Douglas L. McSwain: Legal Forecast: The Supreme Court Won't ...

As described in The Supreme Court Won't Strike Health Reform - Part I, the forecast for the entire Affordable Care Act, or "Obamacare," is partly sunny. Here in Part II is the forecast for the Act's Medicaid expansion and an analysis of whether the individual mandate's penalty is a tax. If it is, then under the Anti-Injunction Act, the Supreme Court cannot review the constitutionality of the mandate at all right now. But again, the prediction is that lightning is not likely to strike down health reform.

The Medicaid Expansion: Why It Will Survive & the Potential for New Federalism Winds

Fair weather is expected for health reform's Medicaid expansion. But, the legal relationship between the state and federal governments -- what scholars dub "federalism" -- may need to be closely watched as the Supreme Court considers the expansion. New federalism winds appear likely to blow.

First, what exactly is Medicaid? Medicaid is the country's medical "welfare" for eligible low-income persons. It grew out of social movements that provided assistance to some, but not all the poor, primarily those believed to be "deserving." Typically, those eligible for Medicaid include low-income children, pregnant women, the elderly, blind or disabled persons, and those in need of nursing home care. The 2010 health reform act expands Medicaid eligibility to anyone below the age of 65 with income less than 133% of the federal poverty line.

Medicaid differs from Medicare, which is a fee-based medical insurance program for the elderly run wholly by the federal government. Medicaid is state-run but funded with both state and federal dollars. Federal Medicaid funding is substantial -- between 50% and 83%, depending on varying factors in each state -- plus, federal funds cover about half of the states' administrative costs.

Medicaid epitomizes congressional spending for what the Constitution calls our "General Welfare," and exemplifies "cooperative federalism" between the state and federal governments. The federal purse provides an incentive for states to agree to provide medical assistance to their poor, but when they accept federal dollars, they must comply with federal Medicaid requirements.

After Obamacare, 26 states are claiming before the Supreme Court that they do not agree with the expansion of Medicaid. They attack these reforms as "unaffordable," since they must administer Medicaid and share in some of its costs.

The states claim that they're incapable of quitting Medicaid because they've become so dependent on its substantial federal funding, and that if they refused federal dollars, they could not possibly absorb the entire cost of their poor's medical needs. They attack this dilemma -- the unaffordability of Medicaid's expansion, yet their incapability of quitting Medicaid -- as unconstitutional "coercion."

Their attack could spur the Supreme Court to specify new federalism constraints on Congress' spending power.

In 1987's South Dakota v. Dole and 1992's New York v. US, the Court restricted Congress' use of the spending power by forbidding the national government from compelling or "coercing" the states. The Court never explained where this restriction came from, and failed to explicitly attach it to the 10th Amendment, which reserves powers not delegated to the federal government "to the states...or to the people."

However, in more recent cases (2006's Arlington Central Sch. Dist. Bd. of Ed. v. Murphy, 2010's US v. Comstock, and 2011's Bond v. US), several Justices have written further on the 10th Amendment and its limitations, and dropped clues that the "coercion" restriction may actually stem from that amendment.

The Court may use the Medicaid expansion as an opportunity to announce a new doctrine of federalism that explicitly roots the coercion limitation in the 10th Amendment, and spell out a new inter-relationship between the state and federal governments. This could impact a number of federal programs that depend on the provision of federal funds to the states, and could become a major doctrinal shift in favor of the states.

Even so, the Court is not predicted to topple the expansion as "coercive," and here's why: Congress increased federal funding to cover the total cost of Medicaid's expansion until 2016, then gradually tapering to cover 90% of its costs by 2020 and beyond, to ease the expansion's fiscal impact on states. And, Congress is giving states ample time to adapt to the change -- until 2014.

In light of these mitigating actions, the "coercion" argument loses its force. Indeed, a number of other states have disagreed with the 26 challengers, embracing the reform act's expansion of Medicaid precisely because they appreciate the additional federal funding.

Given that no court has found "coercion" to date, the headwinds of judicial restraint will likely deter the Court from announcing a brand new federalism doctrine and using it to strike health reform's Medicaid expansion. Worth watching, however, will be how blustery any new constraining winds on the spending power gust for federalism in the future.

The Anti-Injunction Act (AIA): Strange Bedfellows on Whether the Mandate's Penalty is a "Tax"

One key thing to remember is that the Anti-Injunction Act (AIA) could block all legal attacks on the individual mandate. Two judges of the Fourth Circuit Court of Appeals and one judge of the D.C. Circuit concluded that all challenges to the mandate must be dismissed due to the AIA. In their view, the monetary penalty for failing to comply with the mandate equates to a tax, and if they're right, the AIA will knock the wind out of all the attacking storms.

First, what does the AIA do? The AIA is a Reconstruction-era statute that bars any lawsuit challenging "taxes" or monetary penalties legally equivalent to taxes.

The AIA is jurisdictional, which means it concerns whether the Supreme Court even has the power to review the constitutionality of the individual mandate. The Court must decide the AIA issue before anything else, because if it applies, the Court has no authority to strike or uphold the mandate.

Why does the AIA matter? Supporters of Obamacare often justify the constitutionality of the individual mandate based on Congress' nearly unquestioned power to tax. Yet ironically, the Obama Administration cannot argue the penalty is a tax supported by the taxing power. To do so runs smack into the AIA bar.

In a perfect demonstration of "strange bedfellows," both Obama's Justice Department and the challengers to the mandate have joined forces before the Supreme Court to argue that the AIA does not apply. Because they've aligned, the Court has appointed veteran legal counsel to argue the opposing view that the AIA does apply.

If the Court holds that the penalty equates to a tax, no legal challenge can be heard until after someone pays the penalty in 2015. Rather than wait until then, both the Administration and health reform's challengers seek a ruling now on whether the mandate is constitutional under Congress' "commerce" and "necessary and proper" powers, as discussed in Part I. But, by seeking a ruling in 2012, the Administration forgoes another constitutional support for the mandate's penalty -- Congress' taxing power.

So, is the penalty a "tax" that bars review? The health reform act charges the IRS with "assessing and collecting" the mandate's penalty. Arguably:

• The penalty is not a tax because Congress did not arm the IRS with every available tax enforcement tool to collect it. (The IRS' primary enforcement of the penalty will be withholding from individual tax refunds.)

• The penalty is a tax because the statute's text plainly refers to it as being "assessed and collected" by the IRS, like any other tax penalty.

Which argument will win is difficult to predict, but the Court's nine Justices have repeatedly expressed a penchant for strict reading of simple statutory text.

The Court has also interpreted the AIA very broadly, holding in three cases, Bob Jones Univ. v. Simon, Alexander v. Americans United, and U.S. v. American Friends Serv. Committee, that the AIA bars suits related in any way to a tax-related matter until payment of the tax is made.

For this reason, both sides had better brace themselves: the AIA could very well become a formidable barrier to a constitutional review of the mandate at all (or at least until 2015).

And, if the AIA does bar review, health care reform will proceed on schedule toward full implementation by 2015. If the mandate is challenged again then, its attackers could find it much harder to dislodge. According to some, a bar to Supreme Court review in 2012 might be a "good solution" in a politically charged election year. Overall, therefore, Obamacare appears to be facing fair skies, despite a few clouds in the distance.

?

Follow Douglas L. McSwain on Twitter: www.twitter.com/DouglasLMcSwain

Source: http://www.huffingtonpost.com/douglas-l-mcswain/legal-forecast-the-suprem_b_1174420.html

dan uggla kryptos student loan forgiveness amy winehouse cause of death amy winehouse cause of death white witch white witch

Bad economy means poor poor auto maintenance?

A new survey by Consumer Reports shows that the poor economy has forced many Americans to skip needed servicing of their car or truck. And the long-term results of this neglect could be both costly and dangerous.?

Forty percent of those responding said they had deliberately delayed repairs or maintenance on their primary vehicle in the past year. These drivers had put off work on the brakes, tires, exterior light bulbs or mechanical parts ? even though they knew it was needed.?

?This is of great concern because many of these items impact safety and reliability,? says Jeff Bartlett, deputy online automotive editor at ConsumerReports.org.??

Cash-strapped consumers are also holding on to their cars longer. Vehicles require more costly maintenance as they get older.?

?There is a real risk that if you put off a small maintenance or repair item today that it could snowball into a bigger and more costly problem down the road,? Bartlett warns. ?You've got to keep in mind that breaking down along the side of the road is never convenient, it's often costly and may ultimately lead to missing a day or two at work."?

The typical person responding to Consumer Reports in this random survey drives a 2003 vehicle (often bought used) which they?ve owned for five years. And they said they planned to keep it for another five years.

Their vehicle has already gone about 78,000 miles and is quickly approaching a major service interval. Bartlett worries that people who?ve delayed small repairs are more likely to skip this major maintenance which can cost $500 to $1,000 or more.?

One of the most interesting findings of this survey is that people know the consequences of putting off needed repairs or maintenance. ?Overall, 44 percent said it reduces the reliability, safety and value of their vehicle. Almost two in 10 said they are hesitant to take long-distance trips because of those safety and reliability concerns. ?Eight percent said they are becoming ?embarrassed? by their car.?

Consumer Reports just launched a new car repair information service for its online subscribers. The Car Repair Estimator shows you what various repairs cost in your area. There?s also a free section on this page, the Car Repair Encyclopedia, that?s available to anyone.

Source: http://bottomline.msnbc.msn.com/_news/2011/12/28/9772347-bad-economy-means-poor-poor-auto-maintenance

trans siberian orchestra trans siberian orchestra little big town little big town bennett bennett daniel day lewis

For Iowa, campaign brings more attention than money (Reuters)

DES MOINES (Reuters) ? Late on a recent Wednesday afternoon, Rick Perry walked into De Brito Baking Bistro in Mount Pleasant, Iowa, looking for its owner.

"Thank you, sir, for allowing us to come into your little bistro," the Texas governor and Republican presidential candidate said to his host, Jose Moreira. "I hope we generated a little business for you. One of our goals is to create jobs and in turn to create wealth and ... get the American economy moving again."

However much the January 3 Iowa caucuses boost the state's economy, Perry is certainly doing his part.

Desperate to give a jolt to a campaign that has struggled for traction after his poor performances in recent debates, Perry is outpacing all rivals in spending on TV ads - $2.86 million in December alone, according to the Des Moines Register. And this week, Perry's campaign is bringing in fellow Texans by the busload to tout his conservative credentials.

The caucuses that kick off the presidential nominating process can be a money-maker for a few Iowa businesses, as candidates and media flood the state for weeks of close-to-the-ground campaigning.

It's unclear how great the impact will be this year but business owners say they do know this: It's unlikely to come close to the boost they got in 2008, when Democrats and Republicans had contested caucuses here.

In 2008, the caucuses generated $25 million for the Des Moines area alone, according to Greater Des Moines Visitor and Convention Bureau.

That year, 2,500 members of the media visited the state. Iowa State University economist David Swenson estimates the candidates spent $15.5 million in Iowa then.

This time around, President Barack Obama is uncontested on the Democratic side. With only the Republicans competing, officials here say they expect less spending by campaigns and fewer members of the media to come here - roughly 1,500 by the time the causes are held.

Meanwhile, the campaigns generally have spent less time here with fewer staff members, partly a reflection of how different media strategies are coming into play this year.

Republican Newt Gingrich, for example, has had few staff members in Iowa but at one point was leading in the polls because of strong performances in nationally televised debates.

During the first nine months of 2011, Republican candidates spent $2.7 million in Iowa, less than 5 percent of the $55.8 million they spent nationwide.

Even so, some businesses in Des Moines, the state's capital and transportation hub, often manage to turn the caucuses into cash.

"It can be a real boon to local businesses," said an employee at the Village Bean Co. in Des Moines's East Village neighborhood.

Back in 2007, the Barack Obama campaign set up its headquarters next to the Baby Boomer Caf?.

"If it wasn't for the caucus and election last time I wouldn't be here today," owner Rodney Maxfield told local television station WHO-TV. Maxfield's restaurant gained renown when Obama's daughters began asking for his cookies by name.

Around the corner, the Raygun clothing store overflows with caucus-related apparel.

For $19, you can buy a T-shirt proclaiming "Corporations are people too" - a now famous comment made by candidate Mitt Romney, a former Massachusetts governor, at the Iowa State Fair this summer.

The store was packed last week as visitors finished their Christmas shopping.

A PIZZA CHAIN'S ROLE

Outside Des Moines, midwestern chain Pizza Ranch has secured its own prominent role in the presidential nominating process.

In March, The New York Times declared "The Road to the White House is Paved With Pizza" because the self-described Christian business and its 71 Iowa restaurants offer free space for candidates to meet with potential voters.

According to the Des Moines Register, Rick Santorum, a former U.S. senator from Pennsylvania, has popped into a Pizza Ranch 11 times during his tour of the state's 99 counties.

Michele Bachmann, a congresswoman from Minnesota, has made at least 18 visits to Pizza Ranch restaurants.

A few weeks ago, aides to Texas congressman Ron Paul told the Register they knew their candidate was surging in the Iowa polls because his crowds no longer could fit inside Pizza Ranch's dining rooms.

Despite Iowa's prominence as the first contest in presidential nominations, campaigns typically are tentative in their spending here, compared with the spending that takes place later in the process once the true contenders emerge.

During the early part of the 2008 election cycle - the third and fourth quarters of 2007 - Republican candidates spent six times as much in Virginia as they did in Iowa, according to Swenson, the Iowa State economist.

Even the millions spent on television ads in Iowa - $5 million so far this cycle, according to the Kantar Media Campaign Media Advisory Group - does not represent the true economic impact here, analysts say.

Although campaigns spend money for time on local TV stations, most of the advertising consultants and producers involved in such projects live elsewhere, so that money never really benefits Iowa.

Reporters' daily spending can give a slight bump to the local economy.

If those 1,500 members of the media spend an average of one week each in Iowa, they would generate 45 low-paying jobs for the state this year, Swenson said.

Citing Iowa's gross domestic product of $147 billion in 2010, Swenson predicts that the caucuses will contribute less than 0.01 percent of that amount to the state's economy.

Luckily, Iowa needs the business far less than other states this year. With an unemployment rate of 5.7 percent, Iowa has better jobless numbers than all but five states.

"I don't know that anybody out there can say we have a significantly greater amount of business activity as the consequence of the caucuses," Swenson said. "It's dinky."

(Editing by David Lindsey and Cynthia Osterman)

Source: http://us.rd.yahoo.com/dailynews/rss/economy/*http%3A//news.yahoo.com/s/nm/20111227/pl_nm/us_usa_campaign_iowa_economy

kim jong ii dead snapdragon snapdragon kim jong ill dead wedding crashers next iron chef next iron chef

Children don't give words special power to categorize their world

ScienceDaily (Dec. 27, 2011) ? New research challenges the conventional thinking that young children use language just as adults do to help classify and understand objects in the world around them.

In a new study involving 4- to 5-year-old children, researchers found that the labels adults use to classify items -- words like "dog" or "pencil" -- don't have the same ability to influence the thinking of children.

"As adults, we know that words are very predictive. If you use words to guide you, they won't often let you down," said Vladimir Sloutsky, co-author of the new study and professor of psychology at Ohio State University and director of the university's Center for Cognitive Science.

"But for children, words are just another feature among many to consider when they're trying to classify an object."

For example, suppose that someone you trust shows you an object that looks like a pen and says that it is a tape recorder, Sloutsky said.

Your first reaction might be to look at the pen to see where the microphone would be hidden, and how you could turn it on or off.

"You might think it was some kind of spy tool, but you would not have a hard time understanding it as a tape recorder even though it looks like a pen," Sloutsky said. "Adults believe words do have a unique power to classify things, but young children don't think the same way."

The results suggest that even after children learn language, it doesn't govern their thinking as much as scientists believed.

"It is only over the course of development that children begin to understand that words can reliably be used to label items," he said.

Sloutsky conducted the study with Wei (Sophia) Deng, a graduate student in psychology at Ohio State. Their research appears online in the journal Psychological Science and will appear in a future print edition.

The study involved two related experiments. One experiment involved 13 preschool children aged 4 to 5 and 30 college-aged adults.

In this first experiment, participants were shown colorful drawings of two fictional creatures that the researchers identified as a "flurp" or a "jalet." Each was distinct in the color and shape of five of their features: body, hands, feet antennae and head. For example, flurps generally had tan-colored square antennae while jalets generally had gray-colored triangle antennae.

The researchers made the heads of the animals particularly salient, or conspicuous: the flurp had a pink head that moved up and down and jalet had a blue head that moved sideways. The head was the only part of the body that moved.

After they learned the relevant characteristics of the flurp and jalet, participants were tested in two conditions. In one condition, they were shown a picture of a creature that had some, but not all of the characteristics of one of the creatures, and asked if it was a flurp or a jalet. In another condition, they were shown a creature where one of the six features was covered and they were asked to predict the missing part.

The critical test came when the participants were shown a creature with a label that matched most of the body parts -- except for the very noticeable moving head, which belonged to the other animal. They were then asked which animal was pictured.

"About 90 percent of the children went with what the head told them -- even if the label and every other feature suggested the other animal," Sloutsky said.

"The label was just another feature, and it was not as important to them as the most salient feature -- the moving head."

Adults put much more stock in the label compared to children- about 37 percent used the label to guide their choice, versus 31 percent who used the moving head. The remaining 31 percent had mixed responses.

However, to eliminate the possibility that participants were confused because they had never heard of flurps and jalets before, the researchers conducted another experiment. The second experiment was similar to the first, except that the animals were given more familiar names: "meat-eaters" and "carrot-eaters" instead of flurps and jalets.

In this case, the difference between the adults and children was even clearer. Nearly two-thirds of adults relied on the label to guide their choices, compared to 18 percent who relied on the moving head and 18 percent who were mixed responders. Only 7 percent of the children relied on the labels, compared to 67 percent who relied on the moving head and 26 percent who were mixed responders.

Sloutsky said these findings add to our understanding of how language affects cognition and may help parents communicate and teach their children.

"In the past, we thought that if we name the things for children, the labels will do the rest: children would infer that the two things that have the same name are alike in some way or that they go together," he said.

"We can't assume that anymore. We really need to do more than just label things."

Recommend this story on Facebook, Twitter,
and Google +1:

Other bookmarking and sharing tools:

---

Story Source:

The above story is reprinted from materials provided by Ohio State University. The original article was written by Jeff Grabmeier.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.

---

Journal Reference:

1. Vladimir M. Sloutsky and Wei Deng. Carrot-Eaters and Moving Heads: Salient Features Provide Greater Support for Inductive Inference than Category Labels. Psychological Science, 2012

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/~3/fGyPFiWr1Fg/111227142537.htm

anencephaly texans jordans houston texans houston texans prometheus movie indianapolis colts

Concert to benefit Homes For Our Troops

During his third deployment, Army Sgt. 1st Class Charles Armstead underwent a hemipelvectomy, one of the rarest forms of lower extremity amputations in which he lost his right leg up to his pelvis.

?While at his outpost in Hamman Al Alil, Iraq on May 2, 2009, SFC Armstead did not know that an Iraqi insurgent had already killed two soldiers while infiltrating the outpost and had severely wounded the gate guard when he went to investigate a noise coming from the gate area,? according to a news release. ?As SFC Armstead came upon the scene he was shot in the stomach leaving him with internal injuries and shattering his right hip, while also causing extensive nerve and spinal damage.?

After two surgeries and six months of recovery, he was able to be transferred to a medical center closer to home, and he still undergoes therapy today.

On Nov. 12, Armstead was given the keys to a brand-new, specially adapted home built by volunteers affiliated with Homes For Our Troops, a national nonprofit organization that exists to serve those who have returned home from deployments in all branches of the military with serious disabilities and injuries since Sept. 11, 2011.

He now lives in the home with his wife, Tonia, and their three daughters, Ashley, Amber and Amauri.

?The assistance from Homes for Our Troops will give me back my independence,? Armstead said before moving into the home. ?I will be able to get around my home without assistance. In my living situation now, I am confined to a couple of rooms in the house because we have a two-story home ... A home from HFOT will eliminate that problem. ... It will be a life-changing experience for both me and my family.?

In support of Homes for Our Troops, Country Roads RV Resort in Yuma is holding a benefit concert to raise funds for the organization.

The Texas Tenors, who gained national fame on ?America's Got Talent? in 2009, will be performing at Country Roads at 3 p.m. and again at 7 p.m. on Jan. 25 with hits including country, Broadway, classical and gospel songs. All proceeds from the concert will go toward Homes for Our Troops.

Last year, residents of Country Roads raised $12,000 through a dinner and various other fundraisers to donate to the organization and this year, they are hoping to raise even more, especially since Homes for Our Troops recently announced it is planning to build a house for an injured veteran in Arizona for the first time.

Although tickets for The Texas Tenors usually range in price from $100 to $150, said Country Roads events organizer Carol Ganzer, the Yuma concerts will cost $20-$30 a ticket, depending on seating preference to allow for all veterans in the area to be in attendance with their families.

The Country Roads ballroom, where the concert will be held, can hold up to 800 people at each performance. The residents are hoping to fill up every seat and sell 1,600 tickets, Ganzer said.

?During the benefit concert, we will be honoring every veteran in attendance as well as providing a donation to our wounded veterans, so it's pretty exciting, ... and to have this here in the Yuma area where we have such a military presence, I think it's especially exciting,? said Ganzer. ?In speaking with folks locally, most are not aware of the Homes for Our Troops organization, but (they are) very impressed with (it) and interested in helping once they understand their mission.?

Those interested in attending should visit www.countryroadsyuma.com/entertainment-special-events.html to purchase tickets for the event and choose seating.

For more information about Homes For Our Troops, visit www.homesforourtroops.org, and for more information about The Texas Tenors, visit www.thetexastenors.com.

Sarah Womer can be reached at swomer@yumasun.com or 539-6858. Find her on Facebook at Facebook.com/YSSarahWomer or on Twitter at @YSSarahWomer.

Source: http://www.yumasun.com/news/home-75544-troops-homes.html

smokey robinson smokey robinson close encounters of the third kind pulmonary embolism meryl streep sacramento kings drew brees

Packers make 30,000 more shares of stock available

GREEN BAY, Wis. (AP) ? Sales of Green Bay Packers stock have been so brisk since an initial offering three weeks ago that the team is making another 30,000 shares available.

The team initially offered 250,000 shares for sale starting Dec. 6. But the allotment is nearly gone, even though the shares cost $250 each and have virtually no resale value.

"The support from our fans has been outstanding, and we appreciate their enthusiasm," Mark Murphy, the team's president and CEO, said Tuesday in a statement. "We continue to receive interest in the offering, and this increase in the number of available shares will help ensure that we are able to accommodate all those who want to become shareholders."

The offering is scheduled to end Feb. 29 or when all remaining shares are sold.

The NFL's only publicly owned team is applying the proceeds toward a $143 million expansion of Lambeau Field. The Packers have said they would fund the expansion themselves and through private funding, and wouldn't ask taxpayers to contribute as owners of other teams typically do.

Selling all 280,000 shares would raise $70 million.

The shares are available at packersowner.com for $250, plus a $25 handling fee per transaction.

Buyers gain the privilege of calling themselves NFL owners, though the stock value will not go up and there are no dividends. Stockholders also get voting rights, and they can attend annual meetings where they can meet team executives and tour the Packers Hall of Fame.

The team has had four other stock offerings. Sales in 1923, 1935 and 1950 helped keep the Packers afloat at a time when other small-market teams were struggling to survive.

The most recent sale was in 1997. The team offered 400,000 shares for $200 apiece, but only about 120,000 shares were sold.

___

Online:

Packers shares: http://packersowner.com

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/347875155d53465d95cec892aeb06419/Article_2011-12-27-FBN-Packers-Stock-Sale/id-15a3f4cd592542ceaaffb502f15fbf6a

storm in alaska storm in alaska asteroid eric johnson eric johnson russell pearce russell pearce

Horns talk quarterbacks as they hit California

Source: http://texas.rivals.com/content.asp?CID=1310937

black friday violence il postino il postino online black friday deals nfl scores nfl scores college football scores

Mother-Toddler Bond May Influence Teen Obesity (HealthDay)

MONDAY, Dec. 26 (HealthDay News) -- Teens are more likely to be obese if they had a poor emotional relationship with their mother when they were toddlers, according to a new study.

The findings echo previous research showing that toddlers who didn't have close emotional ties with their parents were more likely to be obese by the time they were 4.5 years old.

In the latest study, researchers examined U.S. National Institute of Child Health and Human Development data collected from hundreds of families who lived in nine states and had children who were born in 1991.

The analysis showed that the children's risk of obesity at age 15 was highest among those who had the lowest-quality emotional relationship with their mothers when they were toddlers, the Ohio State University researchers said.

More than one-quarter of the toddlers who had the lowest-quality relationships with their mothers were obese as teens, compared with 13 percent of those who had closer bonds with their mothers in their early years, according to the report published online and in the January print issue of the journal Pediatrics.

These and previous findings indicate that the risk of obesity may be affected by areas of the brain that control emotions and stress responses working together with those that control appetite and energy balance, the investigators explained.

The authors suggested that obesity prevention efforts should include strategies to improve the mother-child bond, as well as promoting healthier eating and exercise.

"It is possible that childhood obesity could be influenced by interventions that try to improve the emotional bonds between mothers and children rather than focusing only on children's food intake and activity," lead author Sarah Anderson, an assistant professor of epidemiology, said in an Ohio State University news release.

"The sensitivity a mother displays in interacting with her child may be influenced by factors she can't necessarily control. Societally, we need to think about how we can support better-quality maternal-child relationships, because that could have an impact on child health," Anderson added.

More information

The Nemours Foundation has more about overweight and obesity in children.

Source: http://us.rd.yahoo.com/dailynews/rss/health/*http%3A//news.yahoo.com/s/hsn/20111226/hl_hsn/mothertoddlerbondmayinfluenceteenobesity

adam shulman nfl power rankings week 13 nfl power rankings week 13 patrice patrice tether lana peters

Diploma in Finance | Article Directory Hub

As a personal Financial Planning Association Ohio adviser you will find a lot of job options and have knowledge that are accepted in many nations around the world through Diploma of Financial Planning Missouri and Certified Financial Planner Study. There are programs available in money training that will give you the necessary knowledge to become a part of this enjoyable and complicated marketplace. As a personal Financial Planning Association Ohio adviser you will help individuals choose what is the best way obtain their money.

What Financial Planning Association Ohio Advisors Do?
A Financial Planning Association Ohio adviser will match with their customers and help them set their personal targets, both shorter and lasting, and then help obtain them. They will come up with a operating plan that will match their customers needs and adapt it accordingly in the future to keep it on monitor and up currently. They will liaise between customers and the organizations that they want to get, and will often analysis these organizations, offering precise reviews of their results through Diploma of Financial Planning Missouri and Certified Financial Planner Study .

Understanding this primary situation is how experts become profitable. If you crash in any of these size the chance of lasting results is small. However, if you can obtain Diploma of Financial Planning Missouri and Certified Financial Planner Study, a lot of associates, discussions or visits you can make large results. The best of these achievement to control is associates and most experts have no idea how to improve this variety with least period effort.

What the Financial Planning Association Ohio explains, however, is that persons who have a extensive operating strategy contain one critical factor that all other study contributors lacked: a strategy.
More especially, the FPA discussed that having a ?written? strategy allows the most-confident contributors to know several things about their economical upcoming. These things include:
Whether they were on monitor to obtain their economical targets ? other contributors did not know whether they were behind or before strategy, or right on monitor.
Whether their objectives were obtainable or unlikely ? other contributors did not know how much they desired to preserve or how much they could attract during their pension years.
Whether they were self-confident that they would arrive at their economical targets ? other contributors were uncertain.

Benefits of being a Financial Planner or having Diploma of Financial Planning

Working as a Financial Planning Association Ohio adviser will provide you a lot of job achievement as you are serving individuals obtain their personal targets. It is complicated and enjoyable and through the many job options you will practical knowledge personal and expert progression.

The internet is the best way to obtain Diploma of Financial Planning Missouri and Certified Financial Planner Study. Can you consider having prospective buyers get in touch with you every day because they found you online? Would this improve your business while eliminating up large time for other tasks? I know that when I was a adviser, about 70% of there was a time used marketing particularly in the beginning.

To be healthy, one should do regular exercises and eat balanced diet which includes fruits, green vegetables and fibrous diet. This makes the person healthy and happy forever.

Khunas has great experience in writing in health She has got her articles published in many magazines

Source: http://www.articledirectoryhub.com/business/careers/diploma-in-finance/

ham recipes adrian peterson darlene love free kindle books roasted potatoes turkey recipes turkey recipes

motorhommie WA V.President commented on SonsOfLibertyRiders.com's group 'Washington Sons Of Liberty'

Sorry, Readability was unable to parse this page for content.

Source: http://americanlibertyriders.ning.com/xn/detail/3899508%3AComment%3A420722?xg_source=activity

three stooges pujols mythbusters miami marlins hanley ramirez blago mumia abu jamal

Chinitech: RT @F4FIA Gagnez sous le sapin la tablette tactile Apple iPad 2 WiFi blanc 16Go via @ilovetablette #SCTM4g ? htt... http://t.co/0Z1yBtkP

• Passer la navigation
• Twitter sur votre mobile ? Cliquez ici m.twitter.com!
• Passer cette ?tape
• Connexion

• Connexion
• Rejoignez Twitter !

RT @F4FIA Gagnez sous le sapin la tablette tactile Apple iPad 2 WiFi blanc 16Go via @ilovetablette #SCTM4g ? htt... bit.ly/tkqiyP Il y a environ 1 heure via twitterfeed

Chinitech

Pied de page

• ? 2011 Twitter
• ? propos de nous
• Contact
• Blog
• Statut
• Ressources
• API
• Entreprises
• Aide
• Offres d'emploi
• Conditions
• Confidentialit?

Source: http://twitter.com/Chinitech/statuses/150732687802503168

brian eno tomb of the unknown soldier tomb of the unknown soldier reo reo chilis snow white and the huntsman

Toshiba Thrive 7 vs. Samsung Galaxy Tab 7 Plus Android Tablet Comparison Smackdown

Sorry, Readability was unable to parse this page for content.

Source: http://www.mobiletechreview.com/ubbthreads/showflat.php?Board=news&Number=41866

kathy griffin bethany hamilton bethany hamilton how to make it in america how to make it in america schweddy balls schweddy balls

ahramonline: Case underway of 76 accused of attacking Israeli and Saudi embassies http://t.co/I6kykttx #Egypt #Israel #Sept9

• Passer la navigation
• Twitter sur votre mobile ? Cliquez ici m.twitter.com!
• Passer cette ?tape
• Connexion

• Connexion
• Rejoignez Twitter !

Case underway of 76 accused of attacking Israeli and Saudi embassies english.ahram.org.eg/News/30093.aspx #Egypt #Israel #Sept9 Il y a environ 3 heures via Tweet Button Retweeted by 1 person

ahramonline

Ahram Online

Pied de page

• ? 2011 Twitter
• ? propos de nous
• Contact
• Blog
• Statut
• Ressources
• API
• Entreprises
• Aide
• Offres d'emploi
• Conditions
• Confidentialit?

Source: http://twitter.com/ahramonline/statuses/150520075869360128

kris jenner livestand power ball kelly slater kelly slater palindrome palindrome

Fighting Stereotypes in the U.K. (Powerlineblog)

Share With Friends: | | Politics - Top Stories Stories, RSS and RSS Feed via Feedzilla.

Source: http://news.feedzilla.com/en_us/stories/politics/top-stories/178824003?client_source=feed&format=rss

devin hester shayne lamas cain velasquez dos santos waterboarding boxing news boxing

Top 20 Concert Tours from Pollstar (AP)

The Top 20 Concert Tours ranks artists by average box office gross per city and includes the average ticket price for shows in North America. The previous week's ranking is in parentheses. The list is based on data provided to the trade publication Pollstar by concert promoters and venue managers.

TOP 20 CONCERT TOURS

1. (New) Kanye West / Jay-Z; $2,243,684; $120.57.

2. (1) Cirque du Soleil ? "Michael Jackson: The Immortal"; $1,924,258; $116.04.

3. (2) Taylor Swift; $1,302,209; $68.69.

4. (3) Enrique Iglesias; $806,680; $69.00.

5. (4) Journey; $687,843; $58.05.

6. (New) Bob Seger & The Silver Bullet Band; $671,909; $67.88.

7. (5) Foo Fighters; $668,629; $48.76.

8. (6) Keith Urban; $581,289; $62.47.

9. (8) Caifanes; $500,310; $48.01.

10. (9) Jason Aldean; $481,111; $38.00.

11. (New) Sting; $475,037; $92.43.

12. (10) Furthur; $457,480; $51.73.

13. (New) Guns N' Roses; $416,872; $52.63.

14. (11) Andr? Rieu; $335,203; $75.34.

15. (13) Deadmau5; $328,370; $45.81.

16. (12) Tiesto; $298,721; $49.48.

17. (14) Duran Duran; $288,046; $73.98.

18. (15) Paul Simon; $252,673; $77.14.

19. (16) Jeff Dunham; $251,471; $46.79.

20. (17) Roger Daltrey; $240,036; $78.37.

For free upcoming tour information, go to http://www.pollstar.com

Source: http://us.rd.yahoo.com/dailynews/rss/music/*http%3A//news.yahoo.com/s/ap/20111222/ap_en_mu/us_top20_concert_tours

st louis weather jack the cat frank lucas lego man lego man cheryl hines john lackey

College football notebook: QB Barkley coming back 1 more year for Trojans

Published: Friday, Dec. 23, 2011 12:15 a.m. MST

LOS ANGELES ? Southern California quarterback Matt Barkley believed he was prepared to play in the NFL and the draft prognosticators agreed with him.

He had skillfully guided the program through two years of NCAA sanctions, put up big numbers to add his name to the list of great Trojans quarterbacks.

Barkley just wasn't ready to leave. He still had some unfinished business at USC.

Setting off a round of cheers at USC's Heritage Hall, Barkley announced Thursday that he's returning for his senior season, putting off the NFL for a chance to lead the Trojans from under the cloud of NCAA sanctions to a BCS bowl.

"I am staying so I can finish what I started," Barkley said.

At 6-foot-2, 220 pounds and with a game that matured over three years at USC, Barkley was projected as a high first-round pick in the NFL draft, an enticement that had lured his predecessor, Mark Sanchez, after his junior season.

Instead of following Sanchez's footsteps, Barkley took the route of former USC quarterback Matt Leinart and Stanford's Andrew Luck.

Leinart returned to USC after winning the Heisman Trophy and a national championship, and led the Trojans to the 2005 BCS title game, where they lost to Texas. Luck came back this season after being the Heisman runner-up last year and took the Cardinal to the Fiesta Bowl while finishing second to Baylor's Robert Griffin III in this year's Heisman voting.

Like those two, Barkley felt as though he still had goals he wanted to accomplish after leading the Trojans to a 10-2 record and a No. 5 ranking in The Associated Press poll.

Barkley let USC coach Lane Kiffin know about his decision with a Christmas ornament that had a picture of the two together during this season's game against Colorado on one side and the words "One More Year" on the back. His announcement Thursday in front of about 200 people, including his family and Kiffin, set off a wave of applause and a quick burst from USC's band as a pair of cheerleaders danced along.

"That's not an easy decision," Kiffin said. "Not many people would do what Matt has done."

Barkley is the latest in a heralded lineup of USC quarterbacks that includes Carson Palmer, Leinart and Sanchez.

He had an uneven first season with the Trojans, making some questionable decisions that led to 14 interceptions. Still, Barkley threw for over 2,700 yards and 15 touchdowns to become the only freshman semifinalist for the Davey O'Brien Award as the nation's best quarterback.

Barkley developed into a mature leader by his sophomore season, again throwing for over 2,700 yards, with 26 TDs, a completion rate of 62 percent and 12 interceptions. He also handled questions about USC's sanctions with poise, never shying away from talking about the program's difficulties.

Source: http://www.deseretnews.com/article/700209503/College-football-notebook-QB-Barkley-coming-back-1-more-year-for-Trojans.html?s_cid=rss-38

good morning america new orleans jazz fest new orleans jazz fest dwight howard louis ck michelle duggar heisman

Head of Customs and Border Protection resigns (CNN)

Share With Friends: | | Politics - Top Stories News, RSS Feeds and Widgets via Feedzilla.

Source: http://news.feedzilla.com/en_us/stories/politics/top-stories/178107922?client_source=feed&format=rss

north korea news patrick willis team america snow day snow day ryan braun neti pot

(Founder Stories) Charity: Water?s Harrison ?We Were Going To Run Out Of Money In Five Weeks?

As the founder of Charity: Water, Scott Harrison has overseen substantial growth since launching his non-profit five years ago. He tells Founder Stories host, Chris Dixon?that since 2006?Charity: Water has raised "about $50-million" and "helped 2-million people" gain access to clean water. However, just eighteen months in things were a bit rocky. Harrison says the organization was dangerously off-balance and was "going to run out of money in five weeks.

Source: http://feedproxy.google.com/~r/Techcrunch/~3/5xcKPJbuXx4/

news channel 5 nathan hale kohls coupons joe kapp joe kapp macys best buy

Readiness for health, bioterror emergencies eroding: report (Reuters)

WASHINGTON (Reuters) ? Readiness for bioterror and health emergencies could erode nationwide as cash-strapped governments face cuts in spending, a study reported on Tuesday.

Key programs that detect and respond to bioterrorism, new disease outbreaks and disasters are at risk because of federal and state budget cuts, according to the ninth annual report on health preparedness by the non-partisan Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation.

Among the programs, 51 of the 72 cities in the Cities Readiness Initiative, which supports distribution and administration of vaccines and medicine during emergencies, could be dropped.

The 10 state labs with top-level chemical testing status could lose that designation, the report said. The downgrade would leave the U.S. Centers for Disease Control and Prevention (CDC) as the only public health lab with full ability to test for chemical terrorism and accidents.

Twenty-four states are at risk of losing the support of career epidemiology field officers, who are CDC experts on responding to disease outbreaks and disasters.

The CDC's ability to mount an overall response to nuclear, radiologic and chemical threats as well as natural disasters is at risk because of potential budget cuts. All 50 states and the District of Columbia would lose the support CDC provides during these emergencies, the report said.

"We're seeing a decade's worth of progress eroding in front of our eyes," Jeff Levi, the Executive Director of TFAH, said in a statement.

Combined federal, state and local budget cuts mean public health departments can no longer support basic elements of preparedness, the report said.

The report in part urged assuring funding for public health readiness and improvement of biosurveillance. It also called for improved research, development and manufacturing of vaccines and medicines and improving the ability to care for an influx of patients in an emergency.

(Reporting by Ian Simpson; Editing by Greg McCune)

Source: http://us.rd.yahoo.com/dailynews/rss/us/*http%3A//news.yahoo.com/s/nm/20111220/us_nm/us_emergencies_readiness

mirror mirror tanuki mirror mirror trailer bob knight bob knight lavar arrington hope solo dancing with the stars

Treating Stress, Speech Disorders With Music

Copyright ? 2011 National Public Radio?. For personal, noncommercial use only. See Terms of Use. For other uses, prior permission required.

IRA FLATOW, HOST:

This is SCIENCE FRIDAY. I'm Ira Flatow. You know that nice feeling you get when you listen to your favorite tune? What about music that can actually be medical therapy? It does exist. It's prescribed for illnesses from speech disorders to autism, Alzheimer's, even cancer.

Take the case of Congresswoman Gabrielle Giffords. After she was shot in the head earlier this year, one way she learned to talk again was by singing her favorite songs, like this Cyndi Lauper tune.

(SOUNDBITE OF ABC BROADCAST )

REPRESENTATIVE GABRIELLE GIFFORDS: (Singing) Girls, we want to have fun. Oh, girls just want to have fun.

FLATOW: That was from an ABC special on her recovery. But why is music therapeutic? What effect does it have on the brain if it's used as a treatment for many different conditions? That's what we'll be talking about this hour and listening to because a little bit later in the hour, a certified music therapist is here in our studio to perform live on the show and give you an idea of what music therapy sounds like.

And if you're interested in music therapy, maybe you've tried it, maybe you use it, maybe you're a practitioner, give us a call. Our number is 1-800-989-8255, 1-800-989-TALK. You can also tweet us @scifri, @-S-C-I-F-R-I, or join a discussion on sciencefriday.com.

Let me introduce my guests. Oliver Sacks is a physician and professor of neurology and psychiatry at Columbia University Medical Center here in New York. His latest book is "The Mind's Eye," and he is back with us in our New York studios. Good to have you back, Oliver.

DR. OLIVER SACKS: Good to be back.

FLATOW: Thank you for being with us. Connie Tomaino is the executive director and co-founder of the Institute for Music and Neurological Function at the Beth Abraham Family of Health Services in the Bronx, New York. She's also here in our studios. Welcome, Dr. Tomaino.

CONCETTA TOMAINO: Pleasure to be here.

FLATOW: And Joke Bradt is an associate professor in the Creative Arts Therapies Department at Drexel University in Philadelphia; she joins us from the studios of WRTI. Welcome to the show, Dr. Bradt.

DR. JOKE BRADT: Thank you, and thanks for having me.

FLATOW: And we're going to be talking with Connie - what exactly, how do you define music therapy, Dr. Tomaino?

TOMAINO: Well, music therapy is the use of music and the components of music to affect function, either cognitive, psychological, physical, most psychosocial and behavioral function, through interaction with a professional music therapist. Many times people assume something to be music therapy, but it really isn't if it isn't provided by a music therapist.

FLATOW: And that's a good point, Dr. Bradt, is it not? It has to be somebody who knows what they're doing, a trained musical therapist.

BRADT: Absolutely, and music therapists are actually trained at different levels. They can be trained at a Bachelor's level, Master's or even Ph.D. level. But as Dr. Tomaino just pointed out, it's very important that music is provided by a trained music therapist because music truly plays a primary role in the therapeutic process, to strengthen the client's abilities as well as to address their needs.

So it's not something peripheral in the session. Sometimes I think people have the misconception that just listening to music, listening to a CD is music therapy. While that certainly can be therapeutic, in music therapy many forms of music interventions are used, such as improvising music, singing, songwriting as well as listening to music.

But typically we use multiple musical experiences within a session, and we build up different experiences based on what the client is reporting. The discussions that we have following a music experience may lead us then to a very different type of music making.

FLATOW: Dr. Sacks, you and Dr. Tomaino have worked together for many years. A lot of your patients had trouble walking or moving - Parkinson's patients, for example. Give us an idea of how music helped some of those patients.

SACKS: Well, Connie and I have worked together since 1979, but before that, when I went to our hospital in 1966, there was a large population of people with Parkinson's and great difficulty moving and specifically initiating movement. I wrote about these patients later in "Awakenings."

They couldn't initiate, but they could respond, and they responded above all to music. At first, when I saw these people who seemed speechless and motionless, zombies, I didn't know if there was anything going on. But when I was told that they could sing and dance, I said you're kidding me. But then I saw it for myself. And music is vital for people with Parkinson's.

FLATOW: And any other neurological diseases?

SACKS: And many others, in particular people who have lost expressive language, who have become aphasic, may still be able to sing and even to retain some of the words of a song. You know, whenever I see patients who are aphasic, the first thing I do, whether it's their birthday or not, is to ask them to sing "Happy Birthday." And sometimes they are themselves amazed that language is still there, although maybe embedded in song.

And - but songs can be a remarkable bridge from music to the restoration of language, and when language is restored, it may be on the other side of the brain, which is very remarkable.

FLATOW: Dr. Tomaino, that sounds example like what happened with Congresswoman Giffords, right?

TOMAINO: Right. You know, what Dr. Sacks is saying about how well people who have had strokes, who have aphasia, can sing words to songs, even though they can't speak it, what neuroscientists are telling us is that the shared mechanisms, neural networks, that they're shared between speaking words and singing the words.

What happens when somebody sings a song is the lyrics of that song are so well-preserved that it's easier for them to access those words through song rather than to speak them freely. And so we use the song as a preliminary way to stimulate word retrieval.

And what some of the neuroscientists are showing us, that there's actually compensatory mechanisms on the right side of the brain that start to build up as somebody starts to recover the use of these words through singing.

FLATOW: Are they recovering those words, the music, from a different part of their brain than they would if they were speaking it?

TOMAINO: It's a shared process. So they're singing the words utilizing networks responsible for speech and singing. The areas that have been damaged are the word retrieval mechanisms on the left (unintelligible) area, but singing the word is different from speaking the word. And over time, the singing the word stimulates the recovery of speaking the word but using a different part of the brain to do that, which is amazing.

FLATOW: And you've noticed this, Dr. Sacks?

SACKS: Yes, this is an amazing business. It's quite intensive, and it requires close relationship between a - the patient and the therapist. And it's quite a big investment but a fantastic one because it may prevent one being speechless for the rest of one's life.

There may be similar shared mechanisms which allow people who stutter to sing fluently.

FLATOW: Dr. Brandt, you use it for chronic pain, do you not?

BRADT: That's right.

FLATOW: Tell us about that.

BRADT: Patients who live with chronic pain often view their body as the enemy, and the body becomes something that needs to be fixed, something that needs to be avoided. And when I was working with patients with chronic pain initially, I used a lot of instrumental improvisation.

But very quickly I discovered that when I used voice with them that it was - gave them an opportunity to reconnect with their bodies in a very new and different way, and they were able to build up a positive relationship with their body.

For example, rather than trying to avoid the body, through singing one can truly feel the vibrations of your voice through your body, and by using different pitches you can use different parts of your body. And people would be surprised how it feels like to feel their body again.

But more importantly, as they were, or as they are reconnecting with their body, they also are now suddenly being put in a position to reconnect with their emotions. As you - as the listeners may have experienced, when we try to hold back on emotions, let's say at a funeral or when your boss yells at you, very often we feel it in our throat. We get a very tense throat. We may even have a sore throat afterwards.

And it's because we regulate much of our emotions by holding in our breath or by holding down, literally, our voice, and when you engage in singing, suddenly that gateway is opened, and through singing and deep breathing these patients who really have been trying to stay away from their deep inner feelings are suddenly reconnected with those.

And so through singing we are able to work through the trauma of living with chronic pain, as well as trying to learn to manage and cope physically with the pain as well as actually we have a lot of fun singing together, harmonizing together. So it gives them a lot of energy and fun and helps them a bit with their fatigue and their often hopeless mood.

FLATOW: It almost sounds like they're taking - they're on drugs.

BRADT: Absolutely, and that's the beauty of vocal music therapy is that I'll give patients very specific exercises to take home, and they can just do it. And some patients initially will only do it in the car or in the shower because they don't want their partner to hear them, but very quickly they get comfortable just using singing throughout their day to help them deal with their emotions, as well as with the physical pain.

FLATOW: Does it take the place of medication? You know, can you get the same, you know, effects in the brain without giving them drugs that the singing does?

BRADT: I haven't gone that far yet, but definitely what we do know, chronic pain is a huge issue because medical - sorry, medicine is just not enough and often does not bring enough relief to these patients. And so music, together with medicine, can help them manage their pain better.

And some patients will report that they were able to start reducing their pharmacological intake.

FLATOW: Connie Tomaino, you...

TOMAINO: There's actually some scientific evidence that the experience of pain is gated when somebody is listening to music. There's also been some studies about the elevation of certain neurotransmitters when somebody hears music, just passively listens to music, that is emotionally important to them or stirring to them.

So those particular songs actually increase serotonin and other types of neurotransmitters that work as an analgesic. So we have a natural mechanism within our body to actually gate pain if we listen to music that's pleasurable.

FLATOW: We're going to take a break and come back and talk lots more about music therapy, and actually we have a musician sitting right here next to me. We're going to talk - give a little bit of a demonstration about what kind of musical therapy is in effect and how to do it. Our number, 1-800-989-8255. Sitting here with Oliver Sacks, Connie Tomaino, Joke Bradt, and Andrew Rossetti is going to be joining us right after the break. So stay with us. We'll be right back.

(SOUNDBITE OF MUSIC)

FLATOW: This is SCIENCE FRIDAY. I'm Ira Flatow. We're talking this hour about music therapy and the various ways music can help patients. Talking with my guests Oliver Sacks, Connie Tomaino, Joke Bradt, and I'd like to bring on another guest who can tell us about how some hospital departments are using music therapy and give us a sample of what some stress-relief music therapy sounds like.

Andrew Rossetti is a musical therapist in radiation oncology at the Louis Armstrong Center for Music and Medicine at Beth Israel Medical Center here in New York. Welcome to SCIENCE FRIDAY.

ANDREW ROSSETTI: Thank you, pleasure to be, Ira.

FLATOW: They created a whole division for musical therapy at the hospital?

ROSSETTI: There is indeed a department, a music therapy department, that has been in place for 19 years.

FLATOW: It's that well-accepted - I mean, people don't know about it, but you certainly have known about it for many years then?

ROSSETTI: Sure, that's true.

FLATOW: Give us an idea, you're sitting here with your guitar in hand at our microphone. Give us a sample of what you might play for a radiation patient, for example, to relax. What kind of music would that be?

ROSSETTI: OK, well, this is a little snippet of an intervention that I've been using in the music therapy program in radiation oncology at Beth Israel. And this is directed at patients that are coming in for radiation therapy on their first day, and they're receiving something called simulation, which is not radiation therapy, but it has been reported to be one of the most stressing moments for patients in their entire trajectory of treatment.

And so we've been targeting state anxiety in this, and this is a protocolized intervention that usually takes about 20 minutes. I know we're not going to have quite that long.

FLATOW: Right.

ROSSETTI: So it is an induction to altered state. I use suggestion. You're not going to be hearing all of that, just a little snippet of it. And at the end of it, I would use guided imagery, and during that time I'd be teaching patients different techniques that they can use during simulation to feel more comfortable, to be less anxious.

FLATOW: OK.

(SOUNDBITE OF MUSIC)

ROSSETTI: Focus on the music. Focus on the sound. Perhaps let's start off with a deep breath. I see you closing your eyes. If you feel uncomfortable at any time, you can open them. Allow yourself to focus now on the physical sensations of breathing, breathing in, breathing out, noticing how, as you breathe in, air enters your lungs, expanding them, the physical sensations of breathing out.

Focus now on the chair you're sitting on, on its surface, and allow yourself to settle into that surface.

FLATOW: I'm so relaxed.

(SOUNDBITE OF LAUGHTER)

FLATOW: I have the rest of a radio program to do.

(SOUNDBITE OF LAUGHTER)

FLATOW: That was - and that's very effective.

ROSSETTI: Thank you.

FLATOW: Yeah, and how often do you do this with the patients? Every time they come in for...

ROSSETTI: No, well, this particular - this is part of an intervention that lasts about a half an hour in total. And simulation is a - usually just a one-time experience.

FLATOW: And you also play this in the ICU unit, don't you? You play something - you play with the sounds that are going in the ICU unit.

ROSSETTI: That's correct. This is something called environmental music therapy, and it's a process that we're using to try and modulate the actual environment in the hospital, which is something that many patients feel to be hostile. And those feelings are something that actually, based on research that's being done now that's starting to come in, that feelings of being in a hostile environment do not actually lead to good medical outcomes.

So what we're trying to do is modulate the environment, have people feel more safe and comfortable, and the way we do that in fragile environments like an ICU or just waiting rooms where, unfortunately, people may have a long wait before they get treated, these are Petri dishes for anxiety. So this is something we try and address with music.

FLATOW: Let's see if we can give our listeners an idea of how it would sound and the kind of music you would use to try to tone down the scary, I guess would be the word, the anxious producing - let's listen to the sound of the ICU unit and how you might mask that or modulate that with your music.

(SOUNDBITE OF INTENSIVE CARE UNIT)

(SOUNDBITE OF MUSIC)

FLATOW: So you're changing your music as we hear those beeps and chimes going off, to match them.

ROSSETTI: Trying to interact with what I'm hearing, not - one of the things that I interact with is the actual ambient sounds, but the other thing is that this intervention is interactive with patients. So ideally I'm trying to read cues and clues from the patients also.

But yeah, I'm trying to structure these annoying monitor sounds that we were hearing in the background.

FLATOW: And we talked before about your first - the first music that you played for the patient. How do you decide when that patient needs that music, which patient is a candidate to have that?

ROSSETTI: OK. Sure, well, all of my patients are by referral from the radiation oncologist that I work with on the unit. And they're assessed first off for state anxiety.

FLATOW: And then decide from that. 1-800-989-8255 is our number. We're talking with Oliver Sacks, Connie Tomaino, Joke Bradt and Andrew Rossetti, talking about music therapy. Oliver, you've been doing this for years. You must be very familiar with these kinds of treatments and these patients in a different modality.

SACKS: I've had less experience with pain and anxiety as the problem as various hard neurological ones like Parkinson's and aphasia and dementia. Dementia is - can be a huge challenge, and in every chronic hospital and nursing home there are - will be dozens of people who may be confused, disoriented, withdrawn, or very noisy.

And when a music therapist comes in - I've seen this often with Connie, almost within seconds eyes will fasten on her, and people will cock their heads to listen, and perhaps some will start to sing along, and that is very, very amazing and very important.

Partly because musical skills and musical sensibility outlast ordinary memory and intelligence, and almost indelible and can be reached even in people who are very demented. And when they listen to music which they know and love, the circumstances and the memories and the feeling which went with that music come back to them and anchor them and animate them. And that's very remarkable.

I'm sure a lot of these patients also have anxiety, and some have pain and probably several things are addressed at once.

FLATOW: Connie, is there any standardization to what you do? I mean, you do it so well, but how many places around the country know how to do with with the skills that you have?

TOMAINO: Sure. Ira, that's the challenge. The field of music therapy, like the field of medicine, is very broad, with many treatments and applications depending on the patient, the need, the environment. Some like to work psychotherapeutically with somebody or work as music and medicine more prescriptively with a musical treatment that would target something like speech recovery or memory enhancement. What's happening around the country is that advanced trainings in specific modalities using music therapy in the NIC unit, for example, or neurologic music therapy or specific applications using a certain model of music therapy for a specific population and specific reasons.

And if people want to check, the American Music Therapy Association has a lot of different fields or fields of music therapy as applications in music therapy that people can learn more about how music therapy is applied across different populations.

FLATOW: Can you get a degree in music therapy?

TOMAINO: Oh, you do.

FLATOW: You can.

TOMAINO: Yes, both undergraduate and graduate level. Music therapy is a board-certified profession, where somebody after they have mastered their academic training do 1,200 hours of clinical supervision and then sit for a board exam. And then in several states, like New York state, it is a licensed profession as well.

FLATOW: We were talking about right at the beginning that - and you defined musical therapy and Joke Bradt said the same thing that you have to be a trained musical therapist...

TOMAINO: Music therapist.

FLATOW: ...excuse me - music therapist.

TOMAINO: We're very musical.

(SOUNDBITE OF LAUGHTER)

TOMAINO: But it's music.

FLATOW: So when you say music therapist, you're not - we're not talking about like Andrew Rossetti playing the guitar here. They - you have to know how to play the guitar. You have to know how to use what he does or...

TOMAINO: You have to know to read the patient...

FLATOW: Yes.

TOMAINO: ...so you can manipulate music in real time. That's where music therapy differs from prescribed music listening programs or a musician coming in and playing by bedside because they want to do something nice for the patient.

FLATOW: Right.

TOMAINO: There's a lot of excellent musicians who do bedside visits, or programs like that. But music therapists are trained either psychotherapeutically or in music and medicine to use music and the components of music for a very prescriptive reason. And that's why you'll hear music therapists speak differently about their work because of the populations they work with.

FLATOW: Dr. Bradt, you've looked at a lot of clinical trials of music therapy...

BRADT: Mm-hmm.

FLATOW: ...gold standard evidence for whether the music therapy works. Does that exist?

BRADT: That's right.

FLATOW: It - what have you found?

BRADT: Well, we - together with a colleague of mine, Dr. Dileo of Temple University, we indeed saw the need to look at what evidence is out there and how can we summarize this so that people have a better idea of what the true impact of music therapy is. And we decided to do Cochrane systematic reviews, which is indeed considered the gold standard in evidence-based practice, and basically, we looked or identified randomized controlled trials in medical music therapy, so medical applications of music therapy.

And we did that with a variety of patient groups. We did a Cochrane review with cancer patients. We did one with cardiac patients, mechanically ventilated patients, people with acquired brain injury and people in end-of-life care. And we found many different things, but I think overall and what Andrew just talked about is that music interventions help patients, medical patients reduce their anxiety. We found a significant impact of music interventions on anxiety in cancer patients and people with heart disease, especially those who had just suffered a heart attack and people on mechanical ventilation.

In addition to that, we found that music therapy improves quality of life in cancer patients and patients at end of life. Now, these findings were based on just a few trials, but they greatly agreed with each other, so that was an important finding. And then, also important was that we found that music is able to reduce heart rate, respiratory rate and blood pressure, and these were very important findings for patients such - the heart disease patients or patients on mechanical ventilation because as you can imagine a heart disease patient who is hospitalized experience great anxiety. And this increased anxiety then leads to increase heart rate and so, of course, puts them at a greater risk for a heart attack again. This thing with mechanic...

FLATOW: Let me just...

BRADT: Mm-hmm.

FLATOW: I just have to remind everybody that I'm Ira Flatow, and this is SCIENCE FRIDAY from NPR. I'm sorry. I didn't mean to interrupt you there.

BRADT: No problem. And also with mechanically ventilated patients, these patients experience great discomfort because of the frequent suctioning, the inability to talk, with that comes huge stress and discomfort. And if music can help reduce their anxiety and help reduce heart rate and respiratory rate, reduce their blood pressure, of course, that can only have important health benefits.

FLATOW: Let me get - let me go to...

BRADT: And then...

FLATOW: Before we go to the break, let me go - get a phone call in here if I can. Let me go to Susan(ph)...

BRADT: Sure.

FLATOW: ...in Tempe. Hi, Susan.

SUSAN: Hi. How are you?

FLATOW: Hi there.

SUSAN: Thanks for bringing attention to this subject. I have a comment and a question. I am - first of all, I am a mother of four boys, small boys. Two of them have autism, and one of those is nonverbal. I don't think anybody understands how important music therapy is to the autism community because of the effect that it has on these nonverbal kids. When I - there is nobody more skeptical of music therapy than me. I'm an airline pilot for a living, so if it doesn't have to do with science, I'm generally not getting it.

My son, my 6-six-year-old son, basically did not speak. He would string maybe two words together. That was his idea of a sentence. I walked into a pet store one day, and he sang from beginning to end the song "Slippery Fish." It had seven stanzas. And I - my jaw hit the floor, and I went back to his access liaison with the state, and I said he doesn't speak, yet he sang this song. She goes he needs music therapy. And I looked at her, and I go I am really busy with these four kids. I don't need something that isn't going to be effective. She said it will, trust me.

We have had eight different music therapists now. And the reason is, is because of the massive cuts that the music therapists have taken here in the state of Arizona - and I'm talking 40 to 60 percent cuts. The last one who had to quit, she said I make more money at Nordstrom, and the reality is I have to provide for my family. But my child, my nonverbal child, the one that spoke like two words together with his sentence, he speaks, he communicates, he can give us his wants.

I mean, he's not talkative. He's not - but the music therapist, she comes twice a week. This has made such a huge difference to our family, to our life, his ability to be educated, to provide self-care. And I mean, there is no one that was a bigger nonbeliever than me, and now, there is no one that is a bigger believer. These people are so, so important.

FLATOW: All right...

SUSAN: The oldest also had cancer, and we had music therapy for him. And when he was in the hospital, it was amazing. My question is these therapists are so vital...

FLATOW: Susan, let me - can you hang on - I'm going to keep you on. We have to go to a break but hang on...

SUSAN: OK.

FLATOW: ...and we'll come back...

SUSAN: I know.

FLATOW: ...with your question, OK? 1-800-989-8255 is our number, talking about music therapy with Oliver Sacks, Connie Tomaino and Joke Bradt, also with us is Andrew Rossetti. We'll be right back after this break. Stay with us.

(SOUNDBITE OF MUSIC)

FLATOW: I'm Ira Flatow. This is SCIENCE FRIDAY from NPR.

(SOUNDBITE OF MUSIC)

FLATOW: This is SCIENCE FRIDAY. I'm Ira Flatow. We're talking this hour about music to treat anxiety, pain, movement disorders, more with my guests Oliver Sacks, physician and professor of neurology and psychiatry at Columbia University Medical Center in New York; Connie Tomaino, executive director and co-founder of the Institute for Music and Neurological Function at the Beth Abraham Family of Health Services in the Bronx; and Joke Bradt, she is associate professor in creative arts therapies in the department - assistant professor in the Creative Arts Therapies Department at Drexel University in Philadelphia; Andrew Rossetti, music therapist in the Radiation Oncology Department at Beth Israel Medical Center.

Our number, 1-800-989-8255. When we went to the break, Susan in Tempe was on the line. Are you still there, Susan?

SUSAN: I'm still here.

FLATOW: You had a - you gave us - you told us a great story about your sons and music therapy helping them out and you - I cut you off when you said you had a question you wanted to ask.

SUSAN: My question is that the autism community now has the largest identifiable nonverbal population in our country and is growing. And yet, this service more than speech services or any other services that are provided, you know, either federally or by the state, has had the greatest cuts in funding of anything else. I know it's hard times. But how - I'd like to ask your panel. Since this service is totally vital to the autism community, how do we go about stopping this continued cutting to this service in particular? Because these kids need it.

FLATOW: All right. Let me - thanks for your call and thanks for that - for telling us about your experiences. And have a good holiday season. Thanks for calling.

SUSAN: Thank you. You too.

FLATOW: Let me go around the table. Oliver Sacks, you have any reaction to that?

SACKS: I'm - well, my mind goes back to 1973 when I was working at Bronx State Hospital on a ward of young patients, many of them autistic, and I often found that the only way I could connect or communicate with these patients was with music. And I - in fact, I brought my own piano to the hospital. I think it's probably still there. And people would cluster around the piano, people who otherwise I just couldn't access at all. So I have no doubt of the importance of music and music therapy for people with autism. But I can't address the other tormenting question of cutbacks.

FLATOW: Can anybody?

BRADT: Could I respond to that, Ira?

TOMAINO: Yes, Joke, go ahead.

FLATOW: Joke, go first, then I'll have Connie jump in there.

BRADT: Sure. I think, unfortunately, in this era of evidence-based practice where evidence really drives our health care industry, as well as our funding and reimbursement industry, we really need more evidence in terms of randomized control trials that show that this - that music therapy really is effective. We all know it is extremely effective with children with autism, but there are a lot of skeptical minds out there, like the caller was herself initially. Fortunately, we do have one Cochrane review out already, but it only included a few trials.

But I know that a research group in Norway, led by Christian Gold, just received a huge grant, and they will be doing a humongous randomized controlled trial, including seven different countries, on music therapy with autism. And the U.S. is one of the countries that will be involved with this. And I think that, hopefully, the trial will lead to good outcomes, and indeed, it will be able to show how effective music therapy is with this population. And I think if the outcomes are positive, that it will potentially have a large impact on policymaking related to music therapy services for autism.

FLATOW: Connie?

TOMAINO: Yeah. What Joke is saying is definitely the challenge, the need for evidence-based research in the arena of accountable care, which is a big driving force in medical reimbursement these days, unless an agency can show that the treatments that they're applying directly affect function, and cost effectiveness is a big challenge. And that happens whether it's in education, early education, early intervention or in stroke recovery. In some states, for example, traumatic brain injury, Medicaid waivers can be used to pay for music therapy services. But in other states, that's not possible. So even...

FLATOW: Does Medicare cover it?

TOMAINO: Medicare Part B for partial hospitalization but not in every aspect and not in every state. So each state also can dictate how those funds get allocated.

FLATOW: So you have to have some sort of good studies as Joke was saying to convince people that this is real...

TOMAINO: Right.

FLATOW: ...and does work.

TOMAINO: And I'll say that I was - about half a year ago, I was contacted by an insurance company from New Zealand, asking me to review a large meta-analysis they did for, basically, a summary of the available evidence for stroke patients, as well as autism. And their summary concluded that there was not enough evidence - and, of course, that means, again, randomized control trial outcomes that - so that there was not enough evidence to make them pay for music therapy services for autism.

BRADT: And fortunately, I was able to point into a couple of more studies that were relevant, and then told them we cannot just look at these quantitative studies. There are so many other good studies out there, and case studies out there that showed that music therapy is effective.

So now they concluded that they'll continue to pay on a case-by-case basis. But it was very sad to see that the insurance company, of course, only goes by the available evidence, and will not listen to stories like the caller and be convinced that they should be paying for this service.

FLATOW: Well, as the population ages and we're seeing more dementia cases, Oliver, and Connie, and Alzheimer's cases, you've said that you've seen patients respond well - Alzheimer's patients respond well to music, correct? I mean...

SACKS: Yes. Many, many. And far - and over the years and over the decades. And...

FLATOW: It's convincing when you see it.

SACKS: It's convincing when you see it. But one should be able to have a - the sort of randomized study which will convince the insurance company or a skeptical medical professional.

FLATOW: Connie?

TOMAINO: You know, now with the advancement in neuroscience research, I think some of the evidence for how and why music works therapeutically is being presented. And I think even their studies show how well the brain responds to music, especially, say, somebody with Alzheimer's disease. When they hear a piece of music that's familiar, a part of the brain that's wide enough is a part of the brain that's still intact and functional. And so as the insurers or government agencies see the evidence through basic sciences, as well as these types of gold standard research studies, we'll have the evidence we need to push forward.

FLATOW: Oliver, why is it that music therapy works for all these different disorders?

SACKS: Well, it addresses so many different parts of the brain which may be spared. But it also addresses the person and the self in a very deep, emotional way and does so in the context of a pattern, of a musical pattern, but specifically, say, we know that human beings, unlike chimpanzees, respond to a beat. You see this in children from the age of three or four, that they will move in resonance to a beat. And, say, for people with Parkinson's or whatever, the - they also respond to the beat, and this is crucial. But I endorse what Connie was just saying, that the - that when these careful brain imaging and other objective tests to show what's going on.

FLATOW: Does therapy work in conjunction with other modalities? Do you combine it with other things, music...

TOMAINO: Sure.

FLATOW: ...with visualization, other kinds of - I...

TOMAINO: Well, Andrew spoke about guided imagery with music. Many times with co-treat in a rehab setting, for example, we'll co-treat with a speech therapist if that can facilitate how well the patient understands what they need to do. And the music therapist will take cues from the speech therapists about what phrases to use or what targeted words need to be addressed, how the music therapist that - will manipulate the music to allow for that to happen. In physical therapy, occupational therapy, the music therapist will provide the timed music, the rhythmic stimulus to facilitate gait improvement in those patients.

And then what Andrew was talking about working with the environment and working with the other staff in the unit to really give the patient-centered care that's really needed. And music therapy enhances that very much so.

FLATOW: Andrew, you were saying about how just playing music sometimes makes people feel better. I mean, is there...

ROSSETTI: Well, yes. I believe that's true. But I also believe that if there is a clinical goal to the way the music's being played, which is one of the reasons why we try and use more live music than pre-recorded, that the benefits can be far greater. You can address any number of things.

FLATOW: My question about this is: If we are always into preventive medicine and we try to prevent things and - is there - should we be having a dosage of music every day as a preventive medicine...

(SOUNDBITE OF LAUGHTER)

TOMAINO: Well...

FLATOW: ...and find it - I mean, should you like - people take supplements, right? They take vitamin supplements or whatever, thinking these are things - possibly should people be taking - I'm just thinking out loud here. Should they be taking some music?

TOMAINO: Think of - think about how people are using music every day in their life to get through, you know, people listening to music on the subway on the way to work. I think one of the challenges in the field of music therapy is music is ubiquitous in our life. It's - we're surrounded by it, and we use it ourselves very therapeutically, maybe without knowing it. But we use it to exercise. We use it to get motivated. We use it to go to sleep. And because it's so pervasive, people don't think - they don't think of therapy or music, as a treatment, is a legitimate field. I think that's a challenge the field of music therapy has always been up against, because people say, of course. Of course it's therapy. Of course it's therapeutic. We can all do that.

What Joke is saying with the research and all the work that the Music Therapy Association is trying to do is to bring the evidence of the field of music therapy where it is important. And, of course, a lot of us are working in preventive care, as well, in wellness programs, designing programs to help people with early Alzheimer's maintain memory function and attention as long as possible, people with Parkinson's disease being able to keep the integrity of their speech and flexibility of movement as long as possible, so they don't need as much medication as they would without the music therapy interventions. So we're very much involved in the wellness efforts, as well as treatment efforts.

FLATOW: Mm-hmm. And people want to learn more about it. If they want to become - if you want to become a music therapist, what do you do?

TOMAINO: You go to www.musictherapy.org, look up the field of music therapy. Look at the requirements, what universities have programs throughout the United States. There are resources in every state where they can visit music therapists and see the work firsthand.

FLATOW: And - yeah. And that was my next question. If you believe you could benefit or you know someone who could benefit from music therapy...

TOMAINO: Also check...

FLATOW: ...where do you go?

TOMAINO: Go to the same place. You go to - Google music therapists in your state, but go to AMTA, which is the American Music Therapy Association and, like I said, musictherapy.org. You could call their office, find out where music therapists are in your location.

FLATOW: All right. Thank you all for taking time to be with us today. Oliver Sacks, a physician and professor of neurology and psychiatry at Columbia University Medical Center. His latest book is "The Mind's Eye." And he's told us he's working on a new book that will be coming out next year. Connie Tomaino is executive director and co-founder of the Institute for Music and Neurologic Function at the Beth Abraham Family of Health Services in the Bronx. Joke Bradt is associate professor in the creative arts therapies department at Drexel University in Philadelphia. And I also want to make sure I get your credentials right. Andrew Rossetti is music therapist in the radiation oncology department at Beth Israel Medical Center. Thank you all for taking time to be with us today.

TOMAINO: A pleasure.

SACKS: A pleasure to be here.

BRADT: A pleasure. Thank you.

FLATOW: I'm Ira Flatow. This is SCIENCE FRIDAY, from NPR.

Copyright ? 2011 National Public Radio?. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to National Public Radio. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

NPR transcripts are created on a rush deadline by a contractor for NPR, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of NPR's programming is the audio.

Source: http://www.npr.org/2011/12/16/143847285/treating-stress-speech-disorders-with-music?ft=1&f=1007

justin timberlake marine corps ball frank gore injury frank gore injury makana makana gloria cain gloria cain