Source:Book Publishing Service

Public release date: 23-Mar-2010

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Contact: Emma Dickinson
edickinson@bmjgroup.com
44-207-383-6529
BMJ-British Medical Journal

Leading journals publish new guidance to improve trial reports

Research: The quality of reports of randomized trials in 2000 and 2006: Comparative study of articles indexed in PubMed

New guidance to improve the reporting of trial findings is published simultaneously today (24 March 2010) by the BMJ and eight other leading journals around the world.

Full and transparent reporting of trials is crucial to ensure that decisions about health care are based on the best available evidence.

The guidance, known as the Consolidated Standards of Reporting Trials (CONSORT) statement, was first published in 1996 and revised in 2001. It includes a checklist to help authors write reports of randomised controlled trials so that others can judge the reliability and validity of the results.

More than 400 journals and three leading editorial groups across the world have now given their official support to CONSORT.

The latest version, CONSORT 2010, improves the specificity and clarity of the previous checklist. Several new items will also make it easier for decision makers to judge the soundness of trial results. A separate explanatory paper, also published by the BMJ today, provides published examples of transparent reporting.

Speaking on behalf of co-authors, Douglas Altman and David Moher, and for the CONSORT Group, Kenneth Schulz, Distinguished Scientist and Vice President of Family Health International in the US emphasises that CONSORT 2010 represents an evolving guideline. He says: “In the future we will further revise the CONSORT material considering comments, criticisms, experiences, and accumulating new evidence. We invite readers to submit recommendations via the CONSORT website (www.consort-statement.org).”

A study also published by the BMJ today to accompany the guidance shows that, although the quality of trial reporting has improved since publication of the revised CONSORT statement in 2001, it remains well below an acceptable level. The researchers conclude that more journals should endorse CONSORT and, most importantly, they should do more to ensure adherence.

This view is supported in an editorial which says that the guidance is clear, but awareness and endorsement are lagging behind. Author Gerd Antes, Director of the German Cochrane Centre, believes that journal editors should do more to incorporate the CONSORT checklist into the peer review process. He also warns that, although CONSORT has been translated into 10 other languages, not much is known about endorsement and adherence in those areas.

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Anil Advani introduces to us Surayia Rahman, a self-trained Kantha artist from Bangladesh. She “guided hundreds of poor women in Bangladesh to create masterworks – exquisitely embroidered tapestries that have been gifted to dignitaries and are admired in collections throughout the world.”

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Material from:How To Publish A Childrens Book

Newsmax :

A former Iranian Revolution Guards officer who spied for the CIA in Iran for nearly decade is telling his story in a new book that will hit bookstores next week.

“A Time to Betray” provides a riveting account of how the author, who uses the pseudonym Reza Kahlili, worked undercover and sent intelligence reports to his CIA handlers, all while a suspicious counterintelligence officer was chasing him.

Read the whole story: Newsmax

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GalleyCat:

As President Barack Obama signs the health insurance reform legislation he championed today, PublicAffairs will team up with The Washington Post to rush a book that will help readers understand the bill passed by the House of Representatives over the weekend.

Read the whole story: GalleyCat

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Material from:How To Publish A Childrens Book

Donwill, a member of the bi-city rap trio Tanya Morgan (a Tribe Called Quest–like group that samples old-school hip-hop), just released a solo album with the interesting title Don Cusack in High Fidelity. As the name suggests, the album is a straight-up homage to Stephen Frears’s 2000 film, with Donwill taking John Cusack’s starring role, complete with spoken re-creations of the movie’s dialogue. (“Did I listen to pop music because I was miserable? Or was I miserable because I listened to pop music?”) The rapper recently spoke to us about using the movie as inspiration, the difficulties of explaining the concept to others, and how he should probably read the book.

With High Fidelity, which came first for you, the book or the movie?
[Long pause.] I’ve not read the book. People keep telling me to; of course, the book is always better than the movie. There was a lot the movie had to leave out or imply that I would enjoy reading, so I’ll probably pick that up.

I was surprised by how much dialogue you recite from the movie. Was that always planned, or did you decide to add that later?
It was definitely added later. When I sat down with the material it just felt like it needed a mechanism to push the songs along in order to gel with the story line.

Was it important to you to stay close to the source?
That was why I did it, to explore the territory of really conceptually digging in — almost like a book report, if you will. I wanted it to be a wholehearted adaptation. At this point, if I did another conceptual album — I don’t think that I would do one, per se — but if I could do this one over, I would do the same thing, really skit-based. I enjoy that.

My sense is that your group, Tanya Morgan, is more or less a democracy. Is that true?
I would agree with that. I would say we maintain a certain individual autonomy. Even with the group material, songs are submitted, even the beats. You can get outvoted on songs. They’re very much involved in my solo material. They’re my council of trust. When I finished the album, the first people to hear it were Von and Ilyas. Those are the two people I trust as my second set of ears.

Given all that, I have to imagine it was kind of satisfying to cast them in supporting roles on the song “Championship Vinyl,” and then later on, refer to their characters as “the musical moron twins.” Did they give you any dirty looks about that?
No, they didn’t. Sometimes as artists, man, we think we know everything, because we love what we love, and our tastes are our tastes. And in the group, we’re subject to each other’s tastes. Doing the album alone was like, “I can get all this singing and R&B on my album, and nobody can tell me I can’t.”

The album has a lot of guests. How do you approach people with an idea like this?
I definitely had to kick it to them differently. Like, with “Ian’s Song,” it was like, “So, Opio, I want to get you on this song. But here’s the catch: You have to say the name Laura and you have to be named Ian.” He was just like, “What?” But when I explained it to him, it turned out he liked the movie also.

Have you gotten any feedback from John Cusack or Nick Hornby or anyone else involved with the movie? Have you run into any kind of rights stuff?
I haven’t. I’m kind of just hoping it can get on-shelf before any sort of anything happens regarding that. But I want them to hear it. I want Nick Hornby to hear it. It’s not like a Warner Bros. release where 250,000 units are shipped; it’s a small independent release. I don’t necessarily see it being a problem. But I do understand how it could be a problem.

The New York Times:

On April 3, when customers pick up their fancy new Apple iPads and want to purchase an e-book, they will have to decide which online bookstore they want to give their money to.

Read the whole story: The New York Times

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Sourse:Greek Salad Recipe

Amid the clamour over the Greek debt crisis, a far more perilous threat to the global economy is becoming increasingly apparent. The global economic and financial crisis has wreaked havoc on the United Kingdom's public finances, with no clear path to salvation.

Consider the following statistics. Greece has a GDP of approximately $350 billion, compared with $2.2 trillion for the UK. In other words, the Greek economy is only 16% the aggregate size of Great Britain's. The proportion of Greece's annual deficit to GDP is 12.5%, a figure that has triggered the current Greek sovereign debt crisis and panic search for a bailout formula within the Eurozone. Yet, in the much larger UK economy, the deficit to GDP ratio has reached 13%, an even higher level than for Greece, which has aroused so much fear among global investors and policymakers. Furthermore, while the UK's official public national debt comprises 68% of GDP, a figure lower than America's and much lower than with Greece, that level of indebtedness is accelerating at a rapid rate. It must be recalled that only three years ago the UK national debt to GDP ratio was only 38%, and with double digit deficits now an inescapable fiscal reality in the United Kingdom, it seems almost certain that the nation's public debt will exceed 100% of GDP within the next three years. Furthermore, it is widely believed by analysts and investors that off balance sheet public debts (as was similarly revealed in relation to Greece's current debt crisis) and unfunded contingent liabilities significantly add to the official figures.

What do these dismal statistics tell us about the future trajectory of the UK's profound sovereign debt and economic crisis? Consider what Kornelius Purps, fixed income director at UniCredit, Europe's 2nd largest bank, told the British newspaper,The Daily Telegraph; “Britain's AAA-rating is highly at risk. The budget deficit is huge at 13% of GDP and investors are not happy. The outgoing government is inactive due to the election. There will have to be absolute cuts in public salaries or pay, but nobody is talking about that.”

In effect, the UK economy is at a dangerous tipping point. Massive public indebtedness occurred as a result of the government's bailout of its banks, yet businesses remain afflicted by a severe credit crunch. Massive stimulus spending has added enormously to the deficit, but the only result has been suspect figures that, if interpreted most optimistically, show that the UK's economy has essentially flatlined after incurring a sharp contraction in economic output during the height of the global financial crisis.

The predictable outcome, as alluded to by Kornelius Purps, is that in the future the UK's treasury gilts will be unable to finance the nation's prodigious borrowing needs with historically low interest rates. At some point, perhaps sooner than many realize, interest rates on the UK's debt instruments will rise precipitously. This will occur while GDP growth is at best sluggish. Sharp reductions in public spending will almost certainly tip the economy back into deep recession, further constricting revenue and maintaining London's fiscal imbalance. However, the alternative is even more unpalatable. The sovereign bond market will demand increasingly higher yields, leading to a fiscal reality that is unsustainable. Ultimately, the United Kingdom will face the real prospect of national insolvency, with all the predictable dire consequences.

This grim trajectory has an even darker meaning for the United States. As bad as the UK's fiscal situation is, America's is far worse. Its annual deficit to GDP ratio is only marginally lower than Great Britain's. Furthermore, its national debt to GDP correlation is significantly higher. More importantly, the average period of turnover on the United Kingdom's debt is 14 years, compared with a mere four years on U.S. Treasuries. Once bond yields start to rise, the short term structure of America's national debt will incur a vast increase in annual interest payments.

It seems to this observer that it is only a matter of time before the UK sinks into an irreversible sovereign debt cataclysm, with the United States not far behind. Anyone who believes that the same political establishment and financial elites that have led both nations to this hellish fiscal precipice can now lead us to a sustainable solution is, in all probability, being excessively hopeful.

Greece has a E8.22 billion redemption due on April 20 and another E8.086 billion payment on May 19, which must be refinanced. It also has sizeable coupon payments in coming months, which total E3.923 billion.

Greece has so far raised E8.0 billion with a new five-year benchmark bond issued via syndication on January 26. It has also raised E2.0 billion in a private placement conducted in December, which was seen as pre-funding for 2010.

In addition, the debt agency has raised E2.8 billion through sales of T-bills with 13-week, 26-week and 52-week maturities, in part to cover a T-bill redemption of E1.51 billion that was due on January 15 and of E1.95 billion redeemed on January 22.

Greece's borrowing programme for 2010 is estimated at E54 billion, considerably less than last year's E66.0 billion.

In the meantime, while both Moody's and Fitch have affirmed their negative outlooks on Greece, both rating agencies can't find enough praise just how wonderful yet more actionless yapping out of Ellada is. And now add the IMF to that list, after the Currency Board expert said that it “welcomes substantial measures by Greece today” and “stands ready to support implementation of the Greek plan (with TECHNICAL assistance).” Whether this means that the IMF's 191 tons of gold (for ~$7 billion) will be sold tomorrow is unclear.

The only voice of reason here seems a little line in the Fitch report which notes that the “debt market access window is closing quite rapidly.”

Full Moody's report below, which is preparing its brand new AAAA rating, especially for Greece. Somehow merely talking about austerity measures is now considered sufficient. We fully expect Arnie to come out and say that California will adopt the same austerity as Greece… in 3049. And Moody's VP Sarah Carlson will be first in line to believe any and all promises. Former Moody's employee Deep Shah had no comment as of the time of this posting.

Moody's: Greece's New Austerity Measures Lend Credibility to Fiscal Adjustment Plan

London, 03 March 2010 — Moody's Investors Service today said that the additional fiscal
measures announced by the Greek government are consistent with Moody's
current A2 rating, with a negative outlook, for Greece's
government bonds. Today Moody's also published an Issuer
Comment, entitled “A Ten-Point Analysis of Greece's
A2 (Neg) Rating”, which reiterates the rating agency's
rationale behind Greece's rating and the conditions under which
that rating could change.

“These new measures are a clear manifestation of the government's
resolve to regain control of public finances,” says Sarah
Carlson, VP-Senior Analyst in Moody's Sovereign Risk
Group and lead analyst for Greece. In an economic and market environment
that has become increasingly challenging, these measures increase
the probability of debt stabilization provided that they, and the
previously announced policy measures, are fully implemented.

“The onus is on the government to demonstrate that it does not merely
announce ambitious plans, but is also able to deliver on these commitments,”
says Ms. Carlson. “However, Moody's does
not expect Greek public finances to be turned around in a fortnight,”
adds Ms. Carlson, insisting that the Greek government needs
to be given time to allow it to follow through on its plan.

As repeatedly stated by the rating agency, Greece's current
A2 (Neg) rating balances two factors: on the one hand, Moody's
assessment that the government faces limited short-term liquidity
risk; on the other, Moody's concern about the long-term
erosion in Greece's creditworthiness given its need to deleverage
the economy (starting with the public sector) in a context of weak competitiveness
and slow regional growth.

Going forward, maintaining the government bond rating at A2 will,
according to Moody's, be contingent upon the government executing
its fiscal austerity programme and delivering the quantum of deficit reduction
that has been promised. Signs that deficit reductions will fall
short of what has been promised would likely lead to downgrades —
as suggested by the negative outlook — in proportion with the shortfall.

Moody's last rating action on Greece was implemented on 22 December
2009, when the rating agency downgraded Greece's government
bond ratings to A2 from A1, with a negative outlook.

The principal methodology used in rating the government of Greece is Moody's
Sovereign Bond Methodology, published in September 2008, which
can be found at www.moodys.com in the Rating Methodologies
sub-directory under the Research & Ratings tab. Other
methodologies and factors that may have been considered in the process
of rating this issuer can also be found in the Rating Methodologies sub-directory
on the Moody's website.

Skeletal Muscle Relaxants

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Over the last few days we have been hearing numerous stories about Gregory “Hurricane” Helms. As most have heard by now, both he and Chris Jericho were arrested a few days ago.

But why was Jericho allowed to compete at the Royal Rumble and Helms was pulled?

The reason is completely simple, Jericho wasn't the man who caused any issues. In fact, the police were called for Helms and his reckless behavior, and because Jericho stuck around (unlike Matt Hardy who was with both Helms and Jericho but ran when police arrived) he was arrested for being intoxicated in public.

Kinda reminds me of what a comedian said. “I was thrown out in public while being in a bar, I was caught by police and they wanted to arrest me for being drunk in public, I wasn't drunk in public, I was drunk in a bar. They threw me out in public.”

They both were apparently play wrestling and Jericho got hit, which is where the black eye you saw him sporting at The Royal Rumble came from. Helms was said to have done that, and allegedly struck a woman.

Helms and Jericho were arrested and then bailed out soon after, but the story doesn't stop there.

At the time of the arrest, Helms had what police said was ”one white round pill.” Now, some could think this was claritan or something along those lines at first glance unless they were a pharmacist or another type of drug professional.

So the police asked Helms about it, and Helms told them it was Soma. The pill is a generic version of the muscle relaxer Carisoprodol and a schedule four narcotic. Many who have used it said it is a very good, I've never tried it so I'm going by online reports here.

Now Helms claimed that he had a prescription for it, but he was unable to prove it at the time of the arrest.

The police did not charge Helms for the single pill, but should he be unable to provide a prescription he will be in violation of the WWE Wellness Policy and Kentucky state law. I am not sure on what their policy is for possession of one Soma pill though.

A lot of wrestlers use pain killers or muscle relaxers, and many in places such as the WWE or TNA have prescriptions for them. There are times in which they do not, where they have some that have a prescription yet have others without one.

But it's mostly Indy wrestlers that don't have prescriptions for drugs nowadays.

In any case, Helms may be out the door quite soon.

And this was before the arrest by the way. According to my sources, Helms met with the WWE legal department early last month about a release from World Wrestling Entertainment.

It was believed that if he was going to be leaving the WWE, it would be after the Royal Rumble at some point.

Helms has a veteran's policy in his contract, which means his no compete clause when released is about 45 days, instead of the normal 90 most wrestlers see upon their release from the WWE.

If he is released from the WWE, it could be at some point this month. It's unlikely the WWE would use him at WrestleMania, and there is no storyline for him going into the Elimination Chamber PPV either.

So with that being said, Helms could be gone very soon. Especially with all the legal trouble he has been in.

While many would think that he is being released for the legal trouble, we should keep in mind that he allegedly asked for the release.

I say stay glued to WWE.com to see if he is gone. But for now this is all the news on Helms I can find and what I've heard from a few sources.

partial source for arrest news: TMZ

Everyone gets sick once in a while. Itis expected. Therefore they have sick time at work. That's why there are physician and insurance organizations. But here are a lot of general things to make sure you stay in principal perfect health. You must wash your hands. In general, not enough people do this. Especially after taking the restroom. Investigations have been shown and a shockingly low %% of men and women wash their hands after taking the restroom or before meals.

I always tell you: Consume water. Liquid cures all ills. Dehydration is the culprit of many common indisposition such as headaches and even bloating. Eight cups of liquid is the minimum so be sure you're getting at least that much. Think that fruits and vegetable juices count towards your daily dose of hydrating drink. Physical activity. Sport does not have to mean hours on the treadmill sweating away to exhaustion. Sport can be as simple as walking across the parking lot to the grocery store or doing housework. That's right! Vacuuming burns calories intake! The more active in basic you are the more do sport you're getting. Think getting a pedometer. Passometer's have shown that men and women who wear pedometer's are more effective than those who don't.

Sources: weightloss

First, the bad news: My weight hasn't exactly plummeted since I started this money diet. Oh, the first week was amazing. The second week, nothing happened. This third week, I seem to have lost a pound or two.

But I am confident that I'm saving money.

For those of you who aren't in the know, I've decided to call my weight loss plan the “Money Diet.” On January 1, I declared on WalletPop that I was finally going to lose weight, and as an incentive, I was going to start adding up what I'd be saving by not spending money on junk food.
During the first week, I lost 11 pounds. I know that sounds incredible, but I think it was due to my putting on the brakes on drinking all those sugar-laden soda pops I'd been consuming. I used to drink them far too much, but since January 1, I think I've had just two Cokes. I also cut out just about every other high calorie food imaginable. I guess now the numbers are becoming more realistic — and less dramatic.

Of course, it didn't help that I went to the gym less this week, or that I broke my diet a few times last weekend when I celebrated my 40th birthday. Still, I'm pretty happy with these numbers.

• My weight when I began: 264
• My weight last week: 253
• My weight this week: 252

Sigh. I have a long way to go, though I'm not really sure exactly where I'm going. Ideally, I'd like to drop another fifty pounds, but if I can knock off twenty more this year, I'll be dancing a jig, so . . . we'll see.

Before I offer my tally of what I really, really considered buying or wanted to buy but didn't, and how much I think I've saved this week, I thought I'd seek a few opinions from some real diet experts and see what tips they could offer for losing weight as inexpensively as possible. Here we go:

Grow your own organic produce. That idea comes from Kami Gray, author of The Denim Diet (a diet book designed to help you fit into that pair of jeans you wish you could fit into, which seems like a fun concept for a book). She's also a TV wardrobe stylist, so she knows something about staying trim (being surrounded by actors every day). Anyway, Gray says that growing your own produce doesn't just save you money, but, as she puts it, “The time you've invested in your garden encourages you to eat healthier and not let your efforts to go waste.” And, you know, there's exercise involved in gardening. When the months get warmer, I may have to try that.

Brown bag it. Michelle May, M.D., author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle, had a lot of ideas for me, but this one stuck out: “Take your lunch to work,” she advises. “You'll save money and eat healthier while taking food that you choose.” No kidding. I don't think I need to elaborate — that advice pretty much speaks for itself.

Focus on cooking one big meal, a few times a week. That suggestion comes from Dr. Richard Kozlenko, the director of research and development for NXT Nutritionals, a developer and marketer of alternative sweeteners and food and beverage products, in Holyoke, Massachusetts. Dr. Kozlenko told me that he likes to make one meal of the day a “giant meal,” like a giant salad, soup or stew, with “everything in it — fresh, lean, healthy vegetables, nuts and seeds, slices of chicken or fresh or water-packed fish.” He might also add in low-fat cottage cheese or yogurt, and maybe a hard-boiled egg. For the other two meals of the day, he goes light and eats something like a bowl of oatmeal for breakfast or soup for dinner or lunch.

“Be creative but strict, with no artificial, high-calorie, greasy or overly sugary junk as ingredients,” says Kozlenko of his large meals. By doing that, he says, “you'll begin to influence a habit pattern of what and how you eat that spreads to the other days of the week in how you prepare and choose your meals.”

That “habit pattern” is what I've been hoping to get with my concerted effort to keep an eye on what I'm not spending every time I forego junk food. So here's what I think I saved in the past week:

• I went on an overnight road trip for a writing project, and I managed to avoid stopping at any fast food places (save for a Diet Coke at a Wendy's). I also didn't pick up any bags of chips for the road. Since I could have done either on my way back, I'll put my estimated savings at…$10.
• Bag of my favorite pretzels that I used to buy weekly but still haven't. Actual savings: $3.29
• Less snacks and soda pop in general…I'm going to estimate my savings was $10.

But I could have saved even more money and lost more weight if (and, granted, it was my birthday) I hadn't bought some candy at the movies. That was $4.

My weekly total saved: $23.29
Saved this year so far: $71.56

I'd rather see more progress on the scale, but that's what's nice about this goofy diet. If you aren't happy with your weight, you can at least enjoy looking at how your bank account is doing.

Geoff Williams is a frequent contributor to WalletPop and co-author of the new book, Living Well with Bad Credit.

Losing weight and getting fit preoccupied Americans in 2009:

• Nearly one out of two American women, including high school girls, were on a diet.

• Over 40 billion was spent on branded diet plans.

• Children as young as 9 to 11 years old were sometimes or very often dieting.

Yet an epidemic of obesity continues to affect more people than ever before:

• Less than a third of adults enjoyed normal weight.

• Children were two to three times more likely to be overweight today than they were 30 years ago.

Can we begin to reverse these worrisome trends in 2010?
We can if we update our old views with new ways to look at fitness in the coming year.

Old View: It's hopeless! Efforts to lose weight are inevitably doomed to fail. Even if a person manages to lose weight, he or she will eventually regain the weight and add back even more.

New View: You can do it! Strategies for making healthier choices involving diet, physical conditioning and improved self-care are available to you and can be learned. Championing this view is Kelly Brownell, Ph. D., who heads the LEARN Program for Weight Management at Yale University. And thanks to widespread access to the Internet, peer counseling in online communities is expanding. Internet support may include food and exercise diaries, weekly counseling, online weight-loss lessons and motivational phone calls.

Old View: Thin is in! Most individuals, especially women, seek to lose weight because they have internalized the media's ultrathin ideal.

New View: Healthy is in! Health is replacing vanity as the primary reason for pursuing fitness and weight loss. In 2009, researchers reported that four healthy habits could reduce or eliminate 80 percent of major medical problems: eating a healthy diet, not smoking, exercising regularly and maintaining a normal body weight. This insight, combined with rising medical costs, is triggering a focus on fitness.

Old View: If you are fat, you are a bad person. Obesity is a personal problem caused by a lack of willpower.

New View: Obesity is a disease that is treatable. The cost of providing medical care per person has skyrocketed from $356 in 1970 to $8,160 in 2009. Moreover, in 2009, the cost of treating obesity-related medical problems reached $147 billion. Given these costs, obesity has become a public health concern requiring a multifaceted community-based approach. In response, community leaders in Albert Lea, Minnesota, implemented a comprehensive lifestyle program to improve the health and longevity of the city's residents. To increase employee productivity and reduce health insurance costs and absenteeism, corporate wellness programs are proliferating.

Old View: Low-fat diets are required to lose weight. Eating fat makes a person fat. To lose weight, a dieter needs to stick with low- or no-fat foods.

New View: Total calories actually determine weight. The total calories consumed by a person, whether from carbs, fats or proteins, determines weight. Since the goal is a balanced diet, the Mediterranean diet, which includes healthy fats, is recommended by the Mayo Clinic and the American Heart Association as a nutritionally sound and healthy eating plan. Nuts, which until recently were on dieters' “do not eat” lists, are making a comeback because of their health benefits, especially almonds, walnuts, cashews, pecans and macadamia nuts. Momentum is growing for mandating information on the caloric content of fast foods and food products.

Photo courtesy of everystockphoto.com

Old View: Medical intervention is needed. Weight-loss drugs or bariatric surgery can solve the problem of surplus pounds for many people, and advances in medicine can address obesity-related problems such as cardiovascular disease, diabetes, stroke and cancer.

New View: A healthy lifestyle is the best way. Prevention, rather than treatment of obesity-related medical problems, will move to the forefront because of the rising cost of medical insurance and healthcare. While the number of bariatric surgeries will continue to skyrocket, family physicians will increasingly write exercise prescriptions in lieu of drug prescriptions.

Old View: Ignore overweight children. Children who are overweight will outgrow their chubbiness, so kids' surplus pounds can be ignored.

New View: Help overweight children now! Dr. Robert Murray, chair of the American Academy of Pediatrics Council on School Health, is alarmed that nearly half of kids and teens are overweight or obese and, as a consequence, children's life expectancies are lower than their parents'. Treating childhood obesity is a serious medical problem that if ignored will place the child at risk for heart disease, diabetes and other serious medical conditions.

Old View: Don't ask, don't tell. Asking employees to modify their unhealthful behavior is an invasion of privacy and violates employees' right to choose their own lifestyle.

New View: Offer help, incentives and access to experts. In 2008, medical insurance premiums reached a record $15,609 for a family of four. Employers are proactively seeking to reduce costs (medical insurance, workers' compensation claims and absenteeism) by restructuring benefit programs. In increasing numbers, employees are being offered incentives to quit smoking or lose weight. They face penalties if they refuse to change habits that drive up the cost of healthcare.

Old View: Hard-core exercise one hour daily. Going to a gym daily for a 60-minute workout on a treadmill and resistance equipment is the best way to exercise.

New View: Diversity, fun and enjoyment. Thanks to popular television programs, dancing for fitness is back, particularly Zumba, a one-hour workout that fuses Latin rhythms with calorie-burning dance movements. Exergaming, such as Wii and Dance Dance Revolution, continues to grow in popularity with young and old alike. Michelle Obama has made the Hula-Hoop popular once again. The use of technologically sophisticated feedback gadgets, from pedometers to heart monitors, will expand. To attract members to the gym during tough economic times, more fitness centers will offer cardio cinema so members can watch a movie while exercising.

Will we continue to get fatter until 2018 when, according to research by Kenneth Thorpe, PhD, of Emory University, 40 percent of us will be obese (and another 33 percent overweight)?

If we are to succeed in reversing the obesity trends and mounting medical care costs, we'll have to find new approaches. And the more readily we learn from the past and update our understanding of the complex nature and causes of obesity, the more quickly we can successfully move into a healthy future.

weight loss tea

Are you looking for a Quick Weight Loss Plan? Every Quick Weight Loss Plan might tell you something different, but there IS an optimum Quick Weight Loss Plan. Depending on your initial weight and body type, your Quick Weight Loss Plan should include these 3 facts.

Quick Weight Loss Plan – Fact #1 – Losing Weight Is Not The Same As Losing Fat

If you are looking for a Quick Weight Loss Plan because of being a little or a lot over weight, you need to recognize your true goals. What you need to focus your attention on is losing FAT, not just losing weight. Now this may take some adjustments in your own mind, as we are all so tuned into what the scale says when we step on it. This paradigm shift must involve being more aware of what you look like in the mirror, than what the scale says.

Why must it be this way? We need to focus our attention on losing fat, because when we focus on just losing weight, we often go about it in an unhealthy manner. We do things to rid ourselves of water weight (which we really need in our bodies) or even worse, we do things that cause us to lose muscle weight (which we really, really need in our bodies!).

Quick Weight Loss Plan – Fact #2 – Water Weight Loss is Not Healthy

If you are considering a weight loss plan that promises that you will lose 10 pounds this weekend, you need to run the other way! Any program with those promises is touting a plan to rid your body of water weight, not fat. Do you know what most of our body is made up of? You guessed it… water.

We need water to keep our bodies healthy. Statistics have shown that more than 80% of Americans are in some state of dehydration. This is not healthy, because all of our organs were designed to operate most efficiently at a certain hydration level. Take the water out of your body and you will soon see decreased function in your liver, intestines, pancreas, lungs, heart and yes, even your brain! We need water and lots of it.

Besides, as you probably already know, when it is just water that we lose, it is bound to come back – and then some! You see, the body has a self preservation mode. When it experiences dehydration, which it does not like, your body reacts to this problem by storing more water in the tissues for the next “drought”. Water weight loss will simply lead to more water weight gain in the end.

Quick Weight Loss Plan – Fact #3 – Muscle Weight Loss is Even Worse

Some Quick Weight Loss Plans promote their results without any exercise. Though it is possible to lose weight without exercising, the best kind of body shaping program (that's what you're really trying to do – reshape your body) will always include nutrition, fat loss and muscle gain. When we strengthen our muscles, our overall metabolism quickens and this in turn will cause our body to burn more calories, even when we are resting. To lose muscle as a weight loss option is absolutely detrimental to not only your overall health, but also your overall body shaping program goal. Muscles are a good thing! And no, I don't mean Mr. or Miss Olympia proportions, just strong, fit muscles.

As we try to reshape our bodies, fat loss should be just one of our goals. A very reasonable fat loss goal would be 1½ – 2 pounds per week. We should also strive not to lose just water and never do we want to lose muscle. Don't over do it, be sensible, have a plan and stick to it. You CAN achieve your goals!

If you are REALLY ready to lose fat, and reshape your body, then I have the next step that you MUST take. Click Here Today to see my #1 Recommended Body Shaping Tool and Resource and also receive a FREE 12 part Fat Burning mini course AND a very helpful, FREE 40 page report “Skyrocket Your Fat Loss Success”. http://www.squidoo.com/Lose-The-Fat/

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High blood pressure is something you need not ignore. Many people are walking around with it all of the time, and don't even know they have it. This is why it should be part of a routine physical every year to have your blood pressure taken. Hypertension can cause kidney failure in people, heart attacks, and strokes. Normal blood pressures for an adult person should run around anywhere from 110-120 for the top systolic numbers, and the diastolic should be from 60-80. That is an example of perfect blood pressure. Borderline high blood pressure is considered anywhere from 130-140 systolic numbers and 85-90 for the lower diastolic numbers. Anytime the blood pressure is over 140 and the diastolic numbers are 90 or more, that is hypertensive levels that need to be watched closely and treated.

There are many ways to treat hypertension naturally. One of the biggest ways is through your dietary habits. Go for foods that are lower in sodium since this is one of the things that tends to raise blood pressure. A person with hypertension should focus in on fresh fruits such as blueberries, cantaloupe, bananas, and others. You should also include high fiber vegetables that are mostly all reasonable in sodium, and zero in on nuts, and low-fat dairy products which will not only help your blood pressure, but your weight too.

That brings me to the next topic when I mention weight. People that are too heavy have a natural tendency toward high blood pressure. The more obese, the higher the risk of hypertension. Losing weight should help tremendously, and making healthy food a part of your diet ought to help lower your blood pressures.

In your foods, use some healthier spices on your food instead of the salt shaker. This will also help to lower your intake of salt. Total sodium in any person's diet should be limited down to 2,400 milligrams daily or less.

Walking also helps to lower high blood pressure. Walking briskly for at least 30 minutes or more a day helps the blood to circulate and keeps blood pressure in healthier ranges as well as your weight.

Medications for hypertension also come in many types. There are the angiotensin II drugs which block the release of hormones into the bloodstream. One example of such a drug is Capoten.

Beta blocking drugs help to control the heartbeat and therefore, regulate blood pressures. One such example of these drugs are Lopressor. Since beta blocking drugs also regulate heartbeat, they in turn control the pressure placed on blood vessels caused by hypertension.

Calcium channel blockers help the body by blocking calcium from circulating around the heart and blood vessel cells, causing relaxation so that the blood pressure stabilizes. Cardizem CD is one example of such a drug.

So controlling the blood pressure can be done using all of these therapies, or by using some of them. It all depends upon the degree to which you have hypertension.

And by the way, did you know that getting a cat or dog helps too? Pets have proven that they help lower the blood pressure in people simply by petting and stroking them. This might be a great option to consider!

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Jeannie Snyder works in the Day Surgery Unit/PACU at St. Joseph East. She has worked many years as an Operating Room R.N. and in the past, worked 3 years as a Research R.N. She has also worked with Debra McDonald on her Hope Eye Care team for the North West Haiti Christian Mission.

May 13, 2005
1- Why is IC so hard to get a diagnosis?

From my experience, IC is difficult to diagnose because physicians are not well schooled about the disease and often it goes undiagnosed properly. From a woman's point of view, we are treated as if it's all psychotic! The physician, instead of sending you to a Urologist that is knowledgeable in IC, send the patient home with a “band aid” such as medication for depression and sedatives!

The best way to diagnose IC is to do a cystoscopy (scoping of the bladder under anesthesia) with hydro distention and biopsy (filling the bladder to capacity and taking a biopsy to be sent to pathology). When the bladder is distended, you can see the hemorrhagic areas. Some have a “Hunners” Ulcer…and ulcer in the bladder wall. Others may not. During one of my Hydro dilatations, I opted to have a spinal so I could see for myself what the tissue looked like. It was like raw hamburger! I thought, well no wonder I hurt!

2- Explain your personal pain management approach to IC

As time went on and I tried many medications that didn't bring relief, I opted for the Interstim Implant. It took care of most of my symptoms by using a wire with 4 leads inserted into the sacral notch of the hip area and guided down near the sacral nerves. It give off a frequency of impulses to the sacral nerves that govern the bladder and it's functions.It helps in the painful pelvic floor pain, urgency and frequency.You cannot have MRI'S after insertion or go through security scanners at airports. You are given a card to keep with you at all times to hand to the agents explaining the device you have implanted. They just do the pat down procedure. In IC patients it's a great relief until you have a urinary infection or flare up. Also and I have experience, you can develop more ulcers. Dr. Ericson has had great success in lasering the ulcers (again under anesthesia) but with me, new ones formed. That is why she put me on a low does of Cyclospoine A to suppress the immunity.My bladder was no longer “angry' and I have not developed any since. This is the first time I have not had any pain!

I watch my diet and also take Prelief that you can get over the counter to neutralize the acid in your urine if you were to eat something acidic. I cut caffeine and drink nothing but water (soda's make it worse) for 4 years now. I also take Elmiron but it didn't seem to do any good in replacing the lining of the bladder wall…hence the ulcers. I also had to cut out as much stress in my life as I could. I have taken a leave of absence from work to just focus on working on me. I had to find my limitations and I do work in a stressful area. I didn't realize how much until I actually took the time off. I guess you could say I was in denial big time.

Now that I do not have pain, I am on an exercise regimen with a trainer and started back hunt/seat/jumping riding lessons. Before, I was in so much pain in a flare up, my main concern was where was the nearest bathroom, how long would it take me to get there and whether I could make it or not!

3- How is IC different in men than in women?

I know IC does not have boundaries of sex and age. I am not familiar how men are affected since I have only women to call me for advice. I do know children can also have the disease. From what I have heard, they mostly deal with spasms and pelvic floor pain.

4- In Your Opinion, what are the best three treatments (a drug, a procedure, and a self help)

I also, since I have bad knees (no cartilage) take Nutramax Cosamine DS. That is the most pure form on the market. There was a research study done by John's Hopkins Hospital that proved it. The company will send it to you. There is an 800 number to call and you and set up an account with them which is cheaper than buying it off the shelf. You can get a 210 count bottle for $63 dollars (1-800-925-5187). This does help to keep down the inflammation. It also has glucosamine besides chondriton in it. I take it 3 times a day and have for the past 4 years. I keep taking the Elmiron hoping it will help but I haven't seen a change with it. The cyclospoine A has been the only thing that has made a dramatic difference. This drug must be monitored for blood levels and it can be toxic to the kidneys. It also must be avoided with certain other medications because of interactions with those medications. It is also given to transplant patients because it helps suppress the rejection of organs which in IC your body is attacking itself. It is a T-cell suppressant. What we are given is a low dose of Sandimmune so it's less likely to have those side effects. I was fatigued during the first few weeks but now have my stamina and strength back. Also, you cannot take vaccines with live viruses.It comes in a gel capsule and peel packaging.

When I would have the hydrodistentions, Urimax helped with the spasms post-op. It also helps with flare-ups. Urimax also not only relaxes the bladder (which is a muscle) but has antiseptic properties as well. and anesthetic properties as well as an anticholinergic (relaxed the bladder). Some people can use B&O Suppositories for this but I am allergic to Codeine and any medication chemically related to it. I had also tried bladder cocktails such as Rimso-50 (broke out in a rash and had violent spasms as if I were going to deliver my bladder!) and the Heparin cocktail. Neither worked to help put a new lining on the bladder wall .I also tried Neurontin to help with bladder capacity but could not see a difference Another medication. You must be careful when going off the Neurontin due to the possibility of causing a seizure. It has to be tapered down in dosage. I am on is Singulair 10 Mg. once a day to help fight the mast cells which in numbers increases inflammation as in Asthma. I was on Tagamet but had to stop for it interferes with the Sandimmune.Tagamet helps target histamine release which occurs in an infection or inflammation.

I also take 1 Mg. Valium to help relax the bladder since it is a muscle 4 times a day and Elavil 50 Mg. at night for the same reason. They help with the nerve pain pathway and I wanted to try to enlarge my bladder capacity which had gone down to 300 cc's at dilatation. Usually I could only hold 50 cc's and had painful spasms at the end of my stream. I was so sleep deprived I could have played lead role in “Night of the living Dead.” The only other medication I take is Estrace 1 Mg. due to a total hysterectomy with ovaries removed in 1993

5- I want to thank you for your time and help in this project. Is there anything you'd like to add about where we are in IC research?

My Urologist, Dr. Deborah Erickson, came from Pennsylvania. She worked with Dr. Susan Keay and they found the protein that produces the toxin that attacks the bladder wall. There will be a cure when they can find out how to turn this off.

Also from patients I have talked with, people can have more than one autoimmune disease going on as well. One young lady I know has had endometriosis (had to have a hysterectomy), IC and developed Lupus!

My first Urologist tried injecting Botox into the bladder wall nerve pathway which Dr. Chancellor in Pittsburg has tried. It lasted for 6 months the first time (for bladder capacity) and the next time it lasted only 3 months. I am a redhead and it was published that Redheads need 25% more anesthesia. So…who knows why we are so different!

There is hope out there for us with this horrible autoimmune disease. We just have to find ways to treat our symptoms until that day comes. Some people have gone into long term remissions. I do not know of many. We must however maintain hope. The more physicians become aware of this disease, the more likely people will not go untreated and suffer.

About Our Expert:
Jeannie Snyder, R.N.
St. Joseph East Hospital

“What I am suggesting is that by extension, that is the job of the company-to sell a product and make a profit, not to better people's lives.”

But so what? How is this even slightly different from the company that sells you your car, or toys for your children, or the food you eat? How is the company's desire for profits different from your desire to get paid for what you do? You presumably wouldn't work as a doctor if you were forbidden from ever getting paid for it – does that mean that no one can trust you?

The proper role of the government is to regulate, not micro-manage. If the companies are well-regulated, then their products will be reasonably safe and we'll get information on efficacy, side-effects, etc., and then it's up to patients and their doctors to decide.

Drug company reps are paid to give the best possible case for their company's product line, similar to a lawyer or real estate agent or car salesperson all giving their best pitch. It's your job to do your own homework, ask tough questions and sort it out. How can you be so trusting in a panel of experts and yet unwilling to do your own job as a doctor making your own decisions?

How can a panel of scientists that get paid a fixed amount regardless of the quality of their decisions be expected to do as good a job as companies that are risking their own money to decide whether to develop a drug? Yes, the company hopes to make a profit. But they know that their profits will be much, much higher if they can find a drug that is clearly better than the others, and they know that they can lose a lot of money if they develop a drug that offers nothing at all that's new or better.

Thus, drug companies only decide to continue researching a drug if it has potential, while some panel of experts would decide based on whims, snap judgments, the fear of approving a drug that might hurt people (which is a reasonable fear but must be balanced against the desire to approve drugs that help people, and the panel would get little or no credit for that), plus there would be the classic decisions in exchange for bribes or in favor of relatives and cronies. The expert panel, like other central planning systems, leads to corruption and incompetence and at best, indifference. Important decisions shouldn't be left to those that don't care about them.

We have plenty of experience with both systems – the panel of expert/central planning approach and the regulated market approach. Why are you suggesting that we ignore decades of experience? Your justification needs to be more than 'people's lives are at stake' – that's true in many, many areas. Shouldn't a government panel of experts be the only ones allowed to do any sort of construction? After all, people's lives could be at stake from shoddy construction or poor design. Shouldn't the government provide our food, and certainly build our cars? By your reasoning, shouldn't the government really control everything, just in case?

DEAR DR. GOTT: My 13-year-old grandson has been plagued with urticaria for the past two years. It appears on his face and all over his body. His mother has taken him to several specialists, but they cannot seem to find a cause or cure. He manages it by taking Zyrtec and Singulair.

Do you have any suggestions or helpful information? This condition bothers him greatly and interferes with his daily life.

DEAR READER: Urticaria is more commonly known as hives and presents with itchy welts that appear and disappear. They are believed to be an autoimmune disorder and may be linked to allergic reactions, thyroid disease, lupus and other health problems. Lesions appear in batches, often on the face, arms and legs, but can also present inside the throat, on the genitalia and on the lips. They can last from a half-hour to a day and a half.

While it may not be possible to pinpoint the cause of your grandson’s problem, any information provided to his physician will be of assistance. For example, are the outbreaks caused by food, food additives such as MSG, herbal supplements, vitamins, medication, stress or physical activity? Are the hives worsened by heat or cold?

Over-the-counter antihistamines might help relieve the itch. Zyrtec and Singulair are both prescribed to reduce the severity of the symptoms he experiences.

Because his physicians have not been able to determine the cause of his hives, it is extremely difficult, if not impossible, to avoid the trigger or triggers that will likely continue until someone determines the cause. However, he can wear light, loose-fitting clothing, avoid scratching or otherwise irritating the affected areas during outbreaks, use a soothing lotion, cool affected areas with a cold washcloth or shower, minimize his activity and use the prescribed medication.

Has he been tested for thyroid disease, hepatitis, lupus or other medical conditions? If he hasn’t undergone allergy testing, this might also be a viable next step. Has any physician attempted to switch the Zyrtec to Allegra, Clarinex, Claritin or other low- or nonsedating antihistamines? Benadryl and others can make him drowsy and could present their own set of problems during the day, but they still allow another option. There are a number of other medications that might be used in conjunction with his current medications for better control. In addition to his primary-care physician, an allergist or dermatologist might see him.

To provide related information, I am sending you copies of my Health Reports “Allergies” and “Thyroid Disorders.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 U.S. check or money order per report to P.O. Box 167, Wickliffe, OH 44092.

I am a certified personal trainer, and I am going to let you in on a little secret that will help you get the lowest possible prices at your club, the cheapest personal training possible.

Thing vary from club to club, but at Bally Total Fitness it went as follows (and this is probably similar to how other clubs do it as well):

There were four levels of training: level 1, 2, 3, and 4. All the “level” meant was different pricing. Level 1 was the cheapest; and level 4 was the most expensive, even though the actual training packages were all the same. Training packages were either four sessions, eight sessions, 16 sessions, 24 sessions or 48. So for example, level 1 eight sessions was considerably cheaper than level 4 eight sessions.

However, a trainer with just one certification could only charge level 1 prices. If a trainer had two certifications, he could charge level 2. And I think you had to have four certs to charge level 3, and more than four to charge level 4.

I had more than four certifications, but I never showed any prospects the level 4 pricing, because the prices were outrageous.

I usually presented the pricing list for level 3. There came a point where, during the consultation, I'd pull out the price booklet. I'd flip to the level 3 page and make sure that the prospect did not catch a glimpse of the level 2 or level 1 pages. The prospect had no idea that below this page was the level 2 page, and below that was the level 1 page. And the prospect would simply see prices for the five different packages. The prices were given in terms of the total, and then shown in different ways it could be broken down by monthly credit card payments, based on a particular down payment.

I'd carefully watch the prospect's reaction. If they nearly fainted upon seeing the prices, I knew they'd never pay level 3 if their life depended on it. So I knew I had to show them level 2, maybe even 1. But instead of flipping to the level 2 page, I instead said something like, “Well…I really want to train you, and I see your reaction to the pricing. The manager is in now. Let me go ask him if I could lower the prices for you. I'm not sure he'll go for it, though. But let me just ask him. He's in a good mood today. I can't lower the prices. Only he can. I'll be right back.”

I fetched the manager and told him, “I just showed level 3 and it's a no-go. Let's see if we can get this prospect for level 2.”

The manager came back with me to meet the prospect. I had put away the price booklet. The manager began talking with the prospect, asking her about her goals, and then talking about the prices I had just shown. The prospect continued to express that she couldn't afford it. So the manager would then slowly scratch behind his neck (or do something like that), and say, “Well, um…let me see now…you know, I normally don't do this. But since you seem really serious about training with Jillita here, and she's our best trainer…well, I'll tell ya what. I think I can take about 10 percent off the prices.”

But instead of showing her the level 2 prices (which would blow the ruse), the manager took out a piece of scrap paper and calculator, pretended to fiddle around with it, and then wrote on the paper the level 2 prices, which he knew by heart.

A lot of times, the prospect, thinking that a special deal was cut for her, fell for this and took the deal. There were times when the manager would quote the level 1 prices. But he was not able to go below level one, since pricing was set by corporate.

If you want the best deal possible for personal training, here are the guidelines:

1) Always act like you can't even come close to affording the prices. Chances are, you are being shown the most expensive, or one of the higher-priced packages. Act shocked at the prices, and you will be offered cheaper prices, but realize that the staff will pretend it's a hardship to get the prices lower. Play along with this ploy. Continue acting shocked until you sense that they are giving you their lowest price possible.

2) Schedule your consultation near the very end of the month. At the end of the month, managers are desperate to get in sales quotas. Even though they can't go below level 1, what they WILL do, out of desperation to make that quota, is throw in a few free training sessions with the package. If the manager offers two free sessions, be firm and tell him, “Throw in four, and you've made yourself a deal.” I can pretty much guarantee he'll go for this, because it won't be HIM training you for four sessions without being paid; it will be his employee!

3) However, if it IS the trainer himself or herself who is lowering the prices, still be adamant about four or five free sessions. The trainer is under pressure to make a sales quota.

More than once, a prospect caught wind of the existence of lower-level pricing, and questioned it. The easy way out of this was to tell the prospect that brand new trainers who aren't yet certified, could only charge level 1 prices. But more experienced trainers with more certifications, were supposed to charge the higher prices. “You get what you pay for,” I'd say.

This all may make me sound unscrupulous, but it was part of my job, clearly instructed to me to do it this way, and like other working class people, I had a lot of bills to pay. I train privately now and charge everyone the same fee.

What was James O'Keefe thinking? When he and the inane clown posse got their telephone man costumes out of the Tickle Trunk and went to Mary Landrieu's office to waste a public servant's time — what was their goal? Why did everyone, even Michelle Malkin, assume he was planting a bug?

(Leading Malkin to write my favorite mental patient comment on the whole thing: “Know your limits. Know the law. Don't get carried away. And don't become what you are targeting.” Because that's the real danger, when you're at war with a force of elemental evil like Mary Landrieu: The abyss also looks into you. “Don't become what you're targeting?” You mean like Batman? That's quality crazy. James O'Keefe doesn't wear a Batman costume! Just “Prescott, The Preppie Pimp” and “Mr. Telephone Man.”)

If he wasn't planting a bug, what was the Dork Knight's plan? What would have happened had it worked? And why can't anyone, from anywhere on the political spectrum, figure out what the point was?

We knew why Andrew Breitbart couldn't explain it. He's not very smart. But why wouldn't anyone else let us in on the gag? It's not like James O'Keefe doesn't like publicity. James O'Keefe and his gang are a lot like Fight Club, if all Fight Club ever did was talk about Fight Club. So why the mystery?

We could only guess. One theory: James O'Keefe is a twitching rageball and his acts are driven by a sexual frustration so powerful it makes suicide bombers look like Girls Gone Wild. But that's just one theory. I'm not a doctor.

Then, finally, late last week, an explanation from O'Keefe himself:

I learned from a number of sources that many of Senator Landrieu's constituents were having trouble getting through to her office to tell her that they didn't want her taking millions of federal dollars in exchange for her vote on the health care bill. When asked about this, Senator Landrieu's explanation was that, “Our lines have been jammed for weeks.” I decided to investigate why a representative of the people would be out of touch with her constituents for “weeks” because her phones were broken. In investigating this matter, we decided to visit Senator Landrieu's district office — the people's office — to ask the staff if their phones were working.

Oww, my sides!

A couple of things.

James O'Keefe is protesting/investigating Senator Landrieu's phones. Because The Peoples' calls aren't getting through. Does he know what the word “jammed” means? It seems like the question was: Why can't I scream at you? And the answer was: Our phones have been jammed. You know, with other people screaming. Hence: “Jammed.” James O'Keefe either doesn't understand six-letter words (The Brietbart Defense) or he chooses to ignore them.

Second, “we decided to visit Senator Landrieu's district office — the people's office” is disingenuous to the point of shit-eating. The issue here isn't whether you dropped in, pencilneck; it's whether you dropped in in disguise. Mike Wallace? Over 100,000 years in investigative journalism; never once in costume.

Third: This is about health care reform? I guess she's really asking for it, then. A good man has no choice but to put on play clothes and take the law into his own hands. Some things are worth going to jail for, and I hope you do.

But here's the most troubling question:

What was supposed to happen when O'Keefe's crew proved that the phones worked?

What would the video mean? What does the viewer learn? What's been illuminated? Who's been punked? How is it hilarious?

I keep trying to get this joke and I cannot.

I think this goes beyond politics. We're in real danger of becoming two entirely different species. Animals that understand how this phone stunt would be funny/devastating and animals that don't. Animals that can follow a Glenn Beck flow chart and animals that can't. Animals that think Mary Landrieu is just a mediocre senator and animals that think she's evil and the only question is: does she deserve vigilante justice, or do we let the law take its course?

We're not even speaking the same language anymore.

James Thurber said the first rule of humor was “the reader should be able to find out what the story is about.”

James O'Keefe can't even do that.

But during Wal-Mart Stores' most recent quarter, revenue at the Sam's Club division slipped nearly 1 percent to $11.55 billion while U.S. Walmart stores posted a 1.2 percent sales increase to $61.81 billion.

“Sam's has been the relative laggard, and it has lagged relative to its direct competitors, Costco and the smaller BJ's (Wholesale Club),” said Craig Johnson, president of retail consultancy Customer Growth Partners.

The move to outsource its food sampling efforts is a way for the company to tout its fresh food offerings in a cost-effective manner, Johnson said.

“'Fresh' is where the real competitive battles are being fought in the club sector,” he said.

Shopper Events will launch a new demo program called “Tastes and Tips” with new carts, signs, uniforms and a trained team, said Cornell. He said the move was not made to save money.

“It's not a cost cutting measure, its really an investment in enhancing our demo program,” he said. Cornell added that Shopper Events plans to hire “roughly the same number of people” cut, and said Sam's Club workers are invited to apply for those positions.

Cornell said Sam's Club decided to eliminate its membership recruiting unit because “we have found that we can more effectively drive membership through targeted member acquisition events and by increasing our partner membership programs.”

“I feel betrayed,” said Sally Grueling, 56, who had worked at Sam's Club for nine years, most recently in Hilliard, Ohio as a new business membership rep.

In a memo to employees, Cornell said eligible workers will receive severance pay and benefits, and that the company will help them find opportunities at other Sam's Clubs and in Walmart stores, in addition to Shopper Events positions.

The cuts come as many Americans had hoped job losses would abate as the economy slowly recovers. However, analysts said Sunday that while this marks Wal-Mart Stores' largest job cut, they expect many employees to be picked up by Shopper Events, so the net effect on the economy probably won't be that bad.

“I would argue that from an economic standpoint it's somewhat nominal,” said David Strasser, a retail analyst with Janney Montgomery Scott. “It looks a lot worse than it really is from a layoff standpoint. My read is the majority of employees are going to be picked up by Shopper Events.”

Strasser said he did not expect the move to materially affect Wal-Mart Stores' fourth-quarter earnings results. Wal-Mart reports results for the quarter and full year in February.

“It really should be neutral to the economy,” Johnson agreed. He said Wal-Mart remains the largest private employer in the world and in the U.S. “None of that changes.”

The number of jobs created via Shopper Events may not be one-to-one, he said, “but should be fairly close. Net net I don't think it makes a huge difference on the economy.”

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