Lose Weight With VIBRATIONS?

Machines like this one which vibrate your body while you stand on it or exercise on it have been touted by gyms as fat-busters. Doctors give their take on their effectiveness and warn that long-term use may lead to nerve and organ damage

Yes, vibration works to help you lose fat and weight – but only if you exercise and follow a sensible diet as well.

The vibration plate machine, which has a platform that vibrates while the person stands on it, has been making its presence felt in workout studios and even homes here.

Since one brand called Power Plate was first sold here six years ago, the number of dedicated Power Plate studios here has grown to six, while that of gyms that stock these machines has risen to 10, said its sole distributor Positive Impact.

It has also sold more than 300 such machines to individuals. Each costs between $5,000 and $23,000, depending on the size of the machine.

Health and wellness retail company Oto has also developed a machine based on whole body vibration. A spokesman said it has sold 25,000 units of the FLABeLOS, at $1,198 each, to individuals here since 2007.

The Power Plate studios combine pilates, kickboxing and core, stretch, toning and cardiovascular exercises with the vibration plate machine. Classes cost between $25 per group session and $90 for a one-to-one session. Each session typically lasts 40 to 45 minutes.

The principle behind this is something called “acceleration training”, in which you need a shorter amount of time to burn the same amount of calories.

Exercising on a vibration plate may also have positive effects on strength, stability and bone density, said doctors and Power Plate master trainer Tay Koon Hua.

This can be helpful for, say, those who have been injured. Exercise on the vibration plate is low-impact and lets them build up their injured muscles or joints, they added.

So far, at least two recent studies have shown that it does lead to increased fat loss.

But there are caveats. Furthermore, no long-term studies on the safety of whole body vibration exercise beyond eight months have been done yet.

BUILDING MUSCLE MASS

Medical and physiotherapy experts interviewed said standing on a vibration plate subjects the body to many small vibrations per second.

This causes the small muscles in the whole body to contract more and the tendons and ligaments to stretch more than when a person is standing on stable ground. This is because the body has to adjust constantly to the motion.

This helps build up muscle mass, strength and flexibility, said the medical experts.

Muscle cells burn more calories than other cells because they are responsible for all movements, including subtle ones such as blinking.

So the increased muscle mass will help the body to burn more calories, leading to the loss of fat.

Dr Daniel Wai, director of the obesity and metabolic unit at Singapore General Hospital, said: “The actual amount of calories burnt after one hour of such exercise (on a vibrating plate) is only around 100calories, but as muscles are built up, it helps increase the amount of energy we burn in the resting state.”

Dr Roger Tian, consultant sports physician and deputy medical director at the Singapore Sports Medicine Centre, said exercising on an unstable platform, such as the vibration plate, increases muscle use as the body tries to maintain stability.

This additional muscle use increases expenditure of calories.

Mr Tay, 39, a former physical education teacher who owns a dedicated Power Plate studio and has shares in Positive Impact, said the machine will increase exercise intensity in two ways.

It helps the body to use more than 90 per cent of its muscles. It also increases the gravitational force by two to six times when a person works out on it. Hence, it will be more difficult for a person to perform exercises on the plate than on the ground.

He said: “As more energy is needed to perform the same exercise, more calories are burnt on the vibrating plate.”

For these reasons, more body fat is lost when whole body vibration training is added to a diet or exercise regimen than either programme on its own or together, two studies have shown.

Both studies – one in Belgium and the other in the United States – were done by doctors and published in peer-reviewed journals.

In the Belgian study on 79 overweight patients published last year, doctors looked at the effect of long-term whole body vibration training on visceral fat.

Visceral fat is the fat surrounding the organs in the abdomen. Abdominal fat is made up of visceral fat and subcutaneous fat, which lies between the skin and the abdominal wall.

The patients were randomly divided into four groups. The first group received a low-calorie diet only, the second dieted and did traditional fitness training, including cardiovascular and weight exercises, the third dieted and followed a progressive Power Plate machine training programme, while the fourth was the control group.

After six months, the group which dieted and followed a Power Plate fitness regimen showed the largest percentage drop in body weight and in visceral fat.

Those in the diet and traditional fitness groups showed a slightly smaller decrease in both measurements, while the control group had no significant change.

In measurements taken at the end of the year-long study, after all participants had returned to their usual lifestyle, the group which exercised on the Power Plate machines was found to have maintained the amount of fat loss. However, the diet and fitness groups had reverted to their initial fat level.

The results were similar in the US study on 55 post-menopausal women, published in 2009. It compared the effects of no exercise, resistance training only and resistance training with whole body vibration.

At the end of eight months, the women who did not exercise gained 1.8 per cent of body fat, while those who did only resistance training lost 1.6 per cent and those who did both types of exercise lost 3 per cent.

RISK OF INTERNAL INJURY

The same effect of burning more calories can be achieved without a vibration plate, said Dr Tian. A person can simply increase the duration or speed of his workout, he said.

Ms Loy Yijun, a senior physiotherapist at National University Hospital’s centre for obesity management and surgery, said whole body vibration therapy alone would probably not lead to weight loss.

Her view is that vibration therapy aims to elicit a similar or superior response to resistance exercises by stimulating muscle reflexes and contractions.

Even if more fat is lost, a person’s cardiovascular fitness may not be significantly improved.

The limitation primarily arises from the lack of a cardiovascular workout, which is essential to burning calories, she said.

Moreover, it is important to realise that vibration plate exercise may result in potential harmful effects, doctors said.

Adjunct Associate Professor Hee Hwan Tak, an orthopaedic surgeon at Singapore Medical Group, said: “This exercise should be done with caution in the elderly or those with balance issues, for fear of falls.”

Soft tissues and body organs could be harmed by long-term vibration. For example, workers using vibration tools such as road drills can suffer from nerve damage to the hands due to chronic vibration. This is called “vibration white finger” disease.

It is not known if long-term use of vibration plate machines will create similar problems.

Dr Wai said: “We do not have studies that last longer than eight months, so do keep in mind that long-term safety is unclear.”


Evaluation of Human Response under
Vibration Condition
Hon Keung Yau, Bing Lam Luk, Sum Sang Chan

Abstract - The purpose of this study is to
investigate the human response under different
vibration frequencies. A total of nine
frequencies (1.6, 2.0, 2.5, 3.15, 4.0, 5.0, 6.3, 8.0
and 10.0Hz) were chosen as stimuli for testing in
the experiment. In this experiment, two tests
were conducted: Comparative Test and Feet Supporting
Test. Ten males and ten females were invited to
participate in the experiment. The major
findings revealed that (i) the uncomfortable
feeling increases with an increase of vibration
frequency, (ii) the feet support does have better
influence to the feeling of comfort for females
than males.

Index Terms – comparative test, human
response, supporting test, vibration

Manuscript received November 15, 2011.
H. K. Yau is with the Department of Systems Engineering and
Engineering Management, City University of Hong Kong, Kowloon
Tong, Kowloon, Hong Kong (corresponding author to provide phone:
852-34426158, Fax: 852-34420173. 

B. L. Luk is with the Department of Mechanical and
Biomedical Engineering, City University of Hong Kong,
Kowloon Tong, Kowloon, Hong Kong.

S. S. Chan was with the Department of Mechanical
and Biomedical Engineering, City University of Hong
Kong, Kowloon Tong, Kowloon, Hong Kong .

I. INTRODUCTION
In Hong Kong, most people take the public
transport to various destinations like schools and
offices every day. Common vibrations we can
experience come mainly from the uneven road,
changing of speed, sound produced when a sudden
stop of the bus and train, etc, and these vibrations
can cause damages to us. Different vibrations can
cause different levels of uncomfortable feeling on
males and females. Some past studies have
investigated how vibration affected working
efficiency, safety and health [5]. However, few
studies investigated the gender differences, if any,
in the human response under different vibration
frequencies. Therefore, we fill this research gap in
this study.

II. LITERATURE REVIEW
Vibration interferes with people’s working
efficiency, safety and health [5]. It also causes
discomfort, fatigue and physical pain [3]. Our
health are affected if the strength of vibration is
too large or the duration of vibration is too long
[1]. Past research results showed that feeling of
discomfort increases when the frequency increases
[8]. 5Hz is the resonance frequency for whole-body vibration.
It was also shown that the spine, inner organs and muscle are in
resonance when vibration frequency reaches 8Hz [6], [7]. The
feeling of discomfort increases even higher when more than one
organ of our body are in resonance. The thigh’s stiffness

can only affect little on the feeling of discomfort during vibration [7] while the tensed posture can increase
our stiffness and decrease the feeling of discomfort [4]. In
addition, the posture of tensed upper body
increases the stiffness of body so as to
increase the resonance frequency [2]. Due to
the resonance of spine and inner organs, the
uncomfortable index increases rapidly [6].
Besides, the uncomfortable feeling is much
worse than the relax pose or even cause
damage to our back if the vibration strength
reaches the resonance frequency [3].
III. RESEARCH METHOD
A. Participants
Twenty people (10 males and 10 females)
were invited to participate in the experiment.
They were of average age 21.95 years,
168.1cm tall and 59.1kg weight.
B. Design of experiment
To acquire the data, the following two tests were
conducted:
(i) Comparative test
(ii) Feet supporting test
(i) Comparative Test
 Method of magnitude estimation
1. To take the stimulus of 5Hz as a reference
2. Try other stimuli
3. Give an uncomfortable index comparing with the
reference stimulus
(ii)Feet Supporting Test
 Method of magnitude estimation
1. Try stimulus without feet support/upper body
relax as a reference stimulus
2. Try the same stimulus with feet support/ upper
body tensed
3. Give uncomfortable index comparing to the
reference stimulus
C. Experiment procedure
For the comparative test, participants were
tested under different vibration frequencies to
analyse discomfort effect at different frequencies.
If the test did not mention about the posture, then
the posture was assumed as upper body relax
without feet support. As many literatures pointed
out that 5Hz was the first starting resonance
frequency, a comparative test referencing at 5Hz
was carried out. Firstly, the participants were
asked to take a stimulus of 5Hz for 4 seconds and a
random selected frequency for another 4 seconds.
After the testing of the two stimuli, participants
were asked to fill in an uncomfortable index survey
as 100 was the mark for 5Hz. For example, if the
participant felt that the selected frequency caused
half uncomfortable feeling compared to that at 5Hz,
then he/she should fill in 50. If they think the
uncomfortable feeling is twice, they should fill in
200. Through the test, we could see whether there
were any differences between the male and
female’s responses at the same vibration level.
For the feet supporting test, participants were
exposed under all vibration frequencies with feet
support for 30 seconds. After that, they were asked
to fill in the uncomfortable index survey.
The test and frequency sequence was
randomized and counterbalanced across trials but
each pair of males and females was under the same
sequence for the analysis of difference in males
and females.

IV. RESULTS AND DISCUSSIONS

(a) Comparative test

Table I: Results of Comparative test
Frequency Index combination

Index male

Index female

1.6Hz 32.25 43 21.5
2.0Hz 39 48 30
2.5Hz 42.75 52 33.5
3.15Hz 62.5 70 55
4Hz 80 82.5 77.5
6.3Hz 117.25 119 115.5
8Hz 144.5 144 145
10Hz 184.5 183 186 

From the Table I, the correlation between
uncomfortable index and frequency for male
and female participants are 0.999 and 0.998,
respectively. Feeling of discomfort basically
increased when the frequency increased. This
finding is consistent with the results of Subashi
et al. [8]. Feelings of both males and females were similar
after the resonance frequency 5Hz. The feeling of
discomfort started to increase obviously at 5Hz. That
may be due to the appearance of resonance since 5Hz
which was mentioned by many researchers as the
resonance frequency for whole-body vibration [6], [7]. As
the resonance frequency will make participants feel more
uncomfortable than other frequencies, the feeling may
become similar for both males and females. There is a
large difference for the response of male respondents than
females for all frequencies except 10Hz. Besides, the
difference between males and females in response became
smaller after 5Hz, we can estimate that the vibration
strength may be too large to make both male and female
feel very uncomfortable, so that the response of males and
females are similar after 5Hz. Therefore, it can be
concluded that the resonance made the response in males
and females become similar after 5Hz. At 8Hz and 10Hz,
the uncomfortable feeling increased rapidly, the
uncomfortable index for 10Hz was almost twice of 5Hz.
That may be due to the resonance of our organs. The spine,
inner organs and muscle was in resonance when the
frequency reached 8Hz [6]. If more than one organ of our
body were in resonance, the feeling of discomfort
increased even higher.

(b) Feet Supporting Test

Table II: Results of feet support test

Frequency Index combination

Index male

Index female

1.6Hz 97.5 95 100
2.0Hz 96.5 98 95
2.5Hz 88.5 92 85
3.15Hz 89.25 90 88.5
4Hz 81.5 87 76
5Hz 80.75 84 77.5
6.3Hz 79 84 74
8Hz 72 82 62
10Hz 74.5 88 61

From the results (Table II), we noted that the
feet support does have better influence to the
feeling of comfort for females than males. The
correlation coefficients for males and females are
0.708 and 0.994 respectively. The uncomfortable
index keeps on decreasing when the frequency
increases up to 5Hz for females. This indicates that
the feet support can help to reduce the feeling of
discomfort. We also noted that the uncomfortable
index for females is lower at almost all frequencies
in the condition of using feet support. That may be
due to the difference in strength of buttock for
male and female. Besides, the feet support can decrease
the feeling of discomfort. As mentioned by some
researchers [7], the thigh’s stiffness will affect little
on the feeling of discomfort during vibration. Instead,
tensed posture can increase our stiffness and decrease the
feeling of uncomfortable [4]. Therefore, the difference
in response between male and female becomes
more obvious after 5Hz. Also, the variation of
uncomfortable index at the same frequency is quite
similar for both male and female as shown from the
table 2. The difference in response between males
and females become most significant at 8Hz and
10Hz. The figure shows a significant difference
between male and female at 8Hz and 10Hz. The
uncomfortable index keeps on decreasing but rising
at 10Hz for males, it may be due to the resonance
in organs as mentioned from the comparative test
[6]. But the feet support test is not suitable for all
people as some participants claimed that the feet
support will make them feel more uncomfortable at
some frequencies.

V. CONCLUSION
A series of human factors experiments
concerning the human response under different
vibration conditions was conducted in this study. It
was concluded that the uncomfortable feeling
increased with the increase of vibration frequency.
The difference in response for males and females is 
not significant after 5Hz. Also, the feet
support was more useful for females than
males. It seemed that feet support provided
more help to females than males especially at
8Hz and 10Hz. It may be due to the difference
in strength of buttock because the feet support
increased the loading of the buttock.

REFERENCES
[1] C.M. Byung, C.C. Soon and J.P. Se., “Automatic responses
of young passengers contingent to the speed and driving
model of a vehicle,” Int J Ind Ergon Vol. 29, pp. 187-198,
2002.

[2] Y. Huang, and M.J. Griffin, “Effect of voluntary periodic
muscular activity on nonlinearity in the apparent mass of the
seated human body during vertical random whole-body
vibration,” Journal of Sound and Vibration Vol. 298, pp. 824-
840, 2006.

[3] J.Z. Liu, M. Kubo, and H. Aoki, “A study on the difference
of human sensation evaluation to whole body vibration in
sitting and lying postures,” Appl Hum Sci, Vol. 14, pp. 219 –
226, 1995.

[4] Y. Matsumoto, and M.J. Griffin, “Non-linear characteristics
in the dynamic responses of seated subjects exposed to
vertical whole-body vibration,” Journal of Biomechanical
Engineering Vol. 124, pp. 527-532, 2002.

[5] R.W. Mcleod, and M.J. Griffin, “Mechanical vibration
included interference with manual control performance,”
Ergonomics Vol. 38, pp. 1431-1444, 1995.

[6] Mester, Spitzepfeil, and Yue., “Vibration Loads: Potential for
strength and Power development”, 2003

[7] N. Nawayseh and M.J. Griffin, “Non-linear dual-axis
biodynamic response to vertical whole-body vibration,”
Journal of Sound and Vibration Vol. 268, pp. 503–523, 2002.

[8] G.H.M.J. Subashia, and N. Nawaysehb, Y. Matsumotoa, and
M.J. Griffin, (2008). “Nonlinear subjective and dynamic
responses of seated subjects exposed to horizontal wholebody
vibration,” Journal of Sound and Vibration Vol. 321,
pp. 416–434, 2008 .

Chapter 19 SPECIFIC RECOMMENDATIONS ON WHAT TO DO TO BUILD YOUR BASELINE OF HEALTH, DAY BY DAY

Chapter 19

SPECIFIC RECOMMENDATIONS ON WHAT
TO DO TO BUILD YOUR BASELINE OF
HEALTH, DAY BY DAY

The secret to health, the secret to all of the success that the great "Miracle Doctors" share, isthat they look to raise every inch of a person's Personal Health Line. If you do that, if you raise
the entire line, the odds of good health (even of recovery from terminal disease) are remarkably
favorable. If you want great health, if you want relief from illness that has not responded to traditional
medicine, try using this program in cooperation with your physician. The results may very
well astound you—and your doctor.

                     Suppplements

Daily For Everyone

>The bedrock of your supplement program is a broad-based supplement. I recommend a biodynamically grown, living-food, multi-vitamin/mineral complex.

>One and a half tablespoons of golden flaxseed ground and mixed with juice twice a day—before breakfast and supper.

>A liquid trace mineral supplement.

>A good probiotic.

>Enzymes with every meal. And at bedtime several times a week.

>A full-spectrum antioxidant.

>Immune booster and pathogen destroyer.

>Drink a minimum of 64 ounces of pure, pH optimized water a day.

Daily For Those Over 30

>Progesterone cream for both men and women

>Testosterone balancing formula for both men and women

Periodic 

.
>2-4 times a year: colon cleanse and detoxification program.

>2-4 times a year: blood/liver detox

If seriously ill, the detox programs above are to be done immediately—back to back. Then, take one week off and repeat, and repeat again as long as necessary.

>Four times a year: fast on fresh juices (absolutely not bottled or canned) for 3 - 7 days. If you prefer, you can combine the quarterly juice fasts with the colon and blood/liver detox programs.

Again, if seriously ill, start a juice fast immediately. Drink up to a gallon of fresh juice a day—an 8 ounce glass every hour you're awake.

Optional

If needed, take a colon activator daily to avoid retaining fecal matter. Also, the worse you eat and/or the more contact you have with toxins, the more often you need to cleanse and detox.

            Lifestyle Changes

Daily Exercise

Even if you are ill (especially if you are ill), you must exercise. If all you can do is hobble around the bed with a walker, do it. Do one lap around the bed the first day, and two the next.

Lessons from the Miracle Doctors - 165 - Specific Recommendations

Relaxation

>Meditate daily, or pray deeply—morning and evening. At the end of each session, practice a healing visualization and affirmation. Use a nerve tonic as needed.

Diet
>You know what to do. If you can't be perfect in your dietary habits, at least be better than you are now.

>If you have a really bad day (filled with chili dogs, beer, and ding dongs), do a one day juice fast the next day. Your body has a remarkable ability to repair itself—if you give it a chance.

If you are ill, you have no choice. You must totally clean up your act until you are well. No cooked foods. No processed foods. Lots of fruits and vegetables—especially fresh juices.

                        Brand Names

I have decided not to include specific brand name recommendations for the various supplements described in the book. Nevertheless, the ingredient lists and specifications for each formula are located in the individual chapters and can be used as a guide if you choose to look for suitable formulas in a health food store.

On the other hand, if you wish to see the specific brands that I personally recommend, you are welcome to visit my WEB site. Since my list of "the best products" and "best buys" changes periodically, I have decided to keep the list online, where I can update it as needed.

You are also welcome to visit the site and sign up for the online global business opportunityof the Baseline of Health Wealth. It's our Financial FREEdom. Click here to Join me. Thank you.

GOOD HEALTH AND LONG LIFE

Doctor’s Politics Affect Your Care

Doctor’s Politics Affect Your Care



I already know that this newsletter is going to upset many people--especially those who don't read beyond the title. Everyone likes to believe that their political views are carefully thought out, rational opinions formed by their awareness of the world around them and a mastery of facts. In other words, they are the result of absolute free will and are therefore entirely independent of all other aspects of their lives. Anything that challenges that opinion, which is effectively a challenge to free will, and especially anything that contains the words Republican and Democrat, really upsets people. In other words, anything that even implies that our politics might be influenced by our fundamental psychological or even genetic makeup or, even worse, that our political proclivities might shape how we view the world and the decisions we make, is going to bring out the dogs of war.

But if we are honest about it, we all intuitively know that political beliefs do indeed spill over into nonpolitical domains such as consumer spending, choice of romantic partner, and job hiring. That said, what we're going to talk about today is something quite different but nevertheless touches on the same hot buttons. A new study suggests that the political beliefs of our primary care physicians may predict their professional decisions--at least for certain health questions.1 According to the study, when it comes to politicized health issues like marijuana and abortion, it turns out that a physician's partisan identity is highly correlated with his/her treatment decisions. Because physicians regularly interact with patients on politically sensitive health issues, and because the medical profession is increasingly politicized (e.g., state governments are regulating politicized aspects of medicine), it is necessary to understand how your doctor's political worldviews might impact their decisions, recommendations, and actions in the medical examination room when it comes to your diagnosis and treatment. That understanding should then inform not only how you filter their recommendations but also whether or not it's in your best interest to look for a new doctor.

The political beliefs of our primary care physicians may predict their professional decisions.

So, setting aside the question of free will for the moment, which really isn't being called into question by this study, let me suggest that you read through to the end of the article as there are real lessons to be learned from the several studies we're going to talk about--real lessons that can affect the health care you receive.

With that in mind, let's take a look at the newly released study in question.


Republicans, Democrats, and Doctors

The co-authors of the study, Eitan Hersh, an assistant professor of political science, and Matthew N. Goldenberg, MD, an assistant professor of psychiatry, linked the records of over 20,000 primary care physicians in 29 US states to a voter registration database, thus obtaining the physicians' political party affiliations. They then contacted 1,529 of them to participate in the study, ending up with a sample of 231 doctors--both Democratic and Republican primary care physicians--whom they then surveyed. The survey involved the physicians evaluating nine patient vignettes which they were told were recounted by patients as part of a complete physical. Three of the vignettes addressed especially politicized health issues (marijuana, abortion, and firearm storage). Specifically, the vignettes presented scenarios such as a healthy-appearing 38-year-old male patient who "acknowledges using recreational marijuana three times per week" or "who is a parent with two small children at home" and "acknowledges having several firearms at home." And yet another fictional patient said she had two abortions in the past five years. Those vignettes were interspersed with some more neutral complaints like obesity, depression, or not wearing a motorcycle helmet.

Hersh and Goldenberg then asked the physicians to rate the seriousness of the issue presented in each vignette and how they would treat the patient. The physicians who responded did not know that the survey was about their politics. Rather, they thought it was about how they administer the patient interviews that primary-care doctors give patients before they first treat them. On the politicized health issues--and only on such issues--Democratic and Republican physicians differed substantially in their expressed concern and their recommended treatment plan. (It should be noted that the study controlled for physician demographics like age, gender, and religiosity, patient population, and geography.)

According to Hersh and Goldenberg, "The evidence suggests that doctors allow their political views to influence their professional decisions in the medical exam room. Just as patients choose physicians of a certain gender to feel more comfortable, our study suggests they may want to make a similar calculation based on their doctor's political views." It's important to note that this is not an insignificant issue as physicians frequently interact with patients about politically salient health issues, such as drug use, firearm safety, and sexual behavior.


Perhaps not too surprisingly, Republican physicians expressed more concern than their Democratic colleagues about the vignettes on marijuana use and abortion whereas the Democratic physicians were more concerned about the vignette related to firearms. Democratic doctors were less likely to discuss the health risks of marijuana or highlight its legal risks or encourage the patient to cut down their usage.  On the other hand, they were more likely to urge patients not to store firearms in the home, whereas the Republican physicians were much more likely to discuss the health and legal risks of marijuana and to advise the patient to cut back. They also were twice as likely as Democrats to discourage patients from having more abortions in the future and 35 percent more likely to discuss mental health in connection with abortions. Interestingly, Republican physicians were also significantly more likely to ask their patients if they were storing their firearms safely, though Democrats were more likely to urge them simply not to have them in the home. It should be noted that research shows that counseling by doctors can help promote safe gun storage. On the other hand, studies show that a majority of doctors choose not to go there. Again, physicians of both parties similarly rated the vignettes on non-political issues like depression, alcohol abuse, obesity, and not wearing a motorcycle helmet.



Effect of "Republican" on seriousness of issue. (PNAS)

The study concluded that physician partisan bias can lead to unwarranted variation in patient care. Thus, awareness of how a physician's political attitudes might affect patient care is important to both physicians and patients alike. As Goldenberg noted, "Given the politicization of certain health issues affecting countless patients, it is imperative that physicians consider how their political views may affect their professional judgments. The evidence calls for heightened awareness among physicians and more training concerning our biases in how we address politically salient health issues." As the authors write in the study, "To be clear, we cannot say with any certainty what the root cause of partisan differences in treatment is. However, regardless of the underlying mechanism that affects physician judgment, the evidence suggests a clear effect from the patient's perspective."

In summary, "Just as a patient may seek out a physician of a certain gender to feel more comfortable, the evidence suggests that a patient may need to make the same calculation regarding political ideology." Of course, a Republican or Democratic doctor would likely live in an area where the majority of his or her patients were of the same party. Still, if a contentious health issue is discussed during an appointment, it might be the provider's political beliefs talking, rather than their medical training. In certain cases, according to the study's authors, it might be worth getting a second opinion--perhaps a few towns over.

That said, although I would tend to agree with the study's observations, I'm not sure I agree with their recommendation, at least as stated. But before we go there, let's take a look at the elephant in the room. (And yes, the pun was deliberate.)

The Elephant in the Room

Hersh said he hopes the study will open up a dialogue about how political bias affects medical decision-making and make practitioners more aware of ways in which their personal beliefs might affect the care they give patients. Depending on the study's response, he says, he might even consider making his data on physician names and party affiliations public. This would be important because until the political data can be effectively linked to actual outcomes, the true extent of how politics affect physicians' decisions won't be clear. Unfortunately, he is likely to encounter resistance, especially among the large number of doctors who don't think that their political views inform their practice decisions. As Rep. Phil Roe (R-Tenn.), a retired obstetrician-gynecologist who co-chairs the GOP Doctors Caucus,4 told the Washington Post, "I never once treated a Republican or Democrat cancer in my life. When a patient walked into my office, I didn't know if they were a Republican or a Democrat, and I honestly didn't care."5 Roe went on to tell the Post that he hopes patients will seek out the best care available regardless of their doctor's political affiliation. "Party affiliation should have nothing to do with patient care."

And he is correct. Party affiliation should have nothing to do with patient care. Unfortunately, his pronouncements on the study have nothing to do with the study's actual conclusions. They are a red herring. In fact, the study has nothing to do with Republican or Democratic cancer. All the study is saying is that certain mindsets that are frequently, but not exclusively, associated with party affiliation do have an effect on physician decision making.

In fact, other research has shown that this is even more ingrained than you might think--that there is frequently a genetic factor to political leanings. A study, conducted by researchers out of the University of California, San Diego and Harvard University, identified a particular gene that seems to predispose certain people to a more "liberal" outlook.6 (We will talk more about what a "liberal" outlook actually means in a moment.) Data from more than 2,500 volunteers in the National Longitudinal Study of Adolescent Health was analyzed to compare people with the R7 variant of the DRD4 gene.7 Keep in mind that a person's political bent has always been assumed to be a product of their environment and social background, not their genes. And while environment and background certainly have a large impact on each person's beliefs, this study strongly indicates there is something going on behind the scenes in our DNA that influences us right down to our core values. Research has established that approximately 38% of us possess the R7 variant of the DRD4 gene. And please keep in mind that scientists hasten to add that neither version of the gene is better than the other -- if one were superior, natural selection most likely would have eliminated the inferior form.





Now let's talk about what we mean by "liberal," at least as far as this study is concerned. In fact, "liberal" in this case does not refer to which candidate you vote for but, rather, refers to a penchant for novelty seeking behavior. Earlier studies have determined a link between the R7 variant and novelty-seeking behavior. People with the variant may be more likely to try new experiences and take some risks. In other words, the study is saying that those who are more likely to be comfortable pushing boundaries and trying new things can be defined as liberal. And those who don't, who like to play it safe, can be defined as conservative. And again, neither is superior when it comes to genetic survival. On the one hand, playing it safe could have certainly been advantageous to prehistoric man if wild animals were about. But being willing to try new things and push out into new territory would have been advantageous if food supplies were strained in your familiar environment. Each tendency can be advantageous depending on the circumstances.

In any case, now researchers are applying the new findings to this information and suggesting that when people with the R7 gene variant have also had an active social network, they may be more likely to seek out their friends' opinions on political subjects and be open to a wider range of lifestyles, creating a more liberal position politically. And that's the tie-in to politics. However, having the variant does not guarantee a final resting point on the political spectrum. For example, if either the variant form of the gene is not there or the adolescent years were not socially popular ones, then the person can fall anywhere on the political spectrum. The findings were the same across age, gender, ethnicity, and background differences. The bottom line is that we're only talking about tendencies here. There are indeed conservative Democrats and liberal Republicans (I believe they're called RINO's...Laughing). Again, we're not really talking about politics. We're talking about a fundamental, psychological way of viewing the world that merely gives people a predilection to end up in one party or another--not a guarantee.

In fact, more than half a century of research in genetics, neuroscience, and psychology has demonstrated that human behaviors, including social and political attitudes, are influenced by genetic and neurobiological factors. However, these findings have not been widely accepted or incorporated into the dominant paradigms that explain the underlying causes of political ideology. This has been attributed in part to measurement and sample limitations, as well the relative absence of molecular genetic studies.

In addition, there's the 2012 study that combined evidence from over 12,000 twins pairs, ascertained from nine different studies conducted in five democracies with the data from three genome-wide association studies on political ideology.8 In other words, it was not a small study. It concluded that political ideology constitutes a fundamental aspect of one's genetically informed psychological disposition.

So what does this mean for doctors? Well, let's return to Rep. Roe's statement: "When a patient walked into my office, I didn't know if they were a Republican or a Democrat, and I honestly didn't care." We should now be able to see that this statement is irrelevant. We're not actually talking about party affiliation. We're talking about genetically informed psychological dispositions that can inform how doctors choose to treat certain conditions--not that they differentiate between Republican and Democratic patients. And yes, people of certain dispositions tend to gravitate to certain political parties that support that disposition--but again, that's only a tendency, not a certainty. In any case, those same psychological dispositions tend to lean doctors towards conclusions and treatments in line with that disposition.

But What Does the Mean to Me?

At this point, let's just throw politics completely out the window, which should simplify the discussion and remove the emotional heat from it. Let's just acknowledge that different doctors will vary in:

What treatment options they recommend in certain situations
Where they fall on the risk vs safety continuum
Now things become much simpler, which allows us to establish some physician selection guidelines.

Surgery

When it comes to surgery, there are essentially two kinds: standard and cutting edge, high risk.

For standard surgical procedures, you probably want a conservative doctor who follows the safest protocols available. When it comes to routine surgery, you don't want a risk taker.
For more cutting edge or experimental surgeries, you probably want a surgeon who is comfortable playing in unfamiliar territory. If the surgical technique involved is not routine, you want a doctor who thrives when playing outside their comfort zone.
And by all means, check out your surgeon's rating for the particular procedure you're looking to have them perform. Why in the world would you choose a doctor to operate on you who isn't very good at performing the operation and tends to leave lots of bodies on the operating table? And for that matter, be sure and check out the safety score for the hospital where your surgeon is going to be performing the procedure. They provide your doctor's support team.

Primary Care Treatment

On the other hand, when it comes to general medical diagnosis and treatment, you probably want a doctor who lines up with your view of health and nutrition.

>If you're into herbs and alternative health, find a doctor who is friendly (or at least not hostile) to those protocols. Why would you want to put yourself in a position where you're constantly fighting with your doctor about the medications he/she prescribes or the supplements you want to take?

>If you're a strong believer in the virtues of toeing the medical line, then track down the most medically astute doctor you can find--regardless of their opinion of alternative health.

>If you smoke marijuana or use birth control, find a doctor who doesn't fight you about it or look askance at your lifestyle.

>If you don't believe in antidepressants or any other class of pharmaceutical drugs, then don't go to a doctor who refuses to explore alternative treatments--even alternative medical treatments--with you.


>And, as with surgeons, even when selecting a primary care physician, it's a good idea to check out how the doctors you're looking at rate with previous patients.

If you find that you are with the wrong doctor, don’t hesitate to change physicians. It's your life, not your doctor's.


The bottom line is that when medical skill is the priority, find the most skillful doctor you can find--regardless of political outlook. When looking for a primary care physician who will work with you on an ongoing basis, find a doctor of like mind and similar disposition. And if you find that you are with the wrong doctor, don't hesitate to change physicians. Remember, it's your life, not your doctor's.

Who Is Dr. Yoshitaka Ohno ?

Dr. Ohno is a native of Osaka, Japan, where he received his education and training in medicine and neuropathology. Early in his medical career, he began searching for ways to stop the suffering of his patients with diseases that could not be treated successfully by standard medicine, and thus had to be managed with multiple drugs. He began to realize that the side effects of these drugs were creating serious chronic problems, as well as increasing the body'd deterioration.  After extensive study Dr.Ohno became convinced that the condition of the human body's water was directly related to the state of the body's health.

After leaving his medical practice, he continued his studies but found that the Japanese medical community was not placing much emphasis on chronic diseases found commonly among the aging population. He decided to enter the United States and accept a position at AMC Hospital in Denver, Colorado, where he could continue his research in geriatric pathology , including MRI studies on the relationship of water and cellular degeneration.  His work led him to investigate the neuropathology of Alzheimer's disease. As a result of his work, he received the Community Leadership Award from the Colorado Alzheimer's Association in 1987, and the Humanitarian Award from the Alzheimer's Disease International in 1993. 

After returning to Japan in 1990, Dr. Ohno discovered a naturally magnetized water that was being used by a prominent physician to treat serious, life-threatening diseases.  As these patients recovered, Dr. Ohno became convinved that this water was unique.  he pursued numerous clinical studies with this water , both in Japan and the United States. In 1998, Dr. Ohno founded the  Ohno Institute on Water and Health, a non-profit research and education center for studying the effect of naturally magnetized water on health and aging. He has been requested as a speaker at several health conferences and has published several articles in professional journals on his findings. Click For Location 

Bio-Magnetism and Water Cumulative Effect of Bio-Magnetism and Water on Increasing the Body's Resistance to Disease and Aging

by by Yoshitaka Ohno, M.D., Ph.D. Howard Reminick, Ph.D.

© Francene Hart The body is under constant attack. Environmental contaminants make their way into the air, food and water, and invade our body. Rapid environmental changes in modern society have led to a breakdown of the body's defenses and a rise in immune-related diseases. Although we are living longer, we are really only living a longer period of time for our body to deteriorate from chronic  disease associated with aging.  Quantityof life, therefore, has replaced  quality of life. Throughout our lifetime, we are  confronted with the mystery of why we  become so susceptible to disease as we  age. After many years of studying the  relationship of water to disease and  aging, I am convinced that the body's  ability to resist disease and unnatural  aging depends on the condition of the  water in our body. What does this mean?  It means that water is the key in providing  our body with what it needs to strengthen its immune system, to better process  nutrients, to maintain electro-chemical  balance, and to protect the cells from  damage by absorbing and flushing out  toxins and wastes before they accumulate and destroy them. The mystery of understanding disease,  therefore, begins basically with knowing  what our body needs throughout its  lifetime to maintain a consistent balance.  It requires investigation; not only what  factors and conditions result in disease,  but also how the body reacts to hosting  various destructive organisms. We also  need to know what known methods can  be utilized in seeking the best preventive  and maintenance measures available. It  also requires understanding the demands  placed upon our body from sudden  changes, without the body having time  to adapt and allow the natural immune  system to help re-establish its balance. Health and aging depend on the quality,  content and structure of the water in our  body. Since our body is 70% water, a cell  is 70% water, and the DNA in the cell is  70% water, then the water we put into our  body must be significant in how we age  and how well our body can maintain a  stable internal environment to keep  disease-producing influences from  destroying it. Symptoms of the body's deterioration  begin to appear when the body loses 5%  of its total water volume. In a healthy,  normal adult, this is seen as fatigue and  general discomfort. Although an adult can  survive with a 5% water volume loss,  this amount can be dehydrating to an  infant. In an elderly person, a 5% water  loss may not be fatal, but the body  chemistry becomes abnormal, especially  if the percent of electrolytes is  overbalanced with sodium. If this percent  decrease in water volume continues, the  body will break down. Symptoms seen in aging, such as fever, nausea, dizziness  and even disorientation will become  standard. Continuous water loss over  time will speed up aging, as well as the  disease process itself. Not maintaining  the required water volume in the body  will result in continuous and apparent destruction.  The body will die in less than a week  without the minimum amount of water  to sustain itself. All body functions take place in water,  interacting with cells. Because water is  an excellent solvent, assimilation of vital  nutrients and proteins take place through  absorption. Water then carries those sub- stances throughout the body to vitalize  and replenish cells, and protect their  exterior walls. This allows such functions  as metabolism, digestion, blood flow and  cellular reproduction to remain normal.  However, all of these functions can be  seriously disrupted when the body's  water is contaminated. Instead of being a  stabilizing force, water can add to the  disturbance of these functions. Studying water as long as I have has led  me to identify a progression of the disease  process in our body. I call this the "cycle  of disease," because I have seen a direct  progression of deterioration in the body  as it becomes susceptible to disease. It  begins with water that is contaminated  with toxins and chemicals that can't be  neutralized and as a result, change the  chemistry of body fluids. As contamination continues in our body,  its water becomes acidic. This sets up a  condition for oxygenation, which disrupts  cell stability by stealing electrons. As a  result, free radicals form and destroy cells.  Now the body is in a state of disease. In  the process of defending the body from  mass destruction, the immune system is  weakened. In the process of recovery,  over medication results in further  weakening the immune system. This is compounded by the autoimmune system response, which attacks  and destroys  healthy cells. We can now see a domino  effect take place, as cells continue to be  invaded and destroyed. Our natural immune system needs time  to respond and help the internal  environment of the body to adapt to  radical changes. In the past, our body  had time to build defenses to protect itself. However, today  we face the constant threat of new toxins  and organisms produced in the environ -ment, which invade our body as the  immune system struggles to build its new  line of defense. During this process, the  human organism remains vulnerable. Much of the power of the immune system  is located in the blood, where it provides protection from foreign pathogens.  Antibodies in the blood locate unfamiliar molecules attached to organisms in the  body and attack them. Blood is composed  of  90% water. When the water,  which composes most of the blood  is contaminated, the antibodies become  disabled and are not effective in  destroying toxic invaders. Knowing  the importance of water and providing  our body with the best water possible  can give us an edge in protecting our  body. Some Important Facts about  the Body's Natural Healing Process The body has the natural ability to  repair and heal itself. This is seen in  every species of life. However, we  have turned away from this and rely  on "modern medical miracles" to  provide a quick fix for recovery from  illness. Healing requires energy. The body is  a molecular structure, composed of  60 trillion cells. Cells are produced  and maintain their structure and  function based on energy. The  production of energy is sustained  by the stability of the electrons of  the cell. Lost electrons create a  disruption in the cell's energy supply.  Metabolism is disturbed and the  cell dies. The body's magnetic wave-form  must be smooth and even in order  for the body to return or remain  in balance. Electromagnetic waves can be  measured with instruments such as  EEG (electroencephalogram) and  EKG. Disturbance in magnetic rhythm is seen in erratic magnetic wave  patterns shown by these instruments. Healing depends on blood circulation  to bring energy, oxygen and nutrients to a distressed area of the body. This requires a continuous rate of flow and a balanced pH, between pH 7.35 and pH 7.45.  It also depends on the blood's ability to prevent plaque from forming on  arterial walls because of a high  viscosity or resistance. Usually we have to return our body  to a state of health in three stages: 1. Detoxification 2. Re-balancing 3. Provide it with protective  mechanisms against disease and unnatural aging. During this period, it is essential that  we increase water consumption in  order to increase intracellular hydration.  However, in order for the healing  process to become activated, two  conditions must be present. First,  the body's water must be capable of  providing an internal environment to  allow the body to remain in balance.  And second, there must be a magnetic  influence to allow the water to  activate the body's energy and physiology. The majority of medical scientists  follow a common principle regarding  disease. Health and disease are  basically determined by states of  order and disorder in our body.  Disease is a disturbance of molecular  structure, which results in a breakdown  of cells and the bio- electrochemical  processes of various systems, as well  as the human organism as a whole.  A natural state of order in our body  is required and is directly related to  a stable, magnetic waveform, which  helps produce, as well as distribute  energy throughout the body. This  waveform is necessary to keep the  body in balance. Whenever the body  is disrupted by internal or external  destructive influences, its magnetic  waveform becomes erratic. In order  for the body to return to balance,  a stable magnetic wave must be  restored. When this happens, the  natural healing responses can  effectively make a correction. The body's magnetism stimulates the biochemistry needed for the body's communication systems and for  natural healing to take place. Healing  begins and ends in the core of every  cell. Because water composes most of  the body, it is the medium for allowing magnetization to activate this healing  process. Minerals that respond to and  activate magnetization in the body  have been depleted from our soil and  drinking water sources. These minerals  must be constantly replaced for our  body to maintain its ability to remain  stable and benefit from its magnetic  energy. The body has a magnetic blue  print and the source and the level of  magnetism affects the level of energy.  Its electrochemical plant in every cell  programs all activity that takes place  in the body. Magnetism is a dominating factor in  all human functions. As geomagnetism  holds the earth and all life in balance,  so is magnetism necessary for the  human body to remain in balance.  Since water is the basis of life, how  it is influenced by magnetism  determines how effective it is in  regulating all bodily functions. Water that is naturally magnetized can communicate and transfer information  from one molecule to another and,  therefore, from one system or organ  to another. This is made possible by  the orderly arrangement of its water  molecules, traveling through the body,  as they are kept aligned by magnetization. Without active magnetization in each  molecule, water will not remain in an  orderly structure after each impulse.  Messages between cells will become  distorted and there will be no steady  magnetic frequency. How Does Naturally Magnetized  Water Work in Our Body? The Japanese symbol for "Perfect  Harmony or Balance" is Nariwa.  完璧なハーモニー Kanpekina hāmonī.  (click here to pronounce) 完璧な調和 Kanpekina chōwa (click to pronounce) This describes what we call  homeostasis, the body in balance.  It seemed like the right word to  describe what I have found out  about how important the water in our  body is to bring it into a state of  harmony or balance. Ever since I discovered Nariwa naturally magnetized water in Japan, which  was being used by physicians to treat  serious, life threatening diseases, and  began experimenting with it, I have  found changes in the health status of  patients whom I have studied. As a  medical researcher, I have struggled  for many years asking questions on  the many causes of the body's  deterioration and susceptibility to  disease, especially diseases associated  with aging. I have conducted several investigations, including controlled  clinical studies and individual case  studies. The results of these  investigations revealed many answers  to my questions. I have exposed this water to stringent  laboratory testing for safety, content  and structure. I have had Darkfield  microscopy done that showed its  unique molecular structure, as well  as its ability to influence changes in  blood cells of diseased patients. The  related scientific support for what  this water does in the body offers  a solid rationale for its use as a  healing and preventive substance. As a result of my extensive research  and experimentation with naturally  magnetized water, I can report four  major findings: 1. The quality, content and structure  of the water in our body is directly  related to how well the body main -tains its ability to control and  prevent influences that cause it to  deteriorate and become susceptible  to disease. 2. Magnetization will change the  structure of water molecules. Regular  drinking water from our faucets or in  commercial bottled water is formed  in large molecular clusters (between  50 to 60). Magnetization in water  will organize molecules into small  clusters (3 to 5) and keep them aligned  during movement and absorption.  This will stabilize the structure and  composition of cells. 3. If elements contained in water are  magnetized, they can attract and  absorb toxins and other contaminated  substances from cells. These can then  be flushed out before they can  accumulate and become destructive. 4. Because of our diet and the  condition of standard drinking water,  the water in our body becomes acidic.  This lowers the pH in body fluids  and can change blood pH stability.  As a result, a condition known as  acidosis can be created over time,  which results in disease. Naturally  magnetized water contains a higher  alkaline pH, which can help  neutralize acidity in body fluids. When a molecule of a different  substance is dissolved and absorbed  in water, a major structural change  takes place with a completely new  molecular structure. Under the effect  of magnetized water, the new  structure will break and change,  influenced by the "magnetic signature"  of the water. Because of the magnetic influence in the water molecules, the  new molecule will also remain stable. This is important regarding the  molecular structure of vitamin and  mineral supplements. Because the  molecules are too large to be completely  broken down and absorbed by the  cells in water that is not bio-magneti -cally activated, they are mostly  flushed out of the system before they  can enter the cell membrane and  properly nourish the cells. However,  naturally magnetized water can  break down vitamins and minerals  into smaller molecular clusters,  absorb them easily and transport  them into the cells. Studies Conducted on Naturally  Magnetized Water Several controlled clinical studies,  as well as individual longitudinal  case studies, have been conducted  over the past five years on how this  water changes the way the body resists  and recovers from health problems.  These studies have consistently reported improvements. Findings indicate that  study subjects exposed to this water  over an average of two months showed  an increase in kidney function. This  was seen in a study that reported cell detoxification, increased cell hydration  and lower pH in body fluids after three  months. A major study, which I  conducted, showed that over time,  naturally magnetized water can stabilize  harmful bacteria in intestinal flora.  Improvements have been documented  with patients suffering from hypertension, diabetes, asthma, psoriasis, arthritis,  colitis, and multiple sclerosis. A study was conducted using  Darkfield microscopy to film blood  samples of patients with long-term  chronic disease. After two months,  changes in blood cell structure and  composition were noticeable, which  substantiated improvements measured  with clinical instruments. This study  has been expanded to test if  improvements remain or are lost after  a withdrawal period from drinking this  water, and if improvements will return  after resuming this water. Four years ago, a double-blind study  was conducted with Alzheimer's  residents at an assisted living facility  on the effect of this naturally  magnetized water on delaying memory  loss. Significant differences were  reported between groups. Subjects  were also given pre- and post-PET scans. Subjects in the Experimental Group  (using naturally magnetized water)  showed greater glucose metabolism  and oxygen flow in the brain. After preliminary investigations  discovering that persons with  Attention Deficit Disorder (ADD) show a high correlation with  dehydration, this water was used  with a large study population of  ADD subjects. This study is not  completed, but preliminary  testing after two months report that  the intracellular fluid volume has  increased. Over fifty individual longitudinal  case studies reported noticeable  changes in health status of patients  suffering from chronic fatigue  syndrome, Crohn's disease, multiple  sclerosis, colitis, diabetes, hypertension, arteriosclerosis, migraine and several  other aging-related disorders. A most  remarkable case was a woman who  had been suffering from psoriasis  arthritis for over twenty years. She  had been given aggressive treatments,  including radiation and high levels of  cortisone. She presented with lesions  throughout her body and limited  movement in joints. She had to quit  her job and could not even handle  daily living tasks. After three months  of drinking this magnetized water,  her lesions disappeared and her range  of motion returned.  These studies and cases are all  documented are all available by  contacting the Ohno Institute.  The Ohno Institute is a non-profit,  research and education center.  About the Authors: Yoshitaka Ohno, M.D., Ph.D.,  Founder and President of Ohno  Institute on Water and Health,  Cleveland, Ohio. U.S.A. Dr. Ohno is a native of Osaka, Japan,  where he received his education and  training in medicine and neuro- pathology. Early in his medical career,  he began searching for ways to stop  the suffering of his patients with  diseases that couldn't be treated  successfully by standard medicine  and had to be managed with  multiple drugs. He began to realize  that the side effects of these drugs  were creating serious chronic  problems, as well as increasing the  body's deterioration. After extensive  study, he because convinced that  the condition of the body's water  was directly related to the state of  the body's health. While continuing  his studies, he found that the  Japanese medical community was  not placing much emphasis on  chronic diseases found commonly  among the aging population. After  receiving his Ph.D. in pathology,  he decided to enter the US and  accept a position at AMC Hospital  in Denver, Colorado, where he could continue his research in geriatric  pathology, including MRI studies on  the relationship of water and cellular degeneration. His work led him to  investigate the n Alzheimer's disease.  As a result of his work, he received  the Community Leadership Award  from the Colorado Alzheimer's  Association in 1987 and the  Humanitarian Award from the  Alzheimer's Disease International  in 1993. After discovering a  naturally magnetized water in  Japan that was being used by  physicians to treat patients,  Dr. Ohno became convinced that  this water could be a breakthrough  in dealing with diseases that  currently cannot be cured. Howard Reminick, Ph.D.,  Vice President of the Ohno Institute  Dr. Reminick was a health educator, administrator and program developer  before joining the Ohno Institute.  His specialty was medical  rehabilitation, where he planned  and developed several rehabilitation  units in hospitals and out-patient  facilities. He created an inter- disciplinary model for rehabilitation,  which became the model for the  State of Ohio Worker's Compen- sation Rehabilitation Division. In  1977, he was appointed as state  delegate to the White House  Conference on Disabilities. Since  1995, he has worked with Dr. Ohno  to develop and promote studies  on health problems associated  with aging. Because of his strong background in research, he was  brought to the Ohno Institute to  lead the team in research and  development of the naturally  magnetized water discovered in  Japan by Dr. Yoshitaka Ohno.