Saturday, October 19, 2013

孙子兵法名家吕罗拨教授


成功习惯12条
  1. 和那些愉快又积极,能助您事业成功的人交往。
  2. 经常总结您的幸福和优点(Count Your Blessing) 。
  3. 体量他人,不埋怨,不诉苦。
  4. 要不断学习高深学问,如兵法,养生,气功,致富与全胜学。
  5. 总要“以患为利”,把困境化作机遇,化压力为活力。
  6. 每天作些静坐吐纳气功,并享受冥想乐趣。
  7. 不计较,不比较。不强调公平。能放弃。
  8. 施比受,更幸福,更有作为。
  9. 照顾自己,是人生第一件事。
  10. “饿不死便有希望”,怎么苦也会活下去。
  11. 要生存下来,真不容易。
  12. 每天要作“六字诀”,“气吼丹田”,“合十嗡声内鸣”,“收功”。

林峰 - 个人语录

“人生是没有天生的定论,定论是由自己所创,一切都在你的手、你的心。就算你有心,但又不用手去做、不用脑去想,也不会成功” ——林峰

大其心,容天下难容之事;潜其心,关天下微妙之理;宽其心,听天下难听之言;定其心,应天下无常之变。

◆【谈“力捧”】
无可否认机会是别人给的,但如果自己不把握、不做好,也不会“捧”出成绩来的。

◆ 【谈“机会”】当一个机会来临,你把握的住,这才是叫机会。你要没把握住的话,就没有下次机会了。所以其实给你一个机会,也是给你一个压力。(2010年陈晨全明星访谈)

◆【谈竞争】有些人的思想,他会觉得,人家如果有什么差错,有什么不好,他可能会有一点点开心,我觉得这是一个非常之不健康的想法。因为就算万一人家有什么不如意,不代表你可能会顶替,或者你会做的更出色。因为你如果将你各种思想,已经转移到人家的失败,你根本没focus(注意)到,去发觉你自己是否努力,你也都没有专注到自己的专业里面,你这个样子注定失败。

◆【谈“峯”】有前辈劝我写“峰”,免得被山压在头上。我说,就让前面永远有一座接一座高山等我跨过好了

◆我觉得自己做回自己,总有喜欢你的人 。

◆思考可以随心所欲,表达想法则必须谨慎小心。 ◆做事之前先学做人。

◆真正的朋友不需要经常见面,因为我好相信君子之交淡如水。在你有需要时,会伸出援手的,这就是真朋友。

◆演员,我觉得是很复杂的一个行业,以前旧一代说什么戏子无情。捞家(罗嘉良)跟我说过,我好认同。他说“戏子是最有情的人”。因为我们用我们的感情,去出卖自己的感情,连自己都要欺骗,那一刻是去娱乐你们的;所以其实是一个戏子有情,同时付出很多的一个行业。

◆我不喜欢解释的,从入行到现在,都不喜欢解释,解释没意思,我未有任何成绩被人看到,讲任何话都是废话;我希望是用时间去证明。

◆做哪一行都是辛苦的,如果你想做出点成绩的话;你一定要“捱”...但最重要的是你自己捱的开心。

◆做每一样交给我的工作,都是要很认真。你要么就不做,要么就做最好。

Sunday, October 13, 2013

Dr. Sean Richardson Sports Psychologist

Many people fail to realize the entrepreneurial aspect of psychology. But not Dr. Sean Richardson, he understands it quite well.

We reached out to Dr. Richardson to see if he would share his story and impart some of his life and career experiences upon us. Thankfully he was eager to share what he has learned.

Richardson believes in following dreams and achieving career goals, and he also understands the importance of a broad education that you can fall back on while you encounter obstacles along the path. Richardson’s advice for a career in psychology is “Focus niche, but look broad”. Read on to find out more about what exactly he means by that. Enjoy!

Can you start off by telling us a bit about yourself and how you came to find yourself in a sports psychology career?

I grew up in Vancouver. In high-school, I wasn’t exactly sure what I wanted to do for a career at the time. My father was a lawyer and he owned his own law firm so it just made sense to be a lawyer, but in my second year at the university, I had second thoughts about what I was doing. I figured maybe I would take a year off college, but then decided instead to do a year as an exchange student in Australia.


That is where I took my first psychology class. I really liked it and decided to switch my major. I still wanted go to law school, but I wanted to do my undergraduate in psychology. I ended up taking an extra year of courses to complete my bachelor’s in psychology.

At some point, I decided I was going to continue with my education in psychology and stop working toward law school, much to my parents’ dismay at the time. Then I got into the master’s program in Psychology at UBC, getting my master’s in research. However, I always wanted to practice and work with clients, rather than being in education and research. Once I finished my master’s degree I realized that I couldn’t stay there for my PHD, it just wasn’t set up for the goals I wanted to achieve.

The program I was in was mostly prepping you for research and academia, and like I said I wanted to work with athletes and other types of clients in professional practice. I came across a book of programs for aspiring sport psychologists published Association for the Advancement of Applied Sports Psychology. There were programs in the States and in Australia that would actually help me get practical experience as a psychologist practitioner in my studies. At that time, there were very few programs that offered sports psychology with practical clinical experience.

I ended up going back to Australia because they had programs that offered the professional psychologist education coupled with the clinical skills that I actually needed to get experience in sports psychology. I ended up going to Victoria University in Melbourne, which had an incredible program, with outstanding staff.

During my studies, while still a student, I did some practical experience with a senior staff member psychologist of a professional football team. I did that for about a year and a half and got some experience in professional sports. Thanks to my master’s degree, I had the ability in Australia to work as a psychologist while finishing my PHD. I had my own private practice during this time and I was working with musicians, ballet dancers, individual and corporate clients.

After that, following from my PHD in over-training and injury, I also ended up consulting for the Australian Ballet company for about five years. Professional ballet dancers are some of the most athletic artists you can imagine, they put a huge amount of stress on their bodies.


When I really got out there looking for a job in the professional sports realm, I got an offer as a player development manager for a professional football team. They wanted me in that role because they figured that would be a good role for me and then I could also be their sports psychologist at the same time. There were some aspects about that offer that I didn’t quite like. But then another offer came through about two months after that from another professional football team to be their sports psychologist.

They had a new head coach and it was his first time as a head coach, and he had a sports psychologist on his last team, so he found it to be very important for the team to have a good sports psychologist. So when they were doing hiring, my name came up and they brought me on. The football gig was really my jumping-off point in my career.

I worked with that coach for 5 years in Australia and then I ended up leaving Australia in 2010. I figured that would be it; I was done with Australian football, but over the years I ended up creating a very strong relationship with this coach, so he decided to keep me on when he moved to a new team, and we communicate via phone and internet to this day. It’s really the psychology of the future that we can start working more over the Internet with our clients.

Working with a head coach is where I think I found my leverage as a sports psychologist. A head coach is the absolute expert of what to do in the game. Some coaches are really good at being able to get into the player’s heads and figuring out how to tap into their potential, but ultimately, most coaches haven’t done a PHD in psychology. It’s not really their role to understand all the layers of the human being at a deep psychological level. They are an expert in the game.

So good coaches, like say Phil Jackson, will have their psychology experts working along side of them to develop the team.

I play a mentor role to coaches on the mindset stuff for the players.


I moved back to Canada in 2010 and decided to get a little bit more into corporate work with sports psychologist roles on the side. I work with the National Women’s field hockey team, and I would love nothing more then to work with the Vancouver Canucks hockey team and a few other private clients.

The thing is, while I love working with athletes, I would really have to travel around and chase professional teams in North America – be prepared to move to wherever they are. I have a great track record from Australia, so I think if I really wanted to I could find a team in North America to work with. But re-locating isn’t what I want for myself or for my family. There would be a lot of travel involved, and I really just want to stay in Vancouver and raise my kids and family here. You have to be prepared to travel a lot and market yourself a lot to the teams in order to be a full-time sports psychologist.

What kind of pointers can you give us on the education of a sports psychologist?

For someone looking to get into sports psychology you have to really ask yourself, ”what do you really want to do?” Most of the programs in North America and Canada focus on human movement or human kinetics. If you take one of these programs and get a PHD, you don’t actually get to be a psychologist. You are an expert in sports psychology but you don’t actually get to do practicums, you don’t do clinical skills, you don’t get to do internships, you don’t get to do the actual stuff that makes you a psychologist. So you really have to make sure that you find the right program if you want to work as an accredited psychologist.

Classical sports psychology is a mix of mental skills training, imagery, visualization, goal setting, and self talk. I find that in my practice, though I am only teaching the mental skills about 20-30 percent of the time. Most of the time I am just dealing with the human being in front of me; it’s a bit more of a counseling or coaching model. You’re trying to help them deal with things in their life that may be holding them back from achieving higher performance.
What should students know about starting a career as a sports psychologist? Could you tell us a bit about how you developed your own career?

So I basically I had to craft my career. Sports Psychology is a very small career pool. Basically, there are a few teams and individuals that have a lot of money that can afford a full-time sports psychologist. That doesn’t leave a large amount of job openings in the sports realm. So in terms of going to school for sport psychology and then getting out of school and going to work full-time as a sports psychologist it can definitely be challenging.

The writing is on the wall from the start. Every other athlete that isn’t on a professional team is on the opposite end of the spectrum. They are typically students living at home who are trying to make it to the Olympics, or living in a basement suite, and pretty much they don’t have money to spend on a psychologist. At some point in the college level and amateur national level they will need sports psychologists. But generally members of the public aren’t looking for a sports psychologist, it’s still a very young field.

When you go through your academics there is actually a lot of discouragement about your chances of getting a job. You’re sitting there learning all this stuff you’re really passionate about and you’re finding out you may not be able to get a job when you’re done. I think that is where, for me, combining and getting a broader base of learning, like getting your psychologist license and making sure you have the clinical skills is important because then you will have more of a choice in the career field. If you really want to make a career as a sports psychologist happen, consider the field a bit more of the field of performance psychology, and you will have a much larger market for your skill-set.

You say you worked in the corporate area for a bit as a sports psychologist, can you tell us about how you used sports psychology in the corporate world?

The thing about sports psychology is you’re working with people that want to be the best in the world. It’s a lot different from a clinical model. Often times a psychologist is working to get someone to a place of function. A lot of clients come to a psychologist because they are having dysfunction in their lives, so the psychologist tries to get this person functional again. As a sports psychologist you are working with someone that is reasonably or highly functional. But you are trying to help them get to the highest level of performance and functionality. The idea is to really get someone to be the best at something. It really switches the way you think about your clients. In sports, functional isn’t good enough, they need help getting to the highest level of performance, to be the best in the world.

In the end, it is not just about sports. There are a lot of people that want to be the best at something that is not about sports. I wanted to go and get practical experience in the human resources consulting and corporate world. Interestingly enough, when you come from a sports psychology background and you enter business, you find yourself very quickly talking to the people at the head of these corporations, mostly because these are the kind of people that are trying to be the best at something or want their company to be the best at something, very similar to athletes. They share a similar mindset. I was able to find practical experience working with HR companies like Hudson and Right Management.

Have you found it difficult to build your own business or brand?

I think it’s challenging in any area of psychology. As a registered psychologist, you create a lot of security for yourself by getting your license in the job field. That license is sort of a fallback so that you can accept members of the public. If you get like 10 hours per week from walk-in clients at $200 per hour, you will be able to at least pay your bills and then focus additionally on your sports psychology roles.


In terms of marketing yourself, you have some channels through your different associations. But for me, it was all about professional development and experience. Often times universities don’t tell you how to build your business. They teach you how to work on patients, but they don’t teach you how to market and manage your own practice. Unless you’re going to get a job in a hospital as a clinical psychologist, you’re going to have to be a bit of an entrepreneur. I don’t want to say it’s difficult, you just have to be smart about it. You have to be proactive and find out which avenues will be fruitful.

I actually found an organization, called Thought Leaders, and they basically teach you how to build a business model around your expertise. That company was a revelation for me, I highly recommend that service. I think that is where I learned the most in regards to marketing and growing my business. To develop a strong practice you’re going to need to develop a business sense. One of the things I did was reach out to psychologists that I knew had been successful and get an idea of what they did to develop their business.

What are some of the things you like most about your job?

I have a very diverse career model. It’s not always sitting in an office talking to people. I occasionally get to be a professional keynote speaker, some speaking events can pay up to $10,000 for a few hours of my time. That way I get to really share my experience, I get to do workshops, speaking, work clinically with clients, and more importantly, I get to help people try to be the best at what they do. I like to be able to help people. When someone comes to you and tells you that you have made a difference in their life, that really means a lot. Making a difference and getting to see the results in your clients is probably the best thing about the job.


The stuff that you learn in sports psychology is amazing. We are able to help people to find that extra edge in their lives, and it is a skill that you just don’t see in other areas of psychology. You can use that skill-set in many different areas if you’re smart and you diversify your career.
What are some difficulties that someone should expect when entering into this field of work?

The thing about sports psychology is that you’re generally always on contract. If you think about a professional team, the coach turnover is about every 3-4 years. And when that coach leaves, there is usually a turnover in staff too. The new coach often will bring in his own staff and his own sports psychologist, or hire a new psychologist.

There is often this turnover in staff in the professional sports teams and for that reason it isn’t often that you will find a job as a sports psychologist for a team for 15 years. It just doesn’t work like that. There will be times when you are working 90 percent in sports psychology and then other times you will find yourself doing more work in other industries and down to 20 percent of your work with actual athletes. It just varies.

Also, this specific career field is for those with an entrepreneurial spirit. If you’re looking to go look at a job board and get your dream career, that just probably won’t happen in this career field. There are jobs in academia, there are jobs in research, but to really go out there and build your practice you’re going to need some entrepreneurial spirit. That’s something you will have to be prepared for.
What are some other ways you can use your education as a sports psychologist to find work?

From a contract entrepreneur standpoint, you will have a skill-set that you can apply everywhere. You’re going to be an expert in the psychology of excellence. It would be so easy to get employed full-time as a psychologist at an HR consulting firm, like at the drop of a hat. I think I got my first HR job almost immediately after getting out of school. So there is great job security with having this education. If you have a PHD in psychology they will tend to put you into the senior consultant level pretty early on.

I personally don’t want to work for other people. I like to do my own thing and work on my own business. So for those that actually want to go out and find a job in the corporate industry, you will probably have no problem getting a job. It’s a great fallback to know that you could work at these big companies.

It’s important to be diverse in your career so that you can move into different niches that your employable in. The main message from me to students is to focus niche but look broad in your career.
What are some general cases that have really inspired you during your work as a sports psychologist ?

I have had a few. But in general terms, I had an athlete that was struggling with a bit of a performance issue. But really the big obstacle wasn’t about what was happening in their sport. Their issue was showing up in their sport and through examination we came to this very deep personal issue. Maybe it was family, or abuse, and in reality the person has a very fractured sense of self-worth. In the media they look amazing and they seem like they really have things together, but internally they are suffering.

So when you get to help them change their perspective and emotional experience, and they walk away feeling good about themselves, that’s amazing. When you see that you got to actually change someone’s self-worth and know that going forward they are going to live much more enriched lives, that is amazing. Then, in turn, you get to see that person then change on the field and become even better in sports and reach a new level of competitive functionality.

The Science of Developing Mental Toughness in Your Health, Your Work, and Your Life

Have you ever wondered what makes someone a good athlete? Or a good leader? Or a good parent? Why do some people accomplish their goals while others fail?

What makes the difference?

Usually we answer these questions by talking about the talent of top performers. He must be the smartest scientist in the lab. She’s faster than everyone else on the team. He is a brilliant business strategist.

But I think we all know there is more to the story than that.

In fact, when you start looking into it, your talent and your intelligence don’t play nearly as big of a role as you might think. The research studies that I have found say that intelligence only accounts for 30% of your achievement — and that’s at the extreme upper end.

What makes a bigger impact than talent or intelligence? Mental toughness.

Research is starting to reveal that your mental toughness — or “grit” as they call it — plays a more important role than anything else for achieving your goals in health, business, and life. That’s good news because you can’t do much about the genes you were born with, but you can do a lot to develop mental toughness.

Why is mental toughness so important? And how can you develop more of it?

Let’s talk about that now.

Mental Toughness and The United States Military

Each year, approximately 1,300 cadets join the entering class at the United States Military Academy, West Point. During their first summer on campus, cadets are required to complete a series of brutal tests. This summer initiation program is known internally as “Beast Barracks.”

In the words of researchers who have studied West Point cadets, “Beast Barracks is deliberately engineered to test the very limits of cadets’ physical, emotional, and mental capacities.”

You might imagine that the cadets who successfully complete Beast Barracks are bigger, stronger, or more intelligent than their peers. But Angela Duckworth, a researcher at the University of Pennsylvania, found something different when she began tracking the cadets.

Duckworth studies achievement, and more specifically, how your mental toughness, perseverance, and passion impact your ability to achieve goals. At West Point, she tracked a total of 2,441 cadets spread across two entering classes. She recorded their high school rank, SAT scores, Leadership Potential Score (which reflects participation in extracurricular activities), Physical Aptitude Exam (a standardized physical exercise evaluation), and Grit Scale (which measures perseverance and passion for long–term goals).

Here’s what she found out…

It wasn’t strength or smarts or leadership potential that accurately predicted whether or not a cadet would finish Beast Barracks. Instead, it was grit — the perseverance and passion to achieve long–term goals — that made the difference.

In fact, cadets who were one standard deviation higher on the Grit Scale were 60% more likely to finish Beast Barracks than their peers. It was mental toughness that predicted whether or not a cadet would be successful, not their talent, intelligence, or genetics.
When Is Mental Toughness Useful?

Duckworth’s research has revealed the importance of mental toughness in a variety of fields.

In addition to the West Point study, she discovered that…
Ivy League undergraduate students who had more grit also had higher GPAs than their peers — even though they had lower SAT scores and weren’t as “smart.”
When comparing two people who are the same age but have different levels of education, grit (and not intelligence) more accurately predicts which one will be better educated.
Competitors in the National Spelling Bee outperform their peers not because of IQ, but because of their grit and commitment to more consistent practice.

And it’s not just education where mental toughness and grit are useful. Duckworth and her colleagues heard similar stories when they started interviewing top performers in all fields…


Our hypothesis that grit is essential to high achievement evolved during interviews with professionals in investment banking, painting, journalism, academia, medicine, and law. Asked what quality distinguishes star performers in their respective fields, these individuals cited grit or a close synonym as often as talent. In fact, many were awed by the achievements of peers who did not at first seem as gifted as others but whose sustained commitment to their ambitions was exceptional. Likewise, many noted with surprise that prodigiously gifted peers did not end up in the upper echelons of their field.
—Angela Duckworth

You have probably seen evidence of this in your own experiences. Remember your friend who squandered their talent? How about that person on your team who squeezed the most out of their potential? Have you known someone who was set on accomplishing a goal, no matter how long it took?

You can read the whole research study here, but this is the bottom line:

In every area of life — from your education to your work to your health — it is your amount of grit, mental toughness, and perseverance predicts your level of success more than any other factor we can find.

In other words, talent is overrated.
What Makes Someone Mentally Tough?

It’s great to talk about mental toughness, grit, and perseverance … but what do those things actually look like in the real world?

In a word, toughness and grit equal consistency.

Mentally tough athletes are more consistent than others. They don’t miss workouts. They don’t miss assignments. They always have their teammates back.

Mentally tough leaders are more consistent than their peers. They have a clear goal that they work towards each day. They don’t let short–term profits, negative feedback, or hectic schedules prevent them from continuing the march towards their vision. They make a habit of building up the people around them — not just once, but over and over and over again.

Mentally tough artists, writers, and employees deliver on a more consistent basis than most. They work on a schedule, not just when they feel motivated. They approach their work like a pro, not an amateur. They do the most important thing first and don’t shirk responsibilities.

The good news is that grit and perseverance can become your defining traits, regardless of the talent you were born with. You can become more consistent. You can develop superhuman levels of mental toughness.

How?

In my experience, these 3 strategies work well in the real world…
1. Define what mental toughness means for you.

For the West Point army cadets being mentally tough meant finishing an entire summer of Beast Barracks.

For you, it might be…
going one month without missing a workout
going one week without eating processed or packaged food
delivering your work ahead of schedule for two days in a row
meditating every morning this week
grinding out one extra rep on each set at the gym today
calling one friend to catch up every Saturday this month
spending one hour doing something creative every evening this week

Whatever it is, be clear about what you’re going after. Mental toughness is an abstract quality, but in the real world it’s tied to concrete actions. You can’t magically think your way to becoming mentally tough, you prove it to yourself by doing something in real life.

Which brings me to my second point…
2. Mental toughness is built through small physical wins.


You can’t become committed or consistent with a weak mind. How many workouts have you missed because your mind, not your body, told you you were tired? How many reps have you missed out on because your mind said, “Nine reps is enough. Don’t worry about the tenth.” Probably thousands for most people, including myself. And 99% are due to weakness of the mind, not the body.
—Drew Shamrock

So often we think that mental toughness is about how we respond to extreme situations. How did you perform in the championship game? Can you keep your life together while grieving the death of a family member? Did you bounce back after your business went bankrupt?

There’s no doubt that extreme situations test our courage, perseverance, and mental toughness … but what about everyday circumstances?

Mental toughness is like a muscle. It needs to be worked to grow and develop. If you haven’t pushed yourself in thousands of small ways, of course you’ll wilt when things get really difficult.

But it doesn’t have to be that way.

Choose to do the tenth rep when it would be easier to just do nine. Choose to create when it would be easier to consume. Choose to ask the extra question when it would be easier to accept. Prove to yourself — in a thousand tiny ways — that you have enough guts to get in the ring and do battle with life.

Mental toughness is built through small wins. It’s the individual choices that we make on a daily basis that build our “mental toughness muscle.” We all want mental strength, but you can’t think your way to it. It’s your physical actions that prove your mental fortitude.
3. Mental toughness is about your habits, not your motivation.

Motivation is fickle. Willpower comes and goes.

Mental toughness isn’t about getting an incredible dose of inspiration or courage. It’s about building the daily habits that allow you to stick to a schedule and overcome challenges and distractions over and over and over again.

Mentally tough people don’t have to be more courageous, more talented, or more intelligent — just more consistent. Mentally tough people develop systems that help them focus on the important stuff regardless of how many obstacles life puts in front of them. It’s their habits that form the foundation of their mental beliefs and ultimately set them apart.

I’ve written about this many times before. Here are the basic steps for building a new habit and links to further information on doing each step.
Start by building your identity.
Focus on small behaviors, not life–changing transformations.
Develop a routine that gets you going regardless of how motivated you feel.
Stick to the schedule and forget about the results.
When you slip up, get back on track as quickly as possible.

Mental toughness comes down to your habits. It’s about doing the things you know you’re supposed to do on a more consistent basis. It’s about your dedication to daily practice and your ability to stick to a schedule.
How Have You Developed Mental Toughness?

Our mission as a community is clear: we are looking to live a healthy lives and make a difference in the world.

To that end, I see it as my responsibility to equip you with the best information, ideas, and strategies for living healthier, becoming happier, and making a bigger impact with your life and work.

But no matter what strategies we discuss, no matter what goals we set our sights on, no matter what vision we have for ourselves and the people around us … none of it can become a reality without mental toughness, perseverance, and grit.

When things get tough for most people, they find something easier to work on. When things get difficult for mentally tough people, they find a way to stay on schedule.

There will always be extreme moments that require incredible bouts of courage, resiliency, and grit … but for 95% of the circumstances in life, toughness simply comes down to being more consistent than most people.

What have you learned about mental toughness? What has worked well for you? Leave a comment below and tell us!

Saturday, October 12, 2013

NUTTING NUTTY : NUTS ABOUT SWEET WILLIAM DAIRY FREE CHOCOLATE BARS

Posted by Vicky on | April 21, 2011 |


A good friend of mine regularly stocks up on Sweet William chocolate products whenever she is back in Australia. Sweet William products are dairy-free, egg-free, gluten-free and of course nut-free! Well, I have great news… these fab products are now available in Singapore. I have found them at the Cold Storage in the Nex shopping mall.

The chocolate bars are not cheap though. I love chocolate (and reluctantly admit I probably qualify as an expert in this field, as I quaff so many bars of the stuff), and if you are searching for a dairy, nut and egg free chocolate bar these are good. The texture is really good, it has the mouth melt feel of proper chocolate, and most importantly it tastes like a real treat.

Their Not Nuts, nut bar (made with soy beans) is great. It has that proper nutty crunch, and the packaging is fab (I’m always a bit of a mug for good marketing). It is humorous and has a cute picture of a squirrel with a line through it, it reads “not suitable for squirrels”. A chocolate bar, and a chortle – who could ask for more!

For more information please check out their website

http://www.sweetwilliam.com.au

They are priced at $4.25 for the original bar, and $4.40 for the Not Nuts nut bar

* They do contain soy

Sunday, October 6, 2013

Good Will Hunting

Will[about Skylar] Don't worry about me, I know what I'm doin'. Yeah, but this girl is like, you know, beautiful. She's smart. She's funny. She's different from most of the girls I've been with.
Sean: So, call her up, Romeo.
Will: Why? So I can realize she's not that smart, that she's fuckin' boring? Y'know? I mean...this girl is like fuckin' perfect right now, I don't wanna ruin that.
Sean: Maybe you're perfect right now. Maybe you don't wanna ruin that. I think that's a super philosophy, Will, that way you can go through your entire life without ever having to really know anybody...My wife used to fart when she was nervous. She had all sorts of wonderful idiosyncrasies. You know what? She used to fart in her sleep. [they laugh] Sorry I shared that with you. One night it was so loud it woke the dog up. She woke up and gone like "oh was that you?" I'd say yeah...I didn't have the heart to tell her...[cracks up] Oh God...
Will[laughing hysterically] She woke herself up?
Sean[in hysterics himself] Yes!.... Oh Christ....aahhh, but, Will, she's been dead two years and that's the shit I remember. [Will stops laughing] Wonderful stuff, you know, little things like that. Ah, but, those are the things I miss the most. The little idiosyncrasies that only I knew about. That's what made her my wife. Oh, and she had the goods on me, too; she knew all my little peccadillos. People call these things imperfections, but they're not — aw that's the good stuff. And then we get to choose who we let into our weird little worlds. You're not perfect, sport. And let me save you the suspense. This girl you met, she isn't perfect either. But the question is: whether or not you're perfect for each other. That's the whole deal. That's what intimacy is all about. Now you can know everything in the world, sport, but the only way you're findin' out that one is by givin' it a shot. You certainly won't learn from an old fucker like me. Even if I did know, I wouldn't tell a pissant like you.
Will: Why not? You told me every other fuckin' thing. Jesus Christ. Fuckin' talk more than any shrink I ever seen in my life.
Sean: I teach this shit, I didn't say I know how to do it.
Will: Yeah...You ever think about gettin' remarried?
Sean: My wife's dead.
Will: Hence the word: remarried.
Sean: She's dead.
Will: Yeah...Well, I think that's a super philosophy, Sean. I mean that way you could actually go through the rest of your life without ever really knowing anybody.
Sean[smiles uncomfortably] Time's up.

Amoebiasis


Amoebiasis
Classification and external resources
Entamoeba histolytica life cycle-en.svg
Life-cycle of the Entamoeba histolytica
ICD-10A06
ICD-9006
DiseasesDB4304
MedlinePlus000298
eMedicinearticle/212029 article/996092
MeSHD000562
Amoebiasis, or Amebiasis, refers to infection caused by the amoeba Entamoeba histolytica.[1][2] The term Entamoebiasis is occasionally seen but is no longer in use;[citation needed] it refers to the same infection.
gastrointestinal infection that may or may not be symptomatic and can remain latent in an infected person for several years, amoebiasis is estimated to cause 70,000 deaths per year world wide.[3] Symptoms can range from mild diarrhea to dysentery with blood and mucus in the stool. E. histolytica is usually a commensal organism.[4] Severe amoebiasis infections (known as invasive or fulminant amoebiasis) occur in two major forms. Invasion of the intestinal lining causes amoebic dysentery or amoebic colitis. If the parasite reaches the bloodstream it can spread through the body, most frequently ending up in the liver where it causes amoebic liver abscessesLiver abscesses can occur without previous development of amoebic dysentery. When no symptoms are present, the infected individual is still a carrier, able to spread the parasite to others through poor hygienic practices. While symptoms at onset can be similar to bacillary dysentery, amoebiasis is not bacteriological in origin and treatments differ, although both infections can be prevented by good sanitary practices.


Most infected people, about 90%,
[5] are asymptomatic, but this disease has the potential to make the sufferer dangerously ill. It is estimated that about 40,000 to 100,000 people worldwide die annually due to amoebiasis.[6]

Signs and symptoms[edit]

Infections can sometimes last for years. Symptoms take from a few days to a few weeks to develop and manifest themselves, but usually it is about two to four weeks. Symptoms can range from mild diarrhea to severe dysentery with blood and mucus. The blood comes from lesions formed by the amoebae invading the lining of the large intestine. In about 10% of invasive cases the amoebae enter the bloodstream and may travel to other organs in the body. Most commonly this means the liver, as this is where blood from the intestine reaches first, but they can end up almost anywhere in the body.
Onset time is highly variable and the average asymptomatic infection persists for over a year. It is theorised that the absence of symptoms or their intensity may vary with such factors as strain of amoeba, immune response of the host, and perhaps associated bacteria and viruses.
In asymptomatic infections the amoeba lives by eating and digesting bacteria and food particles in the gut, a part of the gastrointestinal tract.[citation needed] It does not usually come in contact with the intestine itself due to the protective layer of mucus that lines the gut. Disease occurs when amoeba comes in contact with the cells lining the intestine. It then secretes the same substances it uses to digest bacteria, which include enzymes that destroy cell membranes and proteins. This process can lead to penetration and digestion of human tissues, resulting first in flask-shaped ulcers in the intestine. Entamoeba histolytica ingests the destroyed cells by phagocytosis and is often seen with red blood cells inside when viewed in stool samples. Especially inLatin America,[citation needed] a granulomatous mass (known as an amoeboma) may form in the wall of the ascending colon or rectum due to long-lasting immunological cellular response, and is sometimes confused with cancer.[7]
"Theoretically, the ingestion of one viable cyst can cause an infection."[8]

Cause[edit]

Amoebiasis is an infection caused by the amoeba Entamoeba histolytica Likewise amoebiasis is sometimes incorrectly used to refer to infection with other amoebae, but strictly speaking it should be reserved for Entamoeba histolytica infection. Other amoebae infecting humans include:[9]
Except for Dientamoeba, the parasites above are not thought to cause disease.

Transmission[edit]

Amoebiasis is usually transmitted by the fecal-oral route, but it can also be transmitted indirectly through contact with dirty hands or objects as well as by anal-oral contact. Infection is spread through ingestion of the cyst form of the parasite, a semi-dormant and hardy structure found in feces. Any non-encysted amoebae, or trophozoites, die quickly after leaving the body but may also be present in stool: these are rarely the source of new infections. Since amoebiasis is transmitted through contaminated food and water, it is often endemic in regions of the world with limited modern sanitation systems, including México, Central America, western South AmericaSouth Asia, and western and southern Africa.[14]
Amoebic dysentery is often confused with "traveler's diarrhea" because of its prevalence in developing nations. In fact, most traveler's diarrhea is bacterial or viral in origin.

Diagnosis[edit]

Immature E. histolytica/E. dispar cyst in a concentrated wet mount stained with iodine. This early cyst has only one nucleus and a glycogen mass is visible (brown stain). From CDC’s Division of Parasitic Diseases
Asymptomatic human infections are usually diagnosed by finding cysts shed in the stool. Various flotation or sedimentation procedures have been developed to recover the cysts from fecal matter and stains help to visualize the isolated cysts for microscopic examination. Since cysts are not shed constantly, a minimum of three stools should be examined. In symptomatic infections, the motile form (the trophozoite) can often be seen in fresh feces. Serological tests exist and most individuals (whether with symptoms or not) will test positive for the presence of antibodies. The levels of antibody are much higher in individuals with liver abscesses. Serology only becomes positive about two weeks after infection. More recent developments include a kit that detects the presence of amoeba proteins in the feces and another that detects ameba DNA in feces. These tests are not in widespread use due to their expense.
Amoebae in a colon biopsy from a case of amoebic dysentery.
Microscopy is still by far the most widespread method of diagnosis around the world. However it is not as sensitive or accurate in diagnosis as the other tests available. It is important to distinguish the E. histolytica cyst from the cysts of nonpathogenic intestinal protozoa such as Entamoeba coli by its appearance. E. histolytica cysts have a maximum of four nuclei, while the commensal Entamoeba coli cyst has up to 8 nuclei. Additionally, in E. histolytica, the endosome is centrally located in the nucleus, while it is usually off-center in Entamoeba coli. Finally, chromatoidal bodies in E. histolytica cysts are rounded, while they are jagged in Entamoeba coli. However, other species, Entamoeba dispar and E. moshkovskii, are also commensals and cannot be distinguished from E. histolytica under the microscope. As E. dispar is much more common than E. histolytica in most parts of the world this means that there is a lot of incorrect diagnosis of E. histolytica infection taking place. The WHO recommends that infections diagnosed by microscopy alone should not be treated if they are asymptomatic and there is no other reason to suspect that the infection is actually E. histolytica.
Typically, the organism can no longer be found in the feces once the disease goes extra-intestinal.[citation needed] Serological tests are useful in detecting infection by E. histolytica if the organism goes extra-intestinal and in excluding the organism from the diagnosis of other disorders. An Ova & Parasite (O&P) test or an E. histolytica fecal antigen assay is the proper assay for intestinal infections. Since antibodies may persist for years after clinical cure, a positive serological result may not necessarily indicate an active infection. A negative serological result however can be equally important in excluding suspected tissue invasion by E. histolytica.[citation needed]

Prevention[edit]

Amoebic Ulcer Intestine
To help prevent the spread of amoebiasis around the home :
To help prevent infection:
  • Avoid raw vegetables when in endemic areas, as they may have been fertilized using human feces.
  • Boil water or treat with iodine tablets.
  • Avoid eating street foods especially in public places where others are sharing sauces in one container
Good sanitary practice, as well as responsible sewage disposal or treatment, are necessary for the prevention ofE.histolytica infection on an endemic level. E.histolytica cysts are usually resistant to chlorination, therefore sedimentation and filtration of water supplies are necessary to reduce the incidence of infection.[15]
E. histolytica cysts may be recovered from contaminated food by methods similar to those used for recoveringGiardia lamblia cysts from feces. Filtration is probably the most practical method for recovery from drinking water and liquid foods. E. histolytica cysts must be distinguished from cysts of other parasitic (but nonpathogenic) protozoa and from cysts of free-living protozoa as discussed above. Recovery procedures are not very accurate; cysts are easily lost or damaged beyond recognition, which leads to many falsely negative results in recovery tests.[16]

Treatment[edit]

E. histolytica infections occur in both the intestine and (in people with symptoms) in tissue of the intestine and/or liver.[14] As a result, two different classes of drugs are needed to treat the infection, one for each location. Such anti-amoebic drugs are known as amoebicides.

Prognosis[edit]

In the majority of cases, amoebas remain in the gastrointestinal tract of the hosts. Severe ulceration of the gastrointestinal mucosal surfaces occurs in less than 16% of cases. In fewer cases, the parasite invades the soft tissues, most commonly the liver. Only rarely are masses formed (amoebomas) that lead to intestinal obstruction.(Mistaken for Ca caecum and appendicular mass) Other local complications include bloody diarrhea, pericolic and pericaecal abscess.
Complications of hepatic amoebiasis includes subdiaphragmatic abscess, perforation of diaphgram to pericardium and pleural cavity, perforation to abdominal cavital (amoebic peritonitis) and perforation of skin (amoebic cutis).
Pulmonary amoebiasis can occur from hepatic lesion by haemotagenous spread and also by perforation of pleural cavity and lung. It can cause lung abscess, pulmono pleural fistula, empyema lung and broncho pleural fistula. It can also reach brain through blood vessel and cause amoebic brain abscess and amoebic meningoencephalitis. Cutaneous amoebiasis can also occur in skin around sites of colostomy wound, perianal region, region overlying visceral lesion and at the site of drainage of liver abscess.
Urogenital tract amoebiasis derived from intestinal lesion can cause amoebic vulvovaginitis (May's disease), rectovesicle fistula and rectovaginal fistula.
Entamoeba histolytica infection is associated with malnutrition and stunting of growth.[17]

Epidemiology[edit]

As of 2010 it caused about 55,000 deaths down from 68,000 in 1990.[18]
In older textbooks it is often stated that 10% of the world's population is infected with Entamoeba histolytica.[citation needed] It is now known that at least 90% of these infections are due to E. dispar. Nevertheless, this means that there are up to 50 million true E. histolytica infections and approximately seventy thousand die each year, mostly from liver abscesses or other complications. Although usually considered a tropical parasite, the first case reported (in 1875) was actually in St Petersburg in Russia, near the Arctic Circle.[19] Infection is more common in warmer areas, but this is both because of poorer hygiene and the parasitic cysts surviving longer in warm moist conditions.[14]

Outbreaks[edit]

The most dramatic incident in the USA was the Chicago World's Fair outbreak in 1933 caused by contaminated drinking water; defective plumbing permitted sewage to contaminate water.[20]There were 1,000 cases (with 58 deaths). In 1998 there was an outbreak of amoebiasis in the Republic of Georgia.[21] Between 26 May and 3 September 1998, 177 cases were reported, including 71 cases of intestinal amoebiasis and 106 probable cases of liver abscess.