Skeptic Doctor

World Food Prize Laureate Summit, 10-11-10 Ames Iowa.

2010-10-17T00:20:00.000-05:00

The first of several joint presentations by the two World Food Prize Laureates that occures on Monday night of World food Prize week each year. It is at The Memorial Union Sun Room at Iowa State University in Ames Iowa. There is a two hour reception with posters of student research projects on hunger around the world. They are judged and the winners are announced after the Laureates talk. Here are the two lectures by the laureates and the question perriod. The first question is by me.

Iowa Democratic Party Annual Jefferson/Jackson Dinner 10-16-10

2010-10-16T21:11:00.002-05:00

The event started momentously with fire alarm that was triggered by steam from a dishwasher.

After we finally got back in and everyone seated they went through introducing all the State wide candidates, all the leaders of legislature, all the congressional candidates and finally the top of ticket and the guests. Tom Vilsack and Gov Rendell introduced.
The girls safety squad led the Pledge of Allegiance and the Des Moines Gay Men's Choir sang the Anthem. Benediction given.

Sue Devorsky: we are cleaning up the mess the Republican made and they stood in our way on everything we tried to do.

Cong Bruce Braley

Congressman Bruce Braley: In 2006 we gave them hope in 2008 we gave them change and in 2010 we are going to give them Hell. We are at our best when we are fighting for people. We passed first bill Obama signed giving women equal pay.

Dave Loebsack

Dave Loebsack. We are not going to go into reverse. We are not going to let them take it back. He is very proud of what he did for military in Iraq and Afgan. He cannot believe Supreme court let corp. pump unlimited money into campaign. Lets go forward not backwards.

Cong Leonard Boswell

Cong Leonard Boswell I'm not going to kick this can down the road. We took a lot of risks and we are not going back. We are going to close the doughnut hole.

Roxanne Conlin

Senate Candidate Roxanne Conlin: WE need to retire Grassley he needs a rest. Today deficit 1.3 trillion same as when we took over. Our sacred promise to our veterans. Return to our lead position in the world in Education. The corporations haven't even tried to give me money. WE need to stand up,,,, ad a long list. Our tax dollars should buy American. I represented a raped teenager and a teen that was forced to have sex by her father for three years. Grassley would force them to have a baby if they became pregnant. I am proudly pro-choice. No No No to secret contributions.

Sen. Tom Harkin

Sen Tom Harkin. I can;t wait to have Conlin with me. I enjoy having my three cong caucus with me in Washington. THEY (THE Republicans) ARE NOT HIDING THE PLATFORM. you CAN READ IT JUST HOLD YOUR NOSE. Steve King is demanding Republicans to sign blood oath to shut down govt in Washington if they cannot repeal Health Care. They say vote out the Dem's because they have not gotten us out of Bush;s debt and recession fast enough. When emotions are high intelligence is low. Of course he talked about he greatest accomplishment. The Americans with Disabilities Act. After 29 years I see a change. people with disabilities taking a part in life with their families.

Lt Gov Patty Judge

Lt Gov Patty Judge. I have not seen Kim Reynolds. I was ready to go and Branstead jumped out in front of her and didn't let her do it. I love Chet but no-one tells me when to talk or not talk. I told her I would come to her to debate. i couldn't find her anywhere. You keep showing up when we ask. We know you will keep showing up for the next 17 days. 1st state in Nation to pass all 10 recommendations of DOD since 9/11. They are still fighting for us and we will fight for them.

Gov Chet Culver.

Chet Culver: His 14th event this week. We one last time and we will win this time. Iowa third best run state in American. When Branstead was Gov he had rank of third worse run state in Country. Branstead will cut Government by 15% but will not offer where. The budget will not necessarily be smaller. Another broken promise. He promised 300,000 new jobs his last term. He was 240,000 jobs short during Clinton's job boom. The first bill he signed was raising taxes and then did it 53 times more despite saying he would not raise taxes/. His 15% cut would be a 500M dollar cut in education. Public safety would be cut 67 million. This boils down to everything you learned in third grade math. Addition subtraction and division. I want more research, more health care. He would take away health care and decrease hawkey level of eligibility. He wants to fight Roe v Way. He wants to put ban back in place for embryonic stem cell research.

Gov.Ed Rendell

Gov Ed Rendell: Tom Harkin will go down in History as one of the greatest Senators ever. He thinks Tom running for re-election. Chet Culver has done a good job and deserves to be re-elected. One of the worst ideas is cutting pre-K in Iowa. Every dollar we spend on Pre-K we save 6-7 dollars. Dumb and Dumber. Therte is good Government spending and bad Government spending. They tried to stop our most successful programs time after time salling them socialism and they were wrong then and are wrong now. We have to follow ourPresident. The republican party are increasingly being influenced by people who are absolutely nuts.

Maria Muldaur Farm Concert for Francis Thicke (D) SCTY AG Candidate.

2010-10-16T16:27:00.001-05:00

Maria Muldaur

Maria Muldaur performed today for Francis Thicke campaign for Iowa Secretary of AG at the Des Moinesw Social Club.

I inteviewed him before the concert (see at bottom of this blog). He performed with Maria and here are two short clips of that performance.

I inteviewed him before the concert and will be posting the inteview later today or tomorrow. He basicly is concerned about the loss of the small farmer and the over importance of large corparate farms. While he is not against tillage farming he is for trying to get greater part of the year with ground coverage. Going from at most 4 months coverage to as he called it perenial coverage(though that doesn't quite make sense) I think he means 8-12 months coverage. Overall I found him very knowledgable about farming and agriculture. I is very progressive but main stream from what I learned at the World Food Prize Conference this past week

I was told by his campaign manager that they have polling just finnished yesterdaythat has them within 3 points. Which considering that the governors race has a ten point margin that is very good, if it can be trusted. Unfortunately there were only 20 people at the event.

This took place immediately before the Jeferson Jackson Dinner which is Iowa Democrats annual large fund raiser. This yearKeynote Speaker Gov. Ed Rendell.

WorConversation: More food, better food ld Food Prize:

2010-10-15T10:42:00.000-05:00

Conversation: More food, better food – improving and preserving quality

Philip Nelson – Professor, Purdue University
Great Advances in Ag production but much more needs to be done in the food chain. How do we improve micro nutrients. Cambodia had bumper crop of rice but lost 1/2 because there was no way to get it to market.

Florence Chenoweth – Minister of Agriculture, Liberia
She is trying to rebuild the Ag sector in the face a a region with severe conflict. When she was 17 she heard about hunger that showed her her future . She had career day at school and a man came and talked about hunger in the world. She had to fight to go to national Univ. She brought lawsuit forcing Gov't to let her be 1st girl in Univ. She went through Univ as only girl. 25 years of conflict destroyed the research and institutional aspects that fought hunger. El Salvador and Liberia where two countries that have gotten to 100% of food in schools localy produced. 25 years of anything that walked was eaten and any plant product nothing saved for seed. We are now rebuilding. We are not aproaching hunger holisticly, we do not discuss nutrition. Emphasis is more on suplements rather then getting it from the food.

Howarth Bouis – Director, HarvestPlus
Cereal production doubled in Green revolution while nutritious plant mater fell. Price of fish and non-staple plant food doubled. making harder to get nutrition. 80% of income goes to rice only 20% go to nutritious. This is purely an economic issue. As food prices in Nutritious food increase the % that go to this type decreases.

Dyno Keatinge – Director-General, the World Vegetable Center
We don't have not elephants in the room but tyrannosaurus Rex. Hunger and malnutrition. 1/5 of all diabetic are Indian, 1/10 of China is diabetic. Type II diabetes is a dietary induced disease. If we challenge malnutrition we have to get people to change their diets. Need to consume more Vegis less grain. It's not good enough to feed the world in 2015 if we are not nourishing it. Not all Vegetables created equal. No attention has been addressed by research on his nutirient leafy green Vegis.

Joseph Taets – Vice President, ADM Grain Group
Invest in Ag
We tranfere info to farmers small and lg

promoting Sustainable Ag
We have mult program. Doing it right in Brazil more food better food in sustainable way. Also partnering with industry]=try expert on eliminating post harvest loss

Leveraging our expertise.
In Haiti. We had 800 tons of rice and we made that rice immediately available to Haiti.

Derek Yach – Senior Vice President, Global Health, PepsiCo
We cannot look at hunger without looking at the health and nutrition aspects. The focus of pepsico will not just be on high end markets but will focus on small markets and smallholders and how do you improve the quality of the food supply. How can we embed the knowledge we have into the developing markets.

Jacqueline Morete, Farmer in Haiti.

I asked question on irradiation of food. The rep from ADM and Pepsico could offer no work by their companies about this. The Moderator reinforced that consumer is afraid they would glow in the dark(which is not true) and almost no-one is doing any work on this.

Pepsico will cut sugar in it's products by 25% and within two years remove all coloric drinks from schools.

World Food prize: Hon Rajiv Shah Head USAID: Hunger Fighters

2010-10-15T08:53:00.000-05:00

Rajiv Shah

Hunger Fighters: Rajiv Shah

The Administrator of the USAID program.

Norman Borloug Commemorative research initiative.
First effort to work on wheat rust UG 99. 80% of wheat in USA susceptible to this. Generating rust resistant varieties. Convert CGAIR into several Mega programs. Time to crisis to a few days. Work on the first 1000 days. Move away from monetized assistance to extension aid. Create markets for smallholder feed the world program. $20M directly improve income of smallholders. 1/3 of Tanzanians below poverty, 1/3 of children show bodily stunting. Joining with Gov't of Tanzania to three central regions where they have highest potential for growth. Rather then have diluted country wide program. we are focusing on small area that we can have success. we are building roads, Japan building reservoirs and World Bank developing rice strains for region. Our policy will lift 2M women out of poverty.

Feed the Future Private Investment Sector: Facilitate small business in regions of need to work with those in need.

This is not just happening in Tanzania. In Bangladesh, Ethiopia they have program to invest in sub region and small number of value change. These programs will lift 1.6M children out of poverty. This is in only four of the first twenty countries and in only sub regions. Imagine when we can learn and replicate this we could have a foundation for a new sustainable Green revolution.

Kofi A. Annan,Ending Hunger in Africa. AGRA

2010-10-14T10:09:00.000-05:00

Ending hunger in Africa:Change is now within our Grasp says Kofi A. Annan former UN Sect-Gen and current CEO Alliance for Green Revolution in Africa (AGRA):

Kofi Annan

" Africa is only continent which does not grow enough food to feed itself"

"Never before has there been such a collective drive for change"

The millennium goal of reducing hunger by 2015 will obviously not be met. The goal is not to to eliminate hunger but to make it a sustainable system.

Our goal is to make smallholder farms Profitable sustainable and .

All African Govt to put 10% of their budget into agriculture and drive a 6% growth per year in production.

Central role of women farmers is finally becoming front and center. However, rarely do they have title for land and they have problems with getting their product to market. Less then 3% of all bank lending in Africa is ag related.

At last conference a large number of Bankers were present and this makes me optimistic about Africa's ability to turn the corner. If we miss this current opportunity I don't know when we will get another chance.

Without a stable peaceful Africa our ambitions will not succeed.

World Food Prize: Overcoming Major Constraints Facing Smallholders

2010-10-14T09:24:00.001-05:00

Uma Lele, World Bank, Chaired session 1
How do we bring all the expertise of the panelists together so each is not in a silo.

Rolf Derpsch: soil expert.
We hear very little about problem of degrading soil. We need to focus on soil. We cannot produce crops if soils are eroding away. Degradation and sometimes irreversible destruction of soil have reached frightening level of degrading ability to grow food. >10 M Hectares are destroyed. Plowing degrades soil, Soil erosion, desertification. Intensive tillage leads to erosion and is largest cause of soil degradation.
First :Stop soil degradation
Second:Build soil with calcium and nitrogen.
Conservation agriculture no tillage
Permanent soil coverage
No Tillage
Crop rotation
With no-till farming Brazil double crop production.

Dr. Joseph DeVries: Dir. African Seed System
Very optimistic because of increased supply of improved seed. Seed is maybe the most deliverable. Improved seed is the basis of the who;e green revolution. Lack of improved variety and problem getting seed to farmers if you have that improved variety. We are starting to see improved seed. 150varieties recently released. Micro delivery by bicycle seed dealers. Micro packs. With better seeds can double yield from 800 KG /HA to almost two tons with both fertilizer and better seed.

Dr Nuhu Hatibu: CEO Kilimo Trust.
Africa had green revolution in the 50's before the other green rev. of the 60's. There was markets, irrigation. The markets are the key to making sure the farmers are sustainable. Without markets that give fair prices the farmers cannot suceed. Don't do good by us but do business with us.

The world has changed drastically in the last forty years but our conversation on food has not changed. We are trying to reach 30K farmers to teach them to be independent farmers. Multiple projects. Get information on crops and pest by cell phone to farmers in India. No till demands the application of modern fertilization products and challenge organic farming.

Stephanie Hanson Dir One Acre Fund
Constraint of finance. 30K farmers in Kenya and Uganda. Large banks do not want to do small farmers also micro finances are mostly urban. They provide micro-finance plus. They lend seed and fertilizer instead of cash. they have 150 market points in Kenya and 200 in Uganda. Within walking distance. The farmers receive it in credit and repay it as they sell their crops. Need to teach them how to plant and timing and how to use fertilizer. Repayment rate of 98%. They are doubling farm income. $1.4M is 65% of there budget.

Sarah Munalula, smallfarmer in Zambia
42, four children 1990 she stopped school (soshe went to school till 22) She had to farm because of economic pressure. They could not plant variety. 2007 they got pioneer seed and she planted variety. Six Hectares owned but she only planted one hectare. With Pioneer seed she has increased from 18X55 KG to 180X55KG of maze and now is very successful. She is now chairperson of womens cooperative. The new seed from pioneer is the crucial change.

Nourishing The Planet: World Watch

2010-10-14T08:07:00.000-05:00

Danielle Nierenberg: State of the world pre-release. Visited 200projects across Africa tosee what is working in Africa. Full report released inearly Jan 2011.

Brian Hal : Hunger persists. A policy of agricultural abandomment exist in Africa. Africas food output hasbeen focused on raw commodities not on added value.
First :Make better useof water,there is much greater potential that is not being tapped. As little as 5%gets to crops. Increase mulching, tilling. can increase yeild 20-135% Return on investment was so fast that 5 years later farmers will still use it and spread to surrounding farms
second:Make sure all the post harvest loses are minimized. This can be simple and very effective. Better storage, quickly get rid of spoiled produce, better drying.Community storage very effective.
Third: plan for more farmers incities. By 2020 35-40M African will relie on urban agriculture. There are many models for urban farms.
Fourth: Pay for programs for farmers to store carbon in the soil.i.e. keep farm planted more of the year plant trees. 75 project in 22 countries that are working on this. Great GreenWall initiative and the Billion tree initiative.

Dr Dyno Keatinge: Humanity doesn't live by caloriesalone. We need diverse diet. Grains are just calories. and are 50% of food eaten. We have 2B people who are malnourished. Very few nuts and berries in diet. This is major cause of epidemic of type two diabetes. The Green Revolution is doing disservicebecause we have cast into stone that we put our effort predominately into grains. Malnutrition is principle thing we need to address. Not only to feed the planet but nourish it as well. Rateof return in rice/wheat there is very small rate of return since there are so many people in it. In nuts berries and other side crops the rate of return on $ can be very hi 3-400 %. Broader crops are more likely to help break out of poverty and also address nutritional/vitamin deficiencies. Don't give up what we are doing but expand to other typed of crops.

Hans Herren:Agriculture at the cross roads. We need a paradineshift in agriculture. In particular we need to look a changes from on that produces green house gases to one storing carbon. We need a Brown Revolution in Agriculture. Biggest return on research comes from one program. this was using natural means with zero cost to farmer that preserves the crop better. This is the most easily implement low hanging fruit. If we want to move over into sustainable ag,we need todo these simple steps. Indirect investments. Infra structure, markets,

Analysis: Socialism is Dead in Farming. #foodprize #globalag

2010-10-13T16:02:00.001-05:00

Borlaug World Food Prize Day 1 and Keynote

"Poor farmers are not a problem to be solved. They are the solution." -Bill Gates

The data shows(from almost everyone who spoke) that small holder farmers do as well if not better then large farms or collective farms. The risk with collectives is that the small farmer is ultimately forced out by automation and efficiency of scale leading to an underclass with no hope of getting out of poverty.Examples from all regions were given of going in both directions and how forming collective was disastrous and helping or developing small holders improved both the yield and the level of food security and economics of the small farmers. The critical thing is not to give someone a fish but teach him to fish. This includes several aspects

Access to markets (Howard Buffet's $13M donation) Roads, develop markets.
Ensure the farmer gets most of the market value and it is not lost to middlemen or to the known 1/3 loss of produce between production and consumption.
have to ensure that there is no land grabbing. This is biggest risk to future development.
R&D the best research to help produce the maximum yield. Increased yield is better for environment. It leads to less water need, It allows diversity of crops.
Fertilizer subsidies are good as long as they are not robbing from other aspects that will make the farmer self sufficient rather then dependant upon government subsidies.
Education. You have to efficiently teach the small stake holder farmers to grow properly. Extension services critical.
Make the farmer the stakeholder in a small farm(even as small as a tenth of a hectare)
Get production up to 3 tons per hectare.
Stable government, in multiple examples going from stable govt to unstable led to drastic drop in production and the reverse going from unstable to stable led to amazing increases in production.
need commodity markets to avoid price volatility

Five step(of Dr. Vo-Tong Xuanon how to do this in developing area

Field survey
Verify tech to be adopted
Design water management system
investment projects essential infrastructure
production of rice

Ambassador Quinn does welcome:

Video:

Howard Buffet:

Pradhu Pingali:

Conversation: Smallholder successes around the world

Pedro Sanchez – Director of Tropical Agriculture, the Earth Institute at Columbia University
When you go from 1 ton per hectare to 3 tons you cut water loss and help climate. Growth stunting of kids reversed.

Shenggen Fan – Director-General, International Food Policy Research Institute Grew up on small farm. He was child labor(LOL) policy is very important. Investment in rural roads. Decentralize collectives to small holders.

Ruth Oniang'o – Editor, African Journal of Food, Agriculture, Nutrition, and Development

Ajay Vashee – President, International Federation of Agricultural Producers

Vo Tong Xuan – President, An Giang University Viet Nam second largest rice exporter in the world all on the backs of small stake holders but could not have been done without scientific help. Closed university for 2 months and 2000 students were trained how to make good seedling and how to grow rice. they went out and trained every farmer how to do this on 1/10 of hectare. With this experience he feels that they could do this in Africa.

3:00 pm
Conversation: Smallholders as entrepreneurs and innovators

Louise Fresco – Professor, University of Amsterdam
She talked about the importance of teaching that there are markets and there is a chance to be an entrepreneur. It does not come natural and there is resistance but once they see it they quickly do well.

Marco Ferroni – Executive Director, Syngenta Foundation
He works on extension and linking farmers to markets. For farmers to become entropenaurs need

knowledge
Technology

Eleni Gabre-Madhin – Director, Ethiopian Commodity Exchange
increased tonnage 1.5 to 2.5 per hectare however overwhelming market concern. 50% price volatility year to year. highest in world. 2002 prices collapsed because of good harvest. crop prices collapsed so much the farmers couldn't afford fertilizer so next crop fell to point that Ethiopia had to import massive amounts of food. Contract failure also significant problem. this now gets fair price for farmers and also the farmers know what they have to do produce higher grade of coffee. Farmers aggressively try to improve the grade of their crop to get paid higher. This is free enterprise and not handout.

Rajesh Kumar: had 2 acre farm in small village. Did small kiosk to sell sweet corn both fresh, steamed and roated. Now they have 200 kiosks and also sell kernals. now has 200 Hectares. They have 350 contract farmers that get the produce sold at a fixed price. The kiosks are managed by college students who can study while they man the kiosks.

Kamal El Kheshen – Vice President, African Development Bank
Largest development financial institution in africa $ 100B They got completely out of HIV-aids since there are so many other NGO's involved. But they are getting into HIV vaccine since there are not many investing in this.Doing irrigation scemes in large way.Tripple F crisis Food-Fuel-Financial. Small Holder 80% of work done by women. Micro crdit. Market development.

Shivaji Pandey – Director, Plant Production Division, UN Food & Agriculture Organization
Invest in local community so they can take care of themselves. Walk the talk, don't just criticise.

I will be posting videos and photos as they get processed so check back.

Gap Report:Is there enough to feed world: #FoodPrize

2010-10-13T13:09:00.001-05:00

World Pop will hit 9.4 billion by 2050.

WE need to double global agri output in 40 years. we are now growing at 1.4% per year and will be short by 30% we need to increase to 1.&% to reach these goals. Population growth is heavily front loaded. By the time we get to 2050 pop growth will plateua. Any investment take time to pay off.

Keith Fugile: Rising Global Agri Prod,:
in last 4 years we have only grown productivity by 0.8 percent. way below what we need to be. We can get more output will increased acrage or increased yeild. TFP growth: increase productivity at all levels.
TFP total factorproductivity. this is mostly due to new technology.this is 1.8%per year . no other eresources have increasedin USA. China and brizil have 3% per year. SSA have <1% TFP growth. Countries need both research and extension/edu capacity to maintain high TFP.

Bill Lesher:Concluding remarks.
Water will be one of the main battles.:
Watch his closing remarks.

I will be updating this over next two days as I proccess video. Check back.

Five areas of e
r&d
international trade
private investment
streamline international development
Science development

1st quest: Is it not inadequate to only focas on TFP:

I will be updating this with video and questions. So check back over next twodays.

Borlaug CAST Communication Award

2010-10-13T08:54:00.000-05:00

Wed. October 13th, 2010

Jay Vroom President of Croplife America Foundation:
Dr John Bonner, Exec VP CAST- Council for Agriculture Science and Technology. Dr Borlaug was for the last three years of his life was a communicator first and foremost. He received an award from Cast in 1973. He told cast they had to expand their borders beyond Iowa and the USA. He commanded that CAST needs to not just research and develop but needs to communicate their work. Dr. Borlaug was critical in increasing support for CAST. He wrote the 1st paper published on CAST and 26 years later his last paper was published through CAST.

Dr. Pedro Sanchez presented the award to Dr. Akin Adesina. He is an agronomist with chlorophyll. At Purdue he is the VP of AGRA- Alliance for Green Revolution in Africa. He developed idea of small crop shops run by families. He came up with idea for micro lending in Africa.

Dr, Akin Adesina: I am honored to win this first renamed award after my hero Dr. Borlaug. Sci and tech critical to improve agriculture. His father told him 'If god even enables you to influence the world make sure it is in agriculture.' Africans are not benefiting enough from the science and technology available. Support for Ag has plummeted. the Gains of the Green Revolution have eroded. World Food Crisis was a wake-up call. The world needs to double efforts for food production. We must lead the power of Sci and Tech to the most powerful force that of communication. Agriculture has been managed as development program but it is not a development program it is a business. You can not eat potential. Need to improve access. Increase Agri dealers across Africa, He took plan to African Union and he organized a summit to accomplish this. The African Fertilizer Summit occured. Dr. Borlaug strong armed the attendees to implement the plan. Wehave long pursued policies of abandoment of the farmers of Africa. We have to subsidize the farmers. It is cheaper then importing food. Plans to take African agriculture from development to a real Business. Need to improve acessto markets so farmers can make profit or this will never work. We must put in mechanisms to ensure adaptability to envirnmental change. There is no such thing as half freedom we will march to freedom when our stomachs are full, our kids are fed and our farmers are self supporting. Then we can say Free at last, free at last.

Iowa Hunger Summit, #Worldfoodprize Des Moines Iowa 10-12-10

2010-10-12T10:25:00.010-05:00

9:00 AM “Livestock’s Role in Reducing Food Insecurity”

Organized by Elanco and Heifer International

The Elanco Speaker, Kevin Watkins, presented data that in 1990's we were getting ahead of hunger in the world and the number of those hungry was going down at a good rate. Then in this last decade the number of those in hunger has risen to some of the highest levels seen. He talked about how improving hunger improved almost all aspects of their live. Improved performance in school, better health on several metrics, improved economic situation. He showed how one glass of milk and 2 ounces of protein a day was all that was needed to supplement diets and see measurable improvements.

The Heifer International speaker, an organization which gets livestock into the hands of poor and hungry, do complex engineering of their lives. They teach them how to manage the environment and their livestock. They are taught how to use the animal waste for fuel and fertilizing, how to use hoses to irrigate their fields, how to have safe fireplaces and burn fuel safely(one of the largest sources of death and disease in the third world). They have developed models of how to work in these communities and get the most bang for the buck.

You cannot just give them food. You have to ensure that what you do is sustainable. They require 'Pass-On' were they person getting the livestock shares the result. i.e. community that received ducks the fertile eggs are shared so more and more in the community can support themselves and self perpetuate.

10:00 a.m.

"Starving for Knowledge: Nutrition, Brain Development, & Education"
Mary Minter Hanson, Global Health Consortium: introduced panel. Dr Shah, not on panel, organized the GHC to work on health issues . It is a consortium of all the colleges and Univ. in Iowa.
Dr Robert Zore, Millennium Dev Goal. $ of seven are health related. Underrate/stunting/wasting is simply precursor to child mortality.Uganda: 17% underweight, 38%stunting, 128/1000 child mortality

Two Students will present their work on brain development.

Heme is critical for Brain development. Need to make sure you get enough iron. If not your brain does not get enough oxygen. Iron is the #1 deficiency in the world. Vit C is critical for brain development. Need to get it continuously not in spirits. Countries with high vit C production have some of the highest deficiency since it is exported.
Vit D. New appreciation of importance. Controls 900 genes in the Brain. Motor development, socialization.

Dr Jenifer Hall on impact of Iowan food on other countries.
Lindsey Willstra Grad Student,

Organized by the Heartland Global Health Consortium

11:00 a.m.
“Local and Regional Food Systems:
Countering Food Insecurity in Iowa”
Organized by ISU Extension and the Leopold Center for Sustainable Agriculture
Food Insecurity, access to food on a regular basis. 11% of Iowa do not have enough food. Leads to poor health, physical limitations, more chronic illness, stomach and headaches, more hospitalizations, anxiety and depression, psychosocial dysfunction.
Rich Pirog: Leopold Center
Supply of food. How do we build a local food system. Leopold Center State funded on tax on nitrogen fertilizer. Leopold center charged by legislature to develop sustainable local food plan. 12 key issues to developing a Local food economy:

financing
incentives to farm
Access to land
Insurance
Education-tech
Regulations and policy
workforce
Aggregation/distribution
Marketing Network
Consumer Ed
Data Collection
Resources to pay for programs

Regional food systems working group. Umbrella network of stake holders to develop sustainable local food programs.

Angie Tagtow, Iowa access &health working Group. Emerging group just launched 3/10 six meetings so far. 32 partners,

Brenda Ranum,Iowa food and fitness initiative
Link health with food. Work in 6 counties in NE Iowa only 100,000 people. Ensue school district policies support healthy living. Local food procurement policies, Farm to school program. Goal two: Ensure local healthy food is available, mini-grants and micro-loans, food safety Certificate process , regional food directory. food sales by farmers increased 1.2 million $'s.

Bahia Barry, Southwest Iowa food and farm initiative.
Least populated counties and also most elderly area in Iowa. Mission: build a sustainable regional food system that link production, processing, distribution and consumption. Successes,connecting farmers to farmers markets, awareness building, Farm to School, Link Urban rural projects, Moving forward: issues- infrastructure, transportation, aging populating. Encourage increased participation in human food based agriculture. Increase fresh food in emergency food supply.

12:00 p.m.

The World Food Prize presents the “Hunger Luncheon,” featuring meals used by Iowa-based organizations in food assistance and hunger-relief efforts.
Keynote Address by Tony Hall, director of the Alliance to End Hunger and three-time Nobel Peace Prize nominee

Ambassador Quinn welcomed everyone and told about in this fourth year there is a record attendance.
FDL Financial and Iowa Farm Bureau pledges to sponsor this Hunger Summit for the next five years. $150,000 donation toward the Hall of Laureates.

Ambassador Tony Hall was charged by GW Bush to Feed the world and end insecurity. He has been to 130 nations in the world. 1984 was in Ethiopia during worst famine. OUr elected officials have fallen way short of what the public wants. During the next few eeks go ask the candidates about hunger issues. Mother Teresa: What I do is a drop in the Ocean not a bucket but without out it there would be one less drop.
Iowa
efforts to reduce hunger in Iowa
Last year in 2009.
$ 8,720,000
15,600,000 pounds of food
451,000 hours

This year 2010 in Iowa.
9,380,125 dollars
18,266,006 pounds
539,086 hours.

Side conference on agriculture and health and nutrition. This was amazing. It was like being a fly sitting on the wall. Here were seventeen of the Worlds leading experts on Hunger(see links). Almost everyone has a wiki page. They were discussing how to organize a conference coming up. It was amazing to see this level of negotiating and international discussion. I learned a lot.
Prabhu Pingali from the Gates Foundation.
Rajul Panlya-lorch
Why despite economic growth in India the poverty levels have remained high. We are trying to see how economic growth ensures less poverty and better health.
Conference in India. This is the planning meeting. for "Leveraging Agriculture for improving nutrition and health"
How do you nutritionalize agriculture.
The summary of the conference schedule was reviewed.
Sukhadeo Thorat: Need to improve nutritional value not just quantity of food.
Barbara Underwood: Nutritional impact.
Peter McPhearson: have to make sure that the three professions: Agriculture, Nutrition and Health all need to internalize the other two arms of the conference and not just give lip service to it.
Emmy Simmons: Are we actually do what the title says or not be about production alone but about all aspects of the food-eating - health train.
MERIDITH Soule:Are we really getting into the nutritional and the consumer choice part.
DEREK yach:Health relation from this needs to be greater. Also the issue of livestock. Sweden when they saw that CV was major cause of death they changed their entire food chain to take care of this.Need to deal with satiety and affordability. Need to address subsidy issues.
Bibi Giyose:We need to discuss the systems to implement the changes. without a good system this will not work.
daSilverta Pimleiro:We need to ensure the quality and that contaminated food is not produced/shipped/sold/consumed.After conference make sure those suggestions are implemented.
Prabhu Pingali : Obesity needs to be addressed also. Session on governance and excluded populations, we also need discussion on excluded regions.
Kabba Joiner: We have to avoid a one size fits all solution. The side session on communication tools. Health people cannot communicate. NCD's (non-communicative diseases) What went wrong that increased NCD's. We are all individually comfortable in our comfort zone and we do not like to move out of them. We need to make sure people move out of their comfort zone.
Christian Henckes:Describe at beginning of conference what our view of the future How can it look like. Then let conference figure out how to get there.
Lisa Dreler: How can you create the institutional structure that comes out of the suggestions.
Marie Ruel:Make sure nutrition and health are not just outcomes but are the driving force. The first 1000 days. The target group for malnutrition health vs food born disease health is critical and a big gap.
Stuart Gillespie:How do we design and implement nutrition sensitive agricultural issues. There are very few examples. How do we make visible joint incentives.How do we find all the stakeholders that we don't know about now( suggest to him a moderated poster session.
Peter McPherson: How can we make the 3 disciplines see that they are overlapping? That is the dominant theme I hear here.
Prabhu Pingali: The title is fine. Most of these populations are primarily agricultural and not nutritionists or health workers. You don't want to lose their ability to be good farmers.
Derek: Get historians to present how these three fields were historically linked in Hippocrates, Maimonides.

Shenggen fan: Summed up what everyone said and discussed the plans for the up coming conference.

ACLU Iowa 75th Annual Meeting 10-9-2010

2010-10-09T14:54:00.009-05:00

I covered the meeting for WHO Radio and for my Blog.

ACLU Iowa

Workshop 1: Racial Justice

Dave Kuker: Very disproportionate number of people of color incarcerated. Most arrest though are misdemeanors. project implicit a site to test your prejudices. They have tests on multiple items including race. People of color at all stages of criminal Justice system have worse outcome then kids of non-color. A lot said and basically can be summarized as if your of color the system is against you no solutions or suggestions at all.

Keynote Speaker. Robert Sheer, journalist and social, political commentator.

Covered Vietnam war, 6Day war, interviewed Fidel Castro (first American), interviewed all presidents from Nixon to Clinton. The Great American Stickup is his book just out. Truthdig.com will be having his talk on video.

Robert Scheer

He recommended check out Paul Conrads writings. He talked about the topic of his last two books were abuse of political power and abuse of financial power. Freedoms and local control broke down with the alien and sedition laws. The founding fathers foresaw that if you tried to be an empire you would loss individual freedoms. Washington talks about this in his Farewell address(full Text). Instead of trying to figure out why 9-11 happened we just used it to increase the military budget. When it comes to war and peace rational discussion of freedoms and specifically freedom of the press take a back seat. You can not have a republic and an Empire at the same time. An empire by definition is more totalitarian.

You go to war forget a free press. He talked about how 9-11 report has disclaimer that they had no direct access to witnesses but had to submit questions through military. So even presidential commission did not have free access to info. How can we expect reporters to do better. Pat Tillman and Jessica Lynch are examples of how military lies to press. The military try to change the stories to aid public image of war and not the truth.

Our economic meltdown. Ronald Reagan wanted to remove regulations but then savings and loan debacle hit and he pulled back. Clinton ended federal obligation to poor people i.e welfare reform. Then Rubin got rid of Glass-Steagal act. The in 2000 the commodities future act. He asked to have it explained and was told it was too tricky to understand and was referred to lobbyist working for Wall Street. Formation of Citigroup was major blow to the protections in place from the 1930's. He went through micro dissection of mortgage breakdown. Nothing new but very good summary.Informed public making basic decisions about public policy. He implied that we do not have an informed public but a deceived public.
Questions: No ones going to touch Social Security. There has been no more successful program in USA.
Person hood of corporations: Corrupting our political system. Should FOX news be considered a political party and not a news media. They are news said Scheer

Inteview with Robert Scheer

Workshop :Media:Are newspapers dead? The Future of in Depth Reporting. Rekha Basu, Kevin Cooney, Joyce Russell, Brian Steffen.

Brian Steffen-communication Prof Simpson four of his 16 students did not know the name of the Governor. They had an average score of three out of ten. There were a couple of college students that only got Pres Obama right.

Joyce Russell Iowa Public Radio:New ways to get news since newspapers are cutting back. ProPublica new type of free lance investigative news agency.Iowa center for news. web site.

Rekha Basu

Rekha Basu:Newspapers are not dead but they are morphing. The Des Moines Register is no longer calling itself a newspaper but a media outlet. In India her mother reads 6 newspapers a day and is typical. She also went into a journalism class and only a few of the students read newspaper on daily basis. We cannot be everything to everyone. WE can bring contextual information you can not leave to chance.

Kevin Cooney

Kevin Cooney:We are not as interested in medium but the message. They will die but that doesn't talk about the message, i.e. in depth reporting. That is decreasing because the media cannot pay for it.

Robert Scheer: Predictions of death are premature however the real question is will journalism survive and it will. Readership is way up but profits are down.We are now subject to a ruthless honesty that our predicators did not. Journalism should be driven by passion not that you are making a big living. I wrote a column attacking proPublica. James Leach (former US Rep.Iowa(R)) led fight to get rid of financial regs and is the Chairman of the Board of ProPublica. We are not the Good Old Days but the future is much more promising.

Workshop 3: LGBT: Marriage equality. Mostly a report on the retention vote and were public opinion is on gay marraige issue. The most interesting item is that on Tuesday Oct 19th at Simpson College West Desd Moines 1450 28th Street between 4:30 and 6 pm there will be the only discussion between both side with Van De Platts being there. All must attend.

Performance by 'Thursday's Children' did musical based upon the Tinker case. Here is one song from it.

The Garst Family Tribute. over 50 years of the Garst family supporting the ACLU.

Jonathan Turley: Shapiro Chair for public interest at George Washington Univ.Legal Expert for major news outlets. Considered one of the top 100 attorneys in the country.
Fantastic victory in Iowa on civil liberties. Stripping the court of these three judges is an assault upon all civil liberties. Why we have independent judiciary. The Independence of judges is important to protect us from people of ill humor.by Jefferson. At issue is not the future of these judges but the future of all Iowans.
Many Judges want to be Judge Judy and engage in outrageous actions. Discussed Supreme Court. A deeply flawed institution. He has suggestions to fix it. Increase court to 19 members. does not have ability to reform itself. No term limits and serve for life. Madison is only framer that looks good. He was trusted by both sides. He would have been a member of ACLU he insisted on and wrote Bill of Rights. Mandatory retirement at 70. his pick of nine greatest Justices of all time: We have a disfunctional political system.

Jonathan Turley: Supreme Court Flawed, History and Fix Part 1

Jonathan Turley: Supreme Court Flawed, History and Fix Part 2

Jonathan Turley: Supreme Court Flawed, History and Fix Part 3

I will be covering the World Food Prize and the many associated conferences and lectures and will be reporting on them her.

Future Party: A Rational Response To The Tea Party by Alan Koslow M.D.

2010-10-02T19:58:00.006-05:00

by Alan Koslow M.D.

I am dismayed. I see a growing political movement that is based on looking to the past for answers. They believe the worlds is static and that solutions to current day problems can only be found in the political writings of our Founding Fathers. However, they like religious fundamentalists tend to pick those writings of these venerated Founding Fathers that support their views while ignoring those that refute it. The worst is that they do not see the need to change the game plan as the game changes. I felt this is a critical time to bring a rational perspective to the national political climate. It is the right time to birth a new political movement: The FUTURE PARTY.

The Future Party Manifesto

Where as: Public policy and politics have become irrational, and

Where as: Our Founding Fathers were products of the Enlightenment: and

Where as: The founding documents of the United States, including the Declaration of Independence and the Constitution, are based upon Enlightenment philosophy, and

Where as: The world is not static, and

Where as: Global Warming will make our future more uncertain, and

Where as: We are moving into the Future not the past, and

Where as: The rest of the world is moving into the Future at a faster rate then the USA, i.e. the world is flattening, and
Where as: The Scientific Method is well established as a way to understand our physical world, and
Where as: Rational, critical thinking is often lacking in our political process, and
Where as: Every human being have the right to Life, Liberty and the Pursuit of Happiness as defined in the Declaration of Independence, and
Where as: The majority does not the ability to deny a minority the same rights that majority enjoys, and
Where as: Our fore fathers came to the United States to escape religious intolerance and of all our freedoms the first one enumerated in the Bill of Rights is religious freedom and separation of church and state, and
Where as: The Constitution establishes that there shall be no religious test for office, and
Where as: Our politicians are for sale because of our campaign finance system, and
Where as: Our political system has deteriorated into One dollar One Vote instead of One Person One Vote, and
Where as: Corporation are not persons
Therefor:
We Pledge to: Restore sanity and rationality to public policy and politics, and
We Pledge that: The best scientific knowledge and predictions will be used to form public policy, and
We Pledge that: A Manhattan Project approach to solving Global Warming that does not cripple our economic system will be implemented, and
We Pledge to: Base all political solutions on Enlightenment principles and concepts, and
We Pledge to: Ensure all students are taught critical thinking skills in school starting in pre-K, and
We Pledge to: Ensure all students graduate High School with adequate science skills to understand our physical world and the scientific method that teaches us how that world functions, and
We Pledge to: Ensure all students be taught financial skills to thrive in our complex financial world, and
We Pledge to : Make Consumer Contracts and User agreements be required to have a plain word summary that would fit on a single page, and
We Pledge to: Eliminate the concept of person-hood for corporations, and
We Pledge to: Eliminate private financing of campaigns and have only public financing or small dollar individual contributions, and
We Pledge to: Ensure the freedom of religion, that our fore fathers felt so important is granted to all persons in the USA including the right to not have a religion, and
We Pledge to: Ensure the constitutional demand that NO religious test be used for public office be enforced, and
We pledge that: Theology will not be a basis for public policy and we will fight to uphold the first amendment, and
We Pledge that: College and professional school be affordable for all and not be a barrier to anyone, and
We pledge that: All persons in the United States will have health insurance, and
We Pledge to: Have a pathway to citizenship for all illegal aliens that have not committed a felony, and
We Pledge to: Have a rational visa system to allow enough seasonal workers to come into the country to fill the need not filled be legal residence, and
We Pledge to: Fight for human rights of all, regardless of how small or outcast a group they are in and regardless of age, race, country of national origin, religion (or lack of), sexual orientation, sex or philosophy.

This is a document in Flux. I have already made two major changes. As I get feedback and comments I may make more. i recommend if you are interested in this you re-check this on a weekly basis. I will also post major analysis and academic analysis as a separate blog on 'The Future Party' Blog.

Fools Rush In: Saving Two Lives

2010-09-26T15:10:00.000-05:00

I started another Blog, 'Snippets Of My Life', here is a sample. If you like it go to this link and follow that Blog also. Also please leave comments.

We were living in Vienna Va. and I was working at the American Red Cross Blood Research Laboratories at the NIH campus. The director of industrial design for the Am Red Cross was the regional director of the Industrial Design Group. They arranged a trip to the Amish area of Pennsylvania to tour the John Deer design facility. We had great tour of the design facilities and saw some of the first 3-D CAD systems in the world. We then all had dinner at a family style Amish restaurant. And we left to drive the two and a half hour drive back to DC at about 8 P.M.

We started driving on route 83 from Pennsylvania toward Baltimore. There was a detour and we had to leave the highway and go on a small two lane road that went through a very mountainous area near Hereford MD. Margie was driving and I was sleeping in the passenger seat. All of a sudden Margie stopped short thrusting me against the seat belt. I quickly awoke and looking out the windshield I saw in front of the car before us a tractor trailer laying on its side having rolled over between 120 and 150 degrees, about halfway between being on it's side and being on it's top. There was fuel spilling out of the tank onto the road. I rushed out of the car to the tractor and climbed up to the drivers window.

I climbed up the twelve feet to the window on the drivers side and looked in. I could see the driver trapped by the steering wheel and climbed through the window. He groaned "my brother". All I could see was a massive amount of chains in the back seat of the cab. I quickly realized that his brother was under all those chains. I quickly started to dig out the brother from under out. He had been sleeping in the back seat. Fortunately, I was able to get his head exposed. Neither of them were conscious at this time. It took almost 17 minutes for the local volunteer fire department to arrive. During that time I was keeping the neck stable on the brother in the back seat (I suspected a severe neck injury from having hundreds of pounds of chains fall on him (they were in the compartment under the matress he was sleeping on). Also he was unrestrained and likely to have injured his neck. While I was doing this the driver, his brother vomited. When the Hereford volunteer fire Dept arrived I refused to leave until someone with at least comparable training to myself arrived. I had worked seven years with the FAST team of western NY, was an EMT, had three years of surgical residency behind me. I explained I was already in the best position to render aid and the best skilled at the scene. They explained it was a highly dangerous situation because of the hundreds of gallons of fuel that had spilled. I told them you take care of the fuel and hand me two cervical collars and IV catheters and bags. I started an I.V on each. BTW there was not enough room for anyone else to come into the cab. I was doing this all upside down.I placed an cervical collar on each of the men. Several times I had to clear their months from vomit. I was given the Menaris France Award For Valiant Service in Emergency Medicine at their annual dinner in January 1984.

The Go team from Baltimore Shock Trauma Center was just recently organized and had not flown a mission yet. This rescue was their maiden rescue. The unique aspect of the team was that they had a surgeon, anesthesiologist, trauma nurses and carried O-negative blood for field transfusion. They could set up a full field surgical unit. They arrived about 45 minutes after the fire department and I allowed them to take over from me. I slowly backed out of the cab and was helped down by several of the firemen. It took them nearly 2 hours to get the men extracted. They had to get a crane to lift the cab. They first got a twenty ton crane and it was not enough finally they got a 45 ton crane and were able to get the men out of the tractor cab. We were finally ablee to get on our way about 2:30 in the morning. I took thee next day off from work and slept in. I was given the Citizen Award by the Baltimore County Fire Department. The two men both survived after weeks in critical care and months of rehab.

This Blog Snippets of my life, is going to be a daily blog for at least one year. I will tell stories about me that I hope you find interesting. If you like them please do two things: click to become a follower; and post on your Facebook page or twitter them. I hope to have 10,000 followers by years end. Some stories will be very personal. I will try to remember the correct names of those involved, however, I have a terrible memory for names and some names will be completely fictitious. The stories however are completely truthful as far as I can remember. Hope you enjoy. Some of these blogs may seem mundane. However, they

I RESIGN: Candidacy in Iowa House District 60

2010-09-12T16:23:00.000-05:00

I am(or was) the Democratic candidate for the Iowa House District 60, composed of most of the Polk County portion of West Des Moines. I am running against Peter Cownie the incumbent, who I ran against and lost to two years ago when it was an open seat. Two years ago he out spent me 17 to one. His father is Jim Cownie, one of the founders of the cable network in Iowa and after selling it in 1991 one of the richest men in Iowa. Peter Cownie has distinguished himself in the House with a lack luster first term. Looking at his website he can not even site a single accomplishment or single bill he introduced, other then his committee assignments. He has not a single new plan since he ran two years ago.

We have developed not a meritocracy but an affirmative action system for those of privilege. the system we have of private funding of campaigns through raising campaign contributions has led to corporatization of the United States Congress and our State Houses. We have representatives and senators at all levels costing the Government much more money because they spend based upon their contributors interest rather then the fiduciary interests of the public, their voters.

I feel we are long over due for a Clean Election Bill here in Iowa. There have been lots of court challenges of this because of potential unfairness to third part candidates. As described in Wikipedia:

Unlike traditional campaign finance laws that focus primarily on restricting spending and placing caps on campaign donations, Clean Elections laws provide a public grant to candidates who agree to limit their spending and private fundraising. Candidates participating in a Clean Elections system are required to meet certain qualification criteria, which usually includes collecting a number of signatures and small contributions (generally determined by statute and set at $5 in both Maine and Arizona) before the candidate can receive public support. In most Clean Elections programs, these qualifying contributions must be given by constituents. To receive the government campaign grant, "Clean Candidates" must forgo all other fundraising and accept no other private or personal funds. Candidates who choose not to participate are subject to limits on their fundraising, typically in the form of limits on the size of contributions they may accept and the sources of those contributions (such as limits on corporate or union contributions), and detailed reporting requirements.

I am as I describe myself a community activist who supports myself by being a Vascular Surgeon. I went to Haiti on two medical missions two weeks and two months after the devastating earthquake. I have developed a plan to allow every student attend college/university/professional/technical school and not pay a dime till they were working and then pay a fixed relatively small percentage of their salary for ten years. I developed a plan to pay for all health care in Iowa and not cost the taxpayers anything more. Several news sources credited me with keeping health care as a major issue in the last Presidential caucus cycle by attending and asking questions at 224 caucus events from all 18 candidates of both parties. I started my activism in High School and was one of ten to conceive of and run the first March of Dimes Walk (the first walk to raise money for charity) and developing the first program in the country for High school students to get academic credit for community service. Here in Iowa I have received National Volunteer of the year award from both the March of Dimes for my advocacy for the child health insurance HAWK-I and from the American Diabetes Association for conceiving of and getting passed the Farm-to-School bill and the seed that became the Healthy Child bill. The question and follow-up I asked Mr. Lightfoot in 1998 led to Vilsak being elected Governor (yes one person can make a difference). Seven months ago I completed a nine month diet losing 95 pounds and today is the seven month anniversary of completing it and I haven't gained a single pound back.

Speed your computer Ditch the bitchy virus software.

2010-09-12T12:15:00.000-05:00

This is a draft the full version will be out later today.

Last week I was at Dragon-Con, the worlds largest Science Fiction convention. I happen to be the Volunteer director of the Blood drive and this year we were about 200 units short of the world record for a non-disaster blood drive (well there is always next year). I attended a session at the Electronic Freedom Foundation track ( the same track were I was a panel member discussing medical marijuana), on Why You Should NOT Use a Virus Scanner. My view of virus software was changed forever. I have already made the changes on both my office and home computer and plan to do this on all 7 computers at my medical practice, both desktops and all laptops at home.

First your need to understand that virus and worms need to have administrative permission to do what they do. If they are opened in a user that does not have administrative permission then they just sit there. You don't get infected.

Second you need to know that you can only get a virus if you allow it in. It is like a vampire that it cannot enter your house unless you give it permission(at least according to True Blood). So you have to be super careful not to open attachments you are absolutely sure about. Not to click on any part of a pop up. If anything is suspicious then restart your computer or use task manager to close it. Even if you get am e-mail from a close friend or loved one, unless you are expecting it do not open it.

Third thing to know is that virus/worm/hazard protection is the biggest hog of CPU and memory on your computer. Also you may have multiple competing programs running. i just finished doing this to my wife's computer and she had 7 different forms of protection. Also you will probably be infected before the virus software has your virus's information. Additionally virus software can get expensive. I spend over $450 dollars a year between all the computers at my medical practice and my family. Also it isn't unusual for the protection to lapse and a system not to be protected anyway. So why not ditch the BITCH.

Here is what you do:

Update and run what ever virus software you have.
Do a Back-up of your system.
Using Add/Delete Program from Control panel remove every virus/ad-blocker/spam filter/protector you have on your computer.
For good measure while your at it remove all this programs you haven't used in two years.
I also removed all the Microsoft Office and Word-perfect software (ultimately replacing it with Open Office).
Using Google Chrome Pack I loaded Spyware Doctor and Google Chrome(safest browser to use to prevent malicious programing), you can also load other great free programs at same time.
In Control Panel I opened User Accounts and added user with limited access (no administrative capabilities). I called it by person using computers first name.
I then run Spyware Doctor after updating it and also Defrag and disk Cleanup. All of which can be found in the Control Panel.
I then open my computer Browser and in Documents and Settings, I copy the contents of the current user(with administrative abilities), into the folder of the new user with limited abilities. This gets all your e-mail and bookmarks and preferences to the new user. You obviously don't need to do this if you are setting up a new computer or don't have anything you care about if you were just getting a new computer.
I then turn off all the features of Spyware Doctor so it will not run at all. This is very easy, on status page click the two green on buttons so computer immunization says Disabled and Intelliguard protection is off (when you click it you get pulldown and ppick the never(not recommended) line. Then in settings unclick every box but let it download updates silently.
Now turn off computer and when you restart only open limited user. **Never leave administrative user running in back ground.*****
You are ready to go.

But, you must remember that you need to change some of you habits:

Never open attachment you are 100% sure about.
Never hit reply to e-mail you are not 100% sure about.
If you end up on a web page you didn't expect (i.e you got redirected), then close browser and re-open browser and resume your browsing.
If not sure of e-mail instead of hitting return or clicking on link go to email program or browser and send e-mail asking to clarify if it was ligit email, link or attachment.
If you do need to download something. down load it and then check it with a Web (cloud) based virus scanner, before opening or running it. It is actually less often then you think you will need to do this. I will post here a site to go to later today so it you see this before come back tomorrow.

Haiti: Follow-up, My Medical Experience and Future Needs.

2010-02-14T20:41:00.000-06:00

I felt I should summarize what I did from a medical point of view and some new principles I notices. Also I will talk about the future needs.

I was with a group of 13 physicians and nurses. The first day we split up and eight of us went to CDTI Hospital (one of only two hospitals in Port Au Prince{PAP} still standing) and joined the American team of about 25 already there. The other 5 went to an orphanage 20 minutes away. The hospital had severe damage to the patient room section so all the patients were kept in the courtyard in eight(8) tents set up by the French. The Americans were responsible for four(4) and the French the rest. The Americans were there from 7:30 till 8:30 each day, and we left 3 military medics there over night. The French were there 9AM to 4:30PM and left no one to take care of their patients at night. If one of their patients had a problem hopefully their family would get one of the medics and they could handle it, otherwise the patient died as happened. 3-400 patients came to be evaluated at the hospital each day. I was consulted on about a dozen each day.

The surgeries I performed or assisted in included:

Four reverse solius flaps (assisted 2 and performed 2)
two gastrocnemius flaps
Above elbow arm amputation
Ten (10) dressings under anesthesia (ketamine/versed sedation)
Eight (8) Drainage of abscess and/or debridement of wounds (bone.muscle and skin).

I saw the first patient I ever witnessed die of Tetanus. After that I gave every patient with an open wound a tetanus vaccine.

We had two patients who were anemic, one with HCT=17 and another with HCT=21. I wanted to transfer the patient with 17 to a facility when I found out we could not get blood to our facility to do the transfusion. I was told because of the limited resources we could not transfer the patients till their HCT=12 or HGB=4. This, by the way, is the point when 50% of patients will die. I was told to stop doing blood counts since we most likely couldn't do anything about it. This was one of the hardest things I have ever done in medicine (except maybe the next story).

I was the lead physician of a trauma patient that came in. He was a fifty something man who had been struck by a truck. The police brought him in a police car and dropped him on the curb and drove off without waiting or telling us anything. The man was in coma and had obvious abdominal trauma. In the states he would have been brought immediately to the operating room for an exploration. We had no anesthesia personnel, no labs, no x-ray. He had no blood pressure until we resuscitated him with three liters of fluids. We called the director of the hospital and asked her to arrange transport. She told us there was no transport and to put him in the courtyard on a stretcher and if he is alive in the AM we will then deal with it. I could not accept this. So I told the medics to pump fluid into him to keep his blood pressure over 100 and his urine output over 50 cc per hour. With hard work they kept him alive over night and had to give an additional 7 liters of fluids. He had a liver injury and a fractured pelvis. We transfered him to the French Hospital ship. We found out he had survived.

I wrote about baby Noah multiple times.

Privacy: There was none. Foleys were put in in an open co-ed tent with the other patients and their families looking on. Patients washed themselves out in the open.

There were many patients, I took care of 4 of them (amputating the arm of one and one other had the HCT=17), who had closed crush injuries of their arms. They came to the Hospital 7-14 days after the earthquake with a compartment syndrome. This is when from a crush injury the muscle swells to the point that the nerves and muscle in the limb dies. the skin and bone survive. If you see the patient within hours of the injury (usually less then 6) opening the arm and releasing the pressure can save function in the arm. Opening the arm at 7-14 days has no chance of saving function. It only exposes dead tissue to infection and gives a massive surface that will slowly loss blood (thus the low HCT). If they had not done fasciotomy(opening the arm) the patient would have ultimately needed an amputation but could have had a functional id forearm amputation instead of being condemned to an above elbow amputation.

The temperature was 85-94 degrees every day with 70-85% humidity. This is the definition of an incubator to culture bacteria. Except for the operating room there was no clean areas of patient care. As a matter of fact the patients were housed in an open field with every bacteria blowing around. Every open wound was contaminated, most with pseudomonus. The problem wasn't that we didn't have the antibiotics, we did. It was that with all those open fracture. Open fractures are being treated by putting on an ex-fixiture (ex-fix) to stabilize the bone. The problem is that the area of the fracture with the open skin wound has poor circulation so the antibiotics do not get there. To over come this I started using Daikin's solution. This is a 0ne percent clorax solution. I would drip it at 10 cc's per hour into the wound and the next day there would be no infection.

It was felt that a large number of early amputations may have been unneeded. Therefor before we left there was a policy in place that two American and one Haitian surgeons need to concur on all needs for amputation.

Every patient coming to the hospital was dehydrated and malnourished. I will talk about food and water in a separate post. It is just that from a medical point of view they started behind.

The obvious biggest need is food and water. From a medical perspective the care of the 200-300,000 open fractures is the major medical work that will be done over the next 3-6 weeks. This is phase two of these open fractures, phase one was applying the ex-fix and doing the early amputations. The third phase will be late amputations over the next two months. all of these 200-300,000 open fractures are at risk of this. This could double the number of amputations. Phase four is rehab. There will need to be multiple centers for rehab centers. There will need for 400-500,000 artificial limbs and the people to fit them and the people to do the rehab. I'm currently working to help start this effort. Also there are some inexpensive prostectics used in the third world. I am planning on contacting them.

Finally the rainy season will begin in one to two weeks. This means that almost every day there will be a one-two hour deluge delivering one to one and a half (1-1.5 inch) of rain. Almost every drainage ditch is filled with rubble. Even with them open many streets were turned into rivers in past rainy season. This year with almost no functional drainage ditches most streets will become rivers. With almost 1,000,000 homeless and living in tents on the streets, 200,000 buried inadequately in mass graves and 100-150,000 still under the rubble, a public health crisis on unimaginable proportion is on it's way. I cannot even imagine how to prepare for this or how when it happens it will be handled but I plan to return in the middle of the rainy season so I will be able to report on it.

cdti Hospital, Haiti, earthquake, disaster, Dr. Alan Koslow, french, patients, tetanus, solius flap, gastracnemeus flap, amputation, anesthesia, transfusion, trauma, fasciotomy, pseudomonus, daikin's, rainy season

Haiti: The Disaster and the People.

2010-02-14T20:16:00.000-06:00

I am going to write a series of essays on the state of things in Haiti from my observations and my opinion. Do not take these as authoritative, they are the observations after six days on the ground and my analysis. I welcome any comments and corrections. All of my photos are posted on my facebook page:http://www.facebook.com/alan.koslow?v=wall&ref=profile and the videos are posted on my YouTube page:http://www.youtube.com/user/alankoslow .

Despite having the worst Urban disaster in the history of the world:

230,000 bodies as of 2/12/10 recovered
125-150,000 bodies still expected to be recovered still buried
300-400,000 amputations performed already
200-300,000 patients still at risk of amputation secondary to infection of open fractures
400-600,000 new orphans
800,000-1,000,000 homeless
before earthquake 70% of population earned less then $3.00/day
One of thirty poorest country in the world
one of the highest per capital debts in the world.

This disaster happened in 30 seconds but will worsen critically with coming rainy season.

The Haitian people are among the proudest and dignified people I have ever encounted. They, despite being one of the most sh-t upon people in the history of the world (first by the French, then by the world economic system, by their own government and now by mother nature), have a dignity that is hard to express in words.I have been in several very poor slums (Brazil, Mexico, Middle East, El Salvador) and have been panhandled by many, yet I rarely felt panhandled the entire time in Haiti. Actually while walking by myself through a tent village only one person approached me and it was not for a hand-out but for a translation job at the Hospital. I almost got the feeling that despite they deserve handouts they are too proud to beg. They want to do something for you to earn what you give them. I was blown away by this.

I will be talking more about the makeshift economy and the tents cities that sprung up, but it was amazing how organized despite no-one organizing them they have become. The people want a normal life. The economy and their political system before the quake has conspired against that happening..

These are a people who expect to be sh-t upon yet show a grace that is one of the most noble things I have ever seen. how can you see this grace and nobility and not be moved to help them.

The Haitians are very stoic. I did dressing changes on patients that would not be tolerated by the typical American patient. I did major operations with local anesthesia and the patient awake and watching the operation and sometimes singing or praying.

I was impressed with the professionals I met. They would be impressive people here in the USA. I feel there is hope for Haiti with people of the caliber that I met. Not only are they intelligent they demonstrated a creativity that they do not allow their situation to bridle.

Hait Relief Mission: Dr Koslow Day 5

2010-02-13T20:32:00.000-06:00

These are my facebook posts. I am puting them together in a blog for each day. If you read posts don't need to reread. If you want to see these posts with the comments go to facebook.com/alan.koslow

Haiti Relief Update:Just finnished doing dressing changes in the OR on my two big cases from yesterday. The solius flap looked great(forgot to take photo). the arm amputation looks good also. She feels much better. I have two more big cases a gastroc muscle flap to cover infected tial fx and a Full thickness skin graft. may not have enough anesthesia & OR staff to finish one or both. lots of cases booked

February 4 at 10:57am

Haiti Relief Update:the stafing situation is getting critical. We had close to 50 nurses/emt's/drs and helpers till now. by sat they are going to be down to 12-15, No way the hosp can keep running.Most of the 15 are drs and they won't be able to do routine post-op nursing care.they desprately need nuses and emt's.The second disatser is these patients who need special care not getting it and losing their leg or life.

February 4 at 11:02am ·

Haiti Relief Update:Yesterday I had a pt that needed a blood transfusion. The pt had a HCT=17 HGB=5.5 we had arrange transport after I found out we could not get blood here(I asked the 1st dayand told enough blood was avail.). So I I forgot about the patient and today found she was not transfered because you need Hct=12/HGB=4 before they will accept you for tx for transfusion. 50% of the pts will die before.

February 4 at 11:08am

Haiti Relief Update:The original was home Sun then Sat since no flight Sun.(It would also give me a day to recover before work on Mon.) Then last night told they have reserved seats on flight fri and cannot assure getting out Saturday. i am torn because they need help and would like to stay even single day more if I can but don't want to get stranded. They cannot assure a flight till Tues. if I miss friday.

February 4 at 11:14am

Haiti Relief Update: The busiest people are in triage and urgancy(ER) they see 2-300/day then call us for a question.Interesting things I've consulted on have been baby with chronic hydrocephelis, woman with a brachial plexus injury from arm trapped 6 hrs, Uterine bleeding.They get no rest and are out in the hot sun w/o aircondition.They & the tent nurses are doing the most work & most are leaving w no replacement.

February 4 at 11:23am ·

aiti Relief Update:The pts are in 8 to a tent. They have no change of clothes & we guard what they have. They undress in the open with no privacy. today I walked into a tent and a women was standing there undressed washing herself.Those around her when not paying any attention.Tues we put a foley cath in a pt out in the open were everyone could look and see. Everyone acted like nothing was happening & ignored us.

February 4 at 11:30am

Haiti Relief Update: I am back in Des Moines. I will keep posting till I run out of things to post about. I have lots of pictures still to post and lots of video. I will spend my entire radio show Monday on Haiti. Go to DesMoineLocalLive.com at 2:00 PM central time Monday and click Watch the full video experience. I would love to have you call in and talk to me about my experience.

February 5 at 10:21pm

Hait Relief Mission: Dr Koslow Day 4

2010-02-13T20:19:00.000-06:00

These are my facebook posts. I am puting them together in a blog for each day. If you read posts don't need to reread. If you want to see these posts with the comments go to facebook.com/alan.koslow

Haiti Releif Update:I found out the baby is doing well. Did three wound debridements under anesthesia yesterday. Then went with Dr Savam the owner of the Hospital to tour some of the damages and also to see the nice part of Haiti. we went up to the mountains at 3900 feet and saw a beautiful country.

February 3 at 8:05am

Haiti relief update:Just heard Sunday there will be almost no flights so will try to get out Saturday, back to USA. Do not know what city I will land in, will then have to find way home. Hope the airlines are accomadating.

February 3 at 8:00am

Haiti Releif Update: now for the fun part. Monday night we went to Pizza garden. I had Kibby an apetizer that is a falafal outside wityh a very spicy beef inside. Very good. The piza I had a slice of seafood and a slice of vegitarian. IT was as good as any I have had in States. All the resturants are about 20 minutes drive to an area hardly hit by earthquake. This seams to be the new social center.

February 3 at 8:07am

Nicole Ovregaard I just wanted to let you know that I have been reading your Haiti updates and find your work inspiring, its helping me get through my less than exciting school work. I want to be involved in medical humanitarian aid in the future. I know my mom told you a little bit about what I want to do but hopefully when you get back from Haiti we can talk more. Good luck!

February 3 at 2:18pm ·

Haiti relief Update:The french are playing nicer.I just did a fascinating case that the fr Plastic surgeon, he thinks fr are snoty also, helped me. I watched him do 2. A muscle flap that is never done in USA,reverse solius flap.She has a bad ankle fracture and it was poring out pus. I cleamed it out past 2 days and dripped a weak solution of clorax bleach over night. Today we did flap. Only chance to save her leg.

February 3 at 2:25pm ·

HaitiReleif Update. I have a sad case today a thirty year old mother of two who said it was hard doing her work before the quake. She had a crush injury and now her are is infected she is septic and at risk of dying. I will do an amputation to try and save her live at firstshe said she rather die then have it. The Haitian Ortho Doc talked to her and we are going to do it in a few minutes. Hope it saves her life.

February 3 at 2:31pm

Haiti releief Update:Last night wewere just aboutto go to dinner when a man was dropped onour curb by police and they left very quickly. He had no blood pressure. we worked for an hr and resucitated him but could not transport him to hospital with blood till am. So we left him with army medics at our hosp. with order...

See MoreFebruary 3 at 2:36pm

Haiti Relief Update:Last night we went to gourmet fr rest.Balsamic and gorganzola salad, trad haitian fish dish, red beens &rice(w capers) , swt potato, plantain.Hd bananas flambet for desert. lunch has been the same each day, beens&rice, corn and sardines. Itwas ok 1st day but everyday, yech.Stoped at supermarket&got 10# friut, apples(3 types),tangerines and bananas.I'mnot starving. Actually I may have not lost wt.

February 3 at 2:53pm

Haiti Relief update:It is realy amazing. Ussually you go to a new Hosp. and it takes weeks to get to feel at home. I am the senior surgeon now that every other surgeon has lweft. I am after 3 days the old dog on the block. Also you make bonds with the fellow workers like you've known them for months not days and hours. It is amazing experiance. Waiting for surgery to start. Hope to post more pics tonight.

February 3 at 2:56pm

Haiti relief update. 3rd night in a row as we were leaving 7:30 emergancy comein. Monday Baby Noah,Tues-truck hit pedestrian, tonight two, woman with dysfunctionsal Uterine bleeding and 13 Y.O. w acute appendicitis The anesthesiologist did not want to stay to do case but we finaly conjoled one to stay(keeps all 4here so their stuck anyway.They are getting patient ready for OR dr David from NYC Gen Surg will do it.

February 3 at 6:50pm

Haiti relief update:baby noah had gone to german hospital, he is doing very well, theywere able to take out I.v. the women who found him and has beentrying to

February 3 at 9:54pm

Last pozst continued:have her own baby for ten years. She feels god led her to find baby and has never left it's side. She will be able to adopt him

February 3 at 9:58pm

Lisa N. D'Amico I have been reading your posts about the miracles you are performing in Haiti. Thank you so much for doing what you can to save lives. It has been harrowing, painful, shocking, and uplifting to read what you are doing. Please be safe and know that there are many, many people back here who are inspired by what you are doing. Bless you.

February 3 at 10:04pm ·

Debbie Dicker Keep up the energy and all your good will. My prays and blessings are with you. Keep enjoying the experience. Thanks for being you! Love you cus.

February 4 at 12:15am

Hait Relief Mission: Dr Koslow Day 2 and 3

2010-02-04T11:47:00.000-06:00

These are my facebook posts. I am puting them together in a blog for each day. If you read posts don't need to reread. If you want to see these posts with the comments go to facebook.com/alan.koslow

Have some great stories. I will post tommorow in Detail. Last night we saved a 3 month old baby that was found dehydrated in a drainage ditch. Baby Noah we named him. Also I have a new medical principal that I will be writing a letter to the editor of New England Jounal of med. Will post it here after I write it.
Tue at 2:55pm

In Haiti There is a desperate need for anesthesiologists and nurse anestetists. If you knowany that want to come I can help arrange it.
Tue at 2:58pm ·

Haiti relief update:Just heard Sunday there will be almost no flights so will try to get out Saturday, back to USA. Do not know what city I will land in, will then have to find way home. Hope the airlines are accomadating.
Yesterday at 9:00am

Haiti Releif Update:I found out the baby is doing well. Did three wound debridements under anesthesia yesterday. Then went with Dr Savam the owner of the Hospital to tour some of the damages and also to see the nice part of Haiti. we went up to the mountains at 3900 feet and saw a beautiful country.
Yesterday at 9:05am ·

Haiti Releif Update: now for the fun part. Monday night we went to Pizza garden. I had Kibby an apetizer that is a falafal outside wityh a very spicy beef inside. Very good. The piza I had a slice of seafood and a slice of vegitarian. IT was as good as any I have had in States. All the resturants are about 20 min...utes drive to an area hardly hit by earthquake. This seams to be the new social center.See More
Yesterday at 9:07am

Haiti relief Update:The french are playing nicer.I just did a fascinating case that the fr Plastic surgeon, he thinks fr are snoty also, helped me. I watched him do 2. A muscle flap that is never done in USA,reverse solius flap.She has a bad ankle fracture and it was poring out pus. I cleamed it out past 2 days and dr...ipped a weak solution of clorax bleach over night. Today we did flap. Only chance to save her leg.See More
Yesterday at 3:25pm ·

HaitiReleif Update. I have a sad case today a thirty year old mother of two who said it was hard doing her work before the quake. She had a crush injury and now her are is infected she is septic and at risk of dying. I will do an amputation to try and save her live at firstshe said she rather die then have it. The Ha...itian Ortho Doc talked to her and we are going to do it in a few minutes. Hope it saves her life.See More
Yesterday at 3:31pm ·

Haiti releief Update:Last night wewere just aboutto go to dinner when a man was dropped onour curb by police and they left very quickly. He had no blood pressure. we worked for an hr and resucitated him but could not transport him to hospital with blood till am. So we left him with army medics at our hosp. with order...s to keep urine output and bp up.He was alive in AM, we tx him. He had pelvic fx, liver injury.See More
Yesterday at 3:36pm ·

Haiti Relief Update:Last night we went to gourmet fr rest.Balsamic and gorganzola salad, trad haitian fish dish, red beens &rice(w capers) , swt potato, plantain.Hd bananas flambet for desert. lunch has been the same each day, beens&rice, corn and sardines. Itwas ok 1st day but everyday, yech.Stoped at supermarket&got... 10# friut, apples(3 types),tangerines and bananas.I'mnot starving. Actually I may have not lost wt.See More
Yesterday at 3:53pm

Haiti Relief update:It is realy amazing. Ussually you go to a new Hosp. and it takes weeks to get to feel at home. I am the senior surgeon now that every other surgeon has lweft. I am after 3 days the old dog on the block. Also you make bonds with the fellow workers like you've known them for months not days and hou...rs. It is amazing experiance. Waiting for surgery to start. Hope to post more pics tonight.See More
Yesterday at 3:56pm

Haiti relief update. 3rd night in a row as we were leaving 7:30 emergancy comein. Monday Baby Noah,Tues-truck hit pedestrian, tonight two, woman with dysfunctionsal Uterine bleeding and 13 Y.O. w acute appendicitis The anesthesiologist did not want to stay to do case but we finaly conjoled one to stay(keeps all 4here... so their stuck anyway.They are getting patient ready for OR dr David from NYC Gen Surg will do it.See More
Yesterday at 7:50pm

Haiti relief update:baby noah had gone to german hospital, he is doing very well, theywere able to take out I.v. the women who found him and has beentrying to
Yesterday at 10:54pm

Last pozst continued:have her own baby for ten years. She feels god led her to find baby and has never left it's side. She will be able to adopt him
Yesterday at 10:58pm

Hait Relief Mission: Dr Koslow Day 1

2010-02-04T11:33:00.000-06:00

These are my facebook posts. I am puting them together in a blog for each day. If you read posts don't need to reread. If you want to see these posts with the comments go to facebook.com/alan.koslow

At airport in Chicago. Waiting for flight to Haiti. Have met up with my team. There are 5 teams going on the charter flight. I did not get the list of what to bring, and was told wrong info. So I am sign. under prepared. Told that I will have to do amputations on people without anesthesi\a. I am thinking that if... I put turnaquit up at 300 for 10-15 minutes might make it bearable. This is as bad as civil war.See More
January 31 at 3:45am ·

I most likely won't be able to post till I get back. I will do a video blog daily and post them when I get home. The internet conection at airport is too slow to post the videos I have now. I may be able to post from my satelite phone. I will take lots of pictures and video. This experience will change me. I don'...t think I can even imagine what I am getting into. I will just do my bestSee More
January 31 at 3:53am

The devistation is amazing. 200,000 bodies have been uncovered, 150,000 are expected still buried. Estimated to be over 500,000 orphans. As most families have 5-8 children there is no hope for them finding homesin Haiti.One of the physicians saw a pancaked building with an arm sticking out. The hospital we are at o...ne of only two functioning hospitals Centre Hospitalier du Sacre-Coeur, and is refered to as CDTI.See More
Mon at 1:02pm ·

The devistation is amazing. 200,000 bodies have been uncovered, 150,000 are expected still buried. Estimated to be over 500,000 orphans. As most families have 5-8 children there is no hope for them finding homesin Haiti.One of the physicians saw a pancaked building with an arm sticking out. The hospital we are at o...ne of only two functioning hospitals Centre Hospitalier du Sacre-Coeur, and is refered to as CDTI.See More
Mon at 1:02pm ·

Every where you look you see pancaked buildingsand every blockhas families sleepingin tents on the street because the buildings are not safe or they are just afraid. I have no internet access or phone or 3Gon my Droid. Blackberries and ATT have service. ATT is giving free calls to USA, so I am using oneof the other ...doc's phone. Through friday they were doing 30-40 acute operation each day.See More
Mon at 1:06pm

Since Sat. they have been doing only 15 operation daily and they have been catch-up operations. It is noon and we did 5 operations on the American side. 3 Wound debridements that I did and I watched a solias flap that the french taught one of the orthopods that I am going to be able to use in my practice(makes whole trip worthwhile in itself).
Mon at 1:10pm ·

Things in Haiti are realy slowing down they have caught up to all the initial injuries. We are still doing great good. The wound care and 2 procedures will be an issue for 3months or more. I am trying to decide if a 30Y.O. woman will require an amputation of her arm. It was crushed and didn't receive care till 5 da...ys ago, She has no sensation or motor function and it will be useless. She may be better with amp.See More
Mon at 1:27pm ·

Thought I may not get Haitian food but we went to one ofthe few surviving resturants and hadLambi (conch- a large snail) creole with fried plantain (green) and a very spicy slaw on it. Itwas great. Justhad sardines with red beens and rice. Now back to work.
Mon at 1:31pm ·

I just did another wound change under anesthesia and it was terrible. green pus thatsmelled like pseudomonus(sp?). I had both the fr plastic and am ortho look. we will try to save it but it mostlikely will need an amputation.. I spoke to the husband and he said for days she was missing and he assumed she was alive ...so he is just happy to have her. He 'leaves it in G-ds hand to save her leg'.See More
Mon at 3:37pm

I wanted to talk about anesthesiain Haiti. The hospital does not have enough drugs foranesthesia, however we can dospinals and sedation with versed(like for colonoscopy)so we can do almost any limb procedure and even an apendectomy or c-section delivery with a high epidural. SoI don't have toworry about doing amputau...ion without anesthesia now but they did two weeks ago.See More
Mon at 6:16pm ·

I was done with surgery so went for a walk( about a mile I walked) by myself(yes I felt completely safe.) I cameaccross a tent city in a public park. I was struck by how amazingly organized it is. There are paths between the tents like streets laid out on a uniform grid patern. There are tents from an aid agency and... then between and among them are tents made from sheets and some from4X8 boards.See More
Mon at 6:23pm

The Haitians in these tentcities are developinglocalecomonies. Thereare women cooking plantain and others chicken that are regually placed throughout the tent city. People sellingwaterand others with gas generators that are charging tio charge cell phones. People are settingup kitchens outside their twents and they ...are creating a small economy. Children are playing soccer.See More
Mon at 7:31pm ·

I spoke with the CEO of airline ambasadorsThe umbrella organization that gotussde here to Haiti),to see if there is someplace that I could be of more use. Don't get me wrong I am being used but I have very specialized skills that are not being used. She is going to a meeting of all the aid organizations tonight and i...n AMI may find out they can use me better. Though I will do lots ofgood enven if I stay here.See More
Mon at 7:35pm

Frommy freind ' the guy who get killed in Hollywood movies, also japanese shaking hands man:'Read somewhere online "American's" are being detained from Leaving Haiti. I just wanted to make sure you had a 'out'. (just the paranoia of my 'old' life) I am hearing we go to the airport and they put you on flights to US in ...order you show up. So you can endupany where in US but everyone is gettinfg out on day they show.See More
Mon at 7:42pm ·

My friend Suzzie who is a great friend that I rarely get together with. asked me if there was still a need foramericsan Nurses? YESY YES YES. they have a much bigger need for nurses them dooctors. Get the word out. I can connect you with ways to get down here.
Mon at 7:46pm

IHere at the hospital in Haiti there is a big turf battlebetween the French and the Americans. The fr have an organized team that trains together and works repeatedly together and have been to many disasters together. They are fully paid while here and are not volunteers. The Am are all volunteers who have never seen... each other till they got here. The Am are less organized then the Fr so the fr have been snotty.See More
Mon at 7:53pm

The french here in haiti are very very efficient but at 5 pm they leave and assume someone will take care of the post op of their p[atients.... The Americans of course.
Mon at 7:54pm ·

Goodnight everyone from Haiti Day two in country day one working. See my earlier posts. Hopefully I will still be able to post and woill be able to post video and pictures, Otherwise I will post them when I get back.
Mon at 7:57pm

Test Blog

2010-01-29T20:47:00.000-06:00

This is a test to see if it will still post.

Motorola DROID: I'm in love.

2009-11-29T15:54:00.000-06:00

I resisted getting an IPhone until it met four benchmarks. Well I serendipitously was in the Verizon store on Friday November 6th(the first day of release) because my phone hinge spring was sprung. I saw the signage for the new Droid and asked about it and found it met all four of my criteria to get an IPhone. I've learned that it not only met those but exceeded any and all expectations. It can truly be the IPhone Killer Motorola and Verizon wants. The four criteria were:

Data plan less them $70/ month for ATT: It was $30/month for Data on top of phone plan
Cost less then $400 or even $200: It was $100 for me with rebate with 2 yr contract
16 or 32 Gigs Mem for that price: It comes with 16 and owner can increase with Mem card.
Being usable on Verizon ( I'm stuck with verizon plus network coverage the best): It was
An added bonus was that all the programing was by Google (Big Brother but the best software producers)
Another added bonus: All the accessories are significantly cheaper then for IPhone and they were all 25% off list (more on that below).

So I bought it.

I then had to decide on the accessories to get. So I got one of each and returned those I didn't like. Here is what I consider the minimum to get full use out of your phone (w what I paid):

GPS car window mount ($30, $22.50 w discount): $130 for IPhone version
Bedside Base ($30, $22.50 w discount)
Extra battery, but only if you listen to 9-12 hours of podcasts or music daily like me ($40, $30 w discount).
Hands free wired headset with headset button ($20 at best buy)
Waist/belt pouch ($10 at walmart)
Car Charger($12)
Car radio Sync (I use a cassette type that plugs into my cassette player)($20).

I want to give you some examples of how smoothly and integrated this phone and the apps are. The app I use the most is Doggcatcher. It took about 8-10 hours to get set up but saves me 30 minutes a day. It downloads all my audio podcasts I subscribe to (186) and places them in a playlist. When I have listened to them they are removed. If I want to pause them or take a phone call I click the in line headset switch and the podcasts pauses and/or answers the call. When I click again it restarts the podcast were I left off or 15 seconds before , if a call. Last week I was in New Orleans and needed to travel. I set up the GPS navigator and began listening to my podcasts. When the GPS needed to give me directions it turned off the podcast, gave the directions and resumed the podcast. I didn't miss a second. I next found out that if I got a call all I needed to do was swipe the screen with my finger and I had a handsfree speaker system that both I could hear well and it picked up my voice at normal volume from 2.5 to 3 feet away. It turned off the podcast and then when it needed to give me directions it did (I could hear it but the caller didn't). Then when the call was over it started the podcast 15 seconds before it had stopped it. That was perfectly designed and met all me needs.

Well I then had a one week odyssey of 3-4 hours a day to get it close to how I like it. That was the biggest downside. Since then I have been in love. I have been in love with three other pieces of electronics: 1) My first HP-35 in 1971 ( I was the first engineering student to have one: cost $400); 2) My first palm pilot in 1995; and 3) my first IPod Classic in 2005, when I learned about podcasts (from my friend T Morris himself {he wrote the Idiots Guide to Podcasting}). All of these devices changed my life each in its own but very significant way and they became constant companions never leaving home without them. Well the Droid surpasses them all.

I bought it planning to have it replace four devices. I found that it replaced twelve items I use all the time or daily worth $ 2300 all together. The first four on this list were the original four and here is the entire list of those items I used to use almost everyday:

My Phone (obvious): $100 that I paid, $400 list price.
My Ipod 80 Gig with two year service: $290
Digital Camera (Droid is 5 MegaPixals): $200
Video Camera ( I was about to buy flip video): $150
Voice recorder to dictate my medical notes: $200
GPS with Google Maps and Traffic alerts: $200 plus $30 per month for service.
Clock radio: $50
My travel bedside radio: $25
I-Home or equivelant ( I use this getting up & dressed in AM about 15-20mins/day):$50
Pedometer: $30-70
Laptop (now obsolete for travel, about 2 trips a month of 2-3 days each): $500
Remote temperature sensor and base next to bed: $65

Those were the devices I used almost daily. I then found out there were many devices I have not had that I now did with the Droid. Some I have gotten to use regularly while some I know I will use infrequently, but they are neat to have:

calculator
compass
metal detector
Star Trek TriCorder
Flash light
Barcode scanner
Leveling bubble.
plus many more available through apps market.

Now that I mentioned apps I have to tell you about the top apps that I use. First I have only spent $15 on apps so far and have about 100 free apps. So apps do not have to be a big expense (but they can). Here are the apps I use the most, some daily and all weekly, and now feel I cannot live without:

Doggcatcher ($5): My podcast catcher. It works the best of the 12 that I tried. It saves me 30 minutes everyday (15 in AM and 15 in PM)
Google Chrome full screen web Browser
Pandora internet music radio
e-book reader
Movies: Tells me what is showing and time in all the local theaters
YouTube: Lets me watch YouTube videos anytime anywhere
Facebook and Twitter aps
Amazon.com with bar code reader
weather bug
CardioTrainer
plus lots of cool games

So I want to hear if your experiences match mine. Please post this and pass it around.

facebook.com/alan.koslow

Gates Foundation Donates $ 120 M Dollars To Change Paradigm for Allelviating World Hunger

2009-10-15T08:45:00.000-05:00

I covered Keynote speaker Bill Gates of the Bill and Melinda Gates Foundation today at the World Food Prize Symposium announcing his foundation will be donating $ 120 Million to support the worlds poorest farmers with new agricultural grants. He said. 'How do you help those people who live on less then $1 / day. Helping the world's poorest farmers grow more crops and get those crops to market will be the biggest thing we can do to eliviate hunger.'

'The Green Revolution did amazing things but it didn't do enough. It did not get to Africa, specificly Sub-Saharan Africa.'

'There is also trouble' 'The Global effort to help small farmersis endangered by an ideological wedge that threatens to split the movement in two........One side is a technological approach that increases productivity (Big Ag, many of the attendees at the World Food Prize cinf.) ...the other is an environmental approach that promotes sustainability. (the Community Food Security Coalition, their conf. preceded the World Food prize Conf.)' I posted a blog two days ago highlighting this contrast.

He goes on to say this is a false choice, that blocks important advances. 'We need productivity and sustainability, and I feel we can do both..........The next green revolution must do both and must be guided by small-holder farmers, adapted to local circumstances, and sustainable for the economy and the envirnment.'

'We have to develop crops that can grow in a drought; that can grow in flood; that can resist pest and disease.'

'We need rigorous science to accomplish this.'

'It is essential for Africa to get a hardiar Maze that can grow in a draught and be a complete food source.' 'In some grants, we include transgenic approaches.....because it can address challenges faster.....Of course these technologies must be subject to rigorous scientific review to ensure they are safe and effective.'

We are developing this maze and it will be released royalty free to all of Africa.

Swarna sub-1 rice species was tested in India. when floods came 90% of normal crops dies. 95% of new variety survived.

Wheat rust is fast-moving and threatening the world wheat supply. 'We are partnering with 15 research stations..using a number of approaches to bread wheat varieties that will offer farmers some lasting protection.'

'We focus on small farmers and make investments across the value chain.....and look at the expertise of woman farmers who do most of the farming in Africa.'

African countries must lead. Most countries have pledged 10% of their National Budget. Ghana is the first country to do this and they have turned around their poverty and are almost at the Millennium Goal.

Here is the Video to his talk and the following discussion.

'Poor farmers are not a problem to be solved: they are the solution.'

A book will come out soon called 'Millions Fed" to follow up on 'Millions Saved' The vacine and health story.

He finished with a standing ovation and then went into a Q&A with Dr. Ejeta this years Food Prize laureate.

This was an amazing speach which clearly showed that an over riding philosophy that is rational and that doesn't try to impose a specific solution and which take into account the needs of stake holders from all levels may have a chance to change the world for the better. However this speech was followed by Dr Jeffery Sachs, the Director of the Earth Institute at Columbia University. In this speech he laid out an analysis that was sobering and scary. My next blog will be on that.

Food Security: Two world Outlooks, A World Apart

2009-10-14T13:54:00.000-05:00

This week I attended two main conferences: The World Food Prize (WFP), and 'From Commodity to Community', the 13th Annual Community Food Security Conference (CFSC), with a buffer conference between them the Third Iowa Hunger Summit (IHS). (#foodprize, #csfc) I saw two movements unfortunately a WORLD APART. The first, the CFSC, was attended by 800 passionate activists. Seventy percent of them in their 20's, dungaree and tee shirt wearing, with a passion and energy level that was exhilarating. The second, the WFP, was attended by 950 gray haired, three piece suited, corporate or governmental officials. The sessions were educational, stimulating with a call to action clearly stated. What was missing was the passion of the CFSC. What was missing from both was the missed opportunity for cross pollination between the two. When I had heard the CFSC was being held immediately before the WFP I expected this was done to foster this. However, I was severely disappointed.

There were many areas of common goals between the conferences and their attendees. They both agreed that within 40 years the world population will increase 50% and the need for food will therefore double ( to take into account those living in Hunger now). That this increase needs to be done in a sustainable manner. That women were the key to success (give women: 1-Educational access {the most important}, 2-Economic equality with men, 3-health access, and 4-Political equality with men). That agricultural improvements need to be done in a sustainable manner. Climate change will significantly hinder the ability to meet the world food demand.

There were some serious areas of conflict. Simply put those attending the CFSC felt all solutions needed to be bottom up, while the WFP attendees felt the solutions need to mostly be top down (however they felt bottom-up needs to be incorporated). The CFSC attendees were violently opposed to genetically modified organisms (GMO), while the WFP attendees were it's prophets. They each have their own research the one that shows GMO's are nothing but pure evil while the other has their research that GMO's are manna from heaven. If only there could be more dialogue and sharing of those studies. There was more talking past each other then to each other. However, I did feel that the WFP attendees were more open to bringing in the CSFC people then the other way around.

Those attending CSFC complained of lack of access to the discission makers both in the US and abroad. Yet hardly any of them stayed on (actually in talking to over one hundred of them, most didn't even know anything about the WFP meeting - A failure of the CSFC to inform their members), to interact at the WFP conference. There were many world discission makers at the WFP. Secretary of Agriculture Tom Vilsak, eight Ministers of Agriculture, several former heads of state and multiple CEO's of the most important corporations in Big-AG-Biz.

The big shining light was Dr. Gebisa Ejeta, the WFP winner, in his talk at Iowa State on Monday to kick off the WFP meeting. He talked about the importance of Ag. extension type programs to get small farmers into the 21st century through education while also needing the large Ag-Biz to be the structure over this agricultural revolution.

So I hope that there is more dialogue between the dungarees and the three piece suits. We need both to move this forward and to have any chance of solving the loaming food and climate crisis.

Sustainable Food Conference, An Eye Opening: Hope for the Future.

2009-10-11T21:52:00.000-05:00

I was at first shocked and surprised then encouraged by the distribution of attendees at the Food Security Conference. This week in Des Moines is a series of three international food conferences. The first one 'From Commodity to Community' the 13th Annual Community Food Security Conference, began Saturday 10/10 and will run through Tuesday 10/13. The first day was taken up with field trips to see the state of agriculture in Iowa. Today began with everyone at a breakfast plenary session setting the tone for the conference. But that is not what this first blog is about.

What I noticed, and as I interviewed many people, I found I wasn't the only one to notice, was that there was a bi-modal distribution of ages. Almost everyone fell into two age groups, either 20-32 or over 50. This made me wonder both about why and then what it means for the sustainable food movement. I talking to several attendees, the consensus seemed to be that those over fifty were motivated by the various movements of the sixties and early seventies. These participants felt that they had maintained their drive to improve and save the world. One women expressed despair that here 28 year old daughter was working for a defense contractor and felt having a nicer car and clothes was all she wished for. The older group was after almost four years seeing a new younger generation get enthusiastic about their causes.

The missing group, the doughnut hole, of those between 32 and 50 that were glaringly absent. To a person the attendees felt they were products of the me generation. The generation that went through high school and college and then entered the work force during the late seventies through the ME eighties and into the corporate boom of the nineties. They never got that spark of as the jewish religion says 'Tachun-o-lum', Repair the World. Fortunately, the generation to follow got the bug.

So what does this mean for the sustainable food movement. Well, the movement will survive and thrive. The young blood was both excited and enthusiastic. I saw a movement that has a new strong base that will work hard to move the movement forward. However it will be another ten to fifteen years till this momentum will cause a major shift in public opinion. That fifteen years will though have lots of small victories. Those who have been fighting this battle for four decades can be encouraged that there is a new generation who will take their fight to it succesful conclusion.

IOWA BOARD OF PHARMACY LIKELY TO RECOMMEND LEGALIZING MEDICAL MARIJUANA

2009-10-10T10:03:00.000-05:00

I didn't write this. It is from Iowapolitics.com. However, I post it as follow-up on my previous posts on this. This is the only rational move.

I was at the first of the Boards public hearing and testified. The patients (none of whom I would label as Pot heads were so compelling there were times I saw tears in the eyes of the Bo9ard members.

Below is the news story.

Iowa is moving a step closer to legalizing the medicinal use of marijuana.

The chairman of the Iowa Board of Pharmacy told IowaPolitics.com that if public hearings on the issue this week in Iowa City and Nov. 4 in Council Bluffs are similar to ones held Sept. 2 in Mason City and Aug. 19 in Des Moines, the board will likely recommend that the Iowa Legislature allow medicinal use of the drug.

“I would say that if all the other three had a similar kind of content that we had, the board would probably be looking at having to digest that information and make a decision that there is probably a legitimate medical use for some people,” said Vernon Benjamin, a pharmacist from Argyle.

But even if the board does eventually make that recommendation – they are expected to vote on the matter before the end of the year - there is no guarantee legislators will heed the advice of the board.

“This one is a pretty political issue, so I can’t say if they’re going to follow it or not,” said Lloyd Jessen, director of the board.

Jessen said in the past, recommendations haven’t been political and have generally been changes to bring Iowa law into line with federal law. “It's anybody’s guess if they put any weight in the recommendation or not,” Jessen said. “You have to remember Iowa is a pretty conservative state.”

Senate Majority Leader Mike Gronstal was noncommittal on the topic, saying he will wait and see what the board’s recommendation is, whether a bill comes out of committee and what other stakeholders have to say.

“I think it’s very much up in the air,” the Council Bluffs Democrat said. “I’m certain there’s a law enforcement side to be heard on this issue.”

Thirteen states currently allow the medicinal use of marijuana, Jessen said, while another dozen are considering the issue. Michigan is the only Midwestern state that currently allows its use, while much of the western part of the country has moved toward that policy.

“It seems to be a pretty common topic right now,” Jessen said.

Ann Diehl, a public member of the board from Osceola, said she’s glad the board decided to hold the hearings. Diehl used to be a detoxification nurse at Broadlawns Medical Center in Des Moines.

“It’s been a really interesting experience for me because I just had a totally one-sided view of it, and that was not good,” Diehl said. “I have learned a lot, and I have learned a lot about the medical benefits just from one hearing I've gone to.”

Diehl said she has heard scientific evidence and a lot of compelling stories from people who do have serious medical problems that they feel it helps. “I can say I have a much more open mind on it as far as medical use goes, but I haven’t come to any conclusion yet,” Diehl said.

Peggy Whitworth, a public board member from Cedar Rapids, attended the Iowa City meeting and said she’s been contacted by individuals eager to speak and get their thoughts on the record.

“I think those that have participated have found them interesting and helpful, and I think there are many rank-and-file citizens who are appreciative of an opportunity to express their views,” Whitworth said.

Whitworth said she encouraged the board to gather some solid information through public hearings and base any decision on science. “The reason for the hearings is to gather information from the citizens of Iowa, basically so any action by the Board of Pharmacy is grounded in reality, not simply in vague stories,” Whitworth said.

Benjamin agreed, saying board members are learning about switching the schedule of marijuana just like everybody else is. "You can’t do things like that lightly when federal law says it’s schedule one,” Benjamin said. “We wanted to make sure we had a case to argue if we do support the legalization of it.”

Hospitals in for $200 Billion Windfall Profits per Year from Health Reform.

2009-09-29T22:44:00.000-05:00

I am amazed at the low profile the AHA (American Hospital Association) has been taking in the debate over health care reform. Think back you have heard and seen ads from every other sector but Hospitals, yet hospitals are 31% of the cost of medical care in the USA. Why have they been so quiet? Maybe they have a good reason to take a low profile. Maybe they don't want politicians and the public to realize they will be in for as much as $100-200 billion dollar windfall profits.

When you examine a major change think about who are the biggest losers and winners both before and after the change. This will help you understand the rhetoric or lack of it. Currently the hospital are, along with the uninsured patients, the biggest losers. The pharmaceutical and insurance industry the biggest. Using figures from Iowa from 2006, in a survey by the State Health Department, the states hospitals reported their expenses on unreimbursed indigent (uninsured) care. In Iowa the hospital spent $600,000,000 on care to the uninsured that was not reimbursed. This was not what they would have billed, but their actual expenses. They made this up by offsetting costs to those with private insurance. They still operated in the black. You cannot say they made a profit since they are non-profit. However many executives received large salaries and bonuses and many hospitals did expensive capital investments. This was in the face of $600 million write off. Amazing!!!

Well let us snap our finger and let every uninsured have insurance. Lets also say that this insurance will reimburse hospitals at the same rate (so they are competitive with private insurance) as private insurance. This rate is double or more over the reimbursement rate of Medicare or Medicaid. So the hospitals in Iowa will instead of writing off $600 million will be getting a check for $1.2 Billion. This is a swing on their ledger of $1.8 Billion. Now Iowa has a population of about 3,000,000 or one percent (1%) of the population of the entire country. So, if the number can be expanded to the entire country the hospitals of the United States will have as much as $180 Billion windfall profit each and every year.

$180 Billion is enough to pay f0or the cost of even the more expensive House bill for two years. So what I'm saying is that the hospitals will not be doing any more work (they are doing it now as charity) but will be making $180 Billion each year for no further work. Why not give them only $90 Billion windfall (they should be very happy with this) and pay for the entire system.

Please tell me where my logic is flawed.

Everyone Can Afford College. All Can Go.

2009-09-24T20:41:00.001-05:00

We have a crisis in higher education. Like health care the cost of a college education is increasing at more then twice the rate of inflation, while the money available for scholarships and grants is shrinking. Many cannot attend the college of their choice or attend at all. Private Universities tend to get a disproportionate number of upper middle class to upper class students rather then the best students. I have given this a lot of thought and see a rational plan to solve this. First let me say not everyone should or needs to go to college, but some would benefit from a technical training and this covers that also. Read on to see the plan.

Society and our country benefits by having a more educated workforce and a educated class that can develop new inventions or processes. The person getting an education benefits from added earning potential. Also more lower income and middle income students will be able to attend better schools and not be worried about affording school or being saddled with burdensome debt. Many people will go into teaching or nursing since they will not need to find high paying jobs to pay off college debt. Keep reading the plan is coming.

The individual will benefit from this plan because of increased earning potential. US Census Bureau report shows that: '$4.4 million Estimated lifetime earnings of professional (i.e., medical, law, dentistry and veterinary medicine) degree-holders. This compares with $3.4 million for those with Ph.D.s, $2.5 million for master’s degree-holders, $2.1 million for those with bachelor’s degrees, $1.2 million for high school graduates and $1.0 million for high school dropouts'. Also the individual will be able to go to the best school they qualify with economic resources being no barrier and massive debt will be no barrier to taking the job they want rather then the job they need to pay off their debt. Here comes the plan.

Here is the plan. I will give the numbers to justify it below. The plan is simple students will apply to the colleges they want without concern for the cost. They will be accepted on their qualifications not the ability of their parents to afford it or the desire of the students to go into massive debt. After finishing school, graduate school and any required internships or residencies to complete their training they will pay back the loan this program gives them. They will pay back 0.75- 1.5% of their net income for each year of school they attend for 10 years. i.e. someone going to only four years of school will pay 3-6% of their income (net not gross) for ten years while those doing Medical School will pay 12% of their income for 10 years after they finish their residencies. These percentages are first guesses it may be slightly higher or lower. The final number will have inflation built in so once you fund the first four years the program will pay for itself.

Lets look at some numbers. There are approximately 5,000,000 in each grade level although only 3,000,000 graduate high school (2 million do not, see their lifetime earning potential above, I will present a plan to improve drop out levels in future blog). There are roughly 2,500,000 students entering college each year but there are 18,000,000 in colleges and universities at all levels including college, professional schools and graduate schools. 14,000,000 are in public institutions and 4,000,000 are in private. The total cost of those(14m) in public institutions is 250 billion dollars or $17,000 per student (room, board and expenses averaged of all levels) and those (4M) in private schools is 150 billion dollars or $37,000 per student. Whether private or public the students pay (via loans, scholarships, parent contribution and work study) all but $10,000. So of the 400 billion dollars spent each year on higher education $140B is paid by government, $40B by endowment funds of private universities and colleges and $210B by the student (using: loans; parents contribution, scholarships and work study). Once the program is in place and up and running it will be self supporting. This will mean that local, state and federal government will save $140B yearly or $1.4 trillion over ten years after the first four years and people start repaying loans. Both private and public schools will be able to use the money saved to improve the faculty (both pay and quality) and to improve facilities ( to accommodate the increased number of students that will be attending).

When the program starts those already in school can participate and reimburse the program at 2% each year for ten years of their net income. The repayment will be handled on the persons tax returns.

The beauty of this is that the job a person obtains and therefor the income is based upon the education they get and the field they pick. By setting reimbursement to your income if you decide to go into a low paying job you reimburse less and if you decide to go into a higher paying job you reimburse more. The individual decides. Two people with the same degree may go into opposite ends of the pay schedule.

After eight years there will be approximately 28 million (this number could be almost double if more students go to college then would have) that will be paying back into the program with an average income of $75,000(assuming a combination of those in professions and in trades, with more data this number could be precisely calculated) paying roughly 15% each (averaging those that do just bachelors and those that do graduate or professional degrees) or 315 billion dollars and thus close to self sustaining.

Any one could elect not to be part of the program but they will then need to pay full room/board/tuition of $37,000 yearly at private school and $19,000 at a public school.

This is a first approximation kind of a back of envelope calculation. I want lots of comments and criticism and if you know a college administrator please forward it to them. also to any state or federal legislators.

Sorry I haven't posted in three weeks.

2009-09-22T09:29:00.000-05:00

Those of you friends with me on facebook (www.facebook.com/alan.koslow) know I had a full three weeks. Two Guinness world record attempts. Brunch with Al Franken and Senator Harkin. Presenting at annual Gala for Am. Diabetes Association, Attending worlds largest SciFi convention and Chairing Blood Drive (we had 2628 units of blood donated and after splitting them we had 6300 transfusable units), Preparing for Step Out the annual walk for Diabetes (this Saturday), Attending Get Motivated Seminar (amazing list of speakers and I was on stage dancing to compete for trip), my two radio shows and over a dozen board meetings. All in the last three weeks. I started another Blog devoted to my Weight reduction http://weightloss-skepticdoctor.blogspot.com/. I am making a commitment to post a new Blog at least weekly if not twice a week.

It's the Calories and Only the Calories. Duh!! How I'm Doing It.

2009-08-26T20:41:00.000-05:00

I am 14 1/2 weeks into my diet and exactly halfway done. I am down 46 pounds, as of this morning, with my goal being 90 pounds, so 44 more to go. I posted this on my facebook page and 14 people asked me what I was doing to lose weight so I was stimulated to write this blog on diets and dieting from a skeptical point of view.

Multiple times each day we are bombarded with ads that promise the weight will melt away. When you look at the fine print they almost always say either when combined with an exercise program or even they have the nerve to say when combined with exercise and reducing intake...DUH. Rarely do the diet products work. If they did they would blow the competition out of the market and capture that whole market. The fact that they don't should tell you something.

Science is science and we cannot change the rules of biochemistry, chemistry, thermodynamics or physics. To burn one pound fat you need to burn 3500-4200 calories more then you take in this varies based upon efficiency of converting fat to energy). Now here is where it can get confusion but I will walk you through it. Go to this page http://walking.about.com/cs/calories/l/blcalcalc.htm and calculate your basal metabolic rate(the back ground rate at which you burn calories before you add your exercise). This can vary based upon lots of factors some individual metabolic rate, age weight. I recommend for this number use light activity ( i will explain in a moment), I was 2555 calories at my starting weight and 2300 at my current weight. You then add your exercise, here is a calculator: http://www.neversaydiet.com/tools/calories-burned-calculator?ivNPA=1&sky=ggl|hco|ns|calories|PPCA7FBa|c , When I started I burned 783 calories per day and now am burning 661 calories per day. The reason for the difference is that as you lose weight you are carrying less and therefore both your basal metabolic rate and your calories burned from the same exercise goes down. So at the beginning of my diet I was burning 3338 calories per day and now I am burning 2961 calories per day. This is one of the main reasons as you continue to diet you loss less weight for the same effort and the same calorie intake. So this is one of the reasons but there is evidence also that as you lose weight your abdominal fat cells release a hormone that slows your basal metabolic rate. This number is hard to get a grasp of.

Lets look at the intake side. I cut down to 1200-1500 calories per day lets say 1350. I will talk about how below. So if we subtract this from calories burned you get 1980 calories when I started my diet/exercise and 1610 calories now. That would mean I would lose about .55 pounds at the beginning and about .4 pounds now. Surprise surprise that is exactly what I am losing. If you lose less then you calculate you are either eating more then you think ( patients always say they are eating like a bird and I see in my mind a candor) or exercising less. This is straight math and science. It is so easy to delude yourself. I have not missed a day exercising and have only had 6 days I ate more then my 1200-1500 calories.

O.K. here it is my diet:

Eliminate fried food. I have only had one fried item in 14 weeks.
Eliminate fat containing condiments. No mayonnaise or salad dressing. I have not had any tuna/egg/potato salad and have only had plain balsamic vinegar on my salads. No deviled eggs.
No bread and butter. I have had 3 pieces of bread and butter in 14 weeks
No starch with meals. If you eat out ask for double veggies
When I eat out I ask the waitstaff to only give me half the meal and pack up the rest before they give it to me so it is never on the plate.
Eat as many raw fruits and veggies as you want. Some days I eat 2-3 pounds of melon.
Subway is your friend . A half chicken breast sandwich without dressing (just vinegar) and no cheese is 320 calories for a six inch. Make sure you put on loads of veggies (so 3/4 of the thickness of the sandwich is veggies about 4 times what they normally put on the sandwich)

Have lots of low calorie snacks, here are some of mine:
Pickles 20 calories for large pickle
stick pretzels 5-8 calories each
slice of white meat turkey breast 20 calories with spicy mustard - no calories
slice of smoked salmon 40 calories
assorted nuts 100 calories for one ounce.

I do ask restaurants if they know the calories of the item I want to order. I do keep track in my mind to how many calories I'm eating each day.

Now the exercise. When I started I could only walk briskly for 15 minutes it took me 3 weeks to be able to walk a full hour. At that point I was walking about 2 miles in an hour. by week 5 I was walking 3.0 miles in 50 minutes. A few weeks ago I added stair climbing and now in 60-65 minutes I do 3.0 miles, 17 flights up and 17 flight down. So as you loss weight and sweat less you need to increase what you do. Now about safety. If you are over 40 or get winded when you exercise you need to be concerned. I recommend you get one of those pulse monitors at a pharmacy that you wear on a finger or your wrist. When you start to exercise monitor your pulse rate. Then do the calculation of 220 minus your age. So for me 164. Then take 80% of that so for me 131. If your pulse rate goes over the number for you stop exercising and see you physician before doing anymore exercise. If you have chest pain while exercising stop immediately and call 911.

The final way to be successful and also help others. Tell everyone, and I mean everyone (no exceptions) that you are dieting and exercising to lose weight. The more people you tell the stronger social contract you are making and the more likely you are to stay on your diet. Also this will have a positive effect to get more people to be successful in dieting them self. That is why I blog and post it on my facebook page.

Another One Bites The Dust: Creationist/Inteligent Design Proponents Major Gap Gets Filled.

2009-08-24T21:08:00.000-05:00

One of the biggest Gaps that has been pointed to by Creationist/Intelligent Design advocates has been filled.

The evolution of life is one of the most beautiful things I have studied. I am a puzzle fan. I love to put together complex puzzles whether jigsaw, three dimensional, mathematical or geometric. I have had a fascination with puzzles my whole life. When I have trouble putting it together I don't say there has to be a magical step I sit down and try to solve the step or Gap that I'm having trouble with. I have also been a fan of evolution since I first read The Origin of the Species (celebrating it's 150 anniversary this past February) at the age of nine. When you think about the bits of information on life it is not the 2500 pieces of a complex jigsaw puzzle that gets me excited but the billions of facts that we have amassed from almost every field of science by 100's of thousands of scientists from every country in the world. These scientific disciplines include : biology, biochemistry, chemistry, physics, geology, paleontology, archeology, anthropology mathematics, genetics, mathematics and statistics, plus many more. The amazing thing is that these billions of independently arrived at facts all fit together with very few contradictions and these contradictions do not disprove the theory of evolution but just point out holes or as creationist call them gaps. When there are contradictions or gaps this points to areas were research needs to be done.

It is a thing of beauty how nicely this fits together. An example of this is the biologic clock. Scientist have determined the relative rate at which random changes in amino acids lead to substantive genetic changes. Scientist have found that these happen at relatively fixed periods based upon the number of generations. The beauty is that in any two species ( and ten's of thousands of pairs of animals have been looked at) when you look at the number of differences between them and then calculate when they should have a common ancestor it works out to a very high degree of accuracy. This method has been used by scientists to predict what geological layers these common ancestors will be found in and when they look they find the fossils in the right place. This is the most powerful proof of evolution. There are other similar spectacular predictive aspects to evolution and an amazing array of puzzle pieces, literally billions, that fit the puzzle precisely.

Well that Gap was how did Eukariotic(cells with a nucleus) cells develop from prokaryotic(cells without a nucleus) cells. Well in today's Nature researches using two different prokaryotic cells have seen one cell get engulfed by the other forming an endosymbiote or a cell living in harmony within another cell. Over time there is an exchange of genetic material and the engulfed cell becomes the nucleus for the other cell. Also this occurred in an oxygen poor environment. Photosynthesis could not occur until you had eukaryotic cells. This symbiosis led to terraforming of the entire earth to an oxygen rich environment that allowed life as we know it to evolve. In addition this fusion of two cells produced the mitochondria that is present in all eukaryotic cells.

I am sure that the Creationists will find excuses, such as, this happened in a glass dish and there were no glass dishes in the soup that was our early oceans. They may then say that there are now two gaps, one on each side of this finding. The point is that science predicted this result and it fits all of the mountain of data we have and contradicts none. Why would they want a God of the Gaps whose domain keeps getting cut into smaller and smaller pieces. If there is a God isn't it better to envision that that entity created a universe were life can form and not have to do mental gymnastics that try to fit God into gaps we just haven't filled with facts yet.

Neutriceutical Supplements Can Kill or Help You or Just Waste Your Money!

2009-08-18T18:21:00.000-05:00

When was the last time your doctor asked you if you are taking any supplements? Most of you probably never. I have had patients die or loss a limb from over the counter supplement use.

A recent article from Mayo Clinic Health letter they clarified that over the counter supplements are not always safe. They pointed out that,

"St. John's wort: This supplement can greatly increase or decrease the potency of many medications and cause serious side effects. Patients who take antidepressants, anti-blood-clotting drugs, certain asthma drugs, immune-suppressing medications or steroids should probably avoid St. John's wort.

S-adenosylmethionine (SAM-e): This can cause serious side effects when taken with antidepressant medications that affect serotonin.
Garlic, ginseng, ginger and feverfew: Patients who take anti-clotting medications such as aspirin, warfarin (Coumadin) and clopidogrel (Plavix) should avoid these supplements. They may increase the risk of bleeding. Supplements chondroitin and glucosamine also may interfere with warfarin.
Ginkgo: Ginkgo may increase the risk of bleeding in patients taking anti-clotting medications. Ginkgo can counteract the blood pressure-lowering benefits of thiazide diuretic drugs. It also can interfere with anti-seizure medications."

This is why every Doctor should ask you if you take any Vitamins, supplements or over the counter meds. Unfortunately very few do. You should tell them if they don't. You should also notify your doctor if you add one.

VITAMINS AND SUPPLEMENTS. There are multiple vitamins and supplements that are available on the market. Actually, there are over 3000 uniquely different vitamins and supplements. During a nine-month period of time, I actually reviewed all 3000 of these in order to determine which ones have actual evidence that is peer reviewed and are blinded studies to confirm that these work. I had a second level that they had studies that were not necessarily blinded. Out of the 3000 supplements, there were actually approximately 120 that had more than one study that showed some form of efficacy whether it was blinded or not blinded. 25 of these substances either had such dangerous side effects that I eliminated from my ultimate list or that were not available in the United States in a dosage that was comparable to the dosage used in the study. Either the dose available in the United States was multiple; one is a magnitude larger or multiple others with magnitude smaller. I have therefore distilled this down to a list of 95 substances that had a hint of some level of efficacy. I have to say that for all but a small few there still is not enough data to say they are efficacious or safe. I do not recommend, unless you are having a specific problem that you are taking the supplement for, that you do take the supplement just to prevent the problem. There is no evidence for any supplement whatsoever that they can prevent you from developing a problem except for the ones which I am going to be listing below. The following lists of supplements are ones which, if you fit into the category mentioned, you should be taking these.

1.MULTIVITAMINS – Many adults should be taking a multivitamin because of the highly processed foods that we eat. However, if you eat a balanced diet you most likely do not need one. Many people who do not eat this balanced diet (40% carbs, 30% calories from fat, 30% of calories from protein with 8-12 portions of fresh fruits and vegies per day) do not get the minimal requirements of the full range of multivitamins. I actually recommend taking the senior types of multivitamins and this is because you want to keep down on the total amount of the vitamin A that you have. Vitamin A at 5000 per day will accelerate osteoporosis and the regular multivitamins, usually at 5000, where the senior has 2500 of vitamin A. So if your multivitamin has more then 2500 of vitamin A take it every other day.

2.B-COMPLEX – B-complex has multiple advantages and multiple studies that show it has advantages. Among women who were of child bearing age, it obviously gives them the folic acid (folate) that they need to prevent birth defects. There have been many studies that have shown that Folate actually does prevent birth defects. I recommend taking a B-complex 100 which has 100 mg of each of the B vitamins and then also has folate appropriately dosed. There are many studies that show B-complex reduces Homocysteine and that leads to a decrease in cardiovascular risk.

3.OMEGA 3 FISH OILS – The recommended dose is 3 g per days which is usually three soft gel capsules. This is very important to prevent atherosclerosis and stroke. It has actually been shown in patients who take this versus controls who do not, that you decrease by between 10% and 25% the incidents of heart attacks and strokes in these patients.

4.LUTEIN 20-40 mg – This has been demonstrated to prevent development of macular degeneration, the most common cause of blindness in the entire population followed closely by diabetes-related blindness. It actually has also been shown to reverse the early blindness caused by macular degeneration (in the higher dose). This should be taken by everyone over the age of 45 and should essentially be taken for the rest of your life to prevent macular degenerative blindness.

5.BABY ASPIRIN – The use of aspirin to prevent heart attack and stroke has clearly been demonstrated. There is still some controversy as to whether everyone should be taking this or whether only people at high risk should be taking it. My read of the research studies and my read of the literature indicate that I feel all adults should be taking a baby aspirin. Now, the actual dose is if you take a chewable form of baby aspirin, you take one everyday. If you take an enteric-coated form of the baby aspirin, you take two every day and you try not to take any aspirin for any other cause. Obviously, if you do have an allergy to aspirin or have intolerance to aspirin, you should not use this and you should check with your physician.

6.CALCIUM – Most people and particularly women, postmenopausal, and patients who are obese with a BMI over 35 need to be taking calcium supplementation. Fat and the change in hormonal balance in old women both seem to be contributory factors to loss of calcium. I recommend between 1500 and 3000 mg of calcium per day. The calcium should definitely have vitamin D in it. Note here about vitamin D, 70% to 80% of all adults not living in the Sun Belt are vitamin D deficient. If you have any problem with calcium metabolism, have osteopenia or your have osteoporosis, I strongly recommend that your doctor obtain a vitamin D level on you because that is probably the biggest cause of osteoporosis (pathologically decreased calcium levels in bone) and osteopenia (mildly depleted calcium levels in the bone). Some people might need mega supplementation with vitamin D to get them back to a therapeutic level.

7.GLUCOSAMINE – There has been a lot of discussion about glucosamine and chondroitin and as individuals or as combinations. I have looked at multiple different studies and the bottom line is that these do work. They do decrease joint complications. Every orthopedic surgeon who does total hip or total knee replacement says that every adult should be on glucosamine on a daily basis, although there is no research evidence that supports this position. However, if you do have any jont problems at all, then this is definitely supported by the medical literature to be one of either medication or the combination. Now, let me talk about which of the three forms you should take. I personally recommend glucosamine for multiple reasons. The typical dosage would be 1500 mg per day. There has not been any study that shows that chondroitin has better or worse response than glucosamine and there is no study that shows that the combination of chondroitin and glucosamine increases the efficacy of either one.

8.VITAMIN D – 70% of all children in the USA are vitamin D deficit and 15% serriously. The rate for adults is even higher especially if you live north of the Mason-Dixon Line. This is a vitamin you cannot take too much of. I recommend 2000 per day in summer months and 3000 per day in winter months.

Breast Rescission: or How you can be Raped by your Health Insurance Company.

2009-08-17T21:57:00.000-05:00

I heard the testimony given at a recent senate hearing on a policy called Rescission by Health Insurance Companies. The first testimony was by a woman who had her health insurance for many years having paid her premiums for many years and her Insurance company accepted these premiums. They had the option of not issuing insurance to her in the first place. However, they did issue a policy to her and went along happily taking her money and having very small payout, making lots of money off her. Then one day she comes down with invasive breast cancer involving both her breasts. Her doctor wanted her to have bilateral mastectomies ASAP. They were scheduled for the next week. In the next couple days before she went into the hospital she was told by her insurance company they were canceling her health insurance policy. They broke their explicit contract they had with her. They said she lied on her policy. It turns out she had been diagnosed by a Dermatologist with dermatitis. They claimed this was a precancerous condition and she had lied on her application when she had said she never had cancer or a precancerous lesion. The dermatologist spoke with the insurance company and told them this was acne and completely benign condition and not a pre-cancerous lesion. The insurance company still refused to re-establish her insurance. She could not afford to pay the 10's of thousands of dollars the hospital required to let her have the surgery. Finally after 5 or 6 months she got the decision reversed but she now had a much more advanced cancer that metastasized to her lymph nodes. She is much more likely to die because of this.

Blue Cross Blue Shield of California( not even the largest insurer in Ca.) rescinded 20,000 policy holders over a five year period. This can be extrapolated to hundreds of thousands losing their policy when most vulnerable. Leading to untold pain, suffering and deaths. But hey, they had to protect their profits. When asked if a client did not intentionally lie would they stop rescission all the Insurance CEO's said no they would not. however they would continue to take their clients money.

Half of the people in the United States between Medicare, Medicaid and Veterans services, are insured by the federal government. In 45 years not a single person has had their insurance rescinded by the feds.

This is criminal and should be banned. If there is no allowance for insurance companies to deny people insurance for pre-existing conditions then this will never happen. Rise up and revolt against rescission for you may be the next insured person that finds out on the doorstep of the hospital that you suddenly have no insurance, ending up either bankrupt or dead. RIP.

Medical Marijuana, I'm Skeptical About a Ban.

2009-08-11T21:31:00.000-05:00

One week from today the State Board of Pharmacy of Iowa will hold a public hearing on medicinal use of marijuana. This is an issue that has vexed me for many years. As a physician who treats patients with severe pain syndromes I have seen many a patient get addicted to legal prescription pain medication while still suffering. This is because the legal pain medication is not the best medication to treat a pain syndrome called neuropathic pain. How I explain it to my patients is that narcotic pain medications will knock you out and as you're drifting off you are still experiencing pain. There are multiple studies which have documented good pain relief with smoking marijuana for neuropathic pain syndromes. There are many other proven uses for medical marijuana. However, our prejudices prevent us from using a proven remedy.

Marijuana has a history that is a mixture of myths and falsehoods that make it problematic for opponents to change their attitude. If you haven't seen the film 'Reefer Madness' you should. It is available free on the web if you look for it. This is the beginning of many of the myths. Regardless of how you feel about those myths, and I'm not going to debunk them in this piece, it is important to put marijuana in perspective to both legal over the counter products (alcohol and tobacco) and prescription products (Morphine, Vicodin, Methadone, and many others).

Marijuana has shown no adverse health effects when compared to either alcohol or tobacco. I think you all know the terrible health effects of both alcohol and tobacco. Alcohol and alcoholism causes 85,000 deaths each year from a combination of direct medical problems or traffic related deaths. Tobacco causes 430,000 deaths each year. In Britain, official government statistics listed five deaths from cannabis in the period 1993-1995. "Tetrahydrocannabinol is a very safe drug. Laboratory animals (rats, mice, dogs, monkeys) can tolerate doses about 5,000 times more than is required to produce a high." (from a British government report). When compared to tobacco there are equal or less effect on the lungs.

Alcohol and tobacco are two of the most addictive products in our society. Millions of people are addicted to both. There are questions about the true physical addiction potential of marijuana but most experts agree it is less then either of the two legal products. So if it is purely the addictive potential alcohol and tobacco should be banned and medical marijuana should be approved. Now the real question is, since we are only talking about medical marijuana, how addictive is it compared to prescription pain and anti-nausea medication. All the evidence points to marijuana is far less addictive then almost all prescription pain medication.

So let us get over our paranoia and allow our patients to have the best treatment available for certain conditions.

Senator Tom Harkin Supporter Rants on his Complementary and Alternative Med (CAM) Proposal

2009-08-10T18:57:00.000-05:00

As a strong supporter of Senator Harkin I cannot standby and allow him to put forth an irresponsible,

irrational and dangerous proposal. His proposal is basically the Inclusion of alternative medicine workers in the bill's definition of "health care workforce". This at first seems innocuous, however the consequences will be harmful to our system of evidence based medicine (EBM) and patients health.

The consequences of this is that the government and private insurance companies will be required to pay alternative medicine workers as if they have medical decrees. In other words someone with no education, no certified program, practicing a form of medicine that has no evidence it works and is safe must be reimbursed at the same rate as someone practicing EBM. Currently 34 billion dollars is being spent and not reimbursed for complementary medical care and an additional 34 Billion on over the counter supplements, vitamins, homeopathic (equals water) and naturopathy products. None of them, either the therapies or the products have a single paper showing the work and are safe when compared to placebo.

Senator Harkin claims this will save money. I ask him to explain how......Oh wait..... Maybe the deathers are right Harkins secret plan is that patients who use CAM will not use EBM, that have 150 years and continuing research that shows they work. Instead they will forgo the expensive chemotherapy and go to the Naturopathy for extract of apricot pits (long since proven not to work). This will save money but cost livesI know the Senator is upset. He pushed through and set up the National Center for Complementary and Alternative Medicine, which the taxpayer has spent 100's of millions of dollars to prove that alternative medicine techniques work. However, not a single trial has shown that a CAM technique or product is effective. This has upset the Senator and he feels that the Institute has purposely designed the studies so they would fail. In a statement he said, “One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.” Senator you loaded the institute with people that are true believers and even they cannot prove (or approve) the unprovable when the magnifier of science is applied. Science does not and should never be established to 'validate' or 'approve' something but like Justice, should be blindfolded to the results. As you said during 'W's administration, 'we need to bring rationality back to science instead of politics or ideology'. Well hold a mirror up to yourself who is putting ideology before science who is upset if science doesn't meet your pre-conceived expectation. Except the results of the nearly 1one billion dollars 'your' institute spent ( some would say wasted, not me) and realize that when some CAM modality is shown to work it is then mainstream medicine. I can give you many examples.

There are many reasons on separation of powers and states rule that this should not be done. It removes States rights to license and certify practitioners of medicine and to control the practice of medicine within their state.

So Senator please remove this provision from the bill.

n.b. I apologize the program formatted this weirdly and split words inappropriately.

Dumb, Dumber and Deather

2009-08-08T20:56:00.000-05:00

I don't know who is dumb or dumber the Republican/conservative machine(the deathers) or those in the public who believe them. There are few other issues more important for a patient to discuss with their physician then their living will and what their wishes are if and when they get close to death as we all will one day. Now when a physician who usually spends only 12-15 minutes per patient discusses these issues, which require much more time, they have to lie and claim that they are treating the patient for one of their conditions.

The more rational thing is to allow doctors to have open and frank discussions on these issues with their patients. Then allow the doctor to honestly bill for these services. To think that a legislation is going to get doctors to violate our Hippocratic Oath, how ridiculous. Patients need to understand what their choices are in a living will and their doctor needs to understand their end of life wishes. The proposed legislation simply allows physicians to have the appropriate time for this and to get fairly reimbursed for it. So don't be a dead head, a dumber or a dummy and work to get good health reform that covers everyone, has no pre-existing provisions and prevents Insurance Companies from denying care to those they insure.

Science based Medicin e conferance at TAM-7

2009-07-10T01:36:00.000-05:00

Great Lectures today on Science based medicine. Case studies in Cancer Quackery, Scientific Critique of Chiropractic, Lyme Disease. I will be blogging on each of these after I inteview the presentors friday and saturday. I will give one highlight from each talk.
1) while we need to individualize each patients treatment we often ( and I can see myself doing it) we let errors like false pattern recognition, influenced by quirky personal experience , over reliance on non-specific signs and symptonsand conformational bias.
2)Suzzanne Summers only had Stage one Cancer and had 94-96% chance of 10 year survival with or without additional treatment and chemo would only have added 1-4 % improvement in survival so her claims of alternative medicine cured her is blatantly wrong.
3) 20% of all Basilar strokes are caused by chiropractic manipulation, 1/2 of all chiropractic manipulation has negative side effects, Children should never be manipulated by chiropractor.
4) Chronic Lyme disease: most likely no such thing as chronic Lyme disease ;
definitely no such thing as chronic Lyme disease that responds to antibiotic
Check back over next couple days for full story.

the Science-Based Medicine Conference to start July 9th morning

2009-07-09T00:04:00.000-05:00

I will be attending the Science-Based Medicine Conference chaired by Dr Novella. I will be blogging about it during conference and reporting on it on my radio show The Doctor Is In on macsworldlive.com every Monday at 2 PM central