Short Gut Syndrome Parents' Support Group
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February 27, 2010
10:30 a.m.

Taylorsville Library
4870 S. 2700 W.
Salt Lake City, UT
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February Support Group Meeting
By: Emily H          (10:21 PM 01/31/2010)
Mark your calendars! Our first support group meeting is scheduled for February 27th at the Taylorsville Library. Details are posted on our home page.
Re: February Support Group Meeting
By: callsquawel          (2:15 AM 07/16/2013)

Winter Newsletter
By: Emily H          (10:21 PM 01/31/2010)
Our January newsletter went out tonight. If you haven't signed up to receive it, click on the Join link to request it or the Newsletter link to download it from our website.
Hirschprungs Disease Meeting
By: Emily H          (9:00 AM 03/29/2010)
There is a HD meeting in Rock Island IL on Aug 7, 2010, with a meet & greet on the 6th.
Angela Smith will be speaking, she is the oldest know, HD survivor. There will also be other guest speakers.
If you need more information you can contact Brenda at coultebj@ihs.org
You can RSVP at http://usahdmeetingaugust2010.eventbrite.com/
Oklahoma
By:           (2:51 PM 05/31/2012)
Are there any gatherings ever in Oklahoma?
Your Money VantageScore Ignores Paid Collections in Setting a Credit Score
By: callsquawel          (9:11 AM 10/26/2013)
Who says you need a summer day and a cranky old bucket to make homemade ice cream? Vijay Kumar, the director of MIT's Office of Educational Innovation

and Technology (OEIT) and a senior associate dean, was the principal investigator of the Open Knowledge Initiative (O.K.I), a MIT-led collaborative project to develop an open architecture for enterprise educational applications.
He is the co-editor of Opening Up Education: The Collective Advancement of Education through Open Technology, Open Content, and Open Knowledge, which was published by MIT Press and the Carnegie

Foundation for the Advancement of Teaching and is freely available online. Information Services and Technology's News Coordinator, Robyn Fizz, recently spoke with Kumar about some of the key concepts propelling the open education movement. Q.
Open education is everywhere, from MITx and edX, to initiatives like Khan Academy, Coursera and Udacity. How do you define open education and what's behind its tsunami-like momentum? A. In 2001, MIT launched OpenCourseWare (OCW), which catalyzed the movement. OCW courses are snapshots of real courses and they present good models, they can be emulated. The following year, in 2002, UNESCO coined the term Open Education Resources (OER).
OER means more than open content.
It includes open applications, tools and architecture, as well as legal enablers like Creative Commons that allow the spirit and practice of open education to be exercised.
Over the past decade, the Open Education movement has expanded dramatically.
Openness has become part of the discourse about educational change, whether it's at the level of a university or a country.
For example, there are over 250 institutions in the OpenCourseWare Consortium.
National and international organizations like the Commonwealth of Learning have adopted open

education as a central strategy for providing quality education on a large scale. Q. So there's amazing breadth to the movement, what about depth? How does online learning go beneath the surface? A. First, it's important to distinguish between online learning and open education. Openness brings a lot of added dimensionality to online. Educators often refer to the Four R's — reuse, redistribute, revise, remix — as the critical attributes of openness.
So it's not only about enabling unfettered access to resources but also making it possible for them to be used and adapted based on the goals of the learners. Communities of self-learners can remix open materials and help each other learn. It's an era of connectivity combined with collectivity.
People from around the world can participate, and millions have. Q. Can you give an example of how technology fosters open learning? A. Video lectures have become increasingly common, but how do you search them? The Spoken Lecture Browser, a technology developed by Jim Glass's group in CSAIL, addresses this issue.
Built on voice recognition technology and artificial intelligence, it lets you automatically transcribe the audio portions of a video lecture and then search those videos

using natural language. For example, I can do a search on "angular momentum" if I missed a few classes in introductory physics. The tool lets me find the relevant segments through a search, rather than wading through 20 hours of lectures. OEIT is working to make this technology more widely available to our faculty, perhaps through MIT TechTV. As this intersection of technology and openness becomes broadly available, it's easy to imagine the reuse of precise segments from these lectures by another instructor or by students for self-learning. Searches

on a concept could lead to related materials, either confined to the course or across the Internet, paving the way

for deeper learning experiences or alternate pathways for learners with different motivations.
Q. So

open education enables students to choose the mode of learning that works best for them? A. That's the direction we're headed in. For example, alum George Zaidan, who did OpenLabWare many years ago, recently teamed up with Professor John Essigmann in chemistry to develop online modular offerings for learning core concepts in chemistry such as "buffers" that travel across courses.
This is part of the experiments in modularity launched by the MIT Council on Educational Technology (MITCET). So they focus on a concept,

and they might provide videos of labs to explain the concept, they might provide interactive simulations. They work with different modalities so that students have the opportunity to grok the concept in different ways. Q.
How do these online offerings impact learning in the classroom? A.
Understanding that is an important part of the MITCET experiments. A good example is the approach taken by Professors Karen Willcox and David Darmofal in AeroAstro.
They said, look, if you can modularize topics traditionally taught in the classroom and offer them online, then you can have more opportunities for discussions and active

learning when students come to class. This is what's known as the flipped classroom model. A lot of the lecture and topic-related materials are posted online, and students can review these on their own time. Then, during class, the focus is on hands-on exercises.
Q. What's

next for open and online education? A. There are many exciting developments in the world of open education resources.
One of note is the Open Textbook movement that is gaining legs and helping address a significant obstacle for educational access — the cost of textbooks.
Openness is being employed as a driver for addressing large problems of educational access and quality. One example of this is the Kaleidoscope Project, a project on which I'm an advisor. Funded through a Next Generation Learning Challenges grant, it involves seven community colleges collaborating to create courses using existing OERs, with each course being developed by at least two

partner institutions. The project so far has demonstrated a substantial reduction — around 90 percent — in the cost per course per student, a one-term savings of about $60,000.
The focus, however, is not only on cost-effectiveness but on improving the course design and learning results based on analysis of embedded assessments.
There's a movement to use learning analytics to improve the quality of online education.
Learning analytics refers to the analysis of a wide range of data produced by and gathered on behalf of learners to assess academic progress, predict future performance and spot potential issues.
Through analytics, you reconstruct your interventions with your learners based on how they're accessing the materials, how they're performing, how they're understanding different concepts. Courses are open, but they have to

be constructed in a way that you can use analytics to understand what's working and what's not. The Open

Learning Initiative (OLI) at Carnegie Mellon has a good model for this. What's really ahead is the opportunity to learn a lot about learning — about the use of social networks for learning, about making labs widely available online, about the approaching wave of new applications.SANAA, Yemen - Anti-government tribesmen in northern Yemen stormed a security building and shot dead four soldiers in a revenge attack after government troops opened fire on opposition protesters calling for the president's ouster, witnesses said. Backers of same-sex marriage welcomed what they said was the demise of a biased federal law, while opponents said the Supreme Court had badly overreached.    
Tyler Moore hit a three-run homer and Danny Espinosa homered and drove in three runs, leading Gio Gonzalez and the Washington Nationals over the Pittsburgh Pirates 6-2 Sunday.    
Terek Grozny will be fined 200,000 roubles (4,292 pounds) and play one match at a neutral venue after Chechnya's leader called the referee a "sellout" and a "donkey" over a loudspeaker during a recent match, a senior Russian FA official said on Wednesday.
At five years old, the Congressional Women’s Softball Game looks all grown up. At the game Wednesday night, signs abounded

that the annual charity matchup, which pits members of Congress against the Washington press corps, has become an established tradition on Capitol Hill.
Read full article >>     BEYOND THE CRASH Overcoming the First Crisis of Globalization By Gordon Brown Free Press. 314 pp. $26 For a brief, shining moment, the world stood together, and Gordon Brown was its voice.
On an April afternoon in 2009, as global markets stared down the abyss and the specter of a second Great ...
American distillers find that they can create new whiskey drinkers, especially among women, by adding flavors of honey,

fruit or maple syrup.     When you think of a second home, do you think of a secluded mountain cabin? Perhaps a pied-a-terre in an urban high-rise? What about a second home

with no fixed address? One that floats? Institute will reprogram $10 million in contract funds and team with academia and industry to find drugs to target RAS, mutated in one-third of all cancers It sounded like a good call. To combat organized crime, especially the phenomenon known as "virtual kidnapping," the

Mexican government ordered the owners of every cellphone in the country to register their names, numbers and addresses. Announcement to quit comes four years into role and just a few months into a new three-year contractMike Quigley will retire from corporate life after four years heading the introduction of the National Broadband Network.The announcement comes just a few months after Quigley signed a three-year contract to stay in the role as head of NBN Co, the company building and operating the national broadband network."My job was to lay the foundations for the NBN for the next 30 years. That job is largely complete," Quigley, who came out of retirement to take the position, said on Friday.Quigley's
departure follows weeks of rumours of infighting within the company and speculation the board was looking to replace him.
Pressure on Quigley increased as NBN rollout targets were not met.It was reported in May that NBN Co chair Siobhan McKenna had approached fellow board members to test support for Quigley.However,
Quigley told Fairfax his relationship with McKenna is "a good one".''I started on this thing four years ago.
I am not going to be here when it finishes in 2021. I will choose my retirement when I choose it," he said at the time.Federal broadband minister, Anthony Albanese conceded Quigly's time hadn't always been smooth sailing, but said it was absurd to suggest the government had anything to do with his leaving."No
one does everything perfectly in terms of the creation of a major infrastructure project," he told media in Sydney.Albanese
would not confirm when asked on Friday afternoon whether the NBN board would appoint a replacement before the election.Opposition spokesman for communication and broadband Malcolm Turnbull told ABC radio he would be "amazed" if a new CEO was appointed so near the election."That
would be an act of hubris and recklessness... I would be astonished if they were going to do that," he said.A joint statement on Friday morning from Albanese, and the finance minister, Penny Wong, thanked NBN Co's "first employee" for his contribution and said Quigley was ''instrumental in negotiating the deal with Telstra which has paved the way for the NBN rollout".The
statement

added that Quigley was "eager to join the project because he understood the importance of nation-building infrastructure that is essential for our nation's economic future. Mr Quigley can be tremendously proud of what he has achieved."But Turnbull told media that Quigley's retirement was "a case of the company being utterly leaderless".McKenna "has been seeking to get rid of Quigley for some time", Turnbull said. "He has been pushed out the door."Quigley


will continue in the position until a successor is appointed by the board, according to NBN Co's statement.McKenna said the company was "fortunate" to have had Quigley as chief executive and credited him with taking "NBN Co from a policy vision to a successful operating entity.
The directors are proud of Mike's achievements and

welcome his decision to remain in his post to ensure a

smooth transition to his successor."AustraliaBroadbandTelecommunications industryHelen Davidsonguardian.co.uk
© 2013 Guardian News and Media Limited or its affiliated companies. All rights reserved. | Use of this content is subject to our Terms & Conditions | More Feeds     The

Giants keep their fan-favorite receiver Victor Cruz in the fold with a five-year contract extension worth $43 million.     A scramble by leading Republican lawmakers to halt a loss of support among Hispanic voters is providing strong momentum for an immigration overhaul. The Conservative Political Action Conference began with Senators Rand Paul and Marco Rubio offering their party starkly different paths back to prominence.

SAN JOSE MINE, CHILE - When the world came crashing down, Richard Villarroel thought he would be entombed forever, with little chance that rescuers would ever reach him in a

dark chamber 2,050 feet under the Atacama Desert. The co-author of a new book on adventures in Devon, Cornwall, Somerset and Dorset, shares five 24-hour escapes in hidden corners of these holiday hotspots. You'll need a sleeping bag …The Mendips, SomersetJust 30 minutes from the centre of Bristol are the Mendip Hills, home to Goatchurch Cavern, a vast cave near Burrington Combe. It was once a Victorian show cave but has long since returned to the wild. Bring a torch and bicycle helmet, and leave yourself a trail of breadcrumbs so you can find your way out.For
an afternoon expedition take the spectacular six-mile circular walk around Cheddar Gorge, the deepest canyon in Britain, starting from Black Rock car park, near the top of the gorge.

There are sheer cliff edges, rock pinnacles and you can spot peregrine falcons overhead. Returning to Black Rock, walk a mile east to Velvet Bottom, and explore the little known Roman remains including a rare example of a British amphitheatre. In summer, if you stay until dusk, you can see glow worms.For sunsets in the Mendips you are spoilt for choice.
The dramatic escarpment provides one of the best vantage points in the south-west. Deer Leap and Westbury Beacon, both south-east of Cheddar, are exceptional, and great places

to fly kites. But my favourite sundowner hang-out is the remote hill fort at Sutton Wick, about 10 miles to the north-east. String up your hammock among the ancient oaks and watch as the sun sinks behind Chew Valley Lake. The next morning descend to the shore for a discreet dip.For more lost ruins, head south-east towards Frome and

find the little-known remains of the old Fussell iron works near Mells. They are hidden

in a secluded stream valley and overgrown with wild garlic and moss.
In spring, there are also superb wild daffodils nearby at Edford Woods, backtracking about 5 miles to the west, and a pretty stream for paddling and dam making, a lovely way to while away the day.•
Feast on award-winning, ethical food at the Ethicurean in Bristol, or take tea in the Mells Walled GardenIsle of Purbeck, DorsetEscape the overcrowded beach fronts of Bournemouth and Weymouth and head for the dramatic chalk cliff-tops of White Nothe, located between the two.
From the cliff tops, a tiny smuggler's path leads down through ledges to a truly wild and hidden beach, perfect for skinny dipping and fossil hunting.
About 15 miles further east along the coast there's a good place to snorkel and swim in the crystal-clear lagoons of Winspit and Seacombe, and then explore the cliff-side caverns above – left by miners who dug stone for St Paul's Cathedral.
A mile to the east is Dancing Ledge, where you can dip in the tidal pool and then swim into the adjacent sea cave and hear the waves thrash and echo all around.As
the afternoon draws on, seek out summer orchids on the downland of Corfe Common, with views of the ruined castle; or head back west to near Dorchester and climb the ramparts of Maiden Castle, Europe's largest iron-age hill fort. In the evening, a trip back down to the coast beyond Weymouth brings you to Chesil beach and its phosphorescent lagoon. If you can swim or canoe across you'll find

the wildest beach in the

south-west.•
Collect picnic fare from Clavell's Cafe and Farm Shop in Kimmeridge.


Enjoy local food and ale with a side order of museum curiosities at the Square and Compass in Worth Matravers (01929 439229, squareandcompasspub.co.uk)Dartmoor,
South DevonSwap the traffic-choked lanes and busy beaches of Dartmouth for the ancient stones and moorland streams of

Dartmoor. Begin at the sandy river estuary of Mothecombe, the mouth of the tiny river Erme. You can canoe, paddle or swim upstream through the peaceful creeks and silent backwaters, inaccessible except by water.There
will be kingfishers, curlew and oystercatchers and, if you bring a line, you might catch sea bass. The Erme is a wonderful river in its upper reaches too, with waterfall pools at Ivybridge and the gnarled, twisted woods of Piles Copse, the most ancient fragment of Dartmoor's once verdant forests – like something from the Hobbit. Continue up the Erme and, as views open out to the sea behind you, the giant standing stones of Staldon Row appear and beckon you on to Upper Erme Row. Stretching more than two miles, this is the longest stone row in Britain – possibly the world – yet little masteryikol of its origins or purpose.For a yet wilder experience, head east

across the moor and explore the vast chamber of Pridhamsleigh Cavern, near Ashburton, or embark on a night walk.

My favourite is the Lych Way which is a corpse road from Postbridge to Lydford – along which the dead were taken for burial. Set out on the walk by the milky light of a full moon. You will see

the cart tracks of the coffin bearers, which are still visible, worn into the stone road.Reach Coffin Wood near Willsworthy in the early hours, and fall into a deep, haunted sleep under the gentle sway of the ancient beech trees. The next morning you'll deserve a hearty breakfast and a dip in the pools of Tavy Cleave, near Horndon, to wash away the spirits of the moor.•
The Castle Inn at Lydford does a good breakfast. Riverford shop and kitchen in Buckfastleigh is good for picnic and night-walk suppliesNear Newquay, North CornwallWhen you're done with the bars and lights of England's surf capital of Newquay, head down the coast 20 minutes to kayak or swim out among

the great stacks of Trevellas Cove. The brave jump from the pinnacle heights, but I prefer to watch while I forage for fat low-tide mussels on the waterline, then cook these up on a small fire (must be below the high-tide mark on the beach).After this yummy snack, start to head back towards Newquay along the coast. First seek out the lost chapel of St Piran's, buried under sand dunes near Perranporth, then continue on to explore the remote north end of the beautiful Holywell beach, where you will find a huge sea cavern that contains a holy well, flowing down through a series of calcite flowstones and natural pools.As evening approaches, continue on for three miles to the poppy and corn-marigold meadows on the downs of West Pentire Head, near Newquay.
As the sun goes down, keep watch for dolphins and basking sharks. You could shelter for the night in the sandy caves of Porth Joke beach below, or there's a small campsite in a valley set well behind the beach.Next morning, rise early and venture inland to the Cornish Alps near St Austell to seek out the white peaks and extraordinary opal-blue lagoons left over from the China clay industry, perfect for a morning wake-up plunge. There are eerie mining ruins to explore all around this area, including the remains of a giant waterwheel, leet and viaduct in magical woodland at Luxulyan, about 3 miles north-east of St Austell, or the lost valley of Tregarsus to the west. Or you could climb the iron ladder to the top of the extraordinary ruined hermitage at Roche to the north.•
For sustenance, try the funky Driftwood Spars in Trevaunance Cove (01872 552428, driftwoodspars.com)
or the 17th century ivy-clad Bolingey Arms,

Perranporth (01872 571626, pubtrail.co.uk/cornwall/bolingey-inn-perranporth.htm)Land's End, West CornwallJust a 20-minute walk along the coast from the bustle and arcade games of the Land's End amusement park is the real edge of the Earth, at Nanjizal Bay. Here, at low tide, you can swim through the "song of the sea" rock arch, wallow in jade-green plunge pools and snorkel into sea caves gleaming with coralline. There's also a rope by which you can descend to giant caverns and a secret beach.For the wildest sands, head on a few miles to the atoll-island sand bars at Pedn Vounder, just east of Porthcurno, a spectacular bay with shallow lagoons. It's a

remote and wonderful place to while away the heat of the day paddling in turquoise waters.As
the afternoon draws on, take in some of the mystical bronze-age sites that adorn the landscape. Dance barefoot around the little-known Boscawen-Un stone circle, four miles north-east beyond St Buryan, explore the underground "fogou" burial chambers at Carn Euny, a mile further on near Sancreed, or head eight miles to the north coast and climb high onto the golden moor to the stone shelter at Zennor Quoit.
Here, on a wild craggy outcrop, nearly 350m above the sea, there are stupendous views out over the western ocean.Sleep beside the Quoit itself, or snuggle down in among the heather as night jars sing and stars fill the indigo sky.• Above Pedn Vounder beach at Treen there's a clifftop campsite and a tiny cafe serving breakfast porridge with clotted cream, bilberry jam and heather honey•Wild Guide: Devon, Cornwall and South West, charts more than 500 wild places to visit.
It is published by wildguide.net on 1 May, £14.99 Adventure travelCornwallDevonDorsetUnited KingdomEnglandWalking holidaysTravel guidesguardian.co.uk
©

2013 Guardian News and Media Limited or its affiliated companies.
All rights reserved.
| Use of this content is subject to our Terms & Conditions | More Feeds     Open thread: A union leader claims the threat of being axed is putting teachers and heads off applying for leadership roles at struggling schools.
Do you agree?Turning around the fortunes of a struggling school is an unenviable task. And for many headteachers who do rise to the challenge, failure is not an option. According to the general secretary of the Association of School and College Leaders, Brian Lightman, headteachers can face the axe if the school does not improve within just a few weeks.Lightman
claims that taking on a headship at a failing school is "career suicide". He also criticises politicians and inspectors for treating headteachers as "commodities you can throw away".But
what do you think? Are headships at struggling schools career kryptonite? What incentives should there be to attract talented heads to work in struggling schools? And how do we entice more teachers into leadership roles in some of the worst performing schools?Share your thoughts in the comment section below.This
content is brought to you by Guardian Professional. To get articles direct to your inbox, and to access thousands of free resources, sign up to the Guardian Teacher Network here.
Looking for your next role? See our Guardian jobs for schools site for thousands of the latest teaching, leadership and support jobsSchool leadership and managementLeadershipSchoolsMatthew Jenkinguardian.co.uk
© 2013 Guardian News and Media Limited or its affiliated companies.
All rights reserved. | Use of this content is subject to our Terms & Conditions | More Feeds Myanmar was once isolated, but tourism is expected to increase dramatically. High-end firms have taken notice, with Orient-Express offering a new river cruise.    
Swiss

officials said Wednesday that they planned to restrict immigration from Western European countries starting next month, citing the high number of people coming to their country.     Art, music, engineering and steel all form part of a new festival that includes the world's first windscreen wiper and invites the public to write letters to the Angel of the NorthThe idea for a Festival of the North East, celebrating all things connected with the region, has been around for some time; the question has been finding a suitable time to hold it.The
return of the Lindisfarne Gospels to Durham this summer was seen by many as the ideal moment, so a month-long inaugural festival will take place throughout June in hundreds of venues from the Tweed to the Tees.At the launch this week, Anthony Sargent, who chairs the festival as well as being general director of the Sage Gateshead music centre, described the ethos behind the new festival:It's not just about arts and culture, as a lot of festivals are; it's science, it's technologies, it's inventions, it's discoveries, it's history, it's heritage – and to get all of that range of different versions of the story of the North East into one festival in 30 days is I think amazing.Spread throughout the region will be A History of the North East in 100 Objects, inspired by Neil MacGregor's 100 objects from the British Museum.Bill Griffiths of Tyne & Wear Archives and Museums is organising the project, and hopes it will encourage people to find some of the quirkier objects in less obvious places, as well as stimulate debate about the history of creativity in the region. He said:It's very much "a" history as we

won't have everybody's favourite object. All the objects demonstrate creativity or innovation in the North East and are in public collections, although there are some surprising omissions – the Bowes Museum's silver swan, for example.Included
in the collection are the world's first windscreen wiper, a miners' banner at the Woodhorn Museum, Joseph's Swan's first electric light bulbs, George Stephenson's miners' lamp, a painting by Oliver Kilbourn – one of the Ashington Group of "Pitmen Painters" - and Turbinia, once the fastest ship in the world. Griffiths is refusing to release the full list until nearer the festival, but hopes the public will nominate their own alternatives.Near Redcar, where tens of thousands of people used to work in the steel works, Newcastle's Theatre Royal is organising Salamander, a celebration of all things connected to the steel industry, featuring 500 participants, an audience of around 5,000, and music, dance, visual arts, poetry, storytelling and a male voice choir of steel workers.Artist Steve Tomlinson is creating a steel bird public sculpture for the event, which will be permanently sited at

Dormanstown.Northumbrian piper and composer Kathyrn Tickell is a prime mover of the festival, and its artistic adviser. She is organising One Night in Gateshead at the

Sage on 14 June, which will include traditional North Eastern folk songs rearranged for the Northern Sinfonia, as well as North Eastern singers, writers, actors, dancers and musicians. Kathryn said:It's always been my vision to create a festival which celebrates the amazing creativity of North Eastern people and one with broad appeal that everybody can enjoy.In
Dear Angel, artist Stevie Ronnie is encouraging people to write a letter to the Angel of the North as it celebrates its 15th birthday.
The artist will collate the letters to create "a distinctive record of how we feel about this place we call home." The final artwork will be shown at Newcastle's Globe Gallery, in Durham and on Holy Island.
Letters can be emailed to letters@dearangel.org
or tweeted to @_dearangel.Other
highlights include the requiem for the foghorn at Souter lighthouse, exhibitions and concerts commemorating the centenary of the death of suffragette Emily Davison, the Riveting Stuff project celebrating engineering achievements on Teesside, Walk On, an exhibition at Sunderland's NGCA looking at artists including Richard Long who make artworks based

around walking, the reopening of the National Glass Centre at Sunderland University, and Tyne, a new play by Michael Chaplin to mark the 40th anniversary of Newcastle's Live Theatre.• A guide to the festival is here. The Lindisfarne Gospels will be the centrepiece of an exhibition at Palace Green, Durham, from 1 July to 30 September. Tickets can be ordered here.Alan Sykes Tweets hereFestivalsNewcastleSunderlandDurham UniversityAlan Sykesguardian.co.uk © 2013 Guardian News and Media Limited or its affiliated companies.
All rights reserved.
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recent report in the Lancet uses figures from the Global Burden of Disease Study (2010) to suggest that Britain is

'falling behind' other European countries in terms of health and longevity. Sometimes the history of medicine is essential to help us interpret these sorts of claimsWhat cures tuberculosis?This year is the 110th anniversary of the birth of the writer George Orwell (Eric Blair). I've been listening to the BBC's series

of plays about his life and work, which reminded

me of his writing on health and medicine; his essay on 'how the poor die', for example, or his experience of treatment for tuberculosis – a disease which eventually killed him in 1950 at the age of just 47.Tuberculosis
was a major European health concern in the nineteenth and early twentieth century (and remains so in some places today – especially with new drug-resistant strains). At times it was probably the single biggest killer of young adults, feared particularly because it seemed to attack those in the prime of their lives. Treatments were varied and sometimes desperate: Sulfa-based drugs, open air treatment, bed rest, and surgery (including a phrenic nerve crush) were all tried on Orwell. The first effective drug treatment for tuberculosis, streptomycin, was only released in 1947 – and it was too expensive for many sufferers (Orwell used the proceeds from the American sales of Animal Farm to fund his treatment).
The first preventive, the BCG vaccination, was introduced in 1953.We might expect that these drugs were crucial in the fight against tuberculosis, but in the 1960s and 1970s the doctor and demographer Thomas McKeown argued that something else had caused the massive decline in deaths from this disease. In The Modern Rise of Population (1976) he did something deceptively simple: he plotted the rate of death from tuberculosis in England and Wales over time, and marked on the graph the introduction of drugs and vaccines.
You can see a copy of the graph here.


It's immediately obvious that the major decrease in the disease happened long before streptomycin was invented. McKeown argued that it was not drugs, or vaccines, or scientific medicine which conquered this infectious disease, but money. Specifically, the crucial factor was improved nutrition – this became known as the McKeown Thesis. Many doctors, biologists and pharmacologists rejected this conclusion, but I think the most powerful criticisms have come from historians.
In particular the historian Simon Szreter has done some meticulous work on statistics and death records, and suggested that sanitary measures, clean water and public health are the real causes of the decline in tuberculosis mortality (he's also made it clear how political this process of interpretation can be – something this Lancet editorial recognises for the Global Burden of Disease study too)Changing Definitions: Changing DiseasesOne major flaw in McKeown's argument is that he's assuming tuberculosis is the same thing in 1850 as it is in 1950. It isn't.
Initially tuberculosis was diagnosed symptomatically

- tuberculosis was a disease with all sorts of symptoms, including night sweats and menstrual problems as well as coughing.
Then from around the 1820s some doctors started to use René Laennec's new-fangled stethoscope to listen for tell-tale noises in the chest, insisting that particular kinds of damage in the lungs were the only 'true' indicators of tuberculosis (although such a diagnosis could only be made definitive at autopsy). Then from the 1880s bacteriological and immunological tests were gradually introduced,

which meant that some symptomless people could be told they were infected with (latent) tuberculosis.Lumping
these diseases and diagnostic techniques together is obviously a problem for statistical studies. It's also a problem for historians.
One way of telling the story of tuberculosis is to assume that there is a specific, discrete disease called TB, and that over time we have just 'got better' at diagnosing and understanding (if not curing) it.
That's the 'progressive' story, and it's an extremely common way of writing the history of science and medicine. It's not a good way to do history though – because it starts with the assumption that we're obviously right now, and were therefore obviously wrong then. But diagnosis and disease definitions change all the time; today's is as likely to be proved 'wrong' as yesterday's.
Cervical cancer is now prevented with an anti-viral vaccine; five previously discrete mental illnesses may be redefined as related genetic variations. It's hard work to write with this flux in mind, as if the present wasn't certain, and it's probably impossible to manage it thoroughly, but it's a good goal nonetheless.This
is, after all, a real world problem.
I put it to my students this way: if you were responsible for a nation where infectious and contagious diseases

were the most serious killers, what would you do with your budget? Take the progressivist approach and fund drugs and vaccine research? Take the historian's approach and fund sanitary measures, public health interventions and clean water? Or go with McKeown and use the money to foster economic development and better standards of living? Whose advice would you take?There's been some discussion on science blogs and twitter about the need for 'experts', arguing that we should spend more time listening to their opinions. That seems very common-sensical, but I've already pointed out how hard it can be to figure out who is an 'expert' and who is not. Perhaps it should be obvious once people have made their arguments…but some arguments are easier to communicate than others: McKeown's graph, and the Global Burden of Disease figures are simple and tweetable. It's taken me over 800 words to write a simplification of one fraction of one small part of the historical objections to the McKeown thesis (my students get the benefit of hours of lectures and a

reading list before having to decide how to fund their country!).
Who's got time to read much more than that? Why would you even start to read what a historian has to say when you're looking for 'experts' on health policy and drug effectiveness?Vanessa knows that there are many different types of tuberculosis recognised today & is willing to tweet about all of them...@HPS_Vanessa•
This introduction to this article was amended on 6 March to say that this year is the 110th anniversary of the birth of George Orwell, not of his death.History
of scienceVanessa Heggieguardian.co.uk © 2013 Guardian News and Media Limited or its affiliated companies. All rights reserved.
| Use of this content is subject to our Terms & Conditions | More Feeds The French are apt to keep religious beliefs private, so you wont find recipes

for chopped liver or advertisements for kosher wine in the mainstream

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