Final presentation

Here is some of the information on my final poresentation with the apropriate source sightings. I will email you my powerpoint. A program for performing differential diagnosis on a microcomputer has been developed, utilizing a pattern recognition algorithm. The present configuration allows for input of 15 symptoms of 3 values (present, absent, or unknown), and compares the patient's symptom profile with 50 patterns which point to as many as 10 disease designations. The investigator may stipulate either a rigorous or permissive pattern matching, thus obtaining either a selective or exhaustive ranking of possible diagnoses. The program can record patient data, recall data given any one parameter, and can construct tables of incidence. This inexpensive system was designed for an office or community level practice, where the pattern arrays will be trained for its specific patient populations. Presently, data from the Georgetown University Student Health Service is being introduced as the program's first clinical trial. Background: Clinical decision support systems assist physicians in interpreting complex patient data. However, they typically operate on a per-patient basis and do not exploit the extensive latent medical knowledge in electronic health records (EHRs). The emergence of large EHR systems offers the opportunity to integrate population information actively into these tools. Methods: Here, we assess the ability of a large corpus of electronic records to predict individual discharge diagnoses. We present a method that exploits similarities between patients along multiple dimensions to predict the eventual discharge diagnoses. Results: Using demographic, initial blood and electrocardiography measurements, as well as medical history of hospitalized patients from two independent hospitals, we obtained high performance in cross-validation (area under the curve >0.88) and correctly predicted at least one diagnosis among the top ten predictions for more than 84% of the patients tested. Importantly, our method provides accurate predictions (>0.86 precision in cross validation) for major disease categories, including infectious and parasitic diseases, endocrine and metabolic diseases and diseases of the circulatory systems. Our performance applies to both chronic and acute diagnoses. Conclusions: Our results suggest that one can harness the wealth of population-based information embedded in electronic health records for patient-specific predictive tasks. [ABSTRACT FROM AUTHOR] This paper examines the diagnostic storytelling that medical residents perform in order to situate patients in a story trajectory with an imputed past and future. It is a study of “ordinary” expertise, as practiced by a family practice medical team in a small urban community hospital in the United States. Narrative storytelling—an activity that is at once cognitive and practical—allows residents to identify the sort of disease, the kind of patient, and the likely outcome for this patient, based on what the resident knows about patients like these. Residents acquire a set of narrative templates, or rough outlines, that they deploy when they encounter a new patient or his or her information. Going into an admissions interview, a resident already has a set of “facts” about the patient and his or her complaint. In a process that is routine, habitual, and iterative, a resident starts from this set of facts and draws on his or her repertoire of narrative templates to pursue a line of questioning that starts to define relevance for this patient, a relevance that is revised as the physician begins to settle on a story. These templates make a first organizing pass at answering, “What’s going on with this patient?” They provide the preliminary structure, the warp and weft, for building a patient story that holds together long enough to diagnose, treat, and discharge the patient. Diagnostic stories are shaped by what residents think they can do for the patient, practically speaking, and by habitual hospital activity. Most current model-based diagnosis formalisms and algorithms are defined only for static systems, which is often inadequate for medical reasoning. In this paper we describe a model-based framework plus algorithms for diagnosing time-dependent systems where we can define qualitative temporal scenarios. Complex temporal behavior is described within a logical framework extended by qualitative temporal constraints. Abstract observations aggregate from observations at time points to assumptions over time intervals. These concepts provide a very natural representation and make diagnosis independent of the number of actual observations and the temporal resolution. The concept of abstract temporal diagnosis captures in a natural way the kind of indefinite temporal knowledge which is frequently available in medical diagnoses. We use viral hepatitis B (including a set of real hepatitis B data) to illustrate and evaluate our framework. The comparison of our results with the results of Hepaxpert-I is promising. The diagnosis computed in our system is often more precise than the diagnosis in Hepaxpert-I and we detect inconsistent data sequences which cannot be detected in the latter system. Background: Deriving an appropriate differential diagnosis is a key clinical competency, but there is little data available on how medical students learn this skill. Software resources designed to complement clinical reasoning might be asset in helping them in this task. Aims: The goals of this study were to identify the resources third year medical students use to solve a challenging diagnostic case, and specifically to evaluate the usefulness of Isabel, a second-generation electronic diagnosis support system. Methods: Third year medical students (n = 117) were presented a challenging case and asked to identify and prioritize their top 3 diagnoses, report the time devoted to the exercise, and list the resources they used and their relative usefulness. Students were randomized to receive (or not) free access, instruction, and encouragement to use to a web-based decision support system (Isabel). Results: Students who identified the correct diagnosis as their first choice spent significantly more time on the case than did the other students (3.75 ± 0.28 hours vs 2.88 ± 0.15 hours, p < 0.05). Students used electronic resources extensively, in particular Google. Students who self-reported use of Isabel had greater success identifying the correct diagnosis (24/33 = 73% for users vs 45/84 = 53% for non-users) a difference of borderline statistical significance. Conclusions: These findings indicate that medical trainees use a wide range of electronic decision support products to solve challenging cases. Medical education needs to adapt to this reality, and address the need to teach future clinicians how to use these tools to advantage. [ABSTRACT FROM AUTHOR] Time per visit Objectives. To use an innovative videotape analysis method to examine how clinic time was spent during elderly patients' visits to primary care physicians. Secondary objectives were to identify the factors that influence time allocations. Data Sources. A convenience sample of 392 videotapes of routine office visits conducted between 1998 and 2000 from multiple primary care practices in the United States, supplemented by patient and physician surveys. Research Design. Videotaped visits were examined for visit length and time devoted to specific topics—a novel approach to study time allocation. A survival analysis model analyzed the effects of patient, physician, and physician practice setting on how clinic time was spent. Principal Findings. Very limited amount of time was dedicated to specific topics in office visits. The median visit length was 15.7 minutes covering a median of six topics. About 5 minutes were spent on the longest topic whereas the remaining topics each received 1.1 minutes. While time spent by patient and physician on a topic responded to many factors, length of the visit overall varied little even when contents of visits varied widely. Macro factors associated with each site had more influence on visit and topic length than the nature of the problem patients presented. Conclusions. Many topics compete for visit time, resulting in small amount of time being spent on each topic. A highly regimented schedule might interfere with having sufficient time for patients with complex or multiple problems. Efforts to improve the quality of care need to recognize the time pressure on both patients and physicians, the effects of financial incentives, and the time costs of improving patient–physician interactions. [ABSTRACT FROM AUTHOR] The objectives of this study were to assess the relationship between wait time and parent satisfaction and determine whether time with the physician potentially moderated any observed negative effects of long wait time. Data were collected from parents in a pediatric outpatient clinic. Parent satisfaction with the clinic visit was significantly negatively related to wait times. More time spent with the physician was positively related to satisfaction independent of wait times. Furthermore, among clinic visits with long wait times, more time with the physician showed a relatively strong positive relationship with parent satisfaction. Therefore, although long wait times was related to decreased parent satisfaction with pediatric clinic visits, increased time with the physician tended to moderate this relationship. This paper reports a study exploring patients' views about consulting with a primary care nurse practitioner. United Kingdom based randomized controlled trials comparing the work of doctors and nurse practitioners add considerable weight to the view that patients tend to be more satisfied with primary care nurse practitioner consultations. However, there is a need for qualitative research to explore issues raised by the trials. A judgement sample of 10 patients consulting with a primary care nurse practitioner was drawn. In-depth interviews were conducted and analysed thematically. The data were collected in 2000-2001. The following themes were identified in the data: time spent in the consultation; and time as a commodity in patients' lives. Time matters to patients when they consult on their health, whether it is time to discuss problems or time saved as a result of having issues resolved, thus minimizing further visits. Factors associated with the style and emphasis of consultations are also important. Understanding the relationship between time, and style and emphasis of consultation may help to explain patients' satisfaction with primary care nurse practitioners. Question: Why Do I Wait In the Waiting Room for Such a Long Time at a Doctors Appointment? Patients are often frustrated that they make an appointment for a certain time, they arrive on time, yet they are kept in the waiting room for too long a time before they see the doctor. When we understand why this happens, we can take steps to change it, or make it easier to tolerate. Answer: Like too many questions in healthcare, the answer to why we are kept in the waiting room for so long is, "follow the money." Doctors are paid by insurance and Medicare for every patient they see according to why they see the patient, and what procedures they perform for the patient, and (this is key) not by the amount of time they spend with the patient. Since their goal is to maximize their income, they will schedule as many patients into their day as possible. More patients plus more procedures equals more income. In any given day, they may not be sure what services they'll be performing for individual patients, and some patients require more time for their services than others. Equipment may break down. An obstetrician may be delivering a baby. There may even be emergencies. We lose our patience because we believe the time just has not been scheduled well. Understanding that it's the volume of patients and procedures, not the time spent per patient, that comprises a doctors' income, it's easier to understand why they get so far behind, and why we are kept waiting. Nationwide, the average wait time to see a doctor last year was 23 minutes, according to the health care consultants Press Ganey. Neurosurgeons have the longest wait times (30 minutes) and optometrists the shortest (17 minutes), according to the report. Fisher, Paul. "Micro Computers in Medical Diagnosis." ACM Digital Library. 01 01 1980: 75-79. Web. 13 Dec. 2013. . (Fisher 75-79) Davenport, Nancy. "Medical residents’ use of narrative templates in storytelling and diagnosis." Social Science & Medicine. 01 09 2011: 1. Web. 13 Dec. 2013. (Davenport 1) Johann, Christopher. "Abstract temporal diagnosis in medical domains." Artificial Intellegence in Medicine. 01 07 1997: 1. Web. 13 Dec. 2013. . (Johann 1) Feddock, Christopher. "Is Time Spent With the Physician Associated With Parent Dissatisfaction Due to Long Waiting Times?." Evaluation & The HEalth Profession. 10 05 2010: 1. Web. 13 Dec. 2013. . (Feddock 1) Torrey, Trisha. "Why Do I Wait In the Waiting Room for Such a Long Time at a Doctors Appointment?." Patient Empowerment. 14 11 2008: 1. Web. 13 Dec. 2013. . (Torrey 1) Alderman, Lesley. "The Doctor Will See You Eventually." New York Times. 01 08 2011: 1. Web. 13 Dec. 2013. . (Alderman 1)

Diagnostics

Here is some of the research that I have conducted. I have made a power point that I do not know how to load to this blog, but I am presenting on diagnostics in the doctors office, how this can be improved, how time can be saved, and correct diagnosis can be made effectively nd efficiantly.I am a Human comm and Chemistry major and this presentation addresses both of these areas. A program for performing differential diagnosis on a microcomputer has been developed, utilizing a pattern recognition algorithm. The present configuration allows for input of 15 symptoms of 3 values (present, absent, or unknown), and compares the patient's symptom profile with 50 patterns which point to as many as 10 disease designations. The investigator may stipulate either a rigorous or permissive pattern matching, thus obtaining either a selective or exhaustive ranking of possible diagnoses. The program can record patient data, recall data given any one parameter, and can construct tables of incidence. This inexpensive system was designed for an office or community level practice, where the pattern arrays will be trained for its specific patient populations. Presently, data from the Georgetown University Student Health Service is being introduced as the program's first clinical trial. Background: Clinical decision support systems assist physicians in interpreting complex patient data. However, they typically operate on a per-patient basis and do not exploit the extensive latent medical knowledge in electronic health records (EHRs). The emergence of large EHR systems offers the opportunity to integrate population information actively into these tools. Methods: Here, we assess the ability of a large corpus of electronic records to predict individual discharge diagnoses. We present a method that exploits similarities between patients along multiple dimensions to predict the eventual discharge diagnoses. Results: Using demographic, initial blood and electrocardiography measurements, as well as medical history of hospitalized patients from two independent hospitals, we obtained high performance in cross-validation (area under the curve >0.88) and correctly predicted at least one diagnosis among the top ten predictions for more than 84% of the patients tested. Importantly, our method provides accurate predictions (>0.86 precision in cross validation) for major disease categories, including infectious and parasitic diseases, endocrine and metabolic diseases and diseases of the circulatory systems. Our performance applies to both chronic and acute diagnoses. Conclusions: Our results suggest that one can harness the wealth of population-based information embedded in electronic health records for patient-specific predictive tasks. [ABSTRACT FROM AUTHOR] This paper examines the diagnostic storytelling that medical residents perform in order to situate patients in a story trajectory with an imputed past and future. It is a study of “ordinary” expertise, as practiced by a family practice medical team in a small urban community hospital in the United States. Narrative storytelling—an activity that is at once cognitive and practical—allows residents to identify the sort of disease, the kind of patient, and the likely outcome for this patient, based on what the resident knows about patients like these. Residents acquire a set of narrative templates, or rough outlines, that they deploy when they encounter a new patient or his or her information. Going into an admissions interview, a resident already has a set of “facts” about the patient and his or her complaint. In a process that is routine, habitual, and iterative, a resident starts from this set of facts and draws on his or her repertoire of narrative templates to pursue a line of questioning that starts to define relevance for this patient, a relevance that is revised as the physician begins to settle on a story. These templates make a first organizing pass at answering, “What’s going on with this patient?” They provide the preliminary structure, the warp and weft, for building a patient story that holds together long enough to diagnose, treat, and discharge the patient. Diagnostic stories are shaped by what residents think they can do for the patient, practically speaking, and by habitual hospital activity. Most current model-based diagnosis formalisms and algorithms are defined only for static systems, which is often inadequate for medical reasoning. In this paper we describe a model-based framework plus algorithms for diagnosing time-dependent systems where we can define qualitative temporal scenarios. Complex temporal behavior is described within a logical framework extended by qualitative temporal constraints. Abstract observations aggregate from observations at time points to assumptions over time intervals. These concepts provide a very natural representation and make diagnosis independent of the number of actual observations and the temporal resolution. The concept of abstract temporal diagnosis captures in a natural way the kind of indefinite temporal knowledge which is frequently available in medical diagnoses. We use viral hepatitis B (including a set of real hepatitis B data) to illustrate and evaluate our framework. The comparison of our results with the results of Hepaxpert-I is promising. The diagnosis computed in our system is often more precise than the diagnosis in Hepaxpert-I and we detect inconsistent data sequences which cannot be detected in the latter system. Background: Deriving an appropriate differential diagnosis is a key clinical competency, but there is little data available on how medical students learn this skill. Software resources designed to complement clinical reasoning might be asset in helping them in this task. Aims: The goals of this study were to identify the resources third year medical students use to solve a challenging diagnostic case, and specifically to evaluate the usefulness of Isabel, a second-generation electronic diagnosis support system. Methods: Third year medical students (n = 117) were presented a challenging case and asked to identify and prioritize their top 3 diagnoses, report the time devoted to the exercise, and list the resources they used and their relative usefulness. Students were randomized to receive (or not) free access, instruction, and encouragement to use to a web-based decision support system (Isabel). Results: Students who identified the correct diagnosis as their first choice spent significantly more time on the case than did the other students (3.75 ± 0.28 hours vs 2.88 ± 0.15 hours, p < 0.05). Students used electronic resources extensively, in particular Google. Students who self-reported use of Isabel had greater success identifying the correct diagnosis (24/33 = 73% for users vs 45/84 = 53% for non-users) a difference of borderline statistical significance. Conclusions: These findings indicate that medical trainees use a wide range of electronic decision support products to solve challenging cases. Medical education needs to adapt to this reality, and address the need to teach future clinicians how to use these tools to advantage. [ABSTRACT FROM AUTHOR] Time per visit Objectives. To use an innovative videotape analysis method to examine how clinic time was spent during elderly patients' visits to primary care physicians. Secondary objectives were to identify the factors that influence time allocations. Data Sources. A convenience sample of 392 videotapes of routine office visits conducted between 1998 and 2000 from multiple primary care practices in the United States, supplemented by patient and physician surveys. Research Design. Videotaped visits were examined for visit length and time devoted to specific topics—a novel approach to study time allocation. A survival analysis model analyzed the effects of patient, physician, and physician practice setting on how clinic time was spent. Principal Findings. Very limited amount of time was dedicated to specific topics in office visits. The median visit length was 15.7 minutes covering a median of six topics. About 5 minutes were spent on the longest topic whereas the remaining topics each received 1.1 minutes. While time spent by patient and physician on a topic responded to many factors, length of the visit overall varied little even when contents of visits varied widely. Macro factors associated with each site had more influence on visit and topic length than the nature of the problem patients presented. Conclusions. Many topics compete for visit time, resulting in small amount of time being spent on each topic. A highly regimented schedule might interfere with having sufficient time for patients with complex or multiple problems. Efforts to improve the quality of care need to recognize the time pressure on both patients and physicians, the effects of financial incentives, and the time costs of improving patient–physician interactions. [ABSTRACT FROM AUTHOR] The objectives of this study were to assess the relationship between wait time and parent satisfaction and determine whether time with the physician potentially moderated any observed negative effects of long wait time. Data were collected from parents in a pediatric outpatient clinic. Parent satisfaction with the clinic visit was significantly negatively related to wait times. More time spent with the physician was positively related to satisfaction independent of wait times. Furthermore, among clinic visits with long wait times, more time with the physician showed a relatively strong positive relationship with parent satisfaction. Therefore, although long wait times was related to decreased parent satisfaction with pediatric clinic visits, increased time with the physician tended to moderate this relationship. This paper reports a study exploring patients' views about consulting with a primary care nurse practitioner. United Kingdom based randomized controlled trials comparing the work of doctors and nurse practitioners add considerable weight to the view that patients tend to be more satisfied with primary care nurse practitioner consultations. However, there is a need for qualitative research to explore issues raised by the trials. A judgement sample of 10 patients consulting with a primary care nurse practitioner was drawn. In-depth interviews were conducted and analysed thematically. The data were collected in 2000-2001. The following themes were identified in the data: time spent in the consultation; and time as a commodity in patients' lives. Time matters to patients when they consult on their health, whether it is time to discuss problems or time saved as a result of having issues resolved, thus minimizing further visits. Factors associated with the style and emphasis of consultations are also important. Understanding the relationship between time, and style and emphasis of consultation may help to explain patients' satisfaction with primary care nurse practitioners. Question: Why Do I Wait In the Waiting Room for Such a Long Time at a Doctors Appointment? Patients are often frustrated that they make an appointment for a certain time, they arrive on time, yet they are kept in the waiting room for too long a time before they see the doctor. When we understand why this happens, we can take steps to change it, or make it easier to tolerate. Answer: Like too many questions in healthcare, the answer to why we are kept in the waiting room for so long is, "follow the money." Doctors are paid by insurance and Medicare for every patient they see according to why they see the patient, and what procedures they perform for the patient, and (this is key) not by the amount of time they spend with the patient. Since their goal is to maximize their income, they will schedule as many patients into their day as possible. More patients plus more procedures equals more income. In any given day, they may not be sure what services they'll be performing for individual patients, and some patients require more time for their services than others. Equipment may break down. An obstetrician may be delivering a baby. There may even be emergencies. We lose our patience because we believe the time just has not been scheduled well. Understanding that it's the volume of patients and procedures, not the time spent per patient, that comprises a doctors' income, it's easier to understand why they get so far behind, and why we are kept waiting. Nationwide, the average wait time to see a doctor last year was 23 minutes, according to the health care consultants Press Ganey. Neurosurgeons have the longest wait times (30 minutes) and optometrists the shortest (17 minutes), according to the report. http://dl.acm.org.libproxy.dixie.edu/citation.cfm?id=809930 Ebsco Host AN 90652516 http://www.sciencedirect.com.libproxy.dixie.edu/science/article/pii/S0277953611001201 http://www.sciencedirect.com.libproxy.dixie.edu/science/article/pii/S093336579700393X EBSCO HOST AN 42869273 EBSCO HOST AN 26518045 http://ehp.sagepub.com.libproxy.dixie.edu/content/33/2/216 EBSCO HOST AN 2009124550 http://patients.about.com/od/followthemoney/f/FAQappointments.htm http://www.nytimes.com/2011/08/02/health/policy/02consumer.html?_r=0 Taxes, ball game, plain flight, tee time…………what about a doctors visit?

The Future of Story

Pretty funny the way that Paul Bellini explains so colorfully that story telling is dead. In his article “The Death of Story Telling” he explains that, “We don’t go to the movies to see stories anymore. We go to watch shit blow up. And all we leave the theatre with is shit. Is storytelling dead? Bellini goes on to give ten reasons as to why story telling is dying if not dead. His argument is that the plots of movies in particular are mostly generic. You have a super hero that will in the end defeat the villain. He uses the examples that ghosts are able to move things and can be seen by those that are living. “What is more finite than death?” Bellini believes that television networks are to blame for the downfall of story telling. Gottschall on the other hand has a much grander view and much more optimistic view of the future of story telling. Gottschall sees poetry in the genres of the music that is most popular in today’s societies. Rap and R&B give poetry a new image, an image that is cool, hip, and cutting edge. “Ours is not the age when poetry died; it is the age when poetry triumphed in the form of song.” Gottschall also uses the example of WoW, Call of Duty, and Modern Warfare 3 to explain that story is alive and well in todays youth. It is my opinion that you can take the side of ether of these two men. It would depend on how you define story telling; if you look at the play writes such as Shakespeare, it is my opinion that his brilliance has not been matched, but also that brilliance has not been lost. Take the mind of Spielberg and others who have brought us Star Wars and Avatar. It is my opinion that these are great stories told by brilliant minds. http://gutterbird.com/secrets/?p=1134

The Future of Story

The question is asked is it possible to write a genuinely honest memoir or autobiography? I would say ABSOLUTLY! Here is the thing, do you want it to be entertaining, exciting, and something that everyone would like to read? Most of our lives are mundane and boring. Yes there are exciting times, sad times, times when we are falling in love and falling out of love but those experiences are so short and they seems to be so much time that passes from one exciting moment to the next that in most cases our lives would not be entertaining to others. As human race we have all had the opportunity to experience lose, heartbreak, love, and triumph at one time or another depending on your age. All these experiences draw us together and allow us to have something in common with others. Rather than being sympathetic to someone’s plight, we can be empathetic and understanding because we have experienced these feelings ourselves which gives us the opportunity to feel accepted or to feel that we can contribute to others. It is interesting in this chapter how often Gottschell says “I”. He expresses more frequently in this chapter how he feels the future of story telling will be. Saying things like “we will be doing so in cyber space, not the real world.” Gottschell talks about the introduction of “feelies.” What a scary idea, here you can not only “watch porn” but “feel the smashing lips” scary thought! Gottschell believes that the future will be much like the helm of the “Star Trek Enterprise” it is scary to think that with the technology advancements that we as a species would lose one another, lose the ability to communicate, lose the ability to interact with one another, lose the ability to have sex with one another because we can now experience these things through cyber space! SCARY! We all use our imaginations from childhood into adolescences and into our adult lives. It is my opinion that it is a survival mechanism and that without it we will lose ourselves. Children are encouraged to make believe, to develop their minds and bodies, preparing them for their future. I don’t believe that story telling is going anywhere, but I am concerned with the development of video games, the cyber world, and were these realms may take us. I have decided to go the route of stem cells and the opportunity this research gives the human race. I have used the resources through summon and have come up with these three sources to start. http://www.sciencedirect.com.libproxy.dixie.edu/science/article/pii/S0167779903000039 http://www.sciencedirect.com.libproxy.dixie.edu/science/article/pii/S1526054206000297 STEM CELL RESEARCH; Choice of method for derivation of ESCs depends on the quality of the blastocyte

Tenth Blog Response

Talks about rice and iron deficiency in Africa. It is interesting that by modifying two ingredients in plants that we can change the iron content in rice and therein help millions of starving people in Africa. http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwTV27CgIxEAyiYC1oWn8gRzbJXXK1eogvLDwfZV5bCqL_j3ungtWy1RQ7zLAsyzA21xWqjLoyADoE8hRvfZQul75WqPvUuebodht33lfLPzVvJmyQ71PWNqvTYi2-YQAignZGuKSy7UJVjKW9CoPUkeCJPZ3LJPAykAYn6O5UmSxXuYgmSiwTgA11RJixIS3UmbMR0mCpkthyAuZsfK0vrbttD5928muLZ__4VDxenLS954XQhXwDrkc1JQ New teats in detecting GMOs’. It is becoming increasingly more difficult to detect the use of GMO’s in our food. With this new challenge comes new ways of testing for this modification. Were do we start? What has been modified, and what baseline if any is there? http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwNV3JCgIxDC2i4HlAe_UHOkzb6XZWB3HDg-NyTLejIPr_GDt6CrkFEt7LgyyELKTOImWpW86l98gpYCA0NilwIsvyda472f3WXg56NYwdFvDqKjJKjxnpu_V5uWG_ZwAscGsMEy42SqVskTA99z5wlYIHsEIGbMkxlBStj-Z70Eq3EIEjt4ID3aqYUHLxORmjoE6UTDImFi2CLUVkpGR6c9fe3nfHwa3-bv0qi0_1800R20tdMFk3Hz6tNkk Those against GMO’s. Obviously there are those that are against the modification of our food as well as the modification of any organisms. Messing with nature or the natural way of things is unaccepted by many and they give fact after fact how GMO’s are affecting the health of not only Americans but the entire world population. They paint GMO’s as a destructive approach to humanity. http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwY2BQMDZLM0pNMzYzMTQ0TkoC1imJ5onJBhappomWRmnG4Fvn3AIsfLwswnzNXCBHM4FLczchBqbUPFEGOTfXEGcPXVjRGJ-SkwM6Whd0NJk5MDmKMbAAe8ap4gysacAYAtLAUlMcaII4A0eEZXioRaS3H4QrBOPqFYN3MOkVlogDC2lwBOsa6xkAAOh8J_g Identifying and labeling GMO’s. It is important to be able to identify those food sources that have been modified in one way or another. It is difficult to establish what is an original un-molested organism and that of an organism that has been modified in some cases. With the development of these labeling technics we will be able to correctly label organic organisms form those that have been treated with GMO’s. http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwY2BQMDZLM0pNMzYzMTQ0TkoC1imJ5onJBhappomWRmnG4Fvn3AIsfLwswnzNXHgQhZObEANTap4og5yba4izhy6saIxPycmJN7IEnWQGTI-GhmIMLMCecao4A2saMIaANLDUFAeaIs7AEWEZHmoR6e0H4QrBuHrF4B1MeoUl4sBCGhzBusZ6BgDrUigB Peoples problem with stem cell research. Obviously most people have a problem with embryonic stem cells because of the question……when does life begin? Some view the destruction of embryos as murder. Another issue is that some are viewed as playing God. http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwRV09CwIxDC2i4OB0oF39Az36dW06q4eoJw6eH2Pba0dB9P9jPBWnEAhkSPLeyxBCyFyZLFNWRguhQkBO8dZHDqnyTmbVf52rD7DbwKkxy8kfnOqCDNJtStp6dVys2fcZAIvIMpYFi6uUyG8933GtkvFSZLCdj1p3qJJjFMKg3FUVzngEGTBCOwCXg4sycDEjQ1yoEyWjjIVFi2BLMTkl44s7t3Dd7j9u8XPLR3_4VN6fFLG97wumSv4Coy00-g Uses of adult human stem cells. There is another method that is being used to harvest stem cells. This is with adult cells from bone marrow, umbilical cords, and the farming of stem cells from the nasal cavity and other locations in the adult body. http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwRV09C8JADD1EwcFJ0K7-gZb0rk2vs1rELxzq15jrXUZR9P9jWhWn5E0ZEl7yhvCUmhlkHdhglqbGOdkpVFADNuRUajad61x1sNu1Pe1wMfqTWTVWvXCbqLpa1vNV_DUDiO-5KF7Pzopaw4KCBvRyZGi0Bj0Q-9YzmYAzCtwEQu8AwRU5Z-AaKNvMmHSq-qKnQ6QGLH2VKFwbSe1IDS_l-Wivm_0Hjn8weXZ_T8njFQm1d2MRmwTe9iw18Q Stem cell possabilities and lungs. Stem cell research is fairly new and in its infant stage (no pun intended). Scientists are using stem cells on all kinds of injuries and diseases. Among these diseases is lung disease and cancers. The idea is that these stem cells will be used to establish new tissues to replace the tissues that have been damaged. Lung tissue is one tissue in the body that once destroyed, it will not regenerate of repair itself. http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwRV27CsJQDL2IgoNTQe_qD7T09j47q0V84WB9jLltMgqi_49pVZzCIUOGJOckQ4gQc-2oQNLOKKVjZE0BD00e0EJZkO6_zlXHsNuE894tJ3-yqhIxwPtU1NXqtFin32cAadNN0WmMBqx2bfSWPHqEUPLuwurvKaBrLWgFhgADu7llrXGE0TSkWuqqzKqZGPJCjVKMiBPLlslWcnApxtfyUofb9vCByQ9mz_7wKXu8JHN7XxepzvI3Tog2jg Potential of stem cells and quality of life. It is hard to understand the drive for stem cell research by those who have never experienced true lose. The possibility that stem cell research can improve the quality of life for millions of Americans as well as Millions more across the globe is a very real possibility. With the right backing from the Federal Government and others around the world, it is possible that stem cells could be the cure for hundreds of diseases as well as hundreds of injuries as well increasing the quality of life for millions! http://dixie.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwRV27DsIwDIwQSAxMSJCVH0jVxm2TzECFeImB8hjj1GFDQvD_wi0gJusmDz6ddYN9QsygjJoilHmWASLvFG98SC0V3ukIXepcdbDbtT3tysXoL2rVWPToPhF1tTzOV-obBqBubCkKlVtHpvHko3E-IIGJ6Nrn5iVFJmGD7PMa9hK8YSGkQLqN1kLjjEb0wUE2FX021CTFIPJgubLYSm4uxfDizrW9bvYfOP7B5NkdPiWPl2Rt73ihIEnfJL817w

INK

This weeks read was interesting; I had heard that Hitler at one time was an aspiring artist and that he was homeless and a vagrant at one point in his life. I did not know that the turning point, or the reason that Hitler felt that he would be a great leader came from a five hour symphony that he and his friend attended as youths. It is hard to say weather the world would have been better off if Hitler would have been accepted into art school or if there would have been another leader who would have filled the shoes of Hitler in his absence. The answer to this question we will never know. I agree with Gotschell when he explains that ink is the master of mystery, tears, fear, and triumph! That is the great thing about fiction, we can make it as exciting as we want, the hero can always win, and villain we can understand and sometimes sympathize with them as well. It is no wonder that the human race not only loves fiction and story telling, but needs fiction and story telling. Story telling has become a part of humanity. It is the way we relax and release energy, it is the portrait of our dreams, it is an escape from our mundane lives. Ink to paper is as important to the body as oxygen to blood. Without story telling, without fiction, we as a human race would cease to exist. At least in the way we have become familiar with today! So I agree very strongly with Gotschell that story telling and fiction are not optional but necessary in the human experience. My research with GMO’s is an ongoing process. There are those on both side of this debate to whether GMO’s are good for the future of the human race, and then there are those that claim that GMO’s are the reason that America is the most over weight country in the world, that the morals of the American people are off center. Also thos that support the sciences and that GMO’s are a purer form of organisms and that they are being used in other ways to improve the quality of life not only for Americans but everyone around the world.

The Moral of the Story

In reference to the reading this week “The Moral of the Story” I found it interesting the correlation between religion and biology. Let me explain; religion takes a group of people with the same beliefs and puts them into a group where they can be successful in the way they think a like. The same goes for biologists; by taking like-minded individuals greater ideas can be accomplished and brought to reality. With my second emphasis of human communication I made the connection that all story is communication, it is the way that the story is told as to the impact it will have on an individuals life. But the same can be said for story tellers alike; if like minded individuals are able to come together much like a religious sect, those individuals will give themselves a greater opportunity to be successful. My research project would be to clone each individual so that in the future if you were to encounter any physical defects, you would have a clone that you could take a kidney from, a heart, or any other organ that would be an identical match. There would be doctors and scientists that would be in charge of harvesting, or raising this clone in a healthy environment so that the maximum potential could be taken from your clone and given back to you. This project would also need teachers and others to teach the clone how to read and write, how to communicate with the other clones that were being harvested for other individuals. Of course there are ethics and morals that come into play in this scenario, but we will not get into that. This particular experiment will solve some of the problems we face with disease and sickness. With the success of this experiment you would have an identical twin in the world that you could use for spare parts essentially.

2 Resources

http://www.eurostemcell.org/factsheet/origins-ethics-and-embryos-sources-human-embryonic-stem-cells http://stemcells.nih.gov/info/basics/pages/basics3.aspx These sites cover many, many different areas from the harvesting of embryos, to the opinions of those that support as well as the opinions of those who appose the use of HESC’s. The scientific findings and the diseases and disabilities that HESC’s are being used to treat. They also cover what a stem cell is by definition, what they are capable of becoming, and the hopes these scientists have for HESC’s. The Human Embryonic Stem Cell Debate: Science, Ethics, and Public Policy edited by Suzanne Holland, Karen Lebacqz, Laurie Zoloth This book talks about public opinion, the science, and ethics behind the use of HESC’s. http://rc.kfshrc.edu.sa/ORA/Continuing%20education/files/17d%20stem%20cells%20scieMedPolitical.pdf The New England Journal of Medicine has put out this article explaining the issues and stigma involved with HESC’s and their use.

The Mind is a Story Teller

It is interesting that I Google search Bipolar Communication Issues, and the first web site that pops up has the following topics that they are trying to treat with Seroquel. Depression, Bipolar Disorder, and Schizophrenia; Seroquel is a medication that is used in many applications, one such application is that it is used as an anti-psychotic. In this short article the claim is made that bipolar depression is much worse than a manic depressive state because it lasts much longer and the high’s are much more sever as well as the lows. According to the CDC approximately 9% of adults suffer from depression and 3.4% of adults suffer from extreme depression in the United States. The CDC also states that women are much more likely to report extreme depression over men. I know that we are making great strides in the area of depression when it comes to ways to treat including medications and therapy. In the reading this week I found it a little disturbing that Gottschell seems to almost glorify the sickness. Gottschell makes the connection between bipolar personalities with the brilliant mind of Stephen King. He also talk’s about the fictional character of Sherlock Holms and the brilliance that follows, I am not passing judgment, but it seemed to me bipolar disorder needs to be handled with a little more care. On the other hand there is “border line bipolar” here we have people who are diagnosed as bipolar and have manic episodes who in my opinion will believe anything that they are told. If they are told that the world is coming to an end, then the world is going to end. If they are told that everything is peachy they believe everything is peachy. Here is where the chemistry side of my major comes into play. For far to long people have become more and more dependent on pills. Yes chemists are coming up with better and better drugs, but in some case studies individuals that suffer from bipolar tendencies have been given placebo’s and the same results have been achieved in getting the patient better because they believe the medication is working. It is a hard PILL to swallow how dependent society has become on a magic pill that will take away all of our problems. According to the National Institute on Drug Abuse over 2.5 million individuals will take prescription drugs for non medical reasons this year alone. America is facing an epidemic. As chemists I believe we have to find non addictive drugs that will be able to treat others who are sick. I also understand that bipolar personalities is many times due to a chemical imbalance that will also need to be addressed. I wish Gottschell would have painted a different picture in reference to bipolar disorders. http://www.seroquelxr.com/bipolar-disorder/what-is-bipolar-depression.aspx?source=SERC18536&utm_source=google&utm_medium=cpc&utm_term=manic%20depression&utm_content=General%20&utm_campaign=Unbranded%20Bipolar%20Depression&gclid=CJCOrMSk8bkCFe1AMgodvBYAMQ&gclsrc=aw.ds http://www.webmd.com/depression/news/20100930/how-many-in-united-states-are-depressed http://bipolardisorderdepressionanxiety.com/tag/chemistry/

Night Story

In reference to William Dement, “dreaming permits us to be quietly and safely insane”. I believe that dreams allow us to participate in activities that real life does not permit. Activities such as walking or running in my case, now this does not mean that just because I am running it is a good thing. I could be running for my life, away from some animal, running after one of my children that had just been abducted, or any sort of thing. This is what Dement meant by safely insane. Dreams do not often make sense, and often sound insane when you wake and express your dream to others, or even your internal commentary with yourself. More often than not dreams can be considered INSANE! My interpretations of Gottschall’s statement “trouble is the fat red thread that ties together the fantasies of pretend play, fiction, and dreams” Gottschall is making this statement that dreams mean something, that the activities of your day are reflected in what you may dream that evening. He makes this correlation with the dream he has about his daughter and her falling from a cliff. It is Gottschalls assessment that he needs to spend more time with his children and that the neglect he has shown them from ether reading a book, watching a “BIG GAME”, or neglecting his children is being displayed in his dreams as some horrifying act that he seams to be paralyzed physically and can only watch as the scene unfolds. The way these two statements relate to one another is that first of all we are talking about a dream state. Both refer to how each of us are affected by dreams only that Gottschall seems to hint that we may have more power over what we dream about because our dreams would reflect the experiences of the day or week. Dement does not make any reference as to why we dream about what we do, only that most of the time our dreams do not make scene and we are at no risk physically or mentally from our dreams, that our dreams are relatively safe. In a study conducted by Udini, Frank Nicanor Pascoe conducted tests on 18 subjects as to wether sharing the same dream with one another would bring a couple closer together and increase their ability to communicate with one another. “Most participants reported changes due to their shared dreaming experience, ranging from psychological and spiritual changes perceived in themselves and others, to altering their view of reality and in some cases behavior changes in their daily lives.”(Pascoe) This is very interesting; David Maurice, Ph.D. has challenged the beliefs and ideas of the past about REM sleep. Maurice states that he believes that Rapid Eye Movement is essential not for sleeping but that if the eye does not move in this way that the cornea will suffer damage while sleeping. "Without REM," Maurice told 21stC, "our corneas would starve and suffocate while we are asleep with our eyes closed."(Maurice) It is thinking like Dr. Maurice’s that challenge old ideas and usher in new theories to be tested. http://www.columbia.edu/cu/21stC/issue-3.4/breecher.html http://udini.proquest.com/view/shared-dreaming-and-communication-goid:847028488/

Hell is story friendly

I think it is interesting about Gottschell’s views and ideas of fiction and reality. Here are my thoughts in reference to fiction concerning biology/chemistry and the sciences. Lets take for example the movie Avatar, great show and for me really hit home. Because I have suffered a SCI and the actor in the film Jake Sully also suffered a SCI I found it amazing. I found myself acting and doing a lot of the same things that his character was doing. After entering into the avatar body the first thing that Jake does is wiggle his toes. How amazing would it be to be able to wiggle your toes after years? Next he stands up, and next he runs! He runs and jumps until he stops and realizes that he can feel the dirt beneath his feet, he runs his toes through the dirt digging them in and remembering what that felt like. I can tell you from experience that it is AMAZING that the writers were able to hit this on the head. Given the opportunity I see myself acting much the same way. After Jake is taken out of the avatar body and the reality of his paralysis sets back in he is once again frustrated with his condition. But that is fiction, and in the real world we have not yet found a cure for a SCI. I am hopeful that this will happen but the reality is that real life is not roses, does not always have a happy ending, and in a lot of cases is just plain cruel and makes no sense. Not speaking just for SCI’s but anyone who has experienced lose in their lives things such as cancer, death of a child, disease, etc. Many times these experiences do not make sense, do not seem fair, and seem to be more than we can bare. But in these instances is when we as a race seem to make the most progress. We find the fight to find a cure. We are compassionate and bond together to help. I say this because I have experienced this first hand. Although reality is not as glamorous as fiction and does not always have a happy ending as fiction does it is real. It is my hope that the brilliant minds of fiction will spark for those physicists, doctors, chemists to continue to motive them to find cures for cancer, SCI’s, and many other diseases and injuries. It is my belief that this will one day be reality and just like Jake Sully I will be able to wiggle my toes once again. I think it is completely false that Gottschell's opinion of those who read more fiction are more capable social operators than people wo do not. In fact in his book no more than a paragraph later he states that "these findings are self-evident". Just because Gottschell feels a certain way does not make it so! I do find it interesting that the firing of neurons to fictional stimulous may lead to something in the future with the regeneration of damaged neurons.All in all this week was an interesting read, something to think about as far as the connection of fiction and the firing of stimuli in individuals.In the begining of my injury I would sit infront of a scene with electrodes hooked to my legs. I would watch a screen for hours and ask my muscles to fire. Electrical feedback would tell me if my muscles were firing or if there were no activity at all. For hours at a time day after day watching a screen for bio-feedback. I can tell you from experience it works. Neuro-science is making huge progress in the recovery of SCI's and stroke patients.

The Riddle of Fiction

I believe that Gottschall like Dahl believes that the mind of fiction is much like a “dark wood” that Dahl refers to a as a mind of a child. Dahl is famous for writing children’s stories like Charlie and the Chocolate factory. After reading the chapter “The Riddle of Fiction” it is clear that we start at a very young age (12 months) living in a world of fiction. It is interesting that boys will separate themselves from girls, and girls likewise in their different worlds of fiction. Vivian Paley is quoted saying “Whatever is going on in this network of melodramas, the themes are vast and wondrous. Images of good and evil, birth and death, parent and child, move in and out of the real and the pretend. There is no small talk.” I would argue that story telling is not an adaptive trait rather a trait that we are born with. At such an early age we start in the world of make believe boys with their trucks and guns, and girls with their dolls pretending that they are mothers. It is interesting that Gottschall views this as a nature rather than nurture part of life. I agree with Gottschall’s assessment because we start at such a young age pretending and making up our own fictional stories. I would have to agree with Kessel when he says “fiction, like cocaine, is a drug.” More times than not fiction is much more entertaining than real life. When we hear the gossip, sex scandals, and scary fairytales, this is not part of our normal every day routine and therefore it boarders on fiction for most people that could not imagine themselves wrapped up in such a scandal. That is why we as a species are so interested in the tabloids, t.v. dramas, and stories of others lives, because to us we could not imagine that happening in our lives. As we play out those situations in our heads they become our fiction or story telling.

Neverland

I would define story telling as any form of communication between two or more individuals through text, non-verbal, or oral interaction that is not directly related to a current conversation or topic. Let me try to explain my thoughts. If I am talking to someone about my day and explaining the different experiences, conversations, and people I encountered, that would be considered a story. If my wife wants to go out to dinner and together we decide where we would like to eat, that is not a story. I believe story telling is a thriving art. I do not believe that everyone is a good storyteller. But we begin to tell stories at such a early age with make believe, we have had many years of practice by the time we are adults. Story telling is the way journalists, lawyers, annalists, and many other professions make a living. Story telling is alive and well. By definition of the book, Neverland is a place that we go with our minds to escape our realities. Weather that is for 14 seconds at our cubicles, or in the middle of one of our proffessors lectures, Neverland is personal and unique to each one of us. Neveland is an escape from our mundane lives.

Story telling

Hello, My name is Matt Blanchard. My idea of a story is something that is very personal. When you hear others say "that is just a story" they are referring to someone elses story, not theirs. Each individual will very rarely have the same "story" as the next even if they are describing the same event because we all experience things differently. In my opinion what makes a good or bad story is if the audience can relate to what is being said. If the audience is engauged, depending upon the engaugement, I would classify the story as good or a success. On the other hand if the audience is not interested or engaged in the "story" then it is not a good story, or at least for that audiance it is not a good "story". A story teller can have a horrible story to tell, but if the story teller is animated and entertaining in the way they tell the story then they would be considered a good story teller, not that the story is a good one, just that they are good at telling it. Some of my favorite story tellers would be Anthony Robins, Mike Schlappi, Lou Holtz, motivational speakers are most interesting to me.Musicians such as Emenem, Macelmore, Jay Z, etc. For me it is interesting to read the preface and wonder about "Wonder Land" as Gottschall describes it. "I think therefore I am" this was the "Wonderland" for a Descartes, he was so focused on defining his "Wonderland" he almost went insane! We need to be carful how deep we venture down the rabbit hole and not lose ourselves. Story telling is how we express ourselves and is the lives that we live. In most cases it is what we believe as individuals. Each of us have a story to tell, it is how well we tell the story as to how it will be recieved.