigo.com/user/coolcatteacher/japan">japan</a> <a href="https://www.diigo.com/user/coolcatteacher/tumblr">tumblr</a></p> </li> </ul><p class="diigo-ps">Posted from <a href='https://www.diigo.com'>Diigo</a>. The rest of my favorite links are <a href='https://www.diigo.com/user/coolcatteacher'>here</a>.</p>

Daily Education and Technology News for Schools 02/23/2013

Virtual Participants for Flat Classroom Conference 2013 Japan - Sign up Here The Flat Classroom conf...

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Modern Day Religious Pharisees Now Criticizing Tebow

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4u7n8YJYuPKeAGYZ1AiS9PlLwLTekL8DN_iGcOcDLcMJ16yzp7kJtGgQHX0lYN4jWzsVqUtPxL-sKmZe0rtrbgaPNEPzR3FR5IbWqyNn4LcwHh3iLNLBRwcm-1PpYRfLYR8lu1BMb3SeW/s1600/pharisees_7.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="222" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4u7n8YJYuPKeAGYZ1AiS9PlLwLTekL8DN_iGcOcDLcMJ16yzp7kJtGgQHX0lYN4jWzsVqUtPxL-sKmZe0rtrbgaPNEPzR3FR5IbWqyNn4LcwHh3iLNLBRwcm-1PpYRfLYR8lu1BMb3SeW/s320/pharisees_7.png" width="320" /></a></div>The evangelical Holy Men of God are hell-bent on showing the world that they are the modern-day version of the Pharisees in Jesus' day.<br /><br />Case in point is the criticism being directed at Tim Tebow by men like Vines, Mohler, and Graham this week after Tebow announced he was <a href="http://www.abpnews.com/ministry/people/item/8241-tebow-audibles-on-fbc-dallas-plan#.USh0X2fNnb0" target="_blank">backing out of an April speaking gig at the First Baptist Church of Dallas</a>.<br /><br />For the past several weeks Tebow has been criticized by many in the secular media for his decision to speak at FBC Dallas because of the controversy surrounding their pastor Robert Jeffress and his stand on issues of homosexuality, Catholicism, and Obama. For sure people in the secular media have used their influence to try to pressure Tebow to behave as they believe he should, that he should cancel his speaking engagement.<br /><br />But now that Tebow - as his own man, for his own reasons, and presumably according to the dictates of his own heart and faith -  has decided to <u><b>not</b></u><b> </b>go to FBC Dallas, the Holy Men of God are now doing exactly what they can't stand the secular media trying to do: trying to squeeze Tim Tebow to fit THEIR mold, and criticizing him when he doesn't do what they think he should.<br /><br />I'm perfectly comfortable with Tim canceling his FBC Dallas gig. Why? Simply because I trust his judgment, as he has earned the right to be respected when he makes decisions such as this. Unlike many of the Holy Men now criticizing him, he has shown himself to be the real deal, a real Christian who HAS lived out his faith in the face of intense criticism the past 5 years with nary a complaint. He HAS used his money and influence to do many good works that Jesus would have him do. He has done mountains more to spread the gospel than all the mega church preachers put together. So guess what - I trust his judgment to do what he thinks is best as he lives out his Christian faith. He absolutely does not have have to bow to the whims of modern day Pharisees like Jerry Vines or Albert Mohler or Jack Graham.<br /><br />And speaking of Vines: how sad - and hypocritical - is it that his former pastor, <a href="https://twitter.com/jerryvines" target="_blank">Jerry Vines</a>, openly criticized Tebow via Twitter for simply deciding not to speak at FBC Dallas in April. Look at these Tweets from Vines, and the many "retweets" by Vines' followers:<br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnOQuXR9uAm9zRXVKcaOrJSgHJonZz_HMeciwJePB-NZn8u0Si7bHwl5PQ5svVeYjmxyf-XH3xix_HF3lk3LEeHVN0fLHJwFmmf5-3xMBsg5UZsDVVlJdidZUbkdmoaPqyCBnNZ6aKAe_N/s1600/VinesTweet3.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="185" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgnOQuXR9uAm9zRXVKcaOrJSgHJonZz_HMeciwJePB-NZn8u0Si7bHwl5PQ5svVeYjmxyf-XH3xix_HF3lk3LEeHVN0fLHJwFmmf5-3xMBsg5UZsDVVlJdidZUbkdmoaPqyCBnNZ6aKAe_N/s320/VinesTweet3.png" width="320" /></a></div><div class="separator" style="clear: both; text-align: center;">  <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRHrDqUyU9bSpJB6fDkHrmlfdqDZJnkZfrNartibTdSuwSGEXkfS9RFaxnTmnZhwaMZVKoTfO2_jS14tBqP7I7nZTjxSleunl5kt8RhxHR26yS3yL-kODkxnSgFgxddxgUvs5pqQTqPNzO/s1600/VinesTweet2.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="214" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRHrDqUyU9bSpJB6fDkHrmlfdqDZJnkZfrNartibTdSuwSGEXkfS9RFaxnTmnZhwaMZVKoTfO2_jS14tBqP7I7nZTjxSleunl5kt8RhxHR26yS3yL-kODkxnSgFgxddxgUvs5pqQTqPNzO/s320/VinesTweet2.png" width="320" /></a></div><div class="separator" style="clear: both; text-align: center;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgruwkiBxbFkBUzgDSGXa6JKm5y0SSCyx1S_RSQ6shl54os5tEPs7San7nNME-Wkg7Nw8oeQQvFhYrlOQRWzum4V6J1hQIlBhyNxEp8-bW0wVuL7unRRqwbDBvmnxWuqmXZbbzHjBHOcU8W/s1600/VinesTweet1.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="174" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgruwkiBxbFkBUzgDSGXa6JKm5y0SSCyx1S_RSQ6shl54os5tEPs7San7nNME-Wkg7Nw8oeQQvFhYrlOQRWzum4V6J1hQIlBhyNxEp8-bW0wVuL7unRRqwbDBvmnxWuqmXZbbzHjBHOcU8W/s320/VinesTweet1.png" width="320" /></a></div><br />What a hypocrite. What is Vines talking about? The "devil laughed" when Tebow canceled his speaking engagement? Really? I guess it makes sense that Vines has the inside track on what makes the devil laugh, since Vines doesn't have even 1/10th of the discernment that Tebow has when it comes to choosing speaking venues or choosing speakers. Vines was the one who gave <a href="http://fbcjaxwatchdog.blogspot.com/2010/03/ergun-caners-november-2001-fbc-jax.html" target="_blank">Ergun Caner the pulpit in 2001</a> and nodded with approval as Caner lied through his teeth about being a trained terrorist raised in Turkey. It was Vines who first<a href="http://www.abpnews.com/archives/item/4096-former-rising-star-preacher-pleads-guilty-to-molestation#.USh1lGfNnb0" target="_blank"> brought Darrel Gilyard to Jacksonville</a> to preach and did nothing to warn people at Shiloh Baptist about Gilyard's sexual predation upon Gilyard's return to Jacksonville. It was Vines who went to preach at Gilyard's church in 2006 when Vines knew what a sexual pervert Gilyard had shown himself to be over and over while he was in Dallas - and Vines STILL went to speak at Gilyard's church knowing Gilyard tried to seduce one of Vines' own church members during a youth revival tour. Yes, Vines can only dream that he has a portion of Tebow's discernment.<br /><br />Jerry, if the devil laughed over Tebow's decision to not speak at Dallas, then the devil must have had a month-long Mardi Gras over your decision to preach at Gilyard's church in 2006. The devil also has had a 10-year party while Ergun Caner <a href="http://fbcjaxwatchdog.blogspot.com/2010/03/ergun-caners-november-2001-fbc-jax.html" target="_blank">lied in churches</a> and <a href="http://fbcjaxwatchdog.blogspot.com/2010/08/ergun-caner-turkish-born-former-muslim.html" target="_blank">to our troops</a>. YOU started that, Jerry, when you failed to do your due diligence in 2001 - or worse, maybe you knew Caner was lying, but you didn't care. Which was it? We don't know, because you've been silent over Caner's exposure as a fraud, but you now are making a big deal over Tebow's decision.<br /><br />But this shows the misplaced priorities of Pharisees - they are not so much interested in your good deeds, or what you do for God - or whether you are a habitual liar like Caner or the real-deal like Tebow - what they are most interested is whether or not you agree with their religious teachings, and if you believe exactly as they say you should believe and if you agree with their narrow interpretation of the bible.<br /><br />Even Prestonwood Baptist Church pastor and former SBC president Jack Graham criticized Tebow for his decision, assuming he bowed to the pressure of cultural decay:<br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGh92xzkbJhwCncJ0lcRIEuAvvX3NAnJyDElTsuDjLTaCpcfpnoaPNynkmGPpfIxopX618WILTap-vkEQkH-NSi6P3ZklQbqa0FX9-_gqa1hbtq6V-737TOg_Kb7b3M_uJwM3iPzi7GcL4/s1600/VinesGrahamTweet.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="208" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGh92xzkbJhwCncJ0lcRIEuAvvX3NAnJyDElTsuDjLTaCpcfpnoaPNynkmGPpfIxopX618WILTap-vkEQkH-NSi6P3ZklQbqa0FX9-_gqa1hbtq6V-737TOg_Kb7b3M_uJwM3iPzi7GcL4/s320/VinesGrahamTweet.png" width="320" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVTKPSwQiLmAw4EnVofXsJW7xwyu_bYGP2M6P1ccXEJJCeE010Dw-2SbARv9Y44Yrj5QP_Mlz_RKbZGCtf-7Fy6IUhxLmZ1JbeyN5F-9Pc4Y8bmgQzPlJFe7W5GysICfA9-KMk_pLzu_AM/s1600/VinesParnella.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="172" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVTKPSwQiLmAw4EnVofXsJW7xwyu_bYGP2M6P1ccXEJJCeE010Dw-2SbARv9Y44Yrj5QP_Mlz_RKbZGCtf-7Fy6IUhxLmZ1JbeyN5F-9Pc4Y8bmgQzPlJFe7W5GysICfA9-KMk_pLzu_AM/s320/VinesParnella.png" width="320" /></a></div><br /><br />Perhaps the reason all of these Holy Men of God are so wigged out over Tebow's decision is that they know Tebow's home church in Jacksonville is no different than FBC Dallas. Maybe they're worried that the most influential Christian of our day who has earned the respect they never could - might actually be signaling that he is turning away from his fundamentalist roots. The Holy Men of God know how dangerous this is to their own religious power, as Tebow speaks with the real-life, living-out-his-faith kind of power the Holy Men of God don't have. He doesn't just stand in a pulpit bloviating and dictating on Sunday mornings, collecting a fat check from church coffers like the big wig Holy Men of God. No, Tebow is in the real-world, engaging real people and doing real good works to help hurting people.<br /><br />Tim is learning the sad truth that in the fundamentalist world in which he was raised is that what is important to measure someone's faith by is NOT necessarily <u><b>how much good</b></u> they do, but it is whether you <u><b>believe</b></u> exactly as they do. Pretty sad.<br /><br />All this time Tebow thought it was the secular media who was watching and waiting for him to fall - now he knows it was the modern-day Pharisees who were waiting and watching - not for him to sin but for him to somehow go against their strict teachings. What a loving bunch.<br /><br />The Pharisees criticized Jesus for doing good on the Sabbath, because Jesus dared to break their rules and ignore their teachings, showing them to be hypocrites. <br /><br />Now the modern-day Pharisees are doing the same with Tebow. I hope Tebow continues to show them to be the hypocrites they are.<br /><br /><div style="text-align: center;">--------------------------- </div><br /><div style="text-align: center;"><i>"Then Jesus said to the crowds and to his disciples: 'The teachers of the law and the Pharisees sit in Moses’ seat. So you must be careful to do everything they tell you. But do not do what they do, for they do not practice what they preach. They tie up heavy, cumbersome loads and put them on other people’s shoulders, but they themselves are not willing to lift a finger to move them.' "  </i></div>

Modern Day Religious Pharisees Now Criticizing Tebow

The evangelical Holy Men of God are hell-bent on showing the world that they are the modern-day version of the Pharisees in Jesus' day. ...

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Matt Said Jay Said Debi Daly Edition

<div dir="ltr" style="text-align: left;" trbidi="on"><br /><div class="separator" style="clear: both; text-align: center;"></div>Matt slurs, Jay slurs, You look on with disgust and pity.<br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgX_P3j9Rn9E9noB-1TPF6RwwZU0V0NsbUJdpI049Jv0RW0Cig7XOCCHpGf6FE6nqqrqmrRFAjzZ5Ug7cF02LL1YVAThtcu0bC6PP9w02-m8otiV2_kcXm-vYkHX9ORYnIhuz0io8RtqGc/s1600/Sharon+Stone+Nude+Hot.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgX_P3j9Rn9E9noB-1TPF6RwwZU0V0NsbUJdpI049Jv0RW0Cig7XOCCHpGf6FE6nqqrqmrRFAjzZ5Ug7cF02LL1YVAThtcu0bC6PP9w02-m8otiV2_kcXm-vYkHX9ORYnIhuz0io8RtqGc/s320/Sharon+Stone+Nude+Hot.jpg" width="233" /></a></div>Matt: Yo Yo Diggity Yo!<br />Jay: I’m sorry I have the wrong number.<br />Matt: Jayman is in the Hizzy-House!<br />Jay: I think it’s either “Hizzy” or Hizzouse”<br />Matt: Or, in my case, the “Bagizzy Digs”<br />Jay: Yeah, I don’t know about that.<br />Matt: I like it.<br />Jay: Well, that’s all that matters I guess.<br />Matt: Damn right.<br />Jay: Screw everyone else!<br />Matt: Their opinion means nothing. <br />Jay: Who are they to question your use of “Bagizzy Digs” or “Bagizzy Digizzy”<br />Matt: No, not Digizzy. That just sounds silly.<br />Jay: Yeah, good call.<br />Matt: People can call THEIR Hizzies whatever THEY want.<br />Jay: Well of course they can. THIS IS IS AMERICA!<br />Matt: FREEEEDOMMMMMMMM!<br /><br />Jay: I guess that tapping on your windows last night really was sleet.<br />Matt: I’m sorry it wasn’t a serial killer.<br />Jay: I wasn’t HOPING it was, I was just warning that it might be.<br />Matt: Well, he would have been hanging from the building 25 feet above the ground.<br />Jay: Or she!<br />Matt: What?<br />Jay: Or she! Don’t be sexist. Chicks can be serial killers too.<br />Matt: Right, but they prefer “broads.”<br />Jay: Oh yeah. Anyway, that wouldn’t be much of an obstacle for a decent serial killer.<br />Matt: This being the Meth Capital of the world, I would say our serial killers are probably below average.<br />Jay: Good point. It would be more likely here.<br />Matt: Why?<br />Jay: They could stand in the bed of their raised pickup truck to reach a second floor window.<br />Matt: You’ve really thought this through, haven’t you?<br />Jay: I have a lot of free time on my hands.<br /><br />Matt: We have a really awesome guest lined up for this week’s show man.<br />Jay: Yes. We. Do!<br />Matt: Debi Daly! <i>(<a href="http://www.blogtalkradio.com/debidaly1" target="_blank">Blog Talk Radio</a>, <a href="https://twitter.com/THAREALDEBIDALY" target="_blank">Twitter</a>) </i><br />Jay: More like Debi All Day, Every Day!<br />Matt: She’s really very interesting.<br />Jay: Kind of out there dude.<br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZpCAX6Pqh_p7X3lwPEldv0nKQ_7Lg_W_CK7HuN5FR1lRrOD3rZ1d526RjHKFMRl5w1H7ZGuey3dtRKlX1kmmtbvfflxXtG18k593Wbc8sWFC197t6copSwPbTsgje06n_8dBZ4U7hQDc/s1600/Debi+Daly.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZpCAX6Pqh_p7X3lwPEldv0nKQ_7Lg_W_CK7HuN5FR1lRrOD3rZ1d526RjHKFMRl5w1H7ZGuey3dtRKlX1kmmtbvfflxXtG18k593Wbc8sWFC197t6copSwPbTsgje06n_8dBZ4U7hQDc/s320/Debi+Daly.jpg" width="240" /></a></div>Matt: Oh yeah, but in a good way.<br />Jay: Totally!<br />Matt: She’s got a big following.<br />Jay: Legions of fans.<br />Matt: And a handful of haters.<br />Jay: TROLLS!<br />Matt: STALKERS!<br />Jay: Dudes are obsessed with her.<br />Matt: Which is understandable ‘cause she’s AWESOME!<br />Jay: Damn right, but still, no reason to hate or be jealous.<br />Matt: None at all.<br />Jay: So we’ll ask her about this drama and haters and trolls.<br />Matt: And the good people who defend her.<br />Jay: Like us!<br />Matt: Oh yeah.<br />Jay: And whatever else she wants to talk about.<br />Matt: Of course! She is our guest after all.<br />Jay: And we’re gentlemen.<br />Matt: Mostly.<br />Jay: This one could get pretty wild.<br />Matt: We can handle it.<br />Jay: We’re professionals!<br />Matt: Damn right!<br />Jay: I’m outta here!<br />Matt: Me too!<br /><br />There you go kids. Be sure to tune in to <a href="http://www.blogtalkradio.com/im-with-stupid/2013/02/24/debi-daly-uncrossed" target="_blank">Debi Daly Uncrossed</a> on IWS Saturday Night at 11 PM ET as we welcome the very beautiful and talented <a href="http://www.blogtalkradio.com/debidaly1" target="_blank">Debi Daly</a> to the show! What an awesome show this is going to be!<br /><div><br /></div></div>

Matt Said Jay Said Debi Daly Edition

Matt slurs, Jay slurs, You look on with disgust and pity. Matt: Yo Yo Diggity Yo! Jay: I’m sorry I have the wrong number. Matt: Jayman is in...

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28 in 28 #22: Post-Ductility

<i>February is Book Month on A Daily Dose of Architecture. The "<a href="http://archidose.blogspot.com/search/label/28%20in%2028">28 in 28</a>" series features a different book every day of the month.</i><br /><br /><a href="http://www.papress.com/html/book.details.page.tpl?isbn=9781616890469"><b><i>Post-Ductility: Metals in Architecture and Engineering</i></b></a> edited by Michael Bell, Craig Buckley<br />Princeton Architectural Press, 2012<br />Hardcover, 272 pages<br /><br /><img alt="28-28_ductility.jpg" src="http://www.archidose.org/Blog/28-28_ductility.jpg" title="Book cover" /><br /><br />One of Columbia University GSAPP's "<a href="http://www.arch.columbia.edu/flagship-projects">flagship projects</a>" is the <a href="http://www.arch.columbia.edu/flagship-projects/materials-project">Materials Project</a>, which consists of conferences and subsequent publications on concrete, glass, metals, and plastics, with light supposedly forthcoming. When I reviewed <a href="http://www.archidose.org/writings/book-transparency.html"><i>Engineering Transparency</i></a>, the book on the glass conference, I noted that "the symposium and book are equal parts architecture and engineering, theory and practice, eye candy and data." The same can be said for <i>Post-Ductility</i>, keeping with conference chair Michael Bell's organization of the conferences into a symbiotic mix of the theoretical and the technical. (This extends to the plastics conference, <i>Permanent Change</i>, as <a href="http://archidose.blogspot.com/2011/03/permanent-change-plastics-in.html">my notes from both days</a> attest.)<br /><br />The book is structured in five sections: History and Theory, Projects (five of them), Structural Engineering, Energy and Sustainability, and Experimental Fabrications. While one of the projects, Rafael Moneo's Northwest Corner Building at Columbia (gracing the cover), embodies metal's use both as structure and decoration, the book also delves into the hidden realm of metals—reinforcing, wiring, even ducts. These other areas are in the minority in the book, but they illustrate the post in post-ductility; "the elastic capacities of materials are inextricably lost as determining values," as Bell puts it in his introduction. In other words, a host of other considerations are explored besides, for example, how steel is shaped into complex structures: the production and reuse of metals, the developments of materials scientists, and the implications of metals' pervasiveness.<br /><br />Even with this broad approach to metals, the chapter on structural engineering is a highlight, as are projects like the Northwest Corner Building that are complex structures requiring the use of steel. OMA's CCTV, the new San Francisco-Oakland Bay Bridge, and a bunch of other bridges are part of what make up the structural engineering chapter; these give a strong indication of the link between structure and formal creativity. The energy and sustainability chapter is also a highlight. Perhaps this is because the technical/engineering aspect of these chapters is a nice foil to the history and theory elsewhere in the book. A solid and concerted balance between the technical and the theoretical grounds the various ideas in practice, where thinking about materials really comes into fruition.<br /><br /><b>US: <a href="http://www.amazon.com/gp/product/1616890460/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&tag=aweeklydoseof-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1616890460" target="_blank"><img alt="Buy from Amazon.com" border="0" src="http://www.archidose.org/books/buy-from-tan.gif" /></a> CA: <a href="http://www.amazon.ca/gp/product/1616890460/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&tag=aweeklydoseof-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1616890460" target="_blank"><img alt="Buy from Amazon.ca" border="0" height="28" src="http://www.archidose.org/books/buy-from-tan-ca.gif" width="90" /></a> UK: <a href="http://www.amazon.co.uk/gp/product/1616890460/ref=as_li_qf_sp_asin_il_tl?ie=UTF8&tag=aweeklydoseof-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1616890460" target="_blank"><img alt="Buy from Amazon.co.uk" border="0" height="28" src="http://www.archidose.org/books/buy-from-tan-uk.gif" width="90" /></a></b>

28 in 28 #22: Post-Ductility

February is Book Month on A Daily Dose of Architecture. The " 28 in 28 " series features a different book every day of the month. ...

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Today's archidose #651

Here are a few photos I took of the Tallwoods Road House in Armonk, New York, designed by Arthur Witthoefft <s>in 1957 and restored by Todd Goddard and Andrew Mandolene in 2007</s>.<br /><br /><s>More information can be found at <a href="http://www.dwell.com/house-tours/article/mod-men"><i>Dwell</i></a> and <a href="http://docomomo-nytri.org/2010/09/24/new-on-the-national-register-a-magnificent-modern-in-armonk-ny/">DOCOMOMO US/NY Tri-State</a></s>.<br /><br />Update: The above struck-out text refers to a nearby house also designed by Arthur Witthoefft, not this one. Thanks to Julie for the correction.<br /><br /><a href="http://www.flickr.com/photos/archidose/8497889539/" title="Tallwoods Road House by archidose, on Flickr"><img alt="Tallwoods Road House" height="398" src="http://farm9.staticflickr.com/8523/8497889539_39104b4ddd_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8498994294/" title="Tallwoods Road House by archidose, on Flickr"><img alt="Tallwoods Road House" height="381" src="http://farm9.staticflickr.com/8511/8498994294_3f81229562_z.jpg" width="640" /></a><br /><br /><a href="http://www.flickr.com/photos/archidose/8497890057/" title="Tallwoods Road House by archidose, on Flickr"><img alt="Tallwoods Road House" height="394" src="http://farm9.staticflickr.com/8384/8497890057_9ed02dffe8_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 #651

Here are a few photos I took of the Tallwoods Road House in Armonk, New York, designed by Arthur Witthoefft in 1957 and restored by Todd God...

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Teach This! Teaching with lesson plans and ideas that rock 02/22/2013

<ul class="diigo-linkroll"> <li> <p class="diigo-link"> <a href="https://docs.google.com/spreadsheet/viewform?formkey=dGc4aFVlRy1RczNLNDc0OEtCSXZxd3c6MA#gid=0">Virtual Participants for Flat Classroom Conference 2013 Japan - Sign up Here</a> </p> <p class="diigo-description">The Flat Classroom conference is coming up March 7-10. We have an option for receiving credit (if you're international) and also for full participation. Virtual participants are an important part of our face to face conference as we seek to create experiences that flatten the conference as we collaborate in a problem-based environment. You'll have a team and work with them to create a project that can be brought to the world based upon principles that WORK. Click on this link to learn more about how you can participate in the conference remotely FOR FREE. ;-) We want you.</p> <p class="diigo-tags"> <span>tags:</span> <a href="https://www.diigo.com/user/coolcatteacher/news">news</a> <a href="https://www.diigo.com/user/coolcatteacher/teaching">teaching</a> <a href="https://www.diigo.com/user/coolcatteacher/education">education</a> <a href="https://www.diigo.com/user/coolcatteacher/flatclassroomconference">flatclassroomconference</a> <a href="https://www.diigo.com/user/coolcatteacher/japan">japan</a> <a href="https://www.diigo.com/user/coolcatteacher/tumblr">tumblr</a></p> </li> </ul><p class="diigo-ps">Posted from <a href='https://www.diigo.com'>Diigo</a>. The rest of my favorite links are <a href='https://www.diigo.com/user/coolcatteacher'>here</a>.</p>

Teach This! Teaching with lesson plans and ideas that rock 02/22/2013

Virtual Participants for Flat Classroom Conference 2013 Japan - Sign up Here The Flat Classroom conf...

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For Traumatized Caregivers, Therapy Helps - NYTimes.com

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

For Traumatized Caregivers, Therapy Helps - NYTimes.com

I recently wrote about  caregivers who experienced symptoms of traumatic-like stress , and readers responded with heart-rending stories. Man...

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