کریمی باز هم همه را غافلگیر کرد

خبر انتقال غیر قابل پیش بینی علی کریمی به شالکه ناکامی تیم ملی در جام ملتهای آسیا را تقریبا از یاد فوتبال دوستان برد.کریمی که در آستانه پیوستن به پرسپولیس بود و مذاکراتش را با علی دایی انجام داده بود ناگهان از بوندس لیگا سر در آورد.

در روزهایی که تعداد بازیکنان ایرانی شاغل در اروپا به تعداد انگشتان یک دست هم نمی رسد و لژیونرهایمان به مسعود شجاعی و جواد نکونام محدود شده اند علی کریمی که حتی دربین 18 بازیکن حاضر در جام ملتهای آسیا هم نبود و به تیم ملی دعوت نشد در سن 32 سالگی برای دومین بار راهی فوتبال آلمان می شود.

ستاره فوتبال کشورمان که پیش از این بین سال های 2005 تا 2007 با پیراهن بایرن مونیخ در بوندس لیگا بازی می کرد باردیگر نظر فلیکس ماگات را جلب کرد تا این بار این مربی آلمانی او را به شالکه دعوت کند.

کریمی بعد از اینکه در سال 2004 به عنوان مرد سال فوتبال آسیا انتخاب شد به عنوان بازیکن آزاد از باشگاه الاهلی امارات جدا شد و به بایرن مونیخ پیوست. در آن زمان ماگات هدایت باواریایی ها را به عهده داشت، بعد از جدایی ماگات از بایرن و آمدن هیتسفیلد کریمی هم کمتر فرصت بازی پیدا کرد و بیشتر به یک بازیکن نیمکت نشین تبدیل شده بود تا اینکه در پایان فصل 2007-2006 از اف سی هالیوود جدا شد و با وجود اینکه از تیم های ولفسبورگ، موناکو و سالزبورگ اتریش پیشنهاد داشت قید فوتبال در اروپا را زد و با رقم جالب 3.2 میلیون پوند به باشگاه قطر اسپورت پیوست.

بعد از حضور در فوتبال قطر کریمی بعد از 7 سال بار دیگر به پرسپولیس بازگشت و اولین گلش بعد از بازگشت به جمع سرخپوشان را در دربی پایتخت مقابل استقلال زد تا تیمش را از شکست نجات دهد.در پایان فصل اختلاف با عباس انصاریفرد مدیر عامل وقت پرسپولیس باعث شد جادوگر این تیم را ترک کند و به باشگاه استیل آذین بپیوندد.حضور 1.5 ساله کریمی در استیل آذین نیز با حاشیه های زیادی همراه بود که آخرین آن اخراج موقت به دلیل حضور در دیدار دوستانه الاهلی با میلان بدون اجازه مسئولین استیل آذین بود. کریمی بعد از این اتفاق با توافق حسین هدایتی رئیس استیل آذین از این باشگاه جدا شد. همه تصور می کردند جادوگر در سال های واپسین فوتبال خود بار دیگر به پرسپولیس باز می گردد اما بمب خبری امروز وقتی منفجر شد که سایت معروف کیکر خبر انتقال کریمی به شالکه را تایید کرد.

کریمی که هم در مستطیل سبز و هم خارج از زمین های ورزشی همه را غافلگیر می کند این بار پرسپولیس را دریبل می زند و به بوندس لیگا می رود تا پیراهن تیم شالکه یکی از پرمهره ترین تیم های این فصل بوندس لیگا را بر تن کندمنبع : سایت گل

شروین گیلانیl

Lessons From Norman Rockwell

by Brandon Betancourt



This past summer I got a chance to visit Washington DC. While I was there, I saw a Norman Rockwell exhibition at the Smithsonian American Art Museum. As it turned out, the exhibition was the private collection of George Lucas and Steven Spielberg. The exhibition highlighted Rockwell’s masterful storytelling.
I didn’t know much about Norman Rockwell before that day. I knew he was a famous American painter and I had seen a few of his replicas in restaurants. But after seeing the exhibition, I got a deep, deep appreciation of Rockwell and especially, how he was able to communicate an entire story with a single frame.


The old days
My 75 year old grandfather was with me that day and told me how, back in the day, he couldn’t wait to get the Post Magazine to see Rockwell’s cover and to read it cover to cover. He also shared with me how Rockwell’s pictures told stories about growing up, how they instilled patriotism and depicted American family values.




The influence of storytelling
The exhibition and my grandfather’s account reminded me of how powerful storytelling is. Rockwell did it with pictures and to some extend he moved a nation. But could we use storytelling to do other things such as inspire patients, communicate with customers or stir up emotions in people? I think so. Companies do it all the time. And the ones that have stories that resonate with the public are generally some of the most recognizable companies in our society.






Toyota, Hummer, Harley Davidson, American Express & Target
A perfect example of companies telling stories are car manufactures. When a person buys a Prius, they are telling a story to others about themselves. They are telling others, (and themselves) they are environmentally conscious and are doing their part to contribute towards the “green” cause. The opposite end of the spectrum is Hummer vehicles. The person that drives a Hummer is not concerned about the environment. We know at least that much.
On a Prius, one might find a sticker that reads, “my kid is an honor roll student at George Washington Elementary School,” whereas on the Hummer, you may find a similar sticker but it reads “my son can kick your honor roll kid’s ass.” Each car tells a different story.
Harley Davidson motorcycles tell a story of freedom, ruggedness and loudness. American Express tells a story of class, success and refinement. Which is the complete opposite of “Capital One’s” story. Wal-mart’s story is low prices. But despite being in the same business, Target has a completely different story. Target’s story is “design democratization.”






What is the story?
The story is essentially how we think and feel when we see a product or a service and what we tell others (and ourselves) about us when we use the product or service. Clear as mud, right?






What does all this have to do with our medical practices?
Glad you asked. Just like Starbucks creates a warm, hip, comfortable experience to support their story (different from the Dunkin’ Donuts experience), we too can use some of these storytelling elements I learned from the Norman Rockwell exhibition to help us define the narrative we tell our customers and patients.






Lessons From Rockwell
1. Define the story. We have to characterize what our narrative is going to be. For example, Subaru has had multiple advertising campaigns to support their story. Recently, they’ve used: “Love. It’s what makes a Subaru, a Subaru.” That slogan reinforces their story that people who own a Subaru, LOVE Subaru. It also talks about the Love that goes in to making a Subaru. It is not just an ordinary car. More recently, they’ve focused a lot on “safety.” That’s a story as well.
In our medical practices’ we too can define our story. We can have a customer service story or our story can be about being compassionate, loving and caring. We can tell the story about how we embrace holistic medicine or even be known as an obesity and nutrition clinic. A while back I met a dentist that wanted to have a high-tech dentist office. That was his story.
Answer this: What do you want others to think when they hear your practice’s name?


2. Paint the picture. Rockwell used a canvas to tell his story; Spieldberg and Lucas use movies; Apple Inc uses design to tell their story of sophistication, simplicity and innovation.
In a medical practice, we too can paint our picture and tell our story by how we decorate our offices, how we design our advertising, how we answer the phone and how we treat patients.
Painting the picture is simply the vehicle we choose to tell our stories. It can be done in many different ways. It doesn’t matter how we choose to tell our story. Heck, it could even be a simple as creating a blog for your practice. But always have the story at the center.


3. Cast to support your story. One fascinating tidbit about Rockwell was that he casted the people in his paintings much like a filmmaker cast an actor for a role in a movie. Once he found the right person or group of people, he used them as stand-ins while drawing the picture. He knew that the characters he choose would support his vision for the story he wanted to tell. This was brilliant in my opinion.
Let’s say your story is customer service … do you hire people that can support that story or do you have Ms. Grumpy McGee as the front office clerk?
At their retail stores, Apple “cast” geniuses (if you’ve been to an Apple store, you know what I’m talking about) and Starbucks don’t just have servers, they have “baristas.” Both of which help reinforce each company’s story.


4. Pay attention to detail. Norman Rockwell did not leave anything to chance. Everything in his painting was there for a reason. Every single little detail, every prop, even the supporting characters helped tell the story. In fact, for some, the details were what really emphasized the story. In other words, often it was a little detail that made the story complete.
As Walt Disney once said, “There is no magic in magic, it’s all in the details.”


In a medical practice, there are details that can enhance our story or detract from it. It could be the cleanliness of the waiting room chair or the old magazines or the pictures hanging on the wall. It could be how we answer the telephone to how the doctor is dressed to the manicure of the nurse.
We often underestimate details because, well, they are details. But I’m sure many of you can agree that sometimes, one little detail is the difference between a good story and a bad story. Don’t leave the details to chance.
Well, what do you think about this correlation between Norman Rockwell and a medical office? At first, there might not be much of an association when you first think about it. But I think there are many lessons.

“Now we have to stand up and be counted”

“It’s still a bitter defeat, because we played well, taking the lead and controlling the game. We’ve paid for an error and after their equalizer we couldn’t rectify the situation.” Alessandro Del Piero analyses the game against Udinese, looking to focus the attention on the upcoming fixtures: “We have to accept the critics and think about the next match. As I’ve said against Udinese we didn’t play badly and for several minutes we could run, play together and gave little away against the most in form team of the championship. This should be a starting point from this evening forward.” He commented on the supporters disappointment: “We are disappointed as well, because we have great ambitions and we would like to honour the name of Juventus. The difficulties that we’re facing increase our bitterness. Now we must stay together, stand up and be counted.”
@Juventus.com

Juve Scored: Juve 1 Udinese 0

Impressed by Marchisio magic :)

Montgomery Clift Remebered

"We loved each other in the most complete sense of the word."
Elizabeth Taylor

10 Doctors Who Shamed Their Profession

If you think about it, the comparison of doctors to mechanics is pretty apt. Given the specialized nature of their work and the general helplessness of most patients, doctors, like mechanics, are rarely held accountable for their actions. Sure, for the most part, doctors have your best interest at heart, but like in any profession, there are both good and bad apples. According to the National Patient Safety Foundation, 42 percent of people believed they had personally experienced a medical mistake. Additionally, numerous statistics have shown that a staggering amount of people die each year due to medical error. The following doctors made such blatant mistakes and/or lapses in judgment that they, at the very least, have a reputation that garnered them recognition on this list.
1.Dr. Earl Bradley, Monster: Nothing is worse than violating the trust of a child, which is why Bradley, a former pediatrician from Lewes, Delaware, is such a monster. In February of 2010, he was indicted on 471 charges of child sex abuse involving 103 children. Initial allegations against Bradley surfaced during the mid-’90s, but the hospital for which he worked was unable to verify the claims. They were enough, however, to prompt him to move to Delaware, where more allegations surfaced a decade later, including that he had abused his own son. Bradley was initially arrested in December of 2009 after a year-long investigation, which prompted the indictments two months later.


2.Dr. Robert Ricketson, Screw Up: Ricketson is no longer practicing medicine and the world is better for it. During a spine operation he performed on 73-year-old Arturo Iturralde in 2003, Ricketson intentionally inserted a piece of a screwdriver into the patient’s spine instead of a titanium rod. The rod he had intended to use went missing prior to the surgery, so he took it upon himself to improvise. As a result, Iturralde endured three additional surgeries to insert the proper rod and correct complications. After one of the operations, pieces of the screwdriver were recovered by nurses and the family was alerted. Iturralde became a paraplegic and died two years later, and his family was awarded $5.6 million in a malpractice lawsuit in 2006. During the aftermath, it was discovered that Ricketson’s medical license had been suspended in Oklahoma and Texas and he was denied consideration for a medical license in Kansas in 2002, a year after the botched surgery. He had previously been sued for malpractice several times and had history of narcotics abuse. Not a very impressive resume to say the least.
3.Dr. Jan Adams, Plastic Surgeon Imposter: Adams is most famous for performing the breast augmentation surgery on Donda West, Kanye West’s mom, that resulted in her death in 2007. But that’s not the only blemish on his record. In a malpractice suit against Adams, a previous patient claimed that she didn’t receive proper preoperative or postoperative care, leading to an infection that needed two more surgeries. What’s more, one patient claimed he got her drunk after a surgery and impregnated her, and another claimed a surgical sponge was left inside of her after a breast augmentation. Adams, who attended Harvard University, never received his diploma despite apparently completing his academic requirements. He’s also not a board certified plastic surgeon despite claiming to be one. How was this guy getting work?


4.Julie Ponder and Connell Watkins, Child Killers: Alternative medicine can be a risky proposition given the unproven nature of many of its methods. Attachment therapy in particular can yield tragic results when taken to an extreme. The treatment is used to remedy attachment disorders primarily suffered by adopted and fostered children who persistently misbehave or display little affection toward their new caregivers. In 2000, 10-year-old Candace Newmaker was killed during such treatment when she was suffocated during an intensive rebirthing session. Wrapped in a flannel sheet by psychotherapists Julie Ponder and Connell Watkins, she told to free herself from it while Ponder and Watkins held her down. She pleaded for her life, but was told by Ponder "You want to die? OK, then die. Go ahead, die right now." Newmaker was declared brain dead the next day due to asphyxia. The entire session was videotaped and presented as evidence against Ponder and Watkins, who were each given 16-year prison sentences — Watkins was paroled in 2008 after serving seven years.

5.Dr. James Burt, Ghastly Gyno: The notorious Dr. Burt was exposed for his harmful and downright bizarre practices in the late 1980s when numerous former patients came forward and initiated lawsuits. Beginning in the late 1960s, Burt took it upon himself to perform "love surgeries" in which he altered his patients’ vulvas without their consent. He justified his work in a book he authored in 1975, explaining that "Women are structurally inadequate for intercourse. This is a pathological condition amenable by surgery." He stated the procedure turns them into "horny little mice," though in reality, many of them suffered sexual dysfunction, infection and required corrective surgeries as a result. A $21 million suit was filed against Burt that couldn’t have come close to covering the physical and emotional damages endured by the at least 40 women he hurt.

6.Dr. Cecil Jacobson, Seed Spreader: As a fertility doctor, it was Dr. Jacobson’s duty to assist women in conceiving, and in the 1980s, it appeared he was doing a pretty good job. His patients reported high success rates due to his use of hCG, a hormone released during pregnancy that causes the typical bodily changes. During the supposed pregnancies initiated by hCG, he would identify the fetuses during an ultrasound, but they would usually "die" after about three months. Patients who suspected something was amiss informed a local television station, which investigated and exposed Jacobson. In the process, they discovered he used his semen to artificially inseminate patients who were told they were matched with an anonymous donor. Genetic testing later showed that he was the biological father of at least seven of his patients’ children. Jacobson, who won the Ig Nobel Prize for Biology in 1992 and claimed to have successfully oversaw the impregnation of a male baboon in the 1960s, was stripped of medical license and sentenced to five years in prison.


7.Dr. Rolando R. Sanchez, Accidental Amputator: To be fair to Dr. Sanchez, he has done a fine job of rehabilitating his reputation after the costly mistake he oversaw in 1995 — in fact, he’s still practicing. Even still, it’s the kind of inexcusable error you’d never wish on your worst enemy. In the process of amputating Willie King’s leg, Sanchez was informed by a nurse that he had cut into the wrong one. It was too late, however, and he had to finish what he started — King would later have the original leg amputated by another doctor. Consequently, Sanchez was suspended on the grounds that he presented an "immediate and serious danger to the health, safety and welfare of the public," and King later settled with the hospital.

8.Dr. Red Alinsod, Organ Tattoo Artist: Ingrid Paulicivic certainly won’t be recommending Dr. Alinsod given what occurred during her June 2009 hysterectomy. According to Paulicivic’s lawsuit, while putting the finishing touches on the surgery, Dr. Alinsod decided to brand his work by using an "electrocautery device to carve and burn" her name into her removed uterus. Alinsod claimed the move was necessary to ensure he wouldn’t confuse the uterus with others. Paulicivic became aware of the branding during a follow-up visit in which she complained of the resulting burns on her legs.

9.Dr. Elias Hanna, Carvey Carver: Dr. Hanna nearly caused the premature death of yet another Saturday Night Live legend. In 1998, he botched Dana Carvey’s heart bypass surgery by connecting a healthy portion of his artery to a healthy diagonal vessel instead of the damaged arterial section. It wasn’t until two months after the operation that Hanna discovered the mistake, resulting in an emergency angioplasty for Carvey — his fourth in less than a year. Before it was corrected, he was susceptible to suffering a fatal heart attack. Carvey filed a medical malpractice lawsuit and eventually settled for $7.5 million.


10.Alan Hutchinson, Dirty Dentist: Hutchinson, a dentist from Batley, West Yorkshire, UK, made headlines in 2007 when he was accused of using sterilized instruments to clean his ears and fingernails, working on teeth without washing his hands or using gloves, and urinating in a surgical sink. Complaints from a patient and his nurse, Claire Pygott, eventually led to a guilty verdict from the General Dental Council in London. Pygott said that she was "shocked, disgusted and appalled" by the dentist’s actions, which she had witnessed on more than one occasion.
 
Source : http://www.mastersinhealthcare.com/blog/
special thanks to Celina Jacobson

یک رویا

چند شب پیش خواب  دیدم پس از یک شب بیداری تا سحر ،صبح زود از خواب بیدار می شوم ،از پنجره بیرون را نگاه می کنم با تعجب می بینم باران شدیدی باریده و ساختمان های بتونی تغییر رنگ داده اند. دلم می گیرد و با خود می گویم: "من این همه بیدار ماندم ، این همه سرما،این همه تنهایی ،این همه انتظار ...و هیچ خبری نشد.../پدرام   

For The Time Being

It's a weird thing but not for me; as i'm a slow starter and it's true about this week.I've made up my mind about main objectives and that's so important to keep the pace and rhythm. There are times you must slow down,i mean this slow component will appear as vital as the speedy phase.

A Cinematic Weekend

I watched some great movies,this weekend:

1- Wild River 1960 : a masterpiece by Elia Kazan,starring Montgomery Clift and Lee Remick 
A young field administrator for the TVA comes to rural Tennessee to oversee the building of a dam on the Tennessee River. He encounters opposition from the local people, in particular a farmer who objects to his employment (with pay) of local black laborers. Much of the plot revolves around the eviction of an elderly woman from her home on an island in the River, and the young man's love affair with that woman's widowed granddaughter.(IMDB)
Montgomery Clift is realy eye catching in this movie
 8/10

2-Days of Wine And Roses 1962 : directed by Blake Edwards,starring Jack Lemmon and Lee Remick
An alcoholic falls in love with and gets married to a young woman, whom he systematically addicts to booze so they can share his "passion" together.(IMDB)
I liked the portrait of an ill-mannered couple,a weakness cripples and contagious,victimizes the weakest.The ending sequence is one of my favorites.Music is performed by Henri Mancini.
8/10

3-The Spirit of St. Louis 1957 : directed by Billy Wilder
Biography of Charles Lindbergh and his impressive effort to pursue his adventure:New York to Paris ;The first transatlantic solo flight in 1927.
47 yrar old James Stewart portrayed Charles Lindbergh at the age of 25
the movie became a box office flop when originally released.
I think the movie is years ahead of its time.I enjoyed the picture and the concept of the movie.
8/10

Ferguson:We Were Battered In The First Half

Sir Alex Ferguson has praised the work of Charlie Adam after Manchester United came from behind to beat Blackpool 3-2 at Bloomfield Road on Tuesday.

The United manager paid tribute to his fellow Scot, whose future has been the subject of much media debate.
Speaking to ESPN, Ferguson was honest in his appraisal of his team’s first half display.
“The first half we were battered, and we couldn't handle Charlie Adam, his corner kicks are worth £10m,” he said.
United trailed 2-0 at the break and Ferguson made changes to his side which altered the course of the game.
The experienced boss brought on Ryan Giggs for the ineffectual Darron Gibson and later replaced Wayne Rooney with Javier Hernandez. It was this substitution that kickstarted the red revival.
Ferguson added: “We changed it at half-time, brought on Ryan Giggs, started to penetrate and, in the end, ran out deserved winners. The team kept going, playing their football, penetrating, and they got their reward for that.”
Ferguson, whose team are now five points clear of Arsenal at the top of the Premier league and remain unbeaten, reserved special praise for his young Mexican forward.
He continued: “His [Javier Hernandez's] pace and timing of the runs are fantastic. He is so good at the end, [he] could have scored four goals. He has made a tremendous impact.”

A Rampant Comeback

This was a classic comeback by Manchester United...Hard game to watch.
Berba ,Giggs,Chicharito,Scholes...well done !

Berba : Artful Merit

As a keen artist in his spare time, Dimitar Berbatov recognises the power of imagery. So the Bulgarian will fully appreciate how two contrasting scenes illustrate his evolution into one of the stars of United’s 2010/11 campaign.

Two snapshots of Berbatov, taken five months apart, lay bare a United career dramatically rerouted from enigmatic to integral. Following a missed opportunity at Ewood Park last April, he cut a frustrated figure – prostrate, blinded by his own palms, his disappointment all too evident. Then, during September’s victory over Liverpool, having just scored his stunning overhead kick, he was a beaming hub of jubilance swamped by ecstatic colleagues.
Top scorer both for club and division, the striker's form has made him a mainstay of Sir Alex Ferguson’s side. A five-star show against Blackburn was only the third quintuple in United's history, he took his place in club folklore with the Reds' first hat-trick against Liverpool in 64 years and Saturday’s repeat against Birmingham made the striker only the seventh United player to reach three hat-tricks in the same season.
Those three goal-laden displays account for over half the striker’s total, but he has also popped up with vital solitary strikes to keep United’s points total clicking along apace. He’s looking entirely at home with the Reds’ quick-fire style of play, and his performances have had the effect of galvanising the rest of the team.
“Every club has a blueprint, an identity, and United’s is very strong,” says first-team coach Rene Meulensteen. “United stands for attacking, attractive football played at high speed, with one-touch passing combinations, individual skill and unpredictability. That’s all conducted at pace, with intent.”

It’s an approach which takes some getting used to, but Berbatov has found a way to suffuse his own unique talents with United’s well-established approach. Meulensteen is delighted with the huge impact made by the Bulgarian this season.
“Berba sees the art and beauty of bringing a ball down from 30 yards, then flicking it through for a team-mate with a back-heel,” says the Dutchman. “It’s an artistic approach which gives colour to the game and makes him colourful. He’s a vital ingredient to what the team is trying to achieve.
“I said to him once in training to think of himself as the best musician in the world, and as a team that we’re the best orchestra in the world. Everyone is playing the same tune – and Berba is elevating the whole performance. That’s why you are seeing beautiful things.”
The Bulgarian’s first two seasons after his switch from Spurs brought steady dividends (21 goals and 27 assists in 86 appearances) but Sir Alex Ferguson’s penchant for fielding Wayne Rooney as a lone striker ahead of a midfield trio meant he was often relegated to the substitutes’ bench for United’s bigger games – especially in the Champions League, where he started just three of the Reds’ 11 knockout ties in 2008/09 and 2009/10.
Late last term, United’s inability to pick up valuable domestic points in the injury-enforced absence of Rooney fanned the flames of transfer speculation. Given the sheer volume of big name, big money strikers linked, many media outlets suggested that Berbatov would be the unfortunate one to make room in the squad. Sir Alex’s riposte was brisk and blunt. Blue and white tickertape was still blustering around Stamford Bridge when the manager succinctly confirmed: “Dimitar will be staying here. I trust him.”

What the boss saw in his no.9 was incomparable control, vision and finesse – a skill set unlike that of any other player in the Premier League. The striker’s own response to the rumour mill was similarly unambiguous. Over the summer he maintained his fitness with regular running, and upon his return, increased his work with United’s strength and conditioning coaches. Self-belief has also been key to his move up to the next level of performance.
“You need to stay strong, believe in yourself and know what you can do,” the Bulgarian told Inside United in October. “There will be periods when you don’t feel so great, but you have your team-mates and manager who are always behind you. They always pat you on the back and say: ‘Don’t worry.’ It’s the same for every player, not just strikers.”
An impressive pre-season prompted further praise from Sir Alex, who said after the first warm-up game, against Celtic, “We know we have the right player.” After Berbatov’s Community Shield lob against Chelsea, the boss was even more effusive, labelling the striker “a genius”. And similar encouragement was forthcoming from within the dressing room. “We all know how good Dimitar is,” said Nemanja Vidic, while Darren Fletcher echoed: “He’s an important part of the team.”
According to Meulensteen, United’s inherent culture of rallying round one another for the greater good has played a huge part in Berbatov’s upsurge in confidence. “The good thing about this club is that, with the manager and the staff, there’s a massive loyalty to all the players,” says the Dutchman. “We bring them to the club because we know they can perform for us. So if they do have a difficult spell, they can fall back on us. That’s where we need to work harder to get them back to where they should be. That works and players feel that.

“You can rely on the people here, the people you’re training with, the staff, the manager and you all aim for the one thing: the best possible performance and results, and ultimately silverware.”
Berbatov’s treble in a five-star romp over Birmingham, allied to Manchester City’s defeat at Aston Villa, has given United marginally more breathing room in an enthralling Premier League title race - and Meulensteen says all United’s rivals should beware the Bulgarian as the season enters its nitty-gritty stage.
“Berba has been hugely important so far this season, and he’ll be key for the run-in,” says the Reds coach. “He wants to be key for the team, and he understands what he needs to do to be key for the team. And that’s clear in his performances and the goals that he’s scored. I want to see him with a medal around his neck and the biggest grin on his face at the end of the season, so he can look back and know that he’s really contributed so much to such a massive achievement.”
Should he end the current season a champion, Berbatov’s renaissance will be utterly complete – a triumph of heart for art’s sake.
@manutd.com

On Impact of Physician Burnout

by : Kevin Pho
I wrote last year in USA Today about the impact of physician burnout. Not only do doctors suffer, but so do their patients.

Burnout starts early in residency, with entering interns having a depression rate of 4%, similar to the general public. But after the first year of residency, that number balloons to 25%.
Now, another study adds fuel to this disturbing trend.
A paper published in the Archives of General Surgery looks at the prevalence of physician burnout in surgeons:
In a national survey, one in 16 surgeons reported contemplating suicide, researchers reported.
An increased risk of suicidal ideation was linked to three factors: depression, burnout, and the perception of having made a recent major medical error …
… But only about one in four of those who reported thinking about taking their own lives sought psychiatric or psychologic help.
The rate of suicidal ideation in surgeons, at 6.3%, was almost double of that in the general population (3.3%).
Physician burnout is a phenomenon that’s often ignored. The practice environment is deteriorating, with increasing time pressures and worsening bureaucratic burdens. Little of this is addressed in the national health conversation, or in the recently passed health reform law.
As more doctors burnout and quit medicine, patients will suffer. It’s certainly not an ideal situation as more than 30+ million newly-insured patients will be looking for physicians to care for them in the coming years.
And for the physicians who stay, burnout will impact the care they give to patients — including a decrease in empathy and an increase in medical errors.
Burnt out doctors feel they have little recourse. In the Archives study,
Only 130 surgeons — 26% of those who had recent suicidal thoughts — had sought psychiatric or psychologic help.
Among the 501 doctors who reported suicidal thoughts, 301 said they were reluctant to seek help because of worry that it could affect their medical license.
That’s unacceptable. Hospitals need to better recognize the signs of burnout and increase the support they give to depressed physicians.
Another consideration would be to better monitor work hours to ensure proper work-lifestyle balance. Today, doctors in training are strictly regulated to ensure they work no longer than 80 hours a week. Once they graduate and practice in the real world, that oversight ceases. There is nothing to prevent doctors from working days at time, which can happen at an understaffed, rural hospital, for instance.
The same zeal that goes into limiting residents’ work hours should be applied to doctors in the real world, to ensure their workload doesn’t drive them to burnout and potential suicide.

Compassion And Decency Overwhelmed By Fear

This piece written by Eileen M.K. Bobek,clinging on a heartfelt issue;the matter of our everyday communication clouded by ignorance ,vanity or idifference .It's an old story of coldness hang in the air between us.

The year after I finished my emergency medicine residency, I had all four of my wisdom teeth pulled.

Afterwards, I looked as if I had taken several punches to my face. My jaw was swollen, my skin a cornucopia of muddied blues, purples, greens, yellows and reds. If people didn’t know better, I told my husband with a laugh, they might think that I’d been beaten.
It took weeks for the swelling and discoloration to resolve. I went about my life, aware of both my face and people’s responses to it. Their pitying, uncomfortable, sometimes disgusted expressions told me what they were thinking: I was being abused. But nobody ever asked me how I was, how it had happened or even if it hurt.
“I can’t believe it!” I’d rail to my husband. “Not one person has asked. Not one!”
It wasn’t long before my disbelief gave way to resentment. I started testing people. When our eyes met, I’d refuse to look away, silently daring them to ignore my face. Sometimes I’d relent and reveal that I’d had some teeth pulled. An expression of relief, tinged with lingering suspicion, would wash over their faces. But their nervous laughter and the tension that evaporated from their shoulders told me that their relief was not for me: It was for them. I’d absolved them of the responsibility of asking.
Most of the time, I said nothing, letting the weight of their silence hang in the air between us. Their guilt made me feel certain that I would never be silent.




***

I still don’t know her name.
I saw her only at my six-year-old son’s weekly T-ball games, five years ago. She and her two young sons had the benign, nondescript look of the families advertised in picture frames–all feathery light-brown hair and creamy skin. Her husband dressed in oxford shirts and business slacks, a beeper clinging to his belt. He was a grim-faced Ken doll–clean-shaven, with immobile sandy brown hair and a mouth locked in a thin line.
Once, she and I chatted on the sidelines as our three-year-old boys played together alongside the baseball field. At some point, her son picked up the Styrofoam cup next to her and took a drink from the straw. I saw her husband’s face darken, his body stiffen. He strode from the first base line where he’d been coaching and snatched the cup from his son’s hands, slamming it into the garbage before returning to first base.
The boy retreated to his mother’s lap, leaning his body into hers. As she dipped her head over his, she said, “You know you shouldn’t take Daddy’s drink.”
I thought I saw her glance at me through the curtain of her hair. We never spoke again.
I don’t remember seeing her again until the end of the season. She was sitting on the ground, handing out drinks and snacks to the players. As they swarmed around her like bees, I walked over with my sons. She looked up.
The wind whipped back her hair to reveal a black eye.
She’d made no attempt to hide it; she wasn’t wearing makeup or sunglasses. Her defiant expression mirrored my own of so many years before; she was testing me.
I imagined us in the ER–she sheltered within the walls of a patient room, me sheltered within my white doctor’s coat, freed from my fear and embarrassment and empowered to ask her the question on my lips. If she denied being beaten and got indignant or angry, I could retreat into my role: It’s my responsibility to ask. If she admitted it, I could offer her help–social work, counseling, a safe house, something. But without my coat, there on our sons’ playing field, I felt stripped of my power and authority–a not-so-super hero, crippled without her costume.
I said nothing. There are too many children around, I told myself. This is not the time.
We held each other’s gaze for a few seconds; then she turned away.
Instantly, I knew that I’d made a mistake–but the moment was lost. I reassured myself that I would have another chance; I’d see her after the game, at the nearby ice cream store where they handed out the trophies.
When I didn’t see her there, I approached another mother.
“Do you know the woman at the game who was handing out snacks? She had a black eye. I was wondering if she’s all right.”
She started, darting her eyes away as she stammered, “I…uh…no…I don’t know…I see my son.” She hurried past me, trailing a string of unintelligible words.
It was then that I turned and saw her husband and two sons sitting in a booth ten feet away, eating their ice cream cones in silence. As my son received his trophy, I scanned the entrance for her, willing her to show up and come through the glass doors; she never appeared.
I still think of her sometimes. I don’t know whether her black eye happened by accident or intention. Remembering her husband’s angry response to his young son, I think I know–but still I want to deny.
I recall my own bruised and swollen face and my disbelief that so many people so easily let me go without a word of concern or curiosity. I imagine how alone I would have felt if the unspoken suspicion on their faces had been justified. And I remember her face–defiant, bare of makeup, as if she were testing us, hoping someone might ask. If I had asked, maybe she would have said it was nothing. Maybe she would have lied but also taken comfort in knowing that someone had dared enough, cared enough to ask.
That moment–the wind blowing back her hair, her eyes meeting mine–replays in my mind like an endless loop. I think of all the things I could have said. Are you okay? How did it happen? Does it hurt?
I want to believe that I would never make the same mistake again–that my fear would never again overwhelm my compassion and decency.
I can’t help but think that’s why she didn’t show up later. She had taken a chance on us, and we’d all failed her. I had failed her. I’d had my one chance–and let it slip away.

Eileen M.K. Bobek is a former emergency room physician.

Meeting Between Platini And The Serie A Executives

The meeting arranged by Figc between Serie A teams’ executives and the Uefa President Michel Platini took place yesterday afternoon at the Hotel Parco dei Principi in Rome. They addressed several matters: from the financial fair play to the initiatives against violence, racism and corruption, from the future of European competitions to the Uefa strategies in view of the next four years presidency (2011 - 2015) for which Platini is the only candidate. Juventus President Andrea Agnelli and MD-sports GM Giuseppe Marotta attended the meeting.

After the conference, the latter spoke to media about Juventus condition and targets: «The title? Football is so changeable, but our main object is to qualify for the next Champions League, as already stated at the beginning of this season. Actually, it depends on our opponents’ progress, not only on our squad. The championship is still quite balanced. The difference consists in crucial scorers and, unfortunately, we suffered from many injuries, like that occurred to Fabio Quagliarella. Intervening in the transfer market? We won’t just go through the motions of doing operations, even because now there are no important names suitable for Juventus».
Asked about Del Piero’s contract renewal, Marotta responded that: «Alessandro is a real legend in Juventus, a serious professional who earned the club’s and supporters’ respect. We will deal with this topic as soon as possible».
Finally, about Calciopoli, he said that: «Juventus rely on sports justice. We hope that a deep and accurate verification of the events could be carried out, because there is still a vague situation. We also hope that the solution will be achieved quite quickly».

@Juventus.com

"I believe what doesn't kill you,simply makes you...
                                                       ...stranger "

Valencia Back To Boost United

Antonio Valencia is making rapid progress in his recovery from a broken ankle and damaged ligaments and could be back in the first-team fold at the end of February.

Sir Alex Ferguson has described the winger's impending return as "a big boost" to United's hopes of clinching silverware come May. The Ecuadorian suffered the injury against Rangers in the Champions League match at Old Trafford back in September.
It was initially feared he would be missing for the rest of the season. That timescale was then brought forward after a successful operation, but he is still ahead of schedule.
"Antonio is doing well now, he has started his running programme and he's out with the physios every day, which is a big step forward," confirmed the boss. "He's been given the all clear from the doctors, so he's under our complete control now. That's great news."
The prospect of having Nani on one wing and Valencia on the other flank is an exciting one. "I think possibly towards the end of February he should be back in the first team squad," added the boss. "That's a big boost to us."
@manutd.com

A Laryngectomy Shakes This Physician To The Core

by : Itzhak Brook
As an infectious diseases physician with a special interest in head and neck infections, I had extensive experience in otolaryngological illnesses. However, when I was exposed to new, different, and challenging experiences as a neck cancer patient, I had to deal with these as a patient — not as a physician. I endured the consequences of radiation, repeated surgeries, and prolonged hospitalizations. I confronted medical errors in my care, discrimination following loss of my vocal cords, and the hardships of regaining my ability to speak.

Perhaps most importantly, I struggled to find a new meaning to my life.
Facing the diagnosis of hypo-pharyngeal carcinoma shook me to my core. I had to accept that I am not invincible, and that my life has an end. Even though the small cancer was surgically removed and I received local radiation, a recurrence two years later necessitated laryngectomy.
I encountered two types of physicians: the optimists who saw the cup half full and the pessimists who saw it half empty. I preferred those who told me the truth about the risks, potential complications, and prognosis, even when those predictions were not rosy. This is the best way one can make an educated decision about the best treatment.
Following my laryngectomy, I endured pain, weakness, the effects of narcotics, inability to eat or drink, and of course, inability to speak. I was rendered completely dependent, staying connected to an intravenous line, needing humidified, oxygenated air and constant suctioning to relieve sudden airway obstruction. All of this was an extraordinarily difficult adjustment. I understood for the first time why some patients elect to avoid heroic measures to prolong their lives, especially when their prognosis is poor.
Receiving empathetic and supportive care by the medical staff was extremely important to me. Surgeons can be impatient, rushing, and in a hurry to finish rounds, especially when they have surgeries scheduled. Most senior surgeons and many of the residents were, however, caring attentive and compassionate. I also encountered abrasive and rude physicians. On one occasion, I asked a senior resident to clean my obstructed tracheotomy tube. He reluctantly complied but did it not using a sterile technique and flushed the tube using tap water. The tube he wanted to place back was still dirty, and when I asked him to clean it better, he abrasively responded: “We call the shots here,” and left my room. I felt humiliated, helpless and angry being treated in this fashion.
Physicians need to realize how helpless and dependant their post surgical mute laryngectomees are. They require more patience and time to communicate their thoughts, questions and concerns. Their inability to speak is a very stressful and unfamiliar reality. It requires patience and support, from the medical team. Patients should be encouraged and allowed to fully express their feelings and concerns. This may be a slow and tedious process as they often need to communicate by writing. The emotional well being of the patient is a very important element of the post surgical care and ultimate recovery and adaptation to a life as a laryngectomee.
Life after laryngectomy was different and difficult, as I had to deal with new practical problems like re-learning how to eat and speak and return to a productive life. Moreover, I also confronted a difficult emotional obstacle: the constant fear that the cancer may return.
I had to continuously deal with the feeling of depression and hopelessness. Feeling depressed was surprisingly helpful when I initially faced the gloomy prospect of pending surgeries and uncertain future. It helped me to accept the potentially poor outcome. Yet I did not feel immediate depression after the surgeries because I was focused on my current situation and determined to get better. The depression, however, recurred as I had to deal with my new reality and limitations. This was enhanced by the hypothyroidism and post surgical anemia I developed.
I was determined to cope with my depression by gradually getting re-involved in professional and other activities that I had always enjoyed, including teaching, writing and even lecturing. These were instrumental in enabling me to feel better. The support of my family, a devoted social worker, responsive and caring speech and language pathologist and otolaryngologist , and members of the local support group were invaluable. However, I realized that depression can return and I will have to continuously keep it at bay.
My experiences as a patient greatly affected my approach to my patients and made me more sensitive and understanding to what they and their family are going through and feeling. I try to avoid the patterns of behaviors that were offending and distressing to me and be more compassionate and caring. I strive to model myself in the pattern of devotion, warmth and genuine care I felt from some of my caregivers. I know now better than before how critical they are. I also realize that by doing that I set an example to the physicians in training and students I teach.
Hopefully, my front-line observations will help health care providers to better understand their patients in a diligent and compassionate manner in which they were trained, and which should be the hallmark of their practice.

Dr Itzhak Brook is a Professor of Pediatrics at Georgetown University School of Medicine and author of the book My Voice: A Physician’s Personal Experience With Throat Cancer.

The Fault Line of Democracy

China may have invented the first printing press in 593 and published the first woodblock-printed newspaper, Kaiyuan Za Bao, in Beijing in 713. But in 2010 it wants to curb the newest information innovation led by Google.
To avoid censorship, Google has moved its search engine to Hong Kong and may leave China altogether after hackers, hidden for deniability somewhere deep within the Communist bureaucracy, breached Google’s proprietary systems and pieced together the e-mail exchanges of Chinese dissidents in order to trace their social networks.
Clearly a clash is shaping up that pits the raucous free-for-all of the Internet against China’s long-standing Confucian proclivity for order, respect for authority and a conformist notion of social harmony.
As they try to rebalance a relationship in which China still largely depends on American consumption of its exports and the United States largely relies on China’s purchase of U.S. Treasury debt, these tightly tethered partners in prosperity will only intensify their interaction in the coming decade. Inevitably, as the geo-civilizational plates push up against one another and produce tremors, might the cultural equivalent of subduction take place? Might, for example, more appreciation for freedom of expression shift Eastward and a greater appreciation of governing in the common interest and long-term perspective shift Westward?
To be sure, there is much cultural history under the bridge of today’s interdependence that contributes to the tectonic pace of convergence. China’s ancient “Warring States” period ended with a commitment to unified territorial integrity and stability that led to a modern focus on political control and social harmony. The path to peace after the West’s religious wars led to the opposite ideals: tolerance and diversity. In the Confucian tradition, China has relied on ethics, including obligations of the ruler to the ruled, and education to keep its institutions responsive, fair and honest. The West has relied on the check of democracy.
Nonetheless, as the political philosopher Daniel A. Bell proposes, some common ground can be envisaged along the fault lines.
Counterintuitive as it may sound to the Western ear, China may be more open to fundamental political reform than the United States. Since the rule of law in America is based upon the notion that the state itself is constrained by a body of pre-existing law that is sovereign, any thought of rewriting the Constitution is anathema.
In China, however, some intellectuals point out that Communist Party theory posits that the current system is the “primary stage of socialism,” meaning that it is a transitional phase to a higher and more superior form of socialism. The economic foundation will change with broader prosperity, and thus the legal and political superstructure must also change.
That has led some contemporary Confucian scholars to argue that new institutions for the higher stage of development should be designed based on indigenous sources of legitimacy from within the Chinese experience — meritocratic knowledge of the governing class, the people and tradition.
Mr. Bell, who teaches at Tsinghua University in Beijing, has taken these ideas a bit further. He envisions a meritocratic upper house whose members are chosen not by election, but examination; an elected national democratic legislature that advises the upper house on “preferences;” direct elections up to the provincial level, and freedom of the press. The “symbolic leader of the state” would be chosen from among the most august members of the meritocratic house.
Such a formulation and others similar to it — about which there is a rich debate across China today — sticks to the Confucian idea of meritocratic government mitigated by popular accountability, but not completely ruled by it. This seems precisely the kind of non-Western political modernization we will see as China adopts its own form of democracy.
China desperately needs such a system of accountability to stem the arbitrariness, corruption and cronyism that have accompanied the primary stage of socialism. Yet such an approach as put forth by Mr. Bell seems likely to also maintain stability in a way that parliamentary democracy of the West might not, and thus would be an acceptable course of change in China.
Paradoxically, while Chinese intellectuals seek to expand democratic accountability as the poor become more educated and prosperous, the U.S. has the opposite problem: Too much short-term focus by the citizens of the prosperous consumer democracies is undermining long-term sustainability.
Thus, while institutional innovation in China might focus on a truly empowered — yet checked — elected house, the U.S. would benefit from the type of long-term deliberation offered by bodies such as a meritocratic upper house and some entity with the responsibility for continuity of governance that stands as a unifying symbol in an ever more diverse society.
During the first round of globalization at the turn of the 20th Century, Sun Yat Sen tried to blend the institutions of Western democracy with Confucian meritocracy. Perhaps today, as the “rise of the rest” challenges Western dominance, the political imagination may again be open to new ideas. This time, it won’t be just Western ideas flowing East, but Eastern ideas flowing West as well.


by : Nicolas Berggruen and Nathan Gardels

iPad May Be Best Suited For Nondiagnostic Role

Apple's iPad shows significant potential for a number of radiology applications, but primary interpretation of medical images probably isn't one of them, at least for the current generation of the tablet computer, according to researchers from the University of Maryland in Baltimore.

While its display technology is probably sufficient to handle the job, the iPad's utility for primary interpretation in radiology remains limited by visual, ergonomic, technical, and regulatory hurdles, according to Kamran Shah, MD.

"Where the potential lies in terms of existing technologies and applications [includes] [electronic medical record (EMR)] dashboards, patient interaction and consent forms, education, and as an adjunct for PACS workstations," Shah said.

Shah discussed the prospects for the iPad in radiology during a scientific session at the 2010 RSNA meeting in Chicago.

A lot to offer

At first glance, the iPad's hardware has a lot to offer. It's about one-third the weight of the average thin laptop and about three times the weight of Amazon's Kindle e-reader.

"And it's a whole lot lighter than a 40-lb PACS [display]," he said. "So it's definitely portable."

The iPad's 9.7-inch backlit display employs white LEDs in lieu of cold cathode fluorescent lamps; this provides a higher contrast ratio and increased light output compared to nonwhite LEDs, Shah said. And the LEDs are deployed in an edge-lit configuration, which facilitates a thickness of only 0.5 inches.

It also utilizes in-plane switching technology, which offers benefits such as wider viewing angles and improved color reproduction. Though it doesn't have the retina display featured on the iPhone 4, the iPad provides a resolution of 1024 x 768 pixels. That's sufficient for two frames of 512 x 512 CT or ultrasound images, Shah said.

The iPad display yields a pixel density of 132 pixels per inch, which approaches the pixel density found on 5-megapixel displays, Shah said. It also provides a resolution of 2.6 line pairs per millimeter, which meets the American College of Radiology's (ACR) display recommendation.

It has a display luminance of 300 cd/m², which is similar to what is found on 24-inch PACS monitors.

"If you turn this up to, say, 100% max brightness and hold it in your hand, a 9.7-inch display that you're going to hold a few inches from your face is incredibly bright," he said. "This is a very bright device. Its contrast ratio is on par with what we're seeing with monitors that are being used in diagnostic applications."

Under the hood

The iPad is powered by the proprietary A4 System-on-a-Chip, which combines central processing unit (CPU), graphics processing unit (GPU), and hardware controllers. The fully autonomous GPU can render 720p video and do it in parallel with CPU tasks, Shah said.

Speed is not a high point for the iPad, however. Tests have shown that the iPad is orders of magnitude slower than a PACS workstation, Shah said.

"The iPad is anemic when compared to a PACS," he said. "This is a mobile-class processor, it's not a desktop-class processor. So it's important to recognize that."

Data connectivity is provided via 802.11n Wi-Fi, 3G capability, and Bluetooth 2.1. Memory is nonupgradeable and nonremovable, Shah said.

The iPad runs on a heavily modified version of the iPhone operating system. Multitasking was only recently added in late 2010.

"Applications will have to be rewritten to take advantage of the multitasking -- to, for example, enable DICOM viewing, speech recognition, and EMR right at the same time," he said.

As for security, the iPad offers integration with enterprise security standards and supports Microsoft Exchange ActiveSync policies. Local data are encrypted, and both local and remote data wipe is supported in case the device falls into the wrong hands, Shah said.

There are many DICOM visualization applications being developed for the iPad, all of which are going to require server-side rendering given the iPad's mobile-class processor, Shah said.

Another hurdle for diagnostic use will be the iPad's 9.7-inch display, which is going to pose ergonomic challenges if used for any protracted period of time for primary interpretation, he said.

And U.S. Food and Drug Administration (FDA) clearance for these applications remains a difficult road, Shah said.

"No DICOM visualization applications have been FDA 510(k) [cleared]," Shah said. "There have been a couple of mobile patient data applications that have been FDA 510(k) [cleared] for the iPhone and iPad, but none for image interpretation."

The iPad may also find a niche in a number of nondiagnostic image viewing applications, such as having house staff review images and reports while on rounds, Shah said.

Electronic medical record applications are another active area for the iPad, and there are more than 20 such apps in the iTunes App Store.

"The important thing about these applications is that while they do integrate with the enterprise EMR, there's the possibility of really novel integrations of data," he said. "So that you can have customized views for clinicians or for patients, [providing] a specialized dashboard for the individual user."

Clinicians could also use iPad for showing images to patients without being tethered to a PACS workstation, he said.

In addition, the iPad could be used to transform paper-based processes such as patient consent forms and questionnaires. Resident education also represents a promising application for the iPad, allowing users, for example, to interact with images while reading actual presentations, Shah said.

The iPad could also be used as an interface device, replacing other devices that are prone to failure with a multitouch device that's easier to use and less prone to fail, he said. It could be used for controlling a PACS or even for controlling an imaging modality.

"Multitouch capabilities are built into Windows 7, so it's not a huge step to imagine that this could happen," Shah said.

The iPad could be also used as inspiration for next-generation interfaces, he said.

"The whole concept of what the iPad has done for [user interface] design can be dramatic," he said.

by : Erik L Ridely

Damien Jurado's Night

This song is really breathtaking,cuts so deep and i like all the intellect and vivid sentiment woven into Damien Jurado's music;Just fantastic...

first came the screams and blood on the floor

the alcohol & magazines

in my flashlight, you're a star

razorblade that cuts you clean

smile for the camera

take off that dress

twenty dollars for a kiss

it's me who made you

it's me who will take you

i am not an evil man

i just have a habit i can't kick

it starts with an urge and ends with this

hang up the phone, i ain't finished yet 

song : Amateur Night
by : Damien Jurado 

Facebook reverses on sharing user addresses, phone numbers

On Tuesday, Facebook reversed a change announced on Friday to a permissions dialog box that users see when downloading third-party Facebook apps--a change that potentially makes users' addresses and phone numbers available to app developers.

The tweak was made known to developers of third-party apps Friday night, by way of a post on the Facebook Developer Blog. Basically, when a person starts downloading a third-party Facebook app, a Request for Permission dialog box appears that asks for access to basic information including the downloader's name, profile picture, gender, user ID, list of friends, and more. What's new as of Friday is an additional section that asks for access to the downloader's current address and mobile phone number.

At 2:25 a.m. Tuesday morning, a blog was posted on Facebook's Developer Blog which said:

"Over the weekend, we got some useful feedback that we could make people more clearly aware of when they are granting access to this data. We agree, and we are making changes to help ensure you only share this information when you intend to do so. We’ll be working to launch these updates as soon as possible, and will be temporarily disabling this feature until those changes are ready."