"When Patients Meet Online, Are There Side Effects?"

The New York Times' Natasha Singer takes a look at health-oriented social networking sites, including CureTogether.com and PatientsLikeMe.com.  


Singer injects some quizzical notes, concerning privacy issues, and also asking to what degree drug companies are fronting some groups, for whatever purpose, but the ultimate logic of a social network for health is as powerful as a social network for anything else.  As PatientsLikeMe puts it: 


“When patients share real-world data, collaboration on a global scale becomes possible.   New treatments become possible.”

Newsweek Cover: "Desperately Seeking Cures."

Newsweek's Sharon Begley and Mary Carmichael have collaborated on a must-read cover story in Newsweek, entitled: "Desperately Seeking Cures: Medical Progress Isn't Making Progress Rapidly Enough--Here's Why--And How To Push Things Forward."

The Newsweekers begin by noting the fall-off in the drug pipeline:

From 1996 to 1999, the U.S. food and Drug Administration approved 157 new drugs. In the comparable period a decade later—that is, from 2006 to 2009—the agency approved 74. Not among them were any cures, or even meaningfully effective treatments, for Alzheimer’s disease, lung or pancreatic cancer, Parkinson’s disease, Huntington’s disease, or a host of other afflictions that destroy lives.

What's happened?  The co-authors explain:


“Basic research is healthy in America,” says John Adler, a Stanford University professor who invented the CyberKnife, a robotic device that treats cancer with precise, high doses of radiation. “But patients aren’t benefiting. Our understanding of diseases is greater than ever. But academics think, ‘We had three papers in Science or Nature, so that must have been [NIH] money well spent.’?”


More and more policymakers and patients are therefore asking, where are the cures? The answer is that potential cures, or at least treatments, are stuck in the chasm between a scientific discovery and the doctor’s office: what’s been called the valley of death.


The barriers to exploiting fundamental discoveries begin with science labs themselves. In academia and the NIH, the system of honors, grants, and tenure rewards basic discoveries (a gene for Parkinson’s! a molecule that halts metastasis!), not the grunt work that turns such breakthroughs into drugs. “Colleagues tell me they’re very successful getting NIH grants because their experiments are elegant and likely to yield fundamental discoveries, even if they have no prospect of producing something that helps human diseases,” says cancer biologist Raymond Hohl of the University of Iowa. 


In other words, Begley and Carmichael argue, scientists have come to see working for the NIH as an end in itself.   An ominous development, if true.  


Begley and Carmichael offer some suggestions for exiting this rut, including a greater emphasis on cooperation among "turf-jealous academics," and even direct grants to biotech companies, as championed by Sen. Arlen Specter (D-Pa.)--those biotech companies can be presumed to be more interested in actually getting drugs, and cures, to market.  


But the whole article is worth reading.   

A Vaccine For Breast Cancer? Will the Rationers Allow It? How Will the CBO Score It?

Great news: Scientists are edging closer to a vaccine for breast cancer, reports the BBC:

Vincent Tuohy, from the Cleveland Clinic Lerner Research Institute, said: "We believe that this vaccine will someday be used to prevent breast cancer in adult women in the same way that vaccines have prevented many childhood diseases.  "If it works in humans the way it works in mice, this will be monumental. We could eliminate breast cancer."

Sounds great, but how will the rationers in the federal government regard this possible news?  How will the  Congressional Budget Office score it?  What if it takes another 10 years of research and trials to get the breast-cancer vaccine to market?  Will that decade's worth of effort be counted as a cost--a cost to be pruned--or will it be seen as an investment, to be nurtured along?

The CBO is a hard-working bunch, and mean no harm, but their mandate is to look at everything through their single-variable bean-counting prism.   And that means that something as radical as a costly cure might not fit into scarcitarian vision, or their computer model.

Little Hip Hop

The Promise of Telemedicine: And the challenge of fully accounting for its benefits. Will the federal government calculate all the savings from productivity and efficiency?

The New York Times' reports on the promise of telemedicine, the long dreamed-of idea of long-distance medicine, in which doctors and other healthcare providers are instantaneously connected to patients who might not otherwise be able to get to a doctor, because they are in remote locations, are incarcerated, or are otherwise not mobile.   As the Times'  Milt Freudenheim notes, a fifth of all Americans live in places where primary-care physicians are "scarce," to say nothing of specialists.

The telemedicine idea speaks for itself, described ably by Freudenheim, but the Times reporter raises one interesting point that deserves much further exploration: We know how much we spend on telemedicine, but how much do we save?    Freudenheim reports that interactive diagnosis--of the sort pictured above, showing a Houston physician, Dr. Jerry Jones, working from home--is a $500-million-a-sector, a part of the $3.9 billion in annual expenditures for telemedical devices such as smart phones and other kinds of sensors.

So let's see: That's $3.9 billion expenditure, out of the $2.4 trillion that the US spends annually on healthcare.   But President Obama, and just about everyone else, says that we are spending too much on healthcare. So should telemedicine share in the austerity that we are supposed to be imposing on the healthcare sector? The austerity--some call it rationing--that Uncle Sam is supposed to impose on this dynamic sector of the economy--is that really a good idea?

Here at Serious Medicine Strategy, we are skeptical of the a priori assumption that the US spends too much on healthcare.   But even if we do spend too much on certain aspects of healthcare, a moment's reflection tells us that telemedicine is a winner, not a loser, for the US economy.  And so we should have more telemedicine, not less.   Why?  Three reasons:

First, with telemedicine, a new niche within the healthcare sector is being pioneered, in which people get better healthcare, and are thus made healthier.    (Now, if we can just keep the trial lawyers from destroying it, through liability lawsuits targeted not just at doctors, but also at the telemedicine pipelines, such as the phone companies and the cable companies.  As legal expert James Wootton has warned, creative legal buccaneering will strive to find some theory, no matter how dubious, that holds deep-pocketed pipelines somehow responsible when something goes wrong.)

Second, along the way, a new industry is being created--lots of high-tech jobs, building out and servicing the telemedicine industry, as it evolves in ways that we can't foresee, not only here in the US, but also, potentially, around the world. (See iPad.)   How much is that new industry worth to us?   It should be worth a lot.    And as a matter of dynamic-accounting fairness, the gains from this nascent industry should be deducted from the overall cost of our healthcare, so that we come up with "net" number (healthcare costs minus telemedicine industry gains) for the overall sector.

Third, the savings of telemedicine are already accruing to various institutions, and those savings should be factored in, too, as part of our healthcare bill. It's not fair, and it's not smart, to measure the costs without measuring the benefits--which, in some cases, will way outweigh the costs.   For example, the Times reports that moving a oil-rig worker off an offshore oil platform in some faraway place to a doctor can easily be a $10,000 roundtrip.  So the telemedicine-induced savings for the crew of a single rig might total $500,000 a year.    An even bigger issue is moving prisoners around as they receive medical treatment; obviously it is extremely expensive to move prisoners from prison to a doctor and back.   The Times cites a further estimate that the annual savings of telemedicine to the state of California alone could total $1.2 billion. Which is to say, measured across the whole of the economy, the savings from telemedicine could be enormous.   Shouldn't those savings be subtracted from the net of our national healthcare bill?   Of course they should.

The point here is that telemedicine is a paradigm-shifting approach not only to better medical care, but also to  more jobs and economic growth, as well as more savings to the country.   If only Uncle Sam knew how to account for all that good news.

Shamelessly forcing the people to sacrifice for the RICH CRONIES.

This week star attraction is on CUT THE SUBSIDIES by Idris Al Dunlap Jala. Its a production by an elite UMNO member who had been living on the fast lane. He travels in private jets, have breakfast in Kuala Lumpur, Lunch in Australia and dinner in the Pacific Ocean. He meets the rich and famous and even bedded some film stars who appeared in porno films. Dresses in branded names only. He gives out US100 bill tips generously with icy nose like a jerk. At the roulette table US10,000 per game is chickent feed. So this fella is given the task to cut the subsidies to the poor and needy, and to safe guard the rich cronies.

Looks like Najib is very insistence that the majority of the people should sacrifice their bread and butter so that the cronies can continue their luxury lifestyles.

My old man is one crony who continues to collect more than RM6 million per day till today from the generous APs given by the UMNO government. He is 70 years old. What is an old, old man doing with RM6 million pocket money per day? If the government today wants to be taken seriously, take back the APs from him. There are 15 more men like him who gets such money. So if you times that, you get RM90 million per day. Times that again by 365 days that will come to RM3.3 billion approximately, right? This is not a small amount to be given away for free.

The government should withdraw all APs pertaining to Vehicles, Transport, Sugar and Flour, Electricity and Water, Tolls and get rid of the Indonesians Immigrants then only we can sit down to discuss about cutting the subsidies meant for us the majority citizens of this country.

In nine years time Malaysia will be like Greece predicted Al Dunlap if we do not cut the subsidies given to the people, majority poor and needy, is way too long. We are lucky to be alive, if we have not starve to death before the world ends in 2012, sacrificing for the rich to continue living the good life.

The UMNO government is shamelessly forcing the people to sacrifice for the cronies in BN.

"Running late on the EARLY Act." Breast Cancer Will Have To Wait.

Rep.  Debbie Wasserman-Schultz was the prime mover behind the EARLY Act--that's an acronym for Breast Cancer Education and Awareness Requires Learning Young.  


As Wasserman-Schultz, herself a breast cancern survivor at a young age, observes:  


In 2008, the American Cancer Society estimated that there would be 182,460 new cases of breast cancer in women. Of these cases, more than 10,000 – 11,000 of these women would be under 40 years of age.   Although the incidence of breast cancer in young women is much lower than that of older women, young women's breast cancers are generally more aggressive, are diagnosed at a later stage, and result in lower survival rates. In fact, breast cancer is the leading cause of cancer deaths in young women under the age of 40.


So there's plenty of reason to think that this is a laudable bill with an important purpose.  


But as Lt. Columbo on the old TV show might say, "There's just one thing."  And that is, can the federal government actually accomplish all the goals that it sets out for itself?   It's nice that lawmakers come up with laws with good-sounding titles, and noble purposes, but just isn't so obvious that the government knows how to get these things done.   As the BP oil spill reminds us, there can be a wide gap between what the government says that it is doing and what it gets done.


That was the lesson of a piece by Sarah Kliff in Politico, headlined, "Running late on the EARLY Act," reports:


Although it’s racing to roll out consumer-friendly aspects of the health care law before November’s midterm elections, the Obama administration has just missed the deadlines to set up task forces on breast cancer and health care in Alaska. 

The health care law required Health and Human Services to establish the breast cancer task force by last weekend and the Alaska task force by the first week of May. But sources familiar with the situation said the department isn’t even close to having the two panels ready. 

So the government missed a deadline.  Will there be any consequences for the bureaucrats who missed that deadline?  And will there be any consequences for the politicians who concoct grand legislation, without seeming to worry so much as to whether or not the legislation actually works as promised?  

We desperately need accountability and feedback in the government.  Accountability for failure, and feedback, as in a learning process, so that we can figure out what is and is not working.   We know, now, about federal competence in the BP oil spill.   And thanks to Politico, we are learning, now, about federal competence in the area of women's health.   

Happy Wesak

A good day to forget the world and pamper yourself.

Emotionally high at American Idol 2010

In the words of Simon Cowell "One must know when to go." Today is the end of Simon's ten years role as one of the judges of American Idol.

On a positive side is the crowning of the new American Idol 2010. Lee Dewyze a paint salesman from Chicago. Right from the beginning a dark horse that emerge into a star with a commercial voice.

Antiangiogenic

Stepmothers

Syed Gamal the only son of the late Syed Kechik and first wife Zainab had applied a caveat to restrain his stepmother Sofiah Moo Abdullah and stepsisters Sharifah Zarah and Sharifah Munira from managing the RM400 million estate without first consulting him.

Stepmothers are by nature mean and cruel. There are many reasons why they behave as such. There are no blood tie, the marriage was for the position and money, arranged marriage or was raped so to escape prosecution they quickly got married or pregnant to force the man to marry her............etc.

Only the women themselves know the reason. But some are opened about why they married so and so.

Mahani Daim married for the money and later for the position Daim holds. Her late mother and siblings are frank when ask why she Mahani married Daim. They and even the Mahmood girls (Pak Lah’s ex in laws) had always supported that Mahani make sure she does not leave Daim. They encouraged her to seek Bomohs’ help, take sex lessons from a Mummy in New York with the help of her toyboy and to offer sexual interlude with Mahathir. In other words Mahani must ensure that Daim’s money and assets goes to her and depends on her.. When things do not work well, Mahani uses the son Wira Dani to charm the father. Mahani had seek Bomohs’ help (even today) to even severe the stepdaughters from their own father Daim. Mahani’s suicide are all part of the act so that Daim will never leave her. Today she succeeded 60% in gaining what she wants. The outcome will be seen if Daim dies before her. Then we the public will be in for some fantastic show on what are the things she gave Daim to drink daily and put on the pillows.

Sofiah Moo Abdullah what can I say except that she told me that she rather spend all the money on gambling (Bacarrat) in Genting and now Singapore than to give that boy (Syed Gamal) a single sen. As far as she is concern Syed Kechik had already provided for that boy. Now he wants a share he can forget about it. Sofiah Moo said she had never like or treated that boy as a son, so why must she do that now. To her that boy is long gone and should be a man and stand on his own feet and not come begging to have a share of her loot.

Vincent Tan has three Chinese wives and two Malay wives presently. Every time Vincent Tan goes to the Chinese wives’ home they serve him pork and dog meat and make sure videos are make. So it will be quite a show too when Vincent Tan dies. The big question would be “Was Vincent Tan a practising Muslim at the time of Death?” One of the Malay wives is the present Agong’s sister.

All these Rich Men tales can make superb movies.

Imagineering Medicine: SAP Shows One Approach

Here at SMS, we have been critical of Washington for failing to fully grasp all the opportunities that computers, social networks, and even games have put before us.   How much creativity and ingenuity is waiting to be harnessed?  

Today, we can only get glimpses of what is possible.   One such glimpse comes from  SAP Software, which has created Idea Place, to encourage info-sharing on software ideas and applications.    Some of them concern medicine.

In this video, we see two SAP employees, Tobias Queck and Vandana Deep, talking through a SAP product called Paper UI.  It's a digital pen, which records handwriting information as it is being written.  So the care-provider writes the information on a regular piece of paper, and the information, stored in the pen, can be docked and sync-ed into the overall network.

No doubt there will soon enough be a wireless version of this digital pen, so that the information goes into the network in real time, but no need to get ahead of ourselves.  In the meantime, we might pause to consider the fact that we don't yet know which "paradigm" of electronic health records (EHR) will prevail.   In recent years, we have presumed that some sort of tablet--most notably, perhaps, an iPhone or an iPad--will be the dominant platform.  

But one can make a case that it should be the pen/stylus, because, let's face it, plain old dead-tree paper has advantages.  It never runs out of battery life, it's easy to move around, it survives spills and drops, and so on.  And yet of course, we want all the data to be captured, and backed up--that's what the pen is for.    The grand synthesis of EHR is yet to be seen, although, of course, there may never be a grand synthesis.

Interestingly enough, SAP-ers Queck and Deep were pitching the product at a trade show, DKOM 2010, held in San Francisco earlier this year, and they were in some sort of race with the clock the clock.   As in, they had, it appears, six-and-a-half minutes to make their pitch, before a bell went off.  One could not gain  a sense, from the video, as to what the carrots or sticks might be, and it all seemed good-natured in any case.    Which is to say, game-like elements have penetrated--suffused is probably a more accurate verb--not only the computer culture, but also the computer-medicine culture.   I was also struck by the use of the word "imagineering," which I think was coined by Walt Disney, to describe the engineering used at Disneyland and the other Disney theme parks.

Nothing wrong with that.    On Friday, I published a long piece for Steve Clemons' blog, The Washington Note, arguing that vast reserves of creativity and ingenuity were not being tapped for the cause of healthcare, and the biggest of those untapped reserves was the gamer culture.

Dr. David Gratzer on Dr. Donald Berwick, Obama's choice to run Centers for Medicare and Medicaid Services

Worth a read -- this is going to be a fight in the US Senate, for Dr. Berwick's confirmation to run the Medicare and Medicaid programs.

Some might see it as an early referendum on Obamacare.

Man Made Life: What Would Cordwainer Smith Say to Craig Venter?

As usual, The Economist's take on Craig Venter's announcement of synthetic life--more precisely, the creation of a bacterium with a synthetic genome--is thoughtful and thought-provoking.  The piece was evocatively entitled, "And man made life: Artificial life, the stuff of dreams and nightmares, has arrived."  


There will be much back-and-forthing as to the impact that Venter--working with Hamilton Smith--will have, including some contextualization, even minimalization, of the Venter/Smith achievement, but The Economist gets to the bottom line: 


It will be a while, yet, before lifeforms are routinely designed on a laptop. But this will come. The past decade, since the completion of the Human Genome Project, has seen two related developments that make it almost inevitable. One is an extraordinary rise in the speed, and fall in the cost, of analysing the DNA sequences that encode the natural “software” of life. What once took years and cost millions now takes days and costs thousands. Databases are filling up with the genomes of everything from the tiniest virus to the tallest tree.


Indeed, this might be a case where the who-what-wheres of journalism, important as they are, prove to be inadequate compared to the speculative challenge of understanding the road ahead.


Serious Medicine Strategist Jim Woodhill puts himself in the camp of those who believe that what Venter has wrought will, indeed, be big.   And to illustrate the potential scope of the Venter-ized future, Woodhill reminds us an unjustly neglected sci-fi writer, Cordwainer Smith, who imagined for us a universe in which Serious Medicine is really serious, where Serious Medicine is the most valuable commodity in the cosmos.   As Woodhill recalls it:


Smith wrote of a future world where a drug called "stroon" was distilled from the vomit of gigantic mutant sick sheep.  Stroon, also known (for some unknown reason) as the "Santaclara Drug" granted its taker health without aging while he kept taking it.  The value of stroon was so high that when one 18-year-old Old North Australian sheep rancher was able, with the aid of a family heirloom war computer, to corner the stroon futures market, he became wealthy enough to buy everything.

OK, some might say, that's just sci-fi, published half a century ago.   But Woodhill connects Smith's work to the present debate, specifically, the way that we finance healthcare--and let that healthcare financing get the better of our overall Serious Medicine Strategizing.   Let's remember, folks, the central issue of healthcare is cures, not cost.  The politicians have taken their eye off that ball, because we have let them.   And so the beancounters, who have gained ascendancy over the politicos, in the wonkrooms of Washington, have trumped the medical visionaries, such as Venter.   That's why we could have a healthcare debate, over the last year-and-a-half, that paid almost no attention to the prospect of actually curing diseases.   We will finance illness--and expand the financing of illness--but we seem to have relatively little interest in actually curing disease and restoring people to health.   That's not what the average American thinks, but the average American wasn't really consulted in the debate.   


As Woodhill explains:


One of my (in)sanity checks on the healthcare reform debate is to note that the discovery of a Santaclara Drug that cost, say, 20% of U.S. GDP (initially) to synthesize in great enough amounts for our entire population would be a disaster within the current accepted public policy model.  I mean, 17% of GDP would go to 20%!  (And more than 20% because stroon would not eliminate trauma care, maternity wards, etc., just heart disease, cancer, major mental illness...)


Woodhill is exactly right.   Venter opens up the prospect of genuine medical/scientific breakthroughs, the kind that would paradigm-shift medicine, and paradigm-shift the economy, too.   Just as Cordwainer Smith, in his own way, imagined a half-century ago. 


Today,  we might imagine what America would look like if we were systematically applying Venter's technology--in a legal and ethical way, of course--to the health challenges at hand.   What if we were to help Venter, and all the others doing this work, help us?  What if we launch a national medical-economic strategy to do the sort of research that would lead to the sort of wonder-drugs that would make America a medical and economic magnet for the world?    Such an achievement is admittedly speculative, but if we could do it, the achievement would dwarf some minor tweak--or even a big shift--in the way that we finance healthcare. 


No wonder, then, that Washington isn't interested in turning the reins of healthcare policy over to science--because whatever science creates, by definition, wouldn't be invented in DC.  It might be financed in DC--and maybe it should be financed in DC--but it would be created in a lab out beyond the Beltway somewhere.  And that act of medical-scientific creation would, in effect, disempower the political class.   

Another bail out on the move

Musa Hitam be a man and accept responsibility for the loss in Sime Darby.

Sime Darby was not your first loss. Remember IJN and LCCT-Labu.

Maybe we should remind you what happened in December 11 1993 at the Highland Towers after you okay the Memali incident.

Time has pass but lesson should not be forgotten.

http://en.wikipedia.org/wiki/Highland_Towers_collapse

Abu Kassim Mohamad and Gani Patail can we have a deal?

Yes I am offering MACC and AG a deal. You charge Najib for bribery, tomorrow I make you the Deputy Prime Minister and Prime Minister of Malaysia respectively. Can or not? You scratch my back, I scratch your back.

But NO ONE DARES. Who is Najib? What does he has that is so powerful that the AG, MACC, Police and even the Judiciary are sacred of him? Is he Allah? Or is it because Rosmah opens her fat thighs for easy access?

I am not in a mode like that stupid Rais Yatim to enjoy a sick joke from MACC that they are going to investigate Najib's RM5 mil deal. The dry weather and the bad economy in this country is already driving us crazy. Previous to this MACC opened a file on Khir Toyo and threw it into the bin. So do we allow our ears to listen to lies again?

Go and do what you normally do Abu Kassim attack and kill someone in PKR and enjoy your happy hour in some dump site.

Humble

Life is about learning to live.
To live a life full of love and smile.
Along the way we meet others who show us how.
Asking nothing in return.
Your teaching is so humble.
What more can I ask.
Time is moving forward.
A minute of our time to say thank you.
I love you.

I want the flat belonging to Sharipah and Hanizah

What the heck?

The controversial sale of 500 low-cost flats to Petaling Jaya City Council (MBPJ) officers is morally wrong although it is legally right, Selangor Mentri Besar Tan Sri Khalid Ibrahim said.

A wrong is a wrong. It does not matter whether it is morally or whatever name you give. The flats are meant for those earning below RM2,500. Which mean, I have the right to buy the flat, not council planning director Sharipah Marhaini Syed Ali and engineering assistant director Hanizah Katab whose earning are above RM10,000 per month.

Khalid should not take the easy way and give excuses. Confiscate all the properties bought by MBPJ officers and give them away for free to deserving poor. Set this as an example to stop future abuses of the same kind. DO IT and show us PKR is all action and not mere words.

This is a good opportunity for Khalid to rectify his weakness and failure as Menteri Besar of Selangor.


http://thestar.com.my/metro/story.asp?file=/2010/5/22/central/6315292&sec=central

http://thestar.com.my/metro/story.asp?file=/2010/5/22/central/6313996&sec=central

Kentucky-Fried Crackpot

In the recent primary elections, Kentuckians went for TEA Party favorite Rand Paul to be the GOP nominee to replace retiring Senator Jim Bunning. This was something of a surprise, because Kentucky's other Senator, Mitch McConnell, endorsed and campaigned for Paul's opponent Trent Grayson. Paul is the son of Texas Rep. Ron Paul. Soon after his victory, Rand set about showing us that the nut doesn't fall far from the tree , and he holds the same certifiably loony Libertarian beliefs as his old man.

Hitting the TV/radio interview circuit, Rand told us that he's not a bigot but he thinks any private business should be allowed to discriminate and deny services for any reason and should be permitted to ignore all civil rights laws. He went on to call President Obama's criticism of BP "un-American" because all real American know it was nobody's fault and, hey, accidents happen. Whatever you say, Rand.

Kentucky hasn't elected a Democrat to the Senate in a long time, but the more Rand Paul talks, the more the D's chances improve.

Texas Chainsaw Massacre (Of Historical Fact)

The Texas State Board Of Education is about to vote on their approved curriculum and textbook content. They do this every ten years. This time, the board is set to give the OK to a right-wing revision of history. It looks like the 5 million public school kids in Texas will for the next decade learn social studies, economics and history from textbooks running heavy on Christianity, capitalism and states rights. Here are some of the fear-laden, jingoistic, and amazingly nutty changes they propose:

In discussion of the Age Of Enlightenment, Thomas Jefferson has been dropped in favor of humorless churchman John Calvin (who's about as far from enlightened as you can get).

There is no Constitutional basis for the separation of church and state, says Texas.

Kids will be taught that Joseph McCarthy's 1950's witchhunts looking for Commie infiltrators were justified.

Capitalism will be referred to "free enterprise", which has a more positive connotation, says the Board.

The Civil War was not about slavery. It was about states rights.

There will be no mention of Tejanos fighting and dying at the Alamo alongside Col. Travis, Jim Bowie and Davey Crockett.

The U.S. government is prohibited from promoting any one religion over another. Texas schoolkids won't be hearing anything about that.

American History classes will emphasize the conservative movement of the 1980's and 1990's, specifically discussing Phyllis Schlafly, Newt Gingrich's Contract With America, Jerry Falwell's Moral Majority, and the National Rifle Association.

There will be no mention of the accomplishments and significance of Ted Kennedy or Sonia Sotomayor, but Texas students will become experts on Ronnie Reagan.

Of the 15 people on the Texas Board, not one is a teacher, economist, or historian. No shit. It shows.

White monster

A BIZARRE animal corpse has washed up on a Canadian beach, reviving memories of the infamous "Montauk monster" that was discovered in 2008

Locals in a small Canadian town have been stumped by the appearance of a bizarre creature, which was dragged from a lake.

The animal, which has a long hairy body with bald skin on its head, feet and face, has prompted wild internet speculation that it is a more evolved version of the famous 'Montauk monster'.

The creature was discovered by two nurses in the town of Kitchenuhmaykoosib in Ontario, Canada, while out on a walk with their dog.

When the dog began sniffing in the lake, the two women started investigating, before the dog pulled the dead animal out.

After taking some photographs of the odd animal, the nurses left it alone. When locals decided to go back and retrieve the body, it has disappeared.

'It was discovered first week of May in the creek section of town, hikers noticed Sam sniffing something in the water and they approached to see in what the Sam had detected and they noticed the creature in the water face down.

'The dog jumped in the lake and pulled the creature to the rocks and dragged it out for the hikers to see.

'The creature's tail is like a rat's tail and it is a foot long.'

There has been much speculation about what kind of species the animal is.

The body of the creature appears to look something like an otter, while its face - complete with long fang-like teeth, bears a striking resemblance to a boar-like animal.

Even the local police chief Donny Morris is baffled, saying: 'What it is, I don't know. I'm just as curious as everyone else.'

Government Losses Private Gain

Everytime the Government goes into business it incur big losses. So what is the difference between Sime Darby and Bank Bumiputra, MAS, Hicom, Perwaja etc........... NONE.

The trouble is everyone connected to the Government must have a slice of the cake. It does not matter whether the cake is big enough to be share with in the first place. The first one to grab the cake would be the Finance Minister himself. From Daim, DSAI, Nor Yaakob and now Rosmah the one who is running this country without shame. Which one of them did not eat the cake? Then the assistants to the Finance Minister and the Finance Minister's wife and relatives sharing equal slices of cake with the Prime Minister. Every single one of them should be prosecuted and sent to hang.

I know every single one and their families even their mistresses personally mentioned above. I have known them when they were nobody to filthy rich with titles. These people have sold their souls to Lucifer.

One good example is MAS. My friend Ahmad (who had since gone to the other world)is a nobody in UMNO but he is close to Mahathir, Pak Lah and Nor Yaakob. He would call up MAS for free tickets to London (between 2 to 7 tickets) yearly. In London he and his entourage would stay in apartment belonging to MAS. Then he would call the MAS Manager in London to take him gambling in casinos and visits to prostitutes and gay clubs is compulsory. If the entourage is short of cash for shopping the Ambassador is sure of a call and money would be delivered within 24 hours. Or an UMNO representative is around to take care of their bills.

This is the scenario of how people connected with UMNO rip off our money. So if my friend Ahmad can rip off the government so too those working for the Government.

Zubir was already a thief before joining Sime Darby yet everyone praise him sky high that he was the right man for the job. What happened inside Sime Darby is known by all the Directors concern. So Musa Hitam should not pretend innocent because he had enjoyed the fruit too. Rosmah and Mahathir both are also responsible for the losses.

Like all big losses this one will soon be forgotten easily like the PKFZ scam.

A home may not be a home to others

Camelot the first castle to be built in Malaysia by Maj-Gen Datuk Leong Siew Meng and Datin May Lee-Leong had been in the market for sale for several years now. Till date there is no takers.

At RM6mil, with a land area of nearly 16,000 sq. ft. and a built-up of 18,000 sq. ft. it is below market price.

I have visited Datin May's castle several times after her husband's death but have never felt peace in her home. The rooms are narrow and had that damp feeling. Maybe because I like a well ventilated house to live in. The castle home is good for visits but not to stay in.

Everyone has their dream home, whether it pleases the visitors does not matter because at the end of the day you are the one living in it.

Maybe Joanne can turn the castle into a hotel. After all that castle was built from the late Maj-Gen Datuk Leong's dream.

How To Stop The Oil Leak

It's been a few weeks and BP's broken oil well in the Gulf of Mexico is still gushing shitloads of crude every second. The difficulty capping this leak reveals the lunacy of deep-sea oil drilling -- unlike a tanker with a finite capacity, or a dry-land well you can actually get to, an ocean floor leak could conceivably spew oil for years -- decades! -- before it peters out naturally. How long have they been pumping oil in Texas and Kuwait? Imagine all that gunk just flowing freely into oceans. Our world would be fucked for good.

So everyone agrees we gotta find some way to stop this thing in the Gulf, and we gotta find it now. Incredibly, BP never conceived of such a problem occurring and therefore had no response plan. They've admitted they're essentially just making up shit as they go along. Great! First, they tried a big concrete "hat", which didn't work. Neither did a second smaller hat. Now they've claimed a measure of success by inserting a small tube into the much larger broken line and syphoning off a tiny amount of the leaking crude. This is like trying to divert the course of the Mississippi with a soda straw! There have been thoughts of trying to seal it by dumping massive quantities of mud and concrete over the leak. Some have suggested the line could be plugged with chopped up tires and golf balls.

I may have hit upon a solution: As this situation is rapidly becoming a national emergency, I believe we should be able to rely on some of our greatest Americans and finest patriots to heed the call of duty and do whatever it takes, including the ultimate sacrifice, to stop this leak immediately. The break is in a big 20-inch pipe, so it will take some serious plugging to stem the flow.

Dick Cheneyand Sarah Palin have been two of the most vocal advocates for free and easy drillin', so I'm sure they wouldn't mind helping to clean up their own mess. We stuff them into the pipe first. Next we cram Glenn Beck in there and tamp him down good and tight with one his chalkboard pointers. He's always shedding tears of anxiety over the future of his beloved country. Now he can cry tears of joy doing something positive for the future. And we can finally close the thing off with that huge clot in the artery of common sense, Rush Limbaugh. We jam him in there mouth first so he can taste that deliciously natural mix of oil and water, while doing his patriotic duty and saving the Gulf from further devastation. If there are still any minor cracks or leaks, we'll seal them with Ann Coulter.

I'm tellin' ya, it'll work, and it'll be a hell of a public service to boot.

Understanding the Red Shirt Protesters

GIVEN the sudden and bloody end to the two-month-long protest rally in downtown Bangkok, I believe it is essential the world understands who the Red Shirts are, and what they have been fighting for.

There continues to be a concerted effort from the Thai government and its supporters to delegitimise the movement, paint them as "terrorists," or otherwise seek to deprive the Red Shirts of their legitimate grievances over repeated violations of their democratic rights and reversals of their votes. I can state unequivocally that this movement represents a schism within Thai society that has not been created or developed by any one individual, but represents a fundamental dispute over an exclusionary political system.

As a lawyer representing former prime minister Thaksin Shinawatra, I had the opportunity to visit the encampment just days before the final violence began to investigate recent violations of human rights by the government. The people I met were a polyglot group, young and old, from impoverished farmers to academic intelligentsia, all committed to the peaceful restoration of constitutional democracy. The vast majority of Red Shirts is vocally opposed to the few extremists on the fringe who had resorted to arms, thus distorting the public image and spirit of their movement.

The Red Shirts, otherwise known as the United Front for Democracy against Dictatorship, largely come from the north of the country. While many Red Shirts are impoverished citizens, there are also many lower middle-class migrants to Bangkok who retained their class identity, and others of diverse backgrounds who have sympathised with their cause.

The movement was founded shortly after the 2006 coup that removed Thaksin from office following his second landslide election victory. The first campaign of the Red Shirts was focused on defending the 1997 people's constitution - the first in Thailand's history that was drafted in a popular, democratic manner with participation of elected officials from all the regions - against the imposition of the new 2007 constitution, drafted by handpicked people appointed by the military junta.

The grassroots growth of the Red Shirts rapidly increased the size and influence of the group following a series of repressive actions by the government. The country's most popular political party, Thai Rak Thai, was banned by a court ruling in 2007. The elected prime minister Samak Sundaravej was ousted from office for appearing on a cooking show. The People's Power Party, successor to Thai Rak Thai, was then also banned in 2008, and more than 100 democratically elected members of parliament were disqualified from politics for five years.

The understandable anger felt by many Thai citizens after seeing their popular will suppressed was underscored by systemic double standards exercised by the country's judicial system. One constitutional court judge who banned Samak also regularly did paid appearances on radio and taught at a private university.

When the pro-government elite movement, People's Alliance for Democracy, held disruptive rallies, invaded government buildings, and illegally occupied Bangkok's Suvarnabhumi International Airport in 2008, there was not one single arrest, trial or conviction. Instead, these same people are on television every day. In comparison, scores of Red Shirts have already been imprisoned, and those arrested in the most recent protests were processed and convicted in improbably swift trials.

It was all the more impressive that tens of thousands of these activists volunteered to sleep outside at the rally site in obvious discomfort, while risking their lives before the coming violence to make their point. They came to Bangkok to remind the ruling elites and the world that they also have constitutional rights as Thai citizens, that their votes should count too, no matter their level of wealth, class, and education.

But the distractions from these basic facts are numerous. The ruling military elite argues that the killing of almost 70 civilians (only one confirmed death of a military officer) over the past month is justified because they are armed - although most often with slingshots, homemade fireworks and bamboo sticks. The ruling military elite talks about the funding of the Red Shirts, as though these people are risking their lives for some reason other than the anger over having their votes stolen.

The unlawful deployment of force used by the Thai authorities against the protesters, their flip-flopping on the issues of elections and their unwillingness to meet the protesters' pleadings for negotiations to avoid violence speaks volumes about their legitimacy to govern.

But the facts speak for themselves, and the demands by the Red Shirts for new elections and real representative government must be dealt with in a sincere and orderly reconciliation effort.

Above all, the Red Shirts simply want the right to vote, have a say in who runs the country and how.

Robert Amsterdam is a human rights lawyer

Doctors' blunder causes toilet brush death

A YOUNG mum died after a series of blunders by doctors who failed to spot a six-inch long TOILET BRUSH HANDLE embedded in her buttock, an inquest was told today.
Cindy Corton, 35, was left with the bizarre injury after a drunken fall in a friend's bathroom in 2005 but "serious errors" by doctors then led to her death.

It was two years before Cindy, who was in constant pain, was able to convince doctors that the thin serrated plastic handle was stuck in the flesh of her bottom.

By then what should have been a routine procedure to remove it had become much more dangerous because the handle had become embedded in her pelvis.

After two unsuccessful operations in 2007 the mother-of-one was in such agony that she agreed to undergo further surgery in June last year despite being told it could prove fatal.

Cindy of Sleaford, Lincs, spent more than ten hours in surgery at Nottingham's Queens Medical Centre but died from massive blood loss.

Husband Peter, 61, said that when his wife first attended A&E at Lincoln County Hospital she was sent home with painkillers, despite showing them the wound on her bottom.

Four days later she was in such pain she went to Grantham Hospital and, although x-rays were taken, nothing was found.

He told the inquest in Grantham: "She wasn't properly examined by the doctor at Lincoln.

"At Grantham she wasn't examined properly again.

"This was unsatisfactory. The failures to investigate sufficiently in the first place at Lincoln and Grantham were a major factor in Cindy suffering.

"This could have been prevented by early location and removal of the foreign body which would have been a simple procedure at the time."

Recording a narrative verdict West Lincolnshire coroner Stuart Fisher criticised Dr Killian Mbewe who first examined Mrs Corton at Grantham Hospital.

Despite being told what had happened he simply had an x-ray taken which revealed nothing.

"It appears Dr Mbewe did not seek a second opinion, " said Mr Fisher.

"My view is that this failure to pursue further medical inquiries at this stage was a very serious error on his part.

"Had he done so and surgery had taken place I have no doubt Mrs Corton would be alive today.

"Surely if it was not picked up on the x-ray you don't abandon this woman and send her home with a few tablets.

"It was a significant foreign object. It is difficult to image anything more significant."

Witness Bruce Hickling of Ruskington, Lincs, told the hearing of the night the accident happened when Cindy had arrived at his home drunk.

He said: "She was drunk. After about an hour she wanted to go to the toilet but I had to help her up the stairs.

"Then I heard the toilet flush followed by a bang and a cry.

"I went in and saw Cindy stuck between the toilet and the wall. I tried to lift her but she was wedged tight."

He needed the assistance of a friend to free her before calling an ambulance because she was bleeding.

"When the crew arrived they weren't very happy. They said she was drunk."

He said it was the next day when he discovered that the handle of the toilet brush was snapped off and missing.

Cindy's husband, a construction manager, is now taking legal action against United Lincolnshire Hospitals Trust.

He said after the hearing: "Ok she was drunk but they didn't take her seriously. She showed them the wound but they didn't do a proper examination.

"I think it was probably down to the hospitals trying to save money and doing things as cheaply as possible."

He added: "Cindy got a very poor service from the NHS. I'm sure she would have got better treatment in foreign countries."

Naked in trust

FOUR workers managed to liven what would have been just another dull commute yesterday by travelling naked.

Passengers on the London Underground were shocked to see the men and women riding the escalator and Tube without clothes.

The foursome, who covered their modesty with handbags and briefcases, attracted stares and gasps but acted as if the nothing was out of the ordinary

They were out promoting a new TV series, The Naked Office, that shows workers at struggling companies turning their businesses around.

Despite it seeming a gimmick, Steven Suphi, a behaviour change specialist, said that there was merit in workers stripping off in the office.

"For most people in the UK going to work in the nude is a very daunting prospect," she told Britain's Daily Mail.

"I believe this extreme process will help them push their boundaries and become a close team that trust each other enough to get naked together."
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NAZRI CAN YOU DO THIS?

Serotonin

Definition of Serotonin

Serotonin is a neurotransmitter produced in the brain known to influence the functioning of the cardiovascular, renal, immune, and gastrointestinal systems.
Any disruption in the synthesis, metabolism or uptake of this neurotransmitter has been found to be partly responsible for certain manifestations of schizophrenia, depression, compulsive disorders and learning problems.


Description of Serotonin

Serotonin originates in neurons deep in the midline of the brainstem. Because these neurons profile diffusely throughout the brain, serotonin can affect various brain functions. It also interacts with many other neurotransmitters, either directly through neurons that use both serotonin and another neurotransmitter, or by serotonin neurons influencing neurons that primarily use these other transmitters.
The diffuse connections of serotonin allow it to affect many basic psychological functions such as anxiety mechanisms and the regulation of mood, thoughts, aggression, appetite, sex drive and the sleep/wake cycle. Multiple observations suggest that serotonin, one of the most abundant neurotransmitters, plays an important role in the regulation of mood and a key role in the treatment of depression.

Data suggest that serotonin is associated with reduced serotonin function. Studies of cerebrospinal fluid, whole blood, and plasma have shown that serotonin levels are reduced in depressed patients.

Serotonin reuptake inhibitors such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft) have become part of the medical armamentarium for the treatment of depression. They have joined other drugs that are used to treat depression, including monoamine oxidase inhibitors (MAOIs), lithium, methylphenidate (Ritalin), trazodone (Desyrel), bupropion (Wellbutrin), and the tricyclic antidepressants.

Selective serotonin uptake inhibitors (SSRIs) are no more effective than traditional agents, but their side-effects profiles often present important clinical advantages, such as the low incidence of side effects compared with standard tricyclic and tetracyclic antidepressant drugs. The mildness of their side effects makes then particularly well suited for treating moderately depressed outpatients or the elderly. It has been estimated that 75 to 80 percent of patients taking tricyclic antidepressants receive subtherapeutic doses because of the intolerable side effects associated with higher dosages. Thus, side effects may limit the clinical effectiveness of traditional antidepressant medications.

The SSRIs are also used to treat conditions other than depression, including bulimia nervosa, personality disorders, and obsessive-compulsive disorder. Treatment of these conditions requires higher dosages than the dosages used to treat depression.

Unlike the SSRIs, nefazodone - which exerts significant inhibitory effects on serotonin uptake - does not seem to cause an adverse effect on sexual drive and function.

The precise mechanism of action of antidepressants is largely unknown. In depression, the principal biochemical abnormality appears to be impaired metabolism of one or more central amines or peptide neurotransmitters and their receptor sites. SSRIs inhibit the reuptake of serotonin and, thus, increase the concentration of this neurotransmitter in the central nervous system.

The mechanism of action for the SSRIs is the blocking of the uptake pump action on the presynaptic neuron. This increases the amount of serotonin in the synaptic cleft and at the postsynaptic serotonin receptor site, resulting in greater postsynaptic serotonin stimulation.

In contrast, tricyclic antidepressants and MAOIs not only increase the concentration of serotonin in the central nervous system, but they also increase the levels of norepinephrine and dopamine.

Malaysian Government Funding Red Shirts.

There are rumours that the Malaysian Government is helping Thaksin by funding the red shirt protest in Thailand.

Whether this is true or not is a dangerous game that Najib and Mahathir should not be playing. Ones action can turn the wheel of death for the whole country not only for UMNO. Compare to the Thai Tigers we are kittens.
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The Thai government rejected Tuesday holding immediate peace talks with Red Shirt protest leaders, saying negotiations cannot start until protesters in Bangkok disperse.

Cabinet minister Satit Wonghnongtaey quoted the prime minister as saying that "the situation will end only when the protest stops."

Tuesday's televised comments came after Red Shirt protest leaders said they would accept a proposal from the Senate leader to mediate talks between the two sides to end deadly violence in the Thai capital that has killed 37 people in the past five days.

The country's upper house of Parliament on Monday offered to broker negotiations between the warring sides providing they both stopped that fighting that has transformed large swaths of downtown Bangkok to a war zone.

A Red Shirt leader, Weng Tojirakarn, told a news conference "we accept the proposal from the Senate." Another protest leader, Nattawut Saikua, said, "It would not be right if I set conditions for the Senate."

In perhaps the most hopeful of recent signs that Thailand's two-month-long crisis could be resolved, both sides Monday evening also revealed that the government's chief negotiator and a Red Shirt leader had discussed negotiations in a mobile telephone call.

But previous attempts to negotiate an end to the standoff - which has destabilized a country once regarded as one of Southeast Asia's most stable democracies - have failed. A government offer earlier this month to hold November elections foundered after protest leaders made more demands.

Meanwhile, violence continued unabated on Bangkok's streets with security forces arresting a 12-year-old boy Tuesday morning for allegedly setting fire to several houses during the mayhem.

At least 37 people - mostly civilians - have been killed and 266 wounded since the government began a blockade last Thursday on a sprawling protesters' camp in the heart of Bangkok. Most of the unrest has flared outside the camp, with troops firing live ammunition at roaming protesters who have lit tires to hide their positions.

Prime Minister Abhisit Vejjajiva's administration gave the anti-government demonstrators, who have been entrenched in the upscale Rajprasong district for more than a month, a Monday afternoon deadline to leave or face two-year prison terms.

By Tuesday, there was still no exodus among the estimated 3,000 protesters remaining at the camp, and no sign of troops trying to break through their tire-and-bamboo barricades.

The Red Shirts, many of whom hail from the impoverished north and northeast, have been rallying in the city since March 12 in attempts to unseat Abhisit and force immediate elections. They say the coalition government came to power through manipulation of the courts and the backing of the powerful military, and that it symbolizes a national elite indifferent to their plight.

How to save Math Education

Revenge

It was a tired journey.
BN gave lots of money.
Sibu folks known to befriendly.
Reject BN offer totally.
Sad and angry in misery.
Today in Sarawak suspend 2 Yang Berhormat.
One of them from DAP.
One YB from Keadilan.
What happened to our beloved country.
NO Law No Mercy.
Speakers in our State-Assembly.
Act like cartoon we watch on TV.
I feel sad and sorry.
You are mighty in your assembly.
Allah is watching don't worry.

http://www.bukittunggal.com/2010/05/dominique-ng-and-chong-chieng-jien.html

Smart vs. Experienced vs. Ordinary People vs. The L Word

President Obama has nominated Elena Kagan to the Supreme Court, to fill the seat of the retiring John Paul Stevens. She's the current Solicitor General, representing the U.S. government in cases before the Court. She got her law degree from Harvard, clerked for Thurgood Marshall, worked in the Clinton White House, taught at the University of Chicago Law School, and then was the first female dean at Harvard Law. She is said to be a brilliant legal scholar who plays well with others and is open to all viewpoints, a sort of MENSA mensch. If confirmed, Kagan would be the third woman on the current court. (Perfect proportion would be four and a half women!)

Because Kagan's the nominee of Obama the Anti-Christ and is obviously not a card-carrying member of the John Birch Society, Senate Republicans are duty bound to find some sort of fault with her, however lame. Here's what they've come up with:

1. She's "inexperienced", meaning she's never been a sitting judge. So we should discount all her credentials, forget that she's the country's preeminent Constitutional expert, and give her the thumbs-down because she's never been a judge. Neither had Felix Frankfurter, William Rehnquist, and many others, but forget that too. If it's experience we must have, there are tens of thousands of experienced judges in America. Pick one. How about the traffic court judge from Kokomo? How about Harry Anderson from Night Court?

2. She's an academic who couldn't possibly understand ordinary people in the real world. This is the "Ivy League smarty-pants" argument, which ignores the fact that all the other current justices graduated from either the Harvard or Yale law schools. So it's OK for those eight, but not OK for her? Don't recall anyone bitching about Sam Alito's Ivy League background. And being a smart and educated person is a good thing, especially for a Supreme Court Justice. We've suffered through a whole bunch of dumb in recent years. Right now, I'll take all the smart I can get. But if you really believe the Court should save a seat for the ordinary common man, how about Calvin Borel for the Supreme Court? The Ragin' Cajun jockey is an illiterate eigth-grade dropout, but he can ride horses and count money. Calvin is common as dirt. He'd be a wondermous Justice, I guar-ron-tee!

3. She's a lesbian. Maybe, maybe not, but so what if she is? Who fucking cares? What does that have to do with anything? I hope she is a lesbian. She can do it with donkeys for all I care. Imagine this exchange at her confirmation hearing:

Douchebag Sen. Jeff Sessions (R, Ala.): "Now Ms. Kagan, you're unmarried, is that correct?"

Kagan: "That's right, Senator Sessions. I'm a lesbian and I'm unmarried because assholes like you won't let me. How about you, Jeffy? You married? You like women or men? I bet you go for little boys, you fuckstick!"

That won't happen, of course, but one these days it ought to!

Anyhow, I like the academic smarty-pants lesbian who hasn't been a judge . . . yet. Need more like her.