André Chiote's Architectural Illustrations

Earlier today I included the Sauerbruch Hutton's Brandhorst Museum <a href="http://archidose.blogspot.com/2013/03/todays-archidose-654.html">in a post with colorful buildings</a>. In my inbox are some illustrations from <a href="http://cargocollective.com/andrechioteillustration">André Chiote</a>, an architect who also dabbles in creating "a set of images in which the aim is to simultaneously outline the emblematic and distinctive side of the building while creating a graphic composition whose expression could speak out beyond the building itself." One of the illustrations happens to be the <a href="http://cargocollective.com/andrechioteillustration/ARCHITECTURE-Germany">Brandhorst Museum</a>:<br /><br /><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9Am0uJHbBpBZqA4m65KFCxLCpaqyKnh0vnDKcjEKxRrsme7S07TmC1tMI8XLfWD7wwNdoWxSKV1KuUhLrWpaJ84rT7wMVIu7i-4Hq-Qkkr_vehSywRi3wbtd9wzx9XUZLX7GIi5gV9g9F/s1600/brandhorst.jpg" /><br /><br />Keeping with the theme of color, here are a few more illustrations by Choite, but be sure to <a href="http://cargocollective.com/andrechioteillustration">check out his website</a> for many more.<br /><br /><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAhJwGnjo2RqnVZRa9FGy1vFn66eWWyo8YA3bEyV_a_uaRxptYULGRX_LAlKL6GINfxwpWP0v_-Shg1av-zSze2XKrMqjbAODEZ0NVluhTD-98bMhW16uYTD1L28-8WX8i3Y5F6FlltNgo/s1600/quai_branly.jpg" /><br /><br /><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAELkfhVLDui0EP-7rdGpZSKhVXSxowwbE3sb17o_EFt4f7EL8Nd_KWDTAtLC-mgdB8gJLpVhKRWQwz6yUP7zpWta6l_fWGJvbMsnOISUdH4XwXMJ64LqmQsjrYZBfPHz1oa4zxOATYgbL/s1600/musac.jpg" /><br /><br /><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizqq0YGROsFis2HmqLFhNvuNdd0CdkZo1AvCPebi8JO407qxx0XEdqeTpH2XZJ0NgTvtVf5ipP9wK79TDqsauazFhD4yE9Yd-7pBAFIk-ch0Xv3eRUQtvzngHAH37eJGAmEcPOwyMsSp4w/s1600/casa_historias-pr.jpg" />

André Chiote's Architectural Illustrations

Earlier today I included the Sauerbruch Hutton's Brandhorst Museum in a post with colorful buildings . In my inbox are some illustration...

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GNU Foods Fiber Bars Review

<div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-ocMszKnxGeY/UTPG-m1g4OI/AAAAAAAAGwY/5KmWqjLJ6Ps/s1600/Gnu+Fiber+box!.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-ocMszKnxGeY/UTPG-m1g4OI/AAAAAAAAGwY/5KmWqjLJ6Ps/s320/Gnu+Fiber+box!.jpg" width="320" /></a></div><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">If there's one thing some people don't get enough of it's fiber.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">I have to admit, even eating healthy at times I don't get enough of the daily amount of fiber.</span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">With these delicious snack bars I was given for review by <a href="http://gnufoods.com/">GNU Foods</a> they certainly do give fiber a good name!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">They come in many flavors, and are oh so delicious!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">You won't even know that it's rich in fiber either!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">They are just that good!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">They are all natural, 12 grams of fiber per bar, and kids will love them!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Eating these bars I promise will have you feeling healthier knowing you got your daily dose of fiber, and most importantly a "GNU" you!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">I was sent an assortment box with each flavor and They all sound amazingly delicious!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span><br /><div><span style="font-family: Verdana, sans-serif;">*The flavors*</span></div><div><span style="font-family: Verdana, sans-serif;"><br /></span></div><div><span style="font-family: Verdana, sans-serif;">Chocolate Brownie</span></div><div><span style="font-family: Verdana, sans-serif;">Banana Walnut</span></div><div><span style="font-family: Verdana, sans-serif;">Blondie Bar</span></div><div><span style="font-family: Verdana, sans-serif;">Carrot Cake</span></div><div><span style="font-family: Verdana, sans-serif;">Blueberry Cobbler</span></div><div><span style="font-family: Verdana, sans-serif;">Cinnamon Raisin</span></div><div><span style="font-family: Verdana, sans-serif;">Orange Cranberry</span></div><div><span style="font-family: Verdana, sans-serif;">Espresso Chip</span></div><div><span style="font-family: Verdana, sans-serif;">Peanut Butter</span></div><br /><span style="font-family: Verdana, sans-serif;">Interesting facts:</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">helps with weight management and diet</span><br /><span style="font-family: Verdana, sans-serif;">promotes ongoing natural regularity</span><br /><span style="font-family: Verdana, sans-serif;">supports heart health</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Doesn't include:</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">transfat</span><br /><span style="font-family: Verdana, sans-serif;">high cholesterol</span><br /><span style="font-family: Verdana, sans-serif;">soy</span><br /><span style="font-family: Verdana, sans-serif;">hydrogenated oils</span><br /><span style="font-family: Verdana, sans-serif;">sugar alcohols</span><br /><span style="font-family: Verdana, sans-serif;">refined sugars except blondie</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">These bars are like no other bar, they can't even compare. They are high in fiber.</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Offers only 130-140 calories.</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Made with just only six whole grains!</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Sweetened with fruit juices.</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Made with kamut flours and organic whole wheat.</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Their bars are vegan except for their blondie!</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Loaded with double the fiber insoluble and soluble. </span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-fN6czQ40pyE/UTPHJO6TlII/AAAAAAAAGwg/UooJ2rXgivU/s1600/chocolate+brownie+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://4.bp.blogspot.com/-fN6czQ40pyE/UTPHJO6TlII/AAAAAAAAGwg/UooJ2rXgivU/s320/chocolate+brownie+GNU+bar.jpg" width="320" /></a></div><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">So far I've tried The chocolate brownie and it's so good!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Tastes just like the real thing without all the added fat and calories!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-y3fl0Nf_s-o/UTPHdWwHNhI/AAAAAAAAGwo/1d9FSpW1xZY/s1600/orange+cranberry+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://3.bp.blogspot.com/-y3fl0Nf_s-o/UTPHdWwHNhI/AAAAAAAAGwo/1d9FSpW1xZY/s320/orange+cranberry+GNU+bar.jpg" width="320" /></a></div><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-9-KmO7dgTi0/UTPHnZtA8dI/AAAAAAAAGww/M1YRKi2Pge0/s1600/Carrot+cake+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-9-KmO7dgTi0/UTPHnZtA8dI/AAAAAAAAGww/M1YRKi2Pge0/s320/Carrot+cake+GNU+bar.jpg" width="320" /></a></div><br /></div><div style="text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-wQhPLBfZbyY/UTPHxaLkZEI/AAAAAAAAGw4/iSaJDtGLTEY/s1600/Cinnamon+Raisin+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://3.bp.blogspot.com/-wQhPLBfZbyY/UTPHxaLkZEI/AAAAAAAAGw4/iSaJDtGLTEY/s320/Cinnamon+Raisin+GNU+bar.jpg" width="320" /></a></div><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;"><br /></span><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-U4QUYrNW-z4/UTPH9Q3qXmI/AAAAAAAAGxA/lB3TCNTWqt4/s1600/Banana+Walnut+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://2.bp.blogspot.com/-U4QUYrNW-z4/UTPH9Q3qXmI/AAAAAAAAGxA/lB3TCNTWqt4/s320/Banana+Walnut+GNU+bar.jpg" width="320" /></a></div><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Tasted just like Banana bread to me, which is great because I love it!</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">Didn't taste like a health food at all!</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">I loved the banana taste it wasn't overpowering or hard to eat.</span><br /><span style="font-family: Verdana, sans-serif;"><br /></span><span style="font-family: Verdana, sans-serif;">It was moist and flavorful!</span><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-t8u58cmVUhI/UTPIHECZFaI/AAAAAAAAGxI/OC6tl7shupU/s1600/blondie+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://1.bp.blogspot.com/-t8u58cmVUhI/UTPIHECZFaI/AAAAAAAAGxI/OC6tl7shupU/s320/blondie+GNU+bar.jpg" width="320" /></a></div><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-WFEGW4OCZHs/UTPIO2CbzwI/AAAAAAAAGxQ/EDbJ-5se7Ac/s1600/blueberry+cobbler+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://4.bp.blogspot.com/-WFEGW4OCZHs/UTPIO2CbzwI/AAAAAAAAGxQ/EDbJ-5se7Ac/s320/blueberry+cobbler+GNU+bar.jpg" width="320" /></a></div><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-KFSDPcU6vNQ/UTPIXFExBBI/AAAAAAAAGxY/ZRvqReAKGow/s1600/espresso+chip+GNU+bar.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="http://3.bp.blogspot.com/-KFSDPcU6vNQ/UTPIXFExBBI/AAAAAAAAGxY/ZRvqReAKGow/s320/espresso+chip+GNU+bar.jpg" width="320" /></a></div><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">They also have them in minis!</span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">You can order their products here!</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><a href="http://gnufoods.com/">http://gnufoods.com/</a></span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">Like them on Face Book </span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;">or Follow them on Twitter.</span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><br /></span></div><div style="text-align: center;"><span style="font-family: Verdana, sans-serif;"><a href="https://www.facebook.com/GnuFoods?ref=ts">https://www.facebook.com/GnuFoods?ref=ts</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/gnufoods"><span style="font-family: Verdana, sans-serif;">https://twitter.com/gnufoods</span></a></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div>

GNU Foods Fiber Bars Review

If there's one thing some people don't get enough of it's fiber. I have to admit, even eating healthy at times I don't get e...

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Jerusalem, My Happy Home: Part 6

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QFormat="true" Name="TOC Heading"/> </w:LatentStyles></xml><![endif]--> <!--[if gte mso 10]><style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:Calibri;} </style><![endif]--> <!--StartFragment--> <br /><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">Today, on a boat, in the middle of the Sea of Galilee, we met Lawrence Ferlinghetti’s girlfriend. Actually we met her several days ago but we found out about the Ferlinghetti connection today. Hearkening back to JMHP, Part 2: “God will always surprise us.” -- The Rt. Rev. Sulheil Dawani. Who goes to the Sea of Galilee to meet the girlfriend of, the author of “Coney Island of the Mind, the beat poet who made the other beat poets famous?!?” Werner Heisenberg and Bishop Duwani agree: Reality is, at its heart, unpredictable and delightful. <o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">But that didn’t happen until late afternoon. The day was engaging long before that. Our bus headed East from Jerusalem toward the Dead Sea. At last we came to the desert wilderness I had expected in this Land of the Holy One. It is a “ferocious landscape” (Belden Lane) somewhat similar to Nevada, but distinctive. There are occasional groves of date palms. The dates are used to make honey such as the honey in which John the Baptist dipped his crispy locusts. In the Spring, there are also wildflowers, but basically, ”it’s a desert out there.” <o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">We drove North through that desert, then on through the mountains of Samaria into the rolling green hills of Galilee. At the Sea of Galilee we stopped to visit the Mount of the Beatitudes, a seaside mountain where the Church has long commemorated the Sermon on the Mount. Actually the Sermon on the Mount is a collection of Jesus sayings artistically and theologically arranged by Matthew, but it is a work of spiritual genius and deserves to be commemorated. The beautiful gardens and the octagonal church built to honor the Sermon are fitting. <o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">Venerating holy places is like reading Holy Scripture. Different parts of Scripture must be read in different ways. Some texts are history, others are poetry, some are rules, others are prophecies, and some are cries of passion. Just so, some places are holy for historical reasons. Something important really happened here. Others are holy because of the prayers that have been said there for millennia though no special events are associated with the place. But there is a special dynamic in religion called “sacred geography.” I learned about sacred geography while studying Hinduism from Dianna Eck. A spiritual truth is conveyed through a narrative, which may be historical, fictional, or a mixture “partly truth and partly fiction” – but the point is it contains a spiritual message that cannot be stated as a flat two-dimensional abstraction. It must be expresses as story. There is an art in weaving and telling sacred story. When it is done well, we then go on to construct a sacred geography for the story. We say, “Ram was born in this place.” “The Buddha meditated and was enlightened under the branches of this tree.” “Jesus was born in this place.” If we have designated a place as part of the sacred geography and honored it by association with the story that bears a spiritual truth, the place comes to bear that truth as well. So it is with the Mount of the Beatitudes. <o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">From there we went north, north, north to the borders of Lebanon and then Syria to visit the region of Caesarea Philippi. There are two reasons visiting this place. First, in this area three rivers, fed by the snow melting off the Golan Heights, converge to form the River Jordan. Far be it from me to suggest that this three becoming one is a natural metaphor of the divine nature. Second, this is where Jesus asked his disciples “Who do you say that I am?” and Peter answered, “ You are the messiah, the Son of the Living God.” I am somewhat mystified by why Jesus took his disciples so far north to ask this question. It would have been one long walk from his home base in Capernaum!!! On another occasion, they walked all the way to the region of Tyre and Sidon in Lebanon – even further. He did cover some distance on foot. <o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">We then headed back south into Galilee and visited Capernaum. There is a ruin of a 4^th Century synagogue believed to have been built on top of the ruins of the synagogue where Jesus worked his first exorcism. By the way, my friends of a skeptical bent, recasting Jesus as a wisdom teacher who did not actually do miraculous healings, exorcisms, and other such unscientific things is a case of western modernist cultural imperialism – rewriting the story to fit our worldview, to keep it in our comfort zone. Those who believed in Jesus were unanimous that he worked miracles. No surprise in that. But the people who did not believe in Jesus were also unanimous that he worked miracles. They just denied it was by God’s power he was doing it. When it comes to miracles, I don’t know what’s possible and what’s not. Take it out of my cultural context and I am even less prepared to say what’s impossible. Bottom line: Gabriel said it to my satisfaction, “With God, all things are possible.”<o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">Around the old synagogue are older ruins of houses going back to Jesus’s day. An Orthodox Church is built over one such ruin of a house. The church has a glass floor so one can look down into the ruin. Christians have long regarded this house as the home of Peter’s mother-in-law whom Jesus healed of a fever right after the exorcism in the synagogue. History or more fictional sacred geography? This is somewhere in the middle. Could be true. It’s a house next door to the synagogue. No one can say for sure.<o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">From there we walked down to the rocky beach near the synagogue, which means near the site of the 1^st century village of Capernaum. On this beach, the first disciples were mending their nets when Jesus said, “Follow me” and they did. You can’t say the exact spot where their boat was situated, but it’s a short distance along the beach, easy to walk the length of it – easy to know that right along here, the Kingdom Mission began when Jesus said, “Follow me.” That’s history. <o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><span style="font-family: Calibri; font-size: 14.0pt;">Then we took our boat ride on the Sea of Galilee. It’s a pretty big lake, as I had imagined it would be. The hills come right up to the lake as I had been told. But those hills are taller and greener than I had imagined, a truly beautiful place. The day was enriched by a good exegetical reflection on the Beatitudes by Brother Mark and a moving reflection on storms in our lives given by Dean Graham Smith while we were on the Lake. And that brings us back to where we met Lawrence Ferlinghetti’s girlfriend.<o:p></o:p></span></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><br /></div><div class="MsoNormal"><br /></div><!--EndFragment-->

Jerusalem, My Happy Home: Part 6

Today, on a boat, in the middle of the Sea of Galilee, we met Lawrence Ferlinghetti’s girlfriend. Actually we met her several d...

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Crews to Raze Fla. Home Over Sinkhole; Man Missing

<div dir="ltr" style="text-align: left;" trbidi="on"><br /><iframe height="221" id="kaltura_player_1362338853" src="http://cdnapi.kaltura.com/index.php/kwidget/wid/0_xid6qkpf/uiconf_id/3775332/st_cache/1064?referer=http://abcnews.go.com/GMA/video/florida-sinkhole-opens-beneath-mans-home-18635696&autoPlay=false&addThis.playerSize=392x221&freeWheel.siteSectionId=nws_offsite&closedCaptionActive=true&" style="border: 0px solid #ffffff;" width="392">Unfortunately your browser does not support IFrames.</iframe> <br /><div style="font-size: x-small; margin-top: 0; text-align: left;"><br /><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Crews planned to begin demolishing a Florida home Sunday that is perched over a huge sinkhole, after deeming it too dangerous to keep searching for the man swallowed up from his bedroom.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">The search for Jeff Bush, 37, was called off Saturday and demolition equipment was seen moving into position Sunday. The 20-foot-wide opening of the sinkhole is almost completely covered by the house and rescuers feared it would collapse on them. Two neighboring homes were evacuated as a precaution.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Heavy equipment, including a vehicle with a big bucket scoop on a long arm, was on the street near the house Sunday morning. Authorities said they expected to start the demolition around 8 a.m. Family members gathered on lawn chairs, bundled up with blankets against unusually chilly weather. Several dozen people milled about within view, including officials and reporters.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Hillsborough County Administrator Mike Merrill disclosed the plan hours earlier to raze the home. "At this point it's really not possible to recover the body," Merrill said, later adding "we're dealing with a very unusual sinkhole."</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Jessica Damico, spokeswoman for Hillsborough County Fire Rescue, said the demolition equipment would be positioned on what was believed to be solid ground and reach onto the property to pull apart the house. The crew was expected to try pulling part of the house away from the sinkhole intact so some of the residents' keepsakes can be retrieved.</div><div class="rel_container g_4" id="rel_image_feature" style="background-color: white; clear: left; color: #333333; float: left; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin: 20px 50px 0px 0px; padding: 0px; position: relative; width: 200px;"><div class="rel_content" style="margin: 0px; padding: 0px;"><div class="rel_thumb" style="line-height: 16px; margin: 0px; padding: 0px; position: relative;"><a href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" name="lpos=widget[Left_Rail_Image]&lid=view[Image]" style="color: #336699; margin: 0px; padding: 0px; text-decoration: none;"><img alt="PHOTO: A Florida man is trapped under debris after a sinkhole opened in his home, in Brandon, Fla." border="0" height="112" src="http://a.abcnews.com/images/US/abc_sinkhole_dm_130301_wg.jpg" style="margin: 0px 0px 0px 0.5px; padding: 0px;" title="" width="199" /><span class="image_icon" style="background-color: transparent; background-image: url(http://a.abcnews.com/assets/images/icons/image_icon_35x35.png); background-position: 0px 0px; background-repeat: no-repeat no-repeat; height: 35px; margin: 0px; padding: 0px; position: absolute; right: 5px; top: 73px; width: 35px;"></span></a></div><div class="rel_headline" style="font-family: arial, sans-serif; font-size: 12px; line-height: 15px; margin: 3px 0px 0px; padding: 0px;"><div class="photo_credit" style="color: #aaaaaa; font-size: 11px; line-height: 13px; margin: 0px; padding: 0px; text-align: right;">ABC</div><div class="photo_caption" style="margin: 5px 0px 0px; padding: 0px;">A Florida man is trapped under debris after a... <a href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" name="lpos=widget[Left_Rail_Image]&lid=view[Image]" style="color: #336699; font-weight: bold; margin: 0px; padding: 0px; text-decoration: none;">View Full Size</a></div></div></div></div><div class="rel_container g_4" id="rel_1" style="background-color: white; clear: left; color: #333333; float: left; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin: 20px 50px 0px 0px; padding: 0px; position: relative; width: 200px;"><div class="rel_content" style="margin: 0px; padding: 0px;"><div class="rel_thumb" style="line-height: 16px; margin: 0px; padding: 0px; position: relative;"><a href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" name="lpos=widget[Left_Rail_Video_1]&lid=view[Video]" style="color: #336699; margin: 0px; padding: 0px; text-decoration: none;"><img border="0" height="112" src="http://a.abcnews.com/images/WNT/abc_wn_gutman_130301_wa.jpg" style="margin: 0px; padding: 0px;" width="200" /><span class="image_icon" style="background-color: transparent; background-image: url(http://a.abcnews.com/assets/images/icons/play_icon_35x35.png); background-position: 0px 0px; background-repeat: no-repeat no-repeat; height: 35px; margin: 0px; padding: 0px; position: absolute; right: 5px; top: 73px; width: 35px;"></span></a></div><div class="rel_headline" style="font-family: arial, sans-serif; font-size: 12px; line-height: 15px; margin: 3px 0px 0px; padding: 0px;">Florida Man Believed Dead After Falling into Sinkhole <a class="open" href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" style="color: #336699; font-weight: bold; margin: 0px; padding: 0px; text-decoration: none;">Watch Video</a></div></div></div><div class="rel_container g_4" id="rel_2" style="background-color: white; clear: left; color: #333333; float: left; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin: 20px 50px 0px 0px; padding: 0px; position: relative; width: 200px;"><div class="rel_content" style="margin: 0px; padding: 0px;"><div class="rel_thumb" style="line-height: 16px; margin: 0px; padding: 0px; position: relative;"><a href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" name="lpos=widget[Left_Rail_Video_2]&lid=view[Video]" style="color: #336699; margin: 0px; padding: 0px; text-decoration: none;"><img border="0" height="112" src="http://a.abcnews.com/images/GMA/abc_gma_champion_130301_wa.jpg" style="margin: 0px; padding: 0px;" width="200" /><span class="image_icon" style="background-color: transparent; background-image: url(http://a.abcnews.com/assets/images/icons/play_icon_35x35.png); background-position: 0px 0px; background-repeat: no-repeat no-repeat; height: 35px; margin: 0px; padding: 0px; position: absolute; right: 5px; top: 73px; width: 35px;"></span></a></div><div class="rel_headline" style="font-family: arial, sans-serif; font-size: 12px; line-height: 15px; margin: 3px 0px 0px; padding: 0px;">Florida Sinkhole Swallows House, Man Trapped Inside <a class="open" href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" style="color: #336699; font-weight: bold; margin: 0px; padding: 0px; text-decoration: none;">Watch Video</a></div></div></div><div class="rel_container g_4" id="rel_3" style="background-color: white; clear: left; color: #333333; float: left; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin: 20px 50px 0px 0px; padding: 0px; position: relative; width: 200px;"><div class="rel_content" style="margin: 0px; padding: 0px;"><div class="rel_thumb" style="line-height: 16px; margin: 0px; padding: 0px; position: relative;"><a href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" name="lpos=widget[Left_Rail_Video_3]&lid=view[Video]" style="color: #336699; margin: 0px; padding: 0px; text-decoration: none;"><img border="0" height="112" src="http://a.abcnews.com/images/US/abc_sinkhole_brother_130301_wa.jpg" style="margin: 0px; padding: 0px;" width="200" /><span class="image_icon" style="background-color: transparent; background-image: url(http://a.abcnews.com/assets/images/icons/play_icon_35x35.png); background-position: 0px 0px; background-repeat: no-repeat no-repeat; height: 35px; margin: 0px; padding: 0px; position: absolute; right: 5px; top: 73px; width: 35px;"></span></a></div><div class="rel_headline" style="font-family: arial, sans-serif; font-size: 12px; line-height: 15px; margin: 3px 0px 0px; padding: 0px;">Sinkhole Victim's Brother: 'I Know in My Heart He's Dead' <a class="open" href="http://www.blogger.com/blogger.g?blogID=8896966065785019252" style="color: #336699; font-weight: bold; margin: 0px; padding: 0px; text-decoration: none;">Watch Video</a></div></div></div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Bush was in his bedroom Thursday night in Seffner — a suburb of 8,000 people 15 miles east of downtown Tampa — when the ground opened and took him and everything else in his room. Five others in the house escape unharmed as the earth crumbled.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">The Hillsborough County Sheriff's Office is conducting the investigation. Det. Larry McKinnon said that sheriff's office and the county medical examiner cannot declare Bush dead if his body is still missing. Under Florida law, Bush's family must petition a court to declare him deceased.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">"Based on the circumstances, he's presumed dead, however the official death certificate can only be issued by a judge and the family has to petition the court," McKinnon said.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">On Saturday, the normally quiet neighborhood of concrete block homes painted in Florida pastels was jammed with cars as curious onlookers converged on the scene.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">At the home next door to the Bushes, a family cried and organized boxes. Testing determined that that house and another had been compromised by the sinkhole. The families were allowed to go inside for about a half-hour to gather belongings.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Sisters Soliris and Elbairis Gonzalez, who live on the same street, said neighbors were worried for their safety.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">"I've had nightmares," Soliris Gonzalez, 31, said. "In my dreams, I keep checking for cracks in the house."</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">They said the family has discussed where to go if forced to evacuate, and they've taken their important documents to a storage unit.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">"You never know underneath the ground what's happening," added Elbairis Gonzalez, 30.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Experts say thousands of sinkholes form yearly in Florida because of the state's unique geography, though most are small and deaths rarely occur.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">"There's hardly a place in Florida that's immune to sinkholes," said Sandy Nettles, who owns a geology consulting company in the Tampa area. "There's no way of ever predicting where a sinkhole is going to occur."</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Most sinkholes are small, like one found Saturday morning in Largo, 35 miles away from Seffner. The Largo sinkhole, about 10 feet long and several feet wide, is in a mall parking lot.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">The state sits on limestone, a porous rock that easily dissolves in water, with a layer of clay on top. The clay is thicker in some locations — including the area where Bush became a victim — making them even more prone to sinkholes.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">Jeremy Bush, who tried to rescue his brother, lay flowers near the house Saturday morning and wept.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">He said someone came to his home a couple of months ago to check for sinkholes and other issues, apparently for insurance purposes, but found nothing wrong. State law requires home insurers to provide coverage against sinkholes.</div><div style="background-color: white; color: #333333; font-family: georgia, 'times new roman', serif; font-size: 15px; line-height: 23px; margin-bottom: 22px; padding: 0px 0px 0px 150px;">"And a couple of months later, my brother dies. In a sinkhole," Bush said Friday.</div></div></div>

sinkhole Crews to Raze Fla. Home Over Sinkhole; Man Missing

Unfortunately your browser does not support IFrames. Crews planned to begin demolishing a Florida home Sunday that is perched over a huge s...

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Kevin Hart Dresses Up as Pope Quvenzhane Wallis on Saturday Night Live

<div dir="ltr" style="text-align: left;" trbidi="on"><div dir="ltr" style="text-align: left;" trbidi="on"><br /></div><iframe frameborder="0" height="315" src="http://www.nbc.com/assets/video/widget/widget.html?vid=n33496" width="560"></iframe><br /><br /><div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; outline: 0px; padding: 0px; vertical-align: baseline;"><strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Pope Benedict XVI</strong>'s successor was chosen Saturday, March 2 by <em style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Saturday Night Live</em>. During<strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.usmagazine.com/celebrities/jason-sudeikis" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank"> Jason Sudeikis</a></strong>' <em style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">The Situation Room with Wolf Blitzer</em> sketch, he revealed that 9-year-old Oscar nominee <strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.usmagazine.com/celebrity-news/news/quvenzhane-wallis-best-actress-oscar-nominee-to-star-as-annie-2013242" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">Quvenzhane Wallis</a></strong>, portrayed by host <strong style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Kevin Hart</strong>, had been named the new Pope.</div><div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.usmagazine.com/entertainment/pictures/youngest-oscar-nominees-2013212/28647" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">PHOTOS: Oscars' youngest nominees</a></div><div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; outline: 0px; padding: 0px; vertical-align: baseline;">"I don't think anyone saw this coming," Sudeikis said.</div><div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; outline: 0px; padding: 0px; vertical-align: baseline;">"Quvenzhane Wallis, of course, the first African American, the first female and first child Pope," a reporter at the scene explained. </div><div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="http://www.usmagazine.com/entertainment/pictures/stars-funniest-snl-moments-2009278/2563" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">PHOTOS: Stars' funniest SNL moments</a></div><div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; outline: 0px; padding: 0px; vertical-align: baseline;">Comedian Hart, 32, then made his debut dressed up as Wallis in her navy Giorgio Armani gown and carrying her her favorite <a href="http://www.usmagazine.com/celebrity-moms/news/quvenzhane-wallis-puppy-purses-where-to-buy-them-2013282" style="border: 0px; margin: 0px; outline: 0px; padding: 0px; text-decoration: none; vertical-align: baseline;" target="_blank">puppy purse</a>. To celebrate her victory, Pope Quvenzhane lifted her arms into her signature muscle man pose and then danced the Dougie.</div><div style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; outline: 0px; padding: 0px; vertical-align: baseline;">"Who the man? I'm the man," Pope Quvenzhane said in Latin.</div><span style="border: 0px; font-family: Arial, Helvetica, sans-serif; font-size: 12px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><br /><br /></span></div>

Kevin Hart Kevin Hart Dresses Up as Pope Quvenzhane Wallis on Saturday Night Live

Pope Benedict XVI 's successor was chosen Saturday, March 2 by  Saturday Night Live . During  Jason Sudeikis '  The Situation Room w...

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Rigbys

<p>Last night we went to Rigbys on Leeson Street for dinner.  Ciaran and I joke that we are like old people because we like to eat early.  When I called looking for a reservation for 7pm, I was told that it was no problem but that they would need the table back by 9.30pm.  9.30pm!!! Who eats that late?!</p><p>Rigbys is a little strange in that there are no menus and there are only limited dinner options. For starters, we had a choice of chicken or salmon and then for mains the choice was beef or hake.  There was a further special choice of lobster for dinner for a bargain price of €15.95 for a half and €26.95 for a full lobster.</p><p>Ciaran had  a chicken ballotine to start - this was lovely and I would order it again.  My flaked salmon and cucumber salad was also very good.</p><p>I chose the beef for main while Ciaran selected the lobster.  However, after one bite of his meal he decided he wanted to switch out his lobster for my beef.  I was happy enough to do this!</p><p>Dessert options was a cheese plate or a dessert trio. We decided to split the dessert trio which consisted of a chocolate biscotti, a slice of coffee and chocolate terrine served with brown bread ice cream.  Delicious!</p><p>The atmosphere in this place is great.  It's small and casual.  However, the best thing about Rigbys is that it is BYOB.  It is situated right next door to a very good wine shop who give you 10% off any purchases when you tell them you are dining next door.</p><p>We finished off a great night with a few after dinner drinks in Birchalls in Ranelagh.</p><div class='separator' style='clear: both; text-align: center;'> <a href='https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRhXR7aytFSxpEjhxnVw_yYOOIOGDP6dd6H9b3Mgcc_7FIWZGsxyDJZTqG4wb6NpdeNfpqhm0Hvk1RS1-CbcdHb1pVV_GMtW7_kzf4uRhwyc5EEdnJNlu0yeJgbD2SD1uhyphenhyphennL7hs20giPV/s1600/lobster.jpg' imageanchor='1' style='margin-left: 1em; margin-right: 1em;'> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRhXR7aytFSxpEjhxnVw_yYOOIOGDP6dd6H9b3Mgcc_7FIWZGsxyDJZTqG4wb6NpdeNfpqhm0Hvk1RS1-CbcdHb1pVV_GMtW7_kzf4uRhwyc5EEdnJNlu0yeJgbD2SD1uhyphenhyphennL7hs20giPV/s400/lobster.jpg" /> </a> </div> <br/><br/><div class="separator"style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVR22JVtrkqAp5-vhhfdhv7gEpyZ4kJz3W-MWsLO5grUNrANZoseJZ1Q9sO937pYpBQXJkTIVbuOSsrxeN2wyazuEOcQFoxqbP5a1we8SCSK9zGN1_mtQWTxy5MS_WnsZAegYBu7qFXLLU/s640/blogger-image-1947988693.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVR22JVtrkqAp5-vhhfdhv7gEpyZ4kJz3W-MWsLO5grUNrANZoseJZ1Q9sO937pYpBQXJkTIVbuOSsrxeN2wyazuEOcQFoxqbP5a1we8SCSK9zGN1_mtQWTxy5MS_WnsZAegYBu7qFXLLU/s640/blogger-image-1947988693.jpg" /></a></div>

Rigbys

Last night we went to Rigbys on Leeson Street for dinner.  Ciaran and I joke that we are like old people because we like to eat early.  When...

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Oz

<p>My sister got tickets for the preview of the new Wizard of Oz film.  After a late night I struggled to get up to go see it.  However I was so glad I dragged myself from my bed as I thought it was a great movie- one of the best 3D films I've seen in awhile.</p><p>If you get the opportunity do go see it.  It opens on March 8th in both the States and Ireland.</p><p><a href="http://amydublinia.blogspot.ie/2013/03/blog-post_3.html">Click here</a> for my twin sister's blog post about this event - she has great pictures up!  And here is my younger sisters <a href="http://certifikatie.blogspot.ie/2013/03/irish-preview-oz-great-and-powerful.html">blog post</a> about this movie preview.</p><p>Aren't the 3D glasses awesome?!!</p><div class='separator' style='clear: both; text-align: center;'> <a href='https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7ujxwsDMt4CDV68FT9KuzqkKPoJv0SIDN_cfAoLyO2uD1LKbec1y2PjFtFbprVAyPzE5EJMnyG6NZt2y8uTNIYsAYGQN8RbwMg01glRvusW4YcgJJ1PpkZl4loWrR8j8KUJGNk1Zb_XzR/s1600/photo.JPG' imageanchor='1' style='margin-left: 1em; margin-right: 1em;'> <img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7ujxwsDMt4CDV68FT9KuzqkKPoJv0SIDN_cfAoLyO2uD1LKbec1y2PjFtFbprVAyPzE5EJMnyG6NZt2y8uTNIYsAYGQN8RbwMg01glRvusW4YcgJJ1PpkZl4loWrR8j8KUJGNk1Zb_XzR/s400/photo.JPG" /> </a> </div>

Oz

My sister got tickets for the preview of the new Wizard of Oz film.  After a late night I struggled to get up to go see it.  However I was s...

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Today's archidose #654

Some colorful buildings for this Sunday.<br /><br />Bilbao Arena (2010) in Bilbao, Spain, by <a href="http://www.acxt.es/">ACXT</a>, photographed by <a href="http://www.flickr.com/photos/dwape/">Pawel Paniczko</a>:<br /><a href="http://www.flickr.com/photos/dwape/8484713341/" title="Bilbao Arena by Pawel Paniczko, on Flickr"><img alt="Bilbao Arena" height="427" src="http://farm9.staticflickr.com/8242/8484713341_28a9377293_z.jpg" width="640" /></a><br /><a href="http://www.flickr.com/photos/dwape/8484706263/" title="Bilbao Arena by Pawel Paniczko, on Flickr"><img alt="Bilbao Arena" height="360" src="http://farm9.staticflickr.com/8372/8484706263_ab02c593e0_z.jpg" width="640" /></a><br /><a href="http://www.flickr.com/photos/dwape/8484708343/" title="Bilbao Arena by Pawel Paniczko, on Flickr"><img alt="Bilbao Arena" height="360" src="http://farm9.staticflickr.com/8388/8484708343_8798bbb9cd_z.jpg" width="640" /></a><br /><a href="http://www.flickr.com/photos/dwape/8484709983/" title="Bilbao Arena by Pawel Paniczko, on Flickr"><img alt="Bilbao Arena" height="427" src="http://farm9.staticflickr.com/8100/8484709983_cc9724a8cb_z.jpg" width="640" /></a><br /><br />De Kleine Kikker (Little Frog nursery school, 2003) in Utrecht, Netherlands, by <a href="http://www.drostvanveen.nl/">Drost + van Veen architecten</a>, photographed by <a href="http://www.flickr.com/photos/wojtekgurak/">Wojtek Gurak</a>:<br /><a href="http://www.flickr.com/photos/wojtekgurak/8518226894/" title="De Kleine Kikker by Wojtek Gurak, on Flickr"><img alt="De Kleine Kikker" height="427" src="http://farm9.staticflickr.com/8524/8518226894_efa5b01364_z.jpg" width="640" /></a><br /><br />Brandhorst Museum (2009) in Munich, Germany, by <a href="http://www.sauerbruchhutton.de/">Sauerbruch Hutton Architects</a>, photographed by <a href="http://www.flickr.com/photos/nachoissd/">Víctor Pérez</a>:<br /><a href="http://www.flickr.com/photos/nachoissd/8510375641/" title="Brandhorst Museum by Victor Pérez :: victorperezp.com, on Flickr"><img alt="Brandhorst Museum" height="640" src="http://farm9.staticflickr.com/8366/8510375641_e32b8c34a1_z.jpg" width="640" /></a><br /><br />Theatre Agora (2007) in Lelystad, Netherlands, by <a href="http://www.unstudio.com/">UNStudio</a>, photographed by <a href="http://www.flickr.com/photos/wojtekgurak/">Wojtek Gurak</a>:<br /><a href="http://www.flickr.com/photos/wojtekgurak/8490926018/" title="Agora Theatre by Wojtek Gurak, on Flickr"><img alt="Agora Theatre" height="427" src="http://farm9.staticflickr.com/8237/8490926018_1a4d805bae_z.jpg" width="640" /></a><br /><br />An electrical substation in London covered in ceramic tiles by artist <a href="http://www.poncelet.me.uk/">Jacqueline Poncelet</a>, photographed by "<a href="http://www.flickr.com/photos/bradman334/">bradman334</a>":<br /><a href="http://www.flickr.com/photos/bradman334/8503936450/" title="patterns for energy by bradman334, on Flickr"><img alt="patterns for energy" height="426" src="http://farm9.staticflickr.com/8386/8503936450_b1515349c7_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 #654

Some colorful buildings for this Sunday. Bilbao Arena (2010) in Bilbao, Spain, by ACXT , photographed by Pawel Paniczko : De Kleine Kikker (...

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Experts Want More Studies of Diet’s Role for the Heart - NYTimes.com

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><nyt_text style="color: rgb(51, 51, 51); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; "><div id="articleBody"><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">This is a watershed moment in the field of nutrition, medical experts say. For the first time, researchers have shown that a diet can have an effect as powerful as drugs in preventing what really matters to patients — heart attacks, and strokes and deaths from cardiovascular disease.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The subjects were people at high risk of heart disease, and the diet was a Mediterranean one, high in olive oil or nuts.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The study, published last week in <a title="New England Journal of Medicine article." href="http://www.nejm.org/doi/full/10.1056/NEJMoa1200303?query=featured_home&&#t=article" style="color: rgb(102, 102, 153); text-decoration: none; ">The New England Journal of Medicine</a>, is now shaking up the field of cardiovascular medicine, infusing it with optimism. Scientists are calling for similarly rigorous studies of other popular diets that are routinely recommended by cardiologists even though there is little solid evidence that they work.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"We don't know what the best diet is," said Dr. Michael Lauer, the director of the division of cardiovascular sciences at the National Heart, Lung and Blood Institute. "This is a great opportunity to come together and use power of the scientific method to get closer to the right answer."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Other leading experts agreed.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"This is the start of where we need to go with nutritional clinical trials," said Dr. Neil J. Stone, a professor of preventive cardiology at Northwestern University's Feinberg School of Medicine and a former chairman of the American Heart Association's nutrition committee.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The National Heart, Lung and Blood Institute is supporting a large clinical trial to see if fish oil and <a href="http://health.nytimes.com/health/guides/nutrition/vitamin-d/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Vitamin D." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">vitamin D</a> can prevent heart attacks and cardiovascular deaths. But while that is important, heart experts say it is time to also look at diets as a whole.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"We definitively need to test plausible diets, within the context of what is available and consumed in the U.S., that could lower the risk of heart disease," said Alice H. Lichtenstein, a professor of nutrition science and policy at Tufts University and the lead author of the American Heart Association's dietary guidelines.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Dr. Lawrence Appel, a professor of medicine at Johns Hopkins who was a member of the 2005 and 2010 United States dietary guidelines committees, said he was inspired by the Mediterranean diet study.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"Can we do a trial of fruits and vegetables?" he asked. "I think we can."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The situation in nutrition today reminds Dr. Lauer of an era in the 1950s when doctors struggled to figure out how best to treat heart attack patients.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"Nutrition research is where heart attack research was," Dr. Lauer said. Patients in those days were advised to stay in bed for four to five weeks and take lidocaine to normalize their hearts' rhythms and nitroglycerin to open blood vessels.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">But it turned out that treatment actually hastened death. It took years to find the answers, but eventually, Dr. Lauer said, dozens if not hundreds of large clinical trials radically transformed heart attack treatment.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">But when it comes to diet and heart disease, doctors — and patients — have been going on hunches.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">The new study could be a start in changing all that, heart researchers said.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">It involved 7,447 people in Spain, half of whom were randomly assigned to follow a Mediterranean diet and the rest to follow the sort of standard low-fat diet that cardiologists often prescribe. It was ended early after less than five years because those on the Mediterranean diet had 30 percent fewer heart attacks, strokes and deaths from heart disease compared with people in the control group, who ate more or less the same way that they always had. They had been instructed to follow a low-fat diet but had not been able to comply.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Dr. Ramón Estruch of the University of Barcelona, the lead author of the study, said that although some had thought people would never allow their diets to be decided by a figurative toss of a coin, it was not hard to get people to switch to a Mediterranean diet.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"They wanted to eat the way their grandfathers ate," he said. Most study participants actually thought they were already eating that way. They learned they were not after answering questions about, for example, how often they ate red meat versus fish.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Dr. Estruch said he and his colleagues were so buoyed by the success of their study that they were planning another one.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">They intend to randomly assign people to consume the Mediterranean diet or to exercise while following a similar diet that is lower in calories. The hope is that adding weight loss and exercise will prevent even more heart disease.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">But for now, chaos reigns. The public is bombarded with diet advice, often contradictory and often lacking a rigorous scientific grounding, medical experts said.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"Diets are an extreme case of accepting evidence we want to believe," said Dr. J. Sanford Schwartz, a professor of medicine at the University of Pennsylvania.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">That includes doctors, he added, who overlook that the evidence for the low-fat diets they often recommend is the sort "we would never accept in the practice of medicine."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Those low-fat diets sound sensible — eat fruits and vegetables, fish and lean meats. Cut back on salt- and sugar-laden sodas and potato chips. Cut or sharply limit most fats, including olive oil and nuts. But such diets have not been tested in the way the Mediterranean diet was tested.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Doctors are in a bind, said Dr. Daniel J. Rader, a heart disease specialist at the University of Pennsylvania. When patients ask what to eat, he said, "you have to give them something."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"Given the importance of diets and given the decades of dietary recommendations we have given to people, you would think we would have had more dietary studies with hard endpoints to get at these questions," Dr. Rader said. But the best they have are studies that look at intermediate markers of risk, like <a href="http://health.nytimes.com/health/guides/nutrition/cholesterol/overview.html?inline=nyt-classifier" title="In-depth reference and news articles about Cholesterol." class="meta-classifier" style="color: rgb(102, 102, 153); text-decoration: none; ">cholesterol</a> levels. In the end, he said, "most doctors just give dietary platitudes."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Kevin McNamara, 44, faced a decision about diet after he went into cardiac arrest in June while jogging along the Jersey Shore. Mr. McNamara, an investment manager, had no idea he had heart disease.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">He ended up in the nearest hospital and had bypass surgery to open two blocked arteries. When he returned to his home near Valley Forge, Pa., he sought advice on what to eat and was persuaded by a book that said a vegan diet would prevent and even reverse heart disease.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"I talked to some of my doctors, and they said it wouldn't hurt if I went on a vegan diet," Mr. McNamara said.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Now he wants to discuss the Mediterranean diet with his doctors. He worries because he wants to keep his cholesterol levels very low. "I am paranoid that any sort of fat will build up in my coronary arteries," Mr. McNamara said. But he added, "I am not sure if I want to do a vegan diet for the next 30 or 40 years of my life."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">Vegan diets have never been rigorously tested, and probably never will be, Dr. Lichtenstein said. "Given the high cost of conducting a long-term diet study we have to think about what is feasible for the majority of the U.S. population," she said. "From past experience, we know it is highly unlikely people are going to make radical changes in their diet and stick with those changes long term."</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">But other diet studies are definitely in the offing, researchers said.</p><p itemprop="articleBody" style="color: black; font-size: 1.2em; margin: 0px 0px 1em; line-height: 24px; ">"As we go on, we realize we know less and less," Dr. Lauer said. "We can despair and just make things up, or we can celebrate and say we have a real opportunity to grow here."</p><nyt_correction_bottom><div class="articleCorrection" style="margin-bottom: 2.8em; "></div></nyt_correction_bottom><nyt_update_bottom></nyt_update_bottom></div></nyt_text><span style="color: rgb(51, 51, 51); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); display: inline !important; float: none; "></span></div><a href="http://www.nytimes.com/2013/03/03/health/experts-want-more-studies-of-mediterranean-diets-role-for-the-heart.html?&pagewanted=all">http://www.nytimes.com/2013/03/03/health/experts-want-more-studies-of-mediterranean-diets-role-for-the-heart.html?&pagewanted=all</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Experts Want More Studies of Diet’s Role for the Heart - NYTimes.com

This is a watershed moment in the field of nutrition, medical experts say. For the first time, researchers have shown that a diet can have a...

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

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><div id="well" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-size: 13px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; "><div align="left"><div class="entry-content"><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">In an effort to change entrenched medical practices, 17 major medical specialty groups recommended on Thursday that doctors greatly reduce their use of 90 widely used but largely unnecessary tests and treatments.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">This list of "don'ts" builds on 45 recommendations <a href="http://www.nytimes.com/2012/04/04/health/doctor-panels-urge-fewer-routine-tests.html" style="color: rgb(0, 0, 102); text-decoration: none; ">made last April</a>, under a broad initiative by the American Board of Internal Medicine Foundation, in partnership with the magazine Consumer Reports.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">"As you look through the lists, a lot of these were mea culpas," said Dr. Eric Topol, chief academic officer of Scripps Health, a health care provider in San Diego. Dr. Topol was not involved in creating the new recommendations. "The literature had supported these recommendations, but until now they were not sanctioned as no-no's by the professional groups," he said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Some of <a href="http://www.choosingwisely.org/doctor-patient-lists/" style="color: rgb(0, 0, 102); text-decoration: none; ">the recommendations</a> reinforce existing guidelines, but others aggressively go after procedures that have little evidence of benefit and may cause harm, yet are still practiced on a daily basis.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">For example, the American Society of Echocardiography recommended against using echocardiograms before or during surgery for patients with no history or symptoms of heart disease; doctors routinely perform this test. The Society of Nuclear Medicine and Molecular Imaging urged physicians not to perform routine annual stress testing using a nuclear heart scan after coronary artery surgery. This is also a routine test, and it exposes the patient to radiation equivalent to 2,000 chest X-rays.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">"Many of these tests are wasteful, and they could put patients in danger of harm without any benefits," said Daniel Wolfson, executive vice president of the American Board of Internal Medicine Foundation. "The goal is to begin to change attitudes both from the public side and the physician side that sometimes less is better."</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Each medical specialty society participating in the foundation's initiative has offered up five procedures that patients should question. "That's a key point. I don't think they'll have any impact unless patients get activated," Dr. Topol said.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">The new list includes recommendations against inducing labor or performing a Caesarean section before a woman's 39th week of pregnancy, unless it is medically necessary. Scheduled Caesareans and inductions are commonly performed for convenience, but delivery before 39 weeks is associated with increased risk of learning disabilities, respiratory problems and other risks to the baby.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">The American Academy of Pediatrics urged doctors not to automatically use computed tomography, or CT scans to evaluate children's minor head injuries. According to the report, approximately 50 percent of children who visit hospital emergency departments with head injuries undergo a CT scan, exposing them to radiation. Other groups also called for reductions in the use of CT, PET and M.R.I. scans for a variety of ailments.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Several physician groups recommended against prescribing antibiotics for common respiratory illnesses, including sinusitis, sore throat and bronchitis. The vast majority of these illnesses are caused by viruses, not bacteria, making antibiotics pointless. The pediatrics group also said not to treat children under 4 years of age with cough and cold medicines. Studies have shown that these products have little benefit and may cause serious side effects in children.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">The American Geriatrics Society recommended against using feeding tubes in patients with advanced dementia. These patients should be fed orally. Tube feeding is associated with agitation, increased use of physical and chemical restraints and pressure ulcers.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">Other notable recommendations include:</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">· Don't use opioid or butalbital treatment for migraine except as a last resort. Frequent use of these drugs can worsen headaches.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">· Don't routinely treat acid reflux in infants with anti-reflux therapy. There is emerging evidence that it may be harmful to infants in certain situations.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">· Avoid routine preoperative testing for low-risk surgeries without a clinical indication. Most pre-op tests turn up nothing unusual and don't lead to better outcomes.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">· Avoid using medications to achieve tight control of glucose levels in most adults aged 65 and older with Type 2 diabetes. Moderate control is generally better.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">· Don't use benzodiazepines or other sedative hypnotics in older adults as a first choice for insomnia, agitation or delirium. Studies consistently show a doubling of risk of car accidents, falls and hip fractures in older adults taking these medications.</div><div style="color: rgb(51, 51, 51); font-size: medium; margin-top: 0px; margin-right: 0px; margin-bottom: 0.7em; margin-left: 0px; padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; line-height: 1.375em; ">· Don't perform annual Pap tests in women 30 to 65 years of age who are not at high risk for cervical cancer. The Pap test should be performed every three years in women aged 21 to 30, and every three to five years for women aged 30 to 65.</div></div></div></div></div><a href="http://well.blogs.nytimes.com/2013/02/21/doctor-groups-issue-list-of-overused-medical-tests/?pagewanted=print">http://well.blogs.nytimes.com/2013/02/21/doctor-groups-issue-list-of-overused-medical-tests/?pagewanted=print</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

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

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

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Choosing Wisely | An Initiative of the ABIM Foundation

<base href="data:"><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><p style="margin: 0px 0px 20px; color: rgb(85, 85, 85); font-family: 'PT Sans', sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><em>Choosing Wisely</em><sup style="font-size: 12px; line-height: 0; position: relative; vertical-align: baseline; top: -0.5em; ">®</sup> aims to promote conversations between physicians and patients by helping patients choose care that is:</p><ul style="margin: 1em 0px; padding: 0px; list-style-position: inside; list-style-type: square; color: rgb(85, 85, 85); font-family: 'PT Sans', sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); "><li style="margin: 0px 0px 10px; ">Supported by evidence</li><li style="margin: 0px 0px 10px; ">Not duplicative of other tests or procedures already received</li><li style="margin: 0px 0px 10px; ">Free from harm</li><li style="margin: 0px 0px 10px; ">Truly necessary</li></ul><p style="margin: 0px 0px 20px; color: rgb(85, 85, 85); font-family: 'PT Sans', sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">In response to this challenge, national organizations representing medical specialists have been asked to "choose wisely" by identifying five tests or procedures commonly used in their field, whose necessity should be questioned and discussed. The resulting lists of <a title="Lists" href="http://www.choosingwisely.org/doctor-patient-lists/" style="text-decoration: none; color: rgb(0, 100, 149); ">"Five Things Physicians and Patients Should Question"</a> will spark discussion about the need—or lack thereof—for many frequently ordered tests or treatments.</p><p style="margin: 0px 0px 20px; color: rgb(85, 85, 85); font-family: 'PT Sans', sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); ">This concept was originally conceived and piloted by the <a href="http://npalliance.org/" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); ">National Physicians Alliance</a>, which, through an ABIM Foundation <a href="http://www.abimfoundation.org/Initiatives/Putting-the-Charter-Into-Practice-Grants.aspx" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); "><em>Putting the Charter into Practice</em> grant,</a> created a <a href="http://www.abimfoundation.org/Initiatives/Putting-the-Charter-Into-Practice-Grants/2009-Grantees.aspx" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); ">set of three lists</a> of specific steps physicians in internal medicine, family medicine and pediatrics could take in their practices to promote the <a href="http://www.abimfoundation.org/Resource-Center/Bibliography/Professionalism-Articles-by-Topic.aspx#Resources" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); ">more effective use of health care resources.</a> These lists were first published in<em><a href="http://archinte.ama-assn.org/cgi/content/full/171/15/1385?ijkey=.DaPcj2P7Zd8I&keytype=ref&siteid=amajnls" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); ">Archives of Internal Medicine.</a></em></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 20px; margin-left: 0px; color: rgb(85, 85, 85); font-family: 'PT Sans', sans-serif; font-size: 16px; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 18px; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px; background-color: rgb(255, 255, 255); position: static; z-index: auto; ">Recognizing that patients need better information about what care they truly need to have these conversations with their physicians, <a href="http://consumerhealthchoices.org/" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); ">Consumer Reports </a>is developing <a title="Choosing Wisely® Consumer Partners" href="http://www.choosingwisely.org/partners/choosing-wisely-consumer-communication-collaborators" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); ">patient-friendly materials</a> and is working with consumer groups to disseminate them widely. <a title="http://www.choosingwisely.org/wp-content/uploads/2013/01/choosing-wisely-one-pager-13013.pdf" href="http://www.choosingwisely.org/wp-content/uploads/2013/01/choosing-wisely-one-pager-13013.pdf" target="_blank" style="text-decoration: none; color: rgb(0, 100, 149); ">Learn more</a>.</p></div><a href="http://www.choosingwisely.org/">http://www.choosingwisely.org/</a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

Choosing Wisely | An Initiative of the ABIM Foundation

Choosing Wisely ®  aims to promote conversations between physicians and patients by helping patients choose care that is: Supported by evide...

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For the Elderly, Medical Procedures to Avoid - NYTimes.com

<base href="data:"><div style="color: black; text-align: left; "><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">The Choosing Wisely campaign, an initiative by the American Board of Internal Medicine Foundation in partnership with Consumer Reports, kicked off last spring. It is an attempt to alert both doctors and patients to problematic and commonly overused medical tests, procedures and treatments.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">It took an elegantly simple approach: By working through professional organizations representing medical specialties, Choosing Wisely asked doctors to identify "Five Things Physicians and Patients Should Question."</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">The idea was that doctors and their patients could agree on tests and treatments that are supported by evidence, that don't duplicate what others do, that are "truly necessary" and "free from harm" — and avoid the rest.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">Among the <a href="http://well.blogs.nytimes.com/2013/02/21/doctor-groups-issue-list-of-overused-medical-tests/" title="Well article" style="color: rgb(102, 102, 153); text-decoration: underline; ">18 new lists released last week</a> are recommendations from geriatricians and palliative care specialists, which may be of particular interest to New Old Age readers. I've previously written about a number of these warnings, but it's helpful to have them in single, strongly worded documents.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">The winners — or perhaps, losers?</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">Both the American Geriatrics Society and the American Academy of Hospice and Palliative Medicine agreed on one major "don't." Topping both lists was an admonition against <a href="http://newoldage.blogs.nytimes.com/2011/05/09/feeding-tube-decisions-often-made-in-haste/" style="color: rgb(102, 102, 153); text-decoration: underline; ">feeding tubes for people with advanced dementia</a>.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">"This is not news; the data's been out for at least 15 years," said Sei Lee, a geriatrician at the University of California, San Francisco, and a member of the working group that narrowed more than 100 recommendations down to five. Feeding tubes don't prevent aspiration pneumonia or prolong dementia patients' lives, the research shows, but they do exacerbate bedsores and cause such distress that people often try to pull them out and wind up in restraints. The doctors recommended hand-feeding dementia patients instead.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">The <a href="http://www.choosingwisely.org/doctor-patient-lists/american-geriatrics-society/" style="color: rgb(102, 102, 153); text-decoration: underline; ">geriatricians' list</a> goes on to warn against the routine prescribing of antipsychotic medications for dementia patients who become aggressive or disruptive. Though drugs like Haldol, Risperdal and Zyprexa remain widely used, "all of these have been shown to increase the risk of stroke and cardiovascular death," Dr. Lee said. They should be last resorts, after<a href="http://newoldage.blogs.nytimes.com/2011/02/15/clearing-the-fog-in-nursing-homes/" style="color: rgb(102, 102, 153); text-decoration: underline; ">behavioral interventions</a>.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">The other questionable tests and treatments:</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">No. 3: Prescribing medications to achieve <a href="http://newoldage.blogs.nytimes.com/2011/04/11/for-elderly-diabetics-questions-about-aggressive-care/" style="color: rgb(102, 102, 153); text-decoration: underline; ">"tight glycemic control"</a> (defined as below 7.5 on the A1c test) in elderly diabetics, who need to control their blood sugar, but not as strictly as younger patients.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">No. 4: Turning to sleeping pills as the first choice for older people who suffer from agitation, delirium or insomnia. Xanax, Ativan, Valium, Ambien, Lunesta — "they don't magically disappear from your body when you wake up in the morning," Dr. Lee said. They continue to slow reaction times, resulting in falls and auto accidents. <a href="http://newoldage.blogs.nytimes.com/2011/03/23/simple-rules-for-better-sleep/" style="color: rgb(102, 102, 153); text-decoration: underline; ">Other sleep therapies</a> are preferable.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">No. 5: Prescribing antibiotics when tests indicate a <a href="http://newoldage.blogs.nytimes.com/2011/04/07/in-nursing-homes-a-common-infection-is-commonly-overtreated/" style="color: rgb(102, 102, 153); text-decoration: underline; ">urinary tract infection</a>, but the patient has no discomfort or other symptoms. Many older people have bacteria in their bladders but don't suffer ill effects; repeated use of antibiotics just causes drug resistance, leaving them vulnerable to more dangerous infections. "Treat the patient, not the lab test," Dr. Lee said.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">The <a href="http://www.choosingwisely.org/doctor-patient-lists/american-academy-of-hospice-palliative-medicine/" style="color: rgb(102, 102, 153); text-decoration: underline; ">palliative care doctors' Five Things list</a> cautions against delaying palliative care, which can relieve pain and control symptoms even as patients pursue treatments for their diseases.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">It also urges discussion about <a href="http://newoldage.blogs.nytimes.com/2012/06/07/a-heart-quandary/" style="color: rgb(102, 102, 153); text-decoration: underline; ">deactivating implantable cardioverter-defibrillators</a>, or ICDs, in patients with irreversible diseases. "Being shocked is like being kicked in the chest by a mule," said Eric Widera, a palliative care specialist at the San Francisco V.A. Medical Center who served on the American Academy of Hospice and Palliative Medicine working group. "As someone gets close to the end of life, these ICDs can't prolong life and they cause a lot of pain."</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">Turning the devices off — an option many patients don't realize they have — requires simple computer reprogramming or a magnet, not the surgery that installed them in the first place.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">The palliative care doctors also pointed out that patients suffering pain as cancer spreads to their bones get as much relief, the evidence shows, from a single dose of radiation than from 10 daily doses that require travel to hospitals or treatment centers.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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); "><font class="Apple-style-span" face="'Helvetica Neue'">Finally, their list warned that topical gels widely used by hospice staffs to control nausea do not work because they aren't absorbed through the skin. "We have lots of other ways to give anti-nausea drugs," Dr. Widera said.</font></p><p style="margin-top: 0px; margin-right: 0px; margin-bottom: 1em; margin-left: 0px; line-height: 1.5em; color: rgb(51, 51, 51); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; orphans: 2; text-align: 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; "><font class="Apple-style-span" face="'Helvetica Neue'">You can read all the Five Things lists (more are coming later this year), and the Consumer Reports publications that do a good job of translating them, on the<a href="http://www.choosingwisely.org/" style="color: rgb(102, 102, 153); text-decoration: underline; ">Choosing Wisely</a> Web site.</font></p></div><a href="http://newoldage.blogs.nytimes.com/2013/02/28/for-the-elderly-lists-of-tests-to-avoid/?src=recg"><font class="Apple-style-span" face="'Helvetica Neue'">http://newoldage.blogs.nytimes.com/2013/02/28/for-the-elderly-lists-of-tests-to-avoid/?src=recg</font></a><div style="font-family: Helvetica; font-size: 14px; color: black; text-align: left; "><br class="webkit-block-placeholder"></div>

For the Elderly, Medical Procedures to Avoid - NYTimes.com

The Choosing Wisely campaign, an initiative by the American Board of Internal Medicine Foundation in partnership with Consumer Reports, kick...

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