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When Good Bedside Manner Becomes An Afterthought

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

JENNIFER LUDDEN, host:

This is TALK OF THE NATION. I'm Jennifer Ludden, in Washington. Neal Conan is away.

Anyone who's ever stretched out on an operating table or sat in an exam room waiting for the results of a test knows the importance of bedside manner, the way a doctor communicates the news, good or bad.

In a recent piece in the Washington Post, Dr. Manoj Jain writes that in the midst of examinations and difficult diagnoses, doctors often struggle to show compassion. This touchy-feely part of medicine, he says, has become an afterthought in patient care.

Doctors, nurses and patients, what are the challenges you face in communication? Our number is 800-989-8255. Our email address is talk@npr.org. And you can join the conversation at our website. Go to npr.org and click on TALK OF THE NATION.

Later in the program, we'll look back at Oprah's journey from small-town journalist to media mogul as the countdown to her final episode begins.

But first, bedside manner. Dr. Manoj Jain is an infectious disease physician in Memphis, Tennessee. He's a regular contributor to the Commercial Appeal in Memphis and the Washington Post. Welcome to the program.

Dr. MANOJ JAIN (Infectious Disease Physician): Thank you, Jennifer, glad to be here.

LUDDEN: You, in your most recent piece for the Washington Post, you talked about how this issue came up when you had a conversation with one of your patients. Tell us about that.

Dr. JAIN: Sure. I was talking to Mike Penotta(ph). He's a patient who had pancreatic cancer. And I was standing at his bedside, and he was having chills and rigors, temperature of 103. And sweat was dripping down his side, and I was examining him and talking to him, and I prescribed him some antibiotics.

But being there, I was wondering: You know, how can I show compassion at this very moment to this man who was suffering? I sort of thought about it, and then I realized I could do something.

I grabbed a washcloth from the cabinet, wiped his sweat, gave him some iced water - you know, these tasks which are usually, you know, relegated to the nursing assistant. And that got me thinking on this whole topic of compassion and what doctors and nurses can do.

LUDDEN: Now, is it this patient or another who you found out had actually been told some terrible news in quite a brusque way?

Dr. JAIN: Sure, it was this patient. In fact, what happened was his fever got better, and then a couple of days later I talked to him and I said: Would you be interested in talking about your end-of-life experience?

And I was doing a story on that. And he said very much so. He wanted to share his feeling. And I asked him a simple question. I said: When you were told your diagnosis of the cancer, what went through your mind?

And I was expecting the usual, the usual shock and denial and so forth. But he surprised me. In fact, he startled me. He said, and I'll sort of quote him. He said: Well, the first thing I wanted to do was I wish I was 10 years younger. I would have reached across and slapped the blank out of the doctor.

LUDDEN: Oh my.

Dr. JAIN: Yes. And I sort of stood there, and I said: Why? And then he told me. And he said: You know, the doctor sort of came in, looked at his piece of paper, looked at him, and said this is terminal and then walked out.

LUDDEN: Ugh...

Dr. JAIN: Very, very painful and saddening. And that's when I realized that this is something I should be writing about.

LUDDEN: You have a - we have a lot talk with you about. But let's bring a caller in. There are people who have been on the other end of conversations like that.

Dr. JAIN: Sure.

LUDDEN: Let's listen. Paula(ph) is in Durham, California. Hi there.

PAULA (Caller): Hi, can you hear me well?

LUDDEN: Yes, go right ahead.

PAULA: Okay, hello, nice to talk to you. I wanted to talk about my experience. I'm a breast cancer survivor and an ovarian cancer survivor. And my breast cancer treatment went very well, and I had a great doctor with that. I felt he was my teammate.

We discussed my drugs together. He told me about research, and we did a fine job together, and we beat it and with the help, of course, of my body.

But when I got ovarian cancer, you know, he was there for me again, and we worked together. I was diagnosed with this in 2004. And unfortunately I had a recurrence in 2006, and then something else happened in 2008.

And unfortunately after that the doctor moved out of the area, and I had a new doctor who came into his position. And I felt, you know, very confident, although I had had to retire from my job and I'd had a number of setbacks. And I'm pretty aware of the chance of ovarian cancer when you get it and the stage and your survival rate.

But I came in to meet this new doctor, and I said, you know, hello, nice to meet you, you know, welcome to our town, et cetera. And I said: Well, I had it was stage actually I was 3B I thought it was four(ph) -3B. But it's been over five years. So I've beaten the 40 percent rate.

And he held up his clipboard in his hand and he said: Well, and he draws a line very firmly across the page. You were at 40 percent. And he scribbles 40. But at your recurrence - scribble another line - that made you 30 percent survival. And then he says: Then your other recurrence -scribble a line - that made you 20 percent survival.

LUDDEN: Oh my.

PAULA: And I looked at him, and I'm thinking: You're not my partner in this. I just didn't feel a sense of camaraderie with him at all. That doctor actually has since left our community. I think the whole community felt that same way, especially filling the boots of our other partner doctor.

And since then, I have a new oncologist, new to me. He's been in town a long time. And again, I have a partner. He - I was in a clinical study. I've had to go out of the study because I had a growth and a tumor that just was resistant.

But I said: Well, how about this drug that I took last time? Well, that sounds like a good idea. Why don't we combine it with that? And again, I had a partner.

And so although I've been really realistic, and he's been really realistic to me about when he might have to talk to me about hospice, I'm so glad that I have a doctor like this who talks to me as if I'm intelligent and not lecturing a kindergartener...

LUDDEN: So it's not that you don't want straight-up, realistic information and can handle it. You just need - you need a little compassion when it's delivered.

PAULA: I need compassion when it's delivered, and I needed to be treated as if I was intelligent, as if I could handle this. Well, you do understand that with each recurrence that it might reduce your chances of survival.

Even the tone made a huge amount of difference. But I will never forget that line written across that piece of paper, as if each line was, like, you could feel years scratching away from my life, as if he was looking at me as if, you know, dismissive. I'm not going to spend much time with you because you're terminal.

LUDDEN: Well, Paula, thank you so much for calling.

PAULA: You're welcome.

LUDDEN: Dr. Jain, I mean, how - how do you deliver terrible news like that?

Dr. JAIN: A couple of thoughts on Paula's situation. I think she's making the right statement about, one, getting rid of a doctor who was unwilling to partner with her. I think she used that term very appropriately.

And we all need to think about that, that the whole idea is that we need to partner doctors and patients together to reach our goal, the goal of not just quantity of life, not just the length of life, but also the quality of life.

So that's a critical element that she sort of brought out. And there's a whole movement towards patient-centered care, which is talking about this idea, this idea of doctors and patients partnering. Even in the ICU, we're beginning to see patients and families together talking about diagnosis.

Some of the new ICUs, new initiatives in the ICUs, relate to a family member being part of the team, as well as other family members and patients being part of hospital teams and coming about to new ideas and new ways of solving problems.

LUDDEN: Let's bring someone else into the conversation. Nurses spend a lot of time with patients. They pull 12-hour shifts. They may not be the ones who deliver the diagnoses, but they support patients in the moments before and after.

Oncology nurse Theresa Brown joins us now from a studio in Pittsburgh, Pennsylvania. She's a regular contributor to the New York Times Well blog and wrote the book "Critical Care." Welcome to the program.

Ms. THERESA BROWN (Author, "Critical Care"): Oh, thank you.

LUDDEN: I'm just curious if you can - you know, you must observe different styles. Does it - you know, how much difference do you see when, depending on, you know, the way the doctor has delivered, say, bad news?

Ms. BROWN: Well, it definitely makes a huge difference. And what I tend to see more than this callous doctor who Paula unfortunately experienced but is a difficulty on the part of anyone on the team to really tell the family that we've run out of options.

And it's almost like hospice becomes a dirty word. And so people talk around it and want different service - say, the oncology service will say, well, here's what's going on with your cancer, but to really talk about your kidney failure, we need to have renal talk to you about that.

And so giving the whole picture of this is a person who really we just can't make them whole again gets partialized sort of in terms of parts of their body and who deals with those parts.

LUDDEN: It's hard to connect everything together.

Ms. BROWN: Right.

Dr. JAIN: Oh, I think this is something that we see all the time. And in fact, I'm guilty of this. You know, recently there was a patient who had heart disease and diabetes and leg ulcer. And the cardiologist sort of went in and was sort of viewing the patient as clogged arteries. The endocrinologist was seeing a failed pancreas. And I was going in and seeing an infected leg.

And you know, I had to step back and say: Wait a second. There's a whole patient, there's a wholeness there, and we as practitioners and doctors need to see that and work with patients more.

LUDDEN: Well certainly in everyday life it is hard to - I can imagine it's hard to deliver difficult news.

Ms. BROWN: And I think also what we see a lot is what I call the hallway conversation, which is where the medical team will say: This really is not good. There's such a poor prognosis here.

Excuse me. And then they go into the room, and their piece of it, it's possible maybe to offer some small amount of hope, but then there's a disconnect.

LUDDEN: All right, both of you, if you can stay with us, and we'll bring in more calls in a moment. Doctors, nurses, patients, what are the challenges you face in communication? Give us a call, 800-989-8255. Our email address is talk@npr.org. I'm Jennifer Ludden. This is TALK OF THE NATION from NPR News.

(Soundbite of music)

LUDDEN: This is TALK OF THE NATION from NPR News. Im Jennifer Ludden in Washington.

We're talking with doctors, nurses and patients about the importance of bedside manner and the challenges many busy doctors and nurses face when it comes to delivering difficult news.

Our guests are Dr. Manoj Jain, an infectious disease physician in Memphis, Tennessee. We've posted a link to his Washington Post piece, "Doctors Often Struggle to Show Compassion While Dealing with Patients." It's on our website.

Also with us, Theresa Brown, an oncology nurse and contributor to the New York Times Well blog. She wrote the book "Critical Care: A New Nurse Faces Death, Life and Everything In Between."

Doctors, nurses and patients, what challenges do you face in communicating? Our number is 800-989-8255. Our email address is talk@npr.org. Or join the conversation at our website. Go to npr.org, and click on TALK OF THE NATION.

Here's an email from Cathy(ph) in Clarksville, Iowa: I am a registered nurse and have worked in management, geriatrics, hospice and psych. In all these settings, the single-most important way of showing you care is presence: eye contact, listening with your whole body, letting the patient express their feelings and questions.

The patient wants to know they are not alone and someone hears them. You may not have the answer, but they know they are not alone.

And let's take a phone call. Julia is in Medical Lake, Washington. Hi, Julia.

JULIA (Caller): Hi. Oh, this is such a wonderful conversation. Thank you so much. I wanted to share with you a very positive aspect to this story, starting with our primary care physician, who diagnosed leukemia in my daughter three years ago.

And obviously when we got that news, it was completely devastating, and suddenly life was in a very suspended state of reality. And I remember we had to go to our hospital and there we were consulting with an oncologist.

And all the time we were there, it was this shroud of, well, we suspect it's leukemia. And for me, that gave me this really, oh, just this glimmer of hope that, well, maybe it's not.

And yet we were in the hospital. We were being admitted. They were talking about surgeries and a bone marrow (unintelligible) and all of these things that really led to, okay, they think they know that this is leukemia.

And our oncologist at the time was terrific, and she was just so informative. But toward the end I finally looked at her and I said: You know, I know we need to do all of these additional things in order to make this really definitive. However, I need to know right now. I can't wait until tomorrow. So based on everything that you know about Aria's(ph) leukemia, does she have it or not?

And she - our doctor took a deep breath and she looked me deeply in the eyes and she just said yes. And at that moment I just felt this relief. I fell into this well of trust that was just never going to be questioned or doubted again. I was able to surrender to this enormous process that lasted two and a half years and - of chemotherapy - and it was just an extraordinary thing.

And later that day our primary care physician showed up in the hospital and - just in tears. And the fact that she could allow herself to be so vulnerable, she could hang up her doctor's coat and be with us as a family and herself a mother and relate to me on that level, it was just extraordinary.

LUDDEN: Julia, how is your daughter now?

JULIA: Thank you for asking. She is - she's rocking the house.

(Soundbite of laughter)

JULIA: (Unintelligible) first grade. She's just doing great.

LUDDEN: That's so good. We're glad to hear that.

JULIA: Thank you.

LUDDEN: Thank you for your call. Theresa Brown, that is - that's wrenching, and - but I can see, it must be so difficult to - to do. I mean, the tendency must be to not tell the whole story.

Ms. BROWN: I think, and I think even sometimes it's very well-motivated, or it's even hard for doctors to say - I mean, for example, we just had a very young patient come in and the talk was, you know, this could be a virus. I mean, a lot of things look like leukemia. And I kept hearing over and over again: It could be a virus, it could be a virus.

And then I realized the medical staff also wanted to believe this very nice man, who was in his early 20s, didn't have leukemia, he just had a virus. And I think it can come from a very human place, this inability to be completely honest.

LUDDEN: Is there, either one of you, another - this may be a strange analogy, but her story made me think of a rule of thumb with children, sometimes, when it's - you say: Well, tell them only when they ask. They're not ready to hear it until they ask. Is there anything like that that goes on with patients or no?

Ms. BROWN: My feeling is people want, they want to know the truth. They want to know what's going on. But they want to be told it in a way that's kind.

Dr. JAIN: And you know, there are lots of uncertainties when one is going through the diagnostic process. And you don't want to be, you know, right up front and say, oh, you know, I really think it's a cancer, and it turns out to be an abscess or an infection of some type. And that actually happened to one of my patients.

He had a large mass in his brain. The neurosurgeon came to him, his bedside. He had seen the MRI, and the neurosurgeon sort of said: I really think this is a cancer. I really believe that we're going to go in, take it out.

And the whole family was in the room. I came back to see him after looking at the MRI and looking at some of his culture reports, and I told him, I said: We really don't know, because it could be an abscess.

As it turned out, the patient did have a brain abscess, and he was fully cured and is doing perfectly well. And so we have to be careful not to give a diagnosis very early on and make the family very anxious and worried.

But obviously in some of the other cases you presented, it was very appropriate to tell the truth or tell as much as you know at the time you know it.

LUDDEN: Okay. Let's take...

Ms. BROWN: But tell as much as you know, right, yeah.

LUDDEN: Let's hear from another caller. Sandy(ph) is in Michigan. Hi there.

SANDY (Caller): Hello, I'm calling - it's a little different spin on the issue that you're talking about. But I am an OB/GYN physician that's also an abortion provider. And I found it very difficult when I would transition from, you know, establishing long-term doctor/patient relationships with my obstetric patients to shifting to a more kind of clinic mindset and trying to establish a well-founded doctor/patient relationship in the essential five to 15 minutes that I had to deal with the patient.

And that was, you know, that was a big transition because our patients come in with a lot of very difficult emotions to deal with, and also they have to deal with the fact that they have a lot of misinformation about the procedure and how they are going to feel about the procedure.

And we try, in the two hours that they're at the clinic and in the 15 minutes that I spend with the patient, to make them comfortable, to understand why they're there and try to fulfill any type of need that they may need. But it's in 15 minutes. So that's - you know, that's a little different atmosphere that(ph) I deal with.

Dr. JAIN: I can understand that. In fact, we were talking about this issue this morning with several doctors at our hospital. And one physician assistant told me about a senior surgeon who would -cardiothoracic surgeon, and what he would do is sit at the patient's bedside, hold their hand, look them in the eye. And he would say: You know, Mrs. Jones, I'm sorry to tell you this, but you have lung cancer. And we're going to do everything we can.

And in just two minutes he would alleviate 20 minutes of distance, talking, the touching, the eye contact, like we've heard. It really shows that you care, and that's what patients want to know.

They forget - and they don't even listen to the statistics and everything that you tell them. They want to make sure that the person who is going to invade their body possibly, who's going to pour chemicals which are going to be toxic in them, really cares about them. And we can do that in a few minutes if we know the strategies, the techniques to do that.

LUDDEN: All right, Sandy, thanks for the call. We have an email here that gets at another part of this issue. It's from Greg(ph), who's a nurse in Oregon. He writes: Are you nuts? We're getting paid to do what we do.

Yes, we show compassion every day, but nearly all of the compassion must be shown by family and friends. We cannot follow the patients day after day and meet all the patients' needs, only some.

I bristle when I hear people who feel we, as nursing staff, don't show enough compassion. All of us struggle with the time and workload constraints we deal with daily. Theresa Brown?

Ms. BROWN: Yeah, I I hear that. I remember recently another nurse I work with saying so-and-so got some bad news today and I really have to carve out some time to just sit down with her.

And much as we are the person who's there with the patient over a 12-hour shift, and as much as we do try to provide passionate care, sometimes the task burden on us is so great that we are also not able to be there.

One thing that would help all of this, I mean, I love the example of the cardiologist sitting down and holding the patient's hand.

But this idea of partnership, if the doctors would partner with us when they're going in to deliver news, if then we could partner with them about what's going on with the patient, just more communication between all the members of the team, including the patient and the family, might make what little time there is to be compassionate go a longer way.

LUDDEN: Well, Dr. Jain, do you - I mean, do you not have to build some sort of an emotional barrier just to do this job or you'd be overwhelmed? I mean, how do you kind of walk that line?

Ms. BROWN: Oh, I can address this.

LUDDEN: OK. Go ahead.

Ms. BROWN: People often ask me that. And, yes, I think that you do have to, in some ways, find ways to disconnect or the job would make you crazy. There are also times, though, when allowing myself to give in, let down my barriers and really be there with someone just renews my complete commitment to what I'm doing. It reminds me why I'm there. And...

LUDDEN: Actually, let's - we've got a call right on this topic.

Ms. BROWN: OK.

LUDDEN: Let's listen to Connor(ph) in Colorado.

CONNOR (Caller): Hey. Howdy? I'm a surgical assistant. And I was working in the OR up at our regional hospital. One of the biggest problems for me was getting too attached to patients. Oftentimes, I'd feel myself (unintelligible) come with me, and, you know, kind of doting on patients that maybe weren't doing so well. And so it was really difficult to kind of let go or just to insulate myself from being too empathetic about patients' issues.

LUDDEN: And so what do you do about that?

CONNOR: It's really just kind of a personal exploration thing. You really have to find a, you know, a middle ground between caring too much and then coming off as cold or maybe impersonal. And it really depends on the type of person. Myself, personally, it was just spending as much time with the patients as I could, getting to know them.

Unfortunately, we didn't have too much patient contact in - as surgical assistants. But after the surgery was over, often I'd go to the post-anesthesia care unit and visit with patients, see how they were doing, making sure that they were recovering fully. Even though that wasn't in my job description, I'd go and do that just to form that connection with patients.

LUDDEN: And to - but to keep yourself from getting too attached, how would you pull back?

CONNOR: It's really just kind of a mental block. It's something that each of us has to go through. When I went to medical school, a lot of us had trouble with that. And some people would just go the extreme distance and be cold to patients, which really doesn't solve anything and makes you look like a jerk, really.

LUDDEN: All right. Connor, thank you so much for calling. You're listening to TALK OF THE NATION from NPR News. Theresa Brown, you can relate there?

Ms. BROWN: Yes, definitely.

(Soundbite of laughter)

Ms. BROWN: Yeah. It's - a nurse told me when I was first started, if you stop feeling sad and caring about the patients, that means you need to get a new job. But the balance is always a challenge.

LUDDEN: Dr. Manoj Jain, you looked at how people are trying to teach compassion in medical school, right?

Dr. JAIN: Yes, we did.

LUDDEN: What's happening?

Dr. JAIN: Well, the whole idea of teaching compassion is not new. In fact, there was a 1983 New York Times story that talked about compassion in health care. And slowly what we're seeing is many medical schools taking on initiatives such as teaching medical students in their first and second year about compassion. What many people are saying is also that you have to get the mentors, those doctors who are practicing and those residents, and get them to learn about compassion and show compassion so that medical students will be compassionate as well.

And William Branch, who's a physician at Emory, has done several studies on this. And, in fact, he did one study where he had a group of doctors go through a training program, a long training program - two years -went through different types of role-playing as well as narrative writings. And what they found was something, which I wasn't aware of, is that you can teach compassion. I always thought that it was a trait that personalities and people had. But we could teach people compassion as well. And this study showed that, and many people can learn from this idea.

LUDDEN: All right. Let's bring in Natalie(ph) in San Antonio, Texas. Hi, Natalie.

NATALIE (Caller): Hey. Thanks for taking my call. You guys really just hit the nail on the head of what I was wondering about. I have a background in counseling. My husband is now in medical school. And I know that even on our end, professionally, we are the counselors. We're there to deal with bereavement, deal with emotions. And even we get jaded. Even, you know, my colleagues will joke about what shouldn't be joked about, or, you know, if you didn't laugh about it, you'd cry about it type of thing. And so I can definitely relate to the idea of creating barriers.

And what I found on our end as counselors or for myself is a lot of boundary creating. And while compassion may be able to be taught, it can also create boundaries with patients. You know, it's the idea of holding the patient's hand, looking into their eyes and giving them news and having them just be these nice people and needed help. That's perfect. But I think, more often than not, there's a shoot the messenger, or there's - there are difficult - difficulties of personalities. People are angry. And I wonder - I guess my question for the doctor is I wonder if it is a personality trait or if there is - if there's a correlation between the amount of time...

Dr. JAIN: I think there's a little bit of both.

NATALIE: ...you're in the field or the amount of - the type of field that you're in or specialization you're in.

LUDDEN: OK, Natalie. Thanks for the call, Natalie. Doctor?

Dr. JAIN: Natalie - yeah. I think it's a little bit of both. I think it's a little bit of a trait and lots of - lot of training. And I'll share an example with you. I have three children, and my middle child is just exceedingly caring and compassionate. When someone in our family gets hurt, like the other day, I had sprained an ankle, she's the one who would put a brace on my leg. She would bring a Band-Aid for her little brother.

And we raised three children the same way. So there is something I find that there is a trait inherent in people that can make them very compassionate. But then, at the other end, we can teach people how to have compassion. It's a skill set that we must get our medical students to use.

LUDDEN: And we must leave it there, Dr. Manoj Jain. We're out of time, but thank you so much for your time. Dr. Manoj Jain is an infectious disease physician in Memphis, Tennessee. And we were also joined by Theresa Brown, an oncology nurse. Thank you both.

Ms. BROWN: Oh, thank you.

Dr. JAIN: Thank you very much.

LUDDEN: Coming up, Oprah calls it quits from daytime TV. NPR's media correspondent David Folkenflik will talk about her legacy. I'm Jennifer Ludden. It's TALK OF THE NATION from NPR News.

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/2011/05/19/136468147/when-good-bedside-manner-becomes-an-afterthought?ft=1&f=5

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Winmau Darts And Accessories Are Top Of The Line

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Source: http://ezinearticles.com/6284742

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Classic Game Room HD ? SEGA GENESIS A/V CABLE ... - Console Solutions

Classic Game Room HD reviews the SEGA GENESIS Audio Video Cable MK-1634 for the Sega Genesis model 2. This cable carries an audio and video signal to a television and also comes in a box printed with pictures and letters. PICTURES AND LETTERS!!!!!! That?s right, no longer do you have to hook your Genesis up with that crappy RF Adapter or with strings attached to potatoes, now you can use the authentic Sega Brand audio video cables for Sega Genesis / Sega Mega Drive. This video gives clues about how to hook up a Sega Genesis to a modern HDTV or televsision set with composite video.

Source: http://www.consolesolutions.net/blog/video_games/classic-game-room-hd-sega-genesis-av-cable-mk-1634-review/

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Changing LCD density turns Honeycomb into Gingerbread

Honeycomb Emulator screen

Wanna see a neat, but mostly useless trick?  Of course you do!  Grab your rooted Honeycomb tablet and change the screen density past 170 and reboot.  You'll be faced with what appears to be the stock Gingerbread launcher.  Change it back below 160 and reboot again to revert all changes.

While it's kind of cool to see things like this, we're not too surprised.  Back in January when the Honeycomb SDK preview was released, we found that fiddling with the screen settings and resolution did just about the same thing (pictured above).  But I digress -- it's cool in a geeky sort of way and we love cool and geeky.  So hit the break to see a video of it in action on a rooted Dell Streak 7 running a Honeycomb emulator port.

Source: Graffix0214's YouTube channel via Pocketables


Source: http://feedproxy.google.com/~r/androidcentral/~3/AMOb29-MZ4Q/changing-lcd-density-turns-honeycomb-gingerbread

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Sarah Michelle Gellar Talks About Her Return To TV In ?Ringer?

Sarah Michelle Gellar Talks About Her Return To TV In ?Ringer?

?I was just fascinated by the show?

Last week we learned that Sarah Michelle Gellar?s new TV series Ringer was picked up by The CW to air this Fall and yesterday we got our first look at the first official photos and video from the show. Today we get to hear from SMG herself on why she decided to return to TV after an 8 year hiatus and we get to see new photos of her in-person appearance at the CW Upfronts presentation in NYC this week.

There are two reasons why Sarah Michelle Gellar, TV?s erstwhile Buffy Summers, elected to return to the small screen after an eight-year absence ? and one of them is a 20-month-old girl named Charlotte Grace Prinze. Speaking with TVLine before The CW?s upfront presentation announcing the premiere of Ringer, on which she plays dual roles, Gellar explained, ?As a mom, I decided it was something that was going to afford me the chance to do both? ? that is, act and be an attentive parent (aka ?the most rewarding experience of my life,? as she put it) ? The other huge draw for Gellar was Ringer?s premise, which has her playing Bridget, a troubled young woman who, to escape the mob, adopts her MIA twin?s identity ? only to realize that her sis, Siobhan, has heaps of problems of her own. ?I was just fascinated by the show,? Gellar says, ?and by the people I got to work with? ? As for tackling a dual role, Gellar says that while ?you might see a little more of Bridget, Siobhan won?t be long-lost? by any stretch. In fact, as seen in some preview clips, Gellar will have numerous opportunities to act opposite herself. As the mysterious narrative unfolds, ?We?re discussing doing some of it from one twin?s perspective, some from the other, you?re going to see flashbacks that explain how they got to where they are?,? Gellar previews. ?I want to make sure that the story for both of these girls comes to life.?

This show sounds so interesting, I am really looking forward to investing as much as possible in Ringer when it premieres this Fall. My guess is that SMG was waiting for the right project to come along at the right time before she decided to make her return to TV. I honestly don?t even care what the reasons for her return are, I?m just glad she?s back. I?m so happy that SMG will return to The CW (which is essentially her old network The WB) to her old Tuesday night time slot. I have a good feeling that Ringer is going to be a big hit.

[Photo credit: Splash News; Source]

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Source: http://www.pinkisthenewblog.com/2011/05/sarah-michelle-gellar-talks-about-her-return-to-tv-in-ringer/

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'Silver Sparrow,' Tayari Jones' Tale Of Secret Sisters

Silver Sparrow by Tayari Jones

Silver Sparrow by Tayari Jones

Silver Sparrow
By Tayari Jones
Hardover, 352 pages
Algonquin Press
List price: $19.95

Chapter 1
The Secret

My father, James Witherspoon, is a bigamist. He was already married ten years when he first clamped eyes on my mother. In 1968, she was working at the gift-wrap counter at Davison's downtown when my father asked her to wrap the carving knife he had bought his wife for their wedding an?niversary. Mother said she knew that something wasn't right between a man and a woman when the gift was a blade. I said that maybe it means there was a kind of trust between them. I love my mother, but we tend to see things a little bit differently. The point is that James's marriage was never hidden from us. James is what I call him. His other daughter, Chaurisse, the one who grew up in the house with him, she calls him Daddy, even now.

When most people think of bigamy, if they think of it at all, they imagine some primitive practice taking place on the pages of National Geographic. In Atlanta, we remember one sect of the back-to-Africa movement that used to run bakeries in the West End. Some people said it was a cult, others called it a cultural movement. Whatever it was, it involved four wives for each husband. The bakeries have since closed down, but sometimes we still see the women, resplendent in white, trailing six humble paces behind their mutual husband. Even in Baptist churches, ushers keep smelling salts on the ready for the new widow confronted at the wake by the other grieving widow and her stair-step kids. Undertakers and judges know that it hap?pens all the time, and not just between religious fanatics, travel?ing salesmen, handsome sociopaths, and desperate women.

It's a shame that there isn't a true name for a woman like my mother, Gwendolyn. My father, James, is a bigamist. That is what he is. Laverne is his wife. She found him first and my mother has always respected the other woman's squatter's rights. But was my mother his wife, too? She has legal documents and even a single Polaroid proving that she stood with James Alexander Witherspoon Junior in front of a judge just over the state line in Alabama. However, to call her only his "wife" doesn't really explain the full complexity of her position.

There are other terms, I know, and when she is tipsy, angry, or sad, Mother uses them to describe herself: concubine, whore, mistress, consort. There are just so many, and none are fair. And there are nasty words, too, for a person like me, the child of a person like her, but these words were not allowed in the air of our home. "You are his daughter. End of story." If this was ever true it was in the first four months of my life, before Chaurisse, his legitimate daughter, was born. My mother would curse at hearing me use that word, legitimate, but if she could hear the other word that formed in my head, she would close herself in her bedroom and cry. In my mind, Chaurisse is his real daughter. With wives, it only matters who gets there first. With daughters, the situation is a bit more complicated.

It matters what you called things. Surveil was my mother's word. If he knew, James would probably say spy, but that is too sinister. We didn't do damage to anyone but ourselves as we trailed Chaurisse and Laverne while they wound their way through their easy lives. I had always imagined that we would eventually be asked to explain ourselves, to press words forward in our own defense. On that day, my mother would be called upon to do the talking. She is gifted with language and is able to layer difficult details in such a way that the result is smooth as water. She is a magician who can make the whole world feel like a dizzy illusion. The truth is a coin she pulls from behind your ear.

Maybe mine was not a blissful girlhood. But is anyone's? Even people whose parents are happily married to each other and no one else, even these people have their share of unhappi?ness. They spend plenty of time nursing old slights, rehashing squabbles. So you see, I have something in common with the whole world.

Mother didn't ruin my childhood or anyone's marriage. She is a good person. She prepared me. Life, you see, is all about knowing things. That is why my mother and I shouldn't be pitied. Yes, we have suffered, but we never doubted that we enjoyed at least one peculiar advantage when it came to what really mattered: I knew about Chaurisse; she didn't know about me. My mother knew about Laverne, but Laverne was under the impression that hers was an ordinary life. We never lost track of that basic and fundamental fact.

When did I first discover that although I was an only child, my father was not my father and mine alone? I really can't say. It's something that I've known for as long as I've known that I had a father. I can only say for sure when I learned that this type of double-duty daddy wasn't ordinary.

I was about five years old, in kindergarten, when the art teacher, Miss Russell, asked us to draw pictures of our fami?lies. While all the other children scribbled with their cray?ons or soft-leaded pencils, I used a blue-ink pen and drew James, Chaurisse, and Laverne. In the background was Raleigh, my father's best friend, the only person we knew from his other life. I drew him with the crayon labeled "Flesh" be?cause he is really light-skinned. This was years and years ago, but I still remember. I hung a necklace around the wife's neck. I gave the girl a big smile, stuffed with square teeth. Near the left margin, I drew my mother and me standing by ourselves. With a marker, I blacked in Mother's long hair and curving lashes. On my own face, I drew only a pair of wide eyes. Above, a friendly sun winked at all six of us.

The art teacher approached me from behind. "Now, who are these people you've drawn so beautifully?"

Charmed, I smiled up at her. "My family. My daddy has two wifes and two girls."

Cocking her head, she said, "I see."

I didn't think much more about it. I was still enjoying the memory of the way she pronounced beautifully. To this day, when I hear anyone say that word, I feel loved. At the end of the month, I brought all of my drawings home in a cardboard folder. James opened up his wallet, which he kept plump with two-dollar bills to reward me for my schoolwork. I saved the portrait, my masterpiece, for last, being as it was so beautifully drawn and everything.

My father picked the page up from the table and held it close to his face like he was looking for a coded message. Mother stood behind me, crossed her arms over my chest, and bent to place a kiss on the top of my head. "It's okay," she said.

"Did you tell your teacher who was in the picture?" James said.

I nodded slowly, the whole time thinking that I probably should lie, although I wasn't quite sure why.

"James," Mother said, "let's not make a molehill into a moun?tain. She's just a child."

"Gwen," he said, "this is important. Don't look so scared. I'm not going to take her out behind the woodshed." Then he chuckled, but my mother didn't laugh.

"All she did was draw a picture. Kids draw pictures."

"Go on in the kitchen, Gwen," James said. "Let me talk to my daughter."

My mother said, "Why can't I stay in here? She's my daugh?ter, too."

"You are with her all the time. You tell me I don't spend enough time talking to her. So now let me talk."

Mother hesitated and then released me. "She's just a little kid, James. She doesn't even know the ins and outs yet."

"Trust me," James said.

She left the room, but I don't know that she trusted him not to say something that would leave me wounded and broken-winged for life. I could see it in her face. When she was upset she moved her jaw around invisible gum. At night, I could hear her in her room, grinding her teeth in her sleep. The sound was like gravel under car wheels.

"Dana, come here." James was wearing a navy chauffeur's uniform. His hat must have been in the car, but I could see the ridged mark across his forehead where the hatband usually rested. "Come closer," he said.

I hesitated, looking to the space in the doorway where Mother had disappeared.

"Dana," he said, "you're not afraid of me, are you? You're not scared of your own father, are you?"

His voice sounded mournful, but I took it as a dare. "No, sir," I said, taking a bold step forward.

"Don't call me sir, Dana. I'm not your boss. When you say that, it makes me feel like an overseer."

I shrugged. Mother told me that I should always call him sir. With a sudden motion, he reached out for me and lifted me up on his lap. He spoke to me with both of our faces looking outward, so I couldn't see his expression.

"Dana, I can't have you making drawings like the one you made for your art class. I can't have you doing things like that. What goes on in this house between your mother and me is grown people's business. I love you. You are my baby girl, and I love you, and I love your mama. But what we do in this house has to be a secret, okay?"

"I didn't even draw this house."

James sighed and bounced me on his lap a little bit. "What happens in my life, in my world, doesn't have anything to do with you. You can't tell your teacher that your daddy has another wife. You can't tell your teacher that my name is James Witherspoon. Atlanta ain't nothing but a country town, and everyone knows everybody."

"Your other wife and your other girl is a secret?" I asked him.

He put me down from his lap, so we could look each other in the face. "No. You've got it the wrong way around. Dana, you are the one that's a secret."

Then he patted me on the head and tugged one of my braids. With a wink he pulled out his billfold and separated three two-dollar bills from the stack. He handed them over to me and I clamped them in my palm.

"Aren't you going to put them in your pocket?"

"Yes, sir."

And for once, he didn't tell me not to call him that.

James took me by the hand and we walked down the hallway to the kitchen for dinner. I closed my eyes on the short walk because I didn't like the wallpaper in the hallway. It was beige with a burgundy pattern. When it had started peeling at the edges, I was accused of picking at the seams. I denied it over and over again, but Mother reported me to James on his weekly visit. He took off his belt and swatted me around the legs and up on my backside, which seemed to satisfy something in my mother.

In the kitchen my mother placed the bowls and plates on the glass table in silence. She wore her favorite apron that James brought back from New Orleans. On the front was a draw?ing of a crawfish holding a spatula aloft and a caption: don't make me poison your food! James took his place at the head of the table and polished the water spots from his fork with his napkin. "I didn't lay a hand on her; I didn't even raise my voice. Did I?"

"No, sir." And this was entirely the truth, but I felt different than I had just a few minutes before when I'd pulled my draw?ing out of its sleeve. My skin stayed the same while this differ?ence snuck in through a pore and attached itself to whatever brittle part forms my center. You are the secret. He'd said it with a smile, touching the tip of my nose with the pad of his finger.

My mother came around and picked me up under my arms and sat me on the stack of phone books in my chair. She kissed my cheek and fixed a plate with salmon croquettes, a spoon of green beans, and corn.

"Are you okay?"

I nodded.

James ate his meal, spooning honey onto a dinner roll when my mother said there would be no dessert. He drank a big glass of Coke.

"Don't eat too much," my mother said. "You'll have to eat again in a little while."

"I'm always happy to eat your food, Gwen. I'm always happy to sit at your table."

Source: http://www.npr.org/2011/05/19/136466056/silver-sparrow-tayari-joness-tale-of-secret-sisters?ft=1&f=1032

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Student Loans and Debt Consolidation ? Business Websites ? RSS ...

by Finance 101 on May 19, 2011

Home Equity Loans are solutions for accessing available equity. We also save homes from foreclosure, perform debt ? http://www.dewmarket.com | Details | Hits: 95 . 105. Hits. Select Financing ? Select Financing Information and resources for stock market investing, advice, software, research and money management. ? http://zaika.select-yuushi.com/ | Details | Hits: 105 ? Read the original: Student Loans and Debt Consolidation ? Business Websites ? RSS ? ?

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Student Loans and Debt Consolidation ? Business Websites ? RSS ?

Source: http://retirement.found-here.info/2011/05/student-loans-and-debt-consolidation-%E2%80%93-business-websites-%E2%80%93-rss-%E2%80%A6-2/

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Beneficial Helpful Hints for Remedying Stress | Weight Loss Diet ...

Relief from stress can be essential for your health and there are many ways to achieve it. Although people experience stress in different ways and situations, you need to find a way to manage it and reduce it. Here are some proven methods for finding relief from stress. You can handle everything more effectively when you know how to relax and feel focused.

Taking walks can be a simple but effective way to reduce stress. The good thing about walking is that most people can do it, and you don?t have to be very fit or athletic. You can walk virtually anyplace, regardless if you reside in the city, the country or the suburbs. While walking outdoors is best, if it?s hard for you to get outside during the day, a walk around an office complex or mall can also be refreshing. Not considering how buy you are, taking even a small walk can be a nice option for impeding a stressful pattern. It can help to play some relaxing music in your MP3 player, iPod or phone while you?re walking.

One simple self healing technique that?s very good for stress is EFT, or Emotional Freedom Technique. To do this, you tap places on your face and body to stimulate acupuncture points. There are several books on the topic, as well as videos online that you can follow along with. Different tapping sequences are used for different purposes and many can reduce stress. EFT is something you can do by yourself with no equipment and the entire routine can be done in a few minutes.

Consuming a wholesome diet can be a terrific option for reducing stress, nevertheless a large number of individuals just do the opposite and consume junk foods that make them feel more excellent in an instant. The dilemma with this is foods, for instance sweets and other consoling foods generally give you a downer that intensifies your stress. In addition, these foods provide you with a lower amount of long term energy and are bad for your health.

Creative outlets come in many forms like drawing, cooking, gardening, or working with clay. Joining a weekly group or taking lessons can help you get more out of your favorite creative activity but you don?t have to be great at it to enjoy the benefits. If you would like to find ways reduce your stress levels, it doesn?t have to be hard to do, although you do need to look for some realistic techniques, like the ones mentioned in this article.

If you desire to discover ways to lessen your stress levels, it doesn?t have to be strenuous, but nevertheless you should search for some handy options, like the ones talked about in this article. It?s ideal to have a steadfast strategy ready for any stressful conditions you may find yourself in, whether it happens to be at work, in your home or driving among other cars. If you can sidetrack yourself even for a few minutes, you can then take in the situation in another way and not feel quite as stressed about it.

I authored this summary about Stress Relief because it?s health related and while contemplating a career in the Dental Assistants arena, I composed a guide titled medical assistant certification you?ll find very interesting.

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Tags: ailments, alternative-medicine, conditions-and-diseases, disease, health fitness, holistic, illness, Medicine, natural cures, stress relief, treatments, wellness

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Source: http://www.weightlossdietinformation.com/beneficial-helpful-hints-for-remedying-stress.html

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