N.Y.U. and Others Offer Shorter Courses Through Medical School

Training to become a doctor takes so long that just the time invested has become, to many, emblematic of the gravity and prestige of the profession.

But now one of the nation’s premier medical schools, New York University, and a few others around the United States are challenging that equation by offering a small percentage of students the chance to finish early, in three years instead of the traditional four.

Administrators at N.Y.U. say they can make the change without compromising quality, by eliminating redundancies in their science curriculum, getting students into clinical training more quickly and adding some extra class time in the summer.

Not only, they say, will those doctors be able to hang out their shingles to practice earlier, but they will save a quarter of the cost of medical school — $49,560 a year in tuition and fees at N.Y.U., and even more when room, board, books, supplies and other expenses are added in.

“We’re confident that our three-year students are going to get the same depth and core knowledge, that we’re not going to turn it into a trade school,” said Dr. Steven Abramson, vice dean for education, faculty and academic affairs at N.Y.U. School of Medicine.

At this point, the effort involves a small number of students at three medical schools: about 16 incoming students at N.Y.U., or about 10 percent of next year’s entering class; 9 at Texas Tech Health Science Center School of Medicine; and even fewer, for now, at Mercer University School of Medicine’s campus in Savannah, Ga. A similar trial at Louisiana State University has been delayed because of budget constraints.

But Dr. Steven Berk, the dean at Texas Tech, said that 10 or 15 other schools across the country had expressed interest in what his university was doing, and the deans of all three schools say that if the approach works, they will extend the option to larger numbers of students.

“You’re going to see this kind of three-year pathway become very prominent across the country,” Dr. Abramson predicted.

The deans say that getting students out the door more quickly will accomplish several goals. By speeding up production of physicians, they say, it could eventually dampen a looming doctor shortage, although the number of doctors would not increase unless the schools enrolled more students in the future.

The three-year program would also curtail student debt, which now averages $150,000 by graduation, and by doing so, persuade more students to go into shortage areas like pediatrics and internal medicine, rather than more lucrative specialties like dermatology.

The idea was supported by Dr. Ezekiel J. Emanuel, a former health adviser to President Obama, and a colleague, Victor R. Fuchs. In an editorial in the Journal of the American Medical Association in March, they said there was “substantial waste” in the nation’s medical education. “Years of training have been added without evidence that they enhance clinical skills or the quality of care,” they wrote. They suggested that the 14 years of college, medical school, residency and fellowship that it now takes to train a subspecialty physician could be reduced by 30 percent, to 10 years.

That opinion, however, is not universally held. Other experts say that a three-year medical program would deprive students of the time they need to delve deeply into their subjects, to consolidate their learning and to reach the level of maturity they need to begin practicing, while adding even more pressure to a stressful academic environment.

“The downside is that you are really tired,” said Dr. Dan Hunt, co-secretary of the Liaison Committee on Medical Education, the accrediting agency for medical schools in the United States and Canada. But because accreditation standards do not dictate the fine points of curriculum, the committee has approved N.Y.U.’s proposal, which exceeds by five weeks its requirement that schools provide at least 130 weeks of medical education.

The medical school is going ahead with its three-year program despite the damage from Hurricane Sandy, which forced NYU Langone Medical Center to evacuate more than 300 patients at the height of the storm and temporarily shut down three of its four main teaching hospitals.

Dr. Abramson of N.Y.U. said that postgraduate training, which typically includes three years in a hospital residency, and often fellowships after that, made it unnecessary to try to cram everything into the medical school years. Students in the three-year program will have to take eight weeks of class before entering medical school, and stay in the top half of their class academically. Those who do not meet the standards will revert to the four-year program.

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Richard Adams dies at 65; gay marriage pioneer

Thirty-seven years ago, Richard Adams made history when he and his partner of four years, Anthony Sullivan, became one of the first gay couples in the country to be granted a marriage license. It happened in Boulder, Colo., where a liberal county clerk issued licenses to six same-sex couples in the spring of 1975.

Adams had hoped to use his marriage to secure permanent residency in the United States for Sullivan, an Australian who had been in the country on a limited visa and was facing deportation.

But Colorado's attorney general declared the Boulder marriages invalid. Several months later, Adams and Sullivan received a letter from the Immigration and Naturalization Service that denied Sullivan's petition for resident status in terms that left no doubt about the reason:

"You have failed to establish that a bona fide marital relationship can exist between two faggots," the notification read.

Adams, who later filed the first federal lawsuit demanding recognition of same-sex marriages, died Monday at his home in Hollywood after a brief illness, said his attorney, Lavi Soloway. He was 65.

Soloway described Adams and Sullivan as "pioneers who stood up and fought for something nobody at that time conceived of as a right, the right of gay couples to be married.

"Attitudes at the time were not supportive, to put it mildly," Soloway said. "They went on the Donahue show and people in the audience said some pretty nasty things. But they withstood it all because they felt it was important to speak out."

Born in Manila on March 9, 1947, Adams immigrated to the U.S. with his family when he was 12. He grew up in Long Prairie, Minn., studied liberal arts at the University of Minnesota and became a naturalized U.S. citizen in 1968.

By 1971 he was working in Los Angeles, where he met Sullivan and fell in love.

Four years later, the two men heard about Boulder County Clerk Clela Rorex: She had decided to issue marriage licenses to gay couples after the Boulder district attorney's office advised her that nothing in state law explicitly prohibited it.

On April 21, 1975, they obtained their license and exchanged marriage vows at the First Unitarian Church of Denver.

The Boulder marriages attracted national media attention, including an article in the New York Times that called Colorado "a mini-Nevada for homosexual couples." Rorex received obscene phone calls, as well as a visit from a cowboy who protested by demanding to marry his horse. (Rorex said she turned him down because the 8-year-old mare was underage.)

After their marriage, Adams and Sullivan filed a petition with the INS seeking permanent residency for Sullivan as the spouse of a U.S. citizen. In November 1975, they received the immigration agency's derogatory letter and lodged a formal protest. Officials reissued the denial notice without the word "faggots."

They took the agency to court in 1979, challenging the constitutionality of the denial. A federal district judge in Los Angeles upheld the INS decision, and Adams and Sullivan lost subsequent appeals.

In a second lawsuit, the couple argued that Sullivan's deportation after an eight-year relationship with Adams would constitute an "extreme hardship." In 1985 a three-judge panel of the U.S. 9th Circuit Court of Appeals rejected the hardship argument and opened the way for Sullivan to be sent back to Australia.

Because Australia had already turned down Adams' request for residency in that country, the couple decided the only way they could stay together was to leave the U.S. In 1985, they flew to Britain and drifted through Europe for the next year.

"It was the most difficult period because I had to leave my family as well as give up my job of 18 1/2 years. It was almost like death," Adams said in "Limited Partnership," a documentary scheduled for release next year.

The pair ended their self-imposed exile after a year and came home. They lived quietly in Los Angeles to avoid drawing the attention of immigration officials, but in recent years began to appear at rallies supporting same-sex marriage, Soloway said.

They were encouraged by new guidelines issued by the Obama administration this fall instructing immigration officials to stop deporting foreigners in long-standing same-sex relationships with U.S. citizens.

Although the policy change came more than three decades after Adams and Sullivan raised the issue, it gave Adams "a sense of vindication," Soloway said.

The day before he died, Sullivan told him that the most important victory was that they were able to remain a couple.

"Richard looked at me," Sullivan told Soloway, "and said, 'Yeah, you're right. We've won.'"

Adams, who was an administrator for a law firm until his retirement in 2010, is survived by Sullivan; his mother, Elenita; sisters Stella, Kathy, Julie and Tammie; and a brother, Tony.

elaine.woo@latimes.com

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Terra/MODIS Color Image of Copahue Eruption Plume Across South America

For the first time since 2000, Copahue is erupting, sending an ash plume across southern South America. So far, the eruption is following the same patterns as the activity that ran from July to October 2000. That activity started with phreatic (water-driven) explosions, so it will be interesting to see if this eruption has new juvenile magma involved. Earlier this year, a study of the summit crater lake suggested new magma was intruding under Copahue and the SERNAGEOMIN report mentioned. that seismicity was rising before today’s eruption.

I grabbed the brand new Terra/MODIS imagery for South America and the plume from the Copahue was glorious – stretching over 350 km across Argentina to the east of the volcano. For a sense of scale on the image, the distance between Copahue and the Embalse los Barreales is ~225 km. The plume itself has been reported to be over 9.5 km / 30,000 feet tall.

UPDATE 12/22 5 PM EST: Eruptions reader Kirby pointed me to the SERNAGEOMIN webcam pointed at Copahue — check out the eruption live!

UPDATE 12/22 7 PM EST: ONEMI has not called for any evacuations on the Chilean side of Copahue — this article also has a nice gallery of pictures from the eruption as well.

Check out the original post with more details.

Erik Klemetti is an assistant professor of Geosciences at Denison University. His passion in geology is volcanoes, and he has studied them all over the world. You can follow Erik on Twitter, where you'll get volcano news and the occasional baseball comment.

Read more by Erik Klemetti

Follow @eruptionsblog on Twitter.

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Iron Butterfly bassist Lee Dorman dies at age 70

LOS ANGELES (AP) — Lee Dorman, the bassist for psychedelic rock band Iron Butterfly, has died at age 70.

Orange County sheriff‘s spokeswoman Gail Krause says Dorman was found dead in a vehicle Friday morning. A coroner’s investigation is under way, but foul play is not suspected.

Krause said Dorman may have been on his way to a doctor’s appointment when he died.

Iron Butterfly was formed and rose to prominence in the late 1960s. Its second album, “In-A-Gadda-Da-Vida,” sold more than 30 million copies, according to the band’s website. The title track’s distinctive notes have been featured in numerous films and TV shows including “The Simpsons,” ”That ’70s Show” and in the series finale of “Rescue Me.”

Douglas Lee Dorman was born in September 1942 and had been living in Laguna Niguel, a coastal city in Southern California, when he died.

A message sent through the band’s website was not immediately returned.

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News Analysis: The Perils of Yoga for Men

MEN are famous for ignoring aches and pains. It’s macho. Men get physical exams less often than women. They tend to remain silent if worried about their health. When hurt, their impulse is to shun doctors and rely on home remedies, like avoiding heavy lifting to ease backaches. Male athletes play through injuries. It’s all about virility and manliness.

The stereotype has exceptions, of course. But denial of injury and ill health — from the relatively inconsequential to the grave — is common enough that physicians seek ways to encourage men to be more forthcoming.

So it pays to listen carefully when guys start talking about intolerable pain and upended lives. Doing so led me to an unexpected finding that I have confirmed in a trove of federal data. It suggests that yoga can be remarkably dangerous — for men.

Guys who bend, stretch and contort their bodies are relatively few in number, perhaps one in five out of an estimated 20 million practitioners in the United States and 250 million around the globe. But proportionally, they are reporting damage more frequently than women, and their doctors are diagnosing more serious injuries — strokes and fractures, dead nerves and shattered backs. In comparison, women tell mainly of minor upsets.

Men who are breaking the code of silence are doing so with physicians in hospital emergency rooms, who in turn report their findings to the federal government.

Their outspokenness reveals much about modern yoga and suggests ways it can be made safer. As a practitioner since 1970, I know some of the guy hazards personally and have learned through painful experience how to live with my inflexible body.

The male disclosures help explain one of the central mysteries of modern yoga — why it is largely a feminine pursuit. As Yoga Journal, the field’s top magazine, put the question: “Where Are All the Men?”

Science has long viewed the female body as relatively elastic. Now the new disclosures suggest that women who tie themselves in knots also enjoy a lower risk of damage. It seems like common sense.

Surprisingly, evidence of the male danger has, to my knowledge, never before been made public. Nor has its flip side — that women seem less vulnerable. The subject of male risk merits discussion if only because the booming yoga industry has long targeted men as a smart way to expand its franchise.

Informal observations hint at possible explanations. Yoga experts say women tend to see classes as refuges while men see challenges — their goal at times to impress the opposite sex.

Women say men push themselves too far, too fast. Men admit to liking the intensity but say the problem is pushy teachers who force them into advanced poses while urging them to ignore pain.

I stumbled on the issue after my book, published in February, laid out a century and a half of science and, in its chapter on injuries, contradicted the usual image of yoga as completely safe. The yoga establishment makes billions of dollars by selling itself as a path to healthy perfection. Predictably, it responded with sharp denials.

I also received a surprising number of moving replies from injured yogis — male and female — including stroke victims.

A letter initiated my inquiry. In April, a man told how an agonizing back injury had turned his life into “a living hell.” Too many instructors, he wrote, are “pushing us too hard and having us do dangerous poses.”

The “us” resonated.

Suddenly, I realized his cry sounded familiar.

I raced through a correspondence file and saw that many of the letters about serious damage had come from men.

Tara Stiles, a yoga teacher who runs a popular studio in Manhattan, told me that guys have more muscle (one reason for their relative inflexibility) and can thus force themselves into challenging poses they might otherwise find impossible. It seemed a plausible explanation for blinding pain.

Other teachers echoed her analysis and cited supporting anecdotes.

Yoga poses are unisex. But in my research, I found a world of poorly known information on gender disparity.

“Science of Flexibility,” by Michael J. Alter, explained how the pelvic regions of women are shaped in a way that permits an unusually large range of motion and joint play. In yoga, the pelvis is the central pivot for extreme bending of the legs, spine and torso.

In June, I turned to the Consumer Product Safety Commission and its National Electronic Injury Surveillance System, which monitors hospital emergency rooms. In July, officials sent me 18 years of annual survey data that summarized the admission records for yoga practitioners hurt between 1994 and 2011, the maximum available span.

First, I needed a baseline that would let me compare the guy admissions to males doing yoga in the United States. Figures in the yoga literature described men as making up some 10 percent of practitioners at the beginning of the period and 23 percent at the end. So the middle ground seemed to be roughly 16 percent.

Then I dug into the medical data. The analysis took weeks, but the results spoke volumes.

William J. Broad is a science reporter for The New York Times and the author of “The Science of Yoga: The Risks and the Rewards.”

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Amazon Book Reviews Deleted in a Purge Aimed at Manipulation

Giving raves to family members is no longer acceptable. Neither is writers’ reviewing other writers. But showering five stars on a book you admittedly have not read is fine.

After several well-publicized cases involving writers buying or manipulating their reviews, Amazon is cracking down. Writers say thousands of reviews have been deleted from the shopping site in recent months.

Amazon has not said how many reviews it has killed, nor has it offered any public explanation. So its sweeping but hazy purge has generated an uproar about what it means to review in an era when everyone is an author and everyone is a reviewer.

Is a review merely a gesture of enthusiasm or should it be held to a higher standard? Should writers be allowed to pass judgment on peers the way they have always done offline or are they competitors whose reviews should be banned? Does a groundswell of raves for a new book mean anything if the author is soliciting the comments?

In a debate percolating on blogs and on Amazon itself, quite a few writers take a permissive view on these issues.

The mystery novelist J. A. Konrath, for example, does not see anything wrong with an author indulging in chicanery. “Customer buys book because of fake review = zero harm,” he wrote on his blog.

Some readers differ. An ad hoc group of purists has formed on Amazon to track its most prominent reviewer, Harriet Klausner, who has over 25,000 reviews. They do not see how she can read so much so fast or why her reviews are overwhelmingly — and, they say, misleadingly — exaltations.

“Everyone in this group will tell you that we’ve all been duped into buying books based on her reviews,” said Margie Brown, a retired city clerk from Arizona.

Once a populist gimmick, the reviews are vital to making sure a new product is not lost in the digital wilderness. Amazon has refined the reviewing process over the years, giving customers the opportunity to rate reviews and comment on them. It is layer after layer of possible criticism.

“A not-insubstantial chunk of their infrastructure is based on their reviews — and all of that depends on having reviews customers can trust,” said Edward W. Robertson, a science fiction novelist who has watched the debate closely.

Nowhere are reviews more crucial than with books, an industry in which Amazon captures nearly a third of every dollar spent. It values reviews more than other online booksellers like Apple or Barnes & Noble, featuring them prominently and using them to help decide which books to acquire for its own imprints by its relatively new publishing arm.

So writers have naturally been vying to get more, and better, notices. Several mystery writers, including R. J. Ellory, Stephen Leather and John Locke, have recently confessed to various forms of manipulation under the general category of “sock puppets,” or online identities used to deceive. That resulted in a widely circulated petition by a loose coalition of writers under the banner, “No Sock Puppets Here Please,” asking people to “vote for book reviews you can trust.”

In explaining its purge of reviews, Amazon has told some writers that “we do not allow reviews on behalf of a person or company with a financial interest in the product or a directly competing product. This includes authors.” But writers say that rule is not applied consistently.

In some cases, the ax fell on those with a direct relationship with the author.

“My sister’s and best friend’s reviews were removed from my books,” the author M. E. Franco said in a blog comment. “They happen to be two of my biggest fans.” Another writer, Valerie X. Armstrong, said her son’s five-star review of her book, “The Survival of the Fattest,” was removed. He immediately tried to put it back “and it wouldn’t take,” she wrote.

In other cases, though, the relationship was more tenuous. Michelle Gagnon lost three reviews on her young adult novel “Don’t Turn Around.” She said she did not know two of the reviewers, while the third was a longtime fan of her work. “How does Amazon know we know each other?” she said. “That’s where I started to get creeped out.”

Mr. Robertson suggested that Amazon applied a broad brush. “I believe they caught a lot of shady reviews, but a lot of innocent ones were erased, too,” he said. He figures the deleted reviews number in the thousands, or perhaps even 10,000.

The explosion of reviews for “The 4-Hour Chef” by Timothy Ferriss shows how the system has evolved from something spontaneous to a means of marketing and promotion. On Nov. 20, publication day, dozens of highly favorable reviews immediately sprouted. Other reviewers quickly criticized Mr. Ferriss, accusing him of buying supporters.

He laughed off those suggestions. “Not only would I never do that — it’s unethical — I simply don’t have to,” he wrote in an e-mail, saying he had sent several hundred review copies to fans and potential fans. “Does that stack the deck? Perhaps, but why send the book to someone who would hate it? That doesn’t help anyone: not the reader, nor the writer.”

As a demonstration of social media’s grip on reviewing, Mr. Ferriss used Twitter and Facebook to ask for a review. “Rallying my readers,” he called it. Within an hour, 61 had complied.

A few of his early reviews were written by people who admitted they had not read the book but were giving it five stars anyway because, well, they knew it would be terrific. “I am looking forward to reading this,” wrote a user posting under the name mhpics.

A spokesman for Amazon, which published “The 4-Hour Chef,” offered this sole comment for this article: “We do not require people to have experienced the product in order to review.”

The dispute over reviews is playing out in the discontent over Mrs. Klausner, an Amazon Hall of Fame reviewer for the last 11 years and undoubtedly one of the most prolific reviewers in literary history.

Mrs. Klausner published review No. 28,366, for “A Red Sun Also Rises” by Mark Hodder. Almost immediately, it had nine critical comments. The first accused it of being “riddled with errors in grammar, spelling and punctuation.” The rest were no more kind. The Harriet Klausner Appreciation Society had struck again.

Mrs. Klausner, a 60-year-old retired librarian who lives in Atlanta, has published an average of seven reviews a day for more than a decade. “To watch her in action is unbelievable,” said her husband, Stanley. “You see the pages turning.”

Mrs. Klausner, who says ailments keep her home and insomnia keeps her up, scoffs at her critics. “You ever read a Harlequin romance?” she said. “You can finish it in one hour. I’ve always been a speed reader.” She has a message for her naysayers: “Get a life. Read a book.”

More than 99.9 percent of Mrs. Klausner’s reviews are four or five stars. “If I can make it past the first 50 pages, that means I like it, and so I review it,” she said. But even Stanley said, “She’s soft, I won’t deny that.”

The campaign against Mrs. Klausner has pushed down her reviewer ratings, which in theory makes her less influential. But when everything is subject to review, the battle is never-ending.

Ragan Buckley, an aspiring novelist active in the campaign against Mrs. Klausner under the name “Sneaky Burrito,” is a little weary. “There are so many fake reviews that I’m often better off just walking into a physical store and picking an item off the shelf at random,” she said.

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Overhaul of state government payroll system at risk of collapse

SACRAMENTO — One of the state's biggest technology endeavors, a $371-million overhaul of the government payroll system, is beset with problems and "in danger of collapsing," according to the state controller's office.

The company hired for the project is in over its head and may be unable to deliver on its promise to update a payroll system so old that even simple salary adjustments can tie it in knots, the controller's chief administrative officer said in a letter.

The state has spent at least $254 million so far on contractors, staff salaries, software and more for the system upgrade, which is five years overdue and has nearly tripled in cost since lawmakers authorized it in 2005.

"The project … is foundering and is in danger of collapsing," administrator Jim Lombard wrote to the contractor, SAP Public Services, in October. Lombard said the new system is not capable of processing "any portion of the state payroll population, let alone the full population of approximately 240,000 employees."

An SAP spokesman, Andy Kendzie, said the company is meeting its contractual obligations.

"Considering the project's complexity, and the many requirements involved in payroll processing, there have been some challenges," Kendzie said in a statement. "Despite these, SAP remains committed to the overall success of the project."

Technology quagmires have become a hallmark of California state government, with delays and cost overruns common.

A new computer system for the public pension fund was finished in September 2011 at twice the original budget. An effort to upgrade accounting databases and allow agencies to coordinate purchasing has fallen years behind schedule, and the estimated cost has increased by hundreds of millions of dollars. Back in 1994, a failed DMV system was canned after $50 million had been spent.

Lombard wrote in his letter that the new payroll system was tested on 1,300 employees this year and failed. Some paychecks were issued to the wrong employees or for the wrong amounts.

Testing began in June, Lombard wrote, and since then "every pay cycle has experienced problems" despite SAP's repeated assurances that improvements were being made. A second trial run, set for September, has been delayed until at least March.

SAP failed to meet nine of its 44 deadlines in the first eight months of this year, says the 37-page letter. Lombard demanded that SAP fix all of the problems identified by the state, including replacing inexperienced project managers and staff.

The controller's spokesman, Jacob Roper, said officials are reviewing a plan that SAP submitted last month to address the state's concerns.

The company has already been paid $50 million. Roper said an additional $6.9 million hasn't been turned over because the project has missed various milestones, and the state plans to withhold remaining funds until problems are fixed.

The goal of the effort, called the 21st Century Project, is to integrate and replace six different human resources systems, some installed in the 1970s and now at risk of failure.

The new system will have to handle a $15-billion payroll across 160 state departments, agencies, boards and commissions, calculating data on 36 medical plans, 12 dental plans and dozens of paycheck deductions.

When finished, it is supposed to allow managers and employees to access and update human resources data much more easily, according to outlines of the project on the controller's website.

The first contractor on the project, BearingPoint, was fired in January 2009 amid mutual finger-pointing and lawsuits, and the project ground to a halt. The company had already been paid nearly $26 million, although the state was able to collect $2.8 million in insurance payments and keep any completed work.

SAP replaced BearingPoint in February 2010.

chris.megerian@latimes.com

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Digital Social Visibility: How Facebook Gifts Change Our Choices

Facebook Gifts rolled out after a two-month beta last week, seamlessly melding social with shopping. Not to be outdone, Amazon recently released its Friends and Family Gifting option with the same kind of social gifting visibility.

For Facebook, another puzzle piece of its business model falls into place. For users, gift giving becomes by default a public rather than private activity: People can now fluidly and visibly give their friends holiday presents ranging from iTunes cards to Chandon champagne.

For our culture, however, an era of subtlety and “secret” Santa gives way to the era of reality TV. In many ways social gifting shrouds purchasing in a cloak of generosity, since the social streaming context removes the gaucheness of sharing these gifts. Yet these new social features also signal a culture where broadcasting our behaviors – whether gifting or other digitally shared activities – becomes the norm rather than the exception.

Digital social visibility doesn’t just turn our private lives inside out, though: It changes the choices we make, both online and offline.

Lauren Rhue is a doctoral candidate and Arun Sundararajan (@digitalarun) is a professor at NYU Stern School of Business, where they conduct research about how digital technologies transform business and society. 

How so? Our research and observations here are based on analyzing visibility behaviors across a range of social platforms over the last three years. Our data includes over 10,000 users who shared more than a million purchases on Blippy across two years, as well as a recent sample of over 1,000 Pinterest users with more than 200,000 connections and close to a million re-pins.

I Anticipate, Therefore I Change

Social influence always seemed to flow from the person who makes the choice, to the people who observe it. But digital visibility reverses the direction and creates a new form of anticipatory influence: What we do is now influenced by the peers who observe us.

We anticipate how people might perceive us or react, and those anticipatory effects change our choices.

Facebook Gifts, for example, might make us think twice about and possibly revise our shopping lists. Because our gifts aren’t just between us and our loved ones anymore: They become part of our social Timelines, our online personas. They’re the future digital ghosts of our Christmas pasts.

Social psychologists have long documented how introducing passive audience observers into situations affects athletic performance, productivity, decision times, memory recall, and even the sunny-ness of our smiles. Interestingly, modifying what one does in response to an audience isn’t simply a socially learned human trait: Similar behavior has also been recognized in non-human species ranging from Budgerigars birds to peacocks to Siamese fighting fish.

So these audience effects are primal; they’re deeply ingrained in who we are. The underlying behavior we’re witnessing now isn’t new. Rather, social technologies are creating a broader and more visible digital public persona by letting us choose our audiences; expanding the audience beyond the individual or an intimate few; making the audience persistent; and transcending the constraints of space and time.

Consider maverick economist Thorsten Veblen‘s theory of conspicuous consumption, which formalized the idea that we make some of our purchases – particularly luxury goods – to advertise economic power and gain social status. Velben wrote his masterpiece “The Theory of the Leisure Class” over a century ago, when we could not transport our real-world social networks across all of our purchasing, gifting, and other consuming sites and moments.

But we no longer need physical and temporal co-location to realize the benefits of being conspicuous. We can now name-drop our Prada bag purchase or dinner at Masa instantly via a data trail or an Instagram picture … or through a Facebook gift in our stream.

Our audience might not be online when we do this, but they’ll probably see it tomorrow, next week, or maybe even next year.

Are You There, Audience? It’s Me, Social

Of course, the audience only matters if it’s actually there. But we don’t really know how many people see what we post on Facebook, which friends are online when, or what fraction of daily incoming tweets our followers actually notice.

This audience uncertainty is due to the absence of any real surroundings, environmental factors, and tactile cues for situating our digital visibility. These are the kinds of familiar cues that, according to sociologist Erving Goffman, shape our presentation in face-to-face settings.

One way of dealing with this audience uncertainty is to picture the group toward which we aim our shares, from whom we seek to maximize approval (or minimize disapproval): our imagined audience. When you buy your favorite employee a cool Facebook gift this holiday, it’s not just the gift recipient audience you’re playing to – you’re also orienting your largesse to other colleagues and maybe your boss too.

Digital social visibility doesn’t just turn our private lives inside out: It changes the choices we make.

The trouble is, you might get the audience wrong. Your audience might instead end up being your spouse or your employee’s significant other, who could misinterpret the intent of your gift. The fissure between imagined and realized audiences can lead to conflict or the feeling that our privacy has been compromised — even though our intent was social.

This is an example of context collapse: facing multiple and unknown contexts for each of our online shares. It’s the result of having a variety of relationships (including those whittled down to just “Facebook friendships”) with competing social norms on the same platform, along with the online data trails that persist long after we leave them.

Digital social visibility is therefore a double-edged sword: As we transcend the boundaries of physical space and time, we also give up the familiar anchors and cues provided in our face-to-face interactions.

How then do people deal with context collapse? By focusing on the small fraction of our network that does provide visible acknowledgement or cues in the form of likes, re-pins, and votes.

Context collapse is the result of having a variety of relationships with competing social norms on the same platform

The problem is that this approach, however, is that it also changes the products we buy. Our research reveals that people buy more in the categories of products for which they get more feedback.

We’re just beginning to understand the phenomenon of image management as commerce and networks merge. The implications are many: for advertising (how should businesses surface choices for gifting?), for measuring influence (Klout doesn’t even begin to capture tacit persuasiveness and cues), for privacy (losing contextual integrity of our shares); and more.

But for us as individuals, the implications go beyond just buying and gifting. Luxury purchases are only one aspect of conspicuous consumption; individual taste-based goods and services are another. You’ll soon – if you’re not already – spend more time hanging out at hip restaurants or rock concerts, monster car rallies or museums, benefit dinners or book readings. Not just because you want to … but because you’ll detract from your digital visible image if you don’t.

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“It’s a Wonderful Life” is top Christmas film with critics

LOS ANGELES (Reuters) – When it comes to Christmas films, “It’s a Wonderful Life” can still melt critics’ hearts nearly 70 years after it was released, according to a survey of the best-reviewed Christmas films.

The survey, to be released on Friday by review aggregator Rotten Tomatoes, found that the 1946 redemption story starring Jimmy Stewart edged out the 1942 Bing Crosby and Fred Astaire musical “Holiday Inn” and Tim Burton‘s 1993 stop-motion fantasy “The Nightmare Before Christmas.”

World War Two drama “Stalag 17,” released in 1953, and 1947′s “Miracle on 34th Street” round out the top five.

“It’s a Wonderful Life” vaulted to the top spot from No. 5 in 2009, when the list was last compiled, bumping “The Nightmare Before Christmas” from its best-reviewed status.

Films that use the holiday as a backdrop for the plot such as 1988′s “Die Hard,” which was No. 6 on the list, and 1983′s “Trading Places” at No. 9, were also eligible, the website said.

Rotten Tomatoes, which analyzes film reviews and assigns a score based on total critical reception, applied that same formula to Christmas films for the list, Matt Atchity, the website’s editor in chief, told Reuters.

“You look at the list and it’s all the classics … the cream floats to the top,” Atchity said, adding that the rankings were weighted to reflect the amount of reviews a film received, which could artificially boost or decline a score.

Films from the 1960s and 1970s were notably absent from the list. Atchity said studios were more focused at that time on work by big-name directors than on seasonal films.

Here are the 25 best-reviewed Christmas films of all time, according to website Rotten Tomatoes:

* “It’s a Wonderful Life” (1946)

* “Holiday Inn” (1942)

* “The Nightmare Before Christmas” (1993)

* “Stalag 17″ (1953)

* “Miracle on 34th Street” (1947)

* “Die Hard” (1988)

* “Arthur Christmas” (2011)

* “A Christmas Story” (1983)

* “Trading Places” (1983)

* “Rare Exports: A Christmas Tale” (2010)

* “Lethal Weapon” (1987)

* “A Midnight Clear” (1992)

* “A Christmas Tale” (2008)

* “While You Were Sleeping” (1995)

* “Scrooge (A Christmas Carol)” (1951)

* “Elf” (2003)

* “Kiss Kiss, Bang Bang” (2005)

* “Gremlins” (1984)

* “The Santa Clause” (1994)

* “The Bishop’s Wife” (1947)

* “Bad Santa” (2003)

* “8 Women” (2002)

* “Batman Returns” (1992)

* “White Christmas” (1954)

* “The Ref” (1994)

The full list can been seen at http://www.rottentomatoes.com/guides/best_christmas_movies_2012/?hub=10

(Reporting by Eric Kelsey, editing by Jill Serjeant and Stacey Joyce)

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Medicare’s Chief Actuary, Richard Foster, Retiring

Carol T. Powers for The New York Times

Richard S. Foster testifying before the House Ways and Means Committee in 2004

WASHINGTON — Richard S. Foster, who as chief actuary of the Medicare program for the last 18 years nettled presidents of both parties with his projections of rapid growth in federal health care spending, will retire next month, the Obama administration said Friday.

Mr. Foster, 63, a career civil servant known for his fierce independence, has been an influential voice on Medicare, Medicaid and the new health care law.

With 100 million people on Medicare or Medicaid and an additional 20 million expected to get federal subsidies for private insurance under President Obama’s health care law, the need for accurate estimates of health spending has never been greater, lawmakers say.

Mr. Foster said that Medicare savings in the 2010 health care law, based on cutbacks in payments to hospitals and other health care providers, were probably unsustainable and could jeopardize access to care for beneficiaries, a judgment that displeased the Obama administration.

In 2003, Mr. Foster found himself in conflict with the Bush administration when he raised questions about the cost of a Republican bill adding a prescription drug benefit to Medicare. Federal investigators later found that a top Medicare official had threatened to fire Mr. Foster if he provided certain cost estimates to Congress.

Marilyn B. Tavenner, acting administrator of the federal Centers for Medicare and Medicaid Services, praised Mr. Foster for “his adherence to the highest levels of professional independence and ethical conduct.” She said he “will be sorely missed by policy makers and officials throughout the administration and Congress.”

Ms. Tavenner said “we will soon begin a national recruitment effort” to find a successor to Mr. Foster, who began working for the federal government 40 years ago.

Proposals to rein in Medicare spending have been at the center of budget negotiations between President Obama and Speaker John A. Boehner. Both sides have relied on data from Mr. Foster’s office.

Congress bolstered the actuary’s independence in a 1997 law stipulating that the holder of the job can be removed from office “only for cause.”

In a report accompanying the law, Congress said that “the office of the actuary has a unique role,” serving both the administration and Congress, and often must work with lawmakers developing legislation.

With help from a staff of nearly 100, the chief actuary issues detailed annual reports on national health spending and the financial outlook for Medicare. In addition, the actuary’s office collects data used to calculate Medicare payment rates for doctors, hospitals and many other health care providers.

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