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	<title>Alstonville Clinic</title>
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	<link>http://alstonvilleclinic.com.au</link>
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		<title>Changing Priorities</title>
		<link>http://alstonvilleclinic.com.au/2013/04/08/changing-priorities/</link>
		<comments>http://alstonvilleclinic.com.au/2013/04/08/changing-priorities/#comments</comments>
		<pubDate>Mon, 08 Apr 2013 12:43:02 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2013/04/08/changing-priorities/</guid>
		<description><![CDATA[A group of 40-year-old buddies discuss where they should have dinner. Finally it is agreed that they should meet at Mario&#8217;s restaurant because the waitresses there have low-cut blouses and nice breasts. &#160; Ten years later, at 50 years of age, the group meets again and once again they discuss where they should have dinner. [...]]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<p><div class='p_embed p_image_embed'> <img alt="Marios" height="225" src="http://getfile2.posterous.com/getfile/files.posterous.com/temp-2013-04-08/mvjocIymIgehhGAzyqmjtxysofprtekEDCeHqCkeACGjgbjgbrjljhbJlfia/marios.jpg" width="400" /> </div>
<p> A group of 40-year-old buddies discuss where they should have dinner. Finally it is agreed that they should meet at Mario&#8217;s restaurant because the waitresses there have low-cut blouses and nice breasts.</p>
<p>&nbsp;</p>
<p>Ten years later, at 50 years of age, the group meets again and once again they discuss where they should have dinner. Finally it is agreed upon that they should meet at Mario&#8217;s because the food
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<p> there is very good and the wine selection is good also.</p>
<p>&nbsp;</p>
<p>Ten years later, at 60 years of age, the group meets again and once again they discuss where they should have dinner. Finally it is agreed upon that they should meet at Mario&#8217;s because they can eat there in peace and quiet and the restaurant is smoke free.</p>
<p>&nbsp;</p>
<p>Ten years later, at 70 years of age, the group meets again and once again they discuss where they should have dinner. Finally it is agreed upon that they should meet at Mario&#8217;s because the restaurant is wheel chair accessible and they even have an elevator.</p>
<p>&nbsp;</p>
<p>Ten years later, at 80 years of age, the group meets again and once again they discuss where they should have dinner.. Finally it is agreed upon that they should meet at Mario&#8217;s because they have never been there before</p>
</p>
<p>&nbsp;</p>
<p>Hat tip to B.</p>
</div>
]]></content:encoded>
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		</item>
		<item>
		<title>Alfabeto Medico</title>
		<link>http://alstonvilleclinic.com.au/2013/03/25/alfabeto-medico/</link>
		<comments>http://alstonvilleclinic.com.au/2013/03/25/alfabeto-medico/#comments</comments>
		<pubDate>Mon, 25 Mar 2013 10:43:23 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2013/03/25/alfabeto-medico/</guid>
		<description><![CDATA[Will sent me this viagra generic and seemed to think it was amusing. Looks perfectly fine to me.]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<p>Will sent me this
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<p> and seemed to think it was amusing.</p>
<p><div class='p_embed p_image_embed'> <img alt="Pastedgraphic-1" height="641" src="http://getfile5.posterous.com/getfile/files.posterous.com/temp-2013-03-25/bdHBwwoxfIuhHlCmraJcJbFAEjxDGDqDHEkhdbmbiswxuIDafroAAJiDrICB/PastedGraphic-1.tiff.scaled1000.jpg" width="460" /> </div>
<p> Looks perfectly fine to me.</p>
</div>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Untitled</title>
		<link>http://alstonvilleclinic.com.au/2013/03/05/untitled/</link>
		<comments>http://alstonvilleclinic.com.au/2013/03/05/untitled/#comments</comments>
		<pubDate>Tue, 05 Mar 2013 09:14:03 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2013/03/05/untitled/</guid>
		<description><![CDATA[You may never look at a can of Coca-Cola in the same way again after reading What Coke Contains by Kevin Ashton. The manufacture of a can of Coke begins in Pinjarra, Western Australia and ends in your local corner store via Greenland, Atlanta, Africa and South America.&#8221;The number of individuals who know how to [...]]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<div class='p_embed p_image_embed'> <a href="http://getfile6.posterous.com/getfile/files.posterous.com/lemlink/miDmmdwJhoeBjDJumDnygavnaCDmmtsiywnAikbhjrgdathkzJvomgkyJofu/p301.jpg.scaled1000.jpg"><img alt="P301" height="480" src="http://getfile6.posterous.com/getfile/files.posterous.com/lemlink/miDmmdwJhoeBjDJumDnygavnaCDmmtsiywnAikbhjrgdathkzJvomgkyJofu/p301.jpg.scaled1000.jpg" width="640" /></a> </div>
</p>
<p>You may never look at a can of Coca-Cola in the same way again after reading <a href="https://medium.com/editors-picks/221d449929ef">What Coke Contains</a> by Kevin Ashton.
<p>The manufacture of a can of Coke begins in Pinjarra, Western Australia and ends in your local corner store via Greenland, Atlanta, Africa and South America.&#8221;The number of individuals who know how to make a can of Coke is zero. The number of individual nations that could produce a can of Coke is zero. This famously American product is not American at all. Invention and creation is something we are all in together. </p>
<p>Modern tool chains are so long and complex that they bind us into one people and one planet. They are not only chains of tools, they are also chains of minds: local and foreign, ancient and modern, living and dead — the result of disparate invention and intelligence distributed over time and space. </p>
<p>Coca-Cola did not teach the world to sing, no matter what its commercials suggest, yet every can of Coke contains humanity’s choir.&#8221;</p>
</div>
]]></content:encoded>
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		<item>
		<title>Are you an Aussie?</title>
		<link>http://alstonvilleclinic.com.au/2013/01/26/are-you-an-aussie/</link>
		<comments>http://alstonvilleclinic.com.au/2013/01/26/are-you-an-aussie/#comments</comments>
		<pubDate>Sat, 26 Jan 2013 01:42:54 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2013/01/26/are-you-an-aussie/</guid>
		<description><![CDATA[Here are Richard Glover&#8217;s 43 top ways to tell if you&#8217;re a local. You know you&#8217;re Australian if &#8230; 1. You know the meaning of the word &#8220;girt&#8221;. 2. You believe that stubbies can be either drunk or worn. 3. You think it&#8217;s normal to have a Treasurer called Wayne. 4. You waddle when you [...]]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<p>Here are Richard Glover&#8217;s 43 top ways to tell if you&#8217;re a local.</p>
<div class='p_embed p_image_embed'> <img alt="Les_paterson" height="225" src="http://getfile0.posterous.com/getfile/files.posterous.com/temp-2013-01-25/trrwzfyyBsIjFuykpehoxvckmwptqzEHAuzihhJBdfaJvfzCoBktIvrmmjqw/les_paterson.jpg" width="300" /> </div>
<p>You know you&#8217;re Australian if &#8230;</p>
<p>1. You know the meaning of the word &#8220;girt&#8221;.</p>
<p>2. You believe that stubbies can be either drunk or worn.</p>
<p>3. You think it&#8217;s normal to have a Treasurer called Wayne.</p>
<p>4. You waddle when you walk due to the 53 expired petrol discount vouchers stuffed in your wallet or purse.</p>
<p>5. You&#8217;ve made a bong out of your garden hose rather than use it for something illegal such as watering the garden.</p>
<p>6. You believe it is appropriate to put a rubber in your son&#8217;s pencil case when he first attends school.</p>
<p>7. When you hear that an American &#8220;roots for his team&#8221; you wonder how often and with whom.</p>
<p>8. You understand that the phrase &#8220;a group of women wearing black thongs&#8221; refers to footwear and may be less alluring than it sounds.</p>
<p>9. You pronounce Melbourne as &#8220;Mel-bin&#8221;.</p>
<p>10. You pronounce Penrith as &#8220;Pen-riff&#8221;.</p>
<p>11. You believe the &#8220;l&#8221; in the word &#8220;Australia&#8221; is optional.</p>
<p>12. You can translate: &#8220;Dazza and Shazza played Acca Dacca on the way to Maccas.&#8221;</p>
<p>13. You believe it makes perfect sense for a nation to decorate its highways with large fibreglass bananas, prawns and sheep.</p>
<p>14. You call your best friend &#8220;a total bastard&#8221; but someone you really, truly despise is just &#8220;a bit of a bastard&#8221;.</p>
<p>15. You think &#8220;Woolloomooloo&#8221; is a perfectly reasonable name for a place.</p>
<p>16. You&#8217;re secretly proud of our killer wildlife.</p>
<p>17. You believe it makes sense for a country to have a $1 coin that&#8217;s twice as big as its $2 coin.</p>
<p>18. You understand that &#8220;Wagga Wagga&#8221; can be abbreviated to &#8220;Wagga&#8221; but &#8220;Woy Woy&#8221; can&#8217;t be called &#8220;Woy&#8221;.</p>
<p>19. You believe that cooked-down axlegrease makes a good breakfast spread.</p>
<p>20. You believe all famous Kiwis are actually Australian, until they stuff up, at which point they again become Kiwis.</p>
<p>21. Hamburger. Beetroot. Of course.</p>
<p>22. You know that certain words must, by law, be shouted out during any rendition of the Angels&#8217; song Am I Ever Gonna See Your Face Again.</p>
<p>23. You believe, as an article of faith, that the confectionary known as the Wagon Wheel hasbecome smaller with every passing year.</p>
<p>24. You still don&#8217;t get why the &#8220;Labor&#8221; in &#8220;Australian Labor Party&#8221; is not spelt with a &#8220;u&#8221;.</p>
<p>25. You wear ugh boots outside the house.</p>
<p>26. You believe, as an article of faith, that every important discovery in the world was made by an Australian but then sold off to the Yanks for a pittance.</p>
<p>27. You believe that the more you shorten someone&#8217;s name the more you like them.</p>
<p>28. Whatever your linguistic skills, you find yourself able to order takeaway fluently in every Asian language.</p>
<p>29. You understand that &#8220;excuse me&#8221; can sound rude, while &#8220;scuse me&#8221; is always polite.</p>
<p>30. You know what it&#8217;s like to swallow a fly, on occasion via your nose.</p>
<p>31. You understand that &#8220;you&#8221; has a plural and that it&#8217;s &#8220;youse&#8221;.</p>
<p>32. You know it&#8217;s not summer until the steering wheel is too hot to handle.</p>
<p>33. Your biggest family argument over the summer concerned the rules for beach cricket.</p>
<p>34. You shake your head in horror when companies try to market what they call &#8220;Anzac cookies&#8221;.</p>
<p>35. You still think of Kylie as &#8220;that girl off Neighbours&#8221;.</p>
<p>36. When returning home from overseas, you expect to be brutally strip-searched by Customs &#8211; just in case you&#8217;re trying to sneak in fruit.</p>
<p>37. You believe the phrase &#8220;smart casual&#8221; refers to a pair of black tracky-daks, suitably laundered.</p>
<p>38. You understand that all train timetables are works of fiction.</p>
<p>39. When working on a bar, you understand male customers will feel the need to offer an excuse whenever they order low-alcohol beer.</p>
<p>40. You get choked up with emotion by the first verse of the national anthem and then have trouble remembering the second.</p>
<p>41. You find yourself ignorant of nearly all the facts deemed essential in the government&#8217;s new test for migrants.</p>
<p>42. You know, whatever the tourist books say, that no one says &#8220;cobber&#8221;.</p>
<p>43. And you will immediately forward this list to other Australians, here and overseas, realising that only they will understand.</p>
<p>Happy Australia Day.</p>
<p><em>First published in the Sydney Morning Herald, January 26, 2008.</em></p>
</p>
</div>
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		</item>
		<item>
		<title>Which of today&#039;s ads will make our grandchildren laugh?</title>
		<link>http://alstonvilleclinic.com.au/2013/01/22/which-of-todays-ads-will-make-our-grandchildren-laugh/</link>
		<comments>http://alstonvilleclinic.com.au/2013/01/22/which-of-todays-ads-will-make-our-grandchildren-laugh/#comments</comments>
		<pubDate>Tue, 22 Jan 2013 02:58:51 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2013/01/22/which-of-todays-ads-will-make-our-grandchildren-laugh/</guid>
		<description><![CDATA[They just don&#8217;t make ads like these anymore (apart from ads for margarine, vitamins, laundry detergents,beer, departments trusted tablets stores,bras &#8230;..) See the full gallery on Posterous I wonder which of our current advertisements will be laughed at by our grandchildren. Cars? Petrol? CDs? iPads? Plane travel? Hat tip to Brendan and Tanya]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<p>They just don&#8217;t make ads like these anymore (apart from ads for margarine, vitamins, laundry detergents,beer, departments
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<p> stores,bras &#8230;..)</p>
<p><div class='p_embed p_image_embed'> <img alt="Att00243" height="640" src="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2013-01-21/scBdDkwtFbwycCzaCfsDnIjpfidHtkxdtGpCaGCdgqcHEehjgGDochAmDkrj/ATT00243.jpg.scaled1000.jpg" width="359" /> <img alt="Att00222" height="458" src="http://getfile0.posterous.com/getfile/files.posterous.com/temp-2013-01-21/cAFleDrAaCkmJGgjmfofihAqaIdIrAshkqjsCEdHsiAEGhjuBngflvyewgIx/ATT00222.jpg" width="480" /> <img alt="Att00225" height="600" src="http://getfile2.posterous.com/getfile/files.posterous.com/temp-2013-01-21/sGfBueFzieHlvIhHaolomqnCvzjmcoHtEGtqrlyuBmdhyuevqfmnBAdGGlro/ATT00225.jpg.scaled1000.jpg" width="480" /> <img alt="Att00228" height="484" src="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2013-01-21/jlhnzGgpgwahbrIBdIvmHCFkbxevvHDorjrzraIqhuDzqCEBGtvbybAIEeAF/ATT00228.jpg" width="369" /> <img alt="Att00231" height="484" src="http://getfile1.posterous.com/getfile/files.posterous.com/temp-2013-01-21/EtybGqHcAitCyiCcuipHqGbChBizvvjpjhnAGDkCbaExufJtxvbglyxDbugq/ATT00231.jpg" width="385" /> <img alt="Att00234" height="274" src="http://getfile5.posterous.com/getfile/files.posterous.com/temp-2013-01-21/JbxlobuAadhDzckusgbFefqsjunhtvrIufbkeBpFJrlywxEoJjvedfBuEDBd/ATT00234.jpg" width="353" /> <img alt="Att00237" height="484" src="http://getfile1.posterous.com/getfile/files.posterous.com/temp-2013-01-21/FhjirHDFExepxwDaCsmGjowjupzGDpiDwfeaezreceFxIiBkuuIDFGElwwdv/ATT00237.jpg" width="364" /> <img alt="Att00240" height="640" src="http://getfile6.posterous.com/getfile/files.posterous.com/temp-2013-01-21/xktzCAaxHGzDnkrfbygcjEGivxBjpFyEcDyzjIgafdvwfJAftpiefziFHFog/ATT00240.jpg.scaled1000.jpg" width="439" /> <img alt="Att00210" height="310" src="http://getfile7.posterous.com/getfile/files.posterous.com/temp-2013-01-21/fjGmrznFEDzwesflnllAlodJGmvjbAswrDfpjcsCECihxrnsmfDfpqzEbIlC/ATT00210.jpg.scaled1000.jpg" width="590" /> <img alt="Att00213" height="569" src="http://getfile8.posterous.com/getfile/files.posterous.com/temp-2013-01-21/BAmkJtEvFEwloCleuCeuajyiendyCgsfBuodwvycfbCxBobypsibItaBitHH/ATT00213.jpg.scaled1000.jpg" width="480" /> <img alt="Att00216" height="640" src="http://getfile6.posterous.com/getfile/files.posterous.com/temp-2013-01-21/FwbuqCJvjsghtvtreHBdbJyoHEgafpGCqEweDElcqeDBIuJsDJFqxwpHhcfx/ATT00216.jpg.scaled1000.jpg" width="444" /> <img alt="Att00219" height="597" src="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2013-01-21/HewiAansoJjzoIzqCBrIiektqJdygFdJtxwHAffebyanfFcdFBDmoxmqEqvm/ATT00219.jpg.scaled1000.jpg" width="480" /> <img alt="Att00195" height="552" src="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2013-01-21/roknvvEasmaFFbeqzkmiaHofzkskmGpyFFochfikeIhhCyJirvEEeEEBGxlx/ATT00195.jpg.scaled1000.jpg" width="480" /> <img alt="Att00198" height="631" src="http://getfile2.posterous.com/getfile/files.posterous.com/temp-2013-01-21/dHbBDBpJfejnhhDCzhovxrArAnCmalkzHrhrCEFheEkntlydsIcvakAajekH/ATT00198.jpg.scaled1000.jpg" width="480" /> <img alt="Att00201" height="483" src="http://getfile6.posterous.com/getfile/files.posterous.com/temp-2013-01-21/vqrDmAsoBdcmphFqIbtIFBFmbGxdBJcFrAocpiBJazjntlBsIpzDIFhtshvJ/ATT00201.jpg" width="480" /> <img alt="Att00204" height="540" src="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2013-01-21/pbtHtHEbwvFhsFnzdoEGmdlacaIBDxmzfyJnwrrwHJFGeswHayenvnjjecrl/ATT00204.jpg.scaled1000.jpg" width="480" /> <img alt="Att00207" height="564" src="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2013-01-21/lqdqfjchxvcmapBucxjjdFEilaoIqcHdlsunbBHFqAldzAgowlgpxitCmDDi/ATT00207.jpg.scaled1000.jpg" width="480" /></p>
<div class='p_see_full_gallery'><a href="http://whatilearnttoday.com.au/which-of-todays-ads-will-make-our-grandchildr">See the full gallery on Posterous</a></div>
</p>
</div>
<p>I wonder which of our current advertisements will be laughed at by our grandchildren.</p>
<p>Cars? Petrol? CDs? iPads? Plane travel?</p>
<p>Hat tip to Brendan and Tanya</p>
</p>
</div>
]]></content:encoded>
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		<slash:comments>0</slash:comments>
		</item>
		<item>
		<title>Quora : A Happier New Year?</title>
		<link>http://alstonvilleclinic.com.au/2013/01/01/quora-a-happier-new-year/</link>
		<comments>http://alstonvilleclinic.com.au/2013/01/01/quora-a-happier-new-year/#comments</comments>
		<pubDate>Tue, 01 Jan 2013 22:07:51 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2013/01/01/quora-a-happier-new-year/</guid>
		<description><![CDATA[How can you have a happier 2013? Perhaps you cpuld ask Quora. Quora is a question and&#160;answer website &#8211; ask a question, and the &#8216;crowd&#8217; answers. Users can vote for the best answers, promoting them up the list, as well as editing other peoples answers to pharmacie en ligne viagra get the most correct response. [...]]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<div class='p_embed p_image_embed'> <img alt="Quora" height="250" src="http://getfile4.posterous.com/getfile/files.posterous.com/temp-2013-01-01/fasnFgxFCuyDksuzFvulpBIyEfIFADehcvznudgropaaCFvekiazAGwaiDGC/quora.png" width="250" /> </div>
</p>
<p>How can you have a happier 2013?</p>
<p>Perhaps you cpuld ask Quora.</p>
<p>Quora is a question and&nbsp;answer website &#8211; ask a question, and the &#8216;crowd&#8217; answers. Users can vote for the best answers, promoting them up the list, as well as editing other peoples answers to
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<p> get the most correct response.</p>
<blockquote class="posterous_medium_quote"><p>Quora is a continually improving collection of questions and answers created, edited, and organized by everyone who uses it. The most important thing is to have each question page become the best possible resource for someone who wants to know about the question.</p>
</blockquote>
<p>Quora was launched by two former Facebook employees in June 2010, and has had tremendous growth, with millions of regular users.</p>
<p>Questions span an enormous range of topics &#8211; from the very prosaic to the very philosophical. What distinguishes it from other similar sites is the calibre of the people who answer &nbsp;-often scientists, doctors, executives, actors, academics &#8211; people who would know.</p>
<p><a href="http://www.quora.com/Elevators/What-happens-if-the-cable-supporting-moving-an-elevator-is-cut-fails-or-breaks">What happens if the cable holding an elevator is cut?</a>&nbsp;was answwered by someone from the legal firm for Otis elevators.</p>
<p><a href="http://www.quora.com/Wreck-It-Ralph-2012-movie/How-did-Disney-get-all-the-intellectual-property-licenses-for-all-the-video-game-characters-used-in-Wreck-It-Ralph">How did Disney get all the intellectual property licenses for all the video game characters used in Wreck-It-Ralph?</a>&nbsp;was answered by Rich Moore,the director of the movie.</p>
<p><a href="http://www.quora.com/How-would-you-define-English-humour">How would you define English humour?</a>&nbsp;was answered by Stephen Fry</p>
<p>The best way to use Quora is to sign up for a weekly email newsletter on topics of interest to you, or use the <a href="https://itunes.apple.com/au/app/quora/id456034437?mt=8&amp;uo=4" target="itunes_store">The iPhone App</a>.</p>
<p>Here is a Quora question to help with new years resolutions.</p>
<p><a href="http://www.quora.com/Happiness/To-be-happier-whats-the-smallest-simplest-thing-an-average-person-could-do">To be happier, what&#8217;s the smallest, simplest thing an average person could do?</a></p>
<p>1964 votes for:</p>
<p>&nbsp;</p>
<p>Rule: When I arrive home from work, the very first thing I tell my wife is the best thing that happened that day.&nbsp;</p>
<p>No exceptions. No complaining. Just the best thing that day, even if it was just a good cup of coffee. This had the effect of starting our evening off on a positive note and it changed our relationship.</p>
<p>&nbsp;</p>
<p>Other high scoring answers &#8211; get more sleep, exercise, and assume positive intent by others.</p>
<p>Sounds like a good start.</p>
<p>&nbsp;</p>
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		<title>The More Things Change &#8211; Deja Vu 2012</title>
		<link>http://alstonvilleclinic.com.au/2012/12/20/the-more-things-change-deja-vu-2012/</link>
		<comments>http://alstonvilleclinic.com.au/2012/12/20/the-more-things-change-deja-vu-2012/#comments</comments>
		<pubDate>Thu, 20 Dec 2012 12:50:08 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2012/12/20/the-more-things-change-deja-vu-2012/</guid>
		<description><![CDATA[The photo editor of Time Magazine calls&#160;2012 &#8216;A year of Deja Vu&#8217;. &#160; Photos can be eerily simililar, even when taken a year apart. Time Lightbox faetures a&#160;series of such similar photos. &#160;]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<p>The photo editor of Time Magazine calls&nbsp;<a href="http://lightbox.time.com/2012/12/18/2012-a-year-of-deja-vu/">2012 &#8216;A year of Deja Vu&#8217;.</a></p>
<p>&nbsp;</p>
<p>Photos can be eerily simililar, even when taken a year apart.</p>
<p>
<div class='p_embed p_image_embed'> <a href="http://getfile7.posterous.com/getfile/files.posterous.com/temp-2012-12-20/wHtDlfahgndaBBGGnjEwBgFBzClrhIkJthrhjIyGmknwHaiECozvvDzoydcf/deja_vu1.png.scaled1000.png"><img alt="Deja_vu1" height="262" src="http://getfile7.posterous.com/getfile/files.posterous.com/temp-2012-12-20/wHtDlfahgndaBBGGnjEwBgFBzClrhIkJthrhjIyGmknwHaiECozvvDzoydcf/deja_vu1.png.scaled1000.png" width="756" /></a> </div>
</p>
<div>
<div class='p_embed p_image_embed'> <a href="http://getfile1.posterous.com/getfile/files.posterous.com/temp-2012-12-20/CuyceGoheICfipgjrmsgbxAoykrajotddukpflIniqaGHugClDjydBvFbmji/deja_vu3.png.scaled1000.png"><img alt="Deja_vu3" height="272" src="http://getfile1.posterous.com/getfile/files.posterous.com/temp-2012-12-20/CuyceGoheICfipgjrmsgbxAoykrajotddukpflIniqaGHugClDjydBvFbmji/deja_vu3.png.scaled1000.png" width="758" /></a> </div>
<div class='p_embed p_image_embed'> <a href="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2012-12-20/ugtFCDAbvwHgnFmHhIiFdrJocltbomnxhxukaiJlhnFyhuiiwgyquCmbCdlj/deja_vu2.png.scaled1000.png"><img alt="Deja_vu2" height="262" src="http://getfile9.posterous.com/getfile/files.posterous.com/temp-2012-12-20/ugtFCDAbvwHgnFmHhIiFdrJocltbomnxhxukaiJlhnFyhuiiwgyquCmbCdlj/deja_vu2.png.scaled1000.png" width="756" /></a> </div>
<p />
<p>Time Lightbox faetures a&nbsp;<a href="http://lightbox.time.com/2012/12/18/2012-a-year-of-deja-vu/">series of such similar photos.</a></p>
<p>&nbsp;</p>
</p></div>
</div>
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		<title>New Recommendations on Ischaemic Heart Disease</title>
		<link>http://alstonvilleclinic.com.au/2012/11/25/new-recommendations-on-ischaemic-heart-disease/</link>
		<comments>http://alstonvilleclinic.com.au/2012/11/25/new-recommendations-on-ischaemic-heart-disease/#comments</comments>
		<pubDate>Sun, 25 Nov 2012 11:26:09 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2012/11/25/new-recommendations-on-ischaemic-heart-disease/</guid>
		<description><![CDATA[Ischemic Heart Disease: New Recommendations Issued on Primary Care Evaluation, ManagementGuidelines on the evaluation and management of stable ischemic heart disease in the primary care setting have been issued by the American College of Physicians in conjunction with several other organizations. The guidelines on evaluation stress the importance of making patients&#8217; preferences a part of [...]]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<p>Ischemic Heart Disease: New Recommendations Issued on Primary Care Evaluation, ManagementGuidelines on the evaluation and management of stable ischemic heart disease in the primary care setting have been issued by the American College of Physicians in conjunction with several other organizations.</p>
<p>The guidelines on evaluation stress the importance of making patients&#8217; preferences a part of the decision on further testing.</p>
<p>The guidelines include algorithms for diagnosis and risk assessment.</p>
<p>The management guidelines also stress the patient &mdash; especially patients&#8217; understanding of their condition and the importance of adhering to treatment regimens and lifestyle changes. Algorithms are also given to
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<p> guide decision making on revascularization for the purposes of improving symptoms and survival.  (A similar set of guidelines is published today in a different form in the Journal of the American College of Cardiology.)</p>
<p><a href="http://annals.org/article.aspx?articleid=1392193"> Annals of Internal Medicine article on evaluation</a> (Free)</p>
<p><a href="http://annals.org/article.aspx?articleid=1392195">Annals of Internal Medicine article on management</a> (Free)</p>
<p><a href="http://content.onlinejacc.org/article.aspx?articleid=1391404"> JACC guidelines</a> (Free abstract)</p>
<p>via&nbsp;<a href="http://jwatch.org">Journal Watch</a></p>
</div>
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		<title>Fasting for Lipid tests</title>
		<link>http://alstonvilleclinic.com.au/2012/11/13/fasting-for-lipid-tests/</link>
		<comments>http://alstonvilleclinic.com.au/2012/11/13/fasting-for-lipid-tests/#comments</comments>
		<pubDate>Tue, 13 Nov 2012 12:19:03 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2012/11/13/fasting-for-lipid-tests/</guid>
		<description><![CDATA[&#8220;The incremental gain in information of a fasting profile is exceedingly small for total and HDL cholesterol values and likely does not offset the logistic impositions placed on our patients, the laboratories, and cheap cialis our ability to provide timely counseling to our patients. This, in my opinion, tips the balance toward relying on nonfasting [...]]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>&#8220;The incremental gain in information of a fasting profile is exceedingly small for total and HDL cholesterol values and likely does not offset the logistic impositions placed on our patients, the laboratories, and
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<p> our ability to provide timely counseling to our patients. This, in my opinion, tips the balance toward relying on nonfasting lipid profiles as the preferred practice&#8221;</p>
<p><a href="http://archinte.jamanetwork.com/article.aspx?articleid=1391012">http://archinte.jamanetwork.com/article.aspx?articleid=1391012</a></p>
</div>
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		<title>Comparison of Basal-Bolus and Premixed Insulin Regimens &#8211; General Medicine</title>
		<link>http://alstonvilleclinic.com.au/2012/10/29/comparison-of-basal-bolus-and-premixed-insulin-regimens-general-medicine/</link>
		<comments>http://alstonvilleclinic.com.au/2012/10/29/comparison-of-basal-bolus-and-premixed-insulin-regimens-general-medicine/#comments</comments>
		<pubDate>Mon, 29 Oct 2012 11:38:06 +0000</pubDate>
		<dc:creator>Tony Lembke</dc:creator>
				<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://alstonvilleclinic.com.au/2012/10/29/comparison-of-basal-bolus-and-premixed-insulin-regimens-general-medicine/</guid>
		<description><![CDATA[Clinicians sometimes prescribe twice-daily premixed 75/25 or 70/30 insulin, on the premise that some diabetic patients find two injections more acceptable than three or four injections daily. In this crossover study (funded by the maker of glargine [Lantus] and glulisine [Apidra] insulins), researchers compared basal-bolus and premixed regimens among 388 insulin-treated diabetic patients. Most participants [...]]]></description>
			<content:encoded><![CDATA[<div class='posterous_autopost'>
<div class="posterous_bookmarklet_entry">
<blockquote>
<div>
<p>Clinicians sometimes prescribe twice-daily premixed 75/25 or 70/30 insulin, on the premise that some diabetic patients find two injections more acceptable than three or four injections daily. In this crossover study (funded by the maker of glargine [Lantus] and glulisine [Apidra] insulins), researchers compared basal-bolus and premixed regimens among 388 insulin-treated diabetic patients. Most participants (79%) had type 2 diabetes, mean age was 54, average diabetes duration was 16 years, mean baseline glycosylated hemoglobin (HbA<sub>1c</sub>) was 7.8%, and 60% of patients used basal-bolus regimens before entering the study.</p>
<p>Patients were randomized to receive either premixed insulin twice daily (Humalog Mix 75/25 or Novolog Mix 70/30) or basal-bolus insulin
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<p> (insulin glargine once daily plus insulin glulisine before each meal). After 12 weeks, each patient crossed over to the other regimen for 12 weeks. Insulin was titrated to an HbA<sub>1c</sub> target of &lt;7%.</p>
<p>Most measures of treatment satisfaction, quality of life, and general health perception favored the basal-bolus phase. The proportion of patients reaching an HbA<sub>1c</sub> level &lt;7% was higher, and diurnal variability in glycemia was lower, with basal-bolus than with premixed treatment. Incidence of hypoglycemia was virtually identical with the two regimens.</p>
<p><b>Comment:</b> Despite its widespread use, I have never been a fan of premixed insulin. This study suggests several advantages for basal-bolus therapy; however, this unavoidably nonblinded study likely overstates these advantages, because most patients already had experience with basal-bolus regimens. Moreover, the 7% HbA<sub>1c</sub> target recently has been questioned for patients with longstanding type 2 diabetes. However, the similar incidence of hypoglycemia in the two groups is reassuring.</p>
<p><b><i>— <a href="http://general-medicine.jwatch.org/misc/board_about.dtl#aBrett">Allan S. Brett, MD</a></i></b></p>
<p><i>Published in</i> <a href="http://general-medicine.jwatch.org">Journal Watch General Medicine</a> <i>October 25, 2012</i></p>
<h3>Citation(s):</h3>
<p>    <a name="ref"></a>  <a name=""></a></p>
<p>Testa MA et al. Comparative effectiveness of basal-bolus <i>versus</i> premix analog insulin on glycemic variability and patient-centered outcomes during insulin intensification in type 1 and type 2 diabetes: A randomized, controlled, crossover trial. <i>J Clin Endocrinol Metab</i>  2012 Oct; 97:3504. (<a href="http://dx.doi.org/10.1210/jc.2012-1763">http://dx.doi.org/10.1210/jc.2012-1763</a>)</p>
<ul>
<li><a href="http://general-medicine.jwatch.org/cgi/content/full/2012/1025/3?ijkey=1pogcbbzVU8EI&amp;keytype=ref&amp;siteid=jnlwatch&amp;q=pfw-featured#">Original article</a> (Subscription may be required)</li>
<li><a href="http://general-medicine.jwatch.org/cgi/content/full/2012/1025/3?ijkey=1pogcbbzVU8EI&amp;keytype=ref&amp;siteid=jnlwatch&amp;q=pfw-featured#">Medline abstract</a> (Free)</li>
</ul>
</div>
</blockquote>
<div class="posterous_quote_citation">via <a href="http://general-medicine.jwatch.org/cgi/content/full/2012/1025/3?ijkey=1pogcbbzVU8EI&amp;keytype=ref&amp;siteid=jnlwatch&amp;q=pfw-featured">general-medicine.jwatch.org</a></div>
</p>
</div>
</div>
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