Changes to television over the years

Changes to television over the years

Television has advanced a great deal in recent years, mainly due to the advancement of digital technology in the digital age.

The History of Television

Not so long ago the UK only had 4 television channels.

Now there are hundreds of channels available, available via your TV aerial, satellite, cable and Internet on digital television

Analogue vs Digital

Sony SET TV on TDT

Sony Entertainment TV SET has been replaced by AXN on Spains TDT service.

This is the reason why you can no longer get SET on TDT and are getting a "scrambled" or "encrypted" message.




http://satandpcguy.com/forum/sony-set-to-be-replaced-by-axn-t2136.html





For more information please visit:

The Sat and PC Guy - Digital Satellite and Terrestrial Installations and Maintenance for the Costa Blanca

or the forum

The Sat and PC Guy FORUM - Digital Satellite and Terrestrial Installations and Maintenance for the Costa Blanca

Sky News HD to officially launch on May 6

Sky has confirmed that Sky News HD will launch on May 6 to coincide with coverage of the election night.

The channel, which became temporarily available on April 22 for the Sky News prime ministerial debate between Gordon Brown, Nick Clegg and David Cameron, will be officially launched next Thursday as the election race reaches crunch time.

The new HD channel is also supported by an upgraded

Install gizmo in Nuke and create icon on menu

1: after you create your part of nuke script into a group (Edit>Node>Group>Collapse To Group (Ctrl+G)
2: Right Click on your Group node's properites> Manage User Knobs... to setup your own gizmo interface what ever you need
3: and click group node's Export as gizmo to your nuke's plugins folder ex: X:/Program Files/Nuke6.0v2/plugins/
4: click X and pick TCL to type the gizmo name you just save, to test saved gizmo working or not?
5: Create a text file call menu.py

toolbar = nuke.toolbar("Nodes")
# The "3DTools" menu
m = toolbar.addMenu("3DTools", "ReConverge.png")
m.addCommand("DepthGrade", "nuke.createNode(\"DepthGrade\")")

and save menu.py into your system folder below:
•Linux:
/users/login name/.nuke
/usr/local/Nuke6.0v2/plugins
•Mac OS X:
/Users/login name/.nuke
/Applications/Nuke6.0v2/Nuke6.0v2.app/Contents/MacOS/plugins
•Windows:
In the .nuke directory, which can be found under the directory pointed to by the HOME environment variable. If this variable is not set (which is common), the .nuke directory
will be under the folder specified by the USERPROFILE
environment variable - which is generally of the form drive letter:\Documents and Settings\login name\ (Windows
XP) or drive letter:\Users\login name\ (Windows Vista).
ex: X:\Documents and Settings\username\.nuke

depthGrade_example....

Show gixmo internal structure after export as gizmo
Gizmos are designed to be hard coded once you export them. To get around this and get back into the structure you will have to locate the .gizmo file in your plugin folder or wherever its stored. Now open this file in a text editor, and change the name "gizmo" on the third line from the top to "group" Now you can copy and paste the acsii text back into Nuke. Now you will have the gizmo back as a group node that you can Show contents and edit.

update: in nuke6 has "copy to group" on gizmo to quick reveal in qroup. cool!

TDT Industry receives complaints about the reception of TDT

TDT Industry receives complaints about the reception of TDT

Since the analogue TV 'off' on 30 March, the Ministry of Industry has received over 1,760 inquiries from people related issues reception of Digital Terrestrial Television (DTT / TDT) until 20 April.


In total, during this period of time, Industry received 86 985 calls, of which 47 739 were treated by agents. Of that number, 88.1% were

What is the best satellite for English channels?

What is the best satellite for English channels?

The main satellites that provide the UK with their satellite TV channels are the Astra 2 and Eurobird 1 satellites, located at 28 degrees east of south.

These satellites carry the main BBC,  ITV, C4, Five and "Sky subscription package" channels for the UK.
They are not available on any other satellite system, and so the answer to this question is

Michael Moore's Look at American Healthcare

With his latest film 'Capitalism: A Love Affair,' Michael Moore once again demonstrates his knack for locating and highlighting the plight of the nameless, faceless ordinary Americans who are virtually ignored by the mass media and most politicians, and who have few if any opportunities to tell their stories. He honed this skill in several previous films and it has become more or less formulaic. This review takes a look at Moore's previous film, 'Sicko,' in which he examines health care in America. Although nearly 50 million Americans have no health insurance and thousands will die every year because they are uninsured, ‘Sicko’ is also about the 250 million American citizens who do have health insurance, but for whom the system is tragically dysfunctional.

Most of the first part of the film focuses on numerous case studies of patients and their problems with the health care industry and insurance companies, and Moore has a unique ability in telling these stories to elicit both tears and laughter from the audience. The first case makes the immediate point of the film by showing a man who accidentally sawed off the tips of two fingers, but who was given the option to repair the middle finger for 60,000USD or the ring finger for 12,000USD. He next profiles a late middle aged couple who were driven to bankruptcy and had to sell their home because their insurance would not cover the costs of their medical treatments, giving them no choice but to move in with their children. Then there is the woman who was in a serious car accident and who was sent a bill by her insurance company for the ambulance ride to the hospital because she did not seek ‘pre-approval’ from the insurance company prior to the accident. Moore located these people and many others by soliciting their stories on his website, through which he received 25,000 replies in the first week alone. Among the respondents was the family of an infant girl who was losing her hearing and who was told by the insurance company that she could only receive a cochlear implant in one ear, since fixing both ears was considered ‘experimental treatment’ and therefore not covered by insurance. However, when the father wrote the insurance company and said he was ready to tell his story to Michael Moore for a new documentary film, the rejection was overturned.

Because of his reputation as an investigative film maker, Moore also began to receive insider information from people in the health care system who were frustrated by the industry for which they worked. One informant, who worked for a health maintenance organization, revealed hundreds of pre-conditions that would automatically exclude people from obtaining health insurance. True to style, Moore names the companies, executives and politicians responsible for the deplorable state of health care in the US. In one case, a patient was told by Blue Shield, one of the pre-eminent health care providers in the US, that she did not have a brain tumor but when she collapsed on vacation in Japan was told by Japanese physicians that an MRI showed she did indeed have a tumor, while Blue Shield had repeatedly refused her an MRI. The medical reviewer of another large health care company, Humana, flatly stated that in the industry the definition of a good medical director was someone who could save the company money, and the doctors with the highest number of treatment denials would actually receive a bonus from the company, while any payments for a claim are termed as a ‘medical loss’ by the industry. Some companies even employ a team of ‘hit men’ to scour health care applications and patient histories going back five years for any clerical errors, health conditions or other factors that could lead to a direct denial of service. Moore makes it clear that the American health system is governed by money, not by concern for the well-being of citizens, and that decisions regarding the provision of health care are done with an eye toward maximizing profits.

Moore found several medical practitioners with a conscience, such as Dr Linda Pino, former medical reviewer at Humana, who told her story to a 1996 Congressional hearing: ‘I am here primarily today to make a public confession. In Spring of 1987 as a physician I denied a man a necessary operation that would have saved his life and thus caused his death. No person and no group has held me accountable for this, because in fact what I did was I saved a company a half a million dollars for this. And furthermore, this particularly secured my reputation as a good medical director and insured my continued advancement in the health care field. I went from making a few hundred dollars a week as a medical reviewer to an escalating six figure income as a physician executive. In all my work I had one primary duty and that was to use my medical expertise for the financial benefit of the organization for which I worked. And I was told repeatedly that I was not denying care, I was simply denying payment. I know how managed care maims and kills patients, so I am here to tell you about the dirty work of managed care and I’m haunted by the thousands of pieces of paper upon which I’ve written that deadly word, denied.’ This prompts Moore, as a patriotic American, to ask, ‘How did we get to the point that doctors and health insurance companies are actually being responsible for the deaths of patients?’ This is followed by some historical review of how the present health maintenance system in the US was proposed during the early 1970s as a for-profit private enterprise by then US President Nixon. When that system was challenged by health care reforms during the Clinton administration, this led to charges of ‘creeping socialism’ by the conservative and business friendly opponents of reform, led by doctors of the American Medical Association, and the health care industry spent over 100 million US dollars to defeat the proposed health care reforms. Since then, as Moore shows in his survey of the American political scene, health care has been firmly in control of the insurance companies and drug companies, who make gratuitous payments to politicians.

Americans have been heavily indoctrinated by government and industry to view any form of socialized public services as the devil’s spawn, a step toward communism and total government control of American lives, and that socialized medical systems are deplorable and generally ineffective. But a quick look at most other industrialized capitalist states suggests that socialized medicine can be highly effective and even become the norm. France is first in the WHO ranking of world health systems (the USA ranked 37), so Moore decided to visit France, along with Canada and the UK, to explore their free universal health care systems. Contrary to the claims voiced loudly in the US corporate media, Moore finds that Canadians are satisfied with and proud of their free universal health care system, where citizens are fully covered for all manner of ailment, illness and injury, with no insurance needed. He finds similar situations in the UK and France. While those who live with free universal health care would not be surprised, Moore dwells on these cases mainly for the sake of Americans propagandized against free universal care by their own government. Moore did find one place on American soil that offered free health care: the Guantanamo Bay military base where the US detains ‘enemy combatants’ from its ‘war on terror,’ who according to the US government itself receive free health care. Moore ventured to take a boatload of US citizens, including some who were injured in the 911 rescue operations but refused treatment in the US, to try and get them free medical treatment at Guantanamo Bay. The tongue in cheek segment, in which Moore says to Guantanamo Bay guards, ‘these are 911 rescue workers, they just want some medical attention, the same kind that al Qaeda is getting,’ makes its ironic point well, although their boat is turned away and Moore was reportedly later investigated by the FBI for the stunt. They were able to visit Cuba, known around the world for having one of the best health care systems and for being most generous in providing doctors and medical equipment to Third World countries, where the US citizens were able to get treatment at Havana hospital and obtain the medicine they needed. One American woman wept when she found the same medicine she needs, for which she pays 150USD in the US, for a few pennies in Cuba.

Michael Moore has his devotees and detractors, and his work is difficult to encapsulate in a short review. What’s clear is that he provides a valuable comparative look at international health care that few are privy to. Several clips from ‘Sicko’ are available on viral media sites, and the trailer can be viewed on the official website. The special edition DVD has in addition to the main feature a number of extra features worth viewing in their own right, some of which provide further evidence of Moore’s conclusions and his responses to detractors.

[This review is by Yusef Progler and originally appeared in the Journal of Research in Medical Sciences, vol. 13, no. 5, 2008.]

Canadians Invade Sharm El Sheik - Beer Crisis

Well not a beer crisis but we sure put a dent in supplies.

We live in Maadi and another trip to Sharm was not high on our "like to do list" but  with family visiting from Canada it was great. There was ten of us ranging in ages from 67 to 12 years, so we had to whole spectrum of "who likes what and who wants to do what".

We all traveled from Cairo. and sister had booked the hotel and tickets from Canada. I arranged all travel to airports etc, as discussed in my previous blog.


Hotel - Renaissance Golden Beach Resort

We wanted family rooms so that restricted hotel choices in Sharm as only 2 offer family suites to accommodate up to four persons. (Check out booking.com as best one I have found for hotel bookings). We had booked 3 suites. Now the fun began.
Transport to Hotel
I phoned ahead and asked if they had a van/bus to pick us from airport thinking they would have a courtesy bus. No, but they could send 3 cars for $30 per car. Did not want to hassle with taxis so agreed. Being Sharm I wrote this down as first rip off.
Hotel Arrival
Rooms were not ready and they seemed to have trouble figuring out what suites to assign as insisted they be next to each other, with sea views. Well, not a big deal as us boys went to Lobby lounge for beers and rest did a wander about. Also wanted to keep and eye on luggage stacked outside entrance as no rooms had been written on tags yet. First comment by family was "Jeez" the place is nothing but stairs everywhere"!  Anyway, got the suites and they had electric carts take us and luggage to suites. Yup more stairs and 2 suites on second floor and one on ground floor (mine).

Suites
Nice - with separate bedroom (cw TV), living room another TV, bit of kitchen, one full bath and also half bath. View incredible. Beds comfortable. Large balconies for suites on 2nd floor and garden for ground floor .Thumbs up! Now here is a funny - brother-in-law phoned desk and said no electric working. They never saw a place where you have to put room key in a slot to turn on the electric. We had a good laugh about that and sure front desk did as well.




Navigating the Place
If your not in shape you will be by the time you leave - we were a week and in end I could actually climb one terrace flight of stairs without heart attack. Not a place for anyone mobility challenged. Pic below gives some idea of number of terraces. Beach area not visible as one more terrace down.

Beach - what beach?
Hotel web site states 350 meters of private beach. One imagines laying on golden sand and when bit hot running into the surf. Nope that is not the case. Maybe 350 meters of sun tanning area one terrace above sea .Beach entry to sea is miniscule and then they ban you from walking on rocks (they say coral?). but have bars a plenty. And have a floating wharf to get to open water and swim. Picture below is sun tan area and looks like on sea adjacent but you'd have to jump off the rock cliff.

Beach entry- maybe 15 meters wide.

Food and Service
Just fine - we liked Acapulco Joe's on lower terrace. Room service good. Food at top terrace restaurant was OK but service was really slow. It was chilly in evening so outside restaurants were great.

 Other Activities


Most of family went on a snorkeling day trip, which was 200 LE per person all found, including lunch on board. (Take your own beer). Boat was really nice but water was freezing. Would have been better if they had recommended renting wet suits. They did provide all other snorkel gear.

Ship wreck corroding nicely -

 Day trip to Saint Katherine's (I organized through Limo Marco in Cairo).

Nice van and guide. Up to St Catherine's then lunch and walk about at Dahab.

Town Center, Naama Bay, Torrisono Beach
Hotel had a free shuttle bus at 12 noon each day to Town Souk Shopping and Naama Bay.  Us boys opted for Naama center for few beer at Hard Rock Cafe and stock up with beer, mixes and even some water from store as price is about
1/3 of hotel.

On previous visits,Torrisino beach was a lively fun beach area with bonfire at night. It is public beach area favored by locals and informed tourists. Was located across road downtown, but now has been relocated across bay and was dead as door nail. We were only ones there and was boring. Had a decent fish meal and left.

Departure
Only exciting thing to mention, besides having to get 3 cars back to airport at $30 a pop, was our luggage.  Electric carts came and pick up the bags, and us, and took up to outside reception. They stacked them pretty close to many other bags so I said to sister, I'll stay and guard. Sure enough, tourists started boarding a bus and staff were picking up all the bags they could find to put on bus. Had their grubby hands on ours as well. Thank goodness we had foresight to keep an eye on the bags or for sure would have been on the bus en route to Italy.

Only hotel prices left to mention. If one lives in Cairo we get shocked by the prices in Sharm. As example, small bottle of water here is less than 2 LE but 8 LE at hotel. Why do these hotels need to gouge so badly?

All said and done, we had a great time and got in shape with all stairs. But for sure my last time in "rip off land".

小米記趣～『仿貴婦提名牌包的搞笑版』

陳小米近期喜愛以貴婦提名牌包的方式拎有手把的玩具或是紙袋，但重點他的長相屬弄臣系列，加上提的也不是貴婦級的包，所以模樣很逗趣，仔細說來他應該跟他阿母一樣是市場大娘的fu拉～

小米記趣～『又再度被阿母剪呆頭瀏海』

因為一心一意想要小米比較女孩兒樣，因此死命都希望他的頭毛趕緊留長，但前面的頭毛就會蓋頭蓋面，阿母就想說要跟小米比快，快手來剪他的瀏海，結果還是不敵像蟲般的小米動來動去的速度，所以呈現最後的瀏海是非常的呆又短！

You! Give me back my new iPone 4G....

news

小米記趣～『一心多用的騎木馬』

那天阿爸去costco買了一包菜瓜布，不知為何小米特愛，一直拎著它逛大街，連騎馬時也不放過！

Aljazeera Documentary on Drug Addiction in Gaza

Following the December 2008 Israeli offensive, a United Nations survey of Gaza residents found increases in risk taking behaviour, including a significant rise in cases of drug addiction. One drug associated with this trend is Tramadol, first developed in Germany during the 1970s and introduced in the 1990s as a centrally acting analgesic with properties similar to codeine and morphine and which is widely prescribed as a pain killer. Although illegal without a prescription in some regions, Tramadol is relatively easy to obtain in Gaza, either with fake prescriptions from pharmacies or on the black market. News reports prior to the 2008 offensive suggested that up to 30 percent of males between the ages of 14 and 30 had already been using Tramadol on a regular basis, with some 15,000 showing signs of addiction. The escalation of this problem since then was documented by the Aljazeera English satellite television channel in its recently aired program ‘Uncomfortably Numb.’

Under the broad ranging and comprehensive Israeli blockade of the Gaza strip, which has been in place since 2007, Gazan society has come to rely heavily on a vast network of cross border tunnels, some as much as 18 meters underground, which have become crucial supply routes for Palestinians who are cut off from the outside world. Around the clock shifts of tunnel workers transport a wide variety of items, from food and clothing to household goods and even furniture. Recently, illicit pharmaceuticals and other drugs have become hot commodities in the burgeoning tunnel trade.

Despite consistent border seizures of the smuggled drugs, thousands of boxes of Tramadol still make their way to Gazans who are increasingly dependent on the drug, some having become seriously addicted. Kamal, an addict interviewed in the program, admitted that, ‘When I take it, I feel completely relaxed. I forget about all my feelings and emotions. I feel total release when I take one or two pills. The higher the dosage the better I feel, the more relaxed.’ Dr Samir Al Zaqout of the Community Health Programme in Gaza, one of the few facilities at which addicts can receive treatment, says of the rising tide of addiction, ‘Most of the addicts are between the ages of 18 and 30. All my cases are in that age bracket, and herein lies the danger. The danger is that those who are supposed to build our future are the most affected. And if the number of cases I have seen are 150, there are hundreds of others who I have not seen and who would never seek the help of a doctor. Why? Because we live in a traditional society that fears the stigma attached to mental illness, and addiction is not just considered to be a mental health issue. It’s seen as even more serious.’ Kamal continues, ‘I take it because of the hardship we’re under. I take it because of what is happening to us. I used to take one or two a day; now I need six. Since the war we have been in a miserable situation. No jobs, Hamas and Fatah fighting, no reconciliation, nothing. We were promised that things would open up and more jobs would become available for me and others. We want the wall to be opened, we don’t want the siege.’ Dr Zaqout adds, ‘The number of addicts went up after the war in Gaza because that war was unprecedented. The occupation employed every form of discriminate and indiscriminate killing leaving the Palestinians here feeling insecure and at risk wherever they are.’

While it was not mentioned in the program, it is worth noting here that researchers have found a very high degree of comorbidity between war-related trauma and depression, along with drug abuse, among Israeli soldiers who, ironically, have also been psychologically affected by the ongoing war.

However, as the Aljazeera reporter Zeina Awad notes, ‘It’s not just the war. Israel’s suffocating siege has cut Gazans off from the outside world and made hundreds of thousands of them jobless. Gazans are becoming poorer by the day, and eight out of ten Gazans are now dependent upon some form of UN handouts.’ University graduates have increasingly difficult times finding jobs, and end up hanging around in cafés. One student interviewed in the program recalls that over 3000 university graduates showed up for a recent job fair at which there were only 100 positions available. Some students turn to drugs to ease their frustration. As suggested by a second student, ‘Even those who don’t do bad things are now thinking about doing them. The war has deeply affected us. Our spirit is destroyed. We have not left since the war, nor had a break. And we’re still carrying it all inside us.’ Another student reports that her brother brought pills home from school that turned out to be Tramadol, which led to an investigation at the school that found a 15 year old student who was dealing in drugs.

The market for Tramadol was at first driven by user need, but when demand outstripped supply a black market arose with an interest in proliferation. This fuelled a lucrative criminal economy of illicit drugs, with dealers getting rich on users who may spend what little cash they have on drugs rather than daily essential needs such as food and clothing. While addicts live one day at a time, many not knowing from where their next fix will come, a battle has emerged between Hamas police forces and the increasingly wealthy and powerful drug dealers. Hamas has taken a hard line on the illegal drug trade, including shooting dead on site known large scale dealers and using torture on drug suspects. Hamas is also attempting to change the drug laws in Gaza, from the looser Israeli norms to those from Egypt that permit life jail sentences for drug dealers and even the death penalty in some cases.

Although the methods employed by Hamas have raised concerns, its crackdown has succeeded in bringing a semblance of order to the formerly lawless streets of Gaza and has reduced the drug supply by 80%, according to a spokesman for the police, who also denied torture was being used. When Fatah was in control of Gaza, drug addicts were often labelled as ‘collaborators’ with Israel, creating a double edged – and potentially deadly – social stigma. The association between addiction and collaboration was continued by Hamas. But such policies have adverse effects, as noted by Dr Zaqout: ‘Psychologically, torture would only increase the person’s addiction, so you are making matters more complicated by beating him. If the addict does not feel that society sees him as a human being, then he or she will become more depressed.’ Coupled with the hardships of the ongoing Israeli occupation, suffering abuse by the Palestinian police and living with social stigma can have the effect of aggravating the problems people face, leading to deeper depression and addiction.

Whatever the tactics and results, the demand for drugs continues and as with any illicit drug trade anywhere in the world, as long as there is demand there will be dealers willing to take whatever risks are necessary to meet that demand and reap its immense profits. In one sequence of the program, Zeina Awad is taken along on a drug bust operation that does not yield any evidence of dealing, but she is later shown what has been seized from previous raids, including supplies of ‘ecstasy’ pills and large quantities of hashish, and countless boxes of Tramadol. Unfortunately, as noted by the Head of the Anti-Drug Task Force, Jamil Al Dahshan, ‘There is a big difference between the number of arrests in 2009 compared to 2008. Drug cases have gone up in the last year. In 2009, we had close to 1,204 cases of which 591 were Tramadol related. We seized close to two and half million Tramadol pills compared to 550,000 in 2008. We had 734 drug cases in total. 109 of those were Tramadol related.

While the program was informative, Aljazeera’s singular focus on the tunnels as the main entry point for Tramadol and other substances into Gaza missed an important opportunity to explore drug trafficking as a transnational crime, evidence of which was clearly shown in the program. Although Tramadol is known as Tramal in Gaza and Tramadex in Israel, the police displayed boxes labelled Tramajack, which is the name under which Tramadol is manufactured in India. The police also showed packets of green capsules labelled Tramadol, but which appear to have originated in the European Union. Other drugs on display were Proxam, a compound including dextropropoxyphene hydrochloride, which is a weak opioid, and Amirol, which is the Australian name for amitriptyline hydrochloride, a powerful antidepressant with sedative properties. In addition to drugs, the police confiscated substances related to the drug trade, such as Marquis Reagent, which is used for testing ecstasy, cocaine and opiates, and even reagents for testing the presence of explosives. Despite this, Jamil Al Dahshan suggests that, ‘The drugs are mostly supplied by Israel, indirectly via Egypt, and the tunnels. Some drugs also come directly from Egypt. The profits temp young people, who want to get rich quick. We have caught dealers between the ages ranged from 20-23 with huge quantities of drugs and they are considered among the biggest dealers in Gaza. The Israelis are the main source of drugs to Gaza and their aim, as our evidence from official cases shows, is to flood Gaza with drugs.’

Beyond meeting with addicts, doctors and police, Aljazeera interviewed workers in the tunnels who admitted taking Tramadol to help them make it through their all night jobs. Awad also visited the Gaza central jail, in a section where 120 prisoners (users and dealers) are held on drug charges. One prisoner says he had been taking drugs for over 10 years, and first took them while working in Israel. Khalid, another addict interviewed, concludes by saying, ‘I would like to be able to stop taking drugs, because I am tired. I am depleted from the inside. I’m talking to you and all of my internal organs are at God’s mercy. Sometimes I feel that my wife will try to wake me up but I won’t wake up. I will be gone and meet God Almighty.’ Kamal, who despite the problem of social stigma is seeking regular treatment to overcome his addiction, puts a human face on the whole affair, and says that the hope lies in improving life in Gaza: ‘The first thing I wish for is a job. The second dream I have is to settle in a house of my own, that I can have a nice home to live in and to leave the Tramadol pills behind.’

‘Uncomfortably Numb’ first aired on the Aljazeera English satellite television channel in January 2010 and is currently available on the Aljazeera English website and viral media sites such as YouTube.

References

Hammami R. Voicing the Needs of Women and Men in Gaza: Beyond the aftermath of the 23 day Israeli military operations. New York: The United Nations Development Fund for Women; 2009.

Lewis KS and Han NH. Tramadol: a new centrally acting analgesic. American Journal of Health System Pharmacy 1997; 54(6): 643-52.

O'Loughlin T. Besieged and stressed Gazans fall victim to black market painkiller. The Guardian 2008; 15 December.

Bleich A, Koslowsky M, Dolev A, Lerer B. Post-traumatic stress disorder and depression. An analysis of comorbidity. The British Journal of Psychiatry 1997; 170: 479-82.

Chawla S and Pietschmann T. Drug trafficking as a transnational crime. In: Reichel P, editor. Handbook of Transnational Crime and Justice. London: Sage; 2005, p. 160-80.

[This review is by Yusef Progler and was originally published in the Journal of Research on Medical Sciences, vol. 15, no. 3, 2010.]

Notes on the BBC Feature 'How Mad Are You?'

‘How Mad Are You?’ is a two part 2008 BBC Horizon/Discovery Channel Co-Production produced and directed by Rob Liddell. The program explores the relationship between character traits and mental illness and considers the social implications of inaccurate diagnosis of the latter. Ten volunteers, five of whom have been previously diagnosed with psychiatric disorders, are observed and interviewed by a panel of three mental health experts who then venture their diagnoses. The experts include a psychiatrist, a professor of clinical psychology, and a psychiatric nurse. The volunteers and experts have no prior knowledge about one another, and were brought together for this one week study.

The program was inspired by the 1972 ‘Rosenhan Experiment,’ in which the American psychologist David Rosenhan and several associates feigned auditory hallucinations in order to have themselves admitted to psychiatric hospitals. Eight of these ‘pseudopatients’ were diagnosed with psychiatric disorders. Although they ceased displaying any symptoms once admitted to a hospital, they were detained for between 17 and 52 days. None were recognized by hospital staff. The experiment’s results, published in the journal Science in 1973, raised questions about the validity of psychiatric diagnosis.

Part One introduces the three experts and ten volunteers and explains that the goal of the study is to attempt to recognize six forms of mental illness: depression, social anxiety disorder, schizophrenia, obsessive-compulsive disorder, bipolar disorder and the eating disorders anorexia and bulimia. The panel of experts has one week of observation to identify whether or not any of the volunteers has one of these illnesses. Before beginning, the panelists discuss the insufficient time for a proper psychiatric diagnosis but appear willing to accept the challenge and lend their expertise to the study.

The ten volunteers complete a variety of tasks designed to determine symptoms of mental illness. The first task is to perform a stand up comedy routine in front of a small audience in a pub. Several of the volunteers have difficulty with this task but for the panel the results are inconclusive. As part of the study the panel makes daily predictions as to which volunteers may later be diagnosed with one or another of the six mental disorders. The second task involves problem solving skills and it utilizes the Wisconsin card sorting test for determining bipolar disorder, schizophrenia and obsessive compulsive disorder (OCD). The results are also inconclusive but the panel begins to focus attention on one of the volunteers. The third task involves cleaning up after farm animals, after which the panel is allowed to interview one volunteer. This interview yields the first clear indication that one of the volunteers may be suffering from OCD. The interview is followed by an explanation of OCD and a set of short interviews in which the volunteers are asked about their perceptions of one another.

By the end of the fourth task, designed to detect depression, the panel found that their observations contradicted earlier predictions, with the narrator noting ‘greater confusion is not what the panel was hoping for.’ As the panel will attempt their first diagnosis after the next task, they discuss their observations so far, which is made more complicated because none of the volunteers indicates the classic signs of depression. This segment is followed by background information about depression.

After the fifth task, a paintball team competition designed to display leadership and teamwork, the panel selects a single volunteer for an extended interview. They are then asked to make their first diagnosis by identifying one volunteer that they think has a mental disorder and one that appears to be normal. This segment is significant because although the conditions are not optimal for a proper psychiatric diagnosis, psychiatry is a profession and as such is expected by society to produce results. The panel takes this seriously and compares notes on the ten volunteers, because, as the narrator suggests, ‘one person here might be about to discover their mental illness marks them out from the group,’ while another person ‘could be burdened with a label of a disorder they don’t actually have.’

The panel is able to correctly identify the volunteer with OCD, based on their observation of his handling of the farm animal cleanup task, and this is followed by an enlightening discussion with the volunteer about life with OCD, in which he expresses his hope that his participation in the study can encourage other OCD sufferers to come to terms with their disorder and seek treatment. However, the panel was incorrect in their selection of a normal volunteer. Despite three days of intensive observation the panel failed to notice that this volunteer had a history of mental illness. In the follow up interview, the volunteer expresses relief that she was not identified as having a mental disorder, stating that her ‘worst fear was that I would be found out on day one,’ adding that the whole point of the program for her was to ‘show that it isn’t obvious.’ Part One concludes with the panelists reflecting on the study so far, with one expert noting that the latter case ‘refutes the argument that if you have a mental health problem, a) you can tell by looking at someone, and b) your life’s over.’ This is further amplified by the producer and director Rob Liddell, who has suggested that airing such concerns is the point of the program: ‘They all tell a powerful story, that having a mental illness doesn't have to become your defining characteristic and that it shouldn't set you apart in society.’

Part Two opens with a map orienteering task that involves running, teamwork, leadership skills and problem solving, returning to the question of whether or not difficulty with such tasks would be due to mental disorder or simply related to character traits. This again raises the point that diagnoses in this study are based only on observation and interviews over a short period of time, not on the usual clinical procedures. However, the experience remains valuable for what it can reveal about the social implications of labeling and in particular the related problem of social stigma. In fact, the issue of social stigma as the result of diagnosis (correct or incorrect) seemed to be of prime importance to some of the volunteers, while the panel of experts took risks that are potentially present for any mental health professional, that there are social implications of identifying people with disorders, for failing to recognize mental disorders, and in labeling someone with a disorder that they do not have.

The next two segments include the tasks and background information related to bipolar disorder and eating disorders, with the latter involving a body image test that reiterates one main point of the study: whether or not discomfort with a situation is an indication of mental illness. The body image test began with the participants photographing one another in tight fitting attire, followed by a computer test in which they are asked to correct a distorted body image of themselves. This leads to the next major diagnosis in the program, in which the panel correctly identifies a volunteer with anorexia nervosa, and is followed by interviews with the volunteers on life with various disorders.

Designed to test perception of self with others, one of the most interesting tasks utilizes a computer simulation to illicit paranoid reaction, featuring a virtual reality environment that simulates being on a train among strangers. All characters on the virtual train were programmed to be neutral, but volunteers were asked if any stood out or seemed to be looking at them, which was expected to help determine if any volunteers were imagining that they were being watched. This task raised questions about social exclusion versus paranoid delusion, and was followed by information on schizophrenia. The final task considered decision making by observing if any volunteers jumped to conclusions when asked from which jar different colored marbles had been drawn after being shown jars with differing amounts of each color, even though all marbles were actually drawn in the same sequence from a tray, not from the jars initially shown to the subjects. This raises valuable questions about the experimental method, because various responses were evaluated with averages and norms ultimately determining the basis for a diagnosis, as it is with most other medical professions.

After conducting another in-depth interview with a volunteer and after noting that the borderlines between mental illness and health are often arbitrary, the panellists make three wrong diagnoses in a row. They incorrectly concluded that one volunteer had bipolar disorder and another had a mood disorder (although one of these two had indeed suffered from depression), and they incorrectly concluded that one volunteer had a history of schizophrenia, while no such history existed. By the end of the study, the volunteers with OCD and an eating disorder were correctly identified, but two volunteers with mental disorders had remained undetected (those with social anxiety and bipolar disorders), and two others without disorders were wrongly identified as having disorders, while a another was diagnosed with a different disorder than the one that she actually had. In a series of follow up interviews, a few of the volunteers appear to feel vindicated by the inability of the experts to diagnose psychiatric disorders, while one of the panelists admits that ‘we have been humbled.’

Although it appears to unfairly burden the experts who are asked to diagnose with insufficient data, the program makes the broader point that if the experts cannot tell who has a mental illness and who does not through observation then certainly the public ought to refrain from making any such judgments. Perceptions and observations, whether from experts or the public, are not enough to be sure about mental illness, which often takes long term systematic evaluation to determine. At the same time there are very real and potentially damaging social implications of labeling people with a mental illness, because those who are labeled may then become stigmatized while those who are undiagnosed may be reluctant to seek help if they feel revealing their disorder will stigmatize them.

While the program readily acknowledges the limitations of short term observation, there are other equally important issues with this study that are left unacknowledged. For example, gender issues are not explored at all, which seems to be an odd exclusion since the panelists were all male and four of the five volunteers that they identified (either correctly or incorrectly) as having psychiatric disorders were women. Nevertheless, the study is useful in that it has provided insights on various mental illnesses and the diagnostic process, letting both the doctors and patients share their views openly, while its overall message of being prudent in identifying mental illness and tolerant toward those who have mental illness cannot be emphasized enough, and even needs further amplification, because labeling and social stigma remain as serious implications for all mental health practitioners.

‘How Mad Are You’ originally aired on the BBC and affiliate stations in November 2008, and is occasionally available for viewing on various viral media sites. The Rosenhan study, ‘On Being Sane In Insane Places,’ was originally published in the journal Science in January 1973 and is available online, and the quote from Rob Liddell is from his article ‘How Mad Are You?’ on the BBC News website, in its 18 November 2008 Magazine section.

[This review is by Yusef Progler and was originally published in the Journal of Research in Medical Sciences, vol. 14, no. 5, 2009.]

小米記趣～『摸蛤兼洗褲』

家裡廁所窄小，所以打從小米一出生就都在他的房間洗澡，打算當天氣漸漸炎熱後，就將洗澡的大工程移師到廁所，因為他無影腳每每都把澡盆的水花濺到四周圍濕答答。但那天因為阿母將洗澡水放好以後，去廚房10秒鐘的時間，一回到房間，居然這位小姐一副若無其事的著裝坐在澡盆裡面，阿～你那麼貼心喔，想洗澡同時幫阿母洗衣服嘛。剛溫勒-_-|||

小米心理旁白：原來穿著衣服洗澡也不賴唷～


若無其事的怡然自得！

The Nature of Tibetan Buddhist Medicine

A 2006 television documentary, ‘The Blue Buddha: Lost Secrets of Tibetan Medicine,’ introduces the Tibetan Buddhist medical tradition and the relationship between Buddhist teachings and medical knowledge, emphasizing that the founder of Buddhism considered himself as a healer, rather than as a god or a prophet, and that he presented his teachings not as doctrines but as remedies intended to heal the body and mind. These teachings form the basis of Buddhist oriented medicine today, with regional variations, and so the documentary begins by surveying its historical development in Tibet.

At an 8th century conference held in Tibet, participants from India, Nepal, Greece, Persia and China met to share their wisdom. Tibetan medicine developed as an inquisitive fusion of these traditions, filtered through the Buddhist spiritual worldview. In the 17th century, the 5th Dalai Lama oversaw the compilation of this knowledge as a series of 79 detailed paintings, which are a blend of medical knowledge and Buddhist teachings, and which serve both as an aid to learning and as an art form. Doctors who mastered this tradition at monasteries in Lhasa travelled throughout Asia spreading their wisdom. In the 20th century, Cold War politics and the Chinese occupation drove many Tibetans into exile in India. In 1961, a medical institute was established in Dharamsala, including a school and a facility to manufacture medicines.

In the Tibetan tradition, virtually anything can be used as medicine and the healing process is usually understood as a collaboration between doctor and patient. Ailments are treated according to methods involving correct diet and behavior, and making use of natural medicine and accessory therapies such as massage and acupuncture. Medicinal compounds made from plants and minerals are stored in a visual encyclopedia along with other aspects of the tradition. A diagnostic painting, for example, depicts a tree with three branches, illustrating the diagnostic technique with its emphasis on touch and pulse taking, and the practice of gaining intimate knowledge of the patient through interviews and questioning.

Along with surveying Tibetan medicine, the documentary emphasizes dialog. Tibetan medicine is forward looking, as suggested by Dorje Dawa, a doctor at the Tibetan Medical and Astrological Institute in Dharamsala, who says that, ‘We cannot be content just to say that Tibetan medicine is one of the most ancient systems of healing. We need to interact with modern medicine so we can authentic our results and cross reference our diagnoses and treatments to correct inaccuracies. That does not mean we should lose our identity in trying to imitate Western medicine. We need to create dialog with Western science.’ Such a dialog would have to recognize the strengths of each tradition, as Dr. Dawa continues, ‘Western medicine is good for acute ailments and for emergency cases, as when there are traumatic injuries, whereas Tibetan medicine is good for long standing conditions or chronic diseases. Its particular strength is getting at the root cause of diseases, rather than masking or just treating the symptoms.’

While Western medicine and science tend to have an uneasy, if not hostile, relationship with religion and spiritual knowledge, in the Tibetan tradition the two work hand in hand. Tibetan doctors have a detailed knowledge of plant habitat and medical uses, for anything ranging from tonics and sedatives to anti-viral compounds, and they learn to combine plants and minerals in myriad ways to treat various diseases. However, these compounds are activated by a series of ritual prayers, some taking months to complete, which energize the medical compounds to do their healing. Another important difference is that death is not seen as a failure of treatment. Instead, according to Buddhist eschatology, death is seen as an awakening from the dream of life, and so part of the role of the Tibetan doctor is to help a patient recognize that death is near and to assist in the preparation for the passage from life, rather than frantically clinging to life.

The ‘Blue Buddha’ also features a profile of Tuvan Dorzhi Radnayevich, a Buddhist monk and doctor of Tibetan medicine who works in Ulan Ude, the capital city of Buryatia, a Russian republic in southern Siberia. Known in the local community as Tuvan Lama, he is shown receiving visitors at his clinic, making house calls and providing various community services. Returning to the theme of dialog, Tuvan Lama suggests, ‘It is not that we ignore modern Western medicine. They have their own excellent aspects, such as surgical treatments and computer analysis. They can be very effective and we can make use of them. In the future I hope we can combine the good points of Western medicine and traditional Buddhist medicine.’

By inserting several calls to dialog within a general overview of Tibetan medicine, the producers seem to be suggesting that the key to dialog between the Tibetan Buddhist and modern Western traditions of medicine is an independent and rigorous training in and acceptance of the Buddhist tradition on its own terms, rather than as a supplement to the Western training. While admirable, this overlooks another crucial aspect of dialog, which is to move the dialog beyond Western medicine, and to create many dialogs among medical traditions of the world, such as the Ayurvedic system of India or the Islamic tradition.

‘The Blue Buddha – Lost Secrets of Tibetan Medicine’ is a Canada/Japan co-production directed by Aerlyn Weissman and Tetsuya Itano, produced in 2006 in association with the Canadian Broadcasting Corporation and the Japan Broadcasting Corporation. It is currently available on Google Video.

[This review is by Yusef Progler and was originally published in the Journal of Research on Medical Sciences, vol. 13, no. 2, 2008.]

小米記趣～『很有型頭毛二』

又是某天睡醒時頭毛又自動sedo好的一個新造型！

Healing Arts in an Ancient Indian Tradition

‘Ayurveda: Art of Being,’ a 2001 documentary film by Pan Nalin, opens with an elderly man collecting and washing plants by a riverside, begging pardon from the Lord for uprooting them, saying that they are necessary for medicine. That single scene encapsulates the main message of this film, echoing Hindu cosmology, that for Ayurveda ‘everything in and around us are one and single existence.’ Dr G. Gangadharan of the Medicinal Plant Conservation Centre in Kerala, India, elaborates on this principle: ‘The microcosm, the body in which we are living, or that of all the living beings, and the macrocosm around us, are all part of one unit. And the role of the physician is merely the role of a conveyer belt between these two, where he may be processing something so that the body can easily assimilate it. Other than that, there is nothing. He is doing nothing other than substituting things which are lacking in the system by things which are available externally.’

The term Ayurveda broadly refers to the ancient Hindu medical system, recorded in texts dating back three thousand years and divided into eight branches that correspond roughly to internal or general medicine, pediatrics, psychiatry, ear, nose and throat, surgery, toxicology, geriatrics and rejuvenation. The earliest texts refer to what would be recognized today as brain research, noting the neurological qualities of health and disease. The ancient corpus was redacted by Charaka in around 300BCE, which provides a codified basis for the continuity of the tradition to the present.

Ayurvedic medicine proceeds from five bodily elements arranged according to three energies: 1) space and air, with the basic quality of movement, 2) fire, with the basic quality of heat, and 3) water and earth, with the basic quality of fluidity. In diagnosing a patient, the physician will take pulses for these three energies on the nerves of the thumb, index and middle fingers, and supplement this with careful examination of the fingernails, which indicate blood flow, and the eyes, which reflect disease and constitution. In addition to demonstrating diagnosis, the film features treatment sessions in which therapies ranging from massage to purging are utilized.

The intimate contact with each patient, from diagnosis through treatment, is underlined by a basic principle, as stated by Ayurvedic physician Brahmanand Swamigal, who insists that, ‘I do not treat diseases, I treat people.’ The film profiles Swamigal, observing his practice and learning something of his training. From a long lineage of fourteen generations of Ayurvedic physicians, he began studying with his father at age thirteen and continued to study throughout his 55 year career, having learned specializations from 20 gurus, or masters, who used poetry as a way to aid in learning the medical principles and formulas. Many of these gurus are now deceased, perhaps pointing to the fragility of a trans-generational master-student tradition, but which is nevertheless necessary to interpret and pass on the interwoven ancient wisdoms to the younger generations.

The moral implications of the Ayurvedic tradition are explored by Brahmanand Swamigal, who suggests that ‘if science is only followed for money, it is wasted’ and that ‘wealth earned from medical sciences is always contaminated as it comes from the suffering of others, thus it must be practiced with compassion and humility, and without greed or ego.’ To demonstrate this, the film takes viewers into a free clinic in rural India, and in a section discussion training of practioners, it is suggested that before entering into a course of medical study or apprenticeship in Ayurvedic traditions, students are screened to be certain they can conform to these basic moral principles.

Throughout the film, several cases are presented in which Ayurvedic and Western traditions are compared. In a demonstration of treatment for diabetic retinitis, for example, Dr B.G. Gokulan, a practioner of Ayurvedic opthamology, notes that the Ayurvedic tradition is more concerned with treating the cause of disease, not just the symptoms. For treating schizophrenia and other mental illnesses, Ayurvedic approaches work to awaken the mind by removing toxins from the body, while the main approach in Western medicine aims to quiet the mind by prescribing sedatives.

Practioners of Ayurvedic medicine outside India are profiled in several case studies, such as at the Holistic Health Centre in Athens, Greece, where Dr Nicolos Kostopoulos applies Ayurvedic principles and methods, including yoga and herbal treatments, to help provide relief for his patients from the stresses of the modern lifestyle. Dr Scott Gerson, a physician at the National Institute of Ayurvedic Medicine New York, discusses questions about adopting the ancient Ayurvedic traditions to modern society, where people are more interested in instant results and shortcuts. Over the twenty years of his practice, he has come to that conclusion that, ‘what we are missing in modern society is being in harmony with the rhythms of nature’ and that many of the diseases of modern society are those of over-consumption, which need a lifestyle change.

Several sections of the film demonstrate the laborious procedures for collecting and preparing the natural ingredients, from minerals and plants, into various Ayurvedic compounds, some of which involve the use of gems and other precious stones integrated with astronomical data. In the end, however, Ayurveda is not merely a system of medicines and treatments. Rather, as Dr Ashwin Barot says, ‘Ayurveda is the art of living, how to live, and Ayurveda is the art of being.’

‘Ayurveda: Art of Being’ was produced by Pandora Films in association with Monsoon Films. Further information is available on the filmmaker's website and the film can be watched in 7 parts on YouTube.]

[This review is by Yusef Progler and originally appeared in the Journal of Research in Medical Sciences, vol. 13, no. 3, 2008.]