Halloween History

I was asked to repeat the history of Halloween again since it had been a couple of years, so here it is.

Halloween is an annual celebration, but just what is it actually a celebration of? And how did this peculiar custom originate? Is it, as some claim, a kind of demon worship and should we be appalled by it? Or is it just a harmless vestige of some ancient pagan ritual?

The Celts, who lived 2,000 years ago in the area that is now Ireland, the United Kingdom, and northern France, celebrated their new year on November 1. This day marked the end of summer and the harvest and the beginning of the dark, cold winter, a time of year that was often associated with human death.

Celts believed that on the night before the New Year, the boundary between the worlds of the living and the dead became blurred. On the night of October 31, they celebrated Samhain, and it was believed that the ghosts of the dead returned to earth at this time. In addition to causing trouble and damaging crops, Celts thought that the presence of the otherworldly spirits made it easier for the Druids, or Celtic priests, to make predictions about the future. For a people entirely dependent on the volatile natural world, these prophecies were an important source of comfort and direction during the long, dark winter.

To commemorate the event, Druids built huge sacred bonfires, where the people gathered to burn crops and animals as sacrifices to the Celtic deities.
During the celebration, the Celts wore costumes, typically consisting of animal heads and skins, and attempted to tell each other's fortunes. When the celebration was over, they re-lit their hearth fires, which they had extinguished earlier that evening, from the sacred bonfire to help protect them during the coming winter.

By A.D. 43, Romans had conquered the majority of Celtic territory. In the course of the four hundred years that they ruled the Celtic lands, two festivals of Roman origin were combined with the traditional Celtic celebration of Samhain.

The first was Feralia, a day in late October when the Romans traditionally commemorated the passing of the dead. The second was a day to honor Pomona, the Roman goddess of fruit and trees. The symbol of Pomona is the apple and the incorporation of this celebration into Samhain probably explains the tradition of "bobbing" for apples that is practiced today on Halloween.

By the 800s, the influence of Christianity had spread into Celtic lands. In the seventh century, Pope Boniface IV designated November 1 All Saints' Day, a time to honor saints and martyrs.

It is widely believed today that the pope was attempting to replace the Celtic festival of the dead with a related, but church-sanctioned holiday. The celebration was also called All-hallows or All-hallowmas (from Middle English Alholowmesse meaning All Saints' Day) and the night before it, the night of Samhain, began to be called All-hallows Eve and, eventually, Halloween. Even later, in A.D. 1000, the church would make November 2 All Souls' Day, a day to honor the dead. It was celebrated similarly to Samhain, with big bonfires, parades, and dressing up in costumes as saints, angels, and devils. Together, the three celebrations, the eve of All Saints', All Saints', and All Souls', were called Hallowmas.

The custom of Halloween was brought to America in the 1840's by Irish immigrants fleeing their country's potato famine. At that time, the favorite pranks in New England included tipping over outhouses and unhinging fence gates and may have been the beginning of pranks associated with this day.

The custom of trick-or-treating is thought to have originated not with the Irish Celts, but with a ninth-century European custom called souling. On November 2, All Souls Day, early Christians would walk from village to village begging for "soul cakes," made out of square pieces of bread with currants. The more soul cakes the beggars would receive, the more prayers they would promise to say on behalf of the dead relatives of the donors. At the time, it was believed that the dead remained in limbo for a time after death, and that prayer, even by strangers, could expedite a soul's passage to heaven.

The Jack-o-lantern custom probably comes from Irish folklore. As the tale is told, a man named Jack, who was notorious as a drunkard and trickster, tricked Satan into climbing a tree. Jack then carved an image of a cross in the tree's trunk, trapping the devil up the tree. Jack made a deal with the devil that, if he would never tempt him again, he would promise to let him down the tree.

According to the folk tale, after Jack died, he was denied entrance to Heaven because of his evil ways, but he was also denied access to Hell because he had tricked the devil. Instead, the devil gave him a single ember to light his way through the frigid darkness. The ember was placed inside a hollowed-out turnip to keep it glowing longer. The Irish used turnips as their "Jack's lanterns" originally. But when the immigrants came to America, they found that pumpkins were far more plentiful than turnips. So the Jack-O-Lantern in America was a hollowed-out pumpkin, lit with an ember.

So, although some cults may have adopted Halloween as their favorite "holiday," the day itself did not grow out of evil practices. It grew out of the rituals of Celts celebrating a new year, and out of medieval prayer rituals of Europeans.

And today, even many churches have Halloween parties or pumpkin carving events for the kids. After all, the day itself is only as evil as one cares to make it.

New Report on Marijuana

The Department of Health in the United Kingdom recently funded a systematic review of many studies related to marijuana use.

It is now suggested there is sufficient new evidence that the use of cannabis (marijuana) increases the risk for later psychotic illness by roughly 40%.

There was also a trend towards an increased risk for depression in people who had used cannabis, but the evidence was not as strong.

The article was recently published in the July 28 issue of The Lancet.

The study revealed that individuals who used cannabis on a weekly or daily basis had about a 2- to 3-fold increase in risk for psychotic outcomes and these were independent of other confounding factors.

The authors feel strongly that the evidence warrants advising everyone, particularly young people, that the use of cannabis does potentially have some health risks and especially if they are using it on a regular basis.

The results showed a consistent increased risk for psychotic outcomes in the people who had ever used cannabis compared to those who never used it and a greater risk in individuals who had used it most frequently.

The overall message is that people who use cannabis on a regular basis need to be aware of this risk, so they can make an informed judgment about whether they want to continue using it, or perhaps try to cut down their use or seek treatment of dependency.

A separate physician from Copenhagen University Hospital in Denmark, wrote an editorial and stated that the study is the most comprehensive meta-analysis to date of this possible causal relationship and the adjustment for confounding factors and transient effects and therefore agreed with the authors' conclusion that there is sufficient evidence to warn young people that cannabis use will increase the risk of psychosis later in life.

The bottom line of the study is:

• Use of cannabis is associated with increased risk for psychosis in later life, with an increased risk of 1.41% and a dose-response relationship.
• Risk for depression may be increased with cannabis use, but evidence is not consistent.

Do your Civic Duty

As a public service to readers and to those who do not know this information, voters do have the ability to avoid the precincts for voting.


The link referred to in the photo is:

http://www.indianavoters.com/PublicSite/(X(1)A(ZRIIPGweRJJcR_R3GtzgIy-x2iITey1J8iNaO9mcIKhlGqcp9bw01uQwyigI1WZ7hc8jFti7VzfoKVfplzweZ3QhCbH8WWJXYYRTr0hnrUk1))/Public/PublicContactLookup.aspx?AspxAutoDetectCookieSupport=1

The link points the viewer to the following locations in Floyd county.

County Election Board Contact Information
Facility:

FLOYD COUNTY VOTER REGISTRATION
Facility Address:
PO BOX 1056
NEW ALBANY
IN
47151-1056
Phone:
812-948-5419

FLOYD COUNTY VOTER REGISTRATION
Facility Address:
PO BOX 1056
NEW ALBANY
IN
47151-1056
Phone:
812-948-5419

Working Replica of Noah's Ark Opens

SCHAGEN, Netherlands

The massive central door in the side of Noah's Ark was thrown open Saturday
- you could say it was the first time in 4,000 years - drawing a crowd
Of curious pilgrims and townsfolk to behold the wonder



Of course, it's only a replica of the biblical Ark, built by Dutch Creationist Johan Huibers as a testament to his faith in the literal truth of the Bible.

Reckoning by the old biblical measurements, Johan's fully functional ark



Is 150 cubits long, 30 cubits high and 20 cubits wide. That's two-thirds the length of a football field and as high as a three-story house. Life-size models of giraffes, elephants, lions, crocodiles, zebras, Bison and other animals greet visitors as they arrive in the main hold.

"The design is by my wife, Bianca," Huibers said. "She didn't really want me to do this at all, but she said if you're going to anyway,it should look like this."

A contractor by trade, Huibers built the ark of cedar and pine --- Biblical Scholars debate exactly what the wood used by Noah would have been.

Huibers did the work mostly with his own hands, using modern tools and occasional help from his son Roy. Construction began in May 2005.

On the uncovered top deck - not quite ready in time for the opening- will come a petting zoo, with baby lambs and chickens, and goats and one camel. Visitors on the first day were stunned.

"It's past comprehension," said Mary Louise Starosciak, who happened to be bicycling by with her husband while on vacation when they saw the ark looming over the local landscape.

"I knew the story of Noah, but I had no idea the boat would have been so big."

In fact, Noah's Ark as described in the Bible was five times larger than Johan's Ark.

But that still leaves enough space near the keel for a 50-seat film theater, where kids can watch the segment of the disney film "Fantasia" that tells the story of Noah.

Another exhibit shows water cascading down on a model of the Ark. Exhibits on the third level show ancient tools and old-fashioned barrels, exotic stuffed animals, and a wax model of an exhausted Noah reclining on a bed in the forecastle.



Genesis says Noah kept seven pairs of most domesticated animals and one breeding pair of all other creatures, plus his wife, three sons and three daughters-in-law together on the boat for almost a year while the world was deluged.

Perhaps it was only logical that the replica project would be the brainchild of a Dutchman: fear of floods are ingrained in the country's collective consciousness by its water-drenched history.

Lois Poppema, visiting from California, said she thought the Netherlands was exactly the right place for an ark.

"Just a few weeks ago we saw Al Gore on television . Saying that all Holland will be flooded" due to rising sea levels, she said. "I don't think the man who made this ever expected that global warning will become (such an important) issue - and suddenly having the ark would be meaningful in the middle of Holland."

Under sunny clear skies Saturday, Huibers said he wasn't worried about another biblical flood, since according to Genesis, the rainbow is the sign of God's promise never to flood the world again. But he does worry that recent events such as the flooding of New Orleans could be seen as a portent of the end of time.

Huibers said he hopes the project will renew interest in Christianity in the Netherlands, where churchgoing has fallen dramatically in the past 50 years. He also plans to visit major cities in Belgium and Germany.

New ACP Diabetic Recommendations

Hemoglobin A1c is a blood test used to measure the average blood sugar in diabetics and it gives a rough estimate on how high or low the blood sugar has been over the past 2-3 months.

It is recommended in all diabetics every three months.

The American College of Physicians (ACP) has recently issued a guidance statement on the optimal hemoglobin A1c targets for patients with type 2 diabetes and it was published in the September 18 issue of the Annals of Internal Medicine. They did this partly because there were varying recommendations from different medical specialties.

After reviewing the available guidelines, the ACP committee issued 3 summary statements:

Statement 1: The goal for blood sugar control should be set as low as is feasible to prevent microvascular complications of diabetes, while avoiding undue risk for adverse events or placing an unacceptable burden on patients. Discussing with the patient the risks and benefits of specific levels of glycemic control should precede setting treatment goals.

Based on individualized assessment, a hemoglobin A1c level less than 7% is a reasonable target for many patients, but not for all. Hemoglobin A1c goals higher than 7% may be indicated for patients who are elderly or frail, who are at higher risk for adverse events from tight control, or who have substantially lowered life expectancy from comorbid conditions. More stringent targets may be indicated in patients who are at increased risk for microvascular complications.

Statement 2: Individualized evaluation of risk for complications from diabetes, comorbidity, life expectancy, and patient preferences should determine the specific goal for hemoglobin A1c level.

Statement 3: The ACP committee recommends additional research to evaluate the optimal level of glycemic control, particularly in patients who have significant comorbid conditions.

As with most things in medicine, the ACP reaffirms the “cookbook” approach is not adequate and may be harmful in some patients.

Once again, we have reinforced the belief there is an art of medicine as well as the science of medicine.

Another good Marketing Move

Wal-Mart has announced it is expanding the $4 prescription program. In doing so, they will add drugs to treat glaucoma, attention deficit disorder/hyperactivity disorder, fungal infections and acne. Fertility and prescription birth control will be available for $9.

It was about a year or so ago that Wal-Mart took the first step to offer this program and many pharmacies have followed the same path. It has given patients an opportunity to help direct their healthcare by asking for drugs on this list. The program now has drugs in most all categories that patients may choose.

This program reportedly accounts for nearly 40% of all prescriptions filled in its Wal-Mart, Sam's Club and Neighborhood Market pharmacies and it is estimated that over the past year, the program has saved customers $613.6 million.

As always, while applauding the expanded program, critics noted that it does not address the often crippling cost of brand-name prescription medicines. I’m not sure why they think Wal-Mart should control the costs of these drugs when the markup and profit margin on brand name drugs is far less than generics.

Insurance companies who often complain about the drug costs as an excuse for high premiums certainly have not dropped their rates since this program was instituted.

It was also noted that Wal-Mart's pharmacies have seen double-digit comparable store sales growth since the program began last fall in Tampa, Florida. I am sure there were many customers who bought more than just prescription drugs making this another profitable move.

Once again, Wal-Mart is showing why they remain a multi-billion dollar company and why so may people still choose to shop there.

Verbal Personality

Many times we find ourselves doing good work and deeds but it is often perceived differently. Why does it occur?

It is often the tone of our voice rather than what we say that makes the difference.

Tone is best defined as what people “hear” you saying, not what you actually said. It’s the expressed but unsaid meaning.

Many of us in our professions are asked to perform a variety of roles throughout the day and to perform the role means that we must many times verbalize information to a colleague, superior, employee, patient etc.

Our voice is our “verbal personality” and is what is heard by the other person. It may actually constitute 33-40 percent of the overall impact or impression on others.

What we actually say may only constitute a mere 7-10 percent.

It has been said that whenever role and voice conflict, people believe the voice…regardless of how well you perform the job.

Good customer service and communication is to make sure your voice always harmonizes with your role or job.

Your role usually dictates the voice you use even if the voice you use is staged for that particular job.

In some regards, we may need to sound differently than how we actually feel in order to get our message across in the manner we wish it to be received.

Other nonverbal cues also need to be in harmony in order to be perceived well.

Remember, we know that at least 93 percent of your impact on people is your delivery style…the way you present what you present.

These are important points to remember when we are dealing with the public, patients, co-workers, but this performance is not always beneficial when trying to build lasting personal relationships.

There are times when truth and honesty have to be addressed even when it may not be received well. Tact is still important here as well.

All of us struggle with these things and if you are like me, I struggle more than the average guy.

But I am still a work in progress.

Newest Study on Vaccines

A new study recently released should reassure families concerned about vaccines and the questionable links to neurological problems in children.

This new study involved 1,047 children who were exposed to varying levels of thimerosal while in the womb or after birth in the 1990s. These children belonged to four health maintenance organizations that are part of a federal project to study the side effects of vaccines. Their mercury exposure was determined through medical and immunization records and interviews with parents.

Each child was tested for speech and language skills, motor coordination and intelligence. Parents, teachers and trained specialists also rated stuttering, attention span and tic disorders such as head shaking, eye blinking and neck jerking. A total of 42 neurological problems were analyzed.

On balance, researchers did not find a consistent pattern between increasing thimerosal exposure and the risk of these problems. However, they said one finding merited further study: Boys exposed to higher mercury levels seemed to have more tic problems – a link seen in previous research.

This large federal study lends further support and should reassure parents about the safety of shots their kids received a decade or more ago.

A separate study due out in a year will look specifically at any link to Autism directly, but it is unlikely to find anything different from this current report.

This CDC study was reviewed by an independent panel of scientists and statisticians who oversaw its design, reviewed results and contributed to writing the report and the panel included one vaccine opponent – Sallie Bernard, executive director of the consumer group SafeMinds.

Although she had a role in planning the study, she asked to be listed as a "dissenting member" because she disagreed with the study's conclusions.

Although past scientific studies have found no link between autism and thimerosal-containing vaccines, these facts have not hindered the lawsuits and the highly charged issue went on trial this summer.

A court in Washington, D.C., heard from an Arizona mother who blamed vaccines on her 12-year-old daughter's severe autism. This case is being followed by about 5,000 families who filed similar claims to receive compensation from a federal vaccine injury fund but as of this date, the fund so far has not paid out an autism claim.

Watch what you say

In a story out of Scranton, Pa. a woman was cited for disorderly conduct because of her “potty mouth” when she allegedly shouted profanities at her overflowing toilet within earshot of a neighbor.

She could face up to 90 days in jail and a fine of up to $300 but an attorney with the American Civil Liberties Union in Philadelphia took issue with the citation and will likely challenge it.

The woman stated, "It doesn't make any sense. I was in my house. It's not like I was outside or drunk." "The toilet was overflowing and leaking down into the kitchen and I was yelling (for my daughter) to get the mop."

She didn’t recall exactly what she said, but she admitted letting more than a few choice words fly near an open bathroom window where her next-door neighbor, a city police officer who was off-duty at the time, asked her to keep it down. When she continued, the officer called police.

The ACLU stands by the claim that you can't prosecute somebody for swearing at a cop or a toilet!

New Diagnostic tool for Lung Cancer

Since Indiana and Kentucky are the two highest ranked states for Lung cancer, this new report is promising.

Researchers recently reported at a cancer conference about a new test that can evaluate elevated blood levels of the protein human aspartyl (asparaginyl) ß-hydroxylase (HAAH) and it offers promise as an additional diagnostic tool for lung cancer.

They stated when used in conjunction with CT scanning, the HAAH serum ELISA might be able to facilitate an earlier diagnosis of lung cancer and increase the rate of survival.

Elevated levels of HAAH cannot confirm whether a person has lung cancer but can be used as a routine screening test for recommending further diagnostic evaluation. This is similar to the way most cancer biomarker tests, like prostate-specific antigen or carcinoembryonic antigen, are meant to work.

Statistically there will be approximately 213,000 individuals living in the United States diagnosed with lung cancer in 2007 and it will also be the underlying cause of more than 160,000 deaths.

Better outcomes could be achieved with earlier diagnosis.

The researches say the 5-year survival for lung cancer is only 15% but could be boosted to 50% when the diagnosis is made when the patient still has localized disease.

This HAAH serum ELISA test therefore has great promise as an additional diagnostic tool for lung cancer but will only be utilized if it is cost effective and accepted by the third party payers.

Breath Testing for Diabetes

Current medical technology has given us CT scans, MRI’s, PET scans, EEG’s, EKG’s and we seem to be getting ever so close to the Tricorder era of Star Trek.

A research group out of California is now looking at using analyses of elevated methyl nitrate content in exhaled gas as a means to monitor blood sugar in patients with diabetes. This would save them from the repeated and dreaded finger sticks.

Breath analysis is showing promise as a diagnostic tool in a number of clinical areas, such as with ulcers and cystic fibrosis but as of now, no clinical breath test exists for diabetes.

Studies are currently underway and of all the gases analyzed, the kinetic profile of exhaled methyl nitrate most strongly statistically correlated with that of plasma glucose (P = .003 – .001) in 16 of 18 experiments.

This study group is currently involved with new studies looking at the correlation of other gases with hyperglycemia and other variables including insulin and will eventually put together a full exhaled gas profile of diabetes and maybe find an easier way to monitor.

The Decline of the Nobel

It would appear that the Nobel Peace Prize just added another controversial recipient to its list and has further subjected this once honorable award to an ever increasing decline. The continued politization of this award is very disappointing.

Just a day or so before the prize was awarded, a London Newpaper posted the following article.

I guess the Nobel Prize committee has adopted the following mantra:

“Don’t Confuse Me With The Facts”

Judge attacks nine errors in Al Gore's 'alarmist' climate change film

A controversial documentary on climate change which has been sent to thousands of schools has been criticised by a High Court judge for being 'alarmist' and 'exaggerated'.

Mr Justice Burton said former US vice-president Al Gore's film, An Inconvenient Truth, was 'one-sided' and would breach education rules unless accompanied by a warning.

Despite winning lavish praise from the environmental lobby and an Oscar from the film industry, Mr Gore's documentary was found to contain 'nine scientific errors' by the judge.

A High Court judge ruled Al Gore's An Inconvenient Truth was 'alarmist' and 'exaggerated'


These inconvenient untruths included the claim that the snows on Mount Kilimanjaro were disapearing and solely due to the global warming and that sea levels will rise up to 20 feet in the near future.

Kent school governor Stewart Dimmock brought the legal action, claiming the film was unfit for schools

Impressed by the film's slick message on climate change, the Government sent copies of the documentary to all secondary schools in England earlier this year, along with two short films and an animation about the carbon cycle produced by Defra.

Ruling that the film could be shown in schools as part of the climate change resource pack, Mr Justice Burton warned it must be accompanied by new guidance notes to balance Mr Gore's partisan views.

The High Court action was brought by a father-of-two who accused Labour of 'brainwashing' children with propaganda.

Kent school governor Stewart Dimmock claimed the film was unfit for schools as it was politically partisan, containing serious scientific inaccuracies and 'sentimental mush'.

Lorry driver and member of the political group, the New Party, Mr Dimmock had sought a court order to ban the documentary after the Government decided to distribute the documentary and four short films to 3,500 schools in February.

Yesterday he said he was delighted with the outcome: "The film contains blatant inaccuracies. It's a political shockumentary, it's not a scientific documentary."

Describing the documentary as 'a powerful, dramatically presented and highly professionally produced film', Mr Justice Burton said it was built round the 'charismatic presence' of the ex vice president 'whose crusade it now is to persuade the world of the dangers of climate change caused by global warming'.

But he said it might be necessary for the Government to make clear to teaching staff that some of Mr Gore's views were not supported or promoted by the Government, and there was 'a view to the contrary'.

Agreeing that Mr Gore's film was 'broadly accurate' on the subject of climate change, he found that errors had arisen in 'the context of alarmism and exaggeration'.
The judge then set out nine errors in the film which went against current mainstream scientific consensus:

When the judge indicated last week what his findings were likely to be, the Government updated the accompanying guidance to schools.

A Government spokesperson said it was not proposing to make any further comment on the case.

At least London hasn't lost all rational thought!!

In addition to the above article, an op-ed peace was posted in the Boston Globe about the award and the overall decline in the legitimacy.

http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/10/13/an_inconvenient_peace_prize/

Alcohol can make a man stumble.....and stupid

Here is a report from a local Portland paper.

PORTLAND, Ore. (AP) - Snake collector Matt Wilkinson of Portland grabbed a 20-inch rattler from the highway near Maupin, and three weeks later, to impress his ex-girlfriend, he stuck the serpent in his mouth.

He was soon near death with a swollen tongue that blocked his throat. Trauma doctors at the Oregon Health and Science University saved his life.

"You can assume alcohol was involved," he said. Actually, not just beer. It was something he called a "mixture of stupid stuff."

Calls from cable network television stations poured in Tuesday, when he still had sore muscles and nerves from the venom.

It happened at a barbecue with friends.

Wilkinson, 23, had downed a six-pack and his ex-girlfriend asked him for a beer. He handed her one, not realizing the snake was also in his hand.

"She said, 'Get that thing out of my face,'" Wilkinson said. "I told her it was a nice snake.
'Nothing can happen. Watch.'"

So he stuck the snake in his mouth.

"It got a hold of my tongue," he said.

He was having breathing problems when his ex-girlfriend drove him to the hospital. "She was the only one sober," Wilkinson said.

En route, they spotted a police car and asked for help.

His next memory, he said, was waking up at the hospital.

Doctors could not get a breathing tube down his throat.

Dr. Richard Mullins cut a hole in Wilkinson's neck to insert the breathing tube. Physicians started giving antivenin, moved him to intensive care and kept him sedated until the swelling went down.

The Poison Control Center sees about 50 people a year with snake bites, usually hikers. Deaths from rattlesnake bites in Oregon are extremely rare.

Wilkinson, who works in construction, has yet to return to work. His three Western diamondback rattlers have been removed from his home.

He says co-workers have been pretty blunt.

"They were like, 'What the heck were you thinking?'" Wilkinson said.
The answer? "It's my own stupidity."


So let's keep the alcohol and snakes separate!

More chart abbreviations

Here are a few more charting abbreviations found during routine reviews:

ADR Ain't Doin' Right.
ART Assuming Room Temperature (recently deceased).
ATSWWT Always Thinks Something's Wrong With Them.
CTD Circling The Drain.
DAAD Dead As A Doornail.
DRT Dead Right There.
FDGB Fall Down Go Boom.
FFFF Female, Fat, Forty and Flatulent.
FLD Funny Looking Dad.
FLK Funny Looking Kid.
FOS Full Of ... Stool.
FTD Fixing To Die.
FTF Failure To Fly.
FTW Friggin Train Wreck (patient with multiple problems).
GFPO Good For Parts Only.
GGTG Gomers Go To Ground (they fall out of bed or gurneys).
GLM Good Looking Mum.
GOMER Get Out of My Emergency Room.
LOLINAD Little Old Lady In No Acute Distress.
MFC Measure For Coffin.
O2T Oxygen Thief.
ODD&DDR Out 'De Door and Down 'De Road.
PBBB Pine Box By Bedside.
PIP Pyjama Induced Paralysis.
PITA Pain In The A**.
PJAR Person Just Ain't Right.
SALT Same As Last Time.
SNEFS Sub-Normal Even For Suffolk.
SWAG Scientific, wild-A** Guess.
TBW Tossed By Wave.
TMB Too Many Birthdays.
TOBAS Take Out Back And Shoot.
TTGA Told To Go Away.
WDWNF Well Developed Well Nourished Female.

I am sure there are more out there

Diet Decisions

Many patients ask my opinion on diets and which one I think is best.
Unfortunately, this is not an easy question to answer.

I believe weight watchers has the best success rate for long term success and lifestyle modification, but the HMR program offered at Floyd and other hospitals is a wonder program for significant weight loss; but it is very regimented and somewhat expensive.

If someone wants to really change to a lifestyle of dietary modification, I believe the Mediterranean diet is the best all around.

The Mediterranean Diet is ideal for people who like to cook, enjoy Mediterranean cuisine, want very few dietary restrictions, and are interested in making a permanent lifestyle change.

Moderation is the key and unlike the customary Western style of quickly eating large portions, the Mediterranean Diet places great emphasis on spending time on preparing and enjoying small, tasty meals.

This plan teaches people to choose low-fat, low- cholesterol foods that are packed with flavor and will leave them feeling fulfilled.

The Mediterranean diet consists of fruits, vegetables, whole grains, beans, nuts, pasta, rice and seeds. Olive oil also accompanies most of these meals as it is a main ingredient in food preparation. Dairy products are consumed in low to moderate amounts in the form of cheese and yogurt and animal proteins are included, but are eaten in lesser amounts when compared to plant proteins.

The Mediterranean Diet was developed because researchers noticed that people who live in the Mediterranean region live longer and have fewer heart attacks than people in other developed countries

Some of the Mediterranean Diet recommendations are:
- Eat lots of complex carbohydrates—breads, pasta, whole grain foods.
- Eat several servings of fruits and vegetables every day. A serving or two of legumes or nuts every day is okay, too.
- Use olive oil and other monosaturated oils (peanut or canola oil) every day.
- Low fat dairy products, like cheese and yoghurt can be eaten every day.
- Eat lots of fish. Most of your “meat” meals should have fish. You can eat fish several times a week.
- Eat smaller amounts of poultry and eggs, but you can still have them several times a week.
- You may have small amounts of sweets a few times a week.
- Eat only very small amounts of red meat, only a few times a month.
- Drink at least six glasses of water a day.
- Drink a little red wine. Most people recommend keeping it to a glass or two a day. You can drink grape juice, if you prefer.

So relax, take time for the meals and enjoy the companionship of family and friends as you eat better and become healthier.

British changing their Dress Code

The “superbug” referred to as MRSA (Methicillin-resistant Staphylococcus aureus) has British hospital officials even more concerned than the US based on their recent dress code banning neckties, long sleeves and jewelry for doctors – and their traditional white coats – in an effort to stop the spread of deadly hospital-borne infections.

They are referring to this as the "bare below the elbows" dress code and hope it will help prevent the spread of MRSA which is resistant to nearly every available antibiotic and can be deadly.

MRSA accounts for more than 40 percent of in-hospital blood infections in Britain and because the bacteria are so hard to kill, health care workers are focusing on containing its spread through improvements to hospital hygiene.

Hospital dress codes typically urge doctors to look professional, which, for male practitioners, has usually meant wearing a tie. But as concern over hospital-borne infections has intensified, doctors are taking a closer look at their clothing.

Neck ties are rarely laundered and many times worn daily contributing to the colonization of bacteria. They also perform no beneficial function in patient care and can therefore be eliminated.

The other measures they are taking are to eliminate fake nails, jewelry and watches.
The 2004 study of doctors' neckties at a New York hospital found nearly half of them carried at least one species of infectious microbe.

The U.S. isn’t recommending these measures as they believe there is no strong evidence that health care workers who don't wear ties or jewelry reduce the risk of infection.

Most in the U.S. believe doctors and nurses who don't adequately wash their hands pose a far bigger risk to patients and that hand-washing should be the focus of infection control efforts in hospitals, but the federal Centers for Disease Control and Prevention does have guidelines advising doctors and nurses against wearing artificial nails in operating rooms and around high-risk patients.

More good reasons to dress casual and save on the clothing allowance.

Ditch the antibiotics, hang on to the dog

We have talked before about allergies and the fact that kid’s exposure to dirt and animals may actually be protective.

There is something now referred to as the hygiene hypothesis of allergy; or germs are good for you.

The hypothesis is that the super-clean environment with minimal microbial exposure may promote the immune response to create more of a certain type of helper T-cell and disrupt the balance.

Previous studies of children raised on farms have suggested that exposure early in life to less hygienic environments resulted in a lower rates of allergy and asthma.

In a more recent study from the journal Chest, children were found to have asthma and allergy problems by age seven if in the first year of life they received repeated courses of antibiotics or if they did not have a dog in the house.

In this study, researchers analyzed health care and prescription data on a cohort of 13,000 children born in Manitoba, Canada, in 1995 and followed up at age 7.

Half the subjects lived in rural areas and the investigators found that, without regard to well-known asthma risk factors, asthma was significantly more likely to develop in children who had received antibiotics in the first year of life and in those homes with no dog.

The risk was highest in children who received more than 4 courses of antibiotics.
The thought so far is that antibiotics kill off germs, whereas dogs bring germs into the home. As lead author Anita Kozyrskyj, MD, put it, "Exposure to germs is lower in the absence of a dog. The administration of an antibiotic may further reduce this exposure and increase the likelihood of asthma development."

So man’s best friend may actually help your health.

Oh my aching back

Back pain is one of the most difficult and frequent complaints in primary care offices. It is difficult partly because many patients who use this complaint for non-legitimate reasons in an effort to obtain drugs or malinger for other financial benefits. It creates a skeptical view from many physicians.

Just recently, the American College of Physicians (ACP) and the American Pain Society (APS) have issued a comprehensive joint clinical practice guideline for the diagnosis and treatment of low back pain and published them in the October 2 issue of the Annals of Internal Medicine.

These new guidelines offer recommendations concerning how to categorize patients, when to perform imaging studies, educational information for patients, self-care, when to prescribe medications and what types, and nonpharmacologic therapy.

The most important recommendation is that clinicians should not routinely order imaging and other diagnostic tests. This will not set well with most patients, because the majority immediately wants an MRI or something else to determine the cause.

The impetus for the creation of these guidelines was a meeting of a multidisciplinary panel of experts convened in 2006 by ACP and APS. Their mission was to develop questions and the scope of an evidence report on low back pain, to review the available evidence in this field, and to generate recommendations assisting primary care clinicians in diagnosing and treating low back pain.

The joint ACP-APS guidelines target primary care physicians and these guidelines do not address invasive therapies performed by specialists.

The current joint ACP-APS recommendations provide an algorithm for physicians that would categorize patients into 1 of 3 general subgroups: (1) nonspecific low back pain (accounts for 85% of patients); (2) back pain potentially associated with spinal conditions, such as spinal stenosis, sciatica, and vertebral compression fracture; and (3) back pain potentially associated with another specific cause, such as cancer.

Of the first group (85%) the guidelines recommend not routinely ordering imaging studies like X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI), or other diagnostic tests.

The guidelines recommend these tests being reserved to evaluate only those patients who have severe or progressive neurologic deficits or who are suspected to have cancer, infection, or other underlying condition.

The specific recommendations in the guidelines are as follows:

• Focused history and physical examination should help categorize patients into 1 of 3 broad groups: nonspecific low back pain, back pain potentially associated with radiculopathy or spinal stenosis, or back pain potentially associated with another specific spinal cause. Evaluation of psychosocial risk factors is essential during history taking because these predict the risk for chronic disabling low back pain (strong recommendation; moderate-quality evidence).
• For patients with nonspecific low back pain, clinicians should not routinely perform imaging studies, including radiographs, CT scans, and MRI, or other diagnostic tests (strong recommendation; moderate-quality evidence).
• Patients with severe or progressive neurologic deficits, or in whom history and physical examination suggest cancer, infection, or other underlying condition as the cause of their low back pain, should undergo imaging studies and other appropriate diagnostic tests (strong recommendation; moderate-quality evidence).
• Patients with persistent low back pain and signs or symptoms of radiculopathy or spinal stenosis should undergo MRI or CT only if positive results would potentially lead to surgery or epidural steroid injection for suspected radiculopathy. In choosing an imaging procedure, MRI is preferred to CT (strong recommendation; moderate-quality evidence).
• Patient education by clinicians should include provision of evidence-based information on low back pain. Topics that should be covered include expected course and effective self-care options. Clinicians should also counsel their patients to stay physically active (strong recommendation; moderate-quality evidence).
• When pharmacotherapy is considered, drugs of choice should be those with proven benefits, and they should be used together with self-care and back care education. Before starting a patient on pharmacotherapy, clinicians should evaluate pain and functional deficits at baseline. They should also review the risk-benefit ratio of specific medications before prescribing them and should consider the relative lack of long-term efficacy and safety data (strong recommendation; moderate-quality evidence). Acetaminophen or NSAIDs are preferred first-line drugs for most patients.
• When self-care options do not result in improvement, clinicians should consider adding nonpharmacologic modalities shown to be of benefit. For acute low back pain, the only modality in this category is spinal manipulation. For chronic or subacute low back pain, modalities shown to be of benefit are intensive interdisciplinary rehabilitation, exercise therapy, acupuncture, massage therapy, spinal manipulation, yoga, cognitive-behavioral therapy, or progressive relaxation (weak recommendation; moderate-quality evidence).

The Newest Agendas

2008 Democratic National Convention Schedule of Events

7:00 pm~ Opening flag burning
7:15 pm~ Pledge of Allegiance to the U. N.
7:20 pm~ Ted Kennedy proposes a toast
7:25 pm~ Nonreligious prayer a nd worship with Jesse Jackson and Al Sharpton
7:45 pm~ Ceremonial tree hugging
7:55 pm~ Ted Kennedy proposes a toast
8:00 pm~ How I Invented the Internet - Al Gore
8:15 pm~ Gay Wedding Planning - Barney Frank presiding
8:35 pm~ Ted Kennedy proposes a toast
8:40 pm~ Our Troops are War Criminals - John Kerry
9.00 pm~ Memorial service for Saddam and his sons - Cindy Sheehan and Susan Sarandon
10:00 pm~ "Answering Machine Etiquette" - Alec Baldwin
11:00 pm~ Ted Kennedy proposes a toast
11:05 pm~ Collection for the Osama Bin Laden kidney transplant fund--Barbra Streisand
11:15 pm~ F ree the Freedom Fighters from Guantanamo Bay- Sean Penn
11:30 pm~ Oval Office Affairs - William Jefferson Clinton
11:45 pm~ Ted Kennedy proposes a toast
11:50 pm~ How George Bush Brought Down the World TradeTowers- Howard Dean
12:15 am~ "Truth in Broadcasting Award" - Presented to Dan Rather by Michael Moore
12:25 am~ Ted Kennedy proposes a toast
12:30 am~ Satellite address by Mahmoud Ahmadinejad
12:45 am ~ Nomination of Hillary Rodham Clinton by Nancy Pelosi
1:00 am~ Ted Kennedy proposes a toast
1:05 am ~ Coronation of Hillary Rodham Clinton
1:30 am~ Ted Kennedy proposes a toast
1:35 am~ Bill Clinton asks Ted Kennedy to drive Hillary home


Republican National Convention Schedule

06:00 pm - Opening Prayer led by the Reverend Jerry Falwell
06:30 pm - Pledge of Allegiance
06:35 pm - Burning of Bill of Rights (excluding 2nd amendment)
06:45 pm - Salute to the Coalition of the Willing
06:46 pm - Seminar #1: "Getting your kid a military deferment"
07:30 pm - First Presidential Beer Bash for Bush
07:35 pm - Serve Freedom Fries
07:40 pm - EPA Address #1: "Mercury: how to ignore the 14 states litigating against the U.S. government"
07:50 pm - William Safire on the dangers of non-Protestant religion
08:00 pm - Vote on which country to invade next
08:05 pm - Trent Lott recognizes/salutes the KKK contingent
08:10 pm - Call EMTs to revive Rush Limbaugh
08:15 pm - John Ashcroft Lecture: "The Homos are after your children"
08:30 pm - Roundtable discussion on reproductive rights (MEN only)
08:50 pm - Seminar #2: "Corporations: the government of the future"
09:00 pm - Condi Rice sings "Can't Help Lovin' Dat Man"
09:05 pm - Second Presidential Beer Bash for Bush
09:10 pm - EPA Address #2:" Trees: the real cause of forest fires"
09:15 pm - Roundtable discussion on the best way to bankrupt the federal government.

09:30 pm - Break for secret meetings

09:35 pm - Dick Cheney on why we must invade Canada and find their weapons of mass destruction.
10:00 pm - Second prayer led by Pat Robertson
10:15 pm - Lecture by Karl Rove: "Doublespeak made easy"
10:30 pm - Rumsfeld demonstration of how to squint and talk macho
10:35 pm - Bush demonstration of his trademark "deer in the headlights" stare
10:40 pm - John Ashcroft demonstrates new mandatory kevlar chastity belt
10:45 pm - Clarence Thomas takes a minute to read the list of black republicans
10:46 pm - Third Presidential Beer Bash for Bush
10:50 pm - Seminar #3: "Education: a drain on our nation's economy"
11:10 pm - Hillary Clinton Piñata
11:20 pm - Second Lecture by John Ashcroft: "Evolutionists -- the dangerous new cult"
11:30 pm - Call EMTs to revive Rush Limbaugh again
11:35 pm - Blame Clinton
11:40 pm - Laura serves milk and cookies
11:45 pm - Pass the hat for the "Kenny Lay Defense Fund"
11:50 pm - Closing Prayer led by Jesus Himself
12:00 am - Nomination of George W. Bush as Holy Supreme Planetary Leader

So which convention would you attend??

Thoughts from the General

In the face of all the media publicity about our current War against Terror, I thought it was appropriate to reiterate what Robert E. Lee once stated





"It appears we have appointed our worst generals to command forces,
and our most gifted and brilliant to edit newspapers.
In fact, I discovered by reading newspapers that these editor/geniuses
plainly saw all my strategic defects from the start,
yet failed to inform me until it was too late.
Accordingly, I am readily willing to yield my command
to these obviously superior intellects, and I will, in turn,
do my best for the Cause by writing editorials - after the fact."
- Robert E. Lee, 1863

Forum for the Politically Active and Concerned

The above announcement was sent out yesterday and I would encourage anyone who is politically motivated or anyone concerned with the issue to try and attend.

This forum would allow good input into changes that may help many of us in Southern Indiana as we sometimes appear to be treated as a stepchild to the larger cities in northern Indiana and the INDY area.

I am not sure if Connie Sipes is participating, but I am sure she will have input. She has been very good to work with in the past and she is a good listener.

ISMA Bulletin

Physicians in Indiana should have received information from the ISMA (Indiana State Medical Association) about the deadline approaching for filing claims under Blue Cross Blue Shield settlement.

Physicians eligible to recover under the recent Blue Cross and Blue Shield (BC/BS) litigation settlement must file claims by Oct. 19, 2007. The settlement is available to physicians, physician groups and physician organizations that provided covered services to any individual enrolled in or covered by a settling BC/BS plan any time between May 22, 1999, and May 31, 2007.

The web site for the above picture is: http://www.ismanet.org/news/e-reports/special_alerts/9-27-07_bluecross.htm

Controversy over the science of data interpretation

In another classic example of medical disagreement and the interpretation of data, Medical Economics published a summary of the controversy over the diabetic drug Avandia.

Re-analysis of data shows no increased or decreased risk of heart attack or death

Diabetic patients who take rosiglitazone (Avandia) have neither an increased nor decreased risk of myocardial infarction and cardiovascular death, according to an article published online Aug. 7 in the Annals of Internal Medicine.

George A. Diamond, M.D., of the University of California Los Angeles, and colleagues reviewed a recent, widely publicized meta-analysis of 42 clinical trials involving 27,847 patients that found that rosiglitazone was associated with a 43 percent increased risk of myocardial infarction and a 64 percent increased risk of death from cardiovascular disease.

Diamond and colleagues fault the original study's authors for not assessing the sensitivity of their conclusions to several methodological choices and for not including all studies showing evidence of rosiglitazone's cardiovascular effects. Using alternate meta-analytic approaches, they found lower odds ratios for myocardial infarction and cardiovascular death that were not statistically significant.

"In the end, we believe that only prospective clinical trials designed for the specific purpose of establishing the cardiovascular benefit or risk of rosiglitazone will resolve the controversy about its safety," the authors conclude. "In our opinion, available evidence does not justify what the authors of the original meta-analysis (as well as the media, the U.S. Congress, and worried patient groups) decried as an 'urgent need for comprehensive evaluations.'"


Once again, physicians and patients are left wondering whose interpretation is correct and what biases may have contributed to the publications!