Cognitive behavioural treatment may work for low-back pain

Low-back pain is a common and costly problem. This study estimated the effectiveness of a group cognitive behavioural intervention in addition to best practice advice in people with low-back pain in primary care.

Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider.

References:

Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. The Lancet, Volume 375, Issue 9718, Pages 916 - 923, 13 March 2010.

Image source: Different regions (curvatures) of the vertebral column, Wikipedia, public domain.

A fab review of "Pink Brain, Blue Brain"

You would think that I wrote Pink Brain, Blue Brain the way I'm obsessed by it. But I just had to share with you the fact that Rosalind C. Barnett and Caryl Rivers, authors of Same Difference: How Gender Myths Are Hurting Our Relationships, Our Children and Our Jobs, have an excellent review in Women Review of Books.

AND I got special permission to share it with you!

It's a PDF file, but it's well worth the download and read. Enjoy.

Episodic hypertension is a strong predictor of stroke risk

The mechanisms by which hypertension causes vascular events are unclear. Guidelines for diagnosis and treatment focus only on underlying mean blood pressure.

In each TIA cohort in this study, visit-to-visit variability in systolic blood pressure (SBP) was a strong predictor of subsequent stroke (eg, top-decile hazard ratio [HR] for SBP 6·22), independent of mean SBP.

Maximum SBP reached was also a strong predictor of stroke (HR 15).

Visit-to-visit variability in SBP on treatment was also a strong predictor of stroke and coronary events (top-decile HR for stroke: 3·25) independent of mean SBP.

Visit-to-visit variability in SBP and maximum SBP are strong predictors of stroke, independent of mean SBP. Increased residual variability in SBP in patients with treated hypertension is associated with a high risk of vascular events.

References:

Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. The Lancet, Volume 375, Issue 9718, Pages 895 - 905, 13 March 2010.

Image source: BP device used for measuring arterial pressure. Wikipedia, GNU Free Documentation License.

Alcohol consumption and raised body mass index (BMI) act together to increase risk of liver disease

Drinkers of 15 or more units per week in any BMI category and obese drinkers had raised relative rates for all definitions of liver disease, compared with underweight/normal weight non-drinkers.

The relative excess risk due to interaction between BMI and alcohol consumption was 5.58.

Raised BMI and alcohol consumption are both related to liver disease, with evidence of a supra-additive interaction between the two.

The occurrence of both factors in the same populations should inform health promotion and public health policies.

References:

Effect of body mass index and alcohol consumption on liver disease: analysis of data from two prospective cohort studies. BMJ 2010;340:c1240.
Alcohol literally kills: Gary Moore had 380mg/dL in his blood, Winehouse 416mg/dL when she died surrounded by 3 empty vodka bottles. Telegraph UK, 2012. 

Image source: Wikipedia, public domain.

New Developments in Treatment of Diabetes Type 2

From The Lancet theme issue on diabetes:

Diabetes confers a two-fold excess risk for a wide range of vascular diseases - heart disease and stroke. Adjusted HRs with diabetes were: 2·00 for coronary heart disease; 2·27 for ischaemic stroke; 1·56 for haemorrhagic stroke; 1·84 for unclassified stroke; and 1·73 for the aggregate of other vascular deaths. http://goo.gl/ucF0

Increased occurrence of cough and change in pulmonary function in the group receiving inhaled insulin - Lancet http://goo.gl/ve3G

Once weekly exenatide is an important therapeutic option for patients with type 2 diabetes http://goo.gl/UL3e

Dapagliflozin, sodium-glucose cotransporter-2 inhibitor (SGLT2 inhibitor), provides a new therapeutic option for type 2 diabetes http://goo.gl/FqIM

Arugula & Bean Salad

When life gives you lemons... make salad dressing.

I've been carrying some big cash around in my wallet since graduation and have been paranoid about losing it for the past week. Yesterday I went to Costco and was planning to spend some of it. However, when I opened my wallet, it was gone. I completely lost it in the middle of the store. Instant panic, followed by a car ride home of crying. Way to go me. Turns out, I'd left it at home anyway. What a great use of emotional energy, huh?

It made me think about all the times in my life that I've freaked out over something so small. Even in that moment I knew it was just money. It wasn't my health, my loved ones, or another oil spill. It was just a piece of paper. I'll work harder at believing that the next time something like this rolls around...

Last night I went to a friend's going away party. The funny thing is that my friend lost her wallet with some big money earlier this week too. I guess it really isn't funny because she never found her money. Hey Universe, when you decide to pay her back, don't forget that she'll be in the Southern California desert. It sucks when the Universe forgets your address.

As me and Ashley were leaving the party, she said that I must be pretty sad now with school being over and friends moving away. What I realized in that moment is that as much as I will miss the people leaving my life, I have enjoyed them being in my life so much that it is okay. If friends didn't move, we'd never have going away parties. And those, are pretty dang fun.

So, when you have a bad day, or maybe you're just hungry, help yourself to a salad with some lemon dressing. It may not make everything better, but at least your tummy will feel good.


Makes 2 salads

4 cups arugula
1/2 cup cooked beans, cooled (I used baby lima beans)
1 tomato, sliced
1/2 yellow onion, sliced
1 Tbs Italian seasoning (If you don't have this handy, just use a mix of thyme, oregano, and basil)
Juice of 1/2 lemon
Olive Oil

Add 2 tablespoons of olive oil to a pan over medium heat. Wait about a minute then add the onion slices and turn the heat to low-medium. Make sure that all the onions are covered in oil and add more if needed. Turn the onions with a spatula every 5 minutes or so. If they start to stick to the pan, add more oil. Add your Italian seasoning after about 15 minutes. The onions should caramelize in about 20-25 minutes.

While the onions are going, mix the lemon juice with 1 tablespoon of olive oil and toss with your greens. Add the greens to two plates and top with the beans. (I always have a stash of cooked beans on hand, but if you don't have any or don't want to cook them yourself, grab a can.)

When the onions have caramelized, or when you get tired of waiting, let them sit for a moment and then add to your salad. Garnish with some tomato slices and serve.

The Beautiful Game can kill you: soccer/football managers and viewers at high risk for heart disease

Almost half of England's football managers have "significant" heart problems and their life-consuming, high-pressure jobs are a "recipe for potential disaster" according to cardiovascular experts. This is hardly surprising considering the range of emotions demonstrated by Fabio Capello (age 64), the current manager of the England national football team, in the videos below:



A stressful soccer match affects everybody involved including the spectators.

The Fédération Internationale de Football Association (FIFA) World Cup, held in Germany from June 9 to July 9, 2006, provided an opportunity to examine the relation between emotional stress and the incidence of cardiovascular events. Cardiovascular events occurring in 4,000 patients in the greater Munich area were prospectively assessed by emergency physicians during the World Cup.

On days of matches involving the German team, the incidence of cardiac emergencies was 2.66 times that during the control period. For men, the incidence was 3.26 times that during the control period, and for women, it was 1.82 times that during the control period.

On those days, the highest average incidence of events was observed during the first 2 hours after the beginning of each match.

Viewing a stressful soccer match more than doubles the risk of an acute cardiovascular event. In view of this excess risk, particularly in men with known coronary heart disease, preventive measures are urgently needed.


Video: Angry Capello [ Algeria Vs England ].

References:

Nearly half of football managers suffer serious heart problems. Independent, 2005.
Cardiovascular events during World Cup soccer. N Engl J Med. 2008 Jan 31;358(5):475-83.

Super Bowl may trigger heart attacks - CNN, 2011.
Top Soccer Players Are Seen to Have Superior Brain Function - NYTimes, 2012 -- Good to know, NYT.

Cream of Asparagus and Broccoli Soup

I'm usually not a "creamy soup" person, but today called for something light yet hearty. I recently fell in love with a new cookbook: Clean Food: A Seasonal Guide to Eating Close to the Source by Terry Walters. I was intrigued by the Cream of Asparagus soup and decided to give it a try. I didn't have enough asparagus on hand, so I threw in some broccoli too.

The directions recommend putting this back in the fridge and letting it sit for a few hours before serving to let the flavors meld together. The flavors do get stronger the longer it sits, but it's perfectly acceptable to serve right off the stove. If it's warm outside, you can also serve it chilled. If you don't have any miso on hand, you can substitute some veggie broth or a bouillon cube for a little extra flavor. This soup goes great with some toasted whole-wheat naan or any bread of your choice.

Serves 6.
2 bunches asparagus (3 cups chopped)
2 heads broccoli (3 cups chopped)
2 Tbs olive oil
2 garlic cloves, minced
3 leeks, white parts only, chopped
1/2 cup rolled oats
3 cups rice milk
1/2 tsp dried dill
sea salt and pepper
1 tsp mellow white miso per serving

Bend each piece of asparagus near the tough dried end until it snaps off at its natural breaking point. Discard ends, wash remaining asparagus, cut into 2-inch pieces and set aside. Wash and chop broccoli and set aside.

In a large pot over medium heat, saute garlic and leeks in olive oil until soft (2-3 minutes). Add asparagus, broccoli, oats, milk, and dill, then add enough water just to cover asparagus and broccoli. Bring to a boil, reduce heat, cover and simmer until asparagus and broccoli are soft (about 10 minutes). Remove from heat and cool slightly.

Puree soup using a blender. Add water if a thinner soup is desired. Season to taste with salt and pepper. Dissolve miso in just enough water to make it a liquid. Stir into each serving. Garnish with dried dill and serve.

Note: Miso is added to individual servings rather than to the full pot so you can reheat leftover soup without destroying miso's living enzymes.

Ethosuximide and valproic acid are more effective than lamotrigine in childhood absence epilepsy

Childhood absence epilepsy, the most common pediatric epilepsy syndrome, is usually treated with ethosuximide, valproic acid, or lamotrigine.

Ethosuximide and valproic acid are more effective than lamotrigine in the treatment of childhood absence epilepsy. Ethosuximide is associated with fewer adverse attentional effects.



References:
Ethosuximide, Valproic Acid, and Lamotrigine in Childhood Absence Epilepsy. NEJM, 2010.

Norepinephrine Causes Fewer Adverse Events Than Dopamine in the Treatment of Shock

Both dopamine and norepinephrine (Levophed) are recommended as first-line vasopressor agents in the treatment of shock. There is a continuing controversy about whether one agent is superior to the other.

Although there was no significant difference in the rate of death between patients with shock who were treated with dopamine as the first-line vasopressor agent and those who were treated with norepinephrine, the use of dopamine was associated with a greater number of adverse events.

References:

Comparison of Dopamine and Norepinephrine in the Treatment of Shock. NEJM, 2010.

Image source: Wikipedia, public domain.

Join the Summer of Feminista

After I posted about the Census and Dept of Ed boxes that don't properly include Latinos & Latinas, I received some comments & emails about this blog. Comments from Latinas about how they felt like they were raised in a feminist way, but without knowing or learning the word feminist. Comments about struggling with feminism as a Latina. Comments about feeling shunned in women's studies courses (as someone who has two women's studies minors broke my heart). So it's been stewing...What can I do about this?

The Summer of Feminista (or so I'm calling it now, other suggestions much appreciated!) was born.

If you are a Latina and have issues with feminism, things you want to discuss about feminism or merely reflect on how your abuelita raised you in such a radically feminist way despite the fact that she never uttered the word, then I am asking you to submit a guest blog post between the June 29th and Sept 14th, in other words, the rest of the summer. While I appreciate the heavy intellectual stuff (feminism vs womanism), I'm also looking for a straight forward post about your thoughts. No need to footnote your post! Unless you want of course.

You will submit posts to me via email and I will link back to you unless you want to post anonymously. I know some of you have already said that you want to be more open than you think you can be with your name attached. I'm cool with that.

Please use this doodle page to sign up for a week. Please, please leave your email so I can contact you! Thanks!

Oral ivermectin superior to topical malathion lotion in eradicating difficult-to-treat head-lice infestation

Head-lice infestation is prevalent worldwide, especially in children 3 to 11 years old.

Topical insecticides (i.e., pyrethroids and malathion) used as a lotion, applied twice at an interval of 7 to 11 days, are typically used for treatment. Resistance of lice to insecticides, particularly pyrethroids, results in treatment failure.

For difficult-to-treat head-lice infestation, oral ivermectin, given twice at a 7-day interval, had superior efficacy as compared with topical 0.5% malathion lotion, a finding that suggests that it could be an alternative treatment.

Why does head louse not infest body and vice versa?

Possible explanation: Body lice lay their eggs on clothing fibers instead of hair fibers (http://emedicine.medscape.com/article/1108991-overview).

References:
Oral Ivermectin versus Malathion Lotion for Difficult-to-Treat Head Lice. NEJM, 2010.

Updated: 06/24/2010

EVENT: Fulfill your pledge at a Chicago Red Stars game!

Remember my challenge to you my dear readers? The one where I asked you to pledge to attend ONE professional women's sporting event in 2010?  Well Chicago friends, July 25th is a wonderful chance to fulfill that pledge!

Chicago Red Stars vs Boston Breakers

July 25, 2010

3 PM

Toyota Park


$19 per ticket

For $19 you get discounted Harlem End tickets with a hot dog or pizza, dessert/fruit cup, and drink during a pre-game tailgate lunch at the stadium. You will be placed in seats with the “I Pledge to Attend a Women’s Sports Game 2010” group. If we purchase 50 tickets in this section, 11 lucky kids, age 11 and under, will be selected to be player escorts for the Chicago Red Stars, leading WPS players onto the field during introductions. Use our super special ticket portal to purchase your tickets!

If you haven't been to a Red Stars game, let me tell you that it's awesome. The crowd is super family friendly, parking is right outside the stadium and the game is great.

In case you are wondering, I am not benefiting from this promotion at all. Not one penny goes to me.

Now go get your tickets and I'll see you at the fruit cups.

Birthday Fajita Salad

Today is Ashley's birthday. I asked what she would like for her birthday meal and I told her that I would make anything she wanted (of course, I would find some way to make it vegan). I had anticipated that she would ask for a cake and had already bought some powdered sugar for the occasion. However, she did not ask for a cake. Or cookies. Or dessert of any kind.

She asked for quinoa salad and fajita salad. Yes, ladies and gentlemen, that is correct. My vegetable-hating, vegan-fearing partner asked for two salads on her birthday. This is truly a moment to celebrate! If you or anyone you know are trying to incorporate more vegetables and/or healthy foods into your diet, I hope this story inspires you. :)

When Ashley and I were first dating she made me Fajita Salad for the first time. Of course, that version was loaded with chicken and cheese, but it is a delicious salad that is incredibly easy to transform into a vegan favorite. If you happen to already be a vegetable lover, feel free to add in some spinach or extra vegetables. If you want a low-fat version, use less vegenaise in the dressing or leave it out entirely.

Serves 4

2 heads romaine lettuce, chopped
1 can black beans
1 can pinto beans
1 cup sweet corn kernels
1 avocado
2 tomatoes, diced
1 bag tortilla chips (there will be extra)

Dressing:
1/4 cup salsa
1/4 cup Catalina dressing
1/4 cup vegenaise

The dressing is made from combining equal parts salsa, Catalina dressing, and vegenaise. 1/4 cup of each of these should make enough for the salad. Combine these together to make the dressing and mix this with the lettuce.

Next, mix in the beans, corn, tomato, and some broken up tortilla chips. Garnish with more tortilla chips and avocado.

P.S.A. testing can’t detect prostate cancer, says its discoverer

Richard J. Ablin in the NYTimes:

"Approved by the Food and Drug Administration in 1994, the P.S.A. test’s popularity has led to a hugely expensive public health disaster. It’s an issue I am painfully familiar with — I discovered P.S.A. in 1970.

The annual bill for P.S.A. screening is at least $3 billion, with much of it paid for by Medicare and the Veterans Administration.

As I’ve been trying to make clear for many years now, P.S.A. testing can’t detect prostate cancer and, more important, it can’t distinguish between the two types of prostate cancer — the one that will kill you and the one that won’t."

References:
The Great Prostate Mistake. NYTimes.
Image source: Wikipedia, public domain.

Book Review: Girl Sleuth by Melanie Rehak

When my daughter was old enough for chapter books, I couldn't wait to get her a Nancy Drew book, specifically a young readers version of Nancy called "Nancy Drew and the Clue Crew." She fell in love!

It's precisely this handing down of Nancy Drew from mother to daughter, aunt to niece and super cool friend of Mom's to a young girl that has allowed Nancy Drew to remain one of the best selling children's book series of all time. In Girl Sleuth: Nancy Drew and the Women Who Created Her, Melanie Rehak does an excellent job at outlining the birth and rise to world domination of our beloved Nancy Drew.

The birth of Nancy Drew came from a combination of "father of only daughters finds feminism" and a new found attention of the massive buying power of teens. In 1922 "the Stratemeyer Syndicate [which birthed Nancy Drew] earned $9.1 million, $1 million of which was from [one of their girls series] (page 98)." Which leads to one of the themes of this double biography - the evolution of girlhood in the USA. How did such a strong girl character catch in the years between the first and second wave of feminism?

Girl Sleuth is the story of the two women who did indeed craft Nancy's character and sustained our appetite for more and more Nancy Drew mysteries. One woman charted her own path in writing and journalism, the other found a career opportunity out of her father's untimely death. Both were partners in crime, yet also were antagonistic to each other over the years.

What made me smile was the way that Rehak weaved in feminist history into Nancy's history. Rehak doesn't say that Nancy is a feminist character, but she does show us how the role of women in the workforce, girlhood and the emergence of the second wave of feminism all impacted Nancy's development.

This isn't a new book. In fact the series my daughter likes to read isn't referenced as it started in 2006 and this book was published in 2005. But it's a book that I've been meaning to read for years. Fellow book worm, Rachel read it years ago and said I had to read it and that I would love it. She was right. I received this book through PaperbackSwap.com.

I would add this to any summer reading list. It's an easy read, enjoyable and if you loved Nancy as a girl, you'll love this book. Purchase a copy from an indie bookstore or Powells.com and toss it in your bag.

* Book links are affiliate links. If you buy your book here I could make a very small amount of money that goes towards this blog.

Lessons From My Kitchen...

For the past two years I have been a student at Antioch University earning my Masters Degree in Organizational Psychology. Yesterday I graduated. I figured I had to acknowledge this here because this blog was inspired by my experience in this program. Today I don't have a recipe for you. Instead, I want to take a moment to share with you some of the lessons I have learned in my kitchen and in life.

Seasons change. I could write a paper for you about change, but I will spare you today. Instead, what I think is important to say here is that even though we may fear change and times of transition, our entire lives are about change. You see this in the world around you as the days slowly get longer, shorter, colder, warmer... as the different foods cross your plate with the various seasons... as beautiful people come into your life and some stay while others go.

What are you letting go of today? What are you letting in? On our last day of class we did a closing activity and each shared what we were letting go of and what we were letting in. I think this a wonderful question to ponder at any moment in your life, but on the eve of summer, I think it is especially important to say goodbye to our bittersweet, rainy spring and welcome the new season.

Trust the process. You have no way of knowing what lies ahead of you in your life. Life is all about the unexpected turns and moments that change our path forever. I believe that all we can do in the here and now is focus on the beauty there is around us and trust that we are all heading in the right direction: "Whatever you are meant to do, move toward it and it will come to you." - Gloria Dunn

I have mentioned here before that I do not consider myself to be "a baker." Baking, for me, is about measuring all the ingredients and then hoping, praying, and crossing my fingers that the cake is going to rise. Every time I bake, I have to trust the process. I have to trust that I did the best I could and believe that when I put the cake in the oven it is going to turn out fine. Most of the time, it's a success. But, I have had my share of failed cakes. That's life.

Recipes aren't always right. There have been many times when I have followed a recipe completely only to find the end result rather disappointing. I have learned that the best cooking method, at least for me, is to look at recipes as needed, but trust my own instincts to modify them. You can't rely on a book for everything. Cookbooks and recipes are amazing and helpful, but they can't teach you how to make food. That comes from experience. I believe that the greatest lessons we learn come from our own lives, not books. And if you disagree with a recipe, change it.

Be present. Where is the fun in cooking if you aren't fully present while eating the food? Any time I have ever injured myself in my kitchen, it is because I was not fully present. There are so many distractions today for all of us, but sometimes it is necessary to turn off the phone, the computer, and our internal chatter just to focus on the moment at hand. From my experience, food always tastes better when we slow down, take small bites, and just eat.

Use it or lose it. You cannot hold on to produce forever because it will eventually go bad. I don't know about you, but I know there have been many times when I have wasted food that I love because I was waiting for the "right time" to use it or eat it. Wasted food is a bummer. And wasted opportunities? Big bummer. The lesson here is that there never is a "right time" to do something - there is just that moment. So, use up that favorite food you have been saving, take that vacation you have been putting off, or make that leap in your life that scares you. The time is now.

Food is about community. The best meals I have had are ones that I have shared with others. In our fast-paced world, we often forget about building community or taking the time to focus on our relationships with others. Food is a beautiful way to build community, whether that means designating Wednesdays as "family dinner night", meeting your neighbors in a community kitchen, or volunteering at a local food bank. People need connection with others and good connections often happen over good food.

It's just food. Have fun. And finally, cooking should be fun. Food is about enjoyment and pleasure. Don't take it too seriously and remember that even the worst situations get better with a good sense of humor. :)

Lawyers Opinion: Risky Business - Tweeting the Symptoms of Social Media

From Risky Business - Tweeting the Symptoms of Social Media (PDF):

"To date there are at least 540 hospitals in the United States utilizing social media tools: Hospitals account for 247 YouTube channels, 316 Facebook pages, 419 Twitter accounts, and 67 blogs.

The number of individual and independent medbloggers is in the thousands.

In December of 2009, a hospital employee was forced to resign because of a single tweet.

On October 29, 2008, a patient provided what is believed to be the first live tweet from the operating room. “Bad bad stick. Ow ow ow ow ow.”

In response to online physician rating websites, like Yelp, RateMD, and others, a company now offers physicians an antidefamation service, including contract provisions restricting a patient’s right to make negative comments on rating websites.

There are a number of other scenarios that could lead to liability. For example, what happens if an “off-duty” physician responds to a health question by a neighbor while doing yard work? Suppose the same exchange occurs through online “messages” between a physician and one of the physician’s “friends” on Facebook, creating an electronic record of the exchange that could potentially support the existence of a physician-patient relationship, thereby creating certain liability arising therefrom (e.g., HIPAA, medical malpractice, patient abandonment, etc.).

The authors of a National Law Journal article warn that bosses who “friend” are begging to be sued."

References:

AHLA Connections: Legal Implications of Health Care Social Media.
"If a patient bashes a physician on rating websites there is little that doctor can do", says Medscape, 2012.
Guide to Winning Your Malpractice Lawsuit - Medscape http://buff.ly/UTaWOq

Image source: public domain.

The Ultimate Social Media in Medicine Presentation (182 Slides)

Networked Social Media in Learning, Teaching and Research

View more presentations from sl.medic.

The author, Maged Boulos, has published widely on social media uses in medicine and health informatics. He features this website in the presentation as one of the examples of medical blogs but I have had no influence on the inclusion. The link is via Berci.

Related reading:

Social media in medical education - Grand Rounds presentation by IUH Med/Peds residency program director http://goo.gl/Zw3lK

Sexual life expectancy is longer for men than women

A BMJ study of middle aged and older adults showed that men were more likely than women to be sexually active, report a good quality sex life, and be interested in sex.

These gender differences increased with age and were greatest among the 75 to 85 year old group: 38.9% of men compared with 16.8% of women were sexually active, 70.8% versus 50.9% of those who were sexually active had a good quality sex life, and 41.2% versus 11.4% were interested in sex.

People in very good or excellent health were 1.5 to 1.8 times more likely to report an interest in sex than those in poorer health. At age 30, sexually active life expectancy was 34.7 years for men and 30.7 years for women compared with 14.9 to 15.3 years for men and 10.6 years for women at age 55.

At age 55, men in very good or excellent health on average gained 5-7 years of sexually active life compared with their peers in poor or fair health. Women in very good or excellent health gained 3-6 years compared with women in poor or fair health.

References:

Sex, health, and years of sexually active life gained due to good health: evidence from two US population based cross sectional surveys of ageing. BMJ 2010;340:c810.

Image source: OpenClipart.org, public domain.

Green Bean Salad

It's time to slooow down. Slow down for some fresh, spring air and green beans. I was at the spa recently and sat down for a long lunch. When was the last time you took a "long lunch"? I couldn't remember.

I was so fortunate to be able to slow down for a delicious meal and take the time to nourish my body. When my food was ready, the server brought me two metal chopsticks. They were absolutely beautiful.

I sat there looking at these chopsticks and thinking about how chopsticks inspire me to slow down. To take smaller bites. To chew fully. To breathe. I don't know about you, but I could use more chopsticks and long lunches in my life.

Have I mentioned Cecile Andrews before? If you aren't familiar with her work, she is absolutely amazing. I have been making my way through her book, Slow is Beautiful, for several months now and she is absolutely inspiring. If you are in need of a little nourishment for the soul, sit down with her book and this green bean salad. Don't forget the chopsticks.

Serves 2-4 as a side dish

1/2 pound green beans
1 tsp rice vinegar
1/2 red onion, sliced
juice from 1/2 lemon
handful of chopped walnuts
handful of sliced almonds
handful of golden raisins
pepper to taste
olive oil

Place the green beans in boiling water for about 4 minutes. Drain and rinse with cold water. Slice them in half (lengthwise). Set aside.

Meanwhile, add olive oil to a pan over medium-high heat. Add the onion slices, walnuts, and almonds. Saute for about 2 minutes until nuts are brown and fragrant. Add this to the green beans. Add rice vinegar, lemon juice, a bit more olive oil. Mix and garnish with golden raisins. Sprinkle with pepper to taste.

What's new in infectious diseases from UpToDate

- Brain MRI may be useful in patients with endocarditis. In one study including 53 patients, early use of cerebral MRI led to the reclassification from possible to definite IE in 30% of cases.

Figure 1. TEE shows AV Endocarditis in a patient with IVDA. There is a large vegetation on the aortic valve with 2-3+ AI (click to enlarge the image). Source: Double Hit – Right and Left-Sided Endocarditis in a Heroin Abuser.

- Cotrimoxazole prophylaxis was associated with a 50 percent reduction in deaths in patients starting antiretroviral therapy with CD4 counts lower than 200 cells.

- Universal influenza immunization: In 2010, the CDC expanded the recommendation for influenza vaccination to include all individuals 6 months of age and older. Previous guidelines recommended influenza vaccination for individuals over age 50 and for those at increased risk of influenza complications and close contacts of such individuals.

How to Subscribe to "What's New" Specialty Page of UpToDate? No Feed, No Problem for Google Reader

35% of UpToDate topics are updated every four months. The editors select a small number of the most important updates and share them via "What's new" page.

The page does not provide RSS feed for the different specialties. One solution is to copy/paste the URL address of each subspecialty page you are interested in the Google Reader "Add a subscription" field (top left corner). Google Reader will automatically create a RSS feed from this "feedless" page.

References:
What's new in infectious diseases. UpToDate, 2010.

UTD Contents: What's New

Are You Dependent on UpToDate for Your Clinical Practice?
5 Tips to Stay Up-to-Date with Medical Literature

Why don't Chicago museums love Chicago kids?

I'm pretty sure I've noticed this before, but it wasn't until a co-worker sent me a list of free days of Chicago museums that it dawned on me again. There are not many free days for Chicago Public School kids. The last day for CPS is not until this Friday, June 18th.

• The Adler Planetarium doesn't have one free day between June 21st and September 6th. In fact they have a free day on the FIRST DAY for CPS. There is a free week two weeks before CPS lets out for the summer.
• The Field Museum has three free days during the CPS summer break. It also has three free days in June before CPS kids are off for the summer.
• The Museum of Science and Industry has one free day during CPS summer break. There is a free week two weeks before CPS lets out for the summer.
• The Shedd Aquarium has ZERO free days during CPS summer break. There is a free week the last week CPS is in session (this week!).

I think that most of us would consider these four museums the four of the big five or major museums in Chicago. The fifth is the Art Institute which has free evenings every Thursday from 5 pm - 8 pm.

So why? Why would four of our biggest museums shut their doors to Chicago Public School kids? Their parents (myself included) pay taxes to support these institutions. Considering the budget cuts in CPS and the lack of field trips to these institutions, I would like to think that these museums would all be accessible to CPS kids during the summer time. In fact, I believe there should be CPS free days. Bring in your report card to prove you go to a CPS school and get in free.

That seems fair, right? 

Until that time, take a look at the list of museums for the smaller ones who remember that they belong to a community.

Electronic Prescribing Decreases Prescribing Errors Seven Fold

For e-prescribing adopters, error rates decreased nearly sevenfold, from 42.5 per 100 prescriptions at baseline to 6.6 per 100 prescriptions one year after adoption.

For non-adopters, error rates remained high at 37 per 100 prescriptions at baseline and 38 per 100 prescriptions at one year.

Illegibility errors were very high at baseline, and not surprisingly, were completely eliminated by e-prescribing (87.6 per 100 prescriptions at baseline for e-prescribing adopters, 0 at one year).

Prescribing errors may occur much more frequently in community-based practices than previously reported. This study findings suggest that stand-alone e-prescribing with clinical decision support may significantly improve ambulatory medication safety.

References:
Electronic Prescribing Improves Medication Safety in Community-Based Office Practices. Journal of General Internal Medicine, 2010.

The Lancet is alive and kicking on social media networks

As per its editor Richard Horton, the journal Lancet is alive and kicking on social media networks with a Twitter and Facebook pages. He commented on the social media involvement of the journal on the regular podcast available from the links below:

Lancet Podcast
http://www.thelancet.com/audio

Facebook
http://www.facebook.com/TheLancetMedicalJournal

Twitter
http://twitter.com/thelancet

Classic Chocolate Chip Cookies

Sometimes you just have to give in. Give in to putting that alarm to sleep for five more minutes. Give in to going for a walk outside just to feel the sun on your face. And give in to yourself and that nagging little voice inside of you that says, "I don't feel like going to the gym today... I feel like making cookies." How I both love and despise that little voice.

I have been reading about organizing your time and your life lately and it's been some interesting research. I'm one of those people that's always got a to-do list going. Every day starts with creating the list and every day ends with an evaluation of how much got done. What I have realized is that I never specifically put fun things on the to-do list. The to-do lists are always about work or chores... writing papers, cleaning the apartment, running errands. As a result, fun things tend to get pushed aside for more "productive" endeavors.

I have never put "make cookies" on my to-do list. But, that certainly changed today. Cookies are an important part of life that often get forgotten in my world. I have decided it is time to bring them back -- along with all my other forgotten treasures like spending more time with friends, creating art, and traveling. And besides, making cookies isn't all about me. There are many people in my life in need of cookies: Ashley, youth at Lambert House, fellow graduate students... I bet if you try real hard you can find some people in your life too.

What's at the top of your to-do list today? What can you throw out and replace with "make cookies"? Or, better yet, make an entire afternoon out of "eating cookies." I think that's on my list for tomorrow.

2 1/4 cups all-purpose flour
1 tsp baking soda
1 tsp salt
1 cup Earth Balance, softened
3/4 cup granulated vegan sugar
3/4 cup packed brown sugar
1 tsp vanilla extract
Egg replacer for 2 eggs
2 cups (12-ounce package) vegan chocolate chips
1 cup chopped nuts (optional)

1. Combine flour, baking soda, and salt in small bowl
2. Beat Earth Balance, sugar, brown sugar, and vanilla in large mixer bowl
3. Add egg replacer one at a time, beating well after each addition; gradually beat in flour mixture.
4. Stir in chips and nuts
5. Drop by rounded tablespoon onto ungreased baking sheets
6. Bake in preheated 375-degree oven for 8 to 10 minutes or until golden brown
7. Let stand for 2 minutes, remove to wire racks to cool completely.

18% tax on pizza and soda can decrease U.S. adults' weight by 5 pounds (2 kg) per year

Nearly a third of American children are overweight or obese. In our inner cities a prevalence of obesity of more than 50% is not uncommon. Too many calories in, too little energy out.

With two-thirds of Americans either overweight or obese, policymakers are increasingly looking at taxing as a way to address obesity on a population level.

The tobacco experience showed that education is not enough: regulation, litigation, and legislation are needed too. Increasing taxes on cigarettes has been the single most effective strategy in reducing smoking.

An important part of the obesity story is clearly the huge increase in consumption of sugar sweetened beverages (SSBs): carbonated sodas, sweet teas, energy drinks, flavoured water, and sports drinks. Their use has more than doubled in recent years.

"Sadly, we are currently subsidizing the wrong things including the product of corn, which makes the corn syrup in sweetened beverages so inexpensive."

Instead, the agricultural subsidies should be used to make healthful foods such as locally grown vegetables, fruits and whole grains less expensive.

Danish government imposed 25% tax on ice cream, chocolate, sweets, and will increase taxes on soft drinks, tobacco, alcohols to combat obesity, heart disease, and other illnesses. BMJ. http://goo.gl/ixc0

 Some pizzas are 'saltier than the sea' (NHS blog).

References:
Tax soda, pizza to cut obesity, researchers say | Reuters.

The case of the sugar sweetened beverage tax. BMJ 2010;341:c3719.

Image source: Soft drinks, Wikipedia, public domain.

Book Review: A Bad Day for Pretty by Sophie Littlefield

Stella looks like and usually acts like your run of the mill grandma. But she has a secret that is protected not by her, but also by the women she helps. Stella spent years in an abusive marriage and busted out of it in the most literal sense. Now she dedicates her life to busting other women out of abusive relationships.

A Bad Day for Pretty by Sophie Littlefield held my attention like no other mystery novel. Not only did I want to learn the conclusion of the murder mystery, but I also wanted to know more about Stella. I wish we all had a Stella in our lives and not just because she kicks ass. I want to share a beer with her.

This book was pitched to me as a feminist mystery novel and there are certainly a lot of feminist messages. What I loved even more was a debate between Stella and her partner-in-crime in training, Chrissy about which women deserve to be saved. There's even an awesome scene where Stella goes off on Working Mother magazine. But in the end, I'd say it is a sisterhood book. Tales of sisterhood. Sprinkled with murder, lust, love, broken hearts and fresh bread.


I give this book a big thumbs up! It was fun, smart and a quick read. Purchase a copy from an indie bookstore or Powells.com and toss it in your beach bag.

Disclaimer: The only payment I received was the copy of the book.

* Book links are affiliate links. If you buy your book here I could make a very small amount of money that goes towards this blog.

EMR or "How Computers are Harming Doctor-Patient Relations" - Rick Payne

EMR or How Computers are Ruining the Doctor's Office and Harming Doctor-Patient Relations - a presentation by Rick Payne.

My experience with EMR has been mostly positive but it is certainly useful to be aware of other points of view.

Related:

Medical Malpractice Liability in the Age of Electronic Health Records - NEJM, 2010 http://goo.gl/cGZG9
"The iPatient is getting wonderful care across America. The real patient wonders, "Where is everybody?" NYTimes, 2011.

Another shooting that targets women & the media just yawns

Jennifer Pozner at WIMNs Voices:

It happened again. Another violent guy shot and killed his wife — and went on to gun down six other women unfortunate enough to be in his path before committing suicide. Four women are now dead; three others are in critical condition. And some media outlets (such as the AP story on Yahoo! News, “5 dead after shooting in Miami-area restaurant,”) are still failing to report this as a gender-based hate crime… echoing previous journalistic failures. 

Me two years ago: 

Friend of Viva la Feminista, Jennifer Pozner has been writing about the gender imbalance in school, now mass, shootings since Jonesboro in 1996. Heck, one of my first pseudo-blogs back then was the keep a running photo memorial to the women killed in the shootings from Jonesboro to Columbine. Yet time again, shooting after shooting, the media scoffs aside the fact that MEN do most of the killing.  

Is there anything new to add to this conversation?

Now go read the rest of Jenn's post. 

**

In light of my 10th year of blogging, I swear, I'm going to find my ancient geocities pages just for kicks. But mostly because I want my Jonesboro webpage. I may need to dig out my Mac Performa and hope it turns on.

Springtime Asparagus

You wouldn't know it these days, but it is springtime in Seattle - and spring means one thing... Asparagus! How do you like your asparagus? (or do you like asparagus?) I love it sauteed in a frying pan with a bit of Earth Balance. Or grilled on a barbeque with a little olive oil. Yum!

On Saturday I went over to Bastyr's Food & Herb fest at their campus in Kenmore. For anyone interested in learning more about alternative medicine, nutrition, or herbs, I highly recommend you check this out next year! This was my first time, but I was very impressed with the different workshops -- everything from making fermented foods to aromatherapy to mindfulness. They also had great food, music, and some interesting vendors. Their session on food from the Farmer's Market inspired me to make a quick stop at one on my way home. And that is how this asparagus came to be...

This fresh asparagus tasted so good that it didn't need a lot of extra flavor. A little salt and pepper and lemon juice was just enough.

Add about a tablespoon of olive oil to a pan over medium-high heat. Add the asparagus and saute for about 3-5 minutes, until it has just a bit of crunch left (depending on how you like it!) Season with salt, pepper, and a squeeze of fresh lemon juice.

Deep Vein Thrombosis - Videos by Cleveland Clinic and Mayo Clinic

Deep Vein Thrombosis - Cleveland Clinic.



John Heit, M.D., a cardiovascular physician at Mayo Clinic.

Oral factor Xa inhibitor apixaban - more effective than enoxaparin for thromboprophylaxis after knee replacement

Low-molecular-weight heparins such as enoxaparin are preferred for prevention of venous thromboembolism after major joint replacement. Apixaban, an orally active factor Xa inhibitor, might be as effective, have lower bleeding risk, and be easier to use than is enoxaparin.

The primary outcome in this Lancet study was the composite of asymptomatic and symptomatic deep vein thrombosis (DVT), non-fatal pulmonary embolism (PE), and all-cause death during treatment. The primary outcome was reported in 15% of apixaban patients and 24% of enoxaparin patients (relative risk 0·62), absolute risk reduction 9·3%.

Major or clinically relevant non-major bleeding occurred in 4% of patients receiving apixaban and 5% of treated with enoxaparin.

The authors concluded that apixaban 2·5 mg twice daily, starting on the morning after total knee replacement, offers a convenient and more effective orally administered alternative to 40 mg per day enoxaparin, without increased bleeding.

References:

Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. The Lancet, Volume 375, Issue 9717, Pages 807 - 815, 6 March 2010.

Image source: Apixaban, Wikipedia, public domain.

I'm still not White, but am I American Indian?

A few months ago when a bunch of us Latinas and Latinos were discussing which box to check on the Census we came up with a good way to express our desire to be seen as Latino to the government. Not white. Latino. We would check yes for Hispanic/Latino and then write in Latino for other.

The Department of Education ain't gonna play that game.

Last month my daughter came home with a note asking us to re-identify her (our) ethnicity for school records [Link is not to her school, just an example]. There was no "other" option (see below). OK, I"ll just leave the second question blank and check the yes for Hispanic/Latino. Then I read further on that if I did that, someone at her school would check a box for us. WTF? The U.S. Department of Education is requiring this of all students, staff, faculty/teachers across the country. As someone who works in education, I had to do this for myself.

Part One: Is this person Hispanic or Latino? (Must choose one)

• Hispanic or Latino
• Not Hispanic or Latino

Part Two: Select one or more of the following categories that apply to this person.

• American Indian or Alaska Native
• Asian
• Black or African American
• Native Hawaiian or Other Pacific Islander
• White

See how in part two, one can be any or all of these, but none of them reflect my heritage as a Mexican-American. The lack of Hispanic/Latino in part two is moving researchers to look into how we see ourselves. Yet, I fear that the researchers aren't quite getting it either. In a recent article about Latinos seeing themselves as White they said:

However, in the New Immigrant Survey used in this study, participants were not given the option of choosing “some other race.” 

As a result, in the New Immigrant Survey, more than three-quarters of respondents (79 percent) identified themselves as white, regardless of their skin color.

“This shows that Latino immigrants do recognize the advantages of a white racial identity. Most are attempting to push the boundaries of whiteness to include them, even if their skin color is darker,” Frank said.

About 14 percent of the sample refused to identify with any of the listed races, even though this was not an official option in the survey. (emphasis mine)

Excuse me? Really? As someone who had to fill out a survey just like the one studied, lemme tell ya how I thought my way thru it. Definitions come from the sidebar on this page. My judgment is in bold & italics.

• American Indian or Alaska Native:: A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. Close...
• Asian:: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. No.
• Black or African American:: A person having origins in any of the black racial groups of Africa. Um, technically we all do, right? But no.
• Native Hawaiian or Other Pacific Islander:: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. No.
• White:: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. No.

I'm left with reaching waaaay back into Conquistador history to check off white. I've also been told that somewhere on my maternal side, a stubborn and in love Spanish girl ran off to Mexico (now Texas) to marry her beloved and start a ranch. Still have to verify this logical* part of my family history. But I kept going back to the American Indian definition. Yes, I have origins in the original peoples of North America, specifically the mountains of Durango and Baja. Many of my family elders look a lot more like Navajo than Spanish or European.

My decision? I marked American Indian. And I feel terrible.

I feel terrible because I believe that American Indian should be reserved for American Indians...Navajo, Cherokee and Alaskan Natives. I was not going to let someone chose my heritage for me. I don't think that White reflects my history either. But there isn't a straight up Latino box!

So going back to the study that said Latinos chose White for the advantages. No. I'd gather to say that Latinos chose White (when other isn't available) because we are practically forced to choose it. For those of us who don't have Hawaiian, Black or Asian ancestors, what else are we supposed to do? Either option I was left with wasn't authentic. I also know that these counts feed into policy. Do I up the Native numbers or the White numbers? What's the implications for that?

I'd love to hear from other Latinos who have had to make this DOEd decision. I'd also welcome comments from the Native community, even if you want to tell me I screwed up.

*This would cement my line about raising the latest in a long line of stubborn women.

Brown Rice Farina

Ah, another rainy morning in Seattle. Hello June. I've really been looking forward to June this year. Not only because I graduate, but because my life is ready to be filled with the beautiful vegetables soon to arrive in my CSA.

It sounds like farms around Washington are having a rainy season too. I was supposed to help out on a farm in Duvall last week, but with all the rain and mud, the trip got canceled. I was also notified the other day that my CSA wouldn't arrive until late June because of the cold weather this season. I guess the vegetables just need a little more time. Hmm, don't we all.

Well, what could be better on a dreary morning than a warm bowl of brown rice farina. What are your thoughts on brown rice farina? Love it? Hate it? Have no clue what I'm talking about? I came to know brown rice farina a couple of years ago when I was on an elimination diet trying figure out if I had food allergies. For anyone unfamiliar with an elimination diet, it typically involves cutting out dairy, soy, gluten, sugar, caffeine, and any processed foods. Depending on your body and the purpose of the diet, you might also have to cut out fruit, especially citrus.

Brown rice farina quickly became one of my favorite breakfast foods. Brown rice farina is simply ground up brown rice. When it's cooked, it becomes similar in texture to oatmeal or any other hot cereal. It's perfect for those with food sensitivities, allergies, or anyone simply looking for a healthy breakfast. Its neutral flavor is perfect because you can add whatever you like to it: milk of your choice (rice and almond are delicious), fresh fruit, dried berries, ground up flax seeds, nuts, or a drizzle of agave. If you cannot have sugar, you might be able to get away with a sprinkle of stevia. Regardless of your toppings, it's a delicious way to start your day!



1 cup brown rice farina
3 cups water
1/2 tsp salt

Bring 3 cups of water and 1/2 teaspoon of salt to a boil. Add 1 cup brown rice farina and turn heat down. Cook for about 5 - 8 minutes stirring occasionally. Be careful not to overcook. Serve with the toppings of your choice. I added in rice milk, chopped almonds, blueberries, raisins, and dried gogi berries.

Are Almonds a Good Source of Calcium?

Over all, you would still get some calcium by eating almonds, but at a lot higher calorie cost than from other foods, like milk.

The amount of calcium in a cup of whole almonds, 378 milligrams, is slightly more than in a cup of milk, about 300 milligrams, but you would be consuming about eight times as many calories.

References:
Q and A - Almonds for Calcium? - Question - NYTimes.com.

Someone send City Hall a dictionary

Apparently "could" and "should" are being mixed up.

The EPA has told Chicago that the Chicago River should be cleaned up to a level where people could swim in it.  The EPA didn't say we should all jump into the Chicago River, but Da Mayor told the Feds to go swim in the Potomac.

Of course the EPA just wants the Chicago River, which is increasingly becoming a place for Chicagoans to canoe and kayak, to be clean enough for people to enjoy. I ran into a friend a few weeks ago and she looked amazing. Her secret? She's rowing. On the Chicago River. She said it stinks like hell, but her guns are loaded! Why is it such a terrible thing for the EPA, hell our own mayor to think that the river should be clean enough that we wouldn't need a series of tetanus shots if we fell in?

For instance, Chicago is the only major U.S. city that doesn't disinfect wastewater before pumping it into waterways. As a result, wastewater pouring out of the district's North Side Treatment Plant contains bacteria levels that are more than 400 times higher than those in disinfected wastewater that Philadelphia pumps into the Delaware River.

Levels of microscopic organisms in the Chicago River also are significantly higher than what Illinois allows in other waterways. Until now, though, pollution standards have been less strict for the Chicago River because it was assumed that people wouldn't come near it.

After five years of study and two years of debate, the federal EPA concluded the river can be restored and made more pleasant for people. "All of us want to see this environmental turnaround continue," the agency said in a statement. [link]

 While Chicago officials are looking up "should" and "could" they should also look up SHAMEFUL because I think their pictures are being installed there. One reason why the river shouldn't cleaned up, according to Chicago officials, is that people will drown!

Richard Lanyon, the district's general superintendent, also cited the death last month of Cashmere Castillo, an 8-year-old boy who tumbled into the river while playing a game of tag. Cashmere could not swim.

"The EPA's misguided advocacy would place additional lives at risk because the waterways are not safe for swimming," Lanyon said.

Shameful to use the name of a boy just lost to the river to prop up a dumb idea that if we cleaned the river it would lead to more deaths. The murkiness of the river led to rescuers at the momenet Cashmere fell in from finding him once he slipped into the water. The murkiness of the river lead to the lengthy recovery of his body. Yet, a clean river would be dangerous.

There's something to be said about such arrogance of public officials. But underneath it all, just under the tiny surface is that clear message from public officials that the Chicago River is a sewer and we need to just suck it up. Hopefully your canoe doesn't tip over while you're sucking.

Video: Heart Disease Myths Dispelled by a Cleveland Clinic Cardiologist

Cleveland Clinic — May 14, 2010 — Dr. Rimmerman, cardiologist and author of "The Cleveland Clinic Guide to Speaking With Your Cardiologist,"dispels common myths regarding heart disease.

Misconceptions about medical blogs

From the newsletter Australian Pharmacists:

"At the heart of social media is the blog, an online diary where news, gossip, industry issues, opinion and scandal jostle for space."

I cover medical news from educational perspective on CasesBlog but I try not to include "gossip, industry issues, opinion and scandal" and with one post per day, they never "jostle for space".

There are many different types of medical blogs, of course.

Image source: public domain.

Health Benefits of Pets - Mayo Clinic Video

May 10, 2010 — Health Benefits of Pets.

People will do a lot for their pets - see below:

- Somebody found a solution: Smokers are motivated to quit to protect their pets from secondhand smoke http://is.gd/iZ58

- "Do it for Fido: smokers may quit smoking because of their pet" http://is.gd/iZtQ

Review: Bitch Magazine the Action Issue

Action Issue Cover
Originally uploaded by bitch_magazine

It never fails. When I see Bitch magazine on the floor in the pile of mail, I squeal. And rarely does the issue fail me.

I'm still getting use to the color thing and the yellow isn't helping, but hey, if that's the worst I can say about this issue...

First, Andi Zeisler in her letter to the editor addresses the "we don't need feminism" bullshit from Venus. Gotta say that I never got into Venus. I have friends who lived by it, but I'm a music dork. And not even Venus could make me cool.

There's an excellent interview with Heidi Durrow, author of The Girl Who Fell Out of the Sky on page 10. I read the few chapters in a book store and fell in love. I really need to get that book. There are awesome pieces on Italian TV and hip hop that acknowledges that us chicks have orgasms too.

But the all out best piece in this issue is a kick ass essay about the hot mom phenomena and how it needs to die.

My mom blogging/tweeting friends know that I say 'Hell Yes!' to this. I feel that women have enough pressure to look hot all the time, to be sexually available all the time and that for moms to also be that way? Fuck that. Correction, fuck the prescriptions that come from blogs, books and magazines about how I should behave, dress and look in order to be a MILF. I'm so tired of being made feel like I'm not sexy just because I don't do this or wear that. I feel that in order to feel sexy, you do what makes you feel sexy. Of course, I won't get a book deal from that line.

But there's more! There is also a great interview with Jen Sorensen about her comics. A look at priv-lit - literature/media that tells women that all they need is to spend a lot of money for their lives to be better. I don't usually read best sellers, so I totally missed the whole "Eat, Pray, Love" mania and after reading this article, I'm kinda happy! But also very curious about how one book could cause such a stir.  For the vocab focused of us is a mind scratching piece about the use or lack of use of the word lesbian.

And of course there are always some wonderful book, DVD & music reviews!

Bitch magazine is independent media. It is feminist media. And we need to support it. So please, if you aren't a subscriber, do it today!