Prof. Joseph S. Pizzo
English/Fine Arts/Modern Languages
firstname.lastname@example.org or email@example.com
Check Your Knowledge
1. When __________ breaks, the cracks move faster than 3,000
miles per hour.
2. The United States Postal Service handles over _____% of the
world's mail volume.
3. -40 degrees Celsius is equal to _______ degrees Fahrenheit.
4. All ____________ (crop) is grown within 1,000 miles of the
5. ________________________________ was both the youngest
and the oldest defense secretary in US history.
6. The first product to have a bar code scanned was
7. 111,111,111 x 111,111,111 = ____________________________ .
8. ______ (Number of) cars can drive side by side on the
Monumental Axis in Brazil, the world's widest road.
9. A 10-gallon hat barely holds ______________________ of
10. ____________________ (Flavor) Jelly Bellies were created
especially for President Ronald Reagan.
Interesting Facts - Answers
3. -40 degrees Fahrenheit
5. Donald Rumsfeld
6. Wrigley's gum
9. 6 pints
Can You Break the Code?
Each phrase below contains the initials of words that will form a familiar idea.
For example, “365 D in a Y” stands for “365 days in a year”.
7 D of the W ______________________________________
12 M of the Y ______________________________________
26 L of the A ______________________________________
7 W of the W ______________________________________
4 Q in a G ______________________________________
1001 A N ______________________________________
12 S of the Z ______________________________________
24 H in a D ______________________________________
9 P in the S S ______________________________________
29 D in F in a L Y ______________________________________
90 D in a R A ______________________________________
(Baby Boomer Bonus) 57 V of H ______________________________________
Can You Break the Code?
7 D of the W = 7 Days of the Week
12 M of the Y = 12 Months of the Year
26 L of the A = Letters of the Alphabet
7 W of the W = Wonders of the World
4 Q in a G = Quarts in a Gallon
1001 A N = 1001 Arabian Nights
12 S of the Z = 12 Signs of the Zodiac
24 H in a D = 24 Hours in a Day
9 P in the S S = Planets in the Solar System
29 D in F in a L Y = 29 Days in February in a Leap Year
90 D in a R A = 90 Degrees in a Right Angle
(Baby Boomer Bonus) 57 V of H = 57 Varieties of Heinz
1. STAND 2. JOBS I’M JOBS
3. PACK 4. L
PACK THE JOB
1, 2, 3, …
7. THOUGHT 8.
1. I understand
2. I’m between jobs
3. Six – pack
4. Lying down on the job
5. A lot of it going around
6. Running around in circles
7. It’s the thought that counts
8. Wave good-bye
I heard shouting and turned to see a fish hurling through the air into a man’s arms. A cheer
followed, and the fish was expertly wrapped and given to a laughing woman. I was
laughing, too. I watched for fifteen minutes. The shouts, cheers, and laughing continued —
mixed with flying fish. At the Pike Place Fish Market in Seattle, Washington, it’s another
day at work. We should all learn something from them. It’s called the FiSH! Philosophy.
You may not ever see yearbooks and fish in the same story again, but at Pike’s, the energy
and enthusiasm for selling fish can help you sell yearbooks and have more fun doing it.
The FiSH! Philosophy, inspired by Pike Place Fish Market and developed by Charthouse®,
is not a rule book or five-step program. It’s about finding what works, deciding what you
believe in and being excited about it. It’s not handed down as law from the top. From the
Web site, “if you impose anything from the top, over time, that’s exactly where it will
remain.” The book has sold more than 4 million copies worldwide in 34 languages and
helps organizations of all kinds improve the atmosphere where they work. It’s a way to
think, which becomes the way we act and the way we communicate with others so choose
your words carefully.
For every order, the employees at Pike’s yell it out together, then one guy grabs the fish
and high-speed pitches it to his coworker waiting with the wrapping paper. Sometimes they
involve the audience. They let the buyer try to catch it (it never works and that’s even
funnier), or they “talk” to a customer by moving the fish’s mouth (hilarious). They greet
everyone, even people who are not stopping. Everyone—Pike’s Fish guys and the
audience—cheers for a good catch. The energy is contagious. The attitude draws people in.
People come from all over the world to buy their fish. You can learn what they’ve done and
create a FiSH! Philosophy for your yearbook program at school.
Paying attention to people makes them feel important and makes them feel involved. You
know how you feel when you get fast food and the employee never even looks at you?
Engage people with eye contact, a smile and your full attention. If someone is considering
buying a book, a positive interaction with you can make the sale. Remember that you are
the human contact between the book and the student buyer. Share your excitement! Let
them know this book is for them!
If you’re going to spend time and effort on the book, you’ve got to have some fun! Some of
the most successful companies in the world encourage fun because they know it can
improve energy, productivity and attitude. For example, the famous SAS® Institute in
Cary, NC, has live music in the cafeteria, an unbelievable gym and jars of candy
everywhere. Employees throw Frisbees® at lunch! Playing fosters creativity, relaxes and
recharges us. Playing around with something can give you the mental flexibility to find a
Playing is also seeing humor in what we do. It’s making those around us enjoy the
experience. Post a funny typo on the wall (if it doesn’t offend anyone, including the writer).
Take funny photos of each staff member and exhibit them. When others see what’s going
on in yearbook, they’ll want to see what all the fun is about.
Make Their Day
If you’ve had a rough morning, something as simple as a compliment or a door being held
for you can make your day. It could be a lollipop given to each yearbook buyer, or a
“bouquet” of ten to every tenth buyer, who can then make other people smile by sharing
them. There are unlimited creative and inexpensive ways to brighten someone’s day. It will
make them think, “Hey, this is a good place to be. I want to be part of it.” Making their day
will make yours too.
Choose Your Attitude
This is the most important element of FiSH! Bad things happen all the time, but how we
react to them is a choice. Is it going to be “that just ruined my day” or “when people ask me
about this am I going to laugh?” Choosing isn’t putting on a front. It’s seeing the situation
for what it is, deciding what kind of person you want to be and dealing with it the best way
you can. Be aware of the fact that your reaction will affect others. You can make it better or
worse. You know what you’d want others to do.
Be innovative in creating your own philosophy. Your school is different from others. What
will make people react positively? What should you avoid? How can you increase the fun
and energy and the belief in what you are doing as a team? Look to FiSH!
University of Oregon
Teacher Effectiveness Program
How do I encourage students to be active/interested?
From the first day, demonstrate and talk about your own enthusiasm for the course
material, and how it effects you personally. Look for ways to connect the material to the
lives of your students. For example: if you are teaching an environmental studies class,
bring in examples of environmental issues going on in the area where your students live
(Eugene, Oregon is perfect for this...). Use current event articles, editorials from local
newspapers, or examples from your own life that illustrate your points. Solicit these
examples from your students.
Think of questions you can ask about the material that make students think about the
subject matter, even if they have not read the material. While students may not have read
the biography of Frederick Douglas, they can talk about what life must have been like for
an African American living at that time in history. Then, during class, attach statements that
come out of their mouths to the reading, so they want to go back and read about their own
Cover course material with effective Discussion Facilitation Techniques.
Create a "need to know." As you are preparing your lesson plans, ask yourself - why would
a student need to know this? This helps you think about material in terms of its relevance to
What are some good ways to facilitate a discussion?
Students must feel comfortable talking to each other. To encourage this, generate a warm
climate at the beginning of the course.
Consider the physical set-up in your classroom. Can students see each other, or are they
sitting side by side in rows facing the front of the room? Is it possible to create a circle or a
Establish criteria for a good discussion at the beginning of the course. Spend a few minutes
letting the students generate these criteria themselves. (One GTF had each student
introduce themselves by completing this sentence: "When I am in a small group discussion,
I usually...) Feedback discussions are wonderful for making this happen.
Make your students responsible for bringing good issues for discussion to class.
Listen well. Respond in a way that indicates that you heard and understood the question or
the comment. Validate questions by either expanding on or challenging them, and
encourage students to challenge you.
Allow enough time for discussion. Good discussions take some time for warm-up,
reflection, and maximum input.
Give students time to respond. A few seconds can feel like a century, but students need that
time to process the question.
Warm up your audience. Use review questions from the last session or even a non-related
current event to get people in the mood. Sometimes controversial events or issues will
jump-start a discussion. Check out The Book of Questions as a resource; it poses dilemmas
of all kinds, and it demands that readers take a stand. Go around the room and let every
Present material as problems to be solved, and encourage the consideration of multiple
solutions. For example: "Let's consider all the ways we might determine the period in
which to place this artifact." --or-- "There are lots of ways this story can be interpreted.
Let's see if we agree or disagree with the critics."
Tell the students in advance what the discussion topics will be.
Offer different options for participation. Letting students turn in written responses often
helps shyer students.
Let students work in groups of three or four. Assign them a discussion topic and give them
five or ten minutes to put together a response. Let them decide how to present their
thoughts to the class.
Prompt students with a variety of questions that require different levels of thinking.
o Some questions can be answered with information from general experience or from
basic knowledge of the discipline.
o Some questions require that students explain the relationship between different
ideas, using this to form general concepts.
o Some require students to apply concepts and principles to new data and different
Tried-and-true techniques for structuring active discussion:
o Sliding Groups (Groups of one to …)
o Feedback Discussions (Value-rated discussions)
o Nominal Group Technique (Anonymous contributions and questions)
How do I deal with apathetic students?
Try to build a personal relationship with these students, and take an interest in them to find
out what is at the bottom of the "perceived apathy." Learning students' names and using
names in class can help students understand that you are interested in them and in their
success in your course. Consider e-mailing a student who seems uninterested or
unresponsive and let him/her know that you would like to help them in any way that you
can. Oftentimes their apparent apathy has nothing to do with the course. There may be
personal matters that are dominating their attention. Some students are going through a
period of depression which disconnects them from their studies. Showing a little concern
can be very helpful.
Measure the students' progress early and regularly, so they have a clear idea about where
they stand academically. This may involve quizzes, short response papers, or some kind of
weekly assignment which gives you some indication of their level of understanding. Your
"apathetic" students may also be the students who are struggling with the class. They could
also be students for whom the class is inappropriate. In either case, it would be good to find
this out early, so you can arrange an appointment with the student to talk about how things
are going. Take some initiative here. Just saying "Drop by my office if you need to see me,"
may not be enough to get them in there (especially freshmen).
How do I get my students to prepare for class?
Give students some kind of assignment. They often need this structure. They also need
accountability. Make sure the assignment is not just busy work. Design it to be relevant and
use whatever the students have prepared directly in class. Some teachers ask a few study
questions, some give a short quiz, some ask students to write a response to the reading. You
can require a short assignment with each reading, but they do not all have to be graded.
You can tell students that out of the 8-10 assignments they will turn in, X will be graded.
These will be done at random so it is important that each assignment is completed. This
will help with your grading workload.
o When assigning reading, give the students a few questions on which they must take
a stand at the next class meeting. This helps make students more active readers. For
"Was Medea justified in her actions?"
"If you were Jimmy Carter, what would you have done?"
"How many ways can we go about figuring the distance between these two
o Have students prepare an outline of their reading assignment.
o Have students write a half page response paper noting what questions and concerns
the reading raised for them. These weekly assignments do not need to necessarily
be graded. Sometimes instructors grade them randomly. Some use a check, check
plus, and check minus system to credit the work.
Let students know they may have a quiz over the reading material.
How will I know if my students are learning?
There are certainly many ways to assess learning. The most obvious of them are tests. One
non-threatening way to test knowledge, is to give a 10 or 15 minute quiz each week over
the material recently covered. This will provide you with some idea of whether or not your
students are "getting it" and will give your students opportunities to receive feedback from
you. A couple of midterms and a final will also tell you if your students are learning,
however they won't give you as many opportunities to assess their progress and perhaps
make changes to the lesson plans or your teaching style. Class discussions can also provide
opportunities for students to demonstrate learning and understanding. However, it can be
difficult to get all students to participate in discussions and therefore difficult to gauge
everyone's understanding. Finally, class assignments and projects can be a very valuable
way for your students to demonstrate gained skills and knowledge. Vary the formats of
assignments so that different styles of learning and performing can be accommodated.
How do I inspire students who are only taking my course because the "have to?"
Make them want to!! Most students are more than willing to enjoy a class rather than just
endure it. Tell them why you love the subject. Share your enthusiasm with them. If you
know others in the field with a lot of enthusiasm, bring them in as guest speakers.
Incorporate interesting or funny anecdotes relevant to the topic into your lectures. Make
them want to learn what you know and then do all you can to help. Don't assume they aren't
interested or can't be inspired by you. Chances are you have enough enthusiasm to go
How can teachers promote excellence and rigor in an encouraging
Make your expectations clear to your students early. Then help them meet those
expectations. That may mean working with them on an individual basis. When grading,
make comments. If something is done poorly, explain how it could have been done better.
When something is done well, convey that with a comment like "Nice work!", "That's
right!", or "Good argument!" Always grade fairly and consistently. If a student does poorly
on a test, make a written comment on it like "See me. I can help." Let your students know
how they are doing in your class on a regular basis. Let your teaching model the rigor,
enthusiasm, and dedication that you want to see in their work.
Should class be fun?
If you can make learning fun, then by all means do it! If your class is uninteresting to
students, they are unlikely to work to their potential, and even less likely to pursue further
studies in the area. Make the material exciting and share your enthusiasm with students.
Frederick Herzberg: Exploring What Motivates Us
Any good manager knows that happy, satisfied workers will generally perform better than those
who don't feel as satisfied. However, managers have always had differing opinions about what it
takes to satisfy workers.
During the 50's and 60's, a man named Fredrick Herzberg decided to carefully study and research
the key factors affecting a worker's performance. During his research, he found that certain factors
tended to cause a worker to feel unsatisfied with his or her job. These factors seemed to directly
relate to the employee's environment such as the physical surroundings, supervisors and even the
company itself. He developed a theory based on this observation, naming it the "Hygiene Theory."
According to his theory, for a worker to be happy and therefore productive, these environmental
factors must not cause discomfort. Although the elimination of the environmental problems may
make a worker productive, it will not necessarily motivate him. The question remains, "How can
managers motivate employees?" Many managers believe that motivating employees requires giving
rewards. Herzberg, however, believed that the workers get motivated through feeling responsible
for and connected to their work. In this case, the work itself is rewarding. Managers can help the
employees connect to their work by giving them more authority over the job, as well as offering
direct and individual feedback.
Mayo's Hawthorne Experiments
George Elton Mayo was in charge of certain experiments on human behavior carried out at the
Hawthorne Works of the General Electric Company in Chicago between 1924 and 1927. His
research findings have contributed to organization development in terms of human relations and
Flowing from the findings of these investigations he came to certain conclusions as follows:
Work is a group activity.
The social world of the adult is primarily patterned about work activity.
The need for recognition, security and sense of belonging is more important in determining
workers' morale and productivity than the physical conditions under which he works.
A complaint is not necessarily an objective recital of facts; it is commonly a symptom
manifesting disturbance of an individual's status position.
The worker is a person whose attitudes and effectiveness are conditioned by social
demands from both inside and outside the work plant.
Informal groups within the work plant exercise strong social controls over the work habits
and attitudes of the individual worker.
The change from an established society in the home to an adaptive society in the work plant
resulting from the use of new techniques tends continually to disrupt the social organization
of a work plant and industry generally.
Group collaboration does not occur by accident; it must be planned and developed. If group
collaboration is achieved the human relations within a work plant may reach a cohesion
which resists the disrupting effects of adaptive society.
Chris Argyris looks to move people from a Model I to a Model II orientation and practice – one that
fosters double-loop learning. He suggests that most people, when asked, will espouse Model II. As
Anderson (1997) has commented, Argyris offers no reason why most people espouse Model II. In
addition, we need to note that the vast bulk of research around the models has been undertaken by
Argyris or his associates.
Exhibit 1: Model I theory-in-use characteristics
The governing Values of Model I are:
Achieve the purpose as the actor defines it
Win, do not lose
Suppress negative feelings
Primary Strategies are:
Control environment and task unilaterally
Protect self and others unilaterally
Usually operationalized by:
Unillustrated attributions and evaluations e.g.. "You seem unmotivated"
Advocating courses of action which discourage inquiry e.g.. "Lets not talk about the past, that's
Treating ones' own views as obviously correct
Making covert attributions and evaluations
Face-saving moves such as leaving potentially embarrassing facts unstated
Low freedom of choice
Reduced production of valid information
Little public testing of ideas
Taken from Argyris, Putnam & McLain Smith (1985, p. 89)
The significant features of Model II include the ability to call upon good quality data and to make
inferences. It looks to include the views and experiences of participants rather than seeking to
impose a view upon the situation. Theories should be made explicit and tested, positions should be
reasoned and open to exploration by others. In other words, Model II can be seen as dialogical –
and more likely to be found in settings and organizations that look to shared leadership. It looks to:
Emphasize common goals and mutual influence.
Encourage open communication, and to publicly test assumptions and beliefs.
Combine advocacy with inquiry (Argyris and Schön 1996; Bolman and Deal 1997: 147-8).
We can see these in the table below.
Exhibit 2: Model II characteristics
The governing values of Model II include:
Free and informed choice
Participation in design and implementation of action
Attribution and evaluation illustrated with relatively directly observable data
Surfacing conflicting view
Encouraging public testing of evaluations
Consequences should include:
Minimally defensive relationships
High freedom of choice
Increased likelihood of double-loop learning
Taken from Anderson 1997
April 11, 2008
Olympic Official Calls Protests a ‘Crisis’
By ANDREW JACOBS
BEIJING — China faced rare criticism of its human rights record from the head of the International
Olympic Committee on Thursday, even as calls for a boycott of the opening ceremony of the
Games grew louder in Europe and the United States.
The president of the Olympic committee, Jacques Rogge, called on the authorities in Beijing to
respect their “moral engagement” to improve human rights in the months leading up to the Games
and to provide the news media with greater access to the country. He also described the protests
that have dogged the international Olympics torch relay as a “crisis” for the organization.
Though Mr. Rogge predicted the Games would still be a success, his comments were a sharp
departure from previous statements in which he avoided any mention of politics. Beijing quickly
rejected his remarks and said they amounted to meddling in its internal affairs.
Meanwhile, pressure increased on world leaders to signal their opposition to China’s policies in
Tibet and its close relations with the government of Sudan by skipping the opening ceremony of the
Games. The European Parliament urged leaders of its 27 member nations to consider a boycott of
the ceremony unless China opens a dialogue with the Dalai Lama, the exiled spiritual leader of
In New York, Secretary General Ban Ki-moon of the United Nations informed China that he would
not attend the ceremony, a spokeswoman said. An official in Mr. Ban’s office said that he had
travel commitments in Europe and Latin America and that he was already scheduled to be in China
in July, shortly before the Games.
China’s human rights policies and the Olympics have become a contentious issue in the race for
president in the United States, where the three remaining candidates from both parties have called
on President Bush, who has plans to attend the Olympics, to skip the opening event.
Senator John McCain, the presumptive Republican nominee, said he would not attend the opening
ceremony if he were president, echoing a statement by Senator Hillary Rodham Clinton earlier this
week. Senator Barack Obama suggested that Mr. Bush should wait to make a final decision, but
leave a boycott “firmly on the table.”
Preparations for the Games were rocked last month when Tibetans staged violent protests against
Chinese rule and security forces cracked down on monks and other supporters of the exiled Dalai
Lama in parts of Western China. The clashes set off sympathy protests and calls around the world
for the boycott. Demonstrators turned the 21-city torch relay into a public relations fiasco for
Beijing and the Olympic committee.
The Dalai Lama, in Japan on Thursday, told reporters no one should try to silence the
demonstrators protesting Chinese rule in Tibet, and he said, “We are not anti-Chinese.” He added,
“Right from the beginning, we supported the Olympic Games.”
Top officials in China have claimed that the Tibetan protests and the international protests are part
of a plot to disrupt the Olympics orchestrated by the Dalai Lama, who lives in India. They have
called him a splittist and a terrorist whose goal is to separate Tibet from China.
On Thursday, officials also said they had uncovered a plot by Islamic terrorists in the Xinjiang
Uighur Autonomous Region to disrupt the Games by kidnapping foreign journalists, athletes and
The police said they arrested 35 people and confiscated explosives and detonators belonging to a
Uighur jihadist group based in Urumqi, the capital of Xinjiang. In the past, officials have
announced the discovery of such plots without providing much evidence. Last month, they claimed
to have foiled a plan to hijack an airplane and blow up a bus.
While China has faced violent attacks from Muslim groups, unflinching social controls have
prevented the emergence of a sustained terrorist threat in the country. Some analysts have suggested
that widely publicized discoveries of weapons caches and terrorist plots are part of a larger effort to
present domestic unrest as a form of international terrorism that the world should help China
Speaking before a two-day meeting of the Olympic committee’s executive board in Beijing, Mr.
Rogge condemned protesters who have hounded torch bearers in several countries. He said that
skirmishes during torch processions in Athens, London, Paris and San Francisco amounted to a
crisis, but insisted that they would not derail the six-continent pageant leading up to the Games.
“There is no scenario of interrupting or bringing the torch back to Beijing,” he said.
Even so, he also called on China to honor its pledges to improve human rights and to give foreign
journalists unfettered access to all parts of the country.
“We will do our best to have this be realized,” he said of a recent Chinese regulation that guarantees
reporters the right to travel to all parts of the country, including Tibet.
Mr. Rogge said he met with Prime Minister Wen Jiabao of China for an hour on Wednesday, but he
would not reveal details of their conversation. Mr. Rogge has long avoided criticizing China, saying
that pressing the government on Tibet and other issues was likely to backfire.
“China will close itself off from the rest of the world, which, don’t forget, it has done for some
2,000 years,” he said, somewhat exaggerating history, in an interview broadcast Wednesday in his
The Chinese government reacted sharply to Mr. Rogge’s criticism. “I believe I.O.C. officials
support the Beijing Olympics and adherence to the Olympic charter of not bringing in any
irrelevant political factors,” said Jiang Yu, a Foreign Ministry spokeswoman.
Olympic committee members have been taken aback by the scope and ferocity of the protests,
which are marring what has traditionally been a festive event involving 20,000 torch bearers.
Although the protests in San Francisco were not as disruptive as in London and Paris, the torch’s
sole North American visit was a disappointment to thousands of spectators after the relay route was
changed at the last minute.
The committee members who gathered at a hotel in central Beijing offered harsh words for
demonstrators who used the relay to publicize issues ranging from Tibetan religious freedom to
environmental concerns. Gunilla Lindberg, a vice president of the committee, likened some of the
more aggressive protesters to terrorists and said they had emboldened committee members to keep
the relay going.
“We will never give into violence,” Ms. Lindberg said. “These are not the friendly demonstrators
for a free Tibet, but professional demonstrators, the ones who show up at G-8 conferences to be
seen and fight.”
Denis Oswald, a committee member from Switzerland, said those who thought that interrupting the
torch relay or the Games would push China to improve its human rights record were wrongheaded
and naïve. He noted that it took Europe several centuries to become truly democratic and said that it
was unwise to expect China to do the same in a few years.
“We have to give them time, and as long as they’re moving in the right direction we should be
patient,” he said. He added that those who disrupt the relay “do not respect the freedom of people
who want to enjoy it.”
In announcing the disruption of what they described as a pair of terrorist plots, Chinese officials
from the Ministry of Public Security said they had arrested leaders of the East Turkestan Islamic
The authorities said they had seized 19 explosive devices, almost nine pounds of explosive
material, seven detonators, and “nine kinds of raw materials to be used for waging a holy war.”
They said the group’s leader had urged his fellow plotters to use “poisonous meat,” “poisonous
gas” and remotely controlled explosives.
Giselle Davies, a spokeswoman for the International Olympic Committee, said that the group was
unaware of the plot and that it had learned about the arrests only from Chinese television. Still, she
said the committee had full confidence that the police would guarantee security at the Games. “We
trust very much the authorities will handle that with the right approach,” she said.
Despite the chaos along the torch relay route, Mr. Rogge said he expected the Olympics to proceed
without a hitch. He cited the murder of 11 Israeli athletes in Munich in 1972 and boycotts in 1976,
1980 and 1984 as far more disruptive and said he hoped the public would soon focus on the essence
of the Olympics: athletic competition and world unity.
“It is a crisis, there is no doubt about that, but the I.O.C. has weathered many bigger storms,” he
Asked if he had any regrets about the Games having been awarded to Beijing, Mr. Rogge said
China’s bid was not only the best among competing nations, but that he thought it was especially
compelling to hold the Games in a country with a fifth of the world’s population. “It is very easy
with hindsight to criticize the decision,” he said. “It’s easy to say now that this was not a wise and
Warren Hoge and Sarah Wheaton contributed reporting from New York.
April 10, 2008
In Shift to Digital, More Repeat Mammograms
By DENISE GRADY
It is a phone call that women dread. Something is not quite right on the mammogram: come back
for another one. But don’t worry, the script goes, most repeat tests wind up normal.
Still, most women know someone who has breast cancer, and even the calmest, most rational minds
may think the worst when summoned back to the clinic.
At many centers, these nerve-racking calls are on the rise, at least temporarily — the price of
progress as more and more radiologists switch from traditional X-ray film to digital mammograms,
in which the X-ray images are displayed on a computer monitor.
Problems can arise during the transition period, while doctors learn to interpret digital
mammograms and compare them to patients’ previous X-ray films. Comparing past and present to
look for changes is an essential part of reading mammograms. But the digital and film versions can
sometimes be hard to reconcile, and radiologists who are retraining their eyes and minds may be
more likely to play it safe by requesting additional X-rays — and sometimes ultrasound exams and
even biopsies — in women who turn out not to have breast cancer.
Digital is growing fast. In the United States, 32 percent of mammography clinics now have at least
one digital machine, up from only 10 percent two years ago. Eventually, film will be phased out.
The rush to digital is occurring in part because for certain women — younger ones and others with
dense breast tissue — it is better than film at finding tumors. Digital is especially good at picking
up tiny calcium deposits, or calcifications, which are sometimes — but by no means always — a
sign of cancer. In the long run, radiologists say, digital technology will make mammograms more
accurate for many women.
There have been no studies yet to measure what happens during the transition period, but many
radiologists say they do find themselves calling more women back. About 35.8 million
mammograms a year are done in the United States, including those for screening and follow-ups for
problems. The National Cancer Institute recommends mammograms every year or two for most
women over 40 (women at high risk may be advised to start earlier). Mammography is not perfect
— it can miss tumors — but even its critics say it has helped to lower death rates from breast
cancer, which is the second leading cause of cancer deaths in women, after lung cancer.
There are about 178,000 new cases of breast cancer each year in the United States, and 40,000
Of 10 radiologists interviewed for this article, eight said that during the transition from film to
digital, recall rates went up in women who were ultimately found to have nothing wrong. Normally
a recall rate of 10 percent or less is considered desirable. But during the transition period at their
clinics, the doctors estimated that callbacks of women who turned out to be healthy increased by a
few percentage points to as many as 10. Only one radiologist reported no problems: Dr. Etta D.
Pisano, a professor of radiology and biomedical engineering at the University of North Carolina.
“I don’t believe it,” Dr. Pisano said. “I question that there’s a problem with the transition.”
But Dr. Mary Mahoney, a professor of radiology and the director of breast imaging at the
University of Cincinnati Medical Center, said, “I am living through the pain of this transition period
on a daily basis.”
Dr. Mahoney’s center recently opened an entirely digital clinic for breast cancer screening.
“Our whole group is kind of pulling our hair out some days,” she said. “You struggle and you
struggle. It’s just so much harder. These are really experienced, qualified radiologists who are
wringing their hands. It’s where the increase in callbacks and biopsies is coming into play. It
happens every day. Many times we’re able to bring the woman back, do additional views and feel
comfortable we can follow that area.”
Regarding the higher callback rates, Dr. Mahoney said: “I know it’s not a small thing, the anxiety.
Patients are practically in tears because they’re so worried. But I think in the long run it’s going to
be to everybody’s benefit.”
Dr. Margarita Zuley, the director of breast imaging at Magee-Women’s Hospital at the University
of Pittsburgh Medical Center, said it could take six months to a year to learn to interpret the new
Lecturing in Manhattan recently about the transition to digital, Dr. Zuley told an audience of
radiologists: “When you first start out, you may feel a little anxious and recall more patients
because everything looks like a cancer to you. It’s O.K. Just bring the patients back. It’s part of the
Regarding higher recall rates during the transition, Dr. Zuley said: “Everybody sort of knows it, but
it’s anecdotal. There are no numbers.”
Meanwhile, patients or their insurers are paying for the extra tests. Fees for mammograms vary
around the country. A clinic in Manhattan recently billed an insurer $387 for a digital mammogram
and then $336 for extra images of one breast — needed because of confusion between the old films
and the new digital pictures — and was paid about half of those fees. Fees for film-based
mammograms are usually $45 to $120 less.
Nancy Liber, a radiologic technologist at Dr. Mahoney’s center, was called back by her own
colleagues at the center after her mammogram last month.
“I thought exactly what every woman does,” Ms. Liber said. “Immediately you panic and think,
‘Oh my gosh, what if something is really wrong?’ ”
She found herself worrying about what would happen if she became ill and unable to take care of
her children. She did not even tell her husband what had happened until after the second test, which
turned out normal. The concerns were due entirely to the difference between film and digital
images. Despite the stressful experience, Ms. Liber said that from what she had seen in her work,
digital mammograms were the way to go.
“The inconvenience it may cause is worth it,” she said. But, she added, “I definitely know what
these women are going through.”
Radiologists say one of digital’s advantages is that it lets them adjust features like contrast and
magnification, and see things that were blurry or maybe even invisible on film. In the long run,
doctors say, the increased clarity of digital mammograms may lead to fewer callbacks of healthy
women — but it takes time to learn the ropes.
Dr. Constance D. Lehman, the director of breast imaging and a professor of radiology at the
University of Washington, said she was not sure whether more women were called back during the
transition. But describing the two technologies, she said, “In some areas it’s like comparing apples
When looking at a woman’s first digital image, Dr. Lehman said, radiologists must ask themselves
whether a seeming change in the breast is truly new, or was it there all along but just not visible
with earlier techniques.
Once a woman has had enough digital mammograms, the comparisons should be easier,
radiologists say. But the first few may raise questions because when radiologists compare, they
often go back to images from two or three years before. And in some clinics that have a mixture of
film and digital machines, if a woman is switched between the two types from year to year,
ambiguities may crop up again and again.
Many women do not know the difference between film and digital, or notice which is being used,
and clinics may or may not inform them of potential problems during the changeover.
Digital mammography got a boost from a large study in 2005 that showed it was better than film at
finding tumors in women under 50, or women of any age who had dense breasts, meaning a lot of
glandular and connective tissue in proportion to fat.
A buzz grew around digital after the study. Some radiologists use the technology as a selling point,
and others feel they must follow suit. Now there is such a demand for digital machines that there is
a six-month wait for certain types, Dr. Zuley said, even though they cost $350,000 to $600,000,
about three to five times as much as units that use film.
Dr. Leonard M. Glassman, who practices at Washington Radiology Associates, said that his
practice in the Washington, D.C., area, which performs 85,000 mammograms a year, converted to
digital about two years ago.
“There’s an increase in the rate of things you think are abnormal for about three months, and then
you get used to it,” Dr. Glassman said. “You take more extra pictures, of things that six months
later you would dismiss. It happened probably 5 to 10 percent of the time right at the beginning, so
it’s a significant amount, and then it tails off.”
When questions first arise, Dr. Glassman said, he does not warn women that the imaging may be
the culprit because he cannot be sure what the problem is until he sees the second set of X-rays.
“At the end I tell patients, ‘You were a victim of technology,’ ” he said. “They give me a blank
stare. I say: ‘Your last one was film; this one was digital. They look different, and we just didn’t
know that.’ ”
April 11, 2008
Public Forum to Address Safety Issues on Vaccines
By GARDINER HARRIS
WASHINGTON — In the midst of yet another controversy about whether vaccines cause autism,
the federal government will hold its first ever public meeting on Friday to discuss a
governmentwide research agenda to explore the safety of vaccines.
The meeting is intended to help defuse years of criticism from vaccine skeptics that the government
is hiding what it knows about vaccine safety or failing to investigate the issue diligently.
But the gathering is unlikely to appease the government’s many critics in part because the latest
notion to grip vaccine skeptics — that vaccinations trigger or worsen something called
mitochondrial dysfunction, which in turn causes autism — will remain largely unaddressed.
“I think there could be real frustration,” Dr. Bruce Gellin, director of the National Vaccine Program
Office, which is coordinating the meeting, said in an interview Thursday.
Indeed, Margaret Dunkle, senior fellow at the Center for Health Services Research and Policy at
George Washington University, said government experts needed to take into account the latest
“If they just talk about the same old issues and don’t reflect what we now know and the concession
the government has made, that would be a huge disappointment,” Ms. Dunkle said.
Ms. Dunkle’s niece, Hannah Poling, of Athens, Ga., was 19 months old and developing normally in
2000 when she received five shots against nine infectious diseases. She became sick and later
Her parents sued, and late last year government lawyers agreed to compensate the family on the
theory that vaccines may have aggravated an underlying mitochondrial disorder. When news of the
government settlement became public, vaccine skeptics said the government had finally conceded
that vaccines cause autism.
Government officials and researchers said they had conceded no such thing.
“The Poling case has changed the media coverage of mitochondrial disorders but has added nothing
to the discussions of what causes or doesn’t cause autism,” Dr. Edwin Trevathan, director of the
National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control
and Prevention, said in an interview Thursday.
On Friday, many of the main players involved in this debate — including Hannah’s mother and her
grandparents, prominent vaccine skeptics and some of the government’s top vaccine researchers —
will all be in the same room to discuss research priorities.
The meeting is the result of a 2005 report by the Institute of Medicine, which suggested that the
disease control agency might engender more trust among skeptics if it included them in its research
At the time, vaccine skeptics were lobbying to have greater access to the agency’s Vaccine Safety
Datalink system, a huge set of health records assembled by large managed care organizations. The
agency uses the system to conduct epidemiological studies to measure whether vaccines or their
components cause common problems.
Such studies, for instance, have found no link between the combined measles, mumps and rubella
vaccine and autism, and they have found no link between a once-common vaccine additive,
thimerosal, and autism.
In the face of such studies, vaccine skeptics have increasingly demanded clinical research, not
epidemiological studies, to determine whether small groups of children may somehow be more
susceptible to vaccine injuries than the general population. Such subsets of children might get lost
in large epidemiological studies, they say.
But that kind of clinical research is generally undertaken or underwritten by the National Institutes
of Health, not the disease control agency.
The issues raised by the Poling case “can’t go very far tomorrow because it’s really not in C.D.C.’s
lane,” Dr. Gellin said.
No decisions are expected to come out of Friday’s meeting; rather, it would allow researchers to
hear the public’s priorities.
Joseph S. Pizzo
Union County College
1033 Springfield Avenue
Union, NJ 07016
(908) 884-4061 (cell phone)
Teacher of Integrated Language Arts at the Black River Middle School in Chester – 32 ½
Adjunct Professor at Centenary College and Union County College
NJCTE Vice-President and Executive Board Member of Educational Foundation of the
Faculty Advisor and Creator with Students, Administrators, and Community for Gregg
Froehner Memorial Garden as tribute to a father, Port Authority Officer, and hero killed in 9/11
Author of NJ ASK Test Review Book for Barron’s Educational Publications – Summer 2008
Master of ceremonies for Gregg Froehner Memorial Tribute
Workshop Presenter at conventions for NCTE, NJCTE, NJAMLE, NMSA, Adjunct Faculty
Institute at Union County College, Conferences on School Restructuring, and NJAWBO of
Creator, writer, and voice-over provider for Joe Pizzo’s School Bell on AM radio’s WRNJ in
Hackettstown, NJ – Advice for parents of school-aged children
Editor and voice-over provider for Silk Road Travel Tours.
Creator, writer, and voice-over provider for Centenary College (NJ) promotional ads for
graduate professional accounting and MBA programs, as well as voice-over provider for
WNTI – 91.9 FM
Co-writer and voice-over provider (including three cameos) for Pride in Education, a
promotional video for the Chester Township Schools
Voice-over provider for The Statue of Billy Yank, produced for Historical Society of
Creator, writer, and host of cable TV’s Education Matters featuring accomplishments of
students in the Chester Township (NJ) Schools
Author, poet, tutor, and editor
US President’s Service Award for 4,000 or more hours of community service
NJ Governor’s Award for Outstanding Achievement in Arts Education
Appreciation Award from United Way of Warren County for voice-overs to promote 2-1-1
NJCTE Educator of the Year – 2005
Geraldine R. Dodge Foundation grant to design Highlands Initiative project (Our A.W.E-some
Environment) including production of cable TV show, student publications, student photo
gallery, student public service announcements, and memorial garden
United Jewish Federation Grant to take 40+ students to Nat’l Holocaust Museum in
WWOR-TV Ch. 9’s A+ for Teachers Hall of Fame – One of first five teachers elected and
featured on internationally-broadcast television program
Who’s Who Among American Teachers
WWOR-TV Ch. 9’s A+ for Kids Outstanding Educator – Featured on promotional salutes to
WWOR-TV Ch. 9’s A+ for Kids Award for Curriculum Design – Three curriculum awards
Impact Two Teacher Network Grant to author book featuring vision of public education in
Geraldine R. Dodge Foundation Summer Opportunity Grant to build an educational bridge
between the middle schools in Fukuchiyama, Japan and Chester, NJ
NJ Governor’s Award for Excellence in Education
NJ Association for Supervision and Curriculum Development Award for Outstanding
Arts Council of the Morris Area Teacher of the Year
Outstanding Young Men in America
Who’s Who in American Colleges and Universities
Merit Badge Counselor for Boy Scout Troops in Chester, NJ
Setting the Write Tone
How do you inspire your students to be effective writers? What can the “Write” teacher
do with the “Write” challenge in the “Write” setting? You have the “Write” answer at
your fingertips. This workshop will provide a variety of activities designed to motivate
writers at their respective levels of mastery. Utilizing these activities combined with
proven motivational techniques, you will be able to create an inviting atmosphere in
which all writers in all subject areas, whether they are novice or veteran, will find the
confidence to write with competence.
Mentoring: Team Up for Success
Beginning teachers work best when they have a role model who is both supportive, as
well as inspirational. Learn the best ways to guide and inspire young teachers, as well
as the traps that can cause these teachers to struggle. We’ll share sound learning
theory, as well as web sites and other resources designed to equip novice teachers with
the proper tools for success.
Building a Success Team in Your School
Roll up your sleeves and get ready for an interactive, hands-on workshop that places
you directly into the decision-making process. Examine the basic fundamentals of
teaming from both the pedagogical and the business perspectives. Explore areas for
potential success, as well as disaster. Begin generating the fundamentals for creating
effective mentor/novice dyads that work together toward common, reachable goals.
Get a Grant the Write Way
We teachers have wonderful programs that excite our students about learning. These
programs should be funded, as well as shared with as many professional colleagues
as possible. Find out the best ways to get funds for your program, no matter how big
or small it may be. Learn how to avoid the most common mistakes teachers make
when writing a grant proposal. Explore ways that you can use your community
to help you with your funding needs.
The Art of Motivating Today’s Students
In today’s classrooms, students are not necessarily entering our classes brimming
with enthusiasm. Let’s explore basic motivational and team building theory, as well
as some exciting ways to “light the fires of curiosity” in our classrooms.
Strategies for Writing Across the Curriculum
Thinking is a prerequisite for success in our classrooms, and theory states that
good writing is nothing more than good thinking. Together let’s see how we can
encourage good thinking by incorporating writing in every curriculum.
For further information, please contact:
Joseph S. Pizzo
Union County College
1033 Springfield Avenue
Union, NJ 07016
(908) 884-4061 (cell phone)