AP Medical
LONDON – The number of women dying in childbirth worldwide has dropped dramatically, a British medical journal reports, adding that it was pressured to delay its findings until after U.N. meetings this week on public health funding.
A new, separate report by a group headed by the United Nations reached a very different conclusion on maternal mortality, saying the figure remains as high as 500,000 deaths a year.
The disagreement reveals the politics behind public health, where progress made in tackling a health problem can jeopardize funding. Public health officials are gearing up to ask for billions of dollars at U.N. meetings.
U.N. Secretary-General Ban Ki-moon is holding a press conference later Wednesday in New York to kick off a new global initiative on reproductive, maternal and newborn health.
The British medical journal Lancet rushed out a paper on Sunday that found the number of women who die in pregnancy or childbirth has dropped by more than 35 percent over 28 years.
Richard Horton, editor of the Lancet, said he was disappointed when maternal health advocates pressured him to delay publishing the report until September, after several critical fundraising meetings. He also wrote a commentary in Lancet on the pressure.
"Activists perceive a lower maternal mortality figure as actually diluting their message," he told The Associated Press on Wednesday. "Advocacy can sometimes get in the way of science."
He did not name any group or individual who tried to pressure him.
In their paper, Christopher Murray and colleagues at the Institute for Health Metrics at the University of Washington found that maternal deaths have fallen from about 500,000 deaths in 1980 to about 343,000 in 2008. The study in the Lancet was based on more data than was previously available in addition to statistical modeling and was paid for by the Bill & Melinda Gates Foundation.
It was a surprising finding for experts who have long assumed that little progress has been made in maternal health.
But on Tuesday, another report by the Partnership for Maternal, Newborn and Child Health, a global alliance hosted by the World Health Organization, claimed progress in maternal health has "lagged." According to their "detailed analysis," from 350,000 to 500,000 women still die in childbirth every year. The authors did not explain where their data came from or what kind of analysis was used to obtain that wide range of figures.
In that report, U.N. officials also claimed they need $20 billion every year between 2011 and 2015 to save women and children in developing countries.
Dr. Flavia Bustreo, director of the Partnership for Maternal, Newborn and Child Health, denied there was any conflict between her group's study and the Lancet study. She said her group was not involved in pressuring the journal not to publish Murray's study.
"The debate on numbers may continue," Bustreo told the AP on Wednesday. "But we welcome this as good news. There is hope at last for maternal health."
In the world of public health, good news can paradoxically be bad news. The more people who are dying, the more money U.N. officials can raise, making some experts less keen to acknowledge that a problem is not as bad as they once thought.
The U.N. is hosting a meeting of public health experts and heads of state on maternal and child health this week in New York, followed by another one in Washington in June.
For years, U.N. AIDS officials threatened that the epidemic would spread among general populations in countries worldwide, and claimed more than 40 million people were infected. Money for projects fighting AIDS, meanwhile, grew exponentially.
When U.N. officials finally admitted they had been overestimating the numbers for years and dramatically revised their figures — down to 33 million — donors began to rethink their financial commitments.
Experts say public health figures need to be taken with a huge grain of salt, particularly when they come from people who are also soliciting funds for the campaign.
"The U.N. has a track record of inflating disease figures to keep the aid money flowing, so I'd probably place more faith in the figures which show a lower disease burden," said Philip Stevens, of International Policy Network, a London think tank. "This is yet more confirmation that whoever paints the most apocalyptic picture gets the most cash, even if they have to manipulate and spin the data."
Experts say autism bowel disease may not exist
LONDON – A new autism disease identified in a flawed paper linking a common children's vaccine to autism, may not exist, new research says.
A dozen years ago, British surgeon Andrew Wakefield and colleagues published a study in the journal Lancet on a new bowel disease and proposed a connection between autism and the vaccine for measles, mumps and rubella.
The study was widely discredited, 10 of Wakefield's co-authors renounced its conclusions and the Lancet retracted the paper in February. The research set off a health scare, and vaccination rates in Britain dropped so low measles outbreaks returned.
In research published Friday in the medical journal BMJ, reporter Brian Deer examines if the illness described by Wakefield and colleagues — autistic enterocolitis, a bowel disease found in autistic people — actually exists.
In 1996, Wakefield was hired by a lawyer to find a new syndrome of bowel and brain disease to help launch a lawsuit against drug companies that made the measles, mumps and rubella vaccine, according to BMJ article.
According to reports from London's Royal Free Hospital, eight of the 11 children included in Wakefield's original study had normal bowels. But in the Lancet study, 11 of the 12 were said to have a swollen bowel, which was said to be proof of a new gastrointestinal disease affecting autistic children.
In 2005, Wakefield started a clinic in Texas to research and treat the syndrome.
The original biopsy slides from the children in the Lancet study are no longer available. Deer asked independent experts to examine hospital reports on the biopsies, who failed to find any distinctive inflammation that would qualify as a new disease.
In an accompanying editorial, Sir Nicholas Wright from the Barts and the London School of Medicine and Dentistry, said "any firm conclusion would be inadvisable." He said several studies have shown a link between inflamed bowels and autism, but too little evidence exists to prove there is a new illness.
In January, Britain's General Medical Council ruled Wakefield had acted unethically. He and the two colleagues who have not renounced the study face being stripped of their right to practice medicine in Britain.
A dozen years ago, British surgeon Andrew Wakefield and colleagues published a study in the journal Lancet on a new bowel disease and proposed a connection between autism and the vaccine for measles, mumps and rubella.
The study was widely discredited, 10 of Wakefield's co-authors renounced its conclusions and the Lancet retracted the paper in February. The research set off a health scare, and vaccination rates in Britain dropped so low measles outbreaks returned.
In research published Friday in the medical journal BMJ, reporter Brian Deer examines if the illness described by Wakefield and colleagues — autistic enterocolitis, a bowel disease found in autistic people — actually exists.
In 1996, Wakefield was hired by a lawyer to find a new syndrome of bowel and brain disease to help launch a lawsuit against drug companies that made the measles, mumps and rubella vaccine, according to BMJ article.
According to reports from London's Royal Free Hospital, eight of the 11 children included in Wakefield's original study had normal bowels. But in the Lancet study, 11 of the 12 were said to have a swollen bowel, which was said to be proof of a new gastrointestinal disease affecting autistic children.
In 2005, Wakefield started a clinic in Texas to research and treat the syndrome.
The original biopsy slides from the children in the Lancet study are no longer available. Deer asked independent experts to examine hospital reports on the biopsies, who failed to find any distinctive inflammation that would qualify as a new disease.
In an accompanying editorial, Sir Nicholas Wright from the Barts and the London School of Medicine and Dentistry, said "any firm conclusion would be inadvisable." He said several studies have shown a link between inflamed bowels and autism, but too little evidence exists to prove there is a new illness.
In January, Britain's General Medical Council ruled Wakefield had acted unethically. He and the two colleagues who have not renounced the study face being stripped of their right to practice medicine in Britain.
Experts differ on health risk of volcanic ash
GENEVA – Europeans should try to stay indoors if ash from Iceland's volcano starts settling, the World Health Organization warned Friday as small amounts fell in Iceland, Scotland and Norway.
WHO spokesman Daniel Epstein said the microscopic ash is potentially dangerous for people when it starts to reach the Earth because inhaled particles can enter the lungs and cause respiratory problems.
"We're very concerned about it," Epstein said. "These particles when inhaled can reach the peripheral regions of ... the lungs and can cause problems — especially for people with asthma or respiratory problems." He also said Europeans who go outside might want to consider wearing a mask.
Other experts, however, weren't convinced the volcanic ash would have a major effect on peoples' health and said WHO's warnings were "hysterical." They said volcanic ash was much less dangerous than cigarette smoke or pollution.
Volcanic ash is made of fine particles of fragmented volcanic rock. It is light gray to black and can be as fine as talcum powder. During a volcanic eruption, the ash can be breathed deep into the lungs and cause irritation even in healthy people. But once it falls from a greater distance — like from the cloud currently hovering above Europe — its health effects are often minimal, experts say.
The Icelandic volcano that erupted Wednesday has sent an enormous cloud of microscopic basalt ash particles across northern Europe, grounding aircraft across continent. It is drifting above 20,000 feet (6,000 meters), high and invisible from the ground.
"Not all particles are created equal," said Ken Donaldson, a professor of respiratory toxicology at the University of Edinburgh, who has studied the impact of volcanic ash in people. "In the great scheme of things, volcanic ash is not all that harmful."
Donaldson said most Europeans' exposure to volcanic ash would be negligible and that only those in the near vicinity of the Icelandic volcano would likely be at risk.
"Once the volcanic particles are in the stratosphere, they're getting massively diluted because there's a lot of air and other particles blowing around," he said.
He said after previous volcanic eruptions, little impact has been seen in people's health, except for those with lung problems who were close to the volcano.
Dr. Stephen Spiro, a professor of respiratory medicine and deputy chair of the British Lung Foundation, said the further the particles travel, they more diluted and less dangerous they will be. "The cloud has already passed over northern Scotland and we haven't heard of any ill effects there," he said. Spiro said to wear masks or stay indoors to avoid volcanic ash was "over the top" and "a bit hysterical."
"If this was really coming down, you'd see a yellow (tinge) in the air from the sulphur," he said. "But we've seen no sign of that."
Britain's Health Protection Agency said the concentration of volcanic particles that might settle on the ground was likely to be low and should not cause serious harm. The agency said people with respiratory problems like bronchitis and asthma might experience more symptoms like itchy eyes, a sore throat and dry cough. It advised those people to carry their inhalers or medicines with them and said any health effects were likely to be short-term.
Experts said the irritants in volcanic ash were likely to be very diluted by the winds by the time they hit continental Europe, and that any rainfall would also lessen their effects.
"People with health problems shouldn't sit around outside looking up at this cloud because there could be microscopic particles falling down," said Dr. Pascal Imperato, dean of the public health school at the State University of New York Downstate Medical Center, who worked on the response to the eruption of Mount St. Helens in 1980. "But for most people, they will not experience any major breathing or other difficulties."
By Associated Press
WHO spokesman Daniel Epstein said the microscopic ash is potentially dangerous for people when it starts to reach the Earth because inhaled particles can enter the lungs and cause respiratory problems.
"We're very concerned about it," Epstein said. "These particles when inhaled can reach the peripheral regions of ... the lungs and can cause problems — especially for people with asthma or respiratory problems." He also said Europeans who go outside might want to consider wearing a mask.
Other experts, however, weren't convinced the volcanic ash would have a major effect on peoples' health and said WHO's warnings were "hysterical." They said volcanic ash was much less dangerous than cigarette smoke or pollution.
Volcanic ash is made of fine particles of fragmented volcanic rock. It is light gray to black and can be as fine as talcum powder. During a volcanic eruption, the ash can be breathed deep into the lungs and cause irritation even in healthy people. But once it falls from a greater distance — like from the cloud currently hovering above Europe — its health effects are often minimal, experts say.
The Icelandic volcano that erupted Wednesday has sent an enormous cloud of microscopic basalt ash particles across northern Europe, grounding aircraft across continent. It is drifting above 20,000 feet (6,000 meters), high and invisible from the ground.
"Not all particles are created equal," said Ken Donaldson, a professor of respiratory toxicology at the University of Edinburgh, who has studied the impact of volcanic ash in people. "In the great scheme of things, volcanic ash is not all that harmful."
Donaldson said most Europeans' exposure to volcanic ash would be negligible and that only those in the near vicinity of the Icelandic volcano would likely be at risk.
"Once the volcanic particles are in the stratosphere, they're getting massively diluted because there's a lot of air and other particles blowing around," he said.
He said after previous volcanic eruptions, little impact has been seen in people's health, except for those with lung problems who were close to the volcano.
Dr. Stephen Spiro, a professor of respiratory medicine and deputy chair of the British Lung Foundation, said the further the particles travel, they more diluted and less dangerous they will be. "The cloud has already passed over northern Scotland and we haven't heard of any ill effects there," he said. Spiro said to wear masks or stay indoors to avoid volcanic ash was "over the top" and "a bit hysterical."
"If this was really coming down, you'd see a yellow (tinge) in the air from the sulphur," he said. "But we've seen no sign of that."
Britain's Health Protection Agency said the concentration of volcanic particles that might settle on the ground was likely to be low and should not cause serious harm. The agency said people with respiratory problems like bronchitis and asthma might experience more symptoms like itchy eyes, a sore throat and dry cough. It advised those people to carry their inhalers or medicines with them and said any health effects were likely to be short-term.
Experts said the irritants in volcanic ash were likely to be very diluted by the winds by the time they hit continental Europe, and that any rainfall would also lessen their effects.
"People with health problems shouldn't sit around outside looking up at this cloud because there could be microscopic particles falling down," said Dr. Pascal Imperato, dean of the public health school at the State University of New York Downstate Medical Center, who worked on the response to the eruption of Mount St. Helens in 1980. "But for most people, they will not experience any major breathing or other difficulties."
By Associated Press
Snag for health fix-it bill — probably temporary
WASHINGTON – It's not quite over yet. Democrats hit a snag Thursday in their drive to rush through a package of fixes to the big health care law signed by President Barack Obama, but they still hoped for final passage in yet another late-night session.
House Majority Leader Steny Hoyer said that if the Senate finished its work by afternoon, as expected, the House would immediately take up the bill. Democrats are saying they do not expect any major problems — but they're also keeping their fingers crossed.
Senate leaders had planned to complete work on the fix-it bill by midday Thursday and get it quickly to Obama. But Republicans established that they would be able to kill some language in the bill that relates to grants for low-income college students. That meant the altered bill would have to be returned to the House — four days after House members thought they'd seen the last of it late Sunday night.
Senators who had been in session past 2 a.m. Thursday returned to work on a long list of proposed Republican amendments.
The president, who signed the separate landmark legislation into law on Tuesday, was flying to Iowa for an afternoon speech, the first of many appearances around the country to sell his health care revamp before the fall congressional elections.
Obama was appearing in Iowa City, where as a presidential candidate in 2007 he touted his ideas for health coverage for all. His trip comes as polls show people are divided over the new law, and Democratic lawmakers hope he can convince more voters by November that their support was the right move.
Meanwhile, House Speaker Nancy Pelosi, D-Calif., voiced concern over warnings of violent reprisals against members of Congress who voted for the overhaul.
She said the response has "no place in a civil debate in our country." Republicans, too, went to the House floor to plead with opponents of the health care law to refrain from violence and threats.
The FBI is working with lawmakers subjected to menacing obscenity-laced phone messages. In some instances, bricks were hurled at congressional offices, including Rep. Louise Slaughter's district headquarters in Niagara Falls, N.Y.
As an exhausted Senate labored into the wee hours Thursday on a stack of GOP amendments to the follow-up bill, Jim Manley, spokesman for Senate Majority Leader Harry Reid, told reporters that Republicans consulting with the chamber's parliamentarian had found "two minor provisions" that violate Congress' budget rules.
Republicans have been hunting for such violations in hopes of bringing down the legislation. Democrats had also been consulting with the parliamentarian, Alan Frumin, and hoped they had written a measure that would not be vulnerable to such problems.
The two provisions were expected to be formally removed from the bill on Thursday. Manley said he expected the Senate to approve the measure without them and send it to the House. He said Senate leaders, after conversations with top House Democrats, expect the House to approve the revised measure.
Both chambers are hoping to begin a spring recess by this weekend.
"This is quite benign. ... Of all the things they could have sent back this is probably the most benign," Pelosi told reporters.
Besides reshaping parts of the landmark health overhaul, the legislation transforms the federal student loan program — in which private banks distribute the money — into one in which the government issues the loans directly. That produces some federal savings, which the bill uses in part to increase Pell grants to needy students.
Democratic aides said the problematic provisions deal with safeguarding students from future cuts in their grants if Congress does not provide enough money for them. The provisions violate budget rules because they do not produce savings, one aide said.
The development came as the Senate completed nine hours of uninterrupted voting on 29 GOP amendments to the legislation. Majority Democrats defeated every amendment.
The legislation would change the new health care law by making drug benefits for Medicare recipients more generous by gradually closing a gap in coverage, increasing tax subsidies to help low-income people afford health care, and boosting federal Medicaid payments to states.
It kills part of the new statute uniquely giving Nebraska extra Medicaid funds — designed to lure support from that state's Sen. Ben Nelson — that had become a glaring embarrassment to Democrats. It also eases a new tax on expensive health coverage bitterly opposed by unions and many House Democrats, while delaying and increasing a new levy on drug makers.
As they began pushing the bill to passage on Wednesday afternoon, Democrats ran into a mountain of GOP amendments. Outnumbered and all but assured of defeat, Republicans forced votes on amendments aimed at reshaping the measure — or at least forcing Democrats to take votes that could be used against them in TV ads in the fall campaigns.
"The majority leader may not think we're serious about changing the bill, but we'd like to change the bill, and with a little help from our friends on the other side we could improve the bill significantly," said Senate Minority Leader Mitch McConnell, R-Ky.
By 57-42, Democrats rejected an amendment by Sen. Tom Coburn, R-Okla., barring federal purchases of Viagra and other erectile dysfunction drugs for sex offenders. Coburn said it would save millions of dollars, while Sen. Max Baucus, D-Mont., called it "a crass political stunt."
The landmark legislation that Obama signed Tuesday would provide health care to 32 million uninsured people, and make coverage more affordable to millions of others by expanding the reach of Medicaid and creating new subsidies. Insurance companies would be forbidden to refuse coverage to people with illnesses, individuals could buy policies on newly created exchanges and parents could keep children on their family plans until their 26th birthdays.
The $938 billion, 10-year price tag would be financed largely by culling savings from Medicare and imposing new taxes on higher income people and the insurance, drug and medical device industries.
By Associated Press
House Majority Leader Steny Hoyer said that if the Senate finished its work by afternoon, as expected, the House would immediately take up the bill. Democrats are saying they do not expect any major problems — but they're also keeping their fingers crossed.
Senate leaders had planned to complete work on the fix-it bill by midday Thursday and get it quickly to Obama. But Republicans established that they would be able to kill some language in the bill that relates to grants for low-income college students. That meant the altered bill would have to be returned to the House — four days after House members thought they'd seen the last of it late Sunday night.
Senators who had been in session past 2 a.m. Thursday returned to work on a long list of proposed Republican amendments.
The president, who signed the separate landmark legislation into law on Tuesday, was flying to Iowa for an afternoon speech, the first of many appearances around the country to sell his health care revamp before the fall congressional elections.
Obama was appearing in Iowa City, where as a presidential candidate in 2007 he touted his ideas for health coverage for all. His trip comes as polls show people are divided over the new law, and Democratic lawmakers hope he can convince more voters by November that their support was the right move.
Meanwhile, House Speaker Nancy Pelosi, D-Calif., voiced concern over warnings of violent reprisals against members of Congress who voted for the overhaul.
She said the response has "no place in a civil debate in our country." Republicans, too, went to the House floor to plead with opponents of the health care law to refrain from violence and threats.
The FBI is working with lawmakers subjected to menacing obscenity-laced phone messages. In some instances, bricks were hurled at congressional offices, including Rep. Louise Slaughter's district headquarters in Niagara Falls, N.Y.
As an exhausted Senate labored into the wee hours Thursday on a stack of GOP amendments to the follow-up bill, Jim Manley, spokesman for Senate Majority Leader Harry Reid, told reporters that Republicans consulting with the chamber's parliamentarian had found "two minor provisions" that violate Congress' budget rules.
Republicans have been hunting for such violations in hopes of bringing down the legislation. Democrats had also been consulting with the parliamentarian, Alan Frumin, and hoped they had written a measure that would not be vulnerable to such problems.
The two provisions were expected to be formally removed from the bill on Thursday. Manley said he expected the Senate to approve the measure without them and send it to the House. He said Senate leaders, after conversations with top House Democrats, expect the House to approve the revised measure.
Both chambers are hoping to begin a spring recess by this weekend.
"This is quite benign. ... Of all the things they could have sent back this is probably the most benign," Pelosi told reporters.
Besides reshaping parts of the landmark health overhaul, the legislation transforms the federal student loan program — in which private banks distribute the money — into one in which the government issues the loans directly. That produces some federal savings, which the bill uses in part to increase Pell grants to needy students.
Democratic aides said the problematic provisions deal with safeguarding students from future cuts in their grants if Congress does not provide enough money for them. The provisions violate budget rules because they do not produce savings, one aide said.
The development came as the Senate completed nine hours of uninterrupted voting on 29 GOP amendments to the legislation. Majority Democrats defeated every amendment.
The legislation would change the new health care law by making drug benefits for Medicare recipients more generous by gradually closing a gap in coverage, increasing tax subsidies to help low-income people afford health care, and boosting federal Medicaid payments to states.
It kills part of the new statute uniquely giving Nebraska extra Medicaid funds — designed to lure support from that state's Sen. Ben Nelson — that had become a glaring embarrassment to Democrats. It also eases a new tax on expensive health coverage bitterly opposed by unions and many House Democrats, while delaying and increasing a new levy on drug makers.
As they began pushing the bill to passage on Wednesday afternoon, Democrats ran into a mountain of GOP amendments. Outnumbered and all but assured of defeat, Republicans forced votes on amendments aimed at reshaping the measure — or at least forcing Democrats to take votes that could be used against them in TV ads in the fall campaigns.
"The majority leader may not think we're serious about changing the bill, but we'd like to change the bill, and with a little help from our friends on the other side we could improve the bill significantly," said Senate Minority Leader Mitch McConnell, R-Ky.
By 57-42, Democrats rejected an amendment by Sen. Tom Coburn, R-Okla., barring federal purchases of Viagra and other erectile dysfunction drugs for sex offenders. Coburn said it would save millions of dollars, while Sen. Max Baucus, D-Mont., called it "a crass political stunt."
The landmark legislation that Obama signed Tuesday would provide health care to 32 million uninsured people, and make coverage more affordable to millions of others by expanding the reach of Medicaid and creating new subsidies. Insurance companies would be forbidden to refuse coverage to people with illnesses, individuals could buy policies on newly created exchanges and parents could keep children on their family plans until their 26th birthdays.
The $938 billion, 10-year price tag would be financed largely by culling savings from Medicare and imposing new taxes on higher income people and the insurance, drug and medical device industries.
By Associated Press
Ways to Change your Life With 20 Minutes
How you can change your life in 20 minutes, step by step:
1.Clear all distractions. Turn off the phone, the tv, the computer. Lock your door, and go to a quiet place.
2.Sit down comfortably at a desk or table, with a blank piece of paper and a pen in front of you.
3.Set a timer for 20 minutes.
4.Go. Write down 100 things you want to do. Or careers you want to have. Or people you would like to meet. The sky is the limit.
5.Don’t be realistic. Dream big. Write down the craziest things you can think of, as well as the things that you don't even think bear mentioning because they are so simple. Write it all down.
6.Work quickly. 20 minutes isn't very long, and you have 100 items to get through, if you can. Don't think about whether or not to write down an idea - just write. Write everything that comes to mind, even if it doesn't make sense. Just keep on writing, and don't stop until that timer goes off.
7.Say " Yes" with your life. If you say " No " , so you dont live! you died.
1.Clear all distractions. Turn off the phone, the tv, the computer. Lock your door, and go to a quiet place.
2.Sit down comfortably at a desk or table, with a blank piece of paper and a pen in front of you.
3.Set a timer for 20 minutes.
4.Go. Write down 100 things you want to do. Or careers you want to have. Or people you would like to meet. The sky is the limit.
5.Don’t be realistic. Dream big. Write down the craziest things you can think of, as well as the things that you don't even think bear mentioning because they are so simple. Write it all down.
6.Work quickly. 20 minutes isn't very long, and you have 100 items to get through, if you can. Don't think about whether or not to write down an idea - just write. Write everything that comes to mind, even if it doesn't make sense. Just keep on writing, and don't stop until that timer goes off.
7.Say " Yes" with your life. If you say " No " , so you dont live! you died.
Have you ever found yourself saying, "I hate my life"? So You want to change?
I longed to be happy. I wanted to be one of the happiest people in the entire world. I also desired meaning in life. I was looking for answers to the questions:
•"Who am I?"
•"Why in the world am I here?"
•"Where am I going?"
More than that, I also longed to be free. I wanted to be one of the freest people in the whole world. Freedom to me was not simply doing what you want to do -- anyone can do that. Freedom, for me, meant having the power to do what you know you ought to do. Most people know what they ought to do but don't have the power to do it. So I started looking for answers.
•"Who am I?"
•"Why in the world am I here?"
•"Where am I going?"
More than that, I also longed to be free. I wanted to be one of the freest people in the whole world. Freedom to me was not simply doing what you want to do -- anyone can do that. Freedom, for me, meant having the power to do what you know you ought to do. Most people know what they ought to do but don't have the power to do it. So I started looking for answers.
How can you change your behaviour? How can you change life? How to break a bad habit?
If you want to solve your problems, you must be active and this often involves changing your habits and ways of thinking.
For example, you may want to reduce your weight, find a better job, complete a difficult task, or change your relations to other people.
These problems are difficult and extensive. To be successful, it might help to divide them into a number of smaller objectives. Begin with the one that comes first and then set new objectives. You do not have to make a list of all the objectives in advance.
Every objective must be clearly defined; e.g., if you want to reduce your weight, you may begin by deciding to take more exercise, but this is not at all clearly defined. It would be better to state that you intend to walk or cycle for 30 minutes a day.
It might be wise not to demand perfection from yourself. You could, for example, decide to exercise 30 minutes at least five days a week instead of 30 minutes a day. That gives you the possibility to succeed even if you don't manage to do it every day.
If you want to achieve a big change, it can be a good idea to divide it into a series of small short-time subgoals, which step by step will bring you closer to your final goal. For example, if your home is unclean and messy and you don't have the energy to clean it all at once, you could decide to clean for 30 minutes a day or do one room every Saturday and finally get the nice, clean home you long for, after a few weeks.
It is often easier to make small changes, one at a time, than large changes in your way of living. To completely change your eating habits may, for example, seem insurmountable. But if you take one step at a time, you will, after several steps, notice that you have achieved much more than you first thought possible.
It is obvious that this approach can be applied to almost anything you want to do.
For example, you may want to reduce your weight, find a better job, complete a difficult task, or change your relations to other people.
These problems are difficult and extensive. To be successful, it might help to divide them into a number of smaller objectives. Begin with the one that comes first and then set new objectives. You do not have to make a list of all the objectives in advance.
Every objective must be clearly defined; e.g., if you want to reduce your weight, you may begin by deciding to take more exercise, but this is not at all clearly defined. It would be better to state that you intend to walk or cycle for 30 minutes a day.
It might be wise not to demand perfection from yourself. You could, for example, decide to exercise 30 minutes at least five days a week instead of 30 minutes a day. That gives you the possibility to succeed even if you don't manage to do it every day.
If you want to achieve a big change, it can be a good idea to divide it into a series of small short-time subgoals, which step by step will bring you closer to your final goal. For example, if your home is unclean and messy and you don't have the energy to clean it all at once, you could decide to clean for 30 minutes a day or do one room every Saturday and finally get the nice, clean home you long for, after a few weeks.
It is often easier to make small changes, one at a time, than large changes in your way of living. To completely change your eating habits may, for example, seem insurmountable. But if you take one step at a time, you will, after several steps, notice that you have achieved much more than you first thought possible.
It is obvious that this approach can be applied to almost anything you want to do.
