Friday, 27 July 2012

EYES ON LONDON: Crowd fired up as ceremony nears

Emily Atha waits for the start of the Opening Ceremony at the 2012 Summer Olympics, Friday, July 27, 2012, in London.(AP Photo/Mike Groll)

Emily Atha waits for the start of the Opening Ceremony at the 2012 Summer Olympics, Friday, July 27, 2012, in London.(AP Photo/Mike Groll)

New Zealand's Caroline Lenamore runs with her horse Lenamore during horse inspection for the equestrian eventing competition at Greenwich Park, the site for the equestrian and modern pentathlon events at the 2012 Summer Olympics, Friday, July 27, 2012, in London. (AP Photo/Markus Schreiber)

Members of the British military rest after working at the ExCel Centre at the 2012 Summer Olympics, Friday, July 27, 2012, in London. Competition begins at the venue on Saturday. (AP Photo/Andrew Medichini)

Canadian swimmer Brent Hayden does kicking drill during a training session for the London 2012 Olympics in London, Friday July 27, 2012. (AP Photo/The Canadian Press, Frank Gunn)

A member of Ukraine's women's rowing team passes under a bridge during training in Eton Dorney, near Windsor, England, at the 2012 Summer Olympics, Friday, July 27, 2012. (AP Photo/Natacha Pisarenko)

(AP) ? Around the 2012 Olympics and its host city with journalists from The Associated Press bringing the flavor and details of the games to you:

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LIKE A FARMYARD

The animals have just come into the stadium. That is 70 sheep, 12 horses, 10 chickens and nine geese. One of those horses is a shire horse. The music is starting to build and there are camera flashes all around the stadium. What will the animals make of that?

? Fergus Bell ? Twitter http://twitter.com/fergb

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MANY COLORS

They've come from all over for these games and this opening ceremony. Fans seen filing into Olympic Stadium wearing the colors of Canada, Mexico, Poland, Italy, Russia, Germany, Brazil and seemingly all points in between.

That includes the most well-represented nation, of course: Team GB.

? Jon Krawczynski ? Twitter http://www.twitter.com/APkrawczynski

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NO RAIN - YET

There's been so much talk about the British weather and if rain would spoil the opening ceremony. Well, it's still anyone's guess.

AP's John Krawczynski, outside the main stadium in Olympic Park, says: "It's cool with a light breeze and no rain. But it does feel as though it could rain at any moment."

? Jon Krawczynski ? Twitter http://twitter.com/APkrawczynski

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ELECTRIC ATMOSPHERE

The atmosphere is absolutely electric. We have already had a few attempts at doing the wave. Crew members in white coveralls and painter hats are parading these clouds around the stadium. Music up. Cheers up. scenes playing on the screens of past Olympians and young kids.

? Danica Kirka ? Twitter http://twitter.com/danicakirka

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CEREMONY SECURITY

Security lines, or lack thereof, are moving easily at the Olympic Park. It does feel a bit like stumbling onto a military base ? fresh-faced young soldiers in uniform are everywhere, and every single X-ray machine and scanner is manned by soldiers rather than other organizing committee staff.

So many soldiers that some are just standing around, waiting for a crushof spectators that has not yet materialized.

? Cassandra Vinograd ? Twitter http://twitter.com/cassvinograd

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PRESIDENTIAL FRIENDS

Maya Moore has spent so much time with the Obama family, she could be an honorary member.

She was the only female basketball player invited to play with the President in a game to celebrate his 49th birthday in 2010. She also did a soon to be released public service announcement with Michelle Obama in May supporting the "Let's Move!" campaign.

The two shared a hug and chatted for a few minutes Friday morning after the first lady opened her stint as leader of the U.S. Olympics delegation attending a breakfast with Olympians.

"That was a little treat," Moore says. "Any time I can see the president or first lady it's such a treat. She's someone who you can relate to because she's very active and enjoys sports. We know that whole family loves basketball."

? Doug Feinberg ? Twitter http://www.twitter.com/dougfeinberg

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EXCITED

Less than an hour before showtime and excited visitors are filing into Olympic Stadium.

Tarik Lacene, a Canadian who lives in London, scored tickets to the opening ceremony.

"It's a once-in-a-lifetime opportunity," Lacene says. "It's amazing to think that over 1 billion people will be watching it on TV and we're actually here."

? Jon Krawczynski ? Twitter http://www.twitter.com/APkrawczynski

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THE ANTICIPATION

From AP's Fergus Bell in place and awaiting the opening ceremony:

"A Mexican wave just started. The crowd are getting fired up. The scene is set on the stage in front of me depicting a rural idyll. There are tractors and a water wheel. There is a small cottage in the middle with two smoking chimneys. I have seen similar scenes in the English countryside but this looks a little cleaner, a little more fairytale.

? Fergus Bell ? Twitter http://twitter.com/fergb

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GETTING THERE

AP's Cassandra Vinograd reports from the streets ? well, the railway tracks ? of London:

This reporter was in a bit of a panic ? left work late and wondered how she would ever get through the crowds to board a train to Olympic Park.

But tubes were not crowded and St. Pancras International, where you catch the high speed Javelin train, is a breeze. There were no lines whatsoever to get on the Javelin ? despite crowd-flow measures (barricades, like what airports use for long check-in lines). The line spaces were all empty.

The only glitch was a few travelers grumbling over a broken ticket machine, leaving only one working dispenser on the Javelin platform.

But no worries in the end. With so few jostling for space, everyone got a ticket in time.

?Cassandra Vinograd ? Twitter http://twitter.com/cassvinograd

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NO KNOCKOFFS

Egypt's Olympic team won't be wearing knockoffs after all at the London Games.

Nike announced Friday it was donating its gear to the Egyptian athletes. This after the country's committee chairman said they'd turned to a Chinese distributor because the real thing was just too expensive.

Not so during the opening ceremony, though. Nike's shipment isn't due to arrive in London until Saturday.

? Maria Sanminiatelli ? Twitter http://twitter.com/SanMin68

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WHITE RIBBONS

The widow of Alexander Litvinenko, the exiled former Russian agent who died from a mysterious case of radiation poisoning, is calling on Londoners to protest Russian President Vladimir Putin's visit to the Olympics.

Litvinenko issued a statement shortly before his 2006 death, accusing Putin of ordering him to be poisoned. He had been living in London since fleeing Russia in 2000. In a book written in exile, he accused Russia's main security agency, for which he once worked, of staging the 1999 apartment building bombings that were blamed on Chechen rebels and used as a justification for starting the second Chechen war.

British-Russian relations suffered a serious setback in 2007 after Russia refused to extradite the man that Britain named as the main suspect in Litvinenko's death.

Marina Litvinenko on Friday issued a statement saying "Mr. Putin's agents killed my husband" and called on Londoners wo wear white ribbons, the emblem of the Russian opposition, to proest Putin's visit Aug. 2 that is to include watching the judo.

? Jim Heintz ? Twitter http://twitter.com/jeheintz

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WHERE TO WATCH?

AP's Jenna Fryer reports from the streets of London:

Is there no such thing as a sports bar here?

Looking for a pub where I can hang with the locals and watch the opening ceremony is proving to be more challenging than I expected.

Since arriving, I've noticed that not that many pubs have televisions, so I've had to ask around for recommendations for the ceremonies. The first two I called ? one of which was the favorite watering hole of the late Amy Winehouse ? said they had no plans to show the ceremonies. "Tonight's just a regular pub night," I was told.

It seemed strange to see bars without TV's, but to not have such a big event blaring from every television in the country tonight is just bizarre.

? Jenna Fryer ? Twitter http://twitter.com/jennafryer

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PREPPED FOR HISTORY

Double-amputee runner Oscar Pistorius has arrived in London for his historic debut at the Olympics and says he's feeling "a mixture of pride, happiness and anticipation" at the end of his long journey to compete at the highest level in able-bodied competition.

Pistorius made the short flight across from his training camp in northern Italy and says he's "really excited" to attend the opening ceremony.

The South African has been battling for four years to reach the 2012 games. He was cleared to compete against able-bodied competitors on his carbon fiber blades in 2008, ran two qualifying times for London in the last 12 months, but missed out on the crucial third under his country's strict qualifying criteria.

But the selectors had a last-minute change of heart weeks before the games and picked him for the individual 400 meters as well as the 4x400 relay.

In an email to the AP, Pistorius says: "This feels like a long time coming and I am ready! This is going to be, I hope, an incredible few weeks of my life."

His first run at the Olympics will be in the 400 heats on Aug. 4. It'll be history.

? Gerald Imray ? Twitter http://twitter.com/GeraldImrayAP

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FOOD WITH NO NAME

Food choices are simple at the ExCel arena, the giant convention center hosting seven Olympic disciplines. Because McDonald's has exclusive rights to sell branded products, the dozen concessions at the venue are prohibited from using a specific name.

So, here's what's on offer on large signs:

?"Traditional Roast."

?"Sandwich."

?"Bagel"

?"Italian" or "Chinese."

? "Baked Potato" ? which, by the way, is often called a "jacket potato" in these parts.

? Stephen Wade ? Twitter http://twitter.com/StephenWadeAP

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KEEP DREAM-ING

You get the sense that LeBron James doesn't want to hear another word about it.

"Who's better ? 1992 or 2012?" That's been a talking point for weeks, the comparison between the 1992 Dream Team that went to Barcelona and this year's Olympic team.

"It's never going to happen," James said Friday of a hypothetical game between the two teams. "It doesn't matter how much conversation that we have about this team and the '92 Dream Team. It's never going to be played. Father Time is not going to allow that to happen. So it doesn't even matter."

That wasn't his way of downplaying expectations about what to expect from the U.S. squad in London.

Quite the contrary.

James, who won the NBA MVP award, the NBA Finals MVP award and led the Miami Heat to the title this past season, is fully expecting to add Olympic gold to his unbelievable year.

"I know one thing," James said. "I know we have a great team. And if we play as a team, like we're capable of doing, we can be one of the best teams ever assembled.

? Tim Reynolds ? Twitter http://www.twitter.com/ByTimReynolds

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EDITOR'S NOTE ? "Eyes on London" shows you the Olympics through the eyes of Associated Press journalists across the 2012 Olympic city and around the world. Follow them on Twitter where available with the handles listed after each item, and get even more AP updates from the Games here: http://twitter.com/AP_Sports

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/cae69a7523db45408eeb2b3a98c0c9c5/Article_2012-07-27-OLY-Eyes-on-London-Package/id-694a593def8d4888bda007c9f35e4f11

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Top 5 High-Tech Cities | Business Computing World

Want to visit the ?city of the future?? Well, you won?t have to look any further than these 5 major world cities where a commitment to research and development and a population?s love for things digital have made them shoot to the top of the list when it comes to all things technology-related.

1. Tokyo, Japan

Every facet of this city has embraced technology ? from its high-speed public transport system to digital toilets! The people have as well. You?ll find that everyone is using sophisticated cell phones, techie gadgets, and taking advantage of broadband speeds several times faster than most of the rest of the world. Additionally, many of the major tech companies have a presence in Tokyo, such as Sony, Nikon, and Panasonic, and the population has also embraced a digital way of life.

2. Singapore

This city-state offers free high-speed wireless broadband to its population, and if you?re out shopping in Singapore, there?s no reason to carry your wallet. Mobile money is legal tender, so you can pay with your cell phone, computer, or even your wristwatch. When it comes time to pay a road toll, you?ll be charged a different price depending on the time you use the road using radio frequency identification tags which are required on each car. Many major industry leaders have a presence here, including HP, Fuji, IBM, and Microsoft.

3. Hong Kong, China

Patrons placing orders with robot waiters and school children scanning their fingerprints for attendance every morning may seem like scenes out of a futuristic movie, but that?s just part of normal life in Hong Kong. Here, the gadget-loving population benefits from the fastest residential broadband in the world and widespread cell phone coverage. And if you head to an area called Cyberport, you?ll find that all apartments and shops receive free Wi-Fi, which has led to a lot of creative and special effects companies taking up shop in the area.

4. Seoul, South Korea

The heart of the country?s mobile phone industry, major industry leaders such as Samsung and LG Group are based in this high-tech city. As a result, the phones here are several times faster than most of the rest of the world. You?ll also find an avid gaming population in Seoul ? a little under half of the country?s population regularly go to internet cafes to play games online ? and it is considered one of the most connected cities in the world with wireless access available on public transport, even while on the subway underground!

5. Silicon Valley, California, USA

Many consider the Silicon Valley / San Jose area to be the capital of the tech movement. You?ll find that it?s the heart of Web 2.0 development with over 225,300 technical jobs and the headquarters of many major tech company located there, such as Google and Apple. It also has the highest concentration of high-tech employees in the United States, so everywhere you turn there?s someone who can help you troubleshoot your computer issues.

Source: http://www.businesscomputingworld.co.uk/top-5-high-tech-cities/

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MEZZA NORTE - Foodamn!

MERCATO CENTRALE Experience Comes to Quezon City

MEZZA NORTE

UP-AyalaLand Technohub

July 26, 2012 - Mezza Norte, the most awaited food hub from the South (Taguig) comes closer to Quezon City, with the launch of Mercato Centrale's sister hang-out night food market located in the bustling compound of Technohub in Commonwealth.?

Foodie adventurers who travel all the way from the North to Mercato Centrale in Taguig in search of new culinary adventures, the Mercato experience is now coming closer to you.

Just recently, the organizers of the popular Mercato Centrale food market in Bonifacio Global City set up the Mezza Norte night food market at the UP-AyalaLand Technohub along Commonwealth Avenue in Quezon City to serve the growing late night food community in the North.

Mezza Norte brings together unique food, drink, pastry and dessert finds from home-based businesses in Quezon City like Dadi?s Berd charcoal-grilled chicken, Frisch?s Liquor Ice Cream, Macheesmo burgers, Sober club?s mocktails, Maria?s Ilocos Empanada, Med Chef?s pastries, Amang?s Grill?s chicken and pork isaw - the market will also have the favorite food finds from Mercato Centrale, which include Manangs?s Chicken, Mochiko ice cream-filled mochi balls, Big Bob?s Freshy charcoal-grilled burgers, Merry Moo Artisan Ice Cream, Angus Beef Tapa, Mio Gelati, Bagwang?s thinly-sliced bagnet strips, Carlo?s Kitchen crunchy belly, Chef Resty?s roast beef and more.

?We are very excited to be part of Quezon City food scene!? shares Anton Diaz, co-organizer of Mezza Norte and also the popular food and travel blogger behind www.OurAwesomePlanet.com. ?Mercato has wanted to serve the North, but we were just waiting for the right location for the food market. We think that the UP-AyalaLand Technohub is a perfect location in the North where we can cater to everyone in Quezon City and the surrounding areas.?

"There are a lot of great up-and-coming food entrepreneurs over here, and we want to give them an opportunity to shine in the market.? Adds RJ Ledesma, the other co-organizer of Mezza Norte. ?Among the entrepreneurs we look forward to having in the market are the students from the nearby colleges and universities along with Quezon City-based cooks, chefs and bakers who want to share their recipes with fellow food enthusiasts.?

On top of making new food discoveries, the marketgoers can also enjoy free wi-fi from Globe Tattoo at Home and live acoustic performances.

Mezza Norte will not only limit Quezon City's food choices, in fact it could be a great alternative from fastfoods, food delieveries, and high end food establishments. No ?worries for those who crave during late nights, given that the night food market is open until 3:00 a.m., there's a wide array of meals and culinary treats.
During the premier opening, invited media were supposed to have a taste samples from the food concessionaires, I doubt if these people can manage to do that, the place was totally crowded and booths are selling like hot cakes! The rains didn't even stopped Mezza Norte activities - it was jam-packed with food explorers from fresh faces to loyal customers. :)


Mezza Norte
UP-Ayala Technohub - opens every Thursday, Friday and Saturday from 6:00 pm to 3:00 am.
[facebook] www.Facebook.com/Mezzanorte
[twitter] @Mezzanorte.

For inquiries on how to become a vendor at Mezza Norte, please email admin@mezzanorte.com or contact 09178401152.

Source: http://www.foodamn.com/2012/07/mezza-norte-night-food-market-at-up.html

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Thursday, 26 July 2012

ANDERSON COOPER'S 360? WORLD VIEW | Triangle Arts and ...

AndersonCooperSpotlight ANDERSON COOPER?S 360? WORLD VIEW

ANDERSON COOPER?S 360? WORLD VIEW

Award-Winning Journalist and Best-selling Author

Live at DPAC, Durham Performing Arts Center on September 21

Anderson Cooper, CNN anchor and Emmy winner will bring his ?Anderson Cooper?s 360? World View? to DPAC, Durham Performing Arts Center this fall on Friday, September 21, 2012.

?Anderson Cooper?s 360? World View? is based on CNN?s program Anderson Cooper 360?.? This fast-paced and provocative news show is an alternative to typical network newscasts.? Cooper goes behind the headlines to tell in-depth stories of the day and gather analysis from experts.? He will bring this format to DPAC as a 45-minute lecture followed by a 45-minute Q&A session that will take place with members of the audience being able to ask Cooper questions about his stories and travels.

Since the launch of Anderson Cooper 360?, Cooper has covered nearly all major news events around theworld and is often reports from the scene. In addition to reporting for CNN, Cooper has launched a new talk show, Anderson, a topical issue/event-driven talk show. Cooper also provides reports for CBS?s 60 Minutes. Dispatches from the Edge, Cooper?s memoirs about covering the South Asia tsunami, Hurricane Katrina and other news events, recently topped the New York Times Bestsellers List and other bestseller charts.

?Fans love special events like this at DPAC as past speakers like David Sedaris, Garrison Keillor, Bill O?Reilly, Ira Glass and Anthony Bourdain have been some of our most talked about presentations since opening. To have an international news figure on our stage brings a whole new dimension to the theater. And as always, our state-of-the-art sound, video and sightlines will ensure guests an intimate experience unmatched by any other theater in the region,? said Bob Klaus, GM for DPAC.

?

Tickets go on sale Saturday, July 28 at 10am:

??????? Online at?DPACnc.com

??????? DPAC Ticket Center: 919.680.2787, 123 Vivian Street, Durham, NC

??????? Ticketmaster.com / Ticketmaster Charge by phone at?800.745.3000

??????? Ticketmaster outlets including Walmart

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Source: http://triangleartsandentertainment.org/event/anderson-coopers-360-world-view/

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The World of Functional Alcoholics

July 26, 2012 on 11:32 am | By admin | In Daily Health News

Most of us have heard about or know a person who is a ?functional alcoholic,? that is a person who is alcohol dependent but who is able, for the most part, to function in everyday life like a ?normal? person. Stated differently, a functional alcoholic is an individual who can go through most aspects of life without displaying any alcoholism signs or the signs of alcohol abuse.

Functional Alcoholics Do Many Responsible Things

Indeed, most functional alcoholics are not only able to go to work everyday, but they are also able to do other ?responsible? things such as pay their bills, do chores around the house, maintain a balance in their checking account, and go to church.

What is more, most functional alcoholics are able to pay for their car insurance, have a family, budget their money, and show up for their doctor and dentist visits. In short, functional alcoholics live mostly ?normal? lives with one exception: they are problem drinkers who are addicted to alcohol.

The Alcohol Related Problems Displayed by Most Alcoholics

I would imagine, however, that functional alcoholics are the exception rather than the rule. That is, most alcoholics are neither responsible nor can they function like other ?normal? people. Indeed, who can explain why so many alcoholics ruin their most important relationships, exhibit poor problem solving skills, and deny the severity of their drinking problems?

In a similar manner, why is it that most alcoholics have financial problems, are unemployed, and have mental health issues? What is more, why is it that most alcoholics display poor decision making skills, have medical problems, and get into legal trouble due to one or more DUI arrests?

The Refusal by Most Alcoholics to Get Alcohol Treatment

Ironically, the one thing that functional alcoholics and other alcoholics have in common, however, is that most of them either refuse to get the alcohol treatment they need or they ignore their problem drinking altogether. At some level I can understand this mentality for ?normal? alcoholics. I have a difficult time, however, making sense of this for functional alcoholics. Indeed, how can they live so responsibly in so many aspects of their life on the one hand and be so out-of-touch about their drinking problem on the other?

Source: http://www.budchism.com/daily-health-news/the-world-of-functional-alcoholics/

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Asbestos Compensation - Personal Injury Solicitors

Written by Felicity Dickson,

The Supreme Court in the UK has now clarified that family members of people who have died following asbestos related illnesses can make a claim for asbestos compensation.

This outcome will now allow families to gain the desperately needed compensation for the loss of their loved ones due to negligent exposure to asbestos. Shocking figures revealed that over 2,000 people die a year due to asbestos in the UK.

Additionally, the number of Britons dying from Mesothelioma is three to five times higher than in America. Thus the Supreme Court?s ruling will finally give these families a chance to start re-building their lives.

Asbestos poisoning, in many cases, is only determined once the victim has passed away as the symptoms can take years to surface. This, in the past, has led to several debates as to whether a claim for asbestos compensation could be made.

The Supreme Court has initiated a ruling, which determines that insurance liability falls when the worker was initially negligently exposed to asbestos, not when the symptoms began to surface.

This definitive ruling has not only brought a clear view to families who wish to claim asbestos compensation but also to the Association of British Insurers who stated legal proceedings were solely needed due to the protestations by a small minority of insurers.

How can solicitors help you claim asbestos compensation

Speak to a member of our team today about making a claim

Exposure to Asbestos- Asbestos compensation

During the 1950s and 1980s, asbestos was commonly used in the construction industry in the UK. Asbestos poisoning can lead to many fatal illnesses including mesothelioma, lung cancer and asbestosis. Yet the effects can take up to 40 years to materialise following exposure.

If you feel a member of your family has been negligently exposed to asbestos whilst at work, you may be entitled to asbestos compensation. Even if they have not experienced any symptoms as yet, they may well do in the future.

Time limits however may apply so it is best to speak to a trained personal injury solicitor as soon as possible as a delay may take away your right to claim. Asbestos compensation can be used to relieve on-going medical bills as well paying for an apparatus that may be needed to ease the symptoms of asbestos poisoning.

Speak to an asbestos solicitor today about making a claim for compensation. Call Duncan Gibbins on and we will be able to offer up to date information and advice regarding asbestos compensation.

Related posts:

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  3. Builder Ignores Risks and Leaves High Exposure to Asbestos in Demolition Project A Dorset builder placed himself and others at risk of...
  4. ?220,000 Asbestos Compensation Awarded to Former Hotel Boss A Darlington man, who managed hotels during his career, has...

Source: http://duncangibbins.co.uk/personal-injury-compensation/expansion-asbestos-compensation-claims/

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Doctors Really Do Die Differently ? Z?calo Public Square - luvpekn's ...

by Ken Murray

In late 2011, I wrote an essay for Z?calo called ?How Doctors Die.? Drawing on my observations and experiences as a doctor, I reported that doctors tend to seek less end-of-life care than ordinary patients do. They know when further treatment is likely to be futile and when life would cease to be worth living. The point I wanted to make was that all of us should have the choice to die that way if we wish?at home, with family, without dramatic hospital interventions, without pain.

The response to this simple idea was overwhelming. I read thousands of comments people posted online regarding the end-of-life care of loved ones. They told of near-dead relatives being assaulted with toxic drugs and painful procedures for no good reason. I am haunted by one description of a patient who could neither talk nor move, begging with her eyes for it all to stop. Thankfully, such stories are slowly becoming less common, and, with an advance directive or POLST, you have considerably better chances of having a peaceful death, if that is what you want.

While the article rarely provoked hostility, it did, among some readers, prompt skepticism. I?d written the article in a personal, anecdotal style, so I rarely made use of numbers, studies, or charts. For example, Ezra Klein, writing in The Washington Post, wanted to see more evidence for my assertions. ?Does anyone know of data on end-of-life spending for doctors?? he asked. ?Or even on the percentage of medical professionals who have signed living wills??

This essay is an attempt to address such questions. Perhaps it should be viewed as a set of endnotes to ?How Doctors Die.? For every assertion of mine that was based on observation, I?ve looked for relevant scholarly evidence that might support or refute it. Here is what I found:

First, and most important, is the question of whether doctors, for the most part, die differently. One of the clearest indicators we have is a survey from Johns Hopkins University. It?s called the Johns Hopkins Precursors Study, and it?s based on the medical histories and decisions of students from the School of Medicine classes of 1948 through 1964 who volunteered to be part of the survey. According to the study, 65 percent of the doctors (or former medical students) had created an advance directive, i.e. a set of legal documents spelling out in advance what sort of end-of-life care they would like. Only about 20 percent of the public does this. When asked whether they would want cardiopulmonary resuscitation, or CPR, if they were in a chronic coma, about 90 percent of the Johns Hopkins doctors said no. Only about 25 percent of the public gives the same answer.

I also asserted in ?How Doctors Die? that CPR is rarely as effective as people seem to think. What people have seen on television is at odds with happens in real life. A 1996 study published in The New England Journal of Medicine found that CPR as portrayed on television was successful in 75 percent of 60 cases and that 65 percent of the patients went home. In contrast, in a 2010 study of more than 95,000 cases of CPR in Japan, health professor Hideo Yasunaga and fellow researchers found that only 8 percent of patients survived for more than one month. Of these, only about 3 percent could lead a mostly normal life. A little more than 3 percent were in a vegetative state, and about 2 percent were alive but had a ?poor? outcome.

My sense that there?s a yearning among ordinary patients to have more peaceful deaths has been echoed in the research of University of Wisconsin-Madison nursing professor Karen Kehl. In an article called ?Moving Toward Peace: An Analysis of the Concept of a Good Death,? Kehl analyzed a collection of relevant articles and, based on their contents, ranked the attributes of an ideal death as follows: being in control, being comfortable, having a sense of closure, having one?s values affirmed, trusting in care providers, and recognizing impending death. Hospitals cannot help with most of these things. Unfortunately, most patients do not see their wishes fulfilled. A 1998 study published in the Journal of the American Geriatrics Society looked at Medicare patients and found that, while most said they preferred to die at home, most died in hospitals.

I discussed the tense, and often tragic, circumstances that surround many of the treatment decisions made in hospitals. Often, I noted, family members or medical staff effectively override the wishes of a dying patient. The studies I?ve found on this suggest that family plays a particularly big role in taking things in an unintended direction, especially when there?s nothing in writing. A 2003 study published in the Journal of Clinical Oncology found that most patients and families agree in theory that patients should make their own end-of-life decisions, but in practice about half of families override the stated preferences of patients. They have disagreements about the use of life-sustaining measures, and they lack written documents to resolve the matter. In contrast, a 2010 study in The New England Journal of Medicine found that people with advance directives usually receive the care they?ve chosen.

Every doctor has heard stories about people who have had miraculous recoveries, despite a doctor?s prediction. (Such stories are one reason doctors hate to make predictions.) But the sort of cases I?ve written about are those where all treatment has failed and the patient faces death soon. When applied to a patient in the last stages of a terminal decline, CPR is particularly ineffective. A 2010 study published in the journal Supportive Care In Cancer looked at terminal patients who wanted no CPR but got it anyway. Of the 69 patients studied, eight regained a pulse, but, 48 hours later, all were dead. Well-meaning CPR advocates talk in terms of ?survival,? but all the term means is that the heart again beats on its own. In the above example, survival was 11 percent, but ?survival? as often understood by the public?regaining a reasonable quality of life?was zero.

We don?t like to think about death. But that avoidance is one reason so many Americans fail to arrange an advance directive, even when they are severely ill. When patients of mine would come to my office accompanied by a family member, I often asked the patient how he or she wanted to die. I didn?t do it because the patient was on the brink of death, or even sick. I did it because I wanted the patient to think about the question and also to make sure that a loved one got to hear the answer. Unwanted futile measures, prolonged deaths, and hospital deaths remain commonplace in America and many other places. But they don?t have to be. It just requires our doctors and, no less, the rest of us to come to terms with the inevitable.

Ken Murray, MD, is Clinical Assistant Professor of Family Medicine at USC. He will be appearing in a Z?calo event, ?How Doctors Die,? on Monday, July 30.

*Photo courtesy of Ephemeral Scraps.

Source: http://zocalopublicsquare.org/thepublicsquare/2012/07/23/doctors-really-do-die-differently/read/nexus/

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Source: http://luvpekn.posterous.com/doctors-really-do-die-differently-zcalo-publi

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