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tv   The News Hour With Jim Lehrer  PBS  November 26, 2009 6:00pm-7:00pm EST

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captioning sponsored by macneil/lehrer productions >> woodruff: good evening. i'm judy woodruff. on the "newshour" this thursday: the lead story is an afghan update from kabul as americans here and in the war zones celebrate thanksgiving. then, after the other news of the day. a report from mumbai, a year after the terrorist attacks. two doctors debate the best way to make health care recommendations for their patients. >> we need to honor judgment and welcome judgment, but we also need to honor evidence and science. >> woodruff: an encore look at
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the importance of school recess. there's more to it than just play time. plus a conversation with dr. david kessler about overeating. and the poet galway kinnell on the pleasures of ordinary things. major funding for the newshour with jim lehrer is provided by: >> 150 years of financial strength and the experience of an established investment firm have come together. wachovia securities is now wells fargo advisors. the financial advisors nearby and nationwide. with the advice and planning expertise to help you address today's unique challenges, we're with you. wachovia securities is now wells fargo advisors. together, we'll go far. >> this is the engine that connects abundant grain from the american heartland to haran's best selling whole wheat, while
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keeping 60 billion pounds of carbon out of the atmosphere every year. bnsf, the engine that connects us. monsanto. producing more. conserving more. improving farmers' lives. that's sustainable agriculture. more at producemoreconservemore.com. >> chevron. this is the power of human energy. and by toyota. >> and by the bill and melinda gates foundation. dedicated to the idea that all people deserve the chance to live a healthy productive life. and with the ongoing support of these institutions and foundations. and... this program was made possible by the corporation for
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public broadcasting. and by contributions to your pbs station from viewers like you. thank you. >> woodruff: americans around the world observed thanksgiving today. in new york city, thousands lined the streets for the annual macy's thanksgiving day parade. for the first time, marching bands, floats, and giant balloons took a new, longer route, bypassing broadway. and across the country, people volunteered in kitchens and helped prepare and serve thanksgiving meals to those in need. overseas, u.s. forces in iraq and afghanistan had their own traditional thanksgiving meals. "newshour" correspondent kwame holman begins our lead story coverage.
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the ambassador later visited troops recovering in a hospital, some eating their thanksgiving meal in bed and sending warm wishes home. >> i love you and i miss you very much. i'm a little bit beat up but i'm okay. >> even soldiers in remote areas >> reporter: even soldiers serving in remote areas of afghanistan received a taste of home. these marines based in a tiny outpost in the town of delaram enjoyed meals trucked in from a larger base. >> it goes good. didn't think we'd be eating so good on thanksgiving. definitely brings home here. >> reporter: today's holiday celebrations come ahead of president obama's announcement of a new battle plan for afghanistan in a national address tuesday night from the united states military academy at west point. the military says it could include some 30,000 troops-- a roughly 50% increase in the number of u.s. forces there, but administration officials caution that the president has not settled on a final figure. in his thanksgiving address from the white house, mr. obama offered gratitude to troops overseas and their families. >> we keep in our thoughts and prayers the many families marking this thanksgiving with
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an empty seat, saved for a son or daughter, a husband or a wife stationed in harm's way. we say a special thanks for the sacrifices those men and women in uniform are making for our safety and freedom. >> reporter: president obama later made calls to 10 u.s. servicemen and women stationed in war zones to give his personal thanks. other nato leaders also are considering sending more troops to afghanistan, including german chancellor angela merkel. officials there were focused today on the forced resignations of the head of germany's armed forces and another senior defense official after it was reported they were involved in withholding details of the nato air strike last september that killed 30 civilians in northern afghanistan. >> woodruff: and as afghans await president obama's tuesday speech, i talked earlier today with washington post kabul correspondent josh partlow.
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rough rough josh partlow, thank you very much for talking with us. let me start by asking you, with president obama's announcement coming up next tuesday, what are ordinary afghan people looking for? what do they want out of this announcement? >> i think primarily they're looking for better security in the country. >> they're going through that very difficult insurgency right now. they want security, they want jobs. you know, i think they want a commitment from the united states that they will be here long-term to help them and, you know, it's a little bit unclear if that will happen but many afghans are afraid of the return of the taliban. they see the united states government as kind of propping up president karzai's government here and without them, you know, the taliban might swoop back into power and a lot of them are afraid of that. at the same time, i think they
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don't want so many more american troops, this is an endless occupation or perceived as such and so there's a lot of nationalism and pride and they want to be the drivers of their own destiny here in afghanistan. so, you know, you have conflicting opinions or people who want more soldiers in the hopes that it will bring better security and there are those who want the afghans to take control of their own country. >> wood rough: what about inside the government, the calf dan government. what are officials saying they want out of this american decision? >> i think they're trying to walk a pretty fine line right now. i think it's clear that more is probably better for president karzai. they want... they want more troops, they want the money, the financial they are-- many people believe they are losing this war right now. they need the help. at the same time, i think he's
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been very careful not to publicly embrace the united states, frankly. there's been a lot of friction between the two countries, especially between the election and the fraud that took place there and he is... he is trying to be... avoid the perception that he is a puppet of the american government. so when you hear him talk about what he wants, he wants the support of the sbesh national community but it's in order to strengthen his own administration, it's to strengthen his afghan army and this speech, his inauguration speech, he said he wants afghan security forces to take full control of the security in the country in five years and many people think that's a pretty ambitious goal but he said he wants international private security companies out at two years. he wants americans out of running the detention centers. he wants more international funding going through the afghan budget, up to about half of
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international funding in a couple years. so he's... he's trying to strengthen his own administration through whatever support, additional support he gets from the united states. >> woodruff: and, josh partlow, we've heard the the afghan government is looking to engage with the taliban. to find a way to negotiate with them. how much are you hearing about that. >> yeah, that's a very big issue right now. it's something president karzai spoke about at his inauguration speech, again. it's his top priority, he says. he said he will convene a large tribal council of leaders, including reaching out to the taliban, he often refers to them as "my taliban brothers" to try to solve these issues. it's a very difficult time do this. they've proven to be a capable insurgency. they have aspirations to control
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afghanistan. again, they're not necessarily in a position of weakness right now and they're not necessarily... have a lot of incentives to negotiate. >> woodruff: last question, josh partlow. you've been in iraq as well as afghanistan. how much safer do the afghan people feel-- or do they-- than, say, six months ago? >> well, i got into afghanistan about four months ago and, you know, i mean, it's been a... i wouldn't say a steady increase in violence, but it's been compared to previous years in this war, we're at the highest levels of violence. so i think people are generally pessimistic about the level of safety and security. it's primarily a rural insurgency, but it's creeping into the cities with more and more regularity. and here in kabul, it's not infrequent to have rocket attacks or car bombs or those things are not as common as they were in the height of the violence in iraq in 2006 and 2007.
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but it's worrisome. it seems to be getting worse. >> woodruff: josh partlow, we thank you for joining us on this thanksgiving day. >> thanks very much for having me. >> woodruff: in other news today: an ongoing inquiry into britain's decision to go to war in iraq revealed the u.s. focused on iraq just hours after the 9/11 attacks. the former british ambassador to the u.s.-- sir christopher meyer-- testified he spoke with then national security adviser condoleezza rice about it on september 11. >> she said, "well, there is no doubt this has been an al qaeda operation." but at the end of the conversation, "we're just looking to see if there could possibly be any connection with saddam hussein," and that was the very first time, on the day itself, that i heard the name of the iraqi leader mentioned in the context of 9/11.
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>> woodruff: meyer also said former prime minister tony blair failed to use his influence with then president bush to stall the rush to invade iraq. the outgoing head of the united nations nuclear agency voiced frustration in his probe into iran's nuclear program. mohamed elbaradei acknowledged virtually no progress had been made because iran has refused t cooperate. speaking in vienna, elbaradei said he was disappointed in iran's rejection of international proposals. >> it is now well over a year since the agency was last able to engage iran in discussions about these outstanding issues. we have effectively reached a dead end, unless iran engages fully with us. it would help if we are able to share with iran more of the material that is at the center of these concerns.
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>> woodruff: elbaradei's assessment comes four days before stepping down from an office he's held for 12 years. china has unveiled its targets for reducing greenhouse gases. the government set out a goal of reducing carbon emissions up to 45% by 2020. that number will be measured against its gross domestic product, which should continue to grow over the next decade. the government also confirmed premier wen jiabao will attend next month's climate summit in denmark. hacked e-mails on climate change drew fresh reaction from climate scientists today. the head of a u.n. panel of climate experts stood by scientific evidence that humans are to blame for global warming. he rejected claims of bias from climate change skeptics. they charged that e-mails stolen from a british university showed scientists colluded to suppress data that might undermine their arguments.
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the catholic church in ireland has been accused of covering up systematic child abuse dating back decades. a three-year investigation into how the church dealt with complaints from hundreds of children found bishops hid the crimes to protect the church's reputation. we have a report from sue saville of "independent television news." >> reporter: the report covering 30 years in the diocese of dublin found that four archbishops did not hand over information on abusers. one priest has admitted sexually abusing more than a hundred children. some of those abused by priests gave their reactions to the report. >> this report is a shocking indictment on the catholic church in dublin. its publication may bring closure for some victims. it may also serve as the only justice some victims ever receive. but its publication, if not acted upon, will have been a wasted opportunity to raise standards of child protection in this country. i
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>> the institution came before the welfare of the children of this country and all their denials are now proved to be false. >> reporter: the irish government has promised to bring pedophile priests to justice for these shocking crimes. >> as i read it i felt a growing sense of revulsion and anger. revulsion at the horrible evil acts committed against young children. >> reporter: the current archbishop of dublin responded to the catholic church. >> i offer to each and every survivor my apology, my sorrow, and my shame for what happened. but i'm aware that no words of apology will ever be sufficient. >> reporter: the irish police say they're deeply sorry for failing to protect children. the reputation of the catholic church in ireland has been severely shaken. >> woodruff: last may, a similar investigation found decades of
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unchecked child abuse in irish schools and orphanages run by the catholic church. the secret service is investigating a security breach during tuesday's white house state dinner. a husband and wife from virginia-- michaele and tareq salahi-- managed to infiltrate the dinner, but were never on the guest list. they posted photographs on the social networking site, "facebook," posing with legitimate guests. among them, were shots of vice president biden, white house chief of staff rahm emanuel, and media personalities. the couple did go through the same security screenings for weapons as other attendees. >> woodruff: and still to come on the "newshour" tonight: making health care decisions; playing for health; ending food cravings, and poet galway kinnell. that follows an update from mumbai, india-- one year after the terrorist attacks.
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it comes from simon israel of "independent television news." >> reporter: india's commandos used today's anniversary for a display of security maneuvers, which were so absent when it mattered a year ago. a parade through the heart of mumbai was an extravagant exhibition of the latest equipment in the multi-million dollars efforts to beef up security since ten gunman rampaged through the city killing 166 and injuring hundreds more. they had come on boats. these new police launchers were on show to offer reassurance it won't happen again. the memories of what happened are stark-- panic had gripped the city. the railway station was littered with bodies. it was the scene of a massacre. today, in place of blood being shed, blood was being donated. 100 beds were set up in the terminal, organized by the railway authorities.
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there were many candlelit vigils across mumbai. not just in remembrance of the victims, but also to protest still not enough is being done to improve a police force which was shamed for it's inadequate response on the night. >> ( translated ): this candlelight vigil is to raise awareness that the supreme court recommendations on police reforms have not been implemented by the government. nothing has been done. >> reporter: today's show of force paraded past the taj mahal hotel which was the scene of a three-day seige, where at the hotel, blazed the gunmen went from room to room rounding up guests, who they either killed or held hostage, whilst the authorities struggled to gain control. the jewish center which became the last refuge for two of the gunmen has only just reopened. the walls are still as they were.
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the bullet holes a reminder of the horrors. it was here rabbi gavriel holtzberg and his wife rifka were held hostage then killed. their two-year-old boy moshe was rescued. today, he saw his grandfather return for the first time. >> when i come here and i see this, my heart is... i see this place, my children, it's a place in the... for the baby. >> reporter: the sole surviving gunman, ajmal kasab, has been on trial for seven months. the prosecution case against him runs to 1,000 pages. >> woodruff: now as the nation considers reforming health care, a discussion on changing the way medical decisions are made.
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ray suarez is in charge. >> suarez: since the health care reform debate began months ago, one key goal repeatedly discussed is lowering costs and improving quality by practicing what's called "evidence-based medicine." that refers to using scientific data in studies to inform decisions about the most effective treatment. president obama himself made the case for it during a prime time news conference earlier this year. >> why would we want to pay for things that don't work? that aren't making us healthier? and here's what i'm confident about. if doctors and patients have the best information about what works and what doesn't, then they're going to want to pay for what works. if there's a blue pill and this red pill and the blue pill is half the price of the red pill and works just as well, why not
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pay half price for the thing's going to make you well? but the system right now doesn't incentivize that. those are the changes that are going to be needed... that we're going to need to make inside the system. >> suarez: but in light of the recent uproar over mammograms and cancer screenings, there is evidence whether evidence-based medicine is the right plan. dr. don berwick and dr. jerome groopman, professor of medicine at harvard medical school and chief of experimental medicine at beth israel deaconess medical center. dr. berwick, let me start with you, give me your best thumbnail definition of evidence-based medicine. >> it's basing decisions we make as doctors and nurses and other practitioners on experiments and trials we can do to assess the
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effectiveness of operations or pills or tests. it's flying with knowledge instead of flying by. >> suarez: so taking perhaps just a second before moving ahead with a course of treatment and assessing what we know about best results. >> yeah. it's making up your mind about what you think works and what doesn't based on evidence instead of habit or just beliefs. >> suarez: well, that was my next question for dr. groopman. evidence-based as opposeed to what? what are the other tools that a diagnose nos tigs makes that makes use of? >> well, i think every good doctor should look at evidence and putting medicine on a firm scientific footing is precisely what we want to do. the problem is that the evidence we have comes from statistics, from clinical studies and they may not apply to the particular patient whom you're caring for.
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so then you have to make a considered judgment. you look at the evidence but then you may also draw on prior experience with other patients similar to this one because not everyone fits into the category where the data come from. there's also important attention to the preferences of people, what a patient wants, the quality of life. do they want to take the risks of that blue pill or red pill versus no treatment? and often we try to encourage them but we should never coerce them. and most importantly, i think, is that evidence changes there is no... it's not absolute. we get new information from new studies but also what we call best practices comes from a group of experts sitting together and making judgments. i've... you know, on those committees there are often credible experts who disagree
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with the data, just like we're seeing in the mammogram debate. and it's not a matter of being ignorant of science, it's a matter of judging the quality of the evidence and how broadly it applies. so i think everyone agrees evidence is extremely important. but we need to be flexible and most importantly we should never mandate that every patient be treated according to one protocol. >> suarez: d. berwick, what about some of those points? let's begin with where dr. groopman began. not every patient fits neatly into your use of evidence data to figure out a course of treatment. >> well, that's essentially right. a good doctor doing his or her best to take care of a patient is combining the kind of evidence we're talking about with other factors that dr. groopman is mentioning like values, uncertainties, specific
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things you can know about a patient. but i still claim evidence is always better than not evidence. having scientific knowledge provides better inout if decisions like that. by the way, we have a lot of evidence that very clear-cut cases where we know what works and what doesn't are not... that information is not honored in decision making. there's a kind of chaos throughout in the health care system where a lot of things patients should get they don't and a lot of things they shouldn't get they do. there are a lot of such clear-cut cases and in those cases i think we should be raising the bar a bit on how strictly we want to adhere to what science is telling us. >> suarez: what about the point that dr. groopman made that evidence changes. that what we know or think we know for sure one year may not be the case further down the road? >> that's a prescription for how you should engage in evidence-based medicine, which is continually to monitor and update what we know. we're way underinvested in the kind of research that dr. groopman's comment would imply. we need to invest much more as a nation in the continuous study and updating of knowledge as
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things go along. to lock ourselves in in concrete at any particular point in time is a mistake because, as dr. groopman says, things will change. but we'll only know they change if we keep doing the research. >> suarez: dr. berwick, is there a risk that when a patient comes in through the front door with a mix of the known and the unknown that we will in effect put them a slot, in a category that fits the evidence that we have at hand rather than forcing us to go places where perhaps our experience isn't as much as a guide? >> absolutely there's a risk and that's why it's wise not to put handcuffs on physicians or nurses and others when they make these decisions. we need to honor judgment and welcome judgment. bewe also need to honor evidence and science. in the end, we want to inform the encounter with the best knowledge we possibly can and leave a wise patient and wise doctor to make the best choice for the patient. >> suarez: dr. groopman, does the available evidence tell us
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enough when trying to figure out where to go next with a patient? in the case of women and minorities who often have not had the best track record in clinical trials because they are undersamples or underinvestigated. >> absolutely. this is one of the great gaps in evidence and i think as dr. berwick-- whom i know as don-- just said, it's very important to invest in getting this kind of information. different ethnic groups, different racial groups often handle drugs differently than this sort of typical caucasian or white patient. women may have different outcomes with regard to heart disease and so on. but i think don and i agree with regard to handcuffing, what concerns me is that there's a big difference between the house bill as currently written and the senate bill.
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the house bill honor what is dr. berwick and i have been saying in that it makes sacred the judgment between doctor and patient. so-called informed, shared decision making. the incentives in the current senate bill to my mind are potentially dangerous because they basically pay people to follow what they say are best practices or evidence-based med anyone is a very broadway. and that could easily lead toe the doctor being in a position to coerce a patient who-to-do something in which the patient wouldn't want to do or where the doctor disagrees with the guidelines. he thinks that evidence t evidence is not compelling. >> suarez: dr. berwick, how do you respond to that point about the effect that it would have to move evidence-based medicine to a more central role in the way we provide care and treatment? >> i have no question in my mind
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that we should move evidence-based medicine2g. there's a lot of chaos out there. i think we have to be very wise about when we attach incentives to any particular form of care for an individual patient. i agree with jerry on that. i would argue that there are some cases in which the scientific evidence is so clear-cut for or against the use of medication that it doesn't make sense to be rewarding behavior behaviors on the part of any clinician that are harm to feel patients. so we have to attend to some form of increasing the stakes around the use of evidence. >> but how would it lower costs, doctor? >> well, there's a balance in our country between underuse of things that can help people and overuse of things that can't. there are a lot of tests done, a
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lot of procedures and hospital admission which is we know scientifically can't help a patient. this isn't a matter of a doctor not exercising good judgment, it's a matter of people ignoring the evidence or not knowing about it. my own opinion is the balance is such that if we did adhere a little more closely to what we know, the overuse of unnecessary things would go down, could go down quite substantially. nobody would be harmed. patients would be better off subjected to less risk and that should reduce cost. there's debate about the balance but i think working hard on the overuse of ineffective practices is a very good way for us to save money and not harm a hair on a patient's head. >> well, that sounds like common sense, dr. groopman, how do you respond to dr. berwick? >> i agree in principle. i think my focus in terms of evidence-based applications where where save quite a bit of money actually comes from the kind of initiatives that don berwick has spearheaded and those are safety initiatives, there are huge sums of money
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with regard to patients entering hospital and developing infections within the hospital. this causes a great deal of suffering, sometimes death, prolonged admissions and so on. and as don says, there are procedures in terms of how to safely put in an intravenous catheter and so on where you can protect parrot and everyone agrees that you could save a great deal of money, you could spare patients harm and there is no threat to patient autonomy. but i think we have to be very, very strict around setting those barriers with the current legislation. because the evidence changes quite a bit once you move away from those kinds of safety measures and what are called rules doing things in a careful procedural way in the intensive care unit or emergency room. a a dr. groopman, dr. berwick, gentlemen, thank you both. >> thank you, ray.
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>> woodruff: there's more about efforts to reform the health care system, including a recent interview with two former secretaries of health and human services on our web site: newshour.pbs.org. now, a story about making recess more productive. once upon a time, school recess was taken for granted. but that's not necessarily the case these days as "newshour" correspondent spencer michels reported earlier this year. here's an encore look. >> reporter: in the playgrounds of inner city schools throughout the country, recess can be chaotic. so unruly in fact, that some schools have eliminated or shortened it. when it's disorganized and unsupervised, kids wander aimlessly; bullying is commonplace; putdowns are part
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of playground life. arguments become fights. that's the way it used to be at this oakland, california, school and others. working on the schoolyard today, bryant hicks says a few years ago, things were far different. >> chaotic; there may be games being played but they're not the safest game being played. so if there's a soccer game being played, there are kids running through games. it's more of a pushing and shoving match. >> reporter: the national emphasis on academic achievement is another reason recess is under threat. some educators argue that time or money put into play periods takes away from teaching the three "rs." but eliminating or cutting back the fourth "r"-- recess -- outrages jill vialet. >> what we know is that kids who get recess perform better academically. >> reporter: she founded
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sports4kids, a non-profit that supplies full-time coaches to 170 mostly inner-city elementary schools across the country to organize and run recess. >> they serve as sort of a proxy for the older kids of yore and they basically are going into the school climate and school environment and they're teaching the kids the rule, the culture of play, the rules of the game-- and it changes the whole school dynamic. >> reporter: she believes play time is essential-- a vital tool that helps, not hinders-- academic performance. >> it makes it possible for teachers to really focus on what they do best. and our person can take responsibility for the culture that develops that, the wrap around services that makes schools work really well. >> reporter: horace mann school in oakland pays $23,500 a year for the program, which actually costs about $50,000. the rest comes from the robert wood johnson foundation-- also a "newshour" funder. this school is 55% latino; 35% african american, and the income
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level is low. the coach keeps the kids playing games, like soccer or four square or double dutch, and settling disputes. >> these kids, i think, maybe it's the environment they live in. it's just more anger. they get angry to start off with. they want to push or shove or yell, to see who the person is who gets to control the game. where we want to make it that any person can play any game, no matter what shape or size. we want a safe environment. >> reporter: alanna lim-- the principal at horace mann-- chose to use the program because of what it does both in the school yard. >> doing yard duty is almost a piece of cake. there are hardly any problems. there hasn't been one single fight on the yard. >> reporter: and in the classroom. >> the teachers spend less time
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dealing in the classroom with playground problems. that means more instructional minutes right off the bat. the kids come back more refreshed. >> reporter: lim also loves the fact that her students are now practicing conflict resolution-- settling arguments about games using "rochambeau." >> you know, rock, paper, scissors, right,-- one, two three, and you choose. the problem is settled right there, whether you disagree with the solution or not. it's worked out really well. >> reporter: marleni sanchez is an 11-year-old fifth grader, who has become a junior coach, helping the sports4kids professional coach on the yard. >> we're trying to get good sportsmanship and play with each other nicely. >> reporter: how do you do that? >> if you get into an argument, all you have to do is rochambeau. whoever wins gets the ball or whatever, it doesn't mean they lose.
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>> reporter: play-- at recess and lunch periods, vialet it also is essential for childhood development. she cites a recent study published in the journal pediatrics, that says children who had at least 15 minutes of recess had fewer behavioral problems than those who got no recess. attendees at a san francisco conference on play heard from researchers who said the necessity of play had been proven in animal studies. psychiatrist and author stuart brown-- founder of the institute for play-- says studies show that young rats need play to function. >> rats, for example, have a tendency to engage in rough and tumble play from four to 15 weeks old. and when you suppress that behavior, they can't tell friend from foe. they have inflexibility in social relationships with other rats, and they have trouble.
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they don't reproduce. >> reporter: there are implications for humans, says brown. >> serious play deprivation in human beings has serious consequences. and those consequences are an inability to have as much resilience and social competency, and other elements like good memory and curiosity. >> reporter: a close observer of the oakland school district and its board, retired teacher jim mordecai is not convinced that spending money on recess is the best way to use school funds. >> each school in oakland that participates is $23,500. you multiply it out by the 37 schools, that's over $800,000. so we just cut 15 early childhood teachers. a lot of them could have been saved by that. in this terrible economy, we have to downsize.
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>> reporter: nevertheless, sports4kids continues preaching the gospel of well-organized play to an ever larger audience. even with school budgets being cut, it is expanding to 240 schools nationwide this fall. >> woodruff: for many americans, today's thanksgiving meal is one of the great feasts of the year. it's also the beginning of a much longer holiday season that includes plenty of parties, plenty of food and, frequently, too many calories. with that in mind, we have a second look at a betty ann bowser conversation about over- eating and our cravings. our health unit is a partnership with the robert wood johnson foundation. >> we've had layers upon layers of fat on fat on fat. >> reporter: when dr. david kessler walks through a food court these days, he see what is
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others may not. >> you could change the name of this place to "fat and sugar." there it's "fat and salt." that's "fat, sugar, and salt." >> reporter: that's because the former commissioner of the food and drug administration has spent the past seven years meeting with doctors, scientists and food industry insiders to understand what drives so many americans to eat so much. kessler explains in his book the end of overeating what he found during his investigation. dr. kessler, why did you decide to write this book? >> the book had several beginnings. i was sitting in my office at yale with a group of residents and students and we asked the question and we want to say there's a line. what can we do to prevent getting a major disease? three quarters of us are going to die of cardiovascular disease or stroke or cancer. so i was very interested in
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preventing disease and if you're interested in preventing disease weight is a critical, critical factor. but for me, understanding what to do about weight was the great mystery. the food industry has been able to figure out the optimal combinations of fat and salt, fat and sugar, fat, sugar and salt that you think tastes good. but when you look at the science we now know that those ingredients stimulate, they activate, the brain's circuitry. they stimulate our intake. they condition us. they drive us to want more... they affect the neurocircuits. for decades, the food industry has said they're just giving consumers what they want. but, in fact, now we know that what they're doing is excessively activating the
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brain's in millions of americans. the most important part of the new nutrition facts label.... >> reporter: for kessler, who tackles big tobacco and reinvented food labels in the 1990s, the research was personal. he was powerless to control his own eating and he found out he wasn't alone. >> i used to think i was eating for nutrition, that i was eating to satisfy myself. i didn't realize that i was eating for stimulation. and that that stimulation locked in the neural circuits strengthened those neural circuits so every time i engaged in that behavior i would do it again and again. i didn't understand why i had gained and lost weight over my lifetime. many times. here is me 1999. >> reporter: i can't believe it! >> here is me thin. >> reporter: and within what
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period of time? >> just up and down throughout my lifetime. >> reporter: all the time, huh? >> and here i am again big. >> reporter: what do you think the problem was? >> i didn't know. i didn't know. i knew it was not as simple as diet and exercise. to me this was the great mystery. i view myself as somebody well disciplined, well educated. why was it so hard to resist? >> reporter: and dr. kessler knows he has plenty of company. about one-third of american adults are obese or overweight, a rate that's double what it was three decades ago according to the centers for disease control. >> if i put these chocolate chip cookies, if i just take these chocolate chip cookies with other chocolate cookies, i put them out. >> reporter: oh, wow, they smell good. >> reporter: why do these cookies have such power over us? that's what i wanted to understand. what is it about these cookies that capture my attention?
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i'm going to be sitting here listening to your question, but these cookies capture my attention. i want these. what it is about that? >> reporter: but what is it? >> there is a theory that has emerged, not a disease but several characteristics that we just studied between taking people who have these characteristics-- loss of control, lack of satiation, preoccupation with food-- and we scanned... we've done the neuroimaging and what's fascinating is that their response to the food, just to the sighttor smell, their brains get activated, their amygdala regions become activated and become amply phied much greater than healthy controls. and what's fascinating is people who've had this condition of hypereating, once they start consuming the food, that activation stays elevated and doesn't shut off until the food
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is gone. it's not a matter of will power. >> reporter: in your book you talk about how americans need to go to food rehab. what does that mean? >> rehab is new learning. it's the laying down of new neural circuitry on top of the old circuitry on top of the old learning. so until i can lay down new circuitry, new learning, i'm never going to be able to resist. diets don't work. what we need is to change our relationship with food. >> reporter: and one of the things dr. kessler thinks would help many people make that change is to force restaurants to disclose the contents of everything on their menu, including calories, salt, sugar, and fat. similar regulations are already in effect in some places like new york city. >> it begins with disclosure, but in the end we're going to have to look at food
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differently. we have to change what we want, what we value. that's the real key. that's how you take on great public health challenges. that's howcx we made the difference in tobacco. we changed how we as a country view the product from where that was something that... a cigarette was something i wanted that's a deadly, disgusting product. the business plan of the industry has been to take that sugar and salt, make it multisensory, make it irresistible, put it on every corner. and that behavior has resulted in millions of americans having a very hard time controlling their eating. it's only going to change once we understand what's going on. if we continue to allow the food industry to put fat, sugar, and salt on every corner. to load it in our food.
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to be double frying our food, to be injecting it with needles, to be bathing it in solutions of sugar and fat, to be pre-digesting that food, adding the emotional advertising, stimulating the brains of millions of americans, we're never going to be able to get a handle on health care and especially the costs of health care. the food is... in essence it's constructed. >> reporter: dr. kessler hopes his book will launch a nationwide movement to make americans more aware of what they are eating and why they eat so much. >> woodruff: finally tonight, an encore poem about the pleasures of ordinary things. it comes from galway kinnell, a pulitzer prize and national book award winner, macarthur fellow and former state poet of
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vermont. >> i'm galway kin nell and i have here a poem called "why regret." the poem took me a very long time to write, perhaps two or three years stopping here and there to add things that came to me in the meantime. i had in mind that the poem is addressed to all readers, including myself reading it over to tell us to remember the pleasures and the confidence we gain from engaging ourselves with the common acts, the ordinary things, the other preachers, toobd remind us in this holiday season when we get reports everyday of the most horrible killings that nevertheless we have very much to be grateful for.
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"why regret. didn't you like the way the ants help the globes open by eating the glue off? weren't you cheered to see the iron workers sitting on an i-beam danging from a cable in a row like starlings eating lunch, mann maybe bologna on white with fluorescent mustard? wasn't it a revelation to wagle from theest chair all the way up the river the kill, the pearl, the run, the rent, the beck, the sight barely tricking to the shock of the spring. didn't you almost shiver hearing book lice clicking their sexual disinnocence inside an old webster's new international, perhaps having just eaten out it easter and thelascicon. forget about backing emaciated. think of the wrens and how little flesh is needed to make a
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song. didn't it seem somehow familiar when the nymph split open and the may fly struggled free and flew and perched and then its own back broke open and the true adult somersaulted out and took flight, seeking the swarm, mouth parts vestigial, alimentary canal come to a stop, a day or hour left to find the desired ones. or when casanova took up the platter of leng qenny and squid ink and slid the stuff out the window telling his startled companions the perfected lover does not eat. didn't you glimpse in the monarchs but seemed your own inner playsonry flapping and gliding in desire in the middle air? weren't you reassured to think
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these flimsy hinged beings and then their offspring, and then their offspring's offspring could navigate, working in shifts all the way to mexico to the xot plot, perhaps the very tree by tracing the flair of the bodies of ancestors who fell in this same migration a year ago? doesn't it outdoor the pleasures of the brilliant concert to fwhak the night and find ourselves holding each other in our sleep? >> woodruff: again, the major developments of the day: an ongoing inquiry into britain's decision to go to war in iraq revealed the u.s. focused on iraq just hours after the 9/11 attacks.
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the head of the united nations nuclear program said his investigation into iran's nuclear program is at a dead end. and the chinese government announced its goals for reducing greenhouse gases and carbon emissions up to 45% by 2020. on newshour.pbs.org, two online- only features tonight. first a conversation with novelist barbara kingsolver about sustainable eating. and a reporter's podcast about britain's special inquiry into the origins of the iraq war, the news about what then white house national security adviser condoleezza rice told the british ambassador, and next steps in the investigation. an editor's note before we go: last night we reported two stories that involved "newshour" funders-- toyota and wells fargo bank-- and failed to point that out. we regret the omission. we'll see you on-line and again here tomorrow evening.
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i'm judy woodruff. thank you and happy thanksgiving! major funding for the newshour with jim lehrer is provided by: >> what the world needs now is energy. the energy to get the economy humming again. the energy to tackle challenges like climate change. what is that energy came from an energy company? everyday, chevron invests $62 million in people, in ideas-- seeking, teaching, building. fueling growth around the world to move us all ahead. this is the power of human energy. chevron. >> and by wells fargo advisors. together, we'll go far.
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>> and by bnsf railway. and by the alfred p. sloan foundation. supporting science, technology, and improved economic performance and financial literacy in the 21st century. and with the ongoing support of these institutions and foundations. and... this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you.
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captioning sponsored by macneil/lehrer productions captioned by media access group at wgbh access.wgbh.org
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