New York Chiropractic College’s (NYCC) Master of Science Program in Clinical Anatomy (MSCA) was approved by New York State’s Education Department - the first of its kind to be introduced at a chiropractic college in conjunction with a medical school. The MSCA program, operating in conjunction with the State University of New York (SUNY) Upstate Medical University in Syracuse and the Albert Einstein College of Medicine of Yeshiva University in New York City, is intended to appeal to doctors of chiropractic who seek to enhance their education in anatomy and to enter careers in teaching the subject in secondary educational settings. The program will begin classes in the fall of 2007 and graduate students two years thereafter. Instruction will take place at NYCC’s Seneca Falls campus - following a weekly schedule that enables students to attend the College’s well-equipped anatomy facility. Teaching practicums will be held at the Seneca Falls campus, at Syracuse’s SUNY Upstate Medical University, and at the Albert Einstein College of Medicine located downstate. Defense of a master’s thesis is a requirement. Robert Walker, PhD, Dean of NYCC’s Master of Science in Clinical Anatomy program will oversee the new curriculum and teach several courses. Walker’s efforts were instrumental in the program’s development. He will be joined by Dr. Barry Berg of SUNY’s Upstate Health Science Center and by Dr. Todd Olson, Director of Anatomy at the Albert Einstein College of Medicine - an active member of the American Association of Clinical Anatomists and the International Association of Medical Science Educators. NYCC faculty members who will also provide instruction include Drs. Raj Philomin, Seva Philomin, Michael Zumpano, Maria Thomadaki, Sandra Hartwell-Ford, Michael Mestan, John Taylor, Jeanmarie Burke and Judy Silvestrone. Dr. Walker explained that the program was badly needed in order to maintain a pool of professionals adequately trained to teach gross anatomy at advanced educational levels. Walker sees the program as a “win-win” situation for NYCC as well as for the SUNY Upstate Health Science Center and the Albert Einstein College of Medicine: “It will give our [NYCC] students excellent teaching experience while providing the other institutions with well-trained laboratory professionals.” Dr. J. Clay McDonald, Executive Vice President of Academic Affairs, is extremely pleased about NYCC’s new program, remarking, “I am very proud of Dr. Walker’s many accomplishments and am excited by the possibilities this program offers our students.”

If you are seeking chiropractic care in New York (NY), you can locate a New York chiropractor by visiting the New York State Chiropractic Association (NYSCA) web site at www.NYSCA.com were over 6000 New York (NY)chiropractors are listed by city, zip code or last name. To find an online Chiropractor follow these instructions. Go to NYSCA’s web site at www.NYSCA.com. Once on the Home Page select “Find a Doctor” button and then enter the City, zip code or last name. It is that simple. This search will allow the public to find a NY Chiropractor or a Chiropractic Office in a city near them. NYSCA is dedicated to maintaining the most up-to-date and accurate Chiropractor Directory of NY chiropractors and information on Chiropractic for the public.

In the ongoing professional debate about the CCGPP Best Practice Initiative CCGPP Executive Committee, presented the fallowing views. The opinions of CCGPP do not reflect the views of New York State Chiropractic Association and are solely presented here for informational purpose. The following observations are submitted to challenge those who believe the CCGPP Best Practice Initiative will limit chiropractic care. We have a differing opinion. Please consider the following: Observation…Chronic care: The CCGPP Best Practice low back draft recommends treatment beyond every guideline in existence today. Given that reality, how could this document be used to limit chiropractic? This is the ONLY document we’ve seen supporting chiropractic treatment of chronic conditions. (see pages 5-19) Show us any others. Observation…Literature ratings: "B" and "C" ratings in the scientific community are not all bad, in fact, with nearly every category of low back condition, no treatments are rated higher than spinal manipulation. (see pages 27-30) Therefore how could this document be used to limit care? “B” and “C” are the equivalent of hitting a triple (using a baseball analogy) in the world of science. There are few home runs in the scientific literature, but manipulation for acute, subacute, and chronic care are rated at the highest levels in the CCGPP Best Practice document, thus improving our chances of expanding benefits. (see pages 27-30) Observation…Passive Modalities: Given that the insurance industry is fully aware of the low rating on passive modalities present in every guideline with which we are aware (ODG, ACOEM, AHCPR, Milliman and Robertson, etc.), what proof do the critics have that this will lead to a 30-40% reduction in income? This issue represents fear mongering at the lowest levels. Observation…X-ray: Given that the CCGPP x-ray recommendations have set the bar as low as "pain and/or limitation of motion" (see page 69), how could this document be used against us, unless you are one of the 1.9% of the DC population who believes in x-raying every patient no matter how uncomplicated the case? Again, why would this lead to a 30-40% drop income? Is there any proof? Answer: NO. Observation…Website as a Resource: Consider the incredible potential every DC will have by having access to reams of data supporting care at the click of a mouse using the website. We also will have the ability to share that information with those who would deny care using a cookbook guideline like ODG, Milliman and Robertson, and ACOEM. Observation…Best Practice vs. Guidelines: The Best Practice Initiative represents an important shift from cookbook guidelines to the "process of care", educating the payors that medical necessity must be based upon clinical decision-making, patient values, risk factors, and documentation, i.e., the uniqueness of each case, versus a guideline cookbook. Encouraging the “process of care” may be the main benefit of CCGPP’s Best Practice Initiative. Observation…Pragmatic viewpoint: To summarize, if the treatment recommendations for the core of what we do, manipulation and active care, expand from acute and subacute into the chronic pain patient population, and the x-ray and PT recommendations are basically no different from what we've been living with for the past 10 years, what is the real problem with this document? This document increases the support for chiropractic management of acute to chronic care in the third party reimbursement world. This document will enhance patient care. (again, please read pages 5-19, What Constitutes Evidence for Best Practice?”

In the ongoing professional debate about the CCGPP Best Practice Initiative Dr. Ronald J. Farabaugh, CCGPP Secretary, presented the fallowing views. His opinions do not reflect the views of New York State Chiropractic Association and are solely presented here for informational purpose. Have you ever been sued for malpractice? I have. The suit was spawned after an ignorant statement from an ER physician. He eagerly told my patient that a DC should not have been treating a herniated disc. Once the seed of malpractice was planted the patient found the possibility of a large cash award too irresistible and filed suit. The case was dropped but the issue illustrated the need for our profession to educate other medical professionals and the public at large about the literature and evidence-based benefits of chiropractic management of herniated discs. By the way, the patient consulted the ER only because he had no insurance and found that trading services with my office (he cleaned my carpets) was unrealistic. He consulted the ER since they were obligated to treat him regardless of coverage. I considered suing the ER physician, but decided to educate him instead. I also attempted to understand him. In his 1997 North American Spine Society Presidential address, Dr. Saul stated: “…physicians often prescribe treatment for their patients based upon their most recent success or failure. We skim our journals for articles that appeal to us, and sort out information that does not support our frame of reference. Even learned people will tend to gather and synthesize information preferentially as it supports and relates to their own opinions and objectives.” “Sort out the information”…….I wonder how many of us are guilty of that level of creative rationalization? Bottom line: despite the uncanny ability for us humans to selectively consider evidence, including literature, we must educate the masses. Recognition of this tendency has let our group, CCGPP, to develop a useable means of sifting through the literature, and it is important to understand the how Best Practice will benefit you and your practice. Please consider the short list of BP benefits: 1. Education of medical providers: This document can be used to educate medical professionals of all types (MDs, DOs, PTs, optometrists, podiatrists, dentists, athletic trainers, nurses, surgeons, personal trainers, massage therapists) in your geographical area about the benefits of DC treatment, especially spinal manipulation and active care, which received the highest rating for the most common conditions treated by DCs. Those who educate win!! 2. Stimulate Referrals: When the medical field has confidence in the literature, and they have a relationship developed thru various forms of communication (email, letters, research summaries, DVDs, websites, etc.) they will readily refer in an effort to help their own patients. This document provides you the resources and confidence you need to begin a consistent program of communication. 3. Education of third party payors, benefit managers, and employers to potentially expanded benefits: We have a better chance to preserve or enhance benefits related to the services provided by DCs given the high rating related the core of a chiropractic practice: manipulation and active care. This document provides us the tools/information we need to educate decision-makers in order to influence benefits in a positive manner. 4. Fight bad consultants. This document can and will be used to illuminate the illogical profit-driven opinions of income-dependant, predictably negative consultants. This document clearly supports chiropractic management for chronic pain, a hot button area of consistent denial by bad consultants who seem oblivious to the literature supporting chiropractic treatment of the chronic pain patient. If you want to shoot back, you need ammunition! 5. Allows greater discretion for physician decision-making. Probably the greatest benefit of this document is the shift away from consultant denials based on traditional guidelines and literature only, and supports the reality that medically necessary care is based upon the combination of: (a) literature, (b) clinical experience, and a consideration of risk factors/stratification that affects the natural history of a condition, and (c) patient preferences. Gone forever should be the consultant denial language of “there is no literature”. Why? Support for care depends more upon the documentation and response to care, versus the literature alone. Literature provides a foundation for care, but should not tyrannize care. This document honors the fact that each patient is unique. 6. More good news: This document clearly identifies the fact that the average chiropractic practice is on an equal, if not superior, scientific foundation compared to most other forms of medical treatment. 7. Patient information: Patients today are Internet savvy, intelligent, and have an emerging knowledge of “Best Practice”. This document and process, along with the other information technologies including interactive websites, DVDs, patient focused publications, etc., will be utilized by those looking for an evidence-based, best practice DC. Patients will seek you out if you become BP certified. What if we do nothing? If we do nothing in the area of evidence-based practice we risk being tyrannized by those who will do it for us, without chiropractic input. It’s been happening for years. We’ve all felt the negative effects of ODG, ACOEM, Milliman and Robertson, and other guidelines that consultants and third party payors have used inappropriately to limit your care. We need to move in a different direction. The Best Practice movement is a concept long overdue. Either we gather and rate the evidence or it will be handed to us on someone else’s financially motivated platter. The future is bright for chiropractic, IF we accept that times are a chang’in. Remember, “Life is Change. Growth is Optional.” Let’s grow together!

SENECA FALLS, NY - As New York Chiropractic College welcomes fall trimester students, it will have to make room for record numbers entering its doctoral and masters programs. NYCC President Dr. Frank J Nicchi expressed his pleasure at the sizeable incoming class: “I am thrilled that our efforts to provide excellent academic offerings are being well received by the public.” Of the one hundred-ninety-seven new students, one hundred–seventeen will enter NYCC’s Doctor of Chiropractic program and thirty begin study for masters’ degrees in its programs for Acupuncture or Acupuncture and Oriental Medicine. In addition, ten new students enrolled in pre-requisite courses NYCC offers in affiliation with Finger Lakes Community College. New this fall, NYCC launched a masters degree program in applied clinical nutrition. Forty students enrolled in the inaugural class for the 2 year program and will attend classes one weekend each month for two years. Faculty provide lectures at the college’s Seneca Falls, Levittown and Depew locations. Such an overwhelming response to the program resulted in a waiting list of applicants. Consequently, the college is considering offering an additional section to the program. Assistant Director of Admissions, Steve Budgar, credits the favorable enrollment picture, in part, to “the College’s delivery of quality programs and its emphasis on excellent customer service.”

DCs Could Face 13.1 Percent Reduction in Medicare Reimbursement Rates The American Chiropractic Association (ACA) is calling on Congress to halt proposed reductions in Medicare physician payments scheduled to take effect Jan. 1, 2007, that could seriously jeopardize access to care for millions of Medicare patients and would significantly reduce chiropractic reimbursement rates under Medicare. ACA says that changes recently proposed by the Centers for Medicare and Medicaid Services (CMS) as part of a congressionally mandated five-year review undermine Congress’ goals of preserving patient access and achieving greater quality of care. The association is pressing for a one-year delay in implementation of the cuts to provide CMS more time to assess the negative impact of the changes. ACA is also pressing Congress for action on another possible Medicare cut, which involves a legally mandated formula—the Sustainable Growth Rate (SGR)—to control Medicare spending. ACA is urging Congress and CMS to explore alternatives to the “inequitable” formulas used to determine physician reimbursement and to correct the system that consistently leaves millions of beneficiaries’ care in jeopardy each year. Proposed Cuts Vary Among Provider Groups This action comes on the heels of two proposed notices released by CMS that outline its plan to revise the way it calculates “relative value units” (RVUs) – or the costs associated with various health care services – under the Medicare physician fee schedule. CMS has proposed to offset an increase in payments to physicians who use higher-level evaluation and management (E/M) services by applying a budget neutrality adjuster across work RVUs for all health care services by 10 percent. This adjuster results in significantly different outcomes depending on the codes a given provider community uses. While some physicians will benefit from the increase in payments for higher-level E/M services, many health care providers will experience a dramatic overall decrease in reimbursements – particularly those providers who cannot bill for or do not frequently use higher-level E/M codes when submitting Medicare claims. In fact, certain health care professionals could experience payment cuts of as much as 15 percent by 2010 in this area of the Medicare payment formula alone. In 2007, doctors of chiropractic are slated to take an 8 percent cut in reimbursement. These cuts under the proposed notice would come in addition to a projected 5.1 percent reduction in payments based on the Sustainable Growth Rate (SGR) – a formula used to control the growth in Medicare. The combination of these requirements and proposals would result in a 13.1 percent total decrease to chiropractic reimbursement rates effective January 1, 2007. ACA Seeks Long-term Solution In addition to seeking immediate congressional action to delay the proposed rule, ACA is pressing for a fix to the Sustainable Growth Rate (SGR) formula. It is advocating not only for addressing next year’s 5.1 percent payment cut, but also to create a long-term policy solution that would lead to more accurate physician reimbursement. “Congress needs to act to halt or fix each of these cuts. CMS should explore ways to value patient time without reducing patient access to care by providers who would be forced to limit services due to such severe reimbursement cuts,” said Richard Brassard, DC, president of the American Chiropractic Association. “Preventing these cuts will ensure that Medicare beneficiaries continue to have access to valuable health care services, including doctors of chiropractic.” How Can Doctors of Chiropractic Help? The American Chiropractic Association is urging its members and chiropractic patients to lobby Congress on this issue before a final rule is unveiled by CMS later this year. Specifically, the ACA is asking doctors of chiropractic to contact their U.S. Representatives and Senators and ask them: To delay for at least one year implementation of the proposed rule as published in the June 29, 2006, Federal Register (71 Fed. Reg. 37170). Preventing these cuts will ensure that Medicare beneficiaries continue to have access to valuable health care services. In delaying implementation, Congress should also require CMS to determine the impact that these severe payment cuts will have on patient access to services. To sign on to the Cardin-Johnson Letter. A letter is being circulated around the U.S. House of Representatives that asks for Congress to take action and prevent the 5.1 percent decrease to the SGR from taking effect. Available on ACA’s Web site is a list of members of Congress who have NOT signed onto this letter as of Sept. 7. If your member of Congress is on this list, please contact him/her and ask them to sign onto this important bi-partisan letter. If your member is not on the list, please contact them and thank them for their support. Representatives and Senators can be reached via the Capitol switchboard at (202) 224-3121 or via the ACA Legislative Action Center. For more information, visit ACA’s Web site at:

Consumption of Vitamin D tablets was found to cut the risk of pancreatic cancer nearly in half, according to a study led by researchers at Northwestern and Harvard universities. The findings point to Vitamin D’s potential to prevent the disease, and is one of the first known studies to use a large-scale epidemiological survey to examine the relationship between the nutrient and cancer of the pancreas. The study, led by Halcyon Skinner, Ph.D., of Northwestern, appears in the September issue of Cancer Epidemiology Biomarkers & Prevention. The study examined data from two large, long-term health surveys and found that taking the U.S. Recommended Daily Allowance of Vitamin D (400 IU/day) reduced the risk of pancreatic cancer by 43 percent. By comparison, those who consumed less than 150 IUs per day experienced a 22 percent reduced risk of cancer. Increased consumption of the vitamin beyond 400 IUs per day resulted in no significant increased benefit. “Because there is no effective screening for pancreatic cancer, identifying controllable risk factors for the disease is essential for developing strategies that can prevent cancer,” said Skinner. “Vitamin D has shown strong potential for preventing and treating prostate cancer, and areas with greater sunlight exposure have lower incidence and mortality for prostate, breast, and colon cancers, leading us to investigate a role for Vitamin D in pancreatic cancer risk. Few studies have examined this association, and we did observe a reduced risk for pancreatic cancer with higher intake of Vitamin D.” Skinner, currently in the Department of Population Health Sciences at the University of Wisconsin School of Medicine and Public Health, and his colleagues analyzed data from two long-term studies of health and diet practices, conducted at Harvard University. They looked at data on 46,771 men aged 40 to 75 years who took part in the Health Professionals Follow-up Study, and 75,427 women aged 38 to 65 years who participated in the Nurses’ Health Study. Between the two studies, they identified 365 cases of pancreatic cancer. The surveys are considered valuable for their prospective design, following health trends instead of looking at purely historical information, high follow-up rates and the ability to enable researchers like Skinner to incorporate data from two independent studies. Pancreatic cancer is a rapidly fatal disease and the fourth-leading cause of death from cancer in the United States. This year, the American Cancer Society estimates that 32,000 new cases of cancer will be diagnosed. About the same number of people will die this year from the disease. It has no known cure, and surgical treatments are not often effective. Except for cigarette smoking, no environmental factors or dietary practices have been linked to the disease. In addition to Vitamin D, the researchers also measured the association between pancreatic cancer and the intakes of calcium and retinol (Vitamin A). Calcium and retinol intakes showed no association with pancreatic cancer risk, although retinol is an antagonist of Vitamin D’s ability to influence mineral balances and bone integrity. For that reason, further research is necessary to determine if Vitamin D ingestion from dietary sources, like eggs, liver and fatty fish or fortified dairy products, or through sun exposure might be preferable to multi-vitamin supplements, which contain retinol. The potential benefits of vitamin D for pancreatic cancer were only recently established by other laboratory studies. Normal and cancerous pancreas tissue contain high levels of the enzyme that converts circulating 25-hydroxyvitamin D into 1,25-dihydroxyvitamin D, the vitamin’s active form. Other studies have shown an anti-cell proliferation effect of 1,25-dihydroxyvitamin D, potentially inhibiting tumor cells. “In concert with laboratory results suggesting anti-tumor effects of Vitamin D, our results point to a possible role for Vitamin D in the prevention and possible reduction in mortality of pancreatic cancer. Since no other environmental or dietary factor showed this risk relationship, more study of Vitamin D’s role is warranted,” Skinner said. Skinner’s colleagues in the study include Dominique Michaud, Edward Giovannucci, Walter Willett and Graham Colditz of Harvard, and Charles Fuchs of the Dana-Farber Cancer Institute. News release, American Association for Cancer Research.

The College was notified late Monday afternoon, August 7, 2006, that the Commission on Accreditation of the Council on Chiropractic Education (CCE) has reaffirmed the accreditation of the Doctor of Chiropractic program of our institution. Reaffirmation marks the beginning of the next eight-(8) year accreditation cycle for Logan. Our next comprehensive site visit is scheduled for Spring 2014. We have received eight years of reaccreditation with NO CONCERNS, acknowledged George A. Goodman, DC, President, Logan College of Chiropractic.

With approximately 2 million spectators lining its route and 270 million watching world wide the ING New York City Marathon is a monumental international event which redefined marathoning. To runners everywhere this is THE marathon. Now is your chance to join the large team of chiropractors and chiropractic students who volunteer along with thousands of other health professionals to provide first aid to the runners and help them make it to the finish line. Dr. Stephen Perle, who is the chiropractic coordinator for the ING NYC Marathon is asking for your support by volunteering to be a part of the medical team. There are many D.C.s for whom their experience at the ING NYC Marathon has provided them with the skills to work at their local road races and serve their local communities better. Volunteers will be providing first aid only to runners. So no need to bring any equipment. There will be shirts, and rain suits supplied to all medical staff volunteers. Everyone MUST attend one of two obligatory orientation in the evening of Monday or Tuesday before the race (Oct 30 or 31) at the Hilton New York. One MUST attend ONE of the orientations. The application must be mailed (no faxes or emails) to Dr. Perle so he has it by September 25th. So do not hesitate fill it out and mail it today to: Stephen M. Perle, D.C., M.S. Chiropractic Coordinator, ING New York City Marathon University of Bridgeport 225 Myrtle Ave Bridgeport, CT 06604 Please see the race web site for more information about the race in general - www.ingnycmarathon.org. If you are interested or have more specific questions about being a volunteer on the medical team, please contact Dr. Perle via email [email protected]. Below please find the application to be a medical volunteer at the 2006 ING New York City Marathon.

Benjamin Ofori, Driss Oraichi, Lucie Blais, Evelyne Rey, Anick Bérard ABSTRACT BACKGROUND: Many women take non-steroidal anti-inflammatory drugs (NSAIDs) during pregnancy but the risks for the infant remain controversial. We carried out a study to quantify the association between those women prescribed NSAIDs in early pregnancy and congenital anomalies. METHODS: A population-based pregnancy registry was built by linking data from three administrative databases in Quebec between 1997-2003. The inclusion criteria were mothers of live singleton infants, between 15-45 years of age, covered by the RAMQ drug plan 12 months before and during pregnancy, and prescribed an NSAID or other medications during pregnancy. We selected as cases infants with any congenital anomaly (ICD-9; 740-759) diagnosed in the first year of life. Up to 10 controls, defined as infants with no congenital anomalies detected were selected for each case. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated. RESULTS: Within the registry, 36,387 pregnant women met the inclusion criteria. We identified 93 births with congenital anomalies in 1056 women (8.8%) who filled prescriptions for NSAIDs in the first trimester of pregnancy, compared to 2478 in 35,331 (7%) women who did not. The adjusted OR for any congenital anomalies for women who filled a prescription for NSAIDs in the first trimester was 2.21 (95% CI=1.72-2.85). The adjusted OR for the anomalies related to cardiac septal closure was 3.34 (95% CI=1.87-5.98). There were no significant associations with anomalies of other major organ systems. CONCLUSIONS: Our study suggests that women prescribed NSAIDs during early pregnancy may be at a greater risk of having children with congenital anomalies, specifically cardiac septal defects. Birth Defects Research (Part B), 2006. © 2006 Wiley-Liss, Inc. Benjamin Ofori 1, Driss Oraichi 1, Lucie Blais 2, Evelyne Rey 3, Anick Bérard 1Research Center, Sainte-Justine Hospital, Montreal, Quebec, Canada 2Faculty of Pharmacy, University of Montreal, Pavillon Jean-Coutu, Montreal, Quebec, Canada 3Faculty of Medicine, University of Montreal, Pavillon Roger-Gaudry, Montreal, Quebec, Canada

We may be taught not to judge a book by its cover, but when we see a new face, our brains decide whether a person is attractive and trustworthy within a tenth of a second, according to recent Princeton research. Princeton University psychologist Alex Todorov has found that people respond intuitively to faces so rapidly that our reasoning minds may not have time to influence the reaction -- and that our intuitions about attraction and trust are among those we form the fastest. "The link between facial features and character may be tenuous at best, but that doesn't stop our minds from sizing other people up at a glance," said Todorov, an assistant professor of psychology. "We decide very quickly whether a person possesses many of the traits we feel are important, such as likeability and competence, even though we have not exchanged a single word with them. It appears that we are hard-wired to draw these inferences in a fast, unreflective way." Todorov and co-author Janine Willis, a student researcher who graduated from Princeton in 2005, used timed experiments and found that snap judgments on character are often formed with insufficient time for rational thought. They published their research in the July issue of the journal Psychological Science. The study formed part of Willis' senior thesis work, which was inspired by an earlier paper by Todorov investigating the outcome of a political campaign. "I had done studies with my students that found there was a direct correlation between how competent a campaigning politician's face was and how great his margin of victory turned out in the final election," Todorov said of his earlier work, published in the journal Science last year. "We might assume that our judgments are founded on deliberate and rational thought processes, but observers had made their judgments about politicians based on a one-second look at their faces. I mentioned the findings to Janine, who suggested we look into just how fast we form these (judgments about) character traits." For the current study, the two researchers conducted several experiments on about 200 people. For one experiment, the researchers asked observers to look at 66 different faces for one of three time durations: either 100 milliseconds, 500 milliseconds or a full second. After each face flashed on the screen and vanished, the observers marked whether they found the face to be trustworthy or not, and also how confident they were in their analysis. Other experiments conducted in similar fashion tested for different specific traits, such as likeability and competence. "What we found was that, if given more time, people's fundamental judgment about faces did not change," Todorov said. "Observers simply became more confident in their judgments as the duration lengthened." Why the brain makes such snap judgments is not yet entirely clear, Todorov said. However, he often works with a sophisticated technological tool for probing brain activity called a functional magnetic resonance imager (fMRI), and Todorov said some of his general research suggests that the part of the brain that responds directly to fear may be involved in judgments of trustworthiness. "The fear response involves the amygdala, a part of the brain that existed in animals for millions of years before the development of the prefrontal cortex, where rational thoughts come from," he said. "We imagine trust to be a rather sophisticated response, but our observations indicate that trust might be a case of a high-level judgment being made by a low-level brain structure. Perhaps the signal bypasses the cortex altogether." The research, Todorov said, explores some of the same topics addressed in "Blink," the recent best-selling book by New York journalist Malcolm Gladwell about the rapid cognition our minds experience when making decisions quickly, especially those based on first impressions made in the "blink" of an eye. Gladwell, who is often described as a type of popular sociologist, has said the impetus for his book was the rapid judgments people made about him because of his long hair. "This paper's results concern specific mechanisms in the mind, while 'Blink' makes broader generalizations," Todorov said. "Gladwell's basic message is not essentially different from ours, though he views snap judgments to be primarily rational in nature. Our research finds that this is often the case, but not always." Todorov cautioned that his findings do not imply, however, that quick first impressions cannot be overcome by the rational mind. "As time passes and you get to know people, you, of course, develop a more rounded conception of them," he said. "But because we make these judgments without conscious thought, we should be aware of what is happening when we look at a person's face." What aspects of a face inspire such judgments remain undetermined, Todorov said. "We still don't know the physical features of a face that lead to a particular trait inference," he said. "We know generally what makes a face attractive, such as its symmetry, the proportions of its parts and the like. But what is it about a face that makes you think its owner is an essentially competent person? That's the subject of another study, one that needs to be done." This research was sponsored in part by the National Science Foundation. Abstract First Impressions: Making Up Your Mind After a 100-Ms Exposure to a Face Janine Willis and Alexander Todorov, Princeton University People often draw trait inferences from the facial appearance of other people. We investigated the minimal conditions under which people make such inferences. In five experiments, each focusing on a specific trait judgment, we manipulated the exposure time of unfamiliar faces. Judgments made after a 100-ms exposure correlated highly with judgments made in the absence of time constraints, suggesting that this exposure time was sufficient for participants to form an impression. In fact, for all judgments — attractiveness, likeability, trustworthiness, competence, and aggressiveness—increased exposure time did not significantly increase the correlations. When exposure time increased from 100 to 500 ms, participants’ judgments became more negative, response times for judgments decreased, and confidence in judgments increased. When exposure time increased from 500 to 1,000 ms, trait judgments and response times did not change significantly (with one exception), but confidence increased for some of the judgments; this result suggests that additional time may simply boost confidence in judgments. However, increased exposure time led to more differentiated person impressions.

Alumni of the former Eisenhower College returned to Seneca Falls August 4-6 to celebrate their annual homecoming weekend at New York Chiropractic College, once home to Eisenhower College. This year’s event marked the 30th anniversary of the Class of 1976 and the 25th anniversary of the Class of 1981. Though held in the dead of summer, celebrations included a “New Year’s Eve Party,” in keeping with the long-standing November tradition at Eisenhower College. On Saturday, alumni enjoyed a picnic lunch and presentation of Eisenhower College Alumni Association (ECAA) scholarship awards to Mynderse Academy students Jonathan R. Young and Matthew B. Quinn. ECAA Archivist Virginia “Gigi” Carnes lectured on the Eisenhower archival collection’s history and the alumni association’s future goals for archiving presidential and college memorabilia currently on display in the New York Chiropractic College library. There was also a rededicated of Punkin Park, a grassy expanse named for Joseph Andrew “Punkin” Campbell. The son of Eisenhower College philosophy professor James Campbell and his wife, Mary Ann, Punkin lost his life in a tragic accident in 1973 at the age of 8. On Saturday, NYCC faculty and graduates currently serving in the New York Guard conducted a flag-raising ceremony to commemorate the 40th anniversary of President and Mrs. Dwight D. Eisenhower‘s gift of the campus flagpole, presented by their son John on December 12, 1966. The flag they raised was flown over the U.S. Capitol building on May 28 of this year to honor the 34th anniversary of the graduation of Eisenhower College’s charter class, and in honor of NYCC. Pam Havens, ECAA chair, expressed the organization’s wishes to “acknowledge our very special and unique bond to this area and to our hosts and friends at New York Chiropractic College.” The ECAA Legacy Award, presented this year to New York Chiropractic College, traditionally recognizes those who have made significant contributions to perpetuating the legacy of Eisenhower College, its world-studies education, or the ECAA itself. Drs. Frank Nicchi, president of NYCC, and Beth Donohue, NYCC’s liaison to Eisenhower’s alumni association, received the award on behalf of NYCC on two separate occasions. Donohue was lauded by the ECAA for having helped pave the way for collaboration between the former and current colleges, and was named as an “Honorary Alumnus” of Eisenhower College. A cocktail party, dinner and awards ceremony honored distinguished alumni and faculty and closed the homecoming events. According to Havens, the Eisenhower College Alumni Association has thrived for nearly 25 years and will continue to work to keep the unique memory of Eisenhower College alive.

On August 14, 2006, Governor Pataki announced a comprehensive plan designed to extend the time for employees and volunteers injured in the rescue, recovery and cleanup operations after the September 11, 2001, terrorist attacks on the World Trade Center to file a claim for workers' compensation benefits and to receive prompt access to medical benefits while their claims are being litigated. Although it has been almost five years since the tragic events of September 11th, many people who participated in the rescue, recovery and cleanup efforts may have hidden health issues or suffer serious, disabling medical conditions that developed more than two years after their participation which may entitle them to workers' compensation benefits. Workers' Compensation Law, Article 8-A As a key part of his plan, Governor Pataki signed into law Article 8-A of the Workers' Compensation Law (hereinafter "WCL"), which extends the time for employees and volunteers who participated in rescue, recovery and cleanup operations following the September 11, 2001 terrorist attacks on the World Trade Center to file claims for workers' compensation benefits, provided they register with the Board before August 14, 2007. (Chapter 446 of the Laws of 2006). In order to register, those employees and volunteers who participated in World Trade Center rescue, recovery and cleanup operations (hereinafter "WTC operations") must file with the Workers' Compensation Board (hereinafter "Board") a sworn statement, on Form WTC-12, listing the dates and locations of their participation in the rescue, recovery and cleanup efforts. The filing of the registration form (Form WTC-12) does NOT constitute the filing of a claim. The filing of the sworn statement does however extend the time to file a claim. With respect to claims that were previously filed and denied as untimely under WCL §18 or §28, upon the filing of the sworn statement the claim will be reopened by the Board to reconsider this claim. This new legislation is effective immediately and is deemed to have been in effect since September 11, 2001. It will apply retroactively. A number of key terms are defined in new Article 8-A. WCL §161 defines a "participant in World Trade Center rescue, recovery or cleanup operations" as any employee or volunteer, who between September 11, 2001 and September 12, 2002: (i) participated in the rescue, recovery or cleanup operations at the World Trade Center site; (ii) worked at the Fresh Kills Land Fill in New York City; (iii) worked at the New York City morgue or the temporary morgue on pier locations on the west side of Manhattan; or (iv) worked on the barges between the west side of Manhattan and the Fresh Kills Land Fill in New York City. The term "World Trade Center site" is defined as "anywhere below a line starting from the Hudson River and Canal Street; east on Canal Street to Pike Street; south on Pike Street to the East River; and extending to the lower tip of Manhattan." Finally, a "qualifying condition" means "any latent disease or condition resulting from a hazardous exposure during participation in" WTC operations. This legislation also modifies the employer notice requirements with regard to claims for "qualifying conditions" resulting from participation in WTC operations. Under the Workers' Compensation Law, a claimant is required to provide notice of a work-related injury to his or her employer "within thirty days after the accident causing such injury" WCL §18. However, pursuant to WCL §163, a claimant with a "qualifying condition" will have two years from the date of disablement or the date when he or she knew or should have known that the latent condition was causally related to his/her participation in WTC operations to provide notice to the employer who employed the participant at the time of his/her participation in the rescue, recovery or cleanup operations. In the case of a volunteer, the volunteer must provide notice to the Board within two years of the date of disablement or the date when he/she should have known that the latent condition was causally related to his/her participation in WTC operations. Article 8-A applies to all pending and future claims filed or to be filed by participants in the World Trade Center rescue, recovery and cleanup operations, including those claims already disallowed because timely notice was not given to the employer (WCL §18) or the claim was not timely filed with the Board (WCL §28). WCL §165 expressly provides that claims previously brought by employees and volunteers who participated in WTC operations, which claims were disallowed based on the claimant's failure to provide timely notice to the employer or to file a timely claim for benefits, will be reopened and redetermined in accordance with the provisions of WCL Article 8-A, provided the claimant files a sworn statement with the Board before August 14, 2007. WCL §166 makes clear that claims brought by employees who participated in WTC operations in the course of their employment will be the liability of the insurance carrier on the risk for the employer on the date that the employee last participated in WTC operations, which is considered the date of accident. With respect to claims by volunteers, WCL §167 provides that benefits will be payable out of federal funds appropriated to the Board for that purpose. However, the uninsured employers' fund shall be deemed to be the employer only for the purposes of administering and paying claims for which it will be reimbursed from federal funds. Benefits to volunteers are payable to the extent that federal funds are appropriated and available for that purpose. Employees and volunteers who participated in rescue, recovery and/or clean-up operations at the World Trade Center site, the Fresh Kills Landfill, the New York City morgue or temporary morgue or the barges between the west side of Manhattan and the Fresh Kills Landfill between September 11, 2001 and September 12, 2002, who were exposed to hazardous conditions must file the registration statement, Board Form WTC-12, before August 14, 2007, in order for the provisions of Article 8-A to apply. Employees and volunteers who do not file the registration statement before August 14, 2007, will not have the benefit of the statute of limitations and notice provisions in Article 8-A. Instead, such claims will be governed by the provisions of WCL §18 and §28, which require notice to the employer within 30 days of the accident and the filing of a claim within two years. Payment Without Prejudice WCL §21-a allows an employer or its insurance carrier to pay workers' compensation lost wage and medical benefits to an injured employee for up to one year without admitting liability for the claim and without prejudice to its right to controvert the claim. At any time during that one-year period, the employer or carrier may provide notice that it is ceasing temporary payments and may then controvert the claim if its investigation reveals that it should not be liable. Rather than automatically controverting the claim, self-insured employers and workers' compensation insurance carriers are encouraged to voluntarily pay lost wage and medical benefits pursuant to WCL §21-a in those claims in which liability is uncertain and more time is needed to investigate the claim. Doing so will provide benefits to injured claimants, while preserving the right of an employer or carrier to later controvert a claim based on the results of its investigation. The employer or carrier is required to provide notice to the claimant and the Board that payments without prejudice have begun by filing Form C-669. Termination of temporary payments by the employer or carrier must be in accordance with the five day notice provisions of WCL §21-a (3). Temporary Payment from Volunteer Fund In claims arising out of employee participation in World Trade Center operations which are controverted by the self-insured employer or insurance carrier, the Board, in the interest of justice, has directed the World Trade Center Volunteer Fund to temporarily pay for a claimant's causally related medical treatment, until liability for the claim is ultimately determined. The World Trade Center Volunteer Fund is the money appropriated by the federal government to the Uninsured Employers' Fund (hereinafter UEF) for claims of volunteers. If claimant's employer or its insurance carrier is ultimately determined to be liable for the claim, the employer or carrier will reimburse the UEF for the cost of medical treatment paid while the claim was being litigated upon demand therefore. Any notice of decision containing a finding that the employer or its carrier is liable to pay the claim will include a direction to the employer or carrier to reimburse the UEF for amounts paid from the World Trade Center Volunteer Fund within thirty days from presentation of a demand by the UEF for reimbursement. Self-insured employers and insurance carriers who have controverted claims by employees for injuries or illnesses caused by participation in WTC operations, which have not yet been established, are directed to submit to the Board within 15 days of the date of this Announcement, and monthly thereafter, an itemized list of all medical bills to be paid from the World Trade Center Volunteer Fund detailing the date of treatment, name and address of the medical provider, diagnostic codes and the amount of the outstanding medical bill(s). The medical bills and the accompanying medical reports must be attached to the itemized list. Board Form WTC-16 MUST accompany each itemized list with attached medical bills and accompanying medical reports sent to the Board for payment initially and monthly thereafter. Health Providers must still request authorization from the self-insured employer or insurance carrier. The self-insured employers and carriers are directed to timely respond to all requests for authorization for special medical services pursuant to the procedures outlined in WCL 13-a(5) and 12 NYCRR 325-1.4(b). Health Providers must continue to forward medical bills to the insurance carrier of record. Reimbursement for pharmaceutical expenses will be accepted although reimbursement for claimants travel allowances will not be payable from this fund. Employer/Carrier Approval of Medical Treatment Medical providers are required by law to seek prior approval from the employer or its insurance carrier for any procedure costing more than $500. Sometimes the required approval cannot be obtained in a timely fashion. Recognizing this, the Board developed a procedure in 2002 to enable medical providers to request Board intervention whenever an employer or insurance carrier fails to promptly respond to a request for authorization, a procedure commonly referred to as the "MD-1 process". See WCB Subject Number 046-116, issued November 24, 2003. Employers and insurance carriers are urged in all cases, and particularly in those claims arising out of an employee or volunteer's participation in WTC operations following the September 11, 2001 attacks, to promptly respond to all requests for authorization of medical treatment. Additionally, medical providers are strongly encouraged to take advantage of the Board's MD-1 process when they do not receive a prompt response to a request for medical authorization. Donna Ferrara Chair

(Arlington, Va. - Aug. 16, 2006) Humana has agreed to a class action settlement resolving claims on behalf of chiropractors and other health care providers in Solomon v. Anthem, et. al., pending before Judge Frederico Moreno of the U.S. District Court for the Southern District of Florida. The ACA participated, through its counsel, in the settlement discussions and is a signatory to the proposed class action settlement agreement. If approved by the Court, Humana will pay $3.5 million to fund payments to class member chiropractors and other health care providers as well as fees and costs advanced by class counsel. Plaintiffs in the Solomon action recently filed a motion seeking to add the ACA as a named plaintiff in the Solomon case and requesting that ACN Group, Inc. and United Healthcare Services, Inc. be added as defendants. The case against ACN, United Healthcare Services and all remaining defendants is still pending. In addition to the cash fund described above, terms of the proposed settlement agreement with Humana include: • Changes in Humana’s business practices, intended to make its claims editing process more transparent and reduce confusion and disagreement over payments. • Online information provided by Humana to help providers understand its payment decisions. • More options for chiropractors and other health care providers to challenge Humana payment decisions in the future, if necessary. • Independent external reviews to resolve billing disputes. • The appointment of an ACA representative to a newly formed Humana health care provider advisory committee, which will provide a means of direct communication on issues and concerns. “We are extremely pleased that Humana has agreed to compensate chiropractors and other non-MD providers for claims that were previously and wrongly denied,” commented ACA President Richard Brassard, DC. “More importantly, however, we are heartened that Humana has committed to improving its business practices in the future and are hopeful that other networks and insurance companies will follow suit. Doing so can only benefit the nation’s health care consumers, who also deserve fair treatment and reimbursement.” As part of the settlement, doctors of chiropractic will be permitted to assign their portion of the recovery to the ACA, if they wish to do so. For a copy of the settlement agreement, click on the link below.

Patients in New York who need physical therapist services can now go directly to their physical therapist without having to wait to receive a referral from a physician. New York is the 43rd state to pass "direct access" legislation that eliminates, under certain conditions, the physician referral requirement for patients needing physical therapist services. The Consumer Access to Physical Therapy bill, S3169/A5622, passed the legislature with bipartisan support and was signed into law late yesterday by Governor George E Pataki. It will become effective in 120 days. This new law will allow patients to directly access the services of a licensed physical therapist for ten visits or thirty days, whichever comes first. "Physical therapists have been working with the state legislature to achieve direct access for patients for nearly 25 years. Now patients in New York, like patients in many other states, will have improved access to physical therapy care. This bill is a thoughtful piece of legislation with patient safety taking the highest priority," said James Dunleavy, PT, MS, president of the New York Physical Therapy Association (NYPTA). "The American Physical Therapy Association (APTA) applauds the state legislature for passing this important legislation to provide patients with direct access to physical therapist services," said APTA President R Scott Ward, PT, PhD. "Direct access helps to remove unnecessary barriers to healthcare and gives consumers a choice in accessing physical therapist services. Many states have had direct access laws on the books for nearly 30 years and evidence has shown that direct access to physical therapist services is cost-effective, safe and has improved access to care. Now residents of New York will be able to benefit from the same access to quality physical therapy services." The New York Physical Therapy Association (NYPTA) is a non-profit professional association of approximately 5,000 physical therapists, physical therapist assistants and students. The NYPTA is dedicated to serving the public's health interests, improving the standard of health for people of all ages and advancing the benefits of physical therapy and the interests of physical therapy professionals in the state of New York. The American Physical Therapy Association is a national professional organization representing more than 66,000 members. Its goal is to foster advancements in physical therapy practice, research, and education. For more information visit The New York Physical Therapy Association (NYPTA) by clicking on the link:

As Many as 540,000 New Yorkers were at risk for identity theft after a security breach was detected. Claimants of NYS Special Funds, a workers compensation carrier, recently received letters describing the possible theft of a personal computer, which contained their private information. However, it was reported today that the computer has been located and is secure. FBI is "reasonably certain" the information was not misused Read the story by clicking on the link:

The New York Road Runners this year initiated a new race the NYC Half Marathon which will go from Central Park to Battery Park. This race in the past has been only in Central Park. For its initial year this race was limited to ten thousand runners and it took only 5 minutes to "sell out." Dr. Stephen Perle who is the chiropractic coordinator for the ING NYC Marathon is asking for your support by volunteering to be a part of the medical team. He says that this is a good opportunity to "get ones feet wet" at a "smaller" race before volunteering for the ING NYC Marathon. There is no obligation to volunteer for this race in order to volunteer for the ING NYC Marathon or visa versa. Volunteers will be providing first aid only to runners. So no need to bring any equipment. There will be shirts and possibly hats supplied to all medical staff volunteers from Nike. Unlike the ING NYC Marathon there is no obligatory orientation. Volunteers will need to show up around 6 am and should be done around 10:30 Please see the race web site for more information about the race in general - New York Road Runners Club. If you are interested or have more specific questions about being a volunteer on the medical team, please contact Dr. Perle via email [email protected] Please keep your eyes on NYSCA's web site for information about volunteering at the ING NYC Marathon which will be November 5th. Keep that date open we would love to see hundreds of chiropractors volunteering.

WASHINGTON -- Medication errors are among the most common medical errors, harming at least 1.5 million people every year, says a new report from the Institute of Medicine of the National Academies. The extra medical costs of treating drug-related injuries occurring in hospitals alone conservatively amount to $3.5 billion a year, and this estimate does not take into account lost wages and productivity or additional health care costs, the report says. The committee that wrote the report recommended a series of actions for patients, health care organizations, government agencies, and pharmaceutical companies. The recommendations include steps to increase communication and improve interactions between health care professionals and patients, as well as steps patients should take to protect themselves. The report also recommends the creation of new, consumer-friendly information resources through which patients can obtain objective, easy-to-understand drug information. In addition, it calls for all prescriptions to be written electronically by 2010 and suggests ways to improve the naming, labeling, and packaging of drugs to reduce confusion and prevent errors. "The frequency of medication errors and preventable adverse drug events is cause for serious concern," said committee co-chair Linda R. Cronenwett, dean and professor, School of Nursing, University of North Carolina, Chapel Hill. "We need a comprehensive approach to reducing these errors that involves not just health care organizations and federal agencies, but the industry and consumers as well," she said. Co-chair J. Lyle Bootman, dean and professor, College of Pharmacy, University of Arizona, Tucson, added, "Our recommendations boil down to ensuring that consumers are fully informed about how to take medications safely and achieve the desired results, and that health care providers have the tools and data necessary to prescribe, dispense, and administer drugs as safely as possible and to monitor for problems. The ultimate goal is to achieve the best care and outcomes for patients each time they take a medication." Estimates of Rates and Costs Medication errors encompass all mistakes involving prescription drugs, over-the-counter products, vitamins, minerals, or herbal supplements. Errors are common at every stage, from prescription and administration of a drug to monitoring of the patient's response, the committee found. It estimated that on average, there is at least one medication error per hospital patient per day, although error rates vary widely across facilities. Not all errors lead to injury or death, but the number of preventable injuries that do occur -- the committee estimated at least 1.5 million each year -- is sobering, the report says. Studies indicate that 400,000 preventable drug-related injuries occur each year in hospitals. Another 800,000 occur in long-term care settings, and roughly 530,000 occur just among Medicare recipients in outpatient clinics. The committee noted that these are likely underestimates. There is insufficient data to determine accurately all the costs associated with medication errors. The conservative estimate of 400,000 preventable drug-related injuries in hospitals will result in at least $3.5 billion in extra medical costs this year, the committee calculated. A study of outpatient clinics found that medication-related injuries there resulted in roughly $887 million in extra medical costs in 2000 -- and the study looked only at injuries experienced by Medicare recipients, a subset of clinic visitors. None of these figures take into account lost wages and productivity or other costs. Improving the Patient-Provider Partnership Establishing and maintaining strong partnerships between health care providers and patients is crucial to reducing medication errors, the report says. The committee called on consumers to be active partners in their medication care and on physicians, nurses, and pharmacists to know and act on patients' medical care rights. The report recommends specific steps that physicians, nurses, pharmacists, and other health professionals should take to ensure that their patients are fully informed about their drug regimens and to minimize opportunities for mistakes to occur. Health care organizations also should make it a standard procedure to inform patients about clinically significant medication errors made in their care, whether the mistakes lead to harm or not. Currently, health care providers typically do not inform the patient or the patient's guardians about errors unless injury or death results. The report also provides consumers with a list of specific questions to ask health care providers, such as how to take their medications properly and what to do if side effects occur. Also included are actions consumers should take, such as requesting that their providers give them a printed record of the drugs they have been prescribed. Patients should maintain an up-to-date list of all medications they use -- including over-the-counter products and dietary supplements -- and share it with all their health care providers. This list should also note the reasons they are taking each product and any drug and food allergies they have. New and Improved Drug Information Resources Although consumers can find helpful drug information online or in the printed materials provided by pharmacies, this information often is too difficult for many people to understand, too scattered, or otherwise not consumer-friendly. The quality of the drug information leaflets that accompany prescriptions varies widely, and these printouts are typically written at a college reading level. The U.S. Food and Drug Administration (FDA) should work with other appropriate groups to standardize the text and design of medication leaflets to ensure that they are comprehensible and useful to all consumers. The committee called on the National Library of Medicine (NLM) to be the chief agency responsible for online health resources for consumers; it should create a Web site to serve as a centralized source of comprehensive, objective, and easy-to-understand information about drugs for consumers. In addition, NLM should work with other groups to evaluate online health information and designate Web sites that provide reliable information. The committee also recommended that NLM, FDA, and the Centers for Medicare and Medicaid Services evaluate ways to build and fund a national network of telephone helplines to assist people who may not be able to access or understand printed medication information because of illiteracy, language barriers, or other obstacles. This telephone network should also enable consumers to report medication-related mistakes or problems. Electronic Prescribing and Other IT Solutions New computerized systems for prescribing drugs and other applications of information technology show promise for reducing the number of drug-related mistakes, the report says. Studies indicate that paper-based prescribing is associated with high error rates. Electronic prescribing is safer because it eliminates problems with handwriting legibility and, when combined with decision-support tools, automatically alerts prescribers to possible interactions, allergies, and other potential problems, the committee found. While it acknowledged that significant regulatory issues and problems with automated alerts still need to be worked out, the committee said that by 2008 all health care providers should have plans in place to write prescriptions electronically. By 2010 all providers should be using e-prescribing systems and all pharmacies should be able to receive prescriptions electronically. The Agency for Healthcare Research and Quality (AHRQ) should take the lead in fostering improvements in IT systems used in ordering, administering, and monitoring drugs. All health care provider groups should be actively monitoring their progress in improving medication safety, the committee recommended. Monitoring efforts might include computer systems that detect medication-related problems and periodic audits of prescriptions filled in community pharmacies. Drug Naming, Labeling, and Packaging Confusion caused by similar drug names accounts for up to 25 percent of all errors reported to the Medication Error Reporting Program operated cooperatively by U.S. Pharmacopeia (USP) and the Institute for Safe Medication Practices (ISMP). In addition, labeling and packaging issues were cited as the cause of 33 percent of errors, including 30 percent of fatalities, reported to the program. Drug naming terms should be standardized as much as possible, and all companies should be required to use the standardized terms, the report urges. FDA, AHRQ, and the pharmaceutical industry should collaborate with USP, ISMP, and other appropriate organizations to develop a plan to address the problems associated with drug naming, labeling, and packaging by the end of 2007. The report also recommends studies to evaluate the impact of free drug samples on overall medication safety. In general, there has been growing unease among health care providers and others about the way free samples are distributed and the resulting lack of documentation of medication use, as well as the bypassing of drug-interaction checks and counseling that are integral parts of the standard prescription process. The study was sponsored by the U.S. Department of Health and Human Services and Centers for Medicare and Medicaid Services. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. A committee roster follows. INSTITUTE OF MEDICINE Board on Health Care Services Committee on Identifying and Preventing Medication Errors J. Lyle Bootman, Ph.D., Sc.D., (co-chair) Dean and Professor University of Arizona College of Pharmacy, and Founding and Executive Director University of Arizona Center for Health Outcomes and PharmacoEconomic Research Tucson Linda R. Cronenwett, R.N., Ph.D. (co-chair) Professor and Dean School of Nursing University of North Carolina Chapel Hill David W. Bates, M.D., M.Sc. Chief Division of General Medicine Brigham and Women’s Hospital; Medical Director of Clinical and Quality Analysis Partners Healthcare System; and Professor of Medicine Harvard Medical School Boston Robert M. Califf, M.D. Associate Vice Chancellor for Clinical Research; Director Duke Clinical Research Institute; and Professor of Medicine Division of Cardiology Duke University Medical Center Durham, N.C. H. Eric Cannon, Pharm.D. Director of Pharmacy Services and Health and Wellness IHC Health Plans Intermountain Health Care Salt Lake City Rebecca W. Chater, M.P.H. Director of Clinical Services Kerr Drug Inc. Asheville, N.C. Michael R. Cohen, Sc.D. President Institute for Safe Medication Practices Huntington Valley, Pa. James B. Conway, M.S. Senior Fellow Institute for Healthcare Improvement, and Senior Consultant Dana-Farber Cancer Institute Boston R. Scott Evans, Ph.D. Senior Medical Informaticist Department of Medical Informatics LDS Hospital and Intermountain Health Care, and Professor Department of Medical Informatics University of Utah Salt Lake City Elizabeth A. Flynn, Ph.D., R.Ph. Associate Research Professor Department of Pharmacy Care Systems Harrison School of Pharmacy Auburn University Auburn, Ala. Jerry H. Gurwitz, M.D. Chief Division of Geriatric Medicine; Dr. John Meyers Professor of Primary Care Medicine; and Executive Director Meyers Primary Care Institute University of Massachusetts Medical School Worcester Charles B. Inlander President People’s Medical Society Allentown, Pa. Kevin B. Johnson, M.D., M.S. Associate Professor and Vice Chair Department of Biomedical Informatics, and Associate Professor Department of Pediatrics Vanderbilt University Medical School Nashville, Tenn. Wilson D. Pace, M.D. Professor of Family Medicine and Green-Edelman Chair for Practice-based Research University of Colorado, and Director National Research Network American Academy of Family Physicians Aurora, Colo. Kathleen R. Stevens, Ed.D., R.N. Professor and Director Academic Center for Evidence-Based Practice University of Texas Health Science Center San Antonio Edward Westrick, M.D., Ph.D. Vice President of Medical Management University of Massachusetts Memorial Health Care Worcester Albert W. Wu, M.D. Professor of Health Policy and Management and Internal Medicine Johns Hopkins University Baltimore INSTITUTE STAFF Philip Aspden, Ph.D. Study Director Pre-publication copies of Preventing Medication Errors are available from the National Academies Press; tel. 202-334-3313 or 1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).

New York Chiropractic College is proud to announce its upcoming commencement exercises scheduled to take place July 2006. On July 29 and 30, NYCC will confer graduate degrees upon candidates for Doctor of Chiropractic and Master of Science in Acupuncture or Acupuncture and Oriental Medicine, respectively. On Saturday, July 29 at 10:00 AM, 32 candidates for the degree of Doctor of Chiropractic will be awarded their diplomas in a ceremony to be held in the campus’ Delavan Theater. The commencement address will be delivered by Dr. Karen Erickson, NYCC Class of 1988 - the first chiropractor to be credentialed by a major teaching hospital in the United States. In 2000, Dr. Erickson was invited to join Beth Israel’s Continuum Center for Health and Healing in New York, where she currently serves on its faculty. A frequent speaker at conferences on chiropractic and integrative health care, Erickson has also authored two chapters on the subject. In 2003 Dr. Erickson graced the cover of New York Magazine in a piece entitled “Meet the New Super Chiropractors.” On Sunday, July 30 at 10:00 AM, the College will graduate its very first class from the NYCC School of Acupuncture and Oriental Medicine as 28 masters’ candidates take the stage. Marilee Murphy, the College’s Dean of Graduate Program in Acupuncture and Oriental Medicine, will read the candidates’ names and President Dr. Frank J. Nicchi, President, will hood the new graduates. Kevin V. Ergil, Director of the Graduate Program in Oriental Medicine and Associate Professor in the School of Health Sciences at Touro College, will deliver the commencement address. A practitioner of traditional Chinese medicine, Mr. Ergil is a practicing licensed acupuncturist (New York and California) and herbalist, having studied East Asian medicine since 1980. Mr. Ergil is a former director and current adviser for the Society for Acupuncture Research. In addition, he served as past president of the American College of Traditional Chinese Medicine in San Francisco and as founding dean of Pacific College of Oriental Medicine’s New York Campus. Ergil also served as Director of Research and as Chair of the Department of Acupuncture at the New York College for Holistic Health Education & Research (now the New York College for Health Professions), and as representative to the Council of Colleges of Acupuncture and Oriental Medicine from 1991 to 2000, where he chaired the Research Information and the Core Curriculum committee. NYCC President Nicchi expressed “extreme pride” that the College would soon graduate its first class of acupuncture and Oriental medicine professionals, and added, “I’m thrilled that we successfully achieved our goal to establish upstate New York’s first acupuncture and Oriental medicine masters program.” First consideration for the College’s expansion into the field of acupuncture and Oriental medicine occurred in 1995. Dr. Nicchi feels that the new AOM program is a perfect fit with the College’s chiropractic program, as acupuncture and chiropractic have long shared close ties. “Many chiropractors work with acupuncturists and refer patients to them,” he explained. Acupuncture is readily accepted by today’s public and has earned respect and acceptance within mainstream healthcare systems. Of the newly graduating AOM students, Dr. Nicchi commented, “They are about to enter a healthcare market that eagerly welcomes professionals skilled in the arts and science of Eastern medicine. Their career options are rife with opportunity.” For further information about New York Chiropractic College’s degree programs in Chiropractic and Acupuncture and Oriental Medicine, please visit our Web site at:

Rates of nausea and vomiting in pregnancy and dietary characteristics across populations Gillian V. Pepper and S. Craig Roberts Abstract: Nausea and vomiting in pregnancy (NVP) is a pervasive and debilitating phenomenon in humans. Several adaptive explanations for NVP occurrence have been recently proposed, the two most prominent of which predict associations with nutritional intake or specific dietary components. Here we extend previous cross-cultural analyses by analysing associations between NVP prevalence in 56 studies (21 countries) and quantitative estimates of per capita intake across major dietary categories, measured for the year of study by the Food and Agriculture Organisation (FAO). Rates of nausea and vomiting in pregnancy were correlated with high intake of macronutrients (kilocalories, protein, fat, carbohydrate), as well as sugars, stimulants, meat, milk and eggs, and with low intake of cereals and pulses. Restricting analyses to studies from North America and Europe caused relationships between macronutrient intake and NVP to disappear, suggesting that they might be influenced by non-dietary confounds associated with geographical region of study. However, factor analysis of dietary components revealed one factor significantly associated with NVP rate, which was characterized by low cereal consumption and high intake of sugars, oilcrops, alcohol and meat. The results provide further evidence for an association between diet and NVP prevalence across populations, and support for the idea that NVP serves an adaptive prophylactic function against potentially harmful foodstuffs. Gillian V. Pepper (AFF1) and S. Craig Roberts (AFF1) AFF1 School of Biological Sciences, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK ISSN: 0962-8452 (Paper) 1471-2954 (Online) Issue: FirstCite Early Online Publishing DOI: 10.1098/rspb.2006.3633