Monday, March 16, 2015

Eat Your Fiber

Eating your daily supply of fiber will keep the intestine and colon running healthy, helping to prevent colon cancer and various intestinal diseases.

Tuesday, February 24, 2015

Bird Conservation Group Wants Tighter Controls on Wind Industry - Blades run afowl of the MBTA

Bird Conservation Group Wants Tighter Controls on Wind Industry | Wind | Rewire | KCET





The SOLUTION - the ENGINEERING SOLUTION - is to SHIFT THE PLANE from rotating the blades in the VERTICAL plane to rotating the blades in the HORIZONTAL plane.
Let's THANK animal (bird) advocates for raising this issue, but let's insist that future design integrate this concern from the outset.
Lots of blade building has already gone ahead, production machinery has been purchased, and workers have been hired and put on the assembly lines.
I raised this concern nearly a decade ago - and suggested this solution about 3-4 years ago. 
Advocates didn't see that as an issue at that time (or some merely said, yes, the blades shouldn't hurt the birds).

So let's "do the math" and consider that, if the IDEA of the SOLUTIONS pre-existed my SEEING the SOLUTION and RAISING the SOLUTION 3-4 years ago, the "solutions" may have pre-existed actuality in the minds of engineering visionaries.  So when we REQUIRE investment in something that the planet and this species needs (birds would rather adjust to global warming and let the infrastructures of human "civilization" decline or erode at the coastal edges), we need, increasingly, to look at the full picture and to engineer ONLY solutions which do NOT solve OUR problems at the expense of other persons (other species of life).

News and analysis about energy in California with an eye toward renewables.


Calling bird law violations inevitable at wind facilities, a group wants tighter controls on permitting. | Photo:  Changhua Coast Conservation Action/Flickr/Creative Commons License

Bird Conservation Group Wants Tighter Controls on Wind Industry

Saturday, September 06, 2014

25 years younger ???

Today I was told that I "look 25 years younger than the calendar says and still have boundless energy."

Well, I do typically get my age estimated to be 12-15 years younger than my age, but not 25. That wasn't (and isn't) always the case.  Staring at a computer, getting inadequate sleep, and drinking tea or coffee can depress the muscles in the eyes and face.  But I think that proper nourishment is important, and merely eating vegan-compliant diets may not do that.  Avoiding the animal-based inputs is important, but ensuring the plant-based inputs is just as important for health.

In the dispute between John McDougall* (vegan diet except for holidays), and Joel Fuhrman (vegan nutritarian all the time) 
(but tolerant of others because they publicly say that their principles apply to everyone, but that meat eaters should not eat much meat or dairy - and McDougall tells them to swear off the dairy first - Fuhrman says that dairy is entirely unnecessary - and shows them how to nourish themselves), 
  • the Fuhrman "nutritarianemphasis is on the nutrient-rich diet and fat-burning (which I strongly advocate - selecting foods for nutrient value, not for taste or satiety.  I think that satiety and satisfaction follow from getting the nutrients in one's daily diet (one MUST exercise** IN ORDER TO build muscle and burn fat - Fuhrman photos show that, despite his foot injury, he hasn't stopped exercising after he left competitive figure skating);
  • the McDougall "starchitarianemphasis seems to be on a "starchitarian" weight loss by "no added fat" - and that means no nuts or oils.
*One of my long-time vegan friends in Boston has FLIPPED his loyalties from the vegan diet of Dr. Joel Fuhrman ("His diet is a good diet") to the vegan diet of Dr. John McDougall on the basis of the emphasis non weight loss (we all have problems with piling on extra weight; Steve lost "mucho" weight when he stopped eating a handful of nuts each day)
** All right - so, to START exercising, one walks around as much as possible; gently move and exercise each of the joints (yoga has ways to do this); in bed before rising, something called "a crunch" is stretching your chest UP toward your abdomen as much as possible - about 8-10 times - that's a set of 'reps' or 'repetitions' - and the goal is to build the muscles one has by exercising each muscle group, including the muscles in the abdomen.  On can also stand up and rotate around the waste, then slowly bend forward, back, sideways, and stretch up and down until one aches.

Everyone can do crunches each day.






The nuance seems to be on the definitions of a 'starch' and a 'carb' or carbohydrate (few of us have the sophistication, but we ought to understand the differences between starches and sugars - particularly simple sugars.  A starch is a carbohydrate; fiber is a carbohydrate.

From Wikipedia:
In food science and in many informal contexts, the term carbohydrate often means any food that is particularly rich in the complex carbohydrate starch (such as cerealsbread, and pasta) or simple carbohydrates, such as sugar (found in candyjams, and desserts).
McDougall likes COMPLEX carbohydrates but not simple carbohydrates; Fuhrman likes the carbohydrates bound in vegetables, beans, and whole fruits, but not those carbs that are ground up into grains and then made into breads.  However, what about whole grain cereals (oatmeal, not instant oatmeal)?
  • As I seem to recall it, McDougall was trying to help us understand how we would educate all of South and Central American about plant-based vegan diets. No one wanted to do that EXCEPT for Victor Forsythe, who inherited the California Vegetarian Association from Blanche Leonardo, then moved to Colorado and joined the Colorado Green Party.  South American root vegetables are SUFFICIENTLY rich in proteins to provide all the human requirements for protein, according to the WHO.  Therefore, one could live entirely on tubers and root vegetables grown in the South American mountains without supplementing with nuts, beans, or soy.  "Protein is not an issue" in a plant-based whole foods diet based on real foods, not prepared and packaged foods.  The indigenous diet is sufficient; in America, the (SAD/MAD) diet isn't mainly whole foods.  When I talk with inquirers, I tell them that many Americans like to "eat out" - eat out of a package, out of a drive-in-window, eat out of a tragically conceived restaurant menu, etc.
  • Fuhrman began as 'a natural hygienist' an told me in person, when we flew together in mid-August 1995 from the 8th International Vegan Festival in San Diego to Boston, that he was 'more vegan' than hygienist - then he said, 'just vegan' with an emphasis on the nutrients in whole fresh vegetables - more vegetables than fruits.
They agree, but they substantially disagree - and they settled on agreeing to the notion that they "agree about 90% of the time..."

From Wikipedia:
Starch is the most common carbohydrate in the human diet and is contained in many staple foods. The major sources of starch intake worldwide are thecereals (ricewheat, and maize) and the root vegetables (potatoes and cassava).[23] Many other starchy foods are grown, some only in specific climates, including acornsarrowrootarracachabananasbarleybreadfruitbuckwheatcannacolacasiakatakurikudzumalangamilletoatsocapolynesian arrowrootsagosorghumsweet potatoesryetarochestnutswater chestnuts and yams, and many kinds of beans, such as favaslentilsmung beans,peas, and chickpeas.
Widely used prepared foods containing starch are breadpancakescerealsnoodlespastaporridge and tortilla.
If we ate fewer starches, might we fart less frequently?

From Wikipedia:
Digestive enzymes have problems digesting crystalline structures. Raw starch will digest poorly in the duodenum and small intestine, while bacterial degradation will take place mainly in the colon
Some of us have celebrated the WIDE VARIETY of available foods of plant origin  Vance Lehmkuhl even sings about it.

I still think that erring on the side of nutrient-density is good, but affordability and refrigeration can be issues.  Therefore, whole vegetables (grow your own, like the Obama family does at the White House); farmers' markets; regular grocery store (shop produce aisle first), etc.  Eat them as you need them (and share the rest).  Further, when talking with students, other singles, and general inquirers, buying vegetables in the grocery is ALWAYS cheaper than dining out.  But college students have overpriced dining hall meal plans.

I need to credit my boss who raised the rhetorical question: "Why do so many Americans NOT want to be thin and attractive?"  Nudging from many sources - my boss, my vegan friends, and my doctor - pushed me to search for how as a vegan I could lose weight on an evidence-based program.

And to credit Michelle Obama, though she and her program are not my specific reason for 'daily motions' throughout my day, every one of us ought to get up and get out there and 'start moving' around...

I'm concerned to live by just principles.  Vegans CAN do that with evidence-based strategies that are built from the growing bodies of knowledge relevant to that project in human history.  Others seem to live, but that may not be justice, simply because they are able to live in health, if they do great damage and harm to other persons - simply because they only ways they know to feed themselves involve the destruction of others.


Maynard         

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~



Maynard S. Clark, MS (Management: Research Administration)

Tuesday, August 26, 2014

Losing Sleep

Losing Sleep | HMS


Losing Sleep
‘Sleep switch’ neurons diminish with age and Alzheimer’s disease
By BONNIE PRESCOTT
August 20, 2014
As people grow older, they often have difficulty falling asleep and staying asleep, and tend to awaken too early in the morning. In individuals with Alzheimer’s disease, this common and troubling symptom of aging tends to be especially pronounced, often leading to nighttime confusion and wandering.
Now, a study led by researchers at Harvard Medical School, Beth Israel Deaconess Medical Center and the University of Toronto/Sunnybrook Health Sciences Centre helps explain why sleep becomes more fragmented with age. Reported online in the journal Brain, the new findings demonstrate for the first time that a group of inhibitory neurons, whose loss leads to sleep disruption in experimental animals, are substantially diminished among the elderly and individuals with Alzheimer’s disease, and that this, in turn, is accompanied by sleep disruption.
“On average, a person in his 70s has about one hour less sleep per night than a person in his 20s,” explained senior author Clifford Saper, the HMS James Jackson Putnam Professor of Neurology at Beth Israel Deaconess. “Sleep loss and sleep fragmentation is associated with a number of health issues, including cognitive dysfunction, increased blood pressure and vascular disease, and a tendency to develop type 2 diabetes. It now appears that loss of these neurons may be contributing to these various disorders as people age.”
Clifford Saper. Image: BIDMC Media ServicesClifford Saper. Image: BIDMC Media ServicesIn 1996, the Saper lab first discovered that the ventrolateral preoptic nucleus, a key cell group of inhibitory neurons, was functioning as a “sleep switch” in rats, turning off the brain’s arousal systems to enable animals to fall asleep. “Our experiments in animals showed that loss of these neurons produced profound insomnia, with animals sleeping only about 50 percent as much as normal and their remaining sleep being fragmented and disrupted,” he explained.
A group of cells in the human brain, the intermediate nucleus, is located in a similar location and has the same inhibitory neurotransmitter, galanin, as the vetrolateral preoptic nucleus in rats. The authors hypothesized that if the intermediate nucleus was important for human sleep and was homologous to the animal’s ventrolateral preoptic nucleus, then it may also similarly regulate humans’ sleep-wake cycles.
In order to test this hypothesis, the investigators analyzed data from theRush Memory and Aging Project, a community-based study of aging and dementia which began in 1997 and has been following a group of almost 1,000 subjects who entered the study as healthy 65-year-olds and are followed until their deaths, at which point their brains are donated for research.
“Since 2005, most of the subjects in the memory and aging project have been undergoing actigraphic recording every two years. This consists of their wearing a small wristwatch-type device on their non-dominant arm for seven to 10 days,” explained first author Andrew S. P. Lim of the University of Toronto and Sunnybrook Health Sciences Centre and a former member of the Saper lab. The actigraphy device, which is waterproof, is worn 24 hours a day and thereby monitors all movements, large and small, divided into 15-second intervals. “Our previous work had determined that these actigraphic recordings are a good measure of the amount and quality of sleep,” he added.
The authors examined the brains of 45 study subjects (median age at death, 89.2), identifying ventrolateral preoptic neurons by staining the brains for the neurotransmitter galanin. They then correlated the actigraphic rest-activity behavior of the 45 individuals in the year prior to their deaths with the number of remaining ventrolateral preoptic neurons at autopsy.
“We found that in the older patients who did not have Alzheimer’s disease, the number of ventrolateral preoptic neurons correlated inversely with the amount of sleep fragmentation,” said Saper. “The fewer the neurons, the more fragmented the sleep became.” The subjects with the most neurons (greater than 6,000) spent 50 percent or more of total rest time in the prolonged periods of non-movement most likely to represent sleep while subjects with the fewest ventrolateral preoptic neurons (fewer than 3,000) spent less than 40 percent of total rest time in extended periods of rest. The results further showed that among Alzheimer’s patients, most sleep impairment seemed to be related to the number of ventrolateral preoptic neurons that had been lost.
“These findings provide the first evidence that the ventrolateral preoptic nucleus in humans probably plays a key role in causing sleep, and functions in a similar way to other species that have been studied,” said Saper. “The loss of these neurons with aging and with Alzheimer’s disease may be an important reason why older individuals often face sleep disruptions. These results may, therefore, lead to new methods to diminish sleep problems in the elderly and prevent sleep-deprivation-related cognitive decline in people with dementia.”
This work was supported by a Dana Foundation Clinical Neuroscience Grant and National Institutes of Health grants P01AG009975, P01HL095491, R01NS072337, R01AG017917, R01AG024480, R01NS078009, R01AG043379 and R01AG042210. Other support came from grants from the Canadian Institutes of Health Research, the Illinois Department of Public Health and the Robert C. Borwell Endowment Fund.
Adapted from a Beth Israel Deaconess news release.

Losing Sleep: ‘Sleep switch’ neurons diminish with age and Alzheimer’s disease | HMS

Losing Sleep | HMS


Losing Sleep
‘Sleep switch’ neurons diminish with age and Alzheimer’s disease
By BONNIE PRESCOTT
August 20, 2014
As people grow older, they often have difficulty falling asleep and staying asleep, and tend to awaken too early in the morning. In individuals with Alzheimer’s disease, this common and troubling symptom of aging tends to be especially pronounced, often leading to nighttime confusion and wandering.
Now, a study led by researchers at Harvard Medical School, Beth Israel Deaconess Medical Center and the University of Toronto/Sunnybrook Health Sciences Centre helps explain why sleep becomes more fragmented with age. Reported online in the journal Brain, the new findings demonstrate for the first time that a group of inhibitory neurons, whose loss leads to sleep disruption in experimental animals, are substantially diminished among the elderly and individuals with Alzheimer’s disease, and that this, in turn, is accompanied by sleep disruption.
“On average, a person in his 70s has about one hour less sleep per night than a person in his 20s,” explained senior author Clifford Saper, the HMS James Jackson Putnam Professor of Neurology at Beth Israel Deaconess. “Sleep loss and sleep fragmentation is associated with a number of health issues, including cognitive dysfunction, increased blood pressure and vascular disease, and a tendency to develop type 2 diabetes. It now appears that loss of these neurons may be contributing to these various disorders as people age.”
Clifford Saper. Image: BIDMC Media ServicesClifford Saper. Image: BIDMC Media ServicesIn 1996, the Saper lab first discovered that the ventrolateral preoptic nucleus, a key cell group of inhibitory neurons, was functioning as a “sleep switch” in rats, turning off the brain’s arousal systems to enable animals to fall asleep. “Our experiments in animals showed that loss of these neurons produced profound insomnia, with animals sleeping only about 50 percent as much as normal and their remaining sleep being fragmented and disrupted,” he explained.
A group of cells in the human brain, the intermediate nucleus, is located in a similar location and has the same inhibitory neurotransmitter, galanin, as the vetrolateral preoptic nucleus in rats. The authors hypothesized that if the intermediate nucleus was important for human sleep and was homologous to the animal’s ventrolateral preoptic nucleus, then it may also similarly regulate humans’ sleep-wake cycles.
In order to test this hypothesis, the investigators analyzed data from theRush Memory and Aging Project, a community-based study of aging and dementia which began in 1997 and has been following a group of almost 1,000 subjects who entered the study as healthy 65-year-olds and are followed until their deaths, at which point their brains are donated for research.
“Since 2005, most of the subjects in the memory and aging project have been undergoing actigraphic recording every two years. This consists of their wearing a small wristwatch-type device on their non-dominant arm for seven to 10 days,” explained first author Andrew S. P. Lim of the University of Toronto and Sunnybrook Health Sciences Centre and a former member of the Saper lab. The actigraphy device, which is waterproof, is worn 24 hours a day and thereby monitors all movements, large and small, divided into 15-second intervals. “Our previous work had determined that these actigraphic recordings are a good measure of the amount and quality of sleep,” he added.
The authors examined the brains of 45 study subjects (median age at death, 89.2), identifying ventrolateral preoptic neurons by staining the brains for the neurotransmitter galanin. They then correlated the actigraphic rest-activity behavior of the 45 individuals in the year prior to their deaths with the number of remaining ventrolateral preoptic neurons at autopsy.
“We found that in the older patients who did not have Alzheimer’s disease, the number of ventrolateral preoptic neurons correlated inversely with the amount of sleep fragmentation,” said Saper. “The fewer the neurons, the more fragmented the sleep became.” The subjects with the most neurons (greater than 6,000) spent 50 percent or more of total rest time in the prolonged periods of non-movement most likely to represent sleep while subjects with the fewest ventrolateral preoptic neurons (fewer than 3,000) spent less than 40 percent of total rest time in extended periods of rest. The results further showed that among Alzheimer’s patients, most sleep impairment seemed to be related to the number of ventrolateral preoptic neurons that had been lost.
“These findings provide the first evidence that the ventrolateral preoptic nucleus in humans probably plays a key role in causing sleep, and functions in a similar way to other species that have been studied,” said Saper. “The loss of these neurons with aging and with Alzheimer’s disease may be an important reason why older individuals often face sleep disruptions. These results may, therefore, lead to new methods to diminish sleep problems in the elderly and prevent sleep-deprivation-related cognitive decline in people with dementia.”
This work was supported by a Dana Foundation Clinical Neuroscience Grant and National Institutes of Health grants P01AG009975, P01HL095491, R01NS072337, R01AG017917, R01AG024480, R01NS078009, R01AG043379 and R01AG042210. Other support came from grants from the Canadian Institutes of Health Research, the Illinois Department of Public Health and the Robert C. Borwell Endowment Fund.
Adapted from a Beth Israel Deaconess news release.

Thursday, June 20, 2013

MGMA: Physician Compensation Increasingly Based on Quality Measures

MGMA: Physician Compensation Increasingly Based on Quality Measures

MGMA: Physician Compensation Increasingly Based on Quality Measures

John Commins, for Health Leaders Media , June 14, 2013

Primary care physicians have 3% of their total compensation based on quality measures, but doctors will increasingly be tied to these metrics as reimbursement aligns more closely with quality and cost measures, Medical Group Management Association data suggests.
Quality measures are emerging as components in physicians' compensation, a trend is expected to grow as value-based reimbursements gradually supplant fee-for-service, volume-based models, a new survey from the Medical Group Management Association shows.
The Physician Compensation and Production Survey: 2013 Report Based on 2012 Data examined data on more than 60,100 physicians, and found that primary care physicians and specialists reported that 3% and 2%, respectively, of their total compensation was based on quality measures.
Although the percentages are small, MGMA's Todd Evenson says physician compensation will increasingly be tied to these metrics as reimbursement aligns more closely with quality and cost measures.


"Really what we are seeing is the very front end for many organizations as they start to address under the Affordable Care Act and the commercial environment value based reimbursement. Ultimately those components of quality and satisfaction will become an ever-emerging component of reimbursement," says Evenson, MGMA's director of data solutions."
Actually, Evenson says the survey is low-balling the extent of quality measures in compensation packages for some healthcare organizations.
"Clearly there are some groups that are much more dynamic in the way they have been able to apply that. It's not uncommon in the industry and in many of the large organizations or health systems for that number to be somewhat higher. I have talked to many colleagues in the industry and figures anywhere from 10% to 30% aren't that uncommon for those larger institutions," Evenson says.
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"As we look toward large healthcare institutions, the likelihood that they have decoupled compensation from collections is very high. And as a function of that in order to promote the behaviors around quality and satisfaction that they would like to see they want to incentivize their physicians in the appropriate ways to compensate them for those behaviors or activities. But overall, when we are looking at smaller organizations or medium-sized organizations then it is much more likely that there is that direct linkage."
Evenson says it's not necessarily a bad idea for some healthcare organizations to wait and watch before launching a quality component in their compensation packages.

Doc Pay

Physician/Specialists Compensation, 2008-2012 (PDF)
"You don't want to be on the cutting edge. You want to be just behind the cutting edge as it relates to how you change your compensation strategies," he says. "It wouldn't be very effective if you were being paid 90% fee-for-service and paid 50% on quality to your teams of providers. The math wouldn't work in your favor."
Physician Compensation
The report also reaffirmed that median compensation for physicians fluctuated by specialty. Primary care physicians reported $216,462 in median compensation in 2012, and specialists reported $388,199 in median compensation. Evenson says the considerable gap in compensation could prove difficult to overcome, even with a concerted push to get more medical school students to take up primary care.
"The last data I had a chance to look at as I looked towards family practitioners just coming out of residency was something like 40% had over $200,000 in debt. And when we see that coupled with the median compensation for a family practitioner this year was right around that $205,000, it ends up being where there is definitely a constraint that is worth noting," Evenson says.
"We and others in the health industry understand the importance of this. The demand for primary care physicians is going to continue to increase but we have seen that kind of differential between primary care and specialty care compensation. We've even seen a number of advocacy efforts from a number of organizations (to improve primary care compensation) and that continues to evolve, but unfortunately it has remained at a static pace as a ratio of one related to the other. We did see some narrowing of that gap over the last few years, but I have seen that stagnate."
Evenson says the report verifies that healthcare organizations are moving toward an increasing reliance on physicians' assistants and nurse practitioners to make up for the shortage of primary care physicians. As a result, these highly specialized nurses are enjoying significant compensation hikes.
Over the past five years nurse practitioners' compensation has increased, on average about 13.4%, to the median of $92,717 in 2012. For physicians' assistances in the surgical suite that compensation increased by 9.6% over five years to a median of $112,689. For physicians' assistants in the primary care setting the compensation increased 10.4%, with a media of $96,834 in 2012, MGMA reported.
"When we look at their compensation this really underscores how the environment and the healthcare system is leveraging providers to the maximum of their license," Evenson says. "It shows how teams and organizations are dealing with that primary care shortage. They are looking towards the nurse practitioner and their role in the organization. Even if you're in a gastroenterology practice they are leaving the scope work to the physicians and the follow up visits to the practitioners. They are leveraging them to try to meet that demand."

John Commins is a senior editor with HealthLeaders Media.