Grow and Groom Your Networks

I prefer the decentralized network, but this image makes for a nice radial design.

HuffingtonPost Blog: Ten Sleep Mistakes You're Probably Making

Too many of us are guilty of a prime sleep mistake: underestimating its importance. Whereas nutrition and exercise are widely acknowledged as so-called "pillars of health," sleep, while well-deserving of such high praise, is often maligned as something that's "for the weak."

But even those of us who have learned to value sufficient shut-eye aren't necessarily sleep saints. In fact, there are a number of myths that derail us and mistakes that prevent us from peacefully drifting off to the Land of Nod. Some of the biggest ones are in the slideshow below.

http://www.huffingtonpost.com/2013/06/19/sleep-mistakes_n_3461583.html?utm_hp_ref=healthy-living

In the News: Obesity as a Disease: What Does It Mean for Americans?

It's the Stay-Puft Marshmallow Man....according to the CDC 35% of Americans have been Stay-Puft.

by Amanda Woerner /Published June 19, 2013 /FoxNews.com

Now that obesity has been officially classified as a disease by the American Medical Association (AMA), many are wondering how this will affect the 35.7 percent of Americans who are described as obese by the Centers for Disease Control and Prevention.

Will this decision help facilitate better treatments for people who are currently obese? And will this new classification help combat the country’s growing obesity epidemic? Dr. Leena Khaitan, director of the bariatric surgery program at University Hospitals Case Medical Center in Cleveland, hopes the answers to those questions will be, ‘Yes.’

“Right now, physicians will treat high blood pressure, diabetes, give patients medications and say, ‘Oh you also need to lose weight,’” Khaitan told FoxNews.com. “I think (this) gives the physicians a little more credibility in pushing patients to address obesity and become healthier. It’s recognized as a disease…not just something that (because) you have poor lifestyle habits, this is your problem.”

The AMA, which voted for the change on Tuesday, concurs, saying they hope their decision will prompt greater communication between doctors and patients.

“The most important point we want to make is it will be important for physicians and patients to work together to develop weight goals and other goals as well,” Dr. Patrice Harris, an AMA board member, told FoxNews.com. “The point is to raise the level of awareness about obesity and have patients and physicians talk together to decide on weight goals, blood pressure goals, cholesterol goals (and) blood glucose goals.”

Obesity is associated with a range of health problems, including high blood pressure, diabetes, cardiovascular disease and an increased risk for cancer. Though numerous treatments exist to treat problems associated with obesity – like high blood pressure and cholesterol – remedies for obesity are limited.

According to Khaitan, bariatric surgery is often the best option for obese people who haven’t been able to lose weight through traditional diet and exercise programs. However, weight loss surgery is often seen as an elective procedure by insurance companies, meaning patients usually have to pass through many hurdles before they undergo the procedure.

“Up until now, without that classification, the path to obesity surgery (has been) very challenging,” Khaitan said. “Oftentimes people have to pay extra to have that type of insurance policy, (and) many employers choose not to cover it because it’s consider an elective operation. Now, we’re saying obesity surgery is no longer elective, it is truly something that will treat (this) disease and is potentially lifesaving.”

Additionally, Khaitan hopes that the changes will also make it easier for obese patients – or those at risk for obesity – to receive nutritional counseling.

“If I send a patient to a dietician, that isn’t covered by insurance,” Khaitan said. “But hopefully by changing this classification, this would become a covered treatment for people, and they’ll be more likely to actually do it.” 

Though there are many upsides to obesity’s new classification, Khaitan hopes that patients will not use the ‘disease’ classification as a crutch.

“I don’t want patients to say, ‘Oh I have this disease,’ and not take accountability for it to make changes they need to make to fight this disease,” Khaitan said.

When asked whether or not they had considered whether obesity could now also be categorized as a disability, Harris said, “We did not have the issue of disability in this particular policy, and that’s not the focus of this policy.” 

Additionally, the AMA expressed the hope that their decision will spur more research into potential prevention and treatments methods – as well as decrease overall health care costs for both patients and insurers.

“The direct cost of obesity is over $535 billion a year, and we could reduce that with improved health outcomes,” Harris said. “Patients could lead healthier lives and reduce health care spending.”

Read more:

http://www.foxnews.com/health/2013/06/19/obesity-as-disease-what-does-it-mean-for-americans/#ixzz2WgJISM4d

Steve Rude (after John Romita Sr.) Mary Jane Watson and Peter Parker Meet

Face it, Tiger -- you jsust hit the jackpot.

Good thing Peter Parker is wearing his Stan Lee cologne.

Welcome: You Are Now on the Don Mangus Network



Which networks are Don Mangus-approved?


The correct answers are B and C.

Pablo Picasso, Project for a Monument to Guillame Apollinaire, 1962, painted steel, Museum of Modern Art

Allen Frances Blog: My 12 Best Tips on Psychiatric Diagnosis

by Allen Frances, Professor Emeritus, Duke University

We already had a crisis in psychiatric diagnosis before DSM-5. It is a sure sign of excess that 25 percent of us qualify for a mental disorder and that 20 percent are on psychiatric medication. Unless checked, DSM-5 will open the floodgates and may turn current diagnostic inflation into future hyperinflation.

Below are my 12 best tips on how best to ensure accurate and safe diagnosis.

1. The less severe the presentation, the more difficult it is to diagnose. There is no bright line demarcating the very heavily populated boundary between mental disorder and normality. Milder problems often resolve spontaneously with time and without need for diagnosis or treatment.

2. When in doubt, it is safer and more accurate to under-diagnose. It's easier to step up to a more severe diagnosis than to step down from it.

3. Children and teenagers are especially hard to diagnose. They have a short track record, varying rates of maturation, may be using drugs, and are reactive to family and environmental stresses. The initial diagnosis is likely to be unstable and inappropriate.

4. The elderly are also hard to diagnose. Their psychiatric symptoms may be caused by medical and neurological illness and they are prone to drug side effects, interactions, and overdose.

5. Take the time and make the effort. It takes time to make the right diagnosis -- adequate time for each interview and often multiple interviews over time to see how things are evolving. Except for classic presentations. quick diagnosis is usually wrong diagnosis.

6. Get all the information you can. No one source is ever complete. Triangulation of data from multiple information sources leads to a more reliable diagnosis.

7. Consider previous diagnoses -- but don't blindly believe them. Based on their tenure, incorrect diagnoses tend to have a long half-life and unfortunate staying power. Always do your own careful evaluation of the person's entire longitudinal course.

8. Constantly revisit the diagnosis. This is especially true when someone is not benefiting from a treatment that is based on it. Clinicians can get tunnel vision once they've fixed on a diagnosis, become too married to it, and are blinded to contradictory data.

9. Hippocrates said that knowing the patient is just as important as knowing the disease. Don't get so caught-up in the details of the symptoms that you miss the context in which they occur.

10. If you hear hoof-beats on Broadway, think horses, not zebras. When in doubt, go with the odds. Exotic diagnoses may be fun to think about -- but you almost never see them. Stick with the bread and butter.

11. Accurate diagnosis can bring great benefits; inaccurate diagnosis can bring disaster.

12. Remember the other enduring dictum from Hippocrates: First, Do No Harm.

(Excerpted from the introduction to Allen Frances' The Essentials of Psychiatric Diagnosis, Guilford Press).

Tuggy Keeper of the Sleep: The Origin Story

Before there was Tuggy -- there was Chuggy. I first set my eyes on Chuggy at my friend Robin's casa.

Robin and his gal-pal Angela were gracious enough to invite me to their Oak Cliff homestead for dinner in April. After getting tangled-up in a malestrom of interstate confusion, misdirected road-rage, and arriving an hour and a half late, I was treated to a fine meal and a tour of the house.

Robin is an avid art, photography, and design patron. His place is tastefully stocked with fabulous period design pieces, topped off with an elegant sound system. Like me, Robin is a mainstream jazz fan. He lives artfully.

Anway, rather unexpectedly, what riveted my attention that night was not the collection of fine objects d'art -- it was the irresistible charm of Chuggy. He was peering down from an armoire, standing watch over the king-size bed below.

 "Who's that?," I exclaimed, feeling a undenialable kinship and magical connection with the little fellow.

"That's Chuggy, the Keeper of Sleep and Drinks. I've carried him with me ever since I was a small child -- even during my overseas stint in the Army," Robin answered. "He's traveled with me everywhere, and he makes sure I enjoy good sleep."

Ah, such sweet slumber, I knew it was true. With my recent disastrous trauma from chronic insomnia, I could dig a helpful Sleep Keeper like Chuggy.

Chuggy, who was named after the popular Roger Miller song "Chug-a-lug," started out as a Santa Claus doll, until Robin's mother transformed and clothed with exotic fashions on four or five different occasions.

As a long-time fan of John Stanley's stories in Marge's Little Lulu and Tubby comics, I seized upon a familial relationship based loosely around the relatonship Tubby Thompkins and his doppleganger cousin," Chubby. Chubby is the pint-sized "mini-me" look-alike of Tubby. Since Robin already had Chuggy, which sounded more than a bit like Chubby, I would conversely pay tribute to Tubby's moniker with Tuggy for a Sleep Keeper of my own.

Tubby Thompkins and his cousin, Chubby. These two amuse me to no end,

So, to eBay. The closest "relative" to Chuggy I could find was a Gingerbread Man, described as an African-American-made vintage doll.

I committed to the $12.50 Buy It Now price, and a few days later Tuggy arrived. His round eyes were blank white circles which made him look a little too much like Saturday Night Live's "Sluggo" from the Mr. Bill segment for comfort, so I drew in some eyelids and a smile using a red Sharpie pen -- an attempt to make him look friendlier and dreamy.

I added an accent of soporific healing bling to Tuggy's garb by accesorizing his look with a cosmic Calvin Begay-crafted Navajo Bear Pendant around his neck.

Tuggy is small enough to ride around in a men's dress shirt pocket.

Older, uptight, white people at the coffee shop have cringed and carped that Tuggy somehow presents an unflattering rascist caricature. Nothing could be further from the truth. Tuggy is simply a magical Gingerbread Man, made with molasses (from the Latin root for "honey") and love.

He's a soulful Keeper of the Sleep and the cousin of Chuggy.

Chuggy with Tuggy at Robin's house on Father's Day 2013.