Money Isn't Everything, Even to Doctors

Time Magazine

Many health policy experts, including those who wrote the Affordable Care Act, believe there's only one thing that can get doctors to change their behavior — money. A new study may blow a giant hole in that belief, just in time to save the government millions or even billions of dollars.

"Pay-For-Performance" is the theory that health care wonks believe could bring the U.S. health care system back from the financial brink. Pay for quality; compensate for competency. If we can just reward doctors when their patients stay or get healthy, we can solve a lot of what ails us systemically. Healthier patients are less expensive to care for and place less strain on the medical system. If doctors are incentivized to keep their patients from getting sick (or sicker), staggering amounts of money and time could be saved. At least that's the theory behind some of the most experimental and innovative provisions in the new health reform law. (More on TIME.com: In Rural Areas, There May Be No Doctors to Tend to Your Sick Kid)

Right now, doctors don't get paid this way. For the most part, the government (via Medicare or Medicaid) or private insurance companies pay physicians for each individual task they perform. There are no penalties or rewards if these doctors choose the wrong treatments or if a patient's chronic disease isn't well managed. The more treatments, surgeries, or office visits a doctor performs, the more money he or she makes. [...]

California rabbis bring show of unity

JPost

The diversity of Jewish religious practice was on display when an eclectic group of 37 male and female rabbis visiting from Northern California shuffled into the Bina Center for Jewish Identity and Hebrew Culture seminary in grimy south Tel Aviv last Thursday.

Some were affiliated with Chabad Hassidut and sported bushy beards and tallit fringes sticking out from their shirts. Others were Reform and Conservative rabbis wearing little or no visible Jewish garb, and at least one female rabbi was wearing a kippa.

They had agreed to put aside their differences and in a show of crossdenominational solidarity come to Israel for a week-long fact-finding mission. [...]

Bostoner Rebbe zt"l

Jewish Action

A very long and productive life came to an end last December—long not just because the Bostoner Rebbe died at the age of eighty-eight (18 Kislev 5770), but because of what he packed into each day.

Why Almost Everything You Hear About Medicine Is Wrong

Newsweek

If you follow the news about health research, you risk whiplash. First garlic lowers bad cholesterol, then—after more study—it doesn’t. Hormone replacement reduces the risk of heart disease in postmenopausal women, until a huge study finds that it doesn’t (and that it raises the risk of breast cancer to boot). Eating a big breakfast cuts your total daily calories, or not—as a study released last week finds. Yet even if biomedical research can be a fickle guide, we rely on it.

But what if wrong answers aren’t the exception but the rule? More and more scholars who scrutinize health research are now making that claim. It isn’t just an individual study here and there that’s flawed, they charge. Instead, the very framework of medical investigation may be off-kilter, leading time and again to findings that are at best unproved and at worst dangerously wrong. The result is a system that leads patients and physicians astray—spurring often costly regimens that won’t help and may even harm you. [...]

Students' Emotional Health at 25-Year Low; Girls Especially Hard Hit

ABC News

 new report -- the most comprehensive annual survey of full-time college students at four-year colleges -- concluding that the emotional health of college freshmen has dropped to its lowest level in 25 years.

The survey, "The American Freshman: National Norms Fall 2010," was conducted by UCLA's Higher Education Research Institute and included 200,000 students. The number of freshmen who said their emotional health was "below average" has risen steadily, according to the report. [...]

Egypt kills all Internet activity in attempts to stem protest tide

Haaretz

Almost simultaneously, the handful of companies that pipe the Internet into and out of Egypt went dark as protesters were gearing up for a fresh round of demonstrations calling for the end of President Hosni Mubarak's nearly 30-year rule, experts said.

Egypt has apparently done what many technologists thought was unthinkable for any country with a major Internet economy: It unplugged itself entirely from the Internet to try and silence dissent. [...]

Seeing others oppressed and not helping is considered being the oppressor

Ibn Ezra (Shemos 22:20): Concerning a ger - When the ger accepts not to worship idols do not upset him in your land just because you have much greater power than he does. Remember that you were once gerim like him. Just as the verse mentions the ger who is helpless, the Torah here also mentions the orphan and the widow who are Jews who are helpless. Furthermore it first says not to upset in the plural grammatical form and then it says if you upset in the singular form. That means whoever sees the orphan or widow being persecuted and doesn’t help them he will also be considered the oppressor.

Ibn Ezra (Shemos 21: 22): If you afflict – The punishment - when one person afflicts another who has no one to protect him – is on everyone [who did not help]. Therefore G d comes after them and in His anger kills all of them….

Nachum Gamzu: Knowing the consequences of delaying help to those in urgent need

Soncino translation.

Tannis (21a): It is related of Nahum of Gamzu that he was blind in both his eyes, his two hands and legs were amputated — and his whole body was covered with boils and he was lying in a dilapidated house on a bed the feet of which were standing in bowls of water in order to prevent the ants from crawling on to him. On one occasion his disciples desired to remove the bed and then clear the things out of the house, but he said to them, My children, first clear out the things [from the house] and then remove my bed for I am confident that so long as I am in the house it will not collapse. They first cleared out the things and then they removed his bed and the house [immediately] collapsed. Thereupon his disciples said to him, Master, since you are wholly righteous, why has all this befallen you? and he replied, I have brought it all upon myself. Once I was journeying on the road and was making for the house of my father-in-law and I had with me three asses, one laden with food, one with drink and one with all kinds of dainties, when a poor man met me and stopped me on the road and said to me, Master, give me something to eat. I replied to him, Wait until I have unloaded something from the ass; I had hardly managed to unload something from the ass when the man died [from hunger]. I then went and laid myself on him and exclaimed, May my eyes which had no pity upon your eyes become blind, may my hands which had no pity upon your hands be cut off, may my legs which had no pity upon your legs be amputated, and my mind was not at rest until I added, may my whole body be covered with boils. Thereupon his pupils exclaimed, ‘Alas! that we see you in such a sore plight’. To this he replied, ‘Woe would it be to me did you not see me in such a sore plight’.

Nabokov Butterfly Theory Is Vindicated

NYTimes

Vladimir Nabokov may be known to most people as the author of classic novels like “Lolita” and “Pale Fire.” But even as he was writing those books, Nabokov had a parallel existence as a self-taught expert on butterflies.

He was the curator of lepidoptera at the Museum of Comparative Zoology at Harvard University, and collected the insects across the United States. He published detailed descriptions of hundreds of species. And in a speculative moment in 1945, he came up with a sweeping hypothesis for the evolution of the butterflies he studied, a group known as the Polyommatus blues. He envisioned them coming to the New World from Asia over millions of years in a series of waves.

Few professional lepidopterists took these ideas seriously during Nabokov’s lifetime. But in the years since his death in 1977, his scientific reputation has grown. And over the past 10 years, a team of scientists has been applying gene-sequencing technology to his hypothesis about how Polyommatus blues evolved. On Tuesday in the Proceedings of the Royal Society of London, they reported that Nabokov was absolutely right. [...]

Mideast in turmoil

NYTimes

As the Obama administration confronts the spectacle of angry protesters and baton-wielding riot police officers from Tunisia to Egypt to Lebanon, it is groping for a plan to deal with an always-vexing region that is now suddenly spinning in dangerous directions.

As the Obama administration confronts the spectacle of angry protesters and baton-wielding riot police officers from Tunisia to Egypt to Lebanon, it is groping for a plan to deal with an always-vexing region that is now suddenly spinning in dangerous directions.

These were surprising turns. But even the administration’s signature project in the region — Israeli-Palestinian peace negotiations — became even more intractable this week, with the publication of confidential documents detailing Palestinian concessions offered in talks with Israel. The disclosure makes it less likely that the Palestinians will agree to any further concessions. [...]

Child & Domestic Abuse vol I & II are selling nicely

The first delivery of books has been made to stores this week and
interest seems high. It is now available in stores in Brooklyn, Boston &
Baltimore. The fears of the stores stocking it seems to have been
overblown. It will take a few weeks to stabilize supply and demand. It
is still available on line at Amazon if your local store doesn't have it..

ADHD: U of Maryland wants participants in online study

Abigail Mintz, M.S. has left a new comment on your post "Attention-Deficit (ADHD) is real and not caused by...":

University of Maryland at College Park is conducting a research study to learn more about fathers who have children with Attention-Deficit/Hyperactivity Disorder (ADHD) so that we can eventually use this knowledge to improve treatment for families of children with ADHD. If you are the biological father of a 5 - 12 year old child with ADHD or undiagnosed significant attention/disruptive behavior problems, you may be eligible for this study.

Your participation in this study would consist of completing online questionnaires which will take approximately 30 minutes. You will be asked questions about your parenting, your own behavior and emotions, and your child’s behavior.

As compensation for your participation, you will be entered into a drawing with a 1 in 50 chance of receiving a $50 Amazon gift certificate.

If you are interested, please follow the link below to the study. This link will direct you to all informed consent documents and the study.

LINK TO STUDY:

https://sites.google.com/site/learningaboutfathers/

If you are the mother of a child with ADHD, we would greatly appreciate if you would consider forwarding this study information to your child's father.

Rashi indicates one's children are punished for not fighting molesters

This weeks' parsha has a wakeup call to all those who are ignoring the problem of child and wife abuse and don't think it warrants their attention.

The Torah in this weeks parsha Shemos (22:21-23) states:

You should not afflict any widow or orphan. If you afflict them, and they cry to Me, I will surely hear their cry; and My anger will burn hot and I will kill you with the sword and your wives will become widows and your children orphans.

Rashi states that this punishment of wife and children applies to all cases where a helpless victim is ignored. It is important to note this is not addressing the punishment of the tormentor but those upstanding citizens who ignore the cries of the helpless and do nothing.

No widow and orphan should be afflicted – In fact no one else should be afflicted either but the Torah is describing the typical case. Since they are weak and helpless, it is common that they are afflicted. And your wives will become widows -  Since this is clearly understood from the fact that the verse says, “I will kill you” so why is it necessary to say that “your wives will become widows and your sons orphans?”  This indicates an additional curse that they will  be prohibited to remarry because there will not be witnesses to the death of their husband. The lesson we learn by the Torah saying “your sons will be orphans” is that the beis din will not allow them to benefit from the inheritance of their father since it will be unknown whether he in fact died or has been captured.

The Malbim says that Rashi is following the view of Rabbi Yishmael that the verse is referring to all those who have no protector - which obviously includes victims of molesters who are defenseless and are ignored. However Rabbi Akiva says this harsh punishment is reserved specifcally for those who ignore the suffering of widows and orphans.

Michale Fruend:Columbus of hidden "Jews"

YNET

He wanders Amazon jungles, travels to Chinese villages, searches Spain for Marranos, and sees India’s Bnei Menashe as his life's mission. Michael Freund has an obsession: Discovering remote Jews [...]