Metabolic Syndrome and Related Disorders Vol. 6, No. 1, Mar 2008 is now available online

 

Liebert Online Table of Contents Alert
Metabolic Syndrome and Related Disorders
Volume: 6, Number: 1 Mar 2008

---

The above issue is now available online from Liebert Online at:
http://www.liebertonline.com/toc/met/6/1

The table of contents for this issue is listed below. Click on the links below to view the abstract for each article, or click on the link above to read the table of contents online.

If you wish to update your preferences, please visit http://www.liebertonline.com/action/showPreferences?menuTab=Alerts

If you wish to unsubscribe from this alert, please visit http://www.liebertonline.com/action/removeAlert?ai=5aaq&sig=qHfFcznpGvU=

If you need any further help, please email us at e-toc@liebertpub.com.

---

	Nonalcoholic Steatohepatitis and the Metabolic Syndrome
	Joy Jiang and Natalie Torok
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 1-7. Abstract | PDF (63 KB) | PDF Plus(102 KB)

	Metabolic Syndrome Status Changes with Fitness Level Change: A Retrospective Analysis
	Mark S. Maxwell, Brian R. Goslin, Ronald L. Gellish, Kenneth R. Hightower, Ronald E. Olson, Virinder K. Moudgil, and Gary D. Russi
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 8-14. Abstract | PDF (72 KB) | PDF Plus(82 KB)

	Prediabetes and its Relationship with Obesity in Mexican Adults: The Mexican Diabetes Prevention (MexDiab) Study
	Fernando Guerrero-Romero, Martha Rodríguez-Morán, Ricardo Pérez-Fuentes, María C. Sánchez-Guillén, Manuel González-Ortiz, Esperanza Martínez-Abundis, Olga Brito-Zurita, Agustín Madero, Benigno Figueroa, Cristina Revilla-Monsalve, Silvia E. Flores-Martínez, Sergio Islas-Andrade, Ramón A. Rascón-Pacheco, Miguel Cruz, and José Sánchez-Corona
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 15-23. Abstract | PDF (147 KB) | PDF Plus(126 KB)

	Genetic Variations at the CCAAT/Enhancer-binding Protein are Associated with Metabolic Phenotypes in the Japanese Population
	Hidesuke Kaji, Chika Fukano, Yukari Kimura, Etsuko Takiguchi, and Keiko Tanida
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 24-31. Abstract | PDF (76 KB) | PDF Plus(85 KB)

	Unlimited Energy, Restricted Carbohydrate Diet Improves Lipid Parameters in Obese Children
	Brian S. Dunlap and James R. Bailes, Jr.
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 32-36. Abstract | PDF (59 KB) | PDF Plus(67 KB)

	Comparisons of Metabolic Syndrome Definitions in Four Populations of the Asia-Pacific Region
	Crystal Man Ying Lee, Rachel R. Huxley, Mark Woodward, Paul Zimmet, Jonathan Shaw, Nam H. Cho, Hyung Rae Kim, Satu Viali, Makoto Tominaga, Dorte Vistisen, Knut Borch-Johnsen, and Stephen Colagiuri
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 37-46. Abstract | PDF (326 KB) | PDF Plus(145 KB)

	Serum Uric Acid and Components of the Metabolic Syndrome in Non-Diabetic Populations in Mauritian Indians and Creoles and in Chinese in Qingdao, China
	Hairong Nan, Qing Qiao, Stefan Söderberg, Weiguo Gao, Paul Zimmet, Jonathan Shaw, George Alberti, Yanhu Dong, Ulla Uusitalo, Vassen Pauvaday, Pierrot Chitson, and Jaakko Tuomilehto
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 47-57. Abstract | PDF (142 KB) | PDF Plus(123 KB)

	Metaboli Syndrome in Railway Employees and its Relation to Lifestyle Factors
	G.P. Parale, V.C. Patil, S.P. Patil, S.V. Sabale, C.V. Pethe, G.S. Manjunath, P.M. Kulkarni, V.N. Dhadke, and N.S. Deshpande
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 58-63. Abstract | PDF (64 KB) | PDF Plus(70 KB)

	Insulin, hs-CRP, Leptin, and Adiponectin. An Analysis of their Relationship to the Metabolic Syndrome in an Obese Population with an Elevated Waist Circumference
	Eric Yan, Steve Chen, Kurt Hong, Woo Sung Kim, Anita Bajpai, Leo Treyzon, Luigi Gratton, Robert Elashoff, He-Jing Wang, Zhaoping Li, and David Heber
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 64-73. Abstract | PDF (185 KB) | PDF Plus(134 KB)

	Dissertations
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 74-78. Citation | PDF (57 KB) | PDF Plus(57 KB)

	Abstracts
	Metabolic Syndrome and Related Disorders Mar 2008, Vol. 6, No. 1: 79-83. Citation | PDF (58 KB) | PDF Plus(58 KB)

---

©2008 Mary Ann Liebert, Inc. All Rights Reserved.

Technology Partner - Atypon Systems, Inc.

Screening for COPD

Screening for COPD (Ann Intern Med)
-----------------------------------------------------------------
Clinical Guidelines
-----------------------------------------------------------------
Screening for Chronic Obstructive Pulmonary Disease Using Spirometry: Summary of the Evidence for the U.S. Preventive Services Task Force Kenneth Lin, Bradley Watkins, Tamara Johnson, Joy Anne Rodriguez, and Mary B. Barton

Screening for Chronic Obstructive Pulmonary Disease Using Spirometry: U.S. Preventive Services Task Force Recommendation Statement  U.S. Preventive Services Task Force    

Screening for Chronic Obstructive Pulmonary Disease: US Preventive Services Task Force Recommendations

Cluster trial: Effectiveness of the diabetes education and self management

Thank you Bob for highlighting the 'cluster trial'. Seems they are on the right track of the design of a community interventional trial, aren't they?

_____________________________________________
From:  
Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial

M J Davies, S Heller, T C Skinner, M J Campbell, M E Carey, S Cradock, H M Dallosso, H Daly, Y Doherty, S Eaton, C Fox, L Oliver, K Rantell, G Rayman, K Khunti on behalf of the Diabetes Education and Self Management for Ongoing and Newly Diagnosed Collaborative

 << File: davies.pdf >>

Interesting article on behaviorial economics

What was I thinking? The latest reasoning about our irrational ways.
by Elizabeth Kolbert
 
A couple of months ago, I went on-line to order a book. The book had a list price of twenty-four dollars; Amazon was offering it for eighteen. I clicked to add it to my "shopping cart" and a message popped up on the screen. "Wait!" it admonished me. "Add $7.00 to your order to qualify for FREE Super Saver Shipping!" I was ordering the book for work; still, I hesitated. I thought about whether there were other books that I might need, or want. I couldn't think of any, so I got up from my desk, went into the living room, and asked my nine-year-old twins. They wanted a Tintin book. Since they already own a large stack of Tintins, it was hard to find one that they didn't have. They scrolled through the possibilities. After much discussion, they picked a three-in-one volume containing two adventures they had previously read. I clicked it into the shopping cart and checked out. By the time I was done, I had saved The New Yorker $3.99 in shipping charges. Meanwhile, I had cost myself $12.91.


Why do people do things like this? From the perspective of neoclassical economics, self-punishing decisions are difficult to explain. Rational calculators are supposed to consider their options, then pick the one that maximizes the benefit to them. Yet actual economic life, as opposed to the theoretical version, is full of miscalculations, from the gallon jar of mayonnaise purchased at spectacular savings to the billions of dollars Americans will spend this year to service their credit-card debt. The real mystery, it could be argued, isn't why we make so many poor economic choices but why we persist in accepting economic theory.
In "Predictably Irrational: The Hidden Forces That Shape Our Decisions" (Harper; $25.95), Dan Ariely, a professor at M.I.T., offers a taxonomy of financial folly. His approach is empirical rather than historical or theoretical. In pursuit of his research, Ariely has served beer laced with vinegar, left plates full of dollar bills in dorm refrigerators, and asked undergraduates to fill out surveys while masturbating. He claims that his experiments, and others like them, reveal the underlying logic to our illogic. "Our irrational behaviors are neither random nor senseless—they are systematic," he writes. "We all make the same types of mistakes over and over." So attached are we to certain kinds of errors, he contends, that we are incapable even of recognizing them as errors. Offered FREE shipping, we take it, even when it costs us.


As an academic discipline, Ariely's field—behavioral economics—is roughly twenty-five years old. It emerged largely in response to work done in the nineteen-seventies by the Israeli-American psychologists Amos Tversky and Daniel Kahneman. (Ariely, too, grew up in Israel.) When they examined how people deal with uncertainty, Tversky and Kahneman found that there were consistent biases to the responses, and that these biases could be traced to mental shortcuts, or what they called "heuristics." Some of these heuristics were pretty obvious—people tend to make inferences from their own experiences, so if they've recently seen a traffic accident they will overestimate the danger of dying in a car crash—but others were more surprising, even downright wacky. For instance, Tversky and Kahneman asked subjects to estimate what proportion of African nations were members of the United Nations. They discovered that they could influence the subjects' responses by spinning a wheel of fortune in front of them to generate a random number: when a big number turned up, the estimates suddenly swelled.


Though Tversky and Kahneman's research had no direct bearing on economics, its implications for the field were disruptive. Can you really regard people as rational calculators if their decisions are influenced by random numbers? (In 2002, Kahneman was awarded a Nobel Prize—Tversky had died in 1996—for having "integrated insights from psychology into economics, thereby laying the foundation for a new field of research.")
Over the years, Tversky and Kahneman's initial discoveries have been confirmed and extended in dozens of experiments. In one example, Ariely and a colleague asked students at M.I.T.'s Sloan School of Management to write the last two digits of their Social Security number at the top of a piece of paper. They then told the students to record, on the same paper, whether they would be willing to pay that many dollars for a fancy bottle of wine, a not-so-fancy bottle of wine, a book, or a box of chocolates. Finally, the students were told to write down the maximum figure they would be willing to spend for each item. Once they had finished, Ariely asked them whether they thought that their Social Security numbers had had any influence on their bids. The students dismissed this idea, but when Ariely tabulated the results he found that they were kidding themselves. The students whose Social Security number ended with the lowest figures—00 to 19—were the lowest bidders. For all the items combined, they were willing to offer, on average, sixty-seven dollars. The students in the second-lowest group—20 to 39—were somewhat more free-spending, offering, on average, a hundred and two dollars. The pattern continued up to the highest group—80 to 99—whose members were willing to spend an average of a hundred and ninety-eight dollars, or three times as much as those in the lowest group, for the same items.
This effect is called "anchoring," and, as Ariely points out, it punches a pretty big hole in microeconomics. When you walk into Starbucks, the prices on the board are supposed to have been determined by the supply of, say, Double Chocolaty Frappuccinos, on the one hand, and the demand for them, on the other. But what if the numbers on the board are influencing your sense of what a Double Chocolaty Frappuccino is worth? In that case, price is not being determined by the interplay of supply and demand; price is, in a sense, determining itself.


Another challenge to standard economic thinking arises from what has become known as the "endowment effect." To probe this effect, Ariely, who earned one of his two Ph.D.s at Duke, exploited the school's passion for basketball. Blue Devils fans who had just won tickets to a big game through a lottery were asked the minimum amount that they would accept in exchange for them. Fans who had failed to win tickets through the same lottery were asked the maximum amount that they would be willing to offer for them.
"From a rational perspective, both the ticket holders and the non-ticket holders should have thought of the game in exactly the same way," Ariely observes. Thus, one might have expected that there would be opportunities for some of the lucky and some of the unlucky to strike deals. But whether or not a lottery entrant had been "endowed" with a ticket turned out to powerfully affect his or her sense of its value. One of the winners Ariely contacted, identified only as Joseph, said that he wouldn't sell his ticket for any price. "Everyone has a price," Ariely claims to have told him. O.K., Joseph responded, how about three grand? On average, the amount that winners were willing to accept for their tickets was twenty-four hundred dollars. On average, the amount that losers were willing to offer was only a hundred and seventy-five dollars. Out of a hundred fans, Ariely reports, not a single ticket holder would sell for a price that a non-ticket holder would pay.


Whatever else it accomplishes, "Predictably Irrational" demonstrates that behavioral economists are willing to experiment on just about anybody. One of the more compelling studies described in the book involved trick-or-treaters. A few Halloweens ago, Ariely laid in a supply of Hershey's Kisses and two kinds of Snickers—regular two-ounce bars and one-ounce miniatures. When the first children came to his door, he handed each of them three Kisses, then offered to make a deal. If they wanted to, the kids could trade one Kiss for a mini-Snickers or two Kisses for a full-sized bar. Almost all of them took the deal and, proving their skills as sugar maximizers, opted for the two-Kiss trade. At some point, Ariely shifted the terms: kids could now trade one of their three Kisses for the larger bar or get a mini-Snickers without giving up anything. In terms of sheer chocolatiness, the trade for the larger bar was still by far the better deal. But, faced with the prospect of getting a mini-Snickers for nothing, the trick-or-treaters could no longer reckon properly. Most of them refused the trade, even though it cost them candy. Ariely speculates that behind the kids' miscalculation was anxiety. As he puts it, "There's no visible possibility of loss when we choose a FREE! item (it's free)." Tellingly, when Ariely performed a similar experiment on adults, they made the same mistake. "If I were to distill one main lesson from the research described in this book, it is that we are all pawns in a game whose forces we largely fail to comprehend," he writes.


A few weeks ago, the Bureau of Economic Analysis released its figures for 2007. They showed that Americans had collectively amassed ten trillion one hundred and eighty-four billion dollars in disposable income and spent very nearly all of it—ten trillion one hundred and thirty-two billion dollars. This rate of spending was somewhat lower than the rate in 2006, when Americans spent all but thirty-nine billion dollars of their total disposable income.


According to standard economic theory, the U.S. savings rate also represents rational choice: Americans, having reviewed their options, have collectively resolved to spend virtually all the money that they have. According to behavioral economists, the low savings rate has a more immediate explanation: it proves—yet again—that people have trouble acting in their own best interests. It's worth noting that Americans, even as they continue to spend, say that they should be putting more money away; one study of participants in 401(k) plans found that more than two-thirds believed their savings rate to be "too low."
In the forthcoming "Nudge: Improving Decisions About Health, Wealth, and Happiness" (Yale; $25), Richard H. Thaler and Cass R. Sunstein follow behavioral economics out of the realm of experiment and into the realm of social policy. Thaler and Sunstein both teach at the University of Chicago, Thaler in the graduate school of business and Sunstein at the law school. They share with Ariely the belief that, faced with certain options, people will consistently make the wrong choice.Therefore, they argue, people should be offered options that work with, rather than against, their unreasoning tendencies. These foolish-proof choices they label "nudges." (A "nudge," they note with scholarly care, should not be confused with a "noodge.")


A typical "nudge" is a scheme that Thaler and Sunstein call "Save More Tomorrow." One of the reasons people have such a hard time putting money away, the authors say, is that they are loss-averse. They are pained by any reduction in their take-home pay—even when it's going toward their own retirement. Under "Save More Tomorrow," employees commit to contributing a greater proportion of their paychecks to their retirement over time, but the increases are scheduled to coincide with their annual raises, so their paychecks never shrink. (The "Save More Tomorrow" scheme was developed by Thaler and the U.C.L.A. economist Shlomo Benartzi, back in 1996, and has already been implemented by several thousand retirement plans.)


People aren't just loss-averse; they are also effort-averse. They hate having to go to the benefits office, pick up a bunch of forms, fill them out, and bring them all the way back. As a consequence, many eligible employees fail to enroll in their companies' retirement plans, or delay doing so for years. (This is the case, research has shown, even at companies where no employee contribution is required.) Thaler and Sunstein propose putting this sort of inertia to use by inverting the choice that's presented. Instead of having to make the trip to the benefits office to opt in, employees should have to make that trip only if they want to opt out. The same basic argument holds whenever a so-called default option is provided. For instance, most states in the U.S. require that those who want to become organ donors register their consent; in this way, many potential donors are lost. An alternative—used, for example, in Austria—is to make consent the default option, and put the burden of registering on those who do not wish to be donors. (It has been estimated that if every state in the U.S. simply switched from an "explicit consent" to a "presumed consent" system several thousand lives would be saved each year.)


"Nudges" could also involve disclosure requirements. To discourage credit-card debt, for instance, Thaler and Sunstein recommend that cardholders receive annual statements detailing how much they have already squandered in late fees and interest. To encourage energy conservation, they propose that new cars come with stickers showing how many dollars' worth of gasoline they are likely to burn through in five years of driving.
Many of the suggestions in "Nudge" seem like good ideas, and even, as with "Save More Tomorrow," practical ones. The whole project, though, as Thaler and Sunstein acknowledge, raises some pretty awkward questions. If the "nudgee" can't be depended on to recognize his own best interests, why stop at a nudge? Why not offer a "push," or perhaps even a "shove"? And if people can't be trusted to make the right choices for themselves how can they possibly be trusted to make the right decisions for the rest of us?
Like neoclassical economics, much democratic theory rests on the assumption that people are rational. Here, too, empirical evidence suggests otherwise. Voters, it has been demonstrated, are influenced by factors ranging from how names are placed on a ballot to the jut of a politician's jaw. A 2004 study of New York City primary-election results put the advantage of being listed first on the ballot for a local office at more than three per cent—enough of a boost to turn many races. (For statewide office, the advantage was around two per cent.) A 2005 study, conducted by psychologists at Princeton, showed that it was possible to predict the results of congressional contests by using photographs. Researchers presented subjects with fleeting images of candidates' faces. Those candidates who, in the subjects' opinion, looked more "competent" won about seventy per cent of the time.


When it comes to public-policy decisions, people exhibit curious—but, once again, predictable—biases. They value a service (say, upgrading fire equipment) more when it is described in isolation than when it is presented as part of a larger good (say, improving disaster preparedness). They are keen on tax "bonuses" but dislike tax "penalties," even though the two are functionally equivalent. They are more inclined to favor a public policy when it is labelled the status quo. In assessing a policy's benefits, they tend to ignore whole orders of magnitude. In an experiment demonstrating this last effect, sometimes called "scope insensitivity," subjects were told that migrating birds were drowning in ponds of oil. They were then asked how much they would pay to prevent the deaths by erecting nets. To save two thousand birds, the subjects were willing to pay, on average, eighty dollars. To save twenty thousand birds, they were willing to pay only seventy-eight dollars, and to save two hundred thousand birds they were willing to pay eighty-eight dollars.
What is to be done with information like this? We can try to become more aware of the patterns governing our blunders, as "Predictably Irrational" urges. Or we can try to prod people toward more rational choices, as "Nudge" suggests. But if we really are wired to make certain kinds of mistakes, as Thaler and Sunstein and Ariely all argue, we will, it seems safe to predict, keep finding new ways to make them. (Ariely confesses that he recently bought a thirty-thousand-dollar car after reading an ad offering FREE oil changes for the next three years.)


If there is any consolation to take from behavioral economics—and this impulse itself probably counts as irrational—it is that irrationality is not always altogether a bad thing. What we most value in other people, after all, has little to do with the values of economics. (Who wants a friend or a lover who is too precise a calculator?) Some of the same experiments that demonstrate people's weak-mindedness also reveal, to use a quaint term, their humanity. One study that Ariely relates explored people's willingness to perform a task for different levels of compensation. Subjects were willing to help out—moving a couch, performing a tedious exercise on a computer—when they were offered a reasonable wage. When they were offered less, they were less likely to make an effort, but when they were asked to contribute their labor for nothing they started trying again. People, it turns out, want to be generous and they want to retain their dignity—even when it doesn't really make sense.

The Advantages of Closing a Few Doors

 

 The Advantages of Closing a Few Doors

By JOHN TIERNEY
The next time you’re juggling options — which friend to see, which house to buy, which career to pursue — try asking yourself this question:

Xiang Yu was a Chinese general in the third century B.C. who took his troops across the Yangtze River into enemy territory and performed an experiment in decision making. He crushed his troops’ cooking pots and burned their ships.
He explained this was to focus them on moving forward — a motivational speech that was not appreciated by many of the soldiers watching their retreat option go up in flames. But General Xiang Yu would be vindicated, both on the battlefield and in the annals of social science research.
He is one of the role models in Dan Ariely’s new book, “Predictably Irrational,” an entertaining look at human foibles like the penchant for keeping too many options open. General Xiang Yu was a rare exception to the norm, a warrior who conquered by being unpredictably rational.
Most people can’t make such a painful choice, not even the students at a bastion of rationality like the Massachusetts Institute of Technology, where Dr. Ariely is a professor of behavioral economics. In a series of experiments, hundreds of students could not bear to let their options vanish, even though it was obviously a dumb strategy (and they weren’t even asked to burn anything).
The experiments involved a game that eliminated the excuses we usually have for refusing to let go.. In the real world, we can always tell ourselves that it’s good to keep options open.
You don’t even know how a camera’s burst-mode flash works, but you persuade yourself to pay for the extra feature just in case. You no longer have anything in common with someone who keeps calling you, but you hate to just zap the relationship.
Your child is exhausted from after-school soccer, ballet and Chinese lessons, but you won’t let her drop the piano lessons. They could come in handy! And who knows? Maybe they will.
In the M.I.T. experiments, the students should have known better. They played a computer game that paid real cash to look for money behind three doors on the screen. (You can play it yourself, without pay, at tierneylab.blogs.nytimes.com.) After they opened a door by clicking on it, each subsequent click earned a little money, with the sum varying each time.
As each player went through the 100 allotted clicks, he could switch rooms to search for higher payoffs, but each switch used up a click to open the new door. The best strategy was to quickly check out the three rooms and settle in the one with the highest rewards.
Even after students got the hang of the game by practicing it, they were flummoxed when a new visual feature was introduced. If they stayed out of any room, its door would start shrinking and eventually disappear.
They should have ignored those disappearing doors, but the students couldn’t. They wasted so many clicks rushing back to reopen doors that their earnings dropped 15 percent. Even when the penalties for switching grew stiffer — besides losing a click, the players had to pay a cash fee — the students kept losing money by frantically keeping all their doors open.
Why were they so attached to those doors? The players, like the parents of that overscheduled piano student, would probably say they were just trying to keep future options open. But that’s not the real reason, according to Dr. Ariely and his collaborator in the experiments, Jiwoong Shin, an economist who is now at Yale.
They plumbed the players’ motivations by introducing yet another twist. This time, even if a door vanished from the screen, players could make it reappear whenever they wanted. But even when they knew it would not cost anything to make the door reappear, they still kept frantically trying to prevent doors from vanishing.
Apparently they did not care so much about maintaining flexibility in the future. What really motivated them was the desire to avoid the immediate pain of watching a door close.
“Closing a door on an option is experienced as a loss, and people are willing to pay a price to avoid the emotion of loss,” Dr. Ariely says. In the experiment, the price was easy to measure in lost cash. In life, the costs are less obvious — wasted time, missed opportunities. If you are afraid to drop any project at the office, you pay for it at home.
“We may work more hours at our jobs,” Dr. Ariely writes in his book, “without realizing that the childhood of our sons and daughters is slipping away. Sometimes these doors close too slowly for us to see them vanishing.”
Dr. Ariely, one of the most prolific authors in his field, does not pretend that he is above this problem himself. When he was trying to decide between job offers from M.I.T. and Stanford, he recalls, within a week or two it was clear that he and his family would be more or less equally happy in either place. But he dragged out the process for months because he became so obsessed with weighing the options.
“I’m just as workaholic and prone to errors as anyone else,” he says.. “I have way too many projects, and it would probably be better for me and the academic community if I focused my efforts. But every time I have an idea or someone offers me a chance to collaborate, I hate to give it up.”
So what can be done? One answer, Dr. Ariely said, is to develop more social checks on overbooking. He points to marriage as an example: “In marriage, we create a situation where we promise ourselves not to keep options open. We close doors and announce to others we’ve closed doors.”
Or we can just try to do it on our own. Since conducting the door experiments, Dr. Ariely says, he has made a conscious effort to cancel projects and give away his ideas to colleagues. He urges the rest of us to resign from committees, prune holiday card lists, rethink hobbies and remember the lessons of door closers like Xiang Yu.
If the general’s tactics seem too crude, Dr. Ariely recommends another role model, Rhett Butler, for his supreme moment of unpredictable rationality at the end of his marriage. Scarlett, like the rest of us, can’t bear the pain of giving up an option, but Rhett recognizes the marriage’s futility and closes the door with astonishing elan. Frankly, he doesn’t give a damn.

Use of Alternative Thresholds Defining Insulin Resistance to Predict Incident Type 2 Diabetes Mellitus and Cardiovascular Disease -- Rutter et al. 117 (8): 1003 -- Circulation

Use of Alternative Thresholds Defining Insulin Resistance to Predict Incident Type 2 Diabetes Mellitus and Cardiovascular Disease
Source: Circulation

Background- The performance characteristics of surrogate insulin resistance (IR) measures, commonly defined as the top 25% of the measure's distribution, used to predict incident type 2 diabetes mellitus (DM) and cardiovascular disease (CVD) have not been critically assessed in community samples.  Methods and Results- Baseline IR was assessed among 2720 Framingham Offspring Study subjects by use of fasting insulin, the homeostasis model assessment of IR (HOMA-IR), and the reciprocal of the Gutt insulin sensitivity index, with 7- to 11-year follow-up for incident DM (130 cases) or CVD (235). Area under the receiver operating characteristic curve, sensitivity, specificity, and positive likelihood ratio were estimated at 12 diagnostic thresholds (quantiles) of IR measures. Positive likelihood ratios for DM or CVD increased in relation to IR quantiles; risk gradients were greater for DM than for CVD, with no 9th to 10th quantile (76th centile) threshold effects. IR had better discrimination for incident DM than for CVD (HOMA-IR area under the receiver operating characteristic curve: DM 0.80 versus CVD 0.63). The HOMA-IR 76th centile threshold was associated with these test-performance values: sensitivity (DM 68%, CVD 40%), specificity (DM 77%, CVD 76%), and positive likelihood ratio (DM 3.0, CVD 1.7). The HOMA-IR threshold that yielded >90% sensitivity was the 6th quantile for DM prediction and the 3rd quantile for CVD. Compared with the 76th centile threshold, these alternative thresholds yielded lower specificity (DM 43%, CVD 17%) and positive likelihood ratios (DM 1.6, CVD 1.1).  Conclusions- Surrogate IR measures have modest performance at the 76th centile, with no threshold effects. Different centile thresholds might be selected to optimize sensitivity versus specificity for DM versus CVD prediction if  surrogate IR measures are used for risk prediction.

Healthy behaviors=14 yr advantage in survival

Combined Impact of Health Behaviours and Mortality in Men and Women: The EPIC-Norfolk Prospective Population Study Background
There is overwhelming evidence that behavioural factors influence health, but their
combined impact on the general population is less well documented. We aimed to quantify the
potential combined impact of four health behaviours on mortality in men and women living in
the general community.

Methods and Findings
We examined the prospective relationship between lifestyle and mortality in a prospective
population study of 20,244 men and women aged 45–79 y with no known cardiovascular
disease or cancer at baseline survey in 1993–1997, living in the general community in the
United Kingdom, and followed up to 2006. Participants scored one point for each health
behaviour: current non-smoking, not physically inactive, moderate alcohol intake (1–14 units a
week) and plasma vitamin C .50 mmol/l indicating fruit and vegetable intake of at least five
servings a day, for a total score ranging from zero to four. After an average 11 y follow-up, the
age-, sex-, body mass–, and social class–adjusted relative risks (95% confidence intervals) for allcause
mortality(1,987 deaths) for men and women who had three, two, one, and zero
compared to four health behaviours were respectively, 1.39 (1.21–1.60), 1.95 (1.70–-2.25), 2.52
(2.13–3.00), and 4.04 (2.95–5.54) p , 0.001 trend. The relationships were consistent in
subgroups stratified by sex, age, body mass index, and social class, and after excluding deaths
within 2 y. The trends were strongest for cardiovascular causes. The mortality risk for those with
four compared to zero health behaviours was equivalent to being 14 y younger in
chronological age.
Conclusions
Four health be haviours combined predict a 4-fold difference in total mortality in men and
women, with an estimated impact equivalent to 14 y in chronological age.

Article of interest

How Much of the Recent Decline in the Incidence of
Myocardial Infarction in British Men Can Be Explained
by Changes in Cardiovascular Risk Factors?
Evidence From a Prospective Population-Based Study
Sarah L. Hardoon, MSc etc.

Background—The incidence of myocardial infarction (MI) in Britain has fallen markedly in recent years. Few studies have  investigated the extent to which this decline can be explained by concurrent changes in major cardiovascular risk factors.
Methods and Results—The British Regional Heart Study examined changes in cardiovascular risk factors and MI  incidence over 25 years from 1978 in a cohort of 7735 men. During this time, the age-adjusted hazard of MI decreased by 3.8% (95% confidence interval 2.6% to 5.0%) per annum, which corresponds to a 62% decline over the 25 years. At the same time, after adjustment for age, cigarette smoking prevalence, mean systolic blood pressure, and mean non–high-density lipoprotein (HDL) cholesterol decreased, whereas mean HDL cholesterol, mean body mass index, and
physical activity levels rose. No significant change occurred in alcohol consumption. The fall in cigarette smoking explained the greatest part of the decline in MI incidence (23%), followed by changes in blood pressure (13%), HDL cholesterol (12%), and non-HDL cholesterol (10%). In combination, 46% (approximate 95% confidence interval 23% to 164%) of the decline in MI could be explained by these risk factor changes. Physical activity and alcohol consumption had little influence, whereas the increase in body mass index would have produced a rise in MI risk.
Conclusions—Modest favorable changes in the major cardiovascular risk factors appear to have contributed to considerable reductions in MI incidence. This highlights the potential value of population-wide measures to reduce exposure to these risk factors in the prevention of coronary heart disease. (Circulation. 2008;117:598-604.)

The second study is about barker's hypothesis and the funding of the children's health study

Do Cholesterol Drugs Do Any Good?

Do Cholesterol Drugs Do Any Good? Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated

TEXAS Trivia

Need to be cheered up?
Happy, Texas 79042
Pep , Texas 79353
Smiley , Texas 78159
Paradise , Texas 76073
Rainbow , Texas 76077
Sweet Home , Texas 77987
Comfort , Texas 78013
Friendship, Texas 76530

Love the Sun?
Sun City , Texas 78628
Sunrise , Texas 76661
Sunset, Texas 76270
Sundown, Texas 79372
Sunray , Texas 79086
Sunny Side , Texas 77423

Want something to eat?
Bacon , Texas 76301
Noodle , Tex as 79536
Oatmeal , Texas 78605
Turkey , Texas 79261
Trout , Texas 75789
Sugar Land , Texas 77479
Salty, Texas 76567
Rice , Texas 75155
And top it off with:
Sweetwater , Texas 79556

Why travel to other cities? Texas has them all!
Detroit , Texas 75436
Colorado City , Texas 79512<
Denver City , Texas 79323
Klondike , Texas 75448
Nevada , Texas 75173
Memphis , Texas 79245
Miami , Texas 79059
Boston , Texas 75570
Santa Fe , Texas 77517
Tennessee Colony , Texas 75861
Reno , Texas 75462

Feel like traveling outside the country? Don't bother buying a plane ticket!
Athens , Texas 75751
Canadian, Texas 79014
China , Texas 77613
Egypt , Texas 77436
Ireland , Texas 76538
Turkey , Texas 79261
London , Texas 76854
New London , Texas 75682
Paris , Texas 75460

No need to travel to Washington D.C.
Whitehouse , Texas 75791

We even have a city named after our planet!
Earth , Texas 79031

And a city named after our State!
Texas City , Texas 77590

Exhausted?
Energy , Texas 76452

Cold?
Blanket , Texas 76432
Winters, Texas

Like to read a bout Histo ry?
Santa Anna , Texas
Goliad , Texas
Alamo , Texas
Gun Barrel City , Texas
Robert lee, Texas

Need Office Supplies?
Staples, Texas 78670

Men are from Mars, women are from Venus , Texas 76084

You guessed it..it's on the state line..
Texline , Texas 79087

For the kids...
Kermit , Texas 79745
Elmo , Texas 75118
Nemo , Texas 76070
Tarzan , Texas 79783
Winnie , Texas 77665
Sylvester , Texas 79560

Other city names in Texas , to make you smile.....
Frognot , Texas 75424
Bigfoot , Texas 78005
Hogeye , Texas 75423
Cactus , Texas 79013
Notrees , Texas 79759
Best, Texas 76932
Veribest , Texas 76886
Kickapoo , Tex as 75763
Dime Box , Texas 77853
Old Dime Box , Texas 77853
Telephone , Texas 75488
Telegraph , Texas 76883
Whiteface , Texas 79379
Twitty, Texas 79079

And last but not least, the Anti-Al Gore City
Kilgore , Texas 75662

And our favorites...
Cut n Shoot, Texas
Gun Barrell City , Texas</ SPAN>
Hoop And Holler, Texas
Ding Dong, Texas and, of co urse,
Muleshoe , Texas


Here is what Jeff Foxworthy has to say about folks from Texas ...
If someone in a Lowe's store offers you assistance and they don't work there, you may live in Texas ;
If you've worn shorts and a parka at the same time, you may live in Texas ;
If you've had a lengthy telephone conversation with someone who dialed a wrong number, you may live in Texas ;
If "Vacation" means going anywhere south of Dallas for the weekend, you may live in Texas;
If you measure distance in hours, you may live in Texas;
If you know several people who have hit a deer more than once, you may live in Texas ;
If you install security lights on your house and garage, but leave both unlocked, you may live in Texas ;
If you carry jumper cables in your car and your wife knows how to use them, you may live in Texas ;
If the speed limit on the highway is 55 mph -- you're going 80 and everybody's passing you, you may live in Texas ;
If you find 60 degrees "a little chilly," you may live in Texas ;
If you actually understand these jokes, and share them with all your Texas friends, you definitely live in Texas .


Here are some little known, very interesting facts about Texas .
1. Beaumont to El Paso : 742 miles
2. Beaumont to Chicago : 770 miles
3. El Paso is closer to California than to Dallas
4. World's first rodeo was in Pecos , July 4, 1883.
5. The Flagship Hotel in Galveston is the only hotel in North America built over water.
6. The Heisman Trophy w s named after John William Heisman who was the first full-time coach at Rice University in Houston .
7. Brazoria County has more species of birds than any other area in North America .
8. Arans as Wildlife Refuge is the winter home of North America 's only remaining flock of whooping cranes.
9. Jalapeno jelly originated in Lake Jackson in 1978.
10. The worst natur al disaster in U.S . history was in 1900, caused by a hurricane, in which over 8,000 lives were lost on Galveston Island .
11. The first word spoken from the moon, July 20, 1969, was " Houston .."
12. King Ranch in South Texas is larger than Rhode Island .
13. Tropical Storm Claudette brought a U.S. rainfall record of 43" in 24 hours in and around Alvin in July of 1979.
14. Texas is the only state to enter the U.S. by TREATY, (known as the Constitution of 1845 by the Republic of Texas to enter the Union ) instead of by annexation. This allows the Texas Flag to fly at the same height as the U.S. Flag, and may divide into 5 states.
15. A Live Oak tree near Fulton is estimated to be 1500 years old.
16. Caddo Lake is the only natural lake in the state.
17. Dr Pepper was invented in Waco in 1885. There is no period in Dr Pepper.
18. Texas has had six capital cities: Washington-on-the Brazos, Harrisburg , Galveston , Velasco, West Columbia and Austin .
19. The Capitol Dome in Austin is the only dome in the U.S. which is taller than the Capitol Building in Washington DC (by 7 feet).
20. The name " Texas " comes from the Hasini Indian word "tejas" meaning friends. Tejas is not Spanish for Texas .
21. The State Mascot is the Armadillo (an interesting bit of trivia about the armadillo is they always have four babies. They have one egg, which splits into four, and they either have four males or four females.).
22. The first domed stadium in the U.S. was the Astrodome in Houston .

Cowboy's Ten Commandments posted on the wall at Cross Trails Church in Fairlie , Texas :
(1) Just one God.
(2) Honor yer Ma & Pa.
(3) No telling tales or gossipin'.
(4) Git yourself to Sunday meeting.
(5) Put nothin' before God.
(6) No foolin' around with another fellow's gal.
(7) No killin'.
(8) Watch yer mouth.
(9) Don't take what ain't yers.
(10) Don't be hankerin' for yer buddy's stuff

Now that's kinda plain an' simple don't ya think?

Assessment of Child and Adolescent Overweight and Obesity
-- Krebs et al. 120 (4): S193 -- Pediatrics
Here's a 36-page review, incl 336 citations. It purports to review assessment methods, and indeed it includes skinfolds and WC. But it avoids mentioning waist-to-height so far as I can tell.
I think that's strange for such a comprehensive review article.

Important REVIEW of Carbohydrates -- European Journal of Clinical Nutrition -- alert Volume 61 Issue S1

Joint FAO/WHO Scientific Update on Carbohydrates in Human Nutrition
Table of Contents
"As part of the normative work and the complimentary mandates of the two organizations to periodically update nutrient requirements and regularly develop related global guidelines, FAO and WHO have been exploring the possibility of holding an expert consultation to update the work of the 1997 Expert Consultation. Considered necessary given the developments and other relevant recommendations made during the intervening period, including those from the 2002 Joint WHO/FAO Expert Consultation (WHO, 2003), FAO and WHO agreed in 2005 to undertake a scientific update on some of the key issues related to carbohydrates in human nutrition. The key issues identified included terminology and classification, measurement, physiology, carbohydrates and diseases (that is, obesity, diabetes mellitus, cardiovascular diseases and cancer), and glycaemic index and glycaemic load. This update of existing knowledge and evidence relating to the current recommendations was viewed as essential in the process leading up to a forthcoming Expert Consultation on Carbohydrates in Human Nutrition."

Sweet, Sour, Salty, Bitter. and Umami

Sweet, Sour, Salty, Bitter… and Umami

So we have time to learn a Japanese word "Umani" (not a exactly word for delicious, I think), and look beyond. By the way, Umani in Chinese is "Xian"
The full story: Sweet sour salty bitter and Umami

Talking Too Much On a Job Interview May Kill Your Chance

Talking Too Much On a Job Interview May Kill Your Chance  
On the eve of Halloween, here's a scary thought: You can blow a promising opportunity by talking too much during a job interview.
That's how one facilities administrator ruined her employment chances at Clark Nuber, a small accounting firm in Bellevue, Wash. Asked to describe her strengths, the applicant delivered a long-winded reply focused on her cleaning of every cabinet in her home. "She probably went on for three to four minutes," recalls Tracy White, the firm's human-resources director. "I doubted she could get the job done in an eight-hour day."
Many nervous job seekers blabber endlessly about irrelevant information. They create a poor impression and cut short the hiring manager's time for further questions. "That official won't pay any attention to you unless you prove you're sharp during the first five minutes," cautions Robin Ryan, a career counselor, author and speaker in Newcastle, Wash.
"Oversharing in an interview is the most dangerous thing you can do," concurs Annie Stevens, a managing partner at ClearRock, a Boston executive-coaching and outplacement concern.
Don't despair. Here are four ways to steer clear of verbosity during a job hunt:
• Prepare short statements on how your background matches the job. Rehearse.
When a hiring manager says, "Tell me about yourself," you can offer a few war stories that recount a work problem, your corrective action and the measurable result. "The stories have to be powerful as well as engaging," lasting no longer than two minutes apiece, says Rich Gee, an executive coach in Stamford, Conn.
He helped Ward Smith, a talkative golf pro and instructor, to win a marketing spot with Black & Decker. During practice sessions with the coach, Mr. Smith supplied elaborate detail about the golf irons that he recommended to students. A hiring manager "doesn't need to know this," Mr. Gee interjected.
Mr. Smith soon realized he should translate "what I was doing into what Black & Decker was looking for," and keep it succinct. During his job interview, he used marketing lingo to describe briefly his teaching methods, explaining how he identified students' objectives, forged a rapport and enabled them to reach solutions. He now is an Atlanta field-marketing coordinator for a Black & Decker unit.
Embracing a similar approach, a jobless organizational-development consultant recently landed follow-up interviews with three possible employers. Callbacks rarely occurred when I "was running off at the mouth," he remembers. Defining yourself concisely also "builds an enormous amount of confidence for the next interview," he notes.
• Make sure you understand a question. Stop every couple of sentences to check.  
If the interviewer requests your career history, you might inquire, "Do you want me to start with my present situation or at the beginning?" This type of response demonstrates a candidate "is preparing mentally for what's he's going to give me," says Peter D. Crist, head of recruiters Crist Associates in Hinsdale, Ill.
Pausing after you speak lets you collect your thoughts -- and seek permission to continue. Before you resume, Ms. White suggests asking, "Did I answer your question enough? Do you want more examples?"
• Watch the interviewer's body language for hints that your answers are getting boring.  
He may stop taking notes, check his watch or glance at his computer. A loquacious middle manager ignored such warning signals after spending 15 minutes telling a West Coast recruiter about several extraneous issues, including her husband's problems with his boss.
"I was rolling my eyes and tapping my pen on her résumé to indicate we should get back to work here,'' the exasperated recruiter says. He finally cut her off because he had many more questions to pose.
• Solicit feedback following an interview.  
The West Coast recruiter decided against referring the middle manager to a client. "You had a number of stories to tell but they weren't relevant," he told her. "Use each minute to its best advantage to sell your background."
With practice, you'll be able to polish your pitch, adjusting the length of your responses until someone says, "You're hired!"

四十岁的女人

１．四十岁的女人，子女尚未长大，老公已经开花。这是一个让女人最焦灼、困惑的年龄，也是女人一生中最敏感、关键的过渡。要开始修心养性，要做到语调平缓、目光柔和、神态优雅、举止从容。

２．四十岁的女人，在事业方面无须过于计较。有一份自己喜欢、愿意为之认真努力的工作便可。若非要在职场上与同龄男人拼个你死我活，那无异于将一辆QQ轿车驶向了F1赛道。

３．四十岁的女人，要有一两样经过岁月洗礼、可以寄托信念的物品。无论是祖辈相传还是定情信物，在你难过流泪的时候可以将它握在手中，当你孤独无助的时候有它相伴相随。

４．四十岁的女人，相当于一辆已经行驶了十四万公里的汽车。务必要做到每六个月检查一次身体，尽早发现如乳腺、卵巢、内分泌系统等疾病。

５．四十岁的女人，要抓紧补充钙质和营养，中年女性百分之七十都有不同性质的骨质疏松症状。胸部可以下垂，皮肤可以松懈，但切记：骨头一定要坚挺。这将使你在五、六十岁的时候受益无穷。

６．四十岁的女人，无论多少要藏一些私房钱，放在贴身隐秘的地方以备不时之需。万一碰到昔日恋人落难或者哪天离家出走不必再向老公伸手要钱。

７．四十岁的女人，可以不掌管经济大权，但要了解小钱的走向，尤其要注意男人的皮夹。譬如，经常晚上开会的丈夫为什么身上总是少个三五百，时不时连续加班的老公又在哪里"遗失"了一两千。

８．四十岁的女人，要将头发束起、衣领提高、裤腰收紧、裙摆放低。纵使身材依旧完好也无需显山露水、故意炫耀。要记住，身段在这个年龄能为你换来的东西已经非常有限。

９．四十岁的女人，不要再过多地涂脂抹粉，这些化妆品虽然在遮盖方面功能强大，却会摧毁你那历经岁月的皮肤。建议经常补充水份以舒缓纹理，多用保湿类和紧致类的护肤品方可延容益颜。

10．四十岁的女人，不要花枝招展、不要妖冶惑众，不要与你们的天敌（二、三十岁的女人）去一争高低。她们有她们的青春和活力，你有你的沉淀和修养。日月转换、江山多娇，此乃不可违抗的自然规律。

11. 四十岁的女人，不要再沉寂于"好男"、"快男"这些智障节目，也别再相信你是一位身份未明、不慎迷失，等待王子前来拯救的公主。水晶鞋穿了四十年也破了，南瓜马车坐了四十年也垮了，与其幻想与小白脸的爱情，不如认真经营自己的婚姻。

12. 四十岁的女人，要避免和男性在麻将桌上消磨时光，那里不但有碍健康，还是黄杏出墙的温床。洗牌时手指无心接触，打牌时腿脚有意碰撞，都是祸害的根源。有数据表明，在出轨中年女性中高达百分之二十五的比例是发生在麻将桌上的。

13. 四十岁的女人，独守空房催人老，孤影自怜心易碎。假如老公不喜欢回家，建议还是要每天烧好晚饭，将他的碗筷和他喜欢的老酒端正的供在桌前。如此持续一段时间，任何良知尚存的男人都会回心转意。

14. 四十岁的女人，如果怀疑老公出轨不要穷追猛打，也无须捉奸在床。身体和灵魂若能挽回其一最好拯救灵魂，如果两者皆飞那就要痛定思痛。真到了曲终人散、劳燕分飞的地步，要尽快找到一个可以救赎自己的方法。

15. 四十岁的女人，可以豪爽但不要豪放，可以浪漫但不要浪荡。你路过了你理当路过的风景，也行驶了你应该行驶的里程。不要心有不甘，不要挂档倒退。把该记忆的记忆，该剔除的剔除。要让四十岁成为美丽的风景，而不是情欲的陷阱。

16. 四十岁的女人，不要大嘴长舌、在别人背后说三道四，也不要喋喋不休、将老公的耳膜击穿。有调查显示，喜欢唠叨的四十岁女性的离婚率是不喜欢唠叨的1.5倍。将唠叨减少一半，把声调降低一倍，会换来更和谐的婚姻和家庭，这其中的奥妙你一试便知。

17. 四十岁的女人，富有于心，成熟于智。要坦然面对这个年龄，不要为过去惆怅，也无需为将来迷茫。春去秋来、花开花落，冥冥之中早有安排。女人走好四十往后的道路有如好书合上、好戏落幕，将赋予此生更多地美感和质感。

18. 四十岁的女人，尽量少去伤肝动火，要宽容待人，要矜持有度，纵使本文作者在篇幅中有什么不当的言辞也不要跟帖骂人。
文章引用自： 朱威廉 http://blog.sina.com.cn/s/blog_4b7ab97601000af3.html

四十岁的男人

1． 四十岁的男人，如果还没有结婚，就别结了。无论你是一次未娶还是多次失败，你的身心已经到了不健康的地步，再把这种不健康带给别人是不负责任的。如果可以做到清心寡欲，独自漫步，也能活的自在。

2． 四十岁的男人，如果一事无成，就难成了。十几年的教育，二十几年的社会，这些都没整出点动静来，就不要为难自己了。当然，没出息的也有没出息的活法：好吸的抽两根小烟，好喝的咪两口小酒，好赌的打两副小牌，好色的看两张小碟。放低目标、摆平心态，日子也照样能过的舒舒服服。

3． 四十岁的男人，如果还没去过K房或者桑拿，最好抽空去一次。倘若有美色、美酒当前却依旧坐怀不乱，那么，你就真正达到了不惑的境界。不惑是一种高度，是一种层次，这其中的美妙待我四十岁时再与你细细道来。

4． 四十岁的男人，不要再像二、三十岁那样，目不斜视、直勾勾地盯着女士着装暴露的部位。纵使心里波涛起伏，也要注意形象得体。非礼勿视、若非要视、最好斜视。

5． 四十岁的男人，如果活得不开心，那估计是要把这份不开心带到棺材里去了。要放宽心胸，成就大小与金钱无关，是否风光无需载入史册。要记住：芸芸众生、人来人往，不是谁都能傲视天下，这其中有命、有运。走过、路过即可，不要耿耿于怀，更不要愤世嫉俗。

6． 四十岁的男人，成就过一两件事情很不容易，什么事情都没做成过更不容易。对于那些一事无成者虽然为时已晚，但大器晚成的例子从古至今、跨越东西也比比皆是。只要还相信自己，就值得再去放手一搏。

7． 四十岁的男人，别把自己的身材搞得一塌糊涂。臀部下垂和腹部隆起不是四十岁男人的专利。腾出些时间适当运动一下，譬如打打球、跑跑步都能对身心的抗老化起到积极的作用。

8． 四十岁的男人，当官的要清廉不垮，经商的要纳税守法，打工的切忌伸手乱拿。二、三十岁犯个什么错还能洗心革面、重新来过，四十岁再来次失足落马可就苦海无边、回天乏术了。

9． 四十岁的男人，应多尽些孝道，事业再怎么大，工作再怎么忙也要抽出些时间陪老人们吃吃饭、聊聊天，传承中华民族优秀精神的同时，也传递一个家庭互爱的传统，给后辈做出榜样。要记住：你怎么对待你的父母，你的后代就会怎么对待你。

10． 四十岁的男人，生活在一个瞬间万变、规则不明的巨大的时代反差里；在一个前不着村、后不着店的年龄中承担着心理和生理的双重变化难免有诸多的焦虑和烦恼。要注重内心修炼，要辨明是非取舍，要懂得照顾自己。

11． 四十岁的男人，纵使有钱到了令人发指的地步，也不要去包养什么二奶小蜜。不管是谁征服了谁，最终使坏的都是金钱。而金钱这东西虽然没有长腿，却和有腿的跑得一样快。除此以外，在这个时代，只要你身旁站着一个比你老婆光鲜靓丽却不是你老婆的女人你就会变得猥琐起来，在旁人看来这不是钱色交易就是权色交易。

12． 四十岁的男人，大多已为人父，最好有一两件精彩的人生故事与你的子女分享。这些故事无需惊天动地、鬼哭神泣，但要让你的子女们知道他们有一个并不庸俗的父亲，身上流淌着不寻常的血液。这个信念在他们未来的人生当中会起到至关重要的作用。

13． 四十岁的男人，要多参加几次葬礼。人生至此已行将过半，在中途先参观一下终点可以让自己消除恐惧的心理，驱赶过一天算一天的麻痹，得以更加感激生命、感激生活、感激岁月。

14． 四十岁的男人，最好每年做两次体检。医疗保险和人寿保险至少要各买一份，要未雨绸缪的为妻子和子女做些安排。四十岁是男人病症高发期，万一不幸需要先行一步，至少能给亲人们留下一份嘱托和希望。

15． 四十岁的男人，要远离二十岁的女孩，无论她多么楚楚动人，无论她多么飞蛾扑火。她尚处桃李年华，而你理当知天命、知是非。若真心欢喜，就不要给她一条泥泞坎坷、异常艰辛的道路。

16． 四十岁的男人，要有肩膀，要扛得起风雨，要承担得起生活的重负。即使再苦再累，也要给妻子一床温暖的被褥，给孩子一个避风的港湾，给家庭一份不悔的承诺。

17． 四十岁的男人，应该去读一些佛法、圣经之类的书籍。要理解，这浩荡人世之外的玄妙；要领悟，这生命一次又一次的轮回；要看到，这滚滚红尘背后的因果；要畏惧，有一双神秘的眼睛，一直在注视着我们。

18．四十岁的男人，就算到四十了也别怕。如果碰到有80后嘲讽年龄，用王朔老师的一句话回击最淋漓至尽：你们牛B什么，不就年轻么？老子也年轻过，可你们老过么?

文章引用自： 朱威廉

Trends in Health and Aging

Trend Analysis

• Trend analysis is a statistical approach to evaluate the linear or nonlinear relationships between two variables. When we talk about the secular trend, one of those variables is time.
• Usually, I tabulate the estimates by grouped time periods at first
• Then, use a regression model [log(rate)] to evaluate trends with calendar time
• Or, Age-Period-Cohort model [log(rate)] to evaluate calendar time trends accounting for age or cohort effects
• We can also use ANOVA (ANalysis Of VAriance) with contrast coefficients (polynomial contrasts, orthogonal polynomial coefficient)
• NCHS (2018, No. 179). National Center for Health Statistics Guidelines for Analysis of Trends in "Series 2. Data Evaluation and Methods Research"
• Yin (2016). Statistical Methods and Software Package for Medical Trend Analysis in Health Rate Review Process
• HealthKnowledge: Time-trend analysis, time series designs
• NCI Software: Joinpoint is statistical software for the analysis of trends using joinpoint models. 
• Kim (2000). Permutation tests for joinpoint regression with applications to cancer rates
• Chandler (2011). Statistical methods for Trend Detection and Analysis in the Environmental Sciences

SUDAAN and Collinearity

Tips: SUDAAN and Collinearity

Dear B,

I have another question about SUDAAN. The following article states that -

"Although SUDAAN controls for collinearity by default, separate regression analyses were performed in each model with SAS (SAS Institute, Inc, Cary, NC) for statistical diagnosis."

Q1: Does SUDAAN really control for collinearity by default?
Q2: If not, how do I test it?

Again, I really appreciate your help.
X

Dear X,

Q1: Does SUDAAN really control for collinearity by default?

SUDAAN does not control for collinearity. When betas (coefficients) get too big or too small (e.g. in logistic) SUDAAN will output whatever answer it computes and also issues a warning message about the possible existence of collinear variables. As far as I know, no software available controls for multicollinearity either. There are statistics that you can request in some software (e.g. SAS) to assess multicollinearity and some actions that you can take in order to alleviate the problem.

Q2: If not, how do I test it?

As you may know, multicollinearity in logistic regression (I am assuming that you are working with logistic regression) models is a result of strong correlations between independent variables.

Effect of multicollinearity:

The existence of multicollinearity inflates the variances of the parameter estimates. That may result, particularly for small and moderate sample sizes, in lack of statistical significance of individual independent variables while the overall model may be strongly significant.

Multicollinearity may also result in wrong signs and magnitudes of regression coefficient estimates, and consequently in incorrect conclusions about relationships between independent and dependent variables.

How to detect multicollinearity?

1-Start with examining the correlations (continuous and ordinal variables) and associations (nominal variables) between independent variables.

However, in some situation, when no pair of variables is highly correlated, but several variables are involved in interdependencies, it may not be sufficient.

2-It is better to use multicollinearity diagnostic statistics produced by linear regression analysis (PROC REG with options VIF TOL in SAS). 

For nominal independent variables, create dummy variables for each category except one (it will become a reference category). Use the dependent variable from logistic regression analysis or any other variable that is not one of the independent variables, as a dependent variable in the linear regression. The collinearity diagnostic statistics are based on the independent variables only, so the choice of the dependent variable does not matter.

Examine Tolerance and Variance Inflation Factor for each variable. Since for each independent variable, Tolerance = 1 – Rsq, where Rsq is the coefficient of determination for the regression of that variable on all remaining independent variables, low values indicate high multivariate correlation. 

The Variance Inflation Factor (VIF) is 1/Tolerance, it is always >= 1 and it is the number of times the variance of the corresponding parameter estimate is increased due to multicollinearity as compared to as it would be if there were no multicollinearity. 

There is no formal cutoff value to use with VIF for determining presence of multicollinearity. Values of VIF exceeding 10 are often regarded as indicating multicollinearity, but in weaker models, which is often the case in logistic regression, values above 2.5 may be a cause for concern (Reference: P.D. Allison, Logistic Regression Using the SAS System, SAS Institute).

What to do about multicollinearity?

In some cases, variables involved in multicollinearity can be combined into a single variable. If combining variables does not make sense, then some variables causing multicollinearity need to be dropped from the model.

Examining the correlations between variables and taking into account practical aspects and importance of the variables help in making a decision what variables to drop from the model.

Hope it helps.

Best,

B

  

The Annals of Internal Medicine - Statistical Guidelines (from 2006)

The Annals of Internal Medicine - Statistical Guidelines

http://www.annals.org/shared/author_info_stats.html