Okay for all you right-wing conspirators who believe in the bible - this thing in Egypt is interesting to me. One of the prophesies regarding the 2nd coming of Christ is that Israel will be besieged by the nations around it and Jerusalem sacked when Christ will come and consume all the infidels who fight against God's covenant people.
Now, one of Israel's most unlikely allies may be poised to become an enemy - just as every other country in the region does that holds democratic elections (AKA thuggery - please don't confuse the thuggery and looting of Egypt's democrat process with the heathen peaceful protests of the Tea Party - the fact that the Tea Partiers clean up after themselves is just OUTRAGEOUS! It's all a sham to suck you in!)
Anyways - I just thought that was interesting. I'm working 20 hour days lately getting ready to launch a concept I'm behind at my company that's going to revolutionize what we're doing in our care for the mentally disabled. So in the meantime - I'm freaking CONSUMED with work - but hopefully this pays off soon......maybe I'll get a name-plaque on my desk or a fancy pen with my name on it after 20 years for this. I HOPE! YEAH!
Gluten-free January Participants: Take the Survey!
Matt Lentzner, Janine Jagger and I have designed a survey for participants of Gluten-free January, using the online application StatCrunch. Janine is an epidemiologist who studies healthcare worker safety at the University of Virginia; she has experience designing surveys for data collection so we're glad to have her on board. The survey will allow us to systematically gather and analyze data on the results of Gluten-free January. It will be 100 percent anonymous-- none of your answers will be connected to your identity in any way.
This survey has the potential to be really informative, but it will only work if you respond! The more people who take the survey, the more informative it will be, even if you didn't avoid gluten for a single day. If not very many people respond, it will be highly susceptible to "selection bias", where perhaps the only people who responded are people who improved the most, skewing the results.
Matt will be sending the survey out to everyone on his mailing list. Please complete it, even if you didn't end up avoiding gluten at all! There's no shame in it. The survey has responses built in for people who didn't avoid gluten. Your survey will still be useful!
We have potential data from over 500 people. After we crunch the numbers, I'll share them on the blog.
This survey has the potential to be really informative, but it will only work if you respond! The more people who take the survey, the more informative it will be, even if you didn't avoid gluten for a single day. If not very many people respond, it will be highly susceptible to "selection bias", where perhaps the only people who responded are people who improved the most, skewing the results.
Matt will be sending the survey out to everyone on his mailing list. Please complete it, even if you didn't end up avoiding gluten at all! There's no shame in it. The survey has responses built in for people who didn't avoid gluten. Your survey will still be useful!
We have potential data from over 500 people. After we crunch the numbers, I'll share them on the blog.
Guest Commentary: Reflections on Community Service
Neil Goldfarb
Associate Dean for Research
Jefferson School of Population Health
On Sunday, January 30th, we held the mid-year retreat for the Greater Philadelphia Albert Schweitzer Fellowship Program at the Aletha R. Wright Center in Camden, NJ. As many of this blog’s readers already know, the Jefferson School of Population Health is the home of this regional chapter of the national Schweitzer Fellowship program. The Program provides opportunities for graduate students in a wide variety of health-related disciplines, from Universities throughout the Delaware Valley, to explore their interests in population health by conducting a year-long community service project, while pursuing their degrees.
The Aletha R. Wright Vision of Hope Center provides shelter and community-based assistance to adult homeless men. The Schweitzer Fellows spent the afternoon painting and sprucing up an exercise room, a media room being converted to a chapel, and a long hallway in need of some character. Afterwards, the Fellows shared their reflections on their projects, at this, the midway point to the academic year. I’d like to share with you a few of my own reflections on the day’s activities.
First, the Schweitzer Fellows are a truly inspirational group. They continually demonstrate passion for helping communities in need, and the program in turn is helping them to see past the “patient” to the “person.” The Fellows are a self-selected group who have applied for these positions through a competitive process. How do we broaden the opportunities for more students to share in this type of experience – especially in light of the constant challenge of securing funding, and resistance from academic program leaders who don’t encourage their students to apply?
Second, Nicole Moore, the Program Director, and I (faculty mentor), contacted many charitable organizations in the Delaware Valley looking for a site interested in having the assistance of 17 volunteers for a day, before Ms. Brown at the Wright Center welcomed us. Most of our calls and e-mails did not even receive a response. I was surprised and appalled, and wonder how often potential volunteers are turned away, or turned off, by non-response to their offers of help. Surely, our charities can do a better job of encouraging volunteerism.
Finally, for those of the Not-so-Great Society who think that we can’t afford the health insurance provisions of the Patient Protection and Affordable Care Act, I encourage you to go spend a day at the Aletha R. Wright Center talking to the residents. Then let’s talk about how we can eliminate all the waste in healthcare today, to pay for coverage for all.
French girls - Titanic and Guns!
Okay - so the republicans are in power in this country.
Our media refuses to cover that our house of representatives voted to repeal obamacare - the Senate Leader refuses to let it come up for a vote - our republicans have proposed to slash our budget by $100Billion - and the media won't cover it. It's cover-your-assets-time for the democrats - they are already running up to 2012 and know if they do ANYTHING so much as fart wrong - it's going to cause a stink. (Don't most farts?) So! There's really not a lot to write about. Just waiting for the R's to undo the evil machinations of the D's - you know? There just comes a time when "common sense" has to prevail - and we are waiting for that. So in the meantime - my political commentary is somewhat lacking.
SO - in the meantime - I really don't have the energy to waste on stupidity - there's only so much you can say about it.
And you - my enlightened readers - have better things to do that waste time on stupidity.
Obama's an idiot! Evil too! And not born in the US. And is a liar! And hates America! Is a terrorist sympathizer and is clueless and a fraud and facade! There - that should get us through until 2012 when Romney wins the White House.
In the meantime - I've put a picture here to hearken our minds back to the movie "Titanic" with a bit of a twist which is about as intelligent as our president.
I went shooting today and killed a few pop cans. That was fun. Fortunately I follow gun safety and treat every gun as though it is loaded. I had my Super .38 1911 in the kitchen to clean it - and I never assume just because the magazine is out that it is unloaded - pulled the slide back and released it as I was deciding how to clean it - then pulled the slide back to check the magazine well and the breech - and sure enough - round chambered - would have gone off in the kitchen if I'd pulled the trigger. Glad I'm safe. One of my shipmates had a weapons discharge once with his .45 1911 because he was going too fast - I always remember that and it's just stuck with me so I actually go through the military check of "clear....safe" and the finger check with my guns now.
I did jack up the slide on my Marlin .444 though - I think I'm going to have to take that to a gunsmith though. That thing is more like shooting a small artillery round or something. Ah well - maybe another day!
Our media refuses to cover that our house of representatives voted to repeal obamacare - the Senate Leader refuses to let it come up for a vote - our republicans have proposed to slash our budget by $100Billion - and the media won't cover it. It's cover-your-assets-time for the democrats - they are already running up to 2012 and know if they do ANYTHING so much as fart wrong - it's going to cause a stink. (Don't most farts?) So! There's really not a lot to write about. Just waiting for the R's to undo the evil machinations of the D's - you know? There just comes a time when "common sense" has to prevail - and we are waiting for that. So in the meantime - my political commentary is somewhat lacking.
SO - in the meantime - I really don't have the energy to waste on stupidity - there's only so much you can say about it. And you - my enlightened readers - have better things to do that waste time on stupidity.
Obama's an idiot! Evil too! And not born in the US. And is a liar! And hates America! Is a terrorist sympathizer and is clueless and a fraud and facade! There - that should get us through until 2012 when Romney wins the White House.
In the meantime - I've put a picture here to hearken our minds back to the movie "Titanic" with a bit of a twist which is about as intelligent as our president.
I did jack up the slide on my Marlin .444 though - I think I'm going to have to take that to a gunsmith though. That thing is more like shooting a small artillery round or something. Ah well - maybe another day!
The Diabetes Epidemic
The CDC just released its latest estimate of diabetes prevalence in the US (1):
These data are self-reported, and do not correct for differences in diagnosis methods, so they should be viewed with caution-- but they still serve to illustrate the trend. There was an increase in diabetes incidence that began in the early 1990s. More than 90 percent of cases are type 2 diabetics. Disturbingly, the trend does not show any signs of slowing.
The diabetes epidemic has followed on the heels of the obesity epidemic with 10-20 years of lag time. Excess body fat is the number one risk factor for diabetes*. As far as I can tell, type 2 diabetes is caused by insulin resistance, which is probably due to energy intake exceeding energy needs (overnutrition), causing a state of cellular insulin resistance as a defense mechanism to protect against the damaging effects of too much glucose and fatty acids (3). In addition, type 2 diabetes requires a predisposition that prevents the pancreatic beta cells from keeping up with the greatly increased insulin needs of an insulin resistant person**. Both factors are required, and not all insulin resistant people will develop diabetes as some people's beta cells are able to compensate by hypersecreting insulin.
Why does energy intake exceed energy needs in modern America and in most affluent countries? Why has the typical person's calorie intake increased by 250 calories per day since 1970 (4)? I believe it's because the fat mass "setpoint" has been increased, typically but not always by industrial food. I've been developing some new thoughts on this lately, and potentially new solutions, which I'll reveal when they're ready.
* In other words, it's the best predictor of future diabetes risk.
** Most of the common gene variants (of known function) linked with type 2 diabetes are thought to impact beta cell function (5).
Diabetes affects 8.3 percent of Americans of all ages, and 11.3 percent of adults aged 20 and older, according to the National Diabetes Fact Sheet for 2011. About 27 percent of those with diabetes—7 million Americans—do not know they have the disease. Prediabetes affects 35 percent of adults aged 20 and older.Wow-- this is a massive problem. The prevalence of diabetes has been increasing over time, due to more people developing the disorder, improvements in diabetes care leading to longer survival time, and changes in the way diabetes is diagnosed. Here's a graph I put together based on CDC data, showing the trend of diabetes prevalence (percent) from 1980 to 2008 in different age categories (2):
These data are self-reported, and do not correct for differences in diagnosis methods, so they should be viewed with caution-- but they still serve to illustrate the trend. There was an increase in diabetes incidence that began in the early 1990s. More than 90 percent of cases are type 2 diabetics. Disturbingly, the trend does not show any signs of slowing.
The diabetes epidemic has followed on the heels of the obesity epidemic with 10-20 years of lag time. Excess body fat is the number one risk factor for diabetes*. As far as I can tell, type 2 diabetes is caused by insulin resistance, which is probably due to energy intake exceeding energy needs (overnutrition), causing a state of cellular insulin resistance as a defense mechanism to protect against the damaging effects of too much glucose and fatty acids (3). In addition, type 2 diabetes requires a predisposition that prevents the pancreatic beta cells from keeping up with the greatly increased insulin needs of an insulin resistant person**. Both factors are required, and not all insulin resistant people will develop diabetes as some people's beta cells are able to compensate by hypersecreting insulin.
Why does energy intake exceed energy needs in modern America and in most affluent countries? Why has the typical person's calorie intake increased by 250 calories per day since 1970 (4)? I believe it's because the fat mass "setpoint" has been increased, typically but not always by industrial food. I've been developing some new thoughts on this lately, and potentially new solutions, which I'll reveal when they're ready.
* In other words, it's the best predictor of future diabetes risk.
** Most of the common gene variants (of known function) linked with type 2 diabetes are thought to impact beta cell function (5).
Two Wheat Challenge Ideas from Commenters
Some people have remarked that the blinded challenge method I posted is cumbersome.
Reader "Me" suggested:
Reader "Me" suggested:
You can buy wheat gluten in a grocery store. Why not simply have your friend add some wheat gluten to your normal protein shake.Reader David suggested:
They sell empty gelatin capsules with carob content to opacify them. Why not fill a few capsules with whole wheat flour, and then a whole bunch with rice starch or other placebo. For two weeks take a set of, say, three capsules every day, with the set of wheat capsules in line to be taken on a random day selected by your friend. This would further reduce the chances that you would see through the blind, and it prevent the risk of not being able to choke the "smoothie" down. It would also keep it to wheat and nothing but wheat (except for the placebo starch).The reason I chose the method in the last post is that it directly tests wheat in a form that a person would be likely to eat: bread. The limitation of the gluten shake method is that it would miss a sensitivity to components in wheat other than gluten. The limitation of the pill method is that raw flour is difficult to digest, so it would be difficult to extrapolate a sensitivity to cooked flour foods. You might be able to get around that by filling the pills with powdered bread crumbs. Those are two alternative ideas to consider if the one I posted seems too involved.
No birth records of Obama in Hawaii.....?
This is just too fun to keep alive - only because it's not dying for ONE reason: He hasn't shown his birth certificate. The other reason? The certificate of live birth produced in 2008 on the internet was an electronic forgery. But now....he misspoke.
STAR WARS! MOTIVATION TIME!!!!
The picture wasn't very funny but the caption was on this one - talk about dysfunctional or a great Jerry Springer episode!
IQ Test
This cracked me up but also horrified me at the same time....
IQ tests that I see on line make me laugh but also horrify me. Not the tests themselves, but the overemphasis people put on IQ tests as a determinant of their abilities and that they use them to assess or measure their worth as an individual. Maybe I'll write a post on IQ sometime. In the meantime - this made me chuckle but is also appalling to someone in the social sciences.
IQ tests that I see on line make me laugh but also horrify me. Not the tests themselves, but the overemphasis people put on IQ tests as a determinant of their abilities and that they use them to assess or measure their worth as an individual. Maybe I'll write a post on IQ sometime. In the meantime - this made me chuckle but is also appalling to someone in the social sciences.
Motorcycles....and......well....you aren't going to believe this.....
Sent to me by Dan....
I never dreamed slowly cruising through a residential neighborhood could be so incredibly dangerous!
Studies have shown that motorcycling requires more decisions per second, and more sheer data processing than nearly any other common activity or sport.
The reactions and accurate decision making abilities needed have been likened to the reactions of fighter pilots! The consequences of bad decisions or poor situational awareness are pretty much the same for both groups too.
Occasionally, as a rider I have caught myself starting to make bad or late decisions while riding. In flight training, my instructors called this being "behind the power curve". It is a mark of experience that when this begins to happen, the rider recognizes the situation, and more importantly, does something about it. A short break, a meal, or even a gas stop can set things right again as it gives the brain a chance to catch up.
Good, accurate, and timely decisions are essential when riding a
motorcycle...at least if you want to remain among the living. In short, the brain needs to keep up with the machine.
I had been banging around the roads of east Texas and as I headed back into Dallas, found myself in very heavy, high-speed traffic on the freeways.
Normally, this is not a problem, I commute in these conditions daily, but suddenly I was nearly run down by a cage that decided it needed my lane more than I did. This is not normally a big deal either, as it happens around here often, but usually I can accurately predict which drivers are not paying attention and avoid them before we are even close. This one I missed seeing until it was nearly too late, and as I took evasive action I nearly broadsided another car that I was not even aware was there!
Two bad decisions and insufficient situational awareness...all within
seconds. I was behind the power curve. Time to get off the freeway.
I hit the next exit, and as I was in an area I knew pretty well, headed
through a few big residential neighborhoods as a new route home. As I turned onto the nearly empty streets I opened the visor on my full-face helmet to help get some air. I figured some slow riding through the quiet surface streets would give me time to relax, think, and regain that "edge" so frequently required when riding.
Little did I suspect...
As I passed an oncoming car, a brown furry missile shot out from under it and tumbled to a stop immediately in front of me. It was a squirrel, and must have been trying to run across the road when it encountered the car. I really was not going very fast, but there was no time to brake or avoid it-it was that close.
I hate to run over animals...and I really hate it on a motorcycle, but a squirrel should pose no danger to me. I barely had time to brace for the impact.
Animal lovers, never fear. Squirrels can take care of themselves!
Inches before impact, the squirrel flipped to his feet. He was standing on his hind legs and facing the oncoming Valkyrie with steadfast resolve in his little beady eyes. His mouth opened, and at the last possible second, he screamed and leapt! I am pretty sure the scream was squirrel for, "Banzai!" or maybe, "Die you gravy-sucking, heathen scum!" as the leap was spectacular and he flew over the windshield and impacted me squarely in the chest.
Instantly he set upon me. If I did not know better I would have sworn he brought twenty of his little buddies along for the attack. Snarling, hissing, and tearing at my clothes, he was a frenzy of activity. As I was dressed only in a light t-shirt, summer riding gloves, and jeans this was a bit of a cause for concern. This furry little tornado was doing some damage!
Picture a large man on a huge black and chrome cruiser, dressed in jeans, a t-shirt, and leather gloves puttering maybe 25mph down a quiet residential street...and in the fight of his life with a squirrel. And losing.
I grabbed for him with my left hand and managed to snag his tail. With all my strength I flung the evil rodent off the left of the bike, almost running into the right curb as I recoiled from the throw.
That should have done it. The matter should have ended right there. It really should have. The squirrel could have sailed into one of the
pristinely kept yards and gone on about his business, and I could have headed home. No one would have been the wiser.
But this was no ordinary squirrel. This was not even an ordinary pissed-off squirrel.
This was an evil attack squirrel of death!
Somehow he caught my gloved finger with one of his little hands, and with the force of the throw swung around and with a resounding thump and an amazing impact he landed square on my back and resumed his rather anti-social and extremely distracting activities. He also managed to take my left glove with him!
The situation was not improved. Not improved at all. His attacks were continuing, and now I could not reach him.
I was startled to say the least. The combination of the force of the throw, only having one hand (the throttle hand) on the handlebars, and my jerking back unfortunately put a healthy twist through my right hand and into the throttle. A healthy twist on the throttle of a Valkyrie can only have one result. Torque. This is what the Valkyrie is made for, and she is very, very good at it.
The engine roared as the front wheel left the pavement. The squirrel
screamed in anger. The Valkyrie screamed in ecstasy. I screamed
in...well...I just plain screamed.
Now picture a large man on a huge black and chrome cruiser, dressed in jeans, a slightly squirrel torn t-shirt, and only one leather glove roaring at maybe 70mph and rapidly accelerating down a quiet residential street...on one wheel and with a demonic squirrel on his back. The man and the squirrel are both screaming bloody murder.
With the sudden acceleration I was forced to put my other hand back on the handlebars and try to get control of the bike. This was leaving the mutant squirrel to his own devices, but I really did not want to crash into somebody's tree, house, or parked car. Also, I had not yet figured out how to release the throttle...my brain was just simply overloaded. I did manage to mash the back brake, but it had little affect against the massive power of the big cruiser.
About this time the squirrel decided that I was not paying sufficient
attention to this very serious battle (maybe he is a Scottish attack
squirrel of death), and he came around my neck and got IN my full-face helmet with me. As the faceplate closed partway and he began hissing in my face I am quite sure my screaming changed tone and intensity. It seemed to have little affect on the squirrel however.
The rpm's on The Dragon maxed out (I was not concerned about shifting at the moment) and her front end started to drop.
Now picture the large man on the huge black and chrome cruiser, dressed in jeans, a very ragged torn t-shirt, and wearing one leather glove, roaring at probably 80mph, still on one wheel, with a large puffy squirrel's tail sticking out his mostly closed full-face helmet. By now the screams are probably getting a little hoarse.
Finally I got the upper hand...I managed to grab his tail again, pulled him out of my helmet, and slung him to the left as hard as I could. This time it worked...sort-of. Spectacularly sort-of, so to speak.
Picture the scene. You are a cop. You and your partner have pulled off on a quiet residential street and parked with your windows down to do some paperwork.
Suddenly a large man on a huge black and chrome cruiser, dressed in jeans, a torn t-shirt flapping in the breeze, and wearing one leather glove, moving at probably 80mph on one wheel, and screaming bloody murder roars by and with all his strength throws a live squirrel grenade directly into your
police car.
I heard screams. They weren't mine...
I managed to get the big motorcycle under directional control and dropped the front wheel to the ground. I then used maximum braking and skidded to a stop in a cloud of tire smoke at the stop sign at a busy cross street.
I would have returned to fess up (and to get my glove back). I really would have. Really. But for two things. First, the cops did not seem interested or the slightest bit concerned about me at the moment. One of them was on his back in the front yard of the house they had been parked in front of and was rapidly crabbing backwards away from the patrol car. The other was standing in the street and was training a riot shotgun on the police cruiser.
So the cops were not interested in me. They often insist to "let the
professionals handle it" anyway. That was one thing. The other? Well, I swear I could see the squirrel, standing in the back window of the patrolcar among shredded and flying pieces of foam and upholstery, and shaking hislittle fist at me. I think he was shooting me the finger...
That is one dangerous squirrel. And now he has a patrol car...
I took a deep breath, turned on my turn-signal, made an easy right turn, and sedately left the neighborhood.
As for my easy and slow drive home? Screw it. Faced with a choice of 80mph cars and inattentive drivers, or the evil, demonic, attack squirrel of death...I'll take my chances with the freeway. Every time.
And I'll buy myself a new pair of gloves.
Auto-Correct doesn't help an argument....
I've had arguments via text...they are kind of tiring.....but having an autocorrect that messes up your words doesn't help your case any....but could be fun!
I still like this one though - passsing a cop at 180mph (290kmh)
I think I've posted this before but - I still crack up on this one because - one - I've been the cop on the side of the road over this stuff - and I used to ride my motorcycle like this.....the thing that sucks is the road is HARD at at that speed - bumps feel like boulders often and even going across those freeway cement/blacktop dividers can be a harrowing experience at that speed - honestly only been up to about 160 on a bike but faster in - lol - my acura - what's eastern oregon for? The whole time I'm thinking - "okay - going so fast now I'm either going to have a blast or die instantly...."
Crash caught on police dash cam
I saw one like this when I was a cop....only it was an RX-7 and it ended up in a tree but the tree "caught" the car and the driver dropped out and then took off running back to his apartment so he could say he didn't know what happened - his story was that he let someone else drive the car for a test drive to sell it and that he didn't know how it got there.....mmmm yeah....he lived though and was unharmed but it was a DUI - that's what saved him.....
Blinded Wheat Challenge
Self-experimentation can be an effective way to improve one's health*. One of the problems with diet self-experimentation is that it's difficult to know which changes are the direct result of eating a food, and which are the result of preconceived ideas about a food. For example, are you more likely to notice the fact that you're grumpy after drinking milk if you think milk makes people grumpy? Maybe you're grumpy every other day regardless of diet? Placebo effects and conscious/unconscious bias can lead us to erroneous conclusions.
The beauty of the scientific method is that it offers us effective tools to minimize this kind of bias. This is probably its main advantage over more subjective forms of inquiry**. One of the most effective tools in the scientific method's toolbox is a control. This is a measurement that's used to establish a baseline for comparison with the intervention, which is what you're interested in. Without a control measurement, the intervention measurement is typically meaningless. For example, if we give 100 people pills that cure belly button lint, we have to give a different group placebo (sugar) pills. Only the comparison between drug and placebo groups can tell us if the drug worked, because maybe the changing seasons, regular doctor's visits, or having your belly button examined once a week affects the likelihood of lint.
Another tool is called blinding. This is where the patient, and often the doctor and investigators, don't know which pills are placebo and which are drug. This minimizes bias on the part of the patient, and sometimes the doctor and investigators. If the patient knew he were receiving drug rather than placebo, that could influence the outcome. Likewise, investigators who aren't blinded while they're collecting data can unconsciously (or consciously) influence it.
Back to diet. I want to know if I react to wheat. I've been gluten-free for about a month. But if I eat a slice of bread, how can I be sure I'm not experiencing symptoms because I think I should? How about blinding and a non-gluten control?
Procedure for a Blinded Wheat Challenge
1. Find a friend who can help you.
2. Buy a loaf of wheat bread and a loaf of gluten-free bread.
3. Have your friend choose one of the loaves without telling you which he/she chose.
4. Have your friend take 1-3 slices, blend them with water in a blender until smooth. This is to eliminate differences in consistency that could allow you to determine what you're eating. Don't watch your friend do this-- you might recognize the loaf.
5. Pinch your nose and drink the "bread smoothie" (yum!). This is so that you can't identify the bread by taste. Rinse your mouth with water before releasing your nose. Record how you feel in the next few hours and days.
6. Wait a week. This is called a "washout period". Repeat the experiment with the second loaf, attempting to keep everything else about the experiment as similar as possible.
7. Compare how you felt each time. Have your friend "unblind" you by telling you which bread you ate on each day. If you experienced symptoms during the wheat challenge but not the control challenge, you may be sensitive to wheat.
If you want to take this to the next level of scientific rigor, repeat the procedure several times to see if the result is consistent. The larger the effect, the fewer times you need to repeat it to be confident in the result.
* Although it can also be disastrous. People who get into the most trouble are "extreme thinkers" who have a tendency to take an idea too far, e.g., avoid all animal foods, avoid all carbohydrate, avoid all fat, run two marathons a week, etc.
** More subjective forms of inquiry have their own advantages.
The beauty of the scientific method is that it offers us effective tools to minimize this kind of bias. This is probably its main advantage over more subjective forms of inquiry**. One of the most effective tools in the scientific method's toolbox is a control. This is a measurement that's used to establish a baseline for comparison with the intervention, which is what you're interested in. Without a control measurement, the intervention measurement is typically meaningless. For example, if we give 100 people pills that cure belly button lint, we have to give a different group placebo (sugar) pills. Only the comparison between drug and placebo groups can tell us if the drug worked, because maybe the changing seasons, regular doctor's visits, or having your belly button examined once a week affects the likelihood of lint.
Another tool is called blinding. This is where the patient, and often the doctor and investigators, don't know which pills are placebo and which are drug. This minimizes bias on the part of the patient, and sometimes the doctor and investigators. If the patient knew he were receiving drug rather than placebo, that could influence the outcome. Likewise, investigators who aren't blinded while they're collecting data can unconsciously (or consciously) influence it.
Back to diet. I want to know if I react to wheat. I've been gluten-free for about a month. But if I eat a slice of bread, how can I be sure I'm not experiencing symptoms because I think I should? How about blinding and a non-gluten control?
Procedure for a Blinded Wheat Challenge
1. Find a friend who can help you.
2. Buy a loaf of wheat bread and a loaf of gluten-free bread.
3. Have your friend choose one of the loaves without telling you which he/she chose.
4. Have your friend take 1-3 slices, blend them with water in a blender until smooth. This is to eliminate differences in consistency that could allow you to determine what you're eating. Don't watch your friend do this-- you might recognize the loaf.
5. Pinch your nose and drink the "bread smoothie" (yum!). This is so that you can't identify the bread by taste. Rinse your mouth with water before releasing your nose. Record how you feel in the next few hours and days.
6. Wait a week. This is called a "washout period". Repeat the experiment with the second loaf, attempting to keep everything else about the experiment as similar as possible.
7. Compare how you felt each time. Have your friend "unblind" you by telling you which bread you ate on each day. If you experienced symptoms during the wheat challenge but not the control challenge, you may be sensitive to wheat.
If you want to take this to the next level of scientific rigor, repeat the procedure several times to see if the result is consistent. The larger the effect, the fewer times you need to repeat it to be confident in the result.
* Although it can also be disastrous. People who get into the most trouble are "extreme thinkers" who have a tendency to take an idea too far, e.g., avoid all animal foods, avoid all carbohydrate, avoid all fat, run two marathons a week, etc.
** More subjective forms of inquiry have their own advantages.
Best way to lose a baby tooth: BY MODEL ROCKET!
Kids - I'm pretty sure you can try this at home because this kid did and I know his dad wasn't a trained professional either.....
Well....there goes that analogy on self defense with guns.....
WELLLLLLL.....proponents of the 2nd amendment have often cited the fact that there aren't shootings in police stations as evidence for the necessity of carrying a firearm to protect one's self. There was, in fact, a shooting at a police station in Detroit. http://www.foxnews.com/us/2011/01/23/detroit-police-department-respond-sto-precinct-shooting-reports/
The police shot and killed the gunman however.
But now I guess the point, or the analogy is - if someone's willing to walk in a police station and shoot the police....who's safe? Why should the police be the only ones armed? Concealed carry! All the more reason to be armed!
The police shot and killed the gunman however.
But now I guess the point, or the analogy is - if someone's willing to walk in a police station and shoot the police....who's safe? Why should the police be the only ones armed? Concealed carry! All the more reason to be armed!
Population Health Colloquium--MARCH 2011
As the nation comes to grip with all the implications of Health Reform, and a renewed interest in work site wellness, prevention, care coordination and value based purchasing, the School of Population Health is presenting a forum to explore all of these issues. The Population Health Colloquium is a three day event co-located with two sister conferences on the Medical Home and Palliative Care set for March 13, 14, 15 and 16 in Philadelphia. Our School will also be conducting a pre conference work shop on the fundamentals of Population Health with lectures by four of our leading faculty members. Our special Sunday night March 13th "Book Event" is a great opportunity to meet more than half a dozen nationally prominent authors who will discuss their recent books, sign copies, and take questions from the audience about their work in health care. Our kick off speaker, Dr Nancy Snyderman, is the Chief Medical Correspondent for NBC National News and herself, an expert on care coordination, patient empowerment, and prevention. I am hoping to see scores of readers at our Colloquium and look forward to the ensuing dialogue. For more information go to www.populationhealthcolloquium.com. See you then!!
Second Amendment Musings....
If the First Amendment read "A free press being necessary to the security of a free state, Congress shall make no law respecting . . . the freedom of speech, or of the press," nobody would argue that free speech belongs only to newspapers. Likewise, they should not argue that the right to keep and bear arms belongs only to government agents. - Chief Justice William Rehnquist, writing for the majority in U.S. v. Verdugo-Urquidez (1990), stated that the term "the people" has the same meaning in the First, Second, Fourth, Ninth and Tenth Amendments. All those five amendments in the Bill of Rights use the term "the people" to guarantee a right for individual citizens, not just some collective right of the state as a whole. There is no reason to believe that the Second Amendment uses the term "the people" differently from the other four amendments.
- The claim that "militia" just refers to the National Guard is ridiculous. The same Congress that passed the Second Amendment also passed the Militia Act of 1792 which defined militia as "each and every able-bodied male citizen" from age 18 to 45 (with some exceptions) and stated that each one shall "provide himself" with a gun, ammunition, and a bayonet.
- The currently effective Militia Act substantially keeps the same language ("all able-bodied males at least 17 years of age and . . . under 45"), and further defines militia as: "(1) the organized militia, which consists of the National Guard and the Naval Militia; and (2) the unorganized militia, which consists of the members of the militia who are not members of the National Guard or the Naval Militia." (10 U.S.C. 311)
Paper Tiger......music - whoop de doo....ChiCom Propaganda at the White House
You know - that's nice and all - poor taste and everything - but I don't think it's going to bring down America. If that's all you can do is squander your 15 minutes of fame to play a song in someone's house that sings about how you hate them and hope someone recognizes it and you get excited and snigger about it in the locker room- I mean - that's so facebook or junior high. I always knew were superior to the commies - morally, intellectually, technologically - you name it and this just shows it again - never mind about everything good in the world has come primarily from Western Civilization while the claim they invented gunpowder and the Muslims claim they invented Arabic numerals which actually came from India.
Besides - we don't have time to write, know or understand propaganda songs in the U.S. They are meaningless to us. While the Chinese and Koreans and other commies sit around singing about how great they are, the Americans are actually out kicking some ass and liberating countries and really doing something good in the world. Songs are for loser regimes who have nothing else going for them. So is communist socialism. Though I imagine Obama knew the tune.....probably sang it in college. I'm sure we'll see camera footage of him tapping his foot to it and singing the words somewhere sometime.
At any rate - you know the guy was doing something in order to score something from his Dear Leader. Maybe the little prick (pronounced short Chinese pianist) had his family in a death camp for accidentally googling Falun Gong or something and he was trying to win sympathy to get them out.You'd think they'd be happy though - here's our Kenyan-in-Chief bending over yet again to kiss some commie leader's ass or smoke his whatever - I thought Obama was going to fix all this for us. I thought everyone was going to love us when he became pres. Either he lied - or the world is a little more complicated than the obamabots think or the democrat media isn't telling us the full story
Pray I don't alter it any further.......
I think I've posted this before but I could use the pick me up.....
Rejection Letter Rejection
Dear Hiring Manager,
Thank you for your letter of March 1.
After careful consideration, I regret to inform you that I am unable to accept your refusal to offer me a position in your department.
This year I have been particularly fortunate in receiving an unusually large number of rejection letters. With such a varied and promising field of candidates, it is impossible for me to accept all refusals.
Despite your companies outstanding qualifications and previous experience in rejecting applicants, I find that your rejection does not meet my needs at this time. Therefore, I will assume the position in your department this August.
I look forward to seeing you then.
Best of luck in rejecting future applicants.
Sincerely,
Interviewee
Thank you for your letter of March 1.
After careful consideration, I regret to inform you that I am unable to accept your refusal to offer me a position in your department.
This year I have been particularly fortunate in receiving an unusually large number of rejection letters. With such a varied and promising field of candidates, it is impossible for me to accept all refusals.
Despite your companies outstanding qualifications and previous experience in rejecting applicants, I find that your rejection does not meet my needs at this time. Therefore, I will assume the position in your department this August.
I look forward to seeing you then.
Best of luck in rejecting future applicants.
Sincerely,
Interviewee
Congress Woman is Concealed Handgun Carrier.....
Well - this is interesting. I do carry a concealed handgun myself but I don't tell people (except the world on my blog).
http://www2.nbc17.com/news/2011/jan/21/rep-ellmers-plans-carry-handgun-ar-713460/
Part of the stratagem of carrying a concealed handgun is the element of surprise. I don't know what good it does to tell everyone you're packing - but - anyways - this is interesting.....
http://www2.nbc17.com/news/2011/jan/21/rep-ellmers-plans-carry-handgun-ar-713460/
Part of the stratagem of carrying a concealed handgun is the element of surprise. I don't know what good it does to tell everyone you're packing - but - anyways - this is interesting.....
Landing the space shuttle......
Back when I was young, I wanted to go into space.....I had my career all mapped out....God has taken me other places instead that are more meaningful than being in the air but I do miss it from when I learned to fly.....at any rate - I think if you get to fly this you've hit the top and there's nowhere else to go any higher.....this is a sweet video.
Third Annual AMSA-IHI Patient Safety and Quality Leadership Institute
More than 50 students, from schools of medicine, pharmacy and nursing descended on the Jefferson School of Population Health for a weekend-long immersion in patient safety and quality movement.
Led by faculty from JSPH, and including leaders from Penn, Vanderbilt, Hofstra and the AAMC, these students were exposed to the latest thinking in curriculum design, experiential learning and safety simulation. The didactic presentations, facilitated workshops, and project presentations were all first rate.
Key themes emerged – insufficient faculty in the health sciences to teach the tenets of quality and safety, insufficient curriculum time devoted to these critical issues and, above all else, a lack of urgency in most schools responsible for career preparation for health professionals. This, despite the fact that 11 persons die every hour in our great nation from preventable medical errors!! That means nearly 300 persons perished during the formal part of our weekend-long teaching and learning event.
We ended the weekend with a checklist of ideas to implement "tomorrow" and a call for renewed energy for curricula and system reform.
For me, it was both an energizing experience to work with so many wonderful students from around the nation, and physically exhausting trying to keep up with their level of enthusiasm for all three days!! I am grateful for their total participation in this annual event and look forward to giving one of the three "Thought Leader" presentations at the 1,000-student strong AMSA Annual Convention on March 11, 2011 in Washington DC.
Are you learning about safety to save lives in your health system??
DAVID NASH
Southern Humor - Southern Jokes
Alabama
| A group of Alabama friends went deer hunting and paired off in twos for the day. That night, one of the hunters returned alone, staggering under the weight of an eight-point buck. "Where's Henry?" the others asked. "Henry had a stroke o' some kind. He's a couple of miles back up the trail," the successful hunter replied. "You left Henry layin' out there and carried the deer back?" they inquired. "A tough call," nodded the hunter. "But I figured no one's gonna steal Henry!" |
Georgia
| The owner of a golf course in Georgia was confused about paying an invoice, so he decided to ask his secretary for some mathematical help. He called her into his office and said, "Y'all graduated from the University of Georgia and I need some help. If I wuz to give yew $20,000, minus 14%, how much would you take off?" The secretary thought a moment, and then replied, "Everthang but my earrings." |
Louisiana
| A senior citizen in Louisiana was overheard saying ... "When the end of the world comes, I hope to be in Louisiana." When asked why, he replied, "I'd rather be in Louisiana 'cause everythang happens in Louisiana 20 years later than in the rest of the world." |
Mississippi
| The young man from Mississippi came running into the store and said to his buddy, "Bubba, somebody just stole your pickup truck from the parking lot!" Bubba replied, "Did y'all see who it was?" The young man answered, "I couldn't tell, but I got the license number." |
North Carolina
| A man in North Carolina had a flat tire, pulled off on the side of the road, and proceeded to put a bouquet of flowers in front of the car and one behind it. Then he got back in the car to wait. A passerby studied the scene as he drove by, and was so curious he turned around and went back. He asked the fellow what the problem was. The man replied, "I got a flat tahr." The passerby asked, "But what's with the flowers?" The man responded, "When you break down they tell you to put flares in the front and flares in the back. I never did understand it neither." |
Tennessee
| A Tennessee State trooper pulled over a pickup on I-65. The trooper asked, "Got any ID?" The driver replied, "Bout whut?" |
Texas
| The Sheriff pulled up next to the guy unloading garbage out of his pick-up into the ditch. The Sheriff asked, "Why are you dumping garbage in the ditch? Don't you see that sign right over your head." "Yep," he replied. "That's why I'm dumpin' it here, 'cause it says: 'Fine For Dumping Garbage.' " |
***
Y'all kin say whut y'all want 'about the South, but y'all never heard o' nobody retirin' an' movin' North.
OVER HALF of U.S. States Oppose Obamacare....
I wish Oregon was one of them.....but this looks promising. They have gone back to 1799 to Thomas Jefferson to pull this one up! Nullify the thing! If 27 states nullified the healthcare law??? Instant death to Obamacare. http://www.foxnews.com/politics/2011/01/20/idaho-nullify-obamas-health-care-law/
Summer Mornings: A break from winter drudgery......
I just needed a break from the rain here......Its Oregon and it goes for months now here.....
Eating Wheat Gluten Causes Symptoms in Some People Who Don't Have Celiac Disease
Irritable bowel syndrome (IBS) is a condition characterized by the frequent occurrence of abdominal pain, diarrhea, constipation, bloating and/or gas. If that sounds like an extremely broad description, that's because it is. The word "syndrome" is medicalese for "we don't know what causes it." IBS seems to be a catch-all for various persistent digestive problems that aren't defined as separate disorders, and it has a very high prevalence: as high as 14 percent of people in the US, although the estimates depend on what diagnostic criteria are used (1). It can be brought on or exacerbated by several different types of stressors, including emotional stress and infection.
Maelán Fontes Villalba at Lund University recently forwarded me an interesting new paper in the American Journal of Gastroenterology (2). Dr. Jessica R. Biesiekierski and colleagues recruited 34 IBS patients who did not have celiac disease, but who felt they had benefited from going gluten-free in their daily lives*. All patients continued on their pre-study gluten-free diet, however, all participants were provided with two slices of gluten-free bread and one gluten-free muffin per day. The investigators added isolated wheat gluten to the bread and muffins of half the study group.
During the six weeks of the intervention, patients receiving the gluten-free food fared considerably better on nearly every symptom of IBS measured. The most striking difference was in tiredness-- the gluten-free group was much less tired on average than the gluten group. Interestingly, they found that a negative reaction to gluten was not necessarily accompanied by the presence of anti-gluten antibodies in the blood, which is a test often used to diagnose gluten sensitivity.
Here's what I take away from this study:
I don't expect everyone to benefit from avoiding gluten. But for those who are really sensitive, it can make a huge difference. Digestive, autoimmune and neurological disorders associate most strongly with gluten sensitivity. Avoiding gluten can be a fruitful thing to try in cases of mysterious chronic illness. We're two-thirds of the way through Gluten-Free January. I've been fastidiously avoiding gluten, as annoying as it's been at times***. Has anyone noticed a change in their health?
* 56% of volunteers carried HLA-DQ2 or DQ8 alleles, which is slightly higher than the general population. Nearly all people with celiac disease carry one of these two alleles. 28% of volunteers were positive for anti-gliadin IgA, which is higher than the general population.
** Some people feel they are reacting to the fructans in wheat, rather than the gluten. If a modest amount of onion causes the same symptoms as eating wheat, then that may be true. If not, then it's probably the gluten.
*** I'm usually about 95% gluten-free anyway. But when I want a real beer, I want one brewed with barley. And when I want Thai food or sushi, I don't worry about a little bit of wheat in the soy sauce. If a friend makes me food with gluten in it, I'll eat it and enjoy it. This month I'm 100% gluten-free though, because I can't in good conscience encourage my blog readership to try it if I'm not doing it myself. At the end of the month, I'm going to do a blinded gluten challenge (with a gluten-free control challenge) to see once and for all if I react to it. Stay tuned for more on that.
Maelán Fontes Villalba at Lund University recently forwarded me an interesting new paper in the American Journal of Gastroenterology (2). Dr. Jessica R. Biesiekierski and colleagues recruited 34 IBS patients who did not have celiac disease, but who felt they had benefited from going gluten-free in their daily lives*. All patients continued on their pre-study gluten-free diet, however, all participants were provided with two slices of gluten-free bread and one gluten-free muffin per day. The investigators added isolated wheat gluten to the bread and muffins of half the study group.
During the six weeks of the intervention, patients receiving the gluten-free food fared considerably better on nearly every symptom of IBS measured. The most striking difference was in tiredness-- the gluten-free group was much less tired on average than the gluten group. Interestingly, they found that a negative reaction to gluten was not necessarily accompanied by the presence of anti-gluten antibodies in the blood, which is a test often used to diagnose gluten sensitivity.
Here's what I take away from this study:
- Wheat gluten can cause symptoms in susceptible people who do not have celiac disease.
- A lack of circulating antibodies against gluten does not necessarily indicate a lack of gluten sensitivity.
- People with mysterious digestive problems may want to try avoiding gluten for a while to see if it improves their symptoms**.
- People with mysterious fatigue may want to try avoiding gluten.
I don't expect everyone to benefit from avoiding gluten. But for those who are really sensitive, it can make a huge difference. Digestive, autoimmune and neurological disorders associate most strongly with gluten sensitivity. Avoiding gluten can be a fruitful thing to try in cases of mysterious chronic illness. We're two-thirds of the way through Gluten-Free January. I've been fastidiously avoiding gluten, as annoying as it's been at times***. Has anyone noticed a change in their health?
* 56% of volunteers carried HLA-DQ2 or DQ8 alleles, which is slightly higher than the general population. Nearly all people with celiac disease carry one of these two alleles. 28% of volunteers were positive for anti-gliadin IgA, which is higher than the general population.
** Some people feel they are reacting to the fructans in wheat, rather than the gluten. If a modest amount of onion causes the same symptoms as eating wheat, then that may be true. If not, then it's probably the gluten.
*** I'm usually about 95% gluten-free anyway. But when I want a real beer, I want one brewed with barley. And when I want Thai food or sushi, I don't worry about a little bit of wheat in the soy sauce. If a friend makes me food with gluten in it, I'll eat it and enjoy it. This month I'm 100% gluten-free though, because I can't in good conscience encourage my blog readership to try it if I'm not doing it myself. At the end of the month, I'm going to do a blinded gluten challenge (with a gluten-free control challenge) to see once and for all if I react to it. Stay tuned for more on that.
Guest Commentary: Developing Improvement Leaders
Valerie Pracilio, MPH
Project Manager for Quality Improvement
Jefferson School of Population Health
There is a "gigantic challenge between the scale of the emergency and the scale of the response" said Bono at the National Prayer Breakfast in 2006. While he was referring to the AIDS epidemic, the same can be said for health care. This weekend, close to 50 students joined together on Jefferson's campus for the 3rd Annual Patient Safety and Quality Leadership Institute to learn how to be leaders in improving our healthcare system and address the emergency. In the time we spent talking about these issues this past weekend, nearly 300 lives were lost to medical errors (11lives/hour), as Dr. Nash mentioned in the previous post. How can this be acceptable in a system that is intended to help them?
Medical, nursing and pharmacy students came together this weekend, making the Institute interdisciplinary for the first time in its three-year history. This accomplishment was the result of collaboration between the program co-sponsors, the Jefferson School of Population Health (JSPH), the American Medical Student Association (AMSA) and the Institute for Healthcare Improvement (IHI). All three of these groups are working to improve the system, but we still have a long way to go.
As an IHI Open School Chapter leader, I hear about these challenges all the time, but we have to be sure to celebrate that there are a lot of great people working to fix the issues. Students have limited opportunities, at best, to learn about quality and safety in the classroom. Their voluntary participation this weekend is an indication that they already recognize safety and quality is part of their responsibility. As Donald Berwick, former CEO of the IHI, says, “the structure of the health-care system encourages good people to make harmful medical errors.”
The challenge facing the students was how to take what they learned back to their school/institution and educate others, in essence becoming advocates for improvement. We have a dual role as clinicians and leaders. The majority of current healthcare professionals don't understand this and future healthcare professionals need to be taught. The weekend started with a group of students interested in learning about quality and safety, but it concluded with a network of improvement leaders energized to create change. There is no doubt that the leaders developed this weekend will advance the improvement movement.
American Idol.....OMG!!!!! NO WAYYYYY!!!!
For those who have daughters who are girly-girls (I can see mine being like this but I won't be surprised if she's not.....she's pretty grounded......). LOL.
Life in Portland.....CANT YOU READ?????
Portland is like a reader's or author's paradise. There are more books and periodical shops here than you'll ever be able to finish in five lifetimes....and it is some mark of sophistication and haute culture to be familiar with them all.....if you live downtown......so I don't know that this is really that FUNNY but it is making fun of the people who live here.....and it did make me laugh though it's over the top.....
BUMPER STICKER TIME!!!!
This is one step up above "Bumper Sticker" - but I like the concept - if you have a ribbon.....you're a good person. Does this mean if you have a bigger ribbon you are better than others? Or a ribbon with glittery stuff?
Illusory Instructions......
Since the news is essentially the same and I don't feel like expending precious brain cells used to become a doctor of psychology on commenting on the fraudulent idiocy that is Obama and the Democrat party....I'll instead post some wonderful instructions.......not that you'll use them, but maybe you'll enjoy them. Maybe these or something like it are what the dems are handing out and calling obamacare.....
The history of medicine.......
"My throat is hurting...."
2000 BC : "eat this root"
1200 AD : "That root is heathen, say this prayer."
1500 AD : "That prayer is superstition, drink this elixir."
1800 AD : "That elixir is snake oil, Take this pill."
1900 AD : "That pill is ineffective, Take this antibiotic."
2000 AD : "That antibiotic is artificial!
Here, why don't you eat this root?"
Photographer of Military Funerals Needs Help......
This is an acquaintance of mine - he attends and photographs every single funeral of our veterans here in the state of Oregon and around washington and sometimes Idaho. He has documented every single casualty of the current wars on his webpages www.iraqwarheroes.com and www.afghanistanwarheroes.com. http://blogs.wweek.com/news/2011/01/18/photographer-of-military-funerals-needs-help-to-continue-his-work/
Anyways, Q only is able to do his work off donations as his work is non-profit. If you'd like to help remember those who have died in the service of their country, click one of the links above and you will find links to donate. I've looked at Q's photography and he has some very impressive work - he posts regularly on his facebook page.
Anyways, Q only is able to do his work off donations as his work is non-profit. If you'd like to help remember those who have died in the service of their country, click one of the links above and you will find links to donate. I've looked at Q's photography and he has some very impressive work - he posts regularly on his facebook page.
CAREFUL!!!!!
We had to post the sign because of legal liabilities. Then OSHA told us we needed more signs and that one wasn't enough warming.
Epic Nervous Breakdown.......
Would you want to be married to this? Or grow up with it? I would say "general anxiety disorder" maybe with OCD tendencies to start with......I would also suspect abuse in her childhood from some of her phraseology....maybe insecure attachment disorder traits.....
random pics!
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| Choking my...... |
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| The gas is always at least half full |
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| Thats......not a muppet in your engine.... |
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| I am your father..... "Noooooooooooooo!!!!" |
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| its pretty..... |
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