News for today's 2018

Approaching Illness as a Team at the Cleveland Clinic - NYTimes.com

10:02 AM Tukiyooo 0

Approaching Illness as a Team at the Cleveland Clinic - NYTimes.com

The Cleveland Clinic , long considered a premier medical system, is gaining new renown for innovation in improving the quality of care whil...

Some Weight Loss Myths

7:29 AM Tukiyooo 0

<div dir="ltr" style="text-align: left;" trbidi="on"><br /><div style="text-align: justify;"><b><span style="font-size: large;"><span style="color: #274e13;">Myths seem to appear daily particularly in areas like health, nutrition, and weight-loss; it is difficult at times to separate the weight loss myths and fact from what is true. Here are some weight loss myths :</span></span></b></div><br /><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9Z2ujWr8K30yWA6124n0s-xCG5ieBLAA5NWwyQPuT0Vo8LOXhwWY6YZa3_KUqb_nVAA3QSPnML3-588JQuiNaNeEqM2ygfJWFt47rXGC3mRLS9AIGd59eUnMYDh-Y2OyBNiu1cVI6p2I/s1600/myths.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="225" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9Z2ujWr8K30yWA6124n0s-xCG5ieBLAA5NWwyQPuT0Vo8LOXhwWY6YZa3_KUqb_nVAA3QSPnML3-588JQuiNaNeEqM2ygfJWFt47rXGC3mRLS9AIGd59eUnMYDh-Y2OyBNiu1cVI6p2I/s320/myths.gif" width="320" /></a></div><br /><br /><br /><span style="color: red;"><span style="font-size: large;"> <b><<span style="font-size: large;">1</span>></b> Starving myself is the best way to lose weight</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">Crash diets are unlikely to result in long-term weight loss. In fact, they can sometimes lead to longer term weight gain. The main problem is that this type of diet is too hard to maintain. Your body will be low on energy, causing you to crave high-fat and high-sugar foods. When you finally give in and eat those foods, you will often eat more calories than you need, causing weight gain</span></div><br /><br /><span style="color: red;"><span style="font-size: large;"><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">2</span>></b></span></span> Skipping meals is a good way to lose weight</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">How many of haven't tried this one? And we all know the result, but somehow we are tempted to try over and over again, swearing that 'this time it will be different.' The end result is over eating at the next meal or at the end of the day. And that 'over eating' usually consists of many more calories by the end of the day. The reason, your body needs nutrients. When you try to fight the body it will win. So, eat healthy, eat several small means, and don't try and trick the body, it doesn't work.</span></div><br /><br /><span style="color: red;"><span style="font-size: large;"><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">3</span>></b></span></span> If you're not thin then you are not healthy.</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">we all need to realize that we come in different shapes and sizes and this is very hard to change (even for some people who want to gain weight). Even if you have difficulty in losing excess fat keep up the exercise program. The internal benefits, that you can not see in the mirror, are more important than the external benefits e.g. lower blood pressure, increased cardiovascular capacity, lower cholesterol, lower chance of diabetes, etc.</span></div><br /><br /><span style="color: red;"><span style="font-size: large;"><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">4</span>></b></span></span> Slimming pills are effective for long-term weight loss</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">No, they're not. Slimming pills alone will not help you keep the weight off long term. They should only be used when prescribed by a doctor.</span></div><br /><br /><span style="font-size: large;"><span style="color: red;"><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">5</span>></b></span></span> I will not lose weight while eating at night</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">Simply not true. Again, it is a total calories consumed compared to total calories used. However, the tendency is that what we eat late at night is usually unhealthy. E.g. pizza, chicken wings, chips, etc.</span></div><br /> <br /><center><script type="text/javascript"></script><script type="text/javascript" src="http://pagead2.googlesyndication.com/pagead/show_ads.js"></script><br /><br /></center> <br /><span style="font-size: large;"><span style="color: red;"><span style="color: red;"><span style="font-size: large;"><b><6<span style="font-size: large;"></span>></b></span></span> I need to cut calories to lose weight faster</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">Weight Loss Truth: Cutting your calories down might be a great thing, if you are drastically overeating and stuffing your face. However, if you are eating proportionally then cutting calories might have an aversive affect. If you are cutting calories and are starving your body, then that will lower your metabolism, or in other words slow it down, which may result in you actually not losing any weight at all, even if you are "cutting calories"</span></div><br /><br /><span style="font-size: large;"><span style="color: red;"><b><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">7</span>></b></span></span></b> Healthy foods are more expensive</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">In fact, healthy foods are not necessarily more expensive than their unhealthy alternatives. You'll typically pay more for a high-fat, high-salt ready meal than you would if you had bought fresh ingredients and made the meal yourself. </span></div><br /><br /><span style="font-size: large;"><span style="color: red;"><b><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">8</span>></b></span></span></b> Eating healthy is too hard</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">Weight Loss Fact: Eating healthy is the simplest thing in the world.....once you have trained yourself to do it. How many times have you placed a goal to lose weight or to "eat better"? The first few days you are doing great, eating all kinds of foods which you normally wouldn't eat. Then something funny started to happen, you went back to your old habits and behaviors. This has happened to you in other areas outside of your health. It could be with making money, looking for a new job, or in your relationships. Creating a new habit takes time because our brain's do not like change. Change to the brain is dangerous. </span></div><br /><br /><span style="font-size: large;"><span style="color: red;"><b><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">9</span>></b></span></span></b> Drinking water helps you lose weight</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">Water does not cause you to lose weight, but it does keep you hydrated, and might help you snack less. Water is essential for good health and wellbeing. Sometimes thirst can be mistaken for hunger; if you're thirsty you may snack more. Drink around two litres of fluid a day.</span></div><br /><br /><span style="font-size: large;"><span style="color: red;"><b><span style="color: red;"><span style="font-size: large;"><b><<span style="font-size: large;">1</span>0></b></span></span></b> I am too fat and too far down the road to begin</span></span><br /><br /><div style="text-align: justify;"><span style="font-size: large;">Weight Loss Fact: A long journey begins one step at a time. It is natural to expect instantaneous results and to even fear the road ahead of you; especially if you are extremely overweight. The secret here is to make SMALL incremental changes. Don't expect perfection because that will lead you to disappointment. You are never too far down the road to where you cannot see the sun's light..</span></div> <br /> <br /><center><script type="text/javascript"></script><script type="text/javascript" src="http://pagead2.googlesyndication.com/pagead/show_ads.js"></script><br /><br /></center> <br /><br /></div>

Weight Loss Some Weight Loss Myths

Myths seem to appear daily particularly in areas like health, nutrition, and weight-loss; it is difficult at times to separate the weight lo...

It's a long long way to......

2:56 AM Tukiyooo 0

It's a long long way to......

Wow what a trip! Left our house at 5am to catch the coach to Dublin Airport. Boarded our flight to Atlanta at 8.30am and then arrived there...

Daily Education and Technology News for Schools 12/25/2012

1:30 AM Tukiyooo 0

<ul class="diigo-linkroll">      <li>      <p class="diigo-link">                <a href="http://www.zdnet.com/buying-streaming-and-storing-your-music-one-place-to-do-it-all-7000004473/">Buying, streaming, and storing your music: One place to do it all? | ZDNet</a>      </p>      <p class="diigo-description">An interesting overview of the different cloud matching services - interestingly the Apple iTunes Match (the most expensive option) will UPGRADE the quality of the music it matches for you, even if you have a lower quality version. Otherwise, as you make up your mind what to do, you'll want to read this article.</p>              <p class="diigo-tags">          <span>tags:</span>                      <a href="http://www.diigo.com/user/coolcatteacher/news">news</a>            <a href="http://www.diigo.com/user/coolcatteacher/music">music</a>            <a href="http://www.diigo.com/user/coolcatteacher/amazon">amazon</a>            <a href="http://www.diigo.com/user/coolcatteacher/itunes">itunes</a>            <a href="http://www.diigo.com/user/coolcatteacher/google">google</a></p>                                        </li>      <li>      <p class="diigo-link">                <a href="http://www.amazon.com/b?ie=UTF8&node=2658409011">Get Started with the Amazon MP3 Store and Cloud Player</a>      </p>      <p class="diigo-description">The Amazon mp3 store and cloud player is another option for your music. If you've been buying music from Amazon, you already have some music in the cloud - I have to buy it on Amazon for the senior tribute movies I make for graduation because iTunes has so much DRM protection that it is hard to find music that I can use in the movies. </p>              <p class="diigo-tags">          <span>tags:</span>                      <a href="http://www.diigo.com/user/coolcatteacher/news">news</a>            <a href="http://www.diigo.com/user/coolcatteacher/amazon">amazon</a>            <a href="http://www.diigo.com/user/coolcatteacher/music">music</a>            <a href="http://www.diigo.com/user/coolcatteacher/apps">apps</a></p>                                        </li>      <li>      <p class="diigo-link">                <a href="http://lifehacker.com/google-music/">Google music News, Videos, Reviews and Gossip - Lifehacker</a>      </p>      <p class="diigo-description">I've been looking at cloud based music services - the Lifehacker people seem to recommend Google music (even if you have an ios device) although if you have more than 20,000 songs you may want to go with Amazon music for $25 a year for 250,000. iTunes Match is $25 a month no matter how much you have and will store everything in the cloud but it is expensive. As for me, I'm going to be setting up google music. Interestingly, some of the coolest gifts we give ourselves are apps in the cloud. this article shares all about Google music.</p>              <p class="diigo-tags">          <span>tags:</span>                      <a href="http://www.diigo.com/user/coolcatteacher/news">news</a>            <a href="http://www.diigo.com/user/coolcatteacher/google">google</a>            <a href="http://www.diigo.com/user/coolcatteacher/music">music</a></p>                                        </li>      <li>      <p class="diigo-link">                <a href="http://lifehacker.com/5859854/how-to-set-up-gmail-google-calendar-and-google-contacts-on-ios">How to Set Up Gmail, Google Calendar, and Google Contacts (Properly) on iOS</a>      </p>      <p class="diigo-description">Caldav is what lifehacker recommends as an alternative to Google sync (which is going away January 31). I've been searching for an alternative to help our office manager figure out what to do. Lifehacker referenced this on their podcast from this week as still being currently the best way to replace Google calendar sync. </p>              <p class="diigo-tags">          <span>tags:</span>                      <a href="http://www.diigo.com/user/coolcatteacher/news">news</a>            <a href="http://www.diigo.com/user/coolcatteacher/apps">apps</a>            <a href="http://www.diigo.com/user/coolcatteacher/gmail">gmail</a>            <a href="http://www.diigo.com/user/coolcatteacher/google">google</a>            <a href="http://www.diigo.com/user/coolcatteacher/outlook">outlook</a>            <a href="http://www.diigo.com/user/coolcatteacher/microsoft">microsoft</a></p>                                        </li>      <li>      <p class="diigo-link">                <a href="http://www.techweekeurope.co.uk/news/facebook-europe-right-to-be-forgotten-tracking-101253/attachment/steganos-infographic">Steganos infographic - data privacy » TechWeekEurope UK</a>      </p>      <p class="diigo-description">The biggest privacy offenders (hat tip Lifehacker podcast) include Facebook, gmail, MSN Live, Skype, Twitter, Dropbox, Google Plus. This demonstrates whoch internet service providers share your personal data without an official court order. If you look at the infographic, you'll see that Facebook is more than twice the second offender, gmail. Many concerned about privacy are moving to services like PATH for just that reason.</p>              <p class="diigo-tags">          <span>tags:</span>                      <a href="http://www.diigo.com/user/coolcatteacher/news">news</a>            <a href="http://www.diigo.com/user/coolcatteacher/privacy">privacy</a>            <a href="http://www.diigo.com/user/coolcatteacher/edtech">edtech</a>            <a href="http://www.diigo.com/user/coolcatteacher/digiteen">digiteen</a>            <a href="http://www.diigo.com/user/coolcatteacher/tumblr">tumblr</a></p>                                        </li>      <li>      <p class="diigo-link">                <a href="http://www.digitaltrends.com/social-media/guardian-pulls-facebook-reader-app/">Guardian wants control over its content, pulls Facebook Social Reader | Digital Trends</a>      </p>      <p class="diigo-description">Guardian has pulled its social media sharing app from Facebook (it is my understanding Wall Street Journal has too as discussed on the TWIT.tv - this week in tech show). As I'm wrapping and washing clothes, I'm listening to Twit on the iCatcher app to keep up with things. Many like the Downcast app, but iCatcher has always worked for me.</p>              <p class="diigo-tags">          <span>tags:</span>                      <a href="http://www.diigo.com/user/coolcatteacher/news">news</a>            <a href="http://www.diigo.com/user/coolcatteacher/apps">apps</a>            <a href="http://www.diigo.com/user/coolcatteacher/facebook">facebook</a></p>                                        </li>  </ul><p class="diigo-ps">Posted from <a href='http://www.diigo.com'>Diigo</a>. The rest of my favorite links are <a href='http://www.diigo.com/user/coolcatteacher'>here</a>.</p>

Daily Education and Technology News for Schools 12/25/2012

Buying, streaming, and storing your music: One place to do it all? | ZDNet An interesting overview o...

Best of Worst of Chrstimas

9:00 PM Tukiyooo 0

<div dir="ltr" style="text-align: left;" trbidi="on"><br />Hola and Feliz Navidad y’all! Since it’s Christmas, and Matt-Man spoke more eloquently on why Christmas is for everyone yesterday, I thought I would just go with some good old fashioned Christmas Lists. Damn right bitches!<br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhq89oXUj7TLN0NP1z0QxiUTIDbjnvDoU79wGls02ZL7C80O8ZSbDErcxDzuwS4eAHoGWDhRFc2XBwz_s-J1wTGfqQ5jt0Gz0yciy8eVSx7xcRmZhHANV_mLq7vH7uESwVe50hQdtnLyVg/s1600/Katy+Perry+Nude+Christmas+Hot+Sexy.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/AVvXsEhq89oXUj7TLN0NP1z0QxiUTIDbjnvDoU79wGls02ZL7C80O8ZSbDErcxDzuwS4eAHoGWDhRFc2XBwz_s-J1wTGfqQ5jt0Gz0yciy8eVSx7xcRmZhHANV_mLq7vH7uESwVe50hQdtnLyVg/s320/Katy+Perry+Nude+Christmas+Hot+Sexy.jpg" width="198" /></a></div><b>Best Christmas Movies*: </b><br /><br />1. A Christmas Story<br />2. Ernest Saves Christmas<br />3. White Christmas<br />4. Fred Claus<br />5. Miracle on 34th Street (1947 version)<br /><br /><b>Worst Christmas Movies: </b><br /><br />1. It’s a Wonderful Life<br />2. Home Alone<br />3. The Santa Claus<br />4. Deck the Halls<br />5. Prancer<br /><br />*Because “A Christmas Carol” is the greatest Christmas movie of all time, and it’s been done so many times, I will now list the best versions of “A Christmas Carol” …<br /><br />1. Scrooge (The Musical, 1970 version w/ Albert Finney)<br />2. The Muppet Christmas Carol<br />3. Scrooged<br />4. A Christmas Carol (1984 version w/ George C. Scott)<br />5. Rich Little’s “A Christmas Carol” which is no longer available.<br /><br /><b>Best Christmas Songs (Religious)</b><br /><br />1. Carol of the Bells<br />2. Silent Night<br />3. Little Drummer Boy<br />4. Joy to the World<br />5. O Holy Night<br /><br /><b>Best Christmas Songs (Secular)</b><br /><br />1. Rudolph the Red Nosed Reindeer<br />2. Frosty the Snow Man<br />3. White Christmas<br />4. I’ll be Home for Christas<br />5. The Christmas Song<br /><br /><b>Worst Christmas Songs </b><br /><br />1. Jingle Bell Rock<br />2. Rocking Around the Christmas Tree<br />3. Anything by Justin Bieber<br />4. Grandma Got Run Over by a Reindeer<br />5. Baby it’s Cold Outside (Date Rape Anthem)<br /><br /><b>Best Christmas TV Special</b><br /><br />1. Charlie Brown Christmas<br />2. Rudolph the Red Nosed Reindeer<br />3. The Grinch Who Stole Christmas<br />4. Frosty the Snowman<br />5. Santa Claus is Coming to Town<br /><br /><b>Worst Christmas TV Special </b><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://i.imgur.com/IXADv.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="http://i.imgur.com/IXADv.gif" width="265" /></a></div>1. Anything that is a sequel to one of the classic shows.<br />2. Anything on the Hallmark Channel<br />3. Anything on the Lifetime Network<br />4. Anything on OWN<br /><br /><b>Best Christmas Treats: </b><br /><br />1. Fudge<br />2. Cookies w/ Icing<br />3. Pecan Pie<br />4. Bourbon Balls<br />5. Red Velvet Cupcakes<br /><br /><b>Worst Christmas Treats:</b><br /><br />1. Peppermint Anything<br />2. Coconut Anything<br />3. Oatmeal Anything<br /><br />Okay, that pretty much covers the Best and Worst of Christmas and it’s just about time for A Christmas Story anyway. So on behalf of IWS World Media to all of you: Merry Christmas!! We love you all!<br /><br />Jayman<br /><a href="mailto:Jayman3768@gmail.com">Jayman3768@gmail.com</a><br /><a href="http://www.twitter.com/jayman_iws" target="_blank">@Jayman_IWS </a><br /><br /></div>

Best of Worst of Chrstimas

Hola and Feliz Navidad y’all! Since it’s Christmas, and Matt-Man spoke more eloquently on why Christmas is for everyone yesterday, I thought...

merry vacation to all

6:22 PM Anonymous 0

I had grand plans to have a whole house tour and shovel out one last dose of Christmas cheer. However, the cheer of real life got in the way and I'm having too much fun to sit still long enough to put together a proper tour. So these pictures will have to do.<br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUttxhK0S5XjPmH0Jge7-o1GyRUDVUg04ZK-IZ7bwtB5kOAtZivtDxiV7xIPD-n_EvOHsbc22xDOKGIz2xrRX4Z557GYyS3UMK1UBNrCV2p75yUQDe2IDftX6sjeMVEY1owxliFT3azwmz/s1600/BlueandWhiteChristmas2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUttxhK0S5XjPmH0Jge7-o1GyRUDVUg04ZK-IZ7bwtB5kOAtZivtDxiV7xIPD-n_EvOHsbc22xDOKGIz2xrRX4Z557GYyS3UMK1UBNrCV2p75yUQDe2IDftX6sjeMVEY1owxliFT3azwmz/s640/BlueandWhiteChristmas2.jpg" width="632" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHzbqviwHk0OpuNYmA90rPH_P7lsPoIIkJlZvjHjkK2tMgTMFDmE7DfILIPQqgQGc-FIffyKykOVKZ_eAYTaq8ZXcuACGXe-J_-MDIV1Kzjv_qcEghHi6SaEqTIPlEASTB2HldCPkT5Xpz/s1600/ChristmasOrnaments.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHzbqviwHk0OpuNYmA90rPH_P7lsPoIIkJlZvjHjkK2tMgTMFDmE7DfILIPQqgQGc-FIffyKykOVKZ_eAYTaq8ZXcuACGXe-J_-MDIV1Kzjv_qcEghHi6SaEqTIPlEASTB2HldCPkT5Xpz/s640/ChristmasOrnaments.jpg" width="640" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6q-XX8YoYYC_QT6naExlrv8F8sbpnY2EJNIc-f47OvA5OCAmtH8580RK3um4dqbpMd2Wk05BHL5HB5xwF7jClK5mBnlw5NwMS628LdpYlhP3fd6eB0IPDUHo5wZ5cWJJk6RObi8FOGo0C/s1600/christmastree.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6q-XX8YoYYC_QT6naExlrv8F8sbpnY2EJNIc-f47OvA5OCAmtH8580RK3um4dqbpMd2Wk05BHL5HB5xwF7jClK5mBnlw5NwMS628LdpYlhP3fd6eB0IPDUHo5wZ5cWJJk6RObi8FOGo0C/s640/christmastree.jpg" width="480" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8vH2_qUdz3mUYiAWwdyEStFv6QMAwBu0RleEEPBX5jE8HhtvRk5pjm6txCl7v18ATgCfKpKGjHl_HeVSMbB7PSoMG2hYKWmlhqirjqq0mj2pdakHa25THIViIQmmOnVLUiSW2zpa5bAnO/s1600/livingroomchristmas.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="590" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8vH2_qUdz3mUYiAWwdyEStFv6QMAwBu0RleEEPBX5jE8HhtvRk5pjm6txCl7v18ATgCfKpKGjHl_HeVSMbB7PSoMG2hYKWmlhqirjqq0mj2pdakHa25THIViIQmmOnVLUiSW2zpa5bAnO/s640/livingroomchristmas.jpg" width="640" /></a></div><span id="goog_1109339394"></span><span id="goog_1109339395"></span><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbsywf2Uc9b1J4u2ZRgfou56MxCf0ezqZ-DDhabHcWxFuiDjfXJUOiHwr1qsq38pMEDmc9ktX_66n1K784lGn5w5vywhOl2sZDGsc7AFNx3iuAooz1VslSdmgvgoH55C-SeMUJCn9TV_Ei/s1600/nativity.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbsywf2Uc9b1J4u2ZRgfou56MxCf0ezqZ-DDhabHcWxFuiDjfXJUOiHwr1qsq38pMEDmc9ktX_66n1K784lGn5w5vywhOl2sZDGsc7AFNx3iuAooz1VslSdmgvgoH55C-SeMUJCn9TV_Ei/s640/nativity.jpg" width="640" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7ILUFqe1xh0OSgPssQhoBXjH2o3gSGwS0tJJQKfqU8Mv8i3VPxQWRxGgeJTjZ4idpE8_PftV18VpWEJskTth9SWvM086fM8r3OsX5sy0g7KvUh9agBFNis9tFbH9mO8jAnUU2fgSE5xJD/s1600/peppermintwreath.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7ILUFqe1xh0OSgPssQhoBXjH2o3gSGwS0tJJQKfqU8Mv8i3VPxQWRxGgeJTjZ4idpE8_PftV18VpWEJskTth9SWvM086fM8r3OsX5sy0g7KvUh9agBFNis9tFbH9mO8jAnUU2fgSE5xJD/s640/peppermintwreath.jpg" width="640" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhF0vrZAV1Pa9RbRZco526-JvXYqAByWXfZ6dhs37U19PAKqwTVcTpb_Dhh-l4hVoXbe72lQIALWHjRCmPzPjeWqCgfL58vAEt3uiUA6wkpX1f8BjWk6JGNppm3NPyX_znG9B_cHlPX7mwe/s1600/peppermintwreath2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhF0vrZAV1Pa9RbRZco526-JvXYqAByWXfZ6dhs37U19PAKqwTVcTpb_Dhh-l4hVoXbe72lQIALWHjRCmPzPjeWqCgfL58vAEt3uiUA6wkpX1f8BjWk6JGNppm3NPyX_znG9B_cHlPX7mwe/s640/peppermintwreath2.jpg" width="640" /></a></div><br />Merry Christmas and see you in the new year!!

Christmas merry vacation to all

I had grand plans to have a whole house tour and shovel out one last dose of Christmas cheer. However, the cheer of real life got in the way...

Ted Kaptchuk of Harvard Medical School studies placebos | Harvard Magazine

8:04 AM Tukiyooo 0

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div class="node-body" style="color: rgb(17, 17, 17); font-family: 'helvetica neue', helvetica, arial, sans-serif; font-size: medium; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; "><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; "><span class="firstwords" style="text-transform: uppercase; font-size: 13px; letter-spacing: 1px; ">TWO WEEKS INTO</span> <a href="http://www.bidmc.org/Research/Departments/Medicine/Divisions/GeneralMedicineandPrimaryCare/ResearchFaculty/Kaptchuk.aspx" style="color: rgb(167, 25, 48); text-decoration: none; ">Ted Kaptchuk</a>'s first randomized clinical drug trial, nearly a third of his 270 subjects complained of awful side effects. All the patients had joined the study hoping to alleviate severe arm pain: carpal tunnel, tendinitis, chronic pain in the elbow, shoulder, wrist. In one part of the study, half the subjects received pain-reducing pills; the others were offered acupuncture treatments. And in both cases, people began to call in, saying they couldn't get out of bed. The pills were making them sluggish, the needles caused swelling and redness; some patients' pain ballooned to nightmarish levels. "The side effects were simply amazing," Kaptchuk explains; curiously, they were exactly what patients had been warned their treatment might produce. But even more astounding, most of the other patients reported real relief, and those who received acupuncture felt even better than those on the anti-pain pill. These were exceptional findings: no one had ever proven that acupuncture worked better than painkillers. But Kaptchuk's study didn't prove it, either. The pills his team had given patients were actually made of cornstarch; the "acupuncture" needles were retractable shams that never pierced the skin. The study wasn't aimed at comparing two treatments. It was designed to compare two fakes.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Although Kaptchuk, an associate professor of medicine, has spent his career studying these mysterious human reactions, he doesn't argue that you can simply "think yourself better." "Sham treatment won't shrink tumors or cure viruses," he says.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">But researchers <em>have</em> found that placebo treatments—interventions with no active drug ingredients—can stimulate real physiological responses, from changes in heart rate and blood pressure to chemical activity in the brain, in cases involving pain, depression, anxiety, fatigue, and even some symptoms of Parkinson's.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">The challenge now, says Kaptchuk, is to uncover the mechanisms behind these physiological responses—what is happening in our bodies, in our brains, in the method of placebo delivery (pill or needle, for example), even in the room where placebo treatments are administered (are the physical surroundings calming? is the doctor caring or curt?). The placebo effect is actually many effects woven together—some stronger than others—and that's what Kaptchuk hopes his "pill versus needle" study shows. The experiment, among the first to tease apart the components of placebo response, shows that the <em>methods</em> of placebo administration are as important as the administration itself, he explains. It's valuable insight for any caregiver: patients' perceptions matter, and the ways physicians frame perceptions can have significant effects on their patients' health.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">For the last 15 years, Kaptchuk and fellow researchers have been dissecting placebo interventions—treatments that, prior to the 1990s, had been studied largely as foils to "real" drugs. To prove amedicine is effective, pharmaceutical companies must show not only that their drug has the desired effects, but that the effects are significantly greater than those of a placebo control group. Both groups often show healing results, Kaptchuk explains, yet for years, "We were struggling to increase drug effects while no one was trying to increase the <em>placebo</em> effect."</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Last year, he and colleagues from several Harvard-affiliated hospitals created the Program in Placebo Studies and the Therapeutic Encounter (PiPS), headquartered at Beth Israel Deaconess Medical Center—the only multidisciplinary institute dedicated solely to placebo study. It's a nod to changing attitudes in Western medicine, and a direct result of the small but growing group of researchers like Kaptchuk who study not <em>if,</em> but <em>how,</em> placebo effects work. Explanations for the phenomenon come from fields across the scientific map—clinical science, psychology, anthropology, biology, social economics, neuroscience. Disregarding the knowledge that placebo treatments can affect certain ailments, Kaptchuk says, "is like ignoring a huge chunk of healthcare." As caregivers, "we should be using every tool in the box."</p><p class="newsection" style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 40px; "><span class="firstwords" style="text-transform: uppercase; font-size: 13px; letter-spacing: 1px; ">WESTERN MEDICINE</span>, however, has been slow to agree with him—partly because of his message, and in his case, often because of the messenger. An acupuncturist by training, he is an unlikely leader in the halls of academia. With a degree in Chinese medicine from an institute in Macao, Kaptchuk is one of the few faculty members at Harvard Medical School (HMS) with neither a Ph.D. nor M.D.—"a debit, not a credit at most medical schools," says Finland professor of clinical pharmacology emeritus Peter Goldman, one of his early Harvard advisers. (Kaptchuk's diploma is recognized as a doctorate in many states, but not in Massachusetts.) When Kaptchuk came to Harvard in 1995, "he knew about Chinese herbs and healing needles, and he'd written a very fine book on Chinese medicine [<em>The Web That Has No Weaver </em>(1983)]," says Goldman, "but he didn't know the first thing about how to conduct clinical studies."</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Kaptchuk joined the faculty as an instructor in medicine and apprenticed himself to several seasoned clinicians and investigators. Within a few years, he was winning National Institutes of Health grants and publishing in medicine's top journals. "What his colleagues saw was a fierce intellect and curiosity," said Goldman. "He was asking questions no one was asking."</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Ironically, says Kaptchuk, it was his success as an acupuncturist that made him leave the profession for academia. "Patients who came to me got better," he says, but sometimes their relief began even before he'd started his treatments. He didn't doubt the value of acupuncture, but he suspected something else was at work. His hunch was that it was his engagement with patients—and perhaps even the act of caring itself.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">For his ideas to gain traction with Western doctors, however, Kaptchuk knew he needed scientific proof. His chance would come in the early 2000s in a collaboration with gastroenterologists studying irritable bowel syndrome (IBS), a chronic gastrointestinal disorder accompanied by pain and constipation. The experiment split 262 adults with IBS into three groups: a no-treatment control group, told they were on a waiting list for treatment; a second group who received sham acupuncture without much interaction with the practitioner; and a third group who received sham acupuncture with great attention lavished upon them—at least 20 minutes of what Kaptchuk describes as "very schmaltzy" care ("I'm so glad to meet you"; "I know how difficult this is for you"; "This treatment has excellent results"). Practitioners were also required to touch the hands or shoulders of members of the third group and spend at least 20 seconds lost in thoughtful silence.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">The results were not surprising: the patients who experienced the greatest relief were those who received the most care. But in an age of rushed doctor's visits and packed waiting rooms, it was the first study to show a "dose-dependent response" for a placebo: the more care people got—even if it was fake—the better they tended to fare.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Kaptchuk's innovative studies were among the first to separate components of the placebo effect, explains Applebaum professor of medicine Russell Phillips, director of the Center for Primary Care at HMS. For years, doctor-patient interactions were lumped into a generic "placebo response": a sum of such variables as patients' reporting bias (a conscious or unconscious desire to please the researchers); patients simply responding to doctors' attention; the different methods of placebo delivery; and symptoms subsiding without treatment—the inevitable trajectory of most chronic ailments. "There was simply no way to quantify the ritual of medicine," says Phillips of the doctor-patient interaction. And the ritual, he adds, is the one finding from placebo research that doctors can apply to their practice immediately.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">But other placebo treatments (sham acupuncture, pills, or other fake interventions) are nowhere near ready for clinical application—and Kaptchuk is not recommending that they should be. Such treatments all require deception on the part of doctors, an aspect of placebo medicine that raises serious ethical questions for practitioners.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">This was disturbing for Kaptchuk, too; deception played no role in his own success as a healer. But years of considering the question led him to his next clinical experiment: What if he simply <em>told</em> people they were taking placebos? The question ultimately inspired a pilot study, published by the peer-reviewed science and medicine journal <em>PLOS ONE </em>in 2010, that yielded his most famous findings to date. His team again compared two groups of IBS sufferers. One group received no treatment. The other patients were told they'd be taking fake, inert drugs (delivered in bottles labeled "placebo pills") and told also that placebos often have healing effects.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">The study's results shocked the investigators themselves: even patients who <em>knew</em>they were taking placebos described real improvement, reporting twice as much symptom relief as the no-treatment group. That's a difference so significant, says Kaptchuk, it's comparable to the improvement seen in trials for the best <em>real</em> IBS drugs.</p><p class="newsection" style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 40px; "><span class="firstwords" style="text-transform: uppercase; font-size: 13px; letter-spacing: 1px; ">ALTHOUGH</span> this IBS "open-label" study was small and has yet to be replicated, fellow placebo researcher Frank Miller of the department of bioethics at the National Institutes of Health considers it a significant step toward legitimizing placebo studies. But to really change minds in mainstream medicine, Miller says, researchers have to show biological evidence that minds actually <em>change—</em>a feat achieved only in the last decade through imaging technology such as positron emission tomography (PET) scans and functional magnetic resonance imaging (fMRI).</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">The first evidence of a physiological basis for the placebo effect appeared in the late 1970s, when researchers studying dental patients found that by chemically blocking the release of endorphins—the brain's natural pain relievers—scientists could also block the placebo effect. This suggested that placebo treatments spurred chemical responses in the brain that are similar to those of active drugs, a theory borne out two decades later by brain-scan technology. Researchers like neuroscientist Fabrizio Benedetti at the University of Turin have since shown that many neurotransmitters are at work—including chemicals that use the same pathways as opium and marijuana. Studies by other researchers have shown that placebos increase dopamine (a chemical that affects emotions and sensations of pleasure and reward) in the brains of Parkinson's patients, and patients suffering from depression who've been given placebos reveal changes in electrical and metabolic activity in several different regions of the brain.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Kaptchuk's team has investigated the neural mechanisms of placebos in collaboration with the Martinos Center for Biomedical Imaging at Massachusetts General Hospital. In two fMRI studies published in the <em>Journal of Neuroscience</em> in 2006 and 2008, they showed that placebo treatments affect the areas of the brain that modulate pain reception, as do <em>negative</em> side effects from placebo treatment—"nocebo effects." (<em>Nocebo</em> is Latin for "I shall harm"; <em>placebo</em> means "I shall please.") But nocebo effects also activate the hippocampus, a different area associated with memory and anxiety. As happened with Kaptchuk's patients in the "pill versus needle" study, the headaches, nausea, insomnia, and fatigue that result from fake treatments can be painfully real, afflicting about a quarter of those assigned to placebo treatment in drug trials(see <a href="http://harvardmagazine.com/2005/05/the-nocebo-effect.html" style="color: rgb(167, 25, 48); text-decoration: none; ">"The Nocebo Effect,"</a> May-June 2005). "What we 'placebo neuroscientists'…have learned [is] that therapeutic rituals move a lot of molecules in the patients' brain, and these molecules are the very same as those activated by the drugs we give in routine clinical practice," Benedetti wrote in an e-mail. "In other words, rituals and drugs use the very same biochemical pathways to influence the patient's brain." It's those advances in "hard science," he added, that have given placebo research a legitimacy it never enjoyed before.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">This new visibility has encouraged not only research funds but also interest from healthcare organizations and pharmaceutical companies. As healthcare companies increasingly reward doctors for maintaining patients' health (rather than for the number of procedures they perform), "research like Ted's becomes increasingly relevant," says Minot professor of medicine and HMS dean for graduate education David Golan, a professor of biological chemistry and molecular pharmacology.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">This year, the Robert Wood Johnson Foundation, the nation's largest philanthropy focused on health and healthcare, awarded Kaptchuk's PiPS program a $250,000 grant to support a series of seminars at Harvard designed to connect placebo experts with researchers in related fields. And the latest findings to emerge from PiPS—a 2012 study showing that genetic variations may explain why only certain people respond to placebo effects—has caught the attention of the Food and Drug Administration.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">That study, published last October in <em>PLOS ONE</em>, showed that patients with a certain variation of a gene linked to the release of dopamine were more likely to respond to sham acupuncture than patients with a different variation—findings that could change the way pharmaceutical companies conduct drug trials, says Gunther Winkler, principal of ASPB Consulting, LLC, which advises biotech and pharmaceutical firms. Companies spend millions of dollars and often decades testing drugs; every drug must outperform placebos if it is to be marketed. "If we can identify people who have a low predisposition for placebo response, drug companies can preselect for them," says Winkler. "This could seriously reduce the size, cost, and duration of clinical trials…bringing cheaper drugs to the market years earlier than before."</p><p class="newsection" style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 40px; "><span class="firstwords" style="text-transform: uppercase; font-size: 13px; letter-spacing: 1px; ">NOT ALL OF</span> Kaptchuk's studies have been so warmly received. Though few academics quarrel with the quality of his research, he's remained a prime target for such watchdog groups as Quackwatch and The Skeptics' Society, organizations that question nonconventional medical approaches. (Other well-known targets include Deepak Chopra, Andrew Weil '63, M.D. '68, and the late Nobel Prize winner Linus Pauling.) In 2011, he and a team of researchers published a paper in <em>The New England Journal of Medicine</em> (<em>NEJM</em>) that raised the hackles of some of his fiercest critics.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">That<em> </em>paper (praised by scholars as one of the most carefully controlled and definitive placebo studies ever done) described a study of 40 asthma patients given four different interventions: active treatments with real albuterol inhalers; placebo treatments with fake inhalers that delivered no medication; sham acupuncture treatments; and intervals with no treatment at all. The patients returned for 12 sequential visits, receiving each<em> </em>type of treatment three times—a novel approach in placebo study that created a large amount of data (480 treatments in total) and turned subjects into their own controls (if patients are compared to themselves from one treatment to the next, researchers can eliminate subjects' individual differences as a variable). The researchers had hoped to find improved lung function with both the real and sham treatments; what they found instead was that only the real treatment yielded results—the others showed no significant improvement. Yet when Kaptchuk's team measured patients' own assessments of improvement, the researchers found no difference reported between the real and sham treatments: the patients'<em>subjective</em> responses directly contradicted their own <em>objective</em> physical measures.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">To Dr. Harriet Hall, a retired family physician who writes critically about alternative and complementary medicine for such publications as <em>Skeptic Magazine</em>and<em> Skeptical Inquirer</em>,<em> </em>this discrepancy between objective and subjective results is precisely where the danger lies. As she told a reporter for <em>The Atlantic</em> in December 2011, following the publication of Kaptchuk's <em>NEJM </em>study, "Asthma can be fatal. If the patient's lung function is getting worse but a placebo makes them feel better, they might delay treatment until it is too late."</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">To Kaptchuk's team, on the other hand, the conflicting results not only reveal important lessons for researchers and clinicians, but illuminate a gap that is central to placebo research. "Placebos have limitations, and we need to know what they are," Kaptchuk says. "We'd hoped for measurable objective changes in breathing; what we got instead was a more precise diagram of placebo effects and how clearly the ritual of medicine makes people more comfortable." That in itself is important information, he says. "Our job <em>is</em> to make people feel better," and though this study was small, "what we've really done here is open up a new set of questions." No one has yet studied how long-term experience with the ritual of medicine might ultimately affect the course of chronic afflictions, he says. "We hope we've opened up that path."</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Kaptchuk and his team have begun to take steps in that direction, continuing to ask new questions and push the boundaries of placebo research. A study published online this past year in the <em>Proceedings of the National Academy of Sciences</em>demonstrated that the placebo response can occur even at the unconscious level. The team showed that images flashed on a screen for a fraction of a second—too quickly for conscious recognition—could trigger the response,but<em> only</em> if patients had learned earlier to associate those specific images with healing. Thus, when patients enter a room containing medical equipment they associate with the possibility of feeling better, "the mind may automatically make associations that lead to actual positive health outcomes," says psychiatry research fellow Karin Jensen, the study's lead author.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">Those findings led to the team's most recent work: imaging the brains of physicians whilethey treat patients—a side of the treatment equation that no one had previously examined. (The researchers constructed an elaborate set-up in which the doctors lay in fMRI machines specially equipped to enable them both to see their patients outside the machine and administer what they thought was a nerve-stimulating treatment.) "Doctors give subtle cues to their patients that neither may be aware of," Kaptchuk explains. "They are a key ingredient in the ritual of medicine." The hope is that the new brain scans will reveal how doctors' unconscious thought figures into the treatment recipe.</p><p class="newsection" style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 40px; "><span class="firstwords" style="text-transform: uppercase; font-size: 13px; letter-spacing: 1px; ">WITHIN ACADEMIA,</span> Kaptchuk and his fellow researchers have not escaped criticism, but the voices have been few and far between. The most notable appeared in 2001 in the<em> NEJM—</em>the same publication that included Kaptchuk's asthma study a decade later<em>. </em>In a paper titled, "Is the Placebo Powerless?" two Danish researchers reviewed 114 published studies involving 7,500 patients and questioned both the research methods and the short duration of most placebo studies. Many of the trials reviewed lacked "no-treatment" groups—an important control group missing even in Kaptchuk's first "pill versus needle" study.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">But Kaptchuk's response to such criticism is perhaps as rare in academia as his pedigree. "If I remember correctly," said Asbjorn Hrobjartsson, the lead author of that 2001 paper during a recent phone conversation, "Ted was already thinking along the same lines as we were and realized [our paper] pointed out real methodological problems." When Hrobjartsson came to speak at Harvard a year later, he stayed at Kaptchuk's home, and in 2011, the two coauthored a paper (with the NIH's Frank Miller) on biases and best practices in placebo study.</p><p style="font-family: georgia, times, serif; font-size: 16px; line-height: 24px; margin-top: 0px; ">When Kaptchuk talks about Hrobjartsson's 2001 paper now, he winces, then nods with acceptance. "At first when I read it, I worried I'd be out of a job," he says. "But frankly, [Hrobjartsson] was absolutely right." In order to legitimize his findings to mainstream practitioners, the results must be expertly quantified, he acknowledges. "We have to transform the art of medicine into the science of care."</p></div><div class="byline" style="margin-top: 30px; color: rgb(17, 17, 17); font-family: 'helvetica neue', helvetica, arial, sans-serif; font-size: medium; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "></div></div><a href="http://harvardmagazine.com/2013/01/the-placebo-phenomenon">http://harvardmagazine.com/2013/01/the-placebo-phenomenon</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Ted Kaptchuk of Harvard Medical School studies placebos | Harvard Magazine

TWO WEEKS INTO Ted Kaptchuk 's first randomized clinical drug trial, nearly a third of his 270 subjects complained of awful side effec...

ISRAEL RUSSIA AND SYRIA

8:01 AM Tukiyooo 0

<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMQVW_pzdNjI-Jnz5dbNQBBWNtkh0ZCrt4eWcLbmSVKq6DPBfiXIpSXNKdPNn3NHgS2_Gp6PM5tmtoSj0N2Ud8waD2mz4aPpcCGnTfUEHQV5lMopZmOgUVj7454MjvpQbm6vztZzgZAj-n/s1600/072312_sr_henry_640.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="180" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMQVW_pzdNjI-Jnz5dbNQBBWNtkh0ZCrt4eWcLbmSVKq6DPBfiXIpSXNKdPNn3NHgS2_Gp6PM5tmtoSj0N2Ud8waD2mz4aPpcCGnTfUEHQV5lMopZmOgUVj7454MjvpQbm6vztZzgZAj-n/s320/072312_sr_henry_640.jpg" width="320" /></a></div><div style="text-align: center;"><br /></div> <br /><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 1;"><b><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman"; mso-font-kerning: 18.0pt;"><br /></span></b></div><div class="MsoNormal" style="line-height: normal; text-align: center;"><span style="color: red;"><span style="font-size: x-large;"><b><span style="font-family: "Times New Roman","serif";">ISRAEL BACKS RUSSIA’S AVOWAL THAT SYRIAN CHEMICAL ARMS ARE SECURE “FOR NOW”</span></b></span></span></div><div class="MsoNormal" style="line-height: normal; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; mso-outline-level: 1;"><br /></div><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">See related article:  <a href="http://news-these-days.blogspot.com.ar/2012/12/russian-forces-take-syrian-chemical.html">http://news-these-days.blogspot.com.ar/2012/12/russian-forces-take-syrian-chemical.html</a></span></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br /></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Via DEBKA<i>file</i></span></div><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><i> </i> </span></div><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">“At the moment, [SYRIA’S] chemical weapons are under control,” said senior ISRAELI defense official Amos Gilad, echoing the statement by RUSSIAN Foreign Minister Sergei Lavrov that “the SYRIAN<b> </b>government has “consolidated its chemical weapons in one or two locations amid a rebel onslaught and they are under control for the time being.”</span></span></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">Prime Minister Binyamin Netanyahu then said enigmatically: “We are facing a near possibility of far-reaching changes in the SYRIAN regime with ramifications for the sensitive weaponry [chemical, biological] present there.”<br />Like Lavrov’s comments, neither ISRAELI statement accounted for the sudden reversal of events in the last 48 hours in the turbulent history of its northern neighbor. As recently as Friday, Bashar Assad’s Scuds and warplanes were battling the rebels to keep his big chemical and biological warfare arsenals at the Al Safira complex near Aleppo out of the hands of al Qaeda adherents who were moving in fast on this target.</span></span><br /><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><b><span style="font-family: "Times New Roman","serif";">TWENTY FOUR HOURS LATER, THE RUSSIAN FOREIGN MINISTER ASSERTED THE WEAPONS WERE SECURE</span></b><span style="font-family: "Times New Roman","serif";">.</span></span></div><div class="MsoNormal" style="line-height: normal;"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">debkafile’s military sources disclose that the battle of al Safira was abruptly interrupted by a foreign military force which stepped in and stopped the fighting in order to commandeer the chemical and biological stocks.</span></span></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">debkafile identified this force as a <a href="http://www.debka.com/article/22627">RUSSIAN special unit.</a></span></span><br /><br /></div><div class="MsoNormal" style="line-height: normal;"><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgi9ywDpkEfnrNOEsmmrVp4ilyNQ_XcPdPE2LYdgF0bpXu4aigVQk7bOQmNlz0VChEPwIgROsh7IpcxzyhWh68BOZz8-bb2bGIXC-bxbUn5-DB5X2vo30s-rAGo4mly6ABfShu_3M4jgtn5/s1600/Fabricating-WMD-%25E2%2580%259CEvidence%25E2%2580%259D-Israeli-Covert-Operation-inside-Syria-to-%25E2%2580%259CTrack-Chemical-Arsenal%25E2%2580%259D.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="209" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgi9ywDpkEfnrNOEsmmrVp4ilyNQ_XcPdPE2LYdgF0bpXu4aigVQk7bOQmNlz0VChEPwIgROsh7IpcxzyhWh68BOZz8-bb2bGIXC-bxbUn5-DB5X2vo30s-rAGo4mly6ABfShu_3M4jgtn5/s320/Fabricating-WMD-%25E2%2580%259CEvidence%25E2%2580%259D-Israeli-Covert-Operation-inside-Syria-to-%25E2%2580%259CTrack-Chemical-Arsenal%25E2%2580%259D.jpg" width="320" /></a></div></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">The entire episode is covered in a heavy blanket of secrecy, imposed from Moscow, Washington, Jerusalem and Damascus. <b>They are using the public preoccupation with the holiday period in the West to keep it dark. </b>However, from the scraps of evidence available, it is transpires that the foreign special unit reaching al Safira gave both sides, the SYRIAN army and the rebels, an ultimatum to hold their fire until the arsenals were removed, or else this special unit would mete out crushing punishment.</span></span></div><div class="MsoNormal" style="line-height: normal;"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><b><span style="font-family: "Times New Roman","serif";">DID THE RUSSIANS CARRIED OUT THEIR OPERATION FOR THE CAPTURE OF ASSAD'S WMD ALONE, OR IN CONJUNCTION WITH THE US AND ISRAEL</span></b></span></div><div class="MsoNormal" style="line-height: normal;"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">Since then, the SYRIAN army and rebels do not appear to have resumed fighting and it is not clear which side remains in control of the al Safira military complex.</span></span></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">One of the many enigmas surrounding this episode is whether the RUSSIANS carried out their operation for the capture of Assad's WMD alone, or in conjunction with the US and ISRAEL. And whether this cooperation extended up to and including implementation, or was confined to the intelligence and preparatory stages.<br />Amos Gilad’s comment points to a measure of international cooperation. <br />Furthermore, it is not clear whether the SYRIAN ruler gave permission for the removal of his unconventional weapons out of the reach of the rebels. Neither is their destination known.  And most of all, what makes RUSSIAN and ISRAELI officials so sure that they are in safe hands?</span></span></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">In his statement Saturday, Lavrov divulged that it had been “consolidated in one or two places” and that “RUSSIAN military advisers... kept close watch over [SYRIA’S] chemical arsenal.”</span></span></div><div class="MsoNormal" style="line-height: normal;"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><b><span style="font-family: "Times New Roman","serif";">CIVIL WAR BETWEEN ASSAD AND OPPOSITION FORCES FIGHTING TO TOPPLE HIM HAD BECOME DEADLOCKED</span></b></span></div><div class="MsoNormal" style="line-height: normal;"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">The ISRAELI defense official was in rare tune with Moscow on the fate of the SYRIAN ruler. He asserted that the civil war between Assad and opposition forces fighting to topple him had become deadlocked, but that the SYRIAN leader showed no signs of heeding international calls to step down.</span></span><br /><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgc9svRmBIUIwGv3VvvZMJDRBsGj-owO780whX2tRnrsi6kAGeIjS6tZRHl-jhu4nKhgHSqSoqBYZgBcBmq4jBqCcY1tKizYW6yBt0nA9HZ5WKB52jr3b3h2ItG03JE0rxq6uJalVmcPG7v/s1600/syria_chem_weapons.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="218" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgc9svRmBIUIwGv3VvvZMJDRBsGj-owO780whX2tRnrsi6kAGeIjS6tZRHl-jhu4nKhgHSqSoqBYZgBcBmq4jBqCcY1tKizYW6yBt0nA9HZ5WKB52jr3b3h2ItG03JE0rxq6uJalVmcPG7v/s320/syria_chem_weapons.jpg" width="320" /></a></div></div><span style="font-size: large;"> </span><br /><div class="MsoNormal" style="line-height: normal;"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">"Suppose he (Assad) does leave, there could be chaos ... in the MIDDLE EAST you never know who will come instead. We need to stay level-headed; the entire world is dealing with this (another reference to multinational action in SYRIA). At the moment, chemical weapons are under control, despite the fact that President Bashar al-Assad has lost control of parts of the country," Gilad said.</span></span></div><div class="MsoNormal" style="line-height: normal;"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal"><span style="font-size: large;"><span style="color: blue; font-family: "Times New Roman","serif"; line-height: 115%;">Geopolitical Analysis and Monitoring on numerous occasions mentioned that for ISRAEL, keeping Assad in power was the better option than having the Muslim Brotherhood running the country. </span></span></div><div class="MsoNormal"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal"><span style="font-size: large;"><b><u><span style="font-family: "Times New Roman","serif"; line-height: 115%;">Background Information</span></u></b><span style="font-family: "Times New Roman","serif"; line-height: 115%;">: See </span></span></div><span style="font-size: large;"> </span><br /><div class="MsoNormal"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif"; line-height: 115%;"><a href="http://news-these-days.blogspot.com.ar/2011/12/syria-cause-and-effect.html">http://news-these-days.blogspot.com.ar/2011/12/syria-cause-and-effect.html</a></span></span></div><span style="font-size: large;"> </span><br /><div class="MsoNormal"><br /></div><span style="font-size: large;"> </span><br /><div class="MsoNormal"><span style="font-size: large;"><span style="font-family: "Times New Roman","serif"; line-height: 115%;"><a href="http://news-these-days.blogspot.com.ar/2012/06/syria-israel-iran-and-usa.html">http://news-these-days.blogspot.com.ar/2012/06/syria-israel-iran-and-usa.html</a></span></span></div><div class="MsoNormal"><br /></div>

ISRAEL RUSSIA AND SYRIA

ISRAEL BACKS RUSSIA’S AVOWAL THAT SYRIAN CHEMICAL ARMS ARE SECURE “FOR NOW” See related article: http://news-these-days.blogspot.com.ar/20...

N.Y.U. and Others Offer Shorter Courses Through Medical School - NYTimes.com

6:47 AM Tukiyooo 0

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Training to become a doctor takes so long that just the time invested has become, to many, emblematic of the gravity and prestige of the profession.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">But now one of the nation's premier <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/medical_schools/index.html?inline=nyt-classifier" title="Recent and archival health news about medical schools." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">medical schools</a>, <a href="http://topics.nytimes.com/top/reference/timestopics/organizations/n/new_york_university/index.html?inline=nyt-org" title="More articles about New York University." class="meta-org" style="color: rgb(102, 102, 153); text-decoration: none; ">New York University</a>, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Not only, they say, will those doctors be able to hang out their shingles to practice earlier, but they will save a quarter of the cost of medical school — $49,560 a year in tuition and fees at N.Y.U., and even more when room, board, books, supplies and other expenses are added in.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"We're confident that our three-year students are going to get the same depth and core knowledge, that we're not going to turn it into a trade school," said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. School of Medicine.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">At this point, the effort involves a small number of students at three medical schools: about 16 incoming students at N.Y.U., or about 10 percent of next year's entering class; 9 at Texas Tech Health Science Center School of Medicine; and even fewer, for now, at Mercer University School of Medicine's campus in Savannah, Ga. A similar trial at Louisiana State University has been delayed because of budget constraints.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">But Dr. Steven Berk, the dean at Texas Tech, said that 10 or 15 other schools across the country had expressed interest in what his university was doing, and the deans of all three schools say that if the approach works, they will extend the option to larger numbers of students.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"You're going to see this kind of three-year pathway become very prominent across the country," Dr. Abramson predicted.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The deans say that getting students out the door more quickly will accomplish several goals. By speeding up production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools enrolled more students in the future.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The three-year program would also curtail student debt, which now averages $150,000 by graduation, and by doing so, persuade more students to go into shortage areas like <a href="http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/pediatrics/index.html?inline=nyt-classifier" title="Recent and archival health news about pediatrics." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">pediatrics</a> and internal medicine, rather than more lucrative specialties like dermatology.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The idea was supported by Dr. Ezekiel J. Emanuel, a former health adviser to President Obama, and a colleague, Victor R. Fuchs. In an <a href="http://jama.jamanetwork.com/article.aspx?articleid=1105095" style="color: rgb(102, 102, 153); text-decoration: none; ">editorial</a> in the Journal of the American Medical Association in March, they said there was "substantial waste" in the nation's medical education. "Years of training have been added without evidence that they enhance clinical skills or the quality of care," they wrote. They suggested that the 14 years of college, medical school, residency and fellowship that it now takes to train a subspecialty physician could be reduced by 30 percent, to 10 years.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">That opinion, however, is not universally held. Other experts say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">"The downside is that you are really tired," said Dr. Dan Hunt, co-secretary of the <a href="http://www.lcme.org/" style="color: rgb(102, 102, 153); text-decoration: none; ">Liaison Committee on Medical Education,</a> the accrediting agency for medical schools in the United States and Canada. But because accreditation standards do not dictate the fine points of curriculum, the committee has approved N.Y.U.'s proposal, which exceeds by five weeks its requirement that schools provide at least 130 weeks of medical education.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The medical school is going ahead with its three-year program despite the damage from <a href="http://topics.nytimes.com/top/reference/timestopics/subjects/h/hurricanes_and_tropical_storms/index.html?inline=nyt-classifier" title="More articles about Hurricane Sandy." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">Hurricane Sandy</a>, which forced NYU Langone Medical Center to evacuate more than 300 patients at the height of the storm and temporarily shut down three of its four main teaching hospitals.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Dr. Abramson of N.Y.U. said that postgraduate training, which typically includes three years in a hospital residency, and often fellowships after that, made it unnecessary to try to cram everything into the medical school years. Students in the three-year program will have to take eight weeks of class before entering medical school, and stay in the top half of their class academically. Those who do not meet the standards will revert to the four-year program.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Similar experiments during the late 1960s and early 1970s, encouraged by federal financial incentives to combat a physician shortage, met with faculty opposition, according to a 1978 study by the Association of American Medical Colleges. But on tests, the study said, the three-year students performed as well as or better than four-year students.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The shorter programs were criticized for compromising basic science, reducing flexibility in the curriculum and pushing students to make career choices too early. Residency directors also felt uncomfortable accepting three-year graduates. About a quarter of the medical schools in the United States experimented with some type of three-year program in the 1970s, the study said, but they were quickly abandoned.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Two Canadian medical schools, at <a href="http://www.mcmaster.ca/" style="color: rgb(102, 102, 153); text-decoration: none; ">McMaster University in Hamilton</a>, Ontario, and the University of Calgary in Alberta, have had their students in three-year programs for more than 40 years, officials at the two schools said.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The three-year programs at Texas Tech and Mercer are focused on producing doctors who want to go into family medicine, which administrators insist is not because family medicine is easier, but because they are responding to the need for more primary and preventive care.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">That focus on only one category of doctors has disturbed some proponents of three-year schools. Dr. Bruce Wright, associate dean of undergraduate medical education at Calgary, said it could create a perception that three-year programs were "medical school lite," turning out second-class physicians. The trend, he suggested, could ultimately lead to lower standards for family medicine graduates, who are already in a lower-paid, lower-prestige field.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">N.Y.U. has decided to open its three-year program to students regardless of what branch of medicine they plan to go into, but Dr. Abramson said it would look for students interested in primary care fields like internal medicine, pediatrics and obstetrics. Students will have to declare their choice when they apply, because they will be guaranteed residencies in an N.Y.U.-affiliated hospital, as a way of lessening anxiety that other residency programs might be wary of their three-year degrees.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">The adjustment would be easier for N.Y.U., he said, because it has already changed its curriculum to begin clinical studies in the first two years, rather than in the traditional third and fourth years, and it already accommodates some students who are earning both medical degrees and master's degrees in public health within four years.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Dr. Emanuel said he would like to see an even bolder approach, like offering the three-year program to 20 percent of the class. "But it's progress," he said. "It's a major school and a place of high visibility."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Eileen Dee, a third-year student in the three-year program at Texas Tech, said the compressed curriculum made her feel "not necessarily more hurried, just more responsible."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">But, she said, doing clinical work while taking classes had reinforced her textbook knowledge and, she believed, improved her score on the science portion of the medical licensing exam.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Natalie Smith, a fourth-year medical student at N.Y.U., who is planning to go into anesthesiology, said that she and her friends had often fantasized about completing medical school in less time, if only to save on tuition. The fourth year of medical school is typically spent on career exploration, by taking elective courses and interviewing for residencies. Yet, she noted, "We're paying that same tuition with less amount of learning."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">Looking back, she said, finishing medical school in three years seems "completely doable."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 24px; font-family: Georgia, serif; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">"It's a profession where you're learning through your entire life," she said. "Doctors say many things they learned in medical school aren't even used anymore."</p></div><a href="http://www.nytimes.com/2012/12/24/education/nyu-and-others-offer-shorter-courses-through-medical-school.html?">http://www.nytimes.com/2012/12/24/education/nyu-and-others-offer-shorter-courses-through-medical-school.html?</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

N.Y.U. and Others Offer Shorter Courses Through Medical School - NYTimes.com

Training to become a doctor takes so long that just the time invested has become, to many, emblematic of the gravity and prestige of the pro...