Tuesday, June 28, 2011

Heating Oil Futures

Heating Oil Futures Contracts:

  • Ticker Symbol: HO
  • Exchange: NYMEX
  • Trading Hours: 9:00 AM until 2:30 PM EST.
  • Contract Size: 42,000 U.S. gallons (1,000 barrels)
  • Contract Months: all months(Jan. - Dec.)
  • Price Quote: U.S. dollars and cents per gallon. Ex $2.15 per gallon
  • Tick Size: $0.0001 (0.01?) per gallon ($4.20 per contract).
  • Last Trading Day: close of business on the last business day of the month preceding the delivery month.

Heating Oil Futures - Fundamentals :

Heating oil is also called a distillate or Number 2 oil.

When crude oil is refined, about 25 percent of the oil becomes heating oil and about 50 percent becomes gasoline. Heating oil is primarily used to heat homes in the Northeast.

The United States produces about 85 percent of its heating oil, while the remainder is imported from Canada, the Virgin Islands and Venezuela.

Oil companies begin to ramp up production of heating oil before the winter season begins to ensure ample supplies of heating oil to meet the winter demand.

Heating Oil Futures Reports:

The main report for heating oil is the EIA Weekly Energy Stocks report.

Weather during the winter months of December, January and February are critical to watch. The weather in the Northeast is the place to focus.

Tips on Trading Heating Oil Futures:

Source: http://commodities.about.com/od/profilesofcommodities/p/heating_oil.htm

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Johnson Aziga, HIV Killer, Threat To Reoffend: Prosecutor

THE CANADIAN PRESS -- HAMILTON - A man believed to be the first in Canada convicted of murder through HIV transmission has an abnormally high libido that could lead him to reoffend if he's eventually freed, court heard Monday.

Crown attorney Karen Shea made her closing submissions in the case of Johnson Aziga, a 54-year-old Ugandan immigrant who has been in jail since his 2003 arrest.

Aziga "will want to have sex when he is released from custody" and has a pattern of hiding his condition from women, she said.

"Unless he discloses his HIV status, the public is not protected," she said.

The Crown is seeking to have Aziga designated a dangerous offender, which could see him jailed indefinitely.

Aziga was convicted in 2009 of two counts of first-degree murder, 10 counts of aggravated sexual assault and one count of attempted aggravated sexual assault.

His convictions are related to 11 women with whom he had unprotected sex without telling them he had HIV. Seven of the women became infected, with two dying of AIDS-related cancers.

Aziga's sex drive "is head and shoulders above" the average man's and "knowing his need for sex is not going to be satisfied" could deter him from disclosing his HIV status to potential partners, Shea argued Monday.

"He didn't abstain from sex knowing what he knew (about having HIV), he didn't discuss his HIV status knowing what he knew and he didn't wear a condom knowing what he knew," she told the court.

Shea cited Aziga's estimate that he had sex with 50 to 100 women. An expert had testified that 20 or 30 is considered high.

Lawyers for the defence said there's no evidence their client's libido is unusual.

"It's mere speculation," Munyonzwe Hamalengwa said outside the courtroom. "Occasionally, people obviously boast that they went out with so many women, when in fact they went out with one or two."

What's more, he said, Aziga's libido will only grow weaker as he ages, making him less likely to seek sexual partners.

"Aziga will be (in custody) until his late 70s," he said. "By then, he won't be going around."

Shea argued aging doesn't guarantee a lower sex drive and noted the availability of drugs meant to boost sexual function.

More importantly, she said, Aziga still doesn't take responsibility for the irreparable harm and severe psychological damage he inflicted on the women with whom he had sex.

Nearly eight years after his arrest, the father of three "is still defiant, he is still defensive and he is still deflecting blame," Shea said.

Aziga previously admitted under cross-examination that by having unprotected sex with 11 women and not telling them he was HIV positive, he exposed them to the virus. But he has so far refused to accept that he infected the women, saying he can't know for sure.

While on the stand last month, Aziga also argued he should not have been convicted of murder and accused the jury of racism in finding him guilty.

He is appealing the murder convictions and if successful, he would be eligible for parole on the remaining convictions.

The defence will make its final arguments Wednesday in Hamilton. The judge is then expected to set a date to deliver his decision.

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Source: http://www.huffingtonpost.ca/2011/06/27/johnson-aziga-hiv-killer_n_885743.html

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Monday, June 27, 2011

Green Business Travel ? Increase Sales and Save the Whales!

So how do you help your team plan the most efficient sales travel? Tell them to purchase a low cost laptop trip management software. There are several versions available from Microsoft, DeLorme, Garmin, ESRI and more. Several packages are under $40. You can even add an integrated GPS receiver to some for under $80 combined.Green Business Travel - Increase Sales and Save the Whales!

Remember the gas ?crises? of the 70?s and 80?s and, oh yeah ? last summer was kind of tough, wasn?t it? One of the things people did to conserve fuel and combat skyrocketing costs was to consolidate trips. Rather than head out and back several times to run daily errands, they?d plan ahead and meet their objectives in one trip instead of two or three. The primary goal here was to save gas dollars ? but one of the side benefits was reduced green-house emissions.

A recent survey conducted by the Association of Corporate Travel Executives found that 79 percent of respondents see cost cutting as a top business travel concern, while only 17 percent felt that promoting environmentally sustainable travel was a top priority. This contrasts with a November 2007 survey where 29 percent of the respondents felt environmentally responsible travel was a top issue.

Well ? the reality is, you gotta do what you gotta do. But for you sales managers laying awake at night sweating your sales organization?s ever-expanding carbon footprint ? take heart! There?s something you can do right now that will green up your sales force -and believe it or not, help you increase sales in the process.

Wow ? environmentally responsible travel seems to have taken a hit in the last 18 months. Gee ? what?s changed between 2007 and 2009. Oh yeah ? duh ? the economy has tanked, hasn?t it?! So ? concern for the environment is trumped by concern for keeping the doors open ? is that it?

Got a sales call pop up that your rep has to fly and see right now? Make sure they use laptop mapping to search for additional prospects in the area. They?re there anyway ? help them make the most of their time by seeing additional opportunities. You know it will lead to more sales ? and spread the trip emissions load over multiple accounts.

These packages will allow your reps to plot their prospects and customers down to the street level on their map. When setting up sales calls, they?ll easily be able to locate the best prospects in a particular region and generate efficient routes that let them maximize their time in front of the prospect selling, and minimize time behind the windshield driving.

Increased productivity through intelligent territory management yields huge sales benefits in addition to reducing costs and saving the polar bears. If your sales force can see 5 prospects a week without planning on a laptop software product, they can see 6 easily with it. Generally, a sales force can increase the amount of prospects they see using laptop mapping by 20 percent. That translates into a 20% increase in sales (sales is about numbers, right?), decreases your cost of sales (seeing more prospects in the same amount of travel expenditures) and of course ? reduces your organization?s carbon footprint.

The bottom line is ? better planning increases your bottom line ? and it simply makes your company greener. So all you sleepless, tortured green conscious sales managers out there ? take heart! You don?t have to choose between reducing costs and traveling green ? you can do both ? and increase sales too!Green Business Travel - Increase Sales and Save the Whales!

Smart businesses are all about increasing productivity. Think about all the initiatives you?ve embarked on over the years to help your people get more done in less time. Well, consolidating trips is a program you can implement right now to increase your sales travel productivity. Not only will your people see more prospects in the same amount of time, but they?ll expend fewer resources and ? bonus ? emit less pollutants into the atmosphere.

Cost conscious managers who help their sales people plan ahead to maximize prospect calls on a trip will reduce travel expenses, increase sales and assuage their pained enviro-consciences. You pick your rationale for why maximizing travel productivity is important ? no matter how you look at it, it just makes good business sense. Regardless of where you are on the environmental spectrum ? I think all of us can agree that taking less ?wasted? trips reduces travel costs, adds dollars to your bottom line and makes the world just a little greener.

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Keith O?Brien is the President and founder of My Point?Exactly, LLC. He has over 15 years of Sales and Marketing experience selling technology products across the U.S. He currently trains sales organizations how to use mapping and GPS to more efficiently prospect and travel their territory. His training helps sales people reduce travel costs, maximize time in front of prospects and increase sales. Learn more about using mapping and GPS to increase sales at http://www.mypointsales.com

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When reps see their accounts plotted on the map, they?ll spot opportunities they might have missed without a visual representation of their territory. Diligently working a region can prevent an unnecessary plane trip back to the same area because you missed a hot prospect on the first run out. And since airplanes make up the biggest emissions component of business travel, any flights you can avoid through better planning will contribute big time to your ?eco-karma?. Not to mention ? save you big money in travel expenses.

Article Local Url : Green Business Travel - Increase Sales and Save the Whales!

Source: http://www.bizxa.com/business-travel/green-business-travel-increase-sales-and-save-the-whales.html

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What the Action of Online Games | Blog Rants

If you haven?t experienced online games, you are in for a treat! There are many different free games to choose from and once you begin you will find that you quickly become addicted. Free fun games online are for both the newbie and the novice and keep the player entertained for hours of sheer enjoyment. The idea of online games is for players to get the gaming experience they desire, without the expense of an expensive gaming console.

What to Look For in an Online Free Games Site

There are many things that you will want to look for when it comes to an online game site. Aside from a multitude of games, you will want good graphics and likely a site where you are able to communicate with other players. There are many online fun, free game sites to choose from, so make certain that you choose one that you are comfortable with.

What Kind of Games Can I Expect At an Online Game Site?

You can expect free, fun games! Online game sites will have free fun games such as Red Remover, Blosics 2 and Bloons. They will also have many board games such as chess. If you like puzzles, then you?ll be in for a treat as well, as online game sites also have puzzle games that will keep you entertained for hours. Aside from fun games, there action packed games such as race cars and shooting are also available. There are thousands of games to choose from and finding the right online game will not be the difficult part, the difficult part will be turning you away from it. Fun games are both simple and challenging and as the player improves, they will quickly begin to become the master at the controls, making the game an even more thrilling adventure.

Source: http://www.astmpubs.com/what-the-action-of-online-games

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International Battery's Lithium-Ion Batteries Propel ... - Hybrid ABC

West Philly Hybrid X Team's EVX GT Hybrid Biodiesel /Electric Race Car at the Green Grand Prix

ALLENTOWN, Pa.?(BUSINESS WIRE)?International Battery (www.internationalbattery.com), a U.S. manufacturer and developer of large-format Lithium-ion rechargeable batteries, today congratulates the West Philly Hybrid X Team for winning the 100 mile fuel economy Road Rally at the Green Grand Prix held at Watkins Glenn Roadway. The High School automotive team entered its EVX GT hybrid supercar that uses International Battery?s Lithium-ion technology for energy storage. The car earned a semifinalist position in Progressive?s Automotive XPrize competition last summer.

?It feels great to be in the winner?s circle?

The Green Grand Prix attracted 45 competitors including industry giants such as the Chevy Volt and GM?s fuel cell powered SUV as well as homemade vehicles such as a Model ?A? designed to run off of propane. West Philly also faced off against three other formidable Automotive XPrize participants including a team from Cornell University. The International Battery-sponsored EVX GT was declared the winner of the 100-mile race achieving 160 miles per gallon (MPG)?making it the most fuel efficient vehicle to participate in the competition.

The modified Factory Five GTM supercar has a unique hybrid configuration using a Volkswagen 1.9 liter biodiesel engine and an electric drive system, powered in part by International Battery?s innovative large-format Lithium-ion battery cells. The battery design incorporates 50 Ah lithium-nickel cobalt manganese cells and contains a total of 8.8 kWh. A modular design, in four packs distributed throughout the car, allows a nominal operating voltage of 180 volts.

A key advantage to utilizing International Battery?s large-format energy storage systems is the company?s unique Battery Management System (BMS). The BMS monitors the voltage and temperature of each cell and provides continuous balancing of the system, maintaining an even state of charge across all cells. The large-format of the prismatic cells results in a less complex system with fewer thermal management issues. This technology allows the EVX GT to be a more efficient and reliable vehicle.

?The Green Grand Prix was a competitive race and a true test of the combination of the EVX GT?s biodiesel engine and International Battery?s Lithium-ion battery system,? explained Dr. Ake Almgren, International Battery?s CEO. ?We are very impressed with their results and congratulate the West Philly Hybrid X team for this major accomplishment.?

?It feels great to be in the winner?s circle,? elated Simon Hauger, West Philly?s Director. ?I think we have a compelling car; it?s sexy, it?s fast, and we just got over 100 miles per gallon on a world famous track. Not bad for a high school.?

New internationalbatterylogo0810-final.jpg

New internationalbatterylogo0810-final.jpg

The partnership between the West Philly Team and International Battery began during the Automotive XPrize competition. During the competition the West Philly Hybrid X Team?s EVX GT out performed 90 other teams including MIT and Tesla, and was also the only high school team to end up in the semifinals.

For more details on the EVX West Philly Hybrid X Team, visit its web site at http://www.evxteam.org. For more information about International Battery, please visit: www.internationalbattery.com. Both International Battery and the EVX GT car will be in attendance at the Sustainable Energy Fund?s annual Energy Path event at DeSales University June 29 and 30, 2011. For more information, visit www.energypath2011.com.

About the West Philly Hybrid X Team

The West Philly Hybrid X Team is headquartered at West Philadelphia High School?s Academy of Automotive and Mechanical Engineering. For the last 10 years, teams of teachers and students have built and competed with alternative fuel vehicles. The current team recently earned a semifinalist position in the $10 million Automotive XPrize competition in June 2010.

About International Battery

Headquartered in Allentown, Pa., International Battery (www.internationalbattery) is a U.S. manufacturer, designer, and developer of large-format prismatic lithium-ion rechargeable cells and batteries for use in a wide range of transportation, industrial, electric utility, smart grid and military applications, employing a uniquely environmentally friendly manufacturing process.

In addition to historical information, this release may contain forward-looking statements. International Battery may, from time-to-time, make written or oral forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Such statements encompass International Battery?s beliefs, expectations, hopes or intentions regarding future events. Words such as ?expects,? ?intends,? ?believes,? ?anticipates,? ?should,? ?likely? and similar expressions identify forward-looking statements. All forward-looking statements included in this release are made as of the date hereof and are based on information available to International Battery as of such date. International Battery assumes no obligation to update any forward-looking statement. Actual results may vary, and may vary materially, from those anticipated, estimated, projected or expected for a number of reasons.

Photos/Multimedia Gallery Available: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=6773945&lang=en

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Source: http://hybridabc.com/international-battery%E2%80%99s-lithium-ion-batteries-propel-west-philly-hybrid-x-team-to-the-winners-circle-at-green-grand-prix/

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A decade, and counting, of publicly mourning 9/11 (AP)

HILLIARD, Ohio ? Carla Gilkerson, a 54-year-old school bus driver, sits at a table with friends at Abner's diner on Main Street in this small Ohio town. She's never been to New York City and doesn't know a soul who died on Sept. 11 ? but talk of the terror attacks a decade ago immediately moves her to tears.

Step outside of Abner's and there, across the road at Main and Center Streets, is one of the largest Sept. 11 memorials outside the attack sites; a granite monument etched with all the victims' names, surrounded by four giant pieces of World Trade Center steel.

Gilkerson often walks and bikes past the memorial, stopping to run her finger over the names. "I feel like I knew them," she said. "And that I can keep their memory alive."

A decade of public mourning for the nearly 3,000 people killed in the nation's worst terror attack hasn't abated; in fact, it thrives in this country, from the steel memorial parks to the fake Statue of Liberty outside a Las Vegas casino to a tiny chapel by ground zero. The attacks have spawned a ritual of extravagant public mourning that hasn't waned; even Americans who didn't lose a loved one on Sept. 11 are still grieving as if they had.

Gilkerson says it best: "I think we'll always mourn our losses from that day."

Experts in grief say the outsized sorrow for "our losses" is Americans' way of processing the most devastating public event of their lifetimes, which they need to do before they can begin to let go. "This," says Michael Katovich, a Texas sociology professor who teaches on death and dying, "is a process of solidifying our memories."

They're still grieving in Hilliard, a suburb of the state capital of Columbus, and an eight hour's drive from New York City. None of its 28,000 residents died on Sept. 11, yet the people who live in the new subdivisions and work in the small brick buildings that line the downtown still mourned. Mayor Don Schonhardt was one of the mourners, and he went to New York to ask authorities there for trade center steel for the city's memorial.

"We felt it was important to be a community in middle America that would say to the U.S. and the world, that we do remember what happened that day," Schonhardt said.

The memorial fills a city block in the center of town with its two pieces of rusted track from the subway that ran underneath the World Trade Center, and two other large hunks of twisted metal from the towers themselves.

Las Vegas has a permanent memorial at the fake Statue of Liberty outside the New York, New York-Hotel Casino. There's a rotating exhibit of items that were left at the casino in the days after the attacks. Recently, about a dozen Fire Department and police T-shirts from around the U.S. were on display in the shadow boxes, which are lighted at night. The hundreds of other items are archived and stored at the University of Nevada Las Vegas. In a city of excess and fantasy, the memorial ? which is across the street from the MGM Grand casino and its golden Lion statue and from Excalibur, a medieval-themed gambling hall ? is a sober reminder of reality, and visitors stop and peer into the shadow boxes while walking from one casino to the next.

The small western Pennsylvania town of Shanksville is touched like no other by the attacks; it's believed to have been an attack site by accident, but one whose residents had little connection to the 40 people who perished aboard the hijacked jetliner that crashed at more than 500 mph into the lush, green landscape.

A $60 million memorial is being built in the field. Inside a temporary visitor center, people write messages on slips of paper. A message signed by "Cathy" on June 18 reads, "Almost ten years and I still can keep back the tears when I visit any of the three memorials or watch a TV show about 9/11. So truly, we never forget."

Psychologists and sociologists who study grief and public mourning say that most of us ? at least for those who didn't lose a loved one in the attacks ? are still processing the pain, which will dwindle with each successive generation.

"It's part of our defense mechanism to distance ourselves," said Katovich, a professor at Texas Christian University.

Carla Ross, an expert on grief and forgiveness from Raleigh, N.C., said many Americans are still actively mourning 9/11.

"There's two things that make it really complicated for people," said Ross, a communication professor at Meredith College. "People don't know who to forgive. They don't know how to let it go. And instead of grieving and letting go, we're blaming a whole culture of people. People are really struggling with that."

Gilkerson and her friends don't want to stop. They say if we do, we'll forget what happened and the sacrifices made by first responders and soldiers who fought in the wars the attacks wrought.

Brad Fetty, a 34-year-old firefighter-in-training and a bus driver with Gilkerson, said that his city's memorial conjures up complicated emotions and questions about that day. While looking at the twisted and rusted steel beams, he said he wonders, "What am I looking at? Was there blood, were there tears, actually on this piece of metal?"

Ross thinks that societies that have experienced large tragedies never really stop grieving, but that the mourning becomes softer, less edgy.

"Usually when people get to the end of the grieving process, they start making sense of things, how it's impacted their lives for the positive," she said.

Karl Glessner is a 60-year-old volunteer "ambassador" at the Flight 93 memorial in Shanksville. He spends entire days at the public viewing area that overlooks the field where the 40 people aboard the plane died, and explains what he saw and heard that day. Glessner stands at the viewing area when it's raining and when it's sweltering, telling people how he felt the ground shake from the plane's impact and saw the smoke cloud from the crash.

He still sometimes chokes up when talking about the day. Talking to hundreds of people a day at the somber viewing area has made him "a better person," he said. "This is basically the best thing I do," he added.

Schonhardt said he pushed to build the Hilliard memorial after talking about Sept. 11 at local schools, and realizing some of the second-graders weren't even born when the attacks happened.

"It was designed to help children of our community understand what happened," he said. "This park helps us put the whole thing in perspective. When you lose that much innocence, it's profound. I think this is one we don't want to forget."

When asked whether Americans will ever stop mourning Sept. 11, Schonhardt paused.

"I hope not," he said. "I think it's important we recall the sacrifice and the way the day changed our lives. Once you stop that mourning process and you move on, there's a tendency to forget."

___

EDITOR'S NOTE ? Tamara Lush is traveling the country writing about the 10th anniversary of the 9/11 attacks. Follow her on Twitter at twitter.com/tamaralush.

Source: http://us.rd.yahoo.com/dailynews/rss/terrorism/*http%3A//news.yahoo.com/s/ap/20110626/ap_on_re_us/us_sept11_still_mourning

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Sunday, June 26, 2011

Palo Alto Online : Stanford program takes aim at eating disorders ...

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Stanford program takes aim at eating disorders Researchers adjust their thinking about the causes and treatment of eating disorders

by Karla KanePalo Alto Weekly Staff

Kristin began starving herself in eighth grade. ?I had low self-esteem,? she said. ?I was by no means fat, but my body developed before my other girlfriends?. I got it in my head that if I lost weight I?d like myself more and other people would like me more; I?d be more popular.? an avid reader of fashion and fitness magazines, she was dismayed by the differences between her body and those of the models she idolized. So first she began to choose health food over junk food, then she started reducing her overall intake, counting calories and weighing herself daily. ?Before I knew it, it became an obsession,? the South Bay resident said. ?I was terrified of gaining weight; I measured everything. The thought of not having that control was too scary.? in four months, she lost 15 pounds. after eight months, she had lost 40. ?It was beyond my control; my life was governed by this fear. It started as a control thing, and by the end I had no control. It was either the hospital or I was going to die.? The ?tween with the athletic body became drastically underweight and, at age 12, she was hospitalized in the Stanford ICU with a dangerously low heart rate. Kristin was diagnosed with anorexia nervosa and placed in the Comprehensive Eating Disorders Program at Lucile Packard Children?s Hospital at Stanford. now 23, Kristin recently celebrated the 10-year anniversary of her hospitalization. in recovery, with health restored, she?s one of the thousands of former patients who?ve been treated for an eating disorder or participated in research studies at Stanford. Eating disorders are serious mental illnesses involving abnormal, unhealthy eating behaviors, including anorexia nervosa (self-starvation), bulimia nervosa (binging and purging) and other, non-specified conditions. Stanford?s program was started in the late 1970s and involves staff from the Lucile Packard Children?s Hospital?s Center for Adolescent Health and the Stanford University School of Medicine divisions of Adolescent Medicine and Child Psychiatry. though eating disorders affect relatively few people, the impact on those suffering from them is severe. Anorexia has the highest mortality rate of any mental illness. Treatment for eating disorders has changed since the ?70s, with a shift toward family-based rather than individual therapy, care that is holistic and a majority of patients being treated as outpatients. Research, too, is evolving, with current Stanford researchers now exploring the tie between eating disorders and larger issues of cognition and thinking patterns. because eating disorders impact both mental and physical health, Stanford?s joint approach is the key to its philosophy, Dr. Cynthia Kapphahn, medical director for the program, said. Not only do adolescent patients work with therapists and physicians, but also nurses, nutritionists and others in a team-based, holistic approach to care. ?There?s even a school teacher to help patients stay caught up. It?s one of the few places in the country like that,? she said. The program offers a 15-bed inpatient unit (currently housed in rented space at Mountain View?s El Camino Hospital) and an ongoing outpatient clinic, with offices in Palo Alto and Mountain View. Kapphahn said she hopes the inpatient clinic, which outgrew its original space, can eventually move back to Lucile Packard when the hospital undergoes its recently approved expansion. Dr. James Lock, the psychiatric director for the program, said that on average 10 of the inpatient beds are filled at any given time, and that between 300 and 400 patients go through the outpatient clinic each year. New-patient evaluations are held three times a week, and around half of the patients come for treatment. about 10 times more girls are diagnosed with eating disorders than boys, Lock said, but that may partially be attributed to less awareness regarding eating disorders in the male population. ?The stereotype is the rich, white girl, but we see tons of boys, and lots of minorities,? Kapphahn said. she said eating disorders seem to be increasingly common in Latino boys, for example, who?ve been overweight, then lose too much. ?We see eating disorders across all groups,? she said. ?But the unconventional people tend to get missed.? A misconception is that eating disorders in adolescents are the fault of controlling, pressuring parents or the fault of popular culture for emphasizing svelte body shapes and unrealistic beauty standards, Lock said. ?Mothers get blamed because we live in a culture in which lots of women worry about their weight, but in fact anorexia is very rare,? Lock said. ?Everyone is exposed to the same media,? he said, while relatively few develop an eating disorder. while media can be a trigger for unhealthy eating habits, it seems a person needs to have certain genetic and cognitive propensities to develop anorexia. Kristin said she had problems with anxiety even prior to the onset of her eating disorder. ?I grew up experiencing a lot of anxiety, but it sort of went under the radar,? she said. ?I come from a family of ?Type A? personalities.? Lock said there may be similarities between those with eating disorders and those with other mental illnesses, such as anxiety and obsessive-compulsive disorders. looking at the behaviors and personality of patients from before they were diagnosed with anorexia, as in Kristin?s case, Lock said they ?tend to be anxious, driven, perfectionistic people? ? the very type who also tend to be quite successful in school and at athletics. Eating-disorder patients ?very commonly have all those traits. if you want to get into Stanford you better have some of those qualities,? Lock said. ?I tell parents, ?If your child does not get straight As, they are very unlikely to have anorexia.?? Kristin described herself as a regimented child who would ?stress about anything,? with even small mistakes such as missing the bus feeling like ?the end of the world. ?I would make lists of things to do, and things had to be done a certain way,? she added. ? Might Palo Alto, with its culture of high academic standards and population of driven Silicon Valley go-getters see a higher rate of adolescents with eating disorders than other areas? ?It?s a high-risk population,? Kapphahn acknowledged. Lock added: ?We don?t have good data, but there is an association; the vulnerability is probably higher,? since there are both genetic and environmental triggers. plus, to be able to afford to raise a family in the area, local parents are often high-achieving, extra-driven personalities themselves. and family does play a role. ?Genetic data suggests that inheritability is very high,? Lock said. but, he emphasized, as with media exposure, clearly not all straight-A students or teenagers unhappy with their weight develop an eating disorder. ?Particular people are more susceptible, ones with super-high expectations that spill into eating certain ways,? Kapphahn said, of what happens when such a person turns all their drive and focus onto controlling their eating habits. ?There?s a disconnect between high expectations and low self-esteem,? she said. It?s normal for adolescents to develop body-image concerns as they hit puberty, with girls generally experiencing more weight gain than boys, Lock said, but those who develop eating disorders take such concerns, along with their perfectionistic tendencies, to an extreme. Kristin?s perfectionism mixed with her low self-esteem created a ?perfect combo for an eating disorder,? she said. there also seems to be a link between the sex hormones that control puberty, particularly estrogen, on brain development and risk for eating disorders. and by far the most cases of eating disorders are diagnosed by age 18, with onsets becoming rare after age 25, Lock said. once the disease takes hold, ?it?s truly shocking how intractable it is, how absolutely compelling,? he said. ?Even when I was at my lowest weight, I never thought I could have anorexia. I couldn?t be thin enough. It was total denial. I was miserable, weak, felt awful, depressed,? Kristin recalled. Anorexia?s mortality rate is about five to nine deaths per 100,000 sufferers, Lock said. half of anorexia-related deaths are from cardiac arrests due to weakened, starved hearts, while the other half are suicides. in those cases, the patient ?loses all perspective. They have nothing left, no energy for relationships. You just begin to feel like you don?t want to live,? Lock said. and with each passing year of having the disease, the risk of death goes up by 1 percent. ?People don?t think they have a problem; they don?t see it. They say, ?No, I?m fine,? even when they?re on a heart monitor in the hospital because their heart rate dropped too low and they?re a skeleton,? he said. For Kristin, ?restricting was all I cared about. Counting calories and exercise was all I lived for. I thought about it 90 percent of the time,? she said. Bulimia is three to four times more common than anorexia, but comes with its own dangers and long-term health risks. ?It?s equally worrying,? Lock said of bulimia, ?but with quite a different set of concerns,? with bulimics struggling more often with appearance-related weight-loss attempts rather than the control issues common in anorexics. Patients with bulimia more often recognize they have a problem and want to stop, but they find themselves trapped in the binge-purge pattern, he said. ?One of the sad things is, eating disorders are still stigmatized,? Lock said. ?Families are blamed; patients are blamed; people think they?re influenced by fashion or the media as opposed to having a psychological disorder.? Kapphahn concurred. ?People feel guilty, like it?s seen as a volitional thing. if you had cancer you wouldn?t be blaming yourself for having cancer. It really is a disease that needs to be treated,? she said. though very dangerous, eating disorders are also highly treatable. Lock said in his experience it takes patients between nine months to a year to recover, with 80 to 90 percent able to say they no longer have the disorder. in Kristin?s case, her parents became concerned by her weight loss but for a while were at a loss as to how to deal with it. she saw a physician and a psychologist but kept losing weight. ?It was the elephant in the room, no one would talk to me about it,? she said. Eventually, she recalled, her mother came up to her room to break the news that she?d need to go to the hospital. ?They want to take you by ambulance, but I?d like to take you myself,? she remembered her mom saying. ?I had to face the music.? most of the patients who come to Stanford are, like Kristin, fairly local, from the Bay Area or Northern California, although some are referred from across the nation and even the world, Lock said. Traditionally, most eating-disorder patients were treated as inpatients, with months of hospitalization, ?but in the last decade by far the largest number are treated as outpatients,? Lock said. ?It?s a real movement forward.? when patients first arrive, medical stabilization is the first priority. even outpatients are often hospitalized for the first nine to 12 days to make sure they?re physically stable, Lock said. Kapphahn and her medical team monitor patients? physical health, helping them recover from malnutrition and a host of side effects that can include low blood pressure, low heart rate or a racing pulse, seizures and more. Nutritionists advise on what meals are appropriate, while for inpatients nurses make sure patients are getting the nutrients they need. ?It?s really hard for patients; they feel overwhelmed and fearful of eating. The nurses are supportive but firm,? Kapphahn said, adding that rarely do Stanford nurses have to resort to the unpleasant nasal-gastric force feeding that sometimes characterized eating-disorder treatment in the past. Kristin, thinking she?d only be in the hospital for a few days and packing accordingly, ended up staying there for a month and a half. For a long time she wasn?t even well enough to take solid food and was bedridden. Eventually she was able to use a modified wheelchair, then progress to walking and going to group therapy. in the hospital, ?I went in and out of acceptance. I was scared I was going to die. It was a really lonely time, although my family visited every day,? she said. Finally, she gained 10 pounds and was able to be released. ? while caring for the physical wellness of patients is crucial, Kapphahn said it?s the psychological treatment that is essential for long-term success in treatment. ?Truly, recovery comes through the mental health side,? she said. For more than two decades, Stanford has been involved in eating-disorders treatment, with Lock as a proponent of what he called evidence-based, family-based therapy for anorexia nervosa, in which the parents and siblings of the patient undergo counseling with him or her and take an active role in the recovery process, including learning about nutrition, making sure the patient eats properly and trying to understand the complexities of the illnesses. Family-based therapy is counter to how anorexia used to be treated, Lock said. in older days, ?treatment left the family completely out,? he said. The belief was that anorexics have parents who are over-controlling and that the disorder ?is about defiance and autonomy,? he said, so therapy focused solely on the patient. ?It seems completely crazy to me now,? Lock said, adding that patients would do well at the hospital, but then continue losing weight once they were back home. having family members involved in the treatment process is key, as the kids suffering from anorexia are initially too disturbed to handle the situation on their own, he said. ?Parents need help helping them. They need to know how to make sure the kid eats every meal, no cheating, no exercise on the side, and make sure their child gets the message, so it disrupts the behavior and it becomes less compelling,? he said. once well enough to return to school, ?they need to be able to manage it in the peer environment, and the parents need to be able to pick up the pieces when it falls apart,? he said. Family-based therapy is now recognized as the treatment of choice, Lock said. According to a joint study by Stanford and the University of Chicago, published in the October issue of Archives of General Psychiatry, family-based therapy was found to be twice as effective as individual psychotherapy in producing full remission in anorexic teens. Kapphahn said the medical side of the program was slower to embrace family-based treatments than the psychiatric side, but over the past eight years she?s seen a paradigm shift. ?The hospital was stuck in an old-fashioned model, really contrary to the work Dr. Lock was doing. now ? we really want the families to be there, our program has shifted,? she said. in Kristin?s case, her parents tried the family therapy, but then dropped out, finding it too difficult. ?My family did everything they could to support me, but they never really tried to understand,? she said. ?But I would still recommend family therapy. I think it?s really important; usually there is something there.? ? Cognitive remediation therapy (CRT), which focuses on patients? thinking patterns and styles rather on specific eating behaviors, is also now used in treating eating-disorder patients. The techniques of CRT are being used to study how the cognitive processes of eating-disorder patients may differ from healthy individuals. CRT ?is something patients tend to really like because it doesn?t ask any questions about food or weight,? Stanford School of Medicine Research Assistant Danielle Colborn said of the treatment, which has also been used in cases of head injury and schizophrenia. Tasks involving memory games, pattern matching and problem-solving quizzes are used to help patients improve brain flexibility. ?It still helps them work toward recovery but without those trigger issues,? Colborn said. ?It?s very new ? some as been done with adult women (with eating disorders) but very little has been done with adolescents. We?re starting to change our way of looking at these illnesses, taking into account their cognitive functioning. Before our way of looking at them was specifically ideas about food and eating, but in addition we should look at addressing their thinking processes themselves,? she said. Colborn and Nandini Datta are two of several Stanford researchers currently conducting studies on the relationship between thinking processes and eating disorders. though their studies are separate, both involve analyzing how a person?s thinking may correlate to psychological illnesses such as anorexia. Datta and her team are currently recruiting subjects for her study, titled, ?Familial Aggregation Study of Anorexia and Cognition,? specifically in females ages 14-19 with anorexia nervosa, and their family members. The study will focus on pairs of sisters close in age, in which one sister has anorexia and the other does not. She?s also recruiting females from that age group with no history of anorexia to serve as controls in the study. ?We give them a neuropsychiatric assessment that shows their thinking processes with various tests,? including IQ tests and games that test spatial and visual intelligence, Datta said. One such test is the Wisconsin Card Sorting Test (WCST), during which participants have to match cards using shape, color or number, with the criteria for matching continually changing. This measures what is called ?set-shifting ability? ? flexibility in thinking. other tests include copying an image from memory, matching a simple image with a more complicated one, and other computer-game-like tasks. The tests focus on central coherence, which Datta described as ?the ability to see the big picture rather than just details.? Anorexics, she said, may be more detail-oriented, making them more successful at some of the tasks and showing cognitive deficiencies in some areas, such as adaptability. Some participants also undergo functional MRI scans, which provide images of their brains so that the potential effect of an eating disorder on brain anatomy can be seen. ?There are not many studies like this done on anorexia yet,? she said, and the hope is that finding predictable cognitive correlations could help identify people who may be at higher risk for developing eating disorders. ?We?re taking a biological view. It?s pretty cool and very new,? she said. ?We?re hoping if we can understand these correlates then we can explain it on a biological level.? Datta?s study is in the early stages, with two families participating so far. The goal is to recruit 40 subjects with anorexia and 40 controls over the course of the five-year study. ? No matter what biological and neurological implications researchers such as Datta and Colborn may discover, for those struggling with eating disorders, ?It?s really important to maintain therapy and support,? Kristin said. Kristin, who continued seeing a therapist on and off in the years since her release from the hospital, went on to study psychology in college and is now a graduate student, working toward her master?s degree in counseling. ?It?s been a slow journey, and I have this awareness when it comes to my health,? she said. her weight fluctuated throughout high school and college, and she continued to struggle with unhealthy habits, including a binging-and-purging phase. she said she?s now developed an understanding of her tendencies toward unhealthy thinking patterns. ?I?m definitely aware of my weight, and of my figure, but I don?t count calories, I don?t weigh myself and I don?t stress about food. Food is a source of nourishment. I?m absolutely able to enjoy food,? she said. She?s found support from the Eating Disorder Resource Center, based in Campbell. Janice Bremis, who herself went through anorexia treatment at Stanford in the 1980s and ?90s, founded the center in 2006. ?I was familiar with the research Stanford was doing. They had all this knowledge but the community didn?t,? Bremis said. The center offers information on treatments, therapists, insurance help, support groups and more. Kristin has been involved as a volunteer and said she?d like to eventually work as a therapist specializing in eating disorders, anxiety disorders and depression, as well as continuing to teach group fitness classes and advocating for eating-disorder education and prevention. ?Ever since going through it I have wanted to work with people with eating disorders,? she said. ?Educating other people about eating disorders and health really heals me.? more information on Stanford?s research studies is available at edresearch.stanford.edu. more information on the Eating Disorders Resource Center is available at www.edrcsv.org. ==I more information on the Comprehensive Eating Disorders Program at Lucile Packard Children?s Hospital is available at www.lpch.org.

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Comments

Posted by Enough!, a resident of the Charleston Gardens neighborhood, 13 hours ago

Just bring in the Paly classes of 2001 and 2002. You will learn quickly how a lot of the boys in those years called girls who were mere sizes THREE and FIVE ?thick? and worse. Many of the girls experienced eating disorders, and many said that to be considered ?thick? or ?fat? in high school was almost as bad, if not worse, than getting bad grades. It certainly lessened your popularity. It is a totally sad situation, and certainly reflective of the influence of the mainstream media on our young women.

Posted by Decades of this, a resident of another community, 13 hours ago

Eating disorders deserve even more media attention than this, but this is a great start.

I?m glad Stanford?s program has advanced from the rudimentary stages when they tried to help me back in the early 1980s. The treatment then was in its infancy and did nothing to help my well-established, heavily-entrenched bulimia disorder.

My original difficulty ten years prior was anorexia nervosa, and I was surrounded by high school friends with the same struggle. few parents or even health care practitioners recognized such behaviors as something aberrant and potentially dangerous, and hadn?t a clue how to deal with it.

After two three-week fasts, a physician told my mom to take me home and force me to eat. Period. No counseling. No follow-up. No nothing. in no time, I had given up my anorexia for bulimia.

15% Off Any Meal Plan

If you have an eating disorder, or if you know someone who has an eating disorder, be very aggressive about getting the very best professional help that you possibly can. Stick with it. Read everything you can find. Talk about it. go online. there are helpful websites. I like:

I believe that this article grossly under-reports fatality statistics from eating disorders. in addition, there are numerous permanent (as well as temporary) negative side-effects of binging and purging. Bulimia will cripple your body, your mind, your spirit, your family relationships, your friendships, your bank account, and your education.

Get help. Today. or yesterday. Not tomorrow.

It can get better! It does get better! You need to deal with it early.

Thank you from one who?s been there.

Posted by Decades of this, a resident of another community, 13 hours ago

Oops, misplaced modifier:

The physician hadn?t been on the two three-week fasts, I had!!!!!

Posted by correct web address, a resident of another community, 13 hours ago

(Check out the blogs. very helpful.)

Posted by Therapist, a resident of Another Palo Alto neighborhood, 11 hours ago

Dr. Lock?s comment ?I tell parents, ?If your child does not get straight As, they are very unlikely to have anorexia.?? is misleading at best, and potentially dangerous if parents are uninformed about the numerous other factors and behaviors associated with this disorder. Hopefully he said this to emphasize the strong correlation between other cognitive and behavioral tendencies and anorexia. I have worked with many many adolescents with anorexia whose anxiety, drive, and perfectionism did not manifest in high academic performance.

Posted by Enough!, a resident of the Charleston Gardens neighborhood, 10 hours ago

Many straight A students at Paly suffered from both anexoria and bullimia. in fact, the overachievers seemed to suffer from the disorder in frighteningly high percentages! Typical food for the day would be: Breakfast, nothing. Lunch: Starbucks Dinner: a tiny amount of food. Later: alcohol, then throw up.

Palo Alto Online : Stanford program takes aim at eating disorders

Source: http://www.the-lose-weight.com/palo-alto-online-stanford-program-takes-aim-at-eating-disorders/

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