Evidence also exists suggesting that the root cause for much dyslexia is a problem with processing very rapidly changing sensory stimuli. For example, studies have shown that dyslexic children have trouble making accurate distinctions among similar auditory signals. They often cannot hear the differences in speech sounds such as “pah,” “dah,” and “bah.” Recently, differences have been noted between the visual pathways of dyslexics and those of nondyslexics that suggest a comparable problem with fast-changing visual stimuli. Researchers have also found several other neuroanatomical abnormalities in the temporal lobe and in other areas of the brain. All of these studies are extremely valuable in helping researchers understand the mechanisms underlying reading problems so that dyslexic children can be accurately identified and more efficiently helped.

    Doctors often overlook or omit steps in the multitude of tasks we perform every day. As Atul Gawande argues in “The Checklist Manifesto,” these are situations where a simple to-do list could help. For example, a five-point checklist implemented in 2001 virtually eradicated central line infections in the intensive care unit at Johns Hopkins Hospital, preventing an estimated 43 infections and eight deaths over 27 months. Gawande notes that when it was later tested in I. C. U.’s in Michigan, the checklist decreased infections by 66 percent within three months and probably saved more than 1,500 lives within a year and a half. 

    Gawande, a professor of surgery at Harvard Medical School and a staff writer at The New Yorker, makes the case that checklists can help us manage the extreme complexity of the modern world. In medicine, he writes, the problem is “making sure we apply the knowledge we have consistently and correctly.” Failure, he argues, results not so much from ignorance (not knowing enough about what works) as from ineptitude (not properly applying what we know works). This is an important insight. Medicine has made great strides, but in many ways doctors have become victims of their own success. Taking care of patients is hard; there is often too much for one doctor to do. Medical care for common disorders like diabetes and pneumonia has been shown to meet national guidelines only slightly more than half the time. 

    Medicine is not the only complex profession where lives are on the line. In making his argument, Gawande deftly weaves in examples of checklist successes in diverse fields like aviation and skyscraper construction. He maintain; that checklists not only help pilots and builders get the stupid stuff right, but foster the communication required to deal with the unexpected. His discussion of aviation accidents, including the emergency landing on the Hudson River last January (during which the copilot simultaneously managed checklists for restarting the engine and ditching the plane), makes for fascinating reading. 

    But Gawande’s missionary zeal can give the book a slanted tone. For instance, there is almost no discussion of the unintended consequences of checklists. Today, insurers are rewarding doctors for using checklists to treat such conditions as heart failure and pneumonia. One item on the pneumonia checklist—that antibiotics be administered to patients within six hours or arrival at the hospital—has been especially problematic. Doctors often cannot diagnose pneumonia that quickly. But with money on the line, there is pressure on doctors to treat, even when the diagnosis isn’t firm. So more and more antibiotics are being used in emergency rooms today, despite the dangers of antibiotic—resistant bacteria and antibiotic-associated infections. 

    Even when doctors know what works, we don’t always know when to apply it. We know that heart failure should be treated with ACE inhibitor drugs, but codifying this recommendation in a checklist risks that these drugs will be prescribed to the wrong patient—a frail older patient with low blood pressure, for example. Checklists may work for managing individual disorders, but it isn’t at all clear what to do when several disorders coexist in the same patient, as is often the case with the elderly. And checklists lack flexibility. They might be useful for simple procedures like central line insertion, but they are hardly a panacea for the myriad ills of modern medicine. Patients are too varied their physiologies too diverse and our knowledge still too limited. 

   Gawande passingly notes that checklists could be used to improve weather prediction. But he doesn’t mention that weather is an inherently chaotic phenomenon small perturbations in initial conditions can result in big, unpredictable effects. When Gawand writes that an investment manager he knows believes a checklist can help him reliably beat the stock market, the case seems to have been pulsed too far. Yet despite its evangelical tone, “The Checklist Manifesto” is an essential primer on complexity in medicine. Doctors resist checklists because we want to believe our profession is as much an art as a science. When Gawande surveyed members of the staff at eight hospitals about a checklist developed by his research team that nearly halved the number of surgical deaths, 20 percent said they thought it wasn’t easy to use and did not improve safety But when asked whether they would want the checklist used if they were having an operation, 93 percent said yes.

        Rebel territory, western Nepal, is one of the most remote regions on earth. We came here to meet the insurgents who are fighting to topple the government of the Himalayan kingdom. Soon there are no roads, no bridges. The only way to cross this river to enter the rebel heartland is this box, suspended from a cable, the bridge blown up a long time ago in the fighting. 

        Here we were approached by a girl in her school uniform. It quickly becomes clear she and two friends have been hiding in the jungle since the previous day from the rebels, they say, notorious for abducting children to become insurgents.

        For the past 10 years, these Maoist rebels, among the last in the world, have been fighting to overthrow the monarchy here and establish a socialist state. More than 12,000 people have died in the fighting, but even more disturbing are the children targeted by both sides, according to human rights group --- thousands of them, by some estimates, abducted, tortured, and killed. The government says the rebels kidnap children to recruit and indoctrinate. 

        The rebels deny it, calling it slanders spread by the government, but the story of these children says otherwise. She is 16 and scared, Ganga says she thought the rebels would kill her. She worries her parents don’t know where she is. She herself doesn’t know where she is. They have no money and no food. They stay the night at the villager’s house. Khum is 15. He says that rebels beat students at his school with sticks and stones when some try to escape. Shobba says she worries about her exams, and worries that rebels will kill her.

        The children are in desperate need for help. We abandon our plans to try and meet the rebels to try to get the children home.

        We suspect there may be some rebels among the villagers here who might want to take the kids away. That’s why we have to get out of here very quickly, and this is how we are going to do it.

        But we may have already been too late. The woman in pink acts in a suspicious way, leading us to think she may be a rebel. She appeared from nowhere and has already been in deep conversation with the children, and tried to convince them to go with her. She claims to be a cousin and says she will take them home through a shortcut in the rebel territory. Out of hope or more likely out of fear, Shobha and Khum decide to go with her. But Ganga joins us in the precarious journey to safety across the river, where the government is in control. Here at the roadside café, Ganga has her first food in two days. We put her on a bus for home, a two-hour drive and then two more hours’ walk. It’s been a terrible ordeal for Ganga and she’s far from alone. Increasingly on the battlefield in Nepal between the government and the rebels are this country’s children.

       It may help to reflect. However, __16__ negative events and emotions definitely causes harm. It only increases your __17__ to keep thinking about your problems. Perhaps you replay a(n) __18__ you had earlier with your best friend over and over in your head. Whenever you think of it, you cannot but hold yourself __19__ for something you said. Or maybe you can’t take your mind off some hurtful comments. You feel greatly __20__, your self-worth damaged. Similar cases keep repeating themselves, and in time, you end up with an unhealthy __21__ with your own misfortune. If that’s what happens to you, __22__ yourself to changing the way you think. First and foremost, recognize it when you’re over-thinking. The more you ruminate, the more likely you are to get stuck in a negative cycle that is hard to break, and thus __23__ a downward spiral. Besides, try to solve your problems by learning from mistakes before you can quit __24__ yourself mentally instead of brooding over them. Lastly, __25__ mindfulness. That is, focus on everything you’re experiencing to improve your state of mind. Learn to live in the here and now, and over time it can tremendously decrease rumination. (AB) blame (AC) accountable (AD) distress (AE) obsession (BC) lasting (BD) inadequate (BE) practice (CD) creates (CE) dwelling on (DE) torturing (ABC) begins (ABD) commit (ABE) suspicious (BCD) quarrel

       There were so many coffins — 19 in all — that they lined an entire wall of the Wat Rat Samakee temple. A long white string, a Buddhist symbol of purity and protection, ran across their tops. Placed around each coffin were items to carry the young children into the afterlife: a Spiderman outfit, a plush kitty, juice boxes, grilled pork and toy trucks, many of them.

       The town of Uthai Sawan on Saturday started formally mourning their dead, 36 of them. Twenty-three were children in a day care center who died Thursday when a former police officer shot and stabbed them in a rampage. There was Asia, 3, who loved cycling and was allowed to ride his bike inside his house. Lying several coffins away was Daen, 4, who loved Matchbox cars.

       Uthai Sawan is a rural town of about 6,000 in northeastern Thailand. The funerals had to be split across three temples. Monks from neighboring provinces traveled to the town to help with the funeral rites. On Saturday morning, the framed photograph of Athibodin Silumtai, whom everyone called Asia, was still not ready because there was only one photo shop in town, said Khamphong Silumtai, his great-aunt.

      “It just feels like this is not his time to go,” said Khamphong, 46. “He is too young and too innocent. He was gone too soon.”

      Thailand is a majority-Buddhist country, where the faithful believe that making merits, or doing good deeds, is essential for the deceased to live well in the afterlife. Funerals are often carried out with that goal in mind.

      Phra Winai, who has been ordained for 24 years, said he traveled to Uthai Sawan from nearby Loei province to see if he could help. He said he has carried out funeral rites for young children who died by drowning or in accidents, but “never anything like this.”

      “This is such a tragedy,” Phra Winai said. But, he said, the tenets of Buddhist teaching are that life is a cycle involving birth, aging, suffering and death.

      “Look at nature: When a tree gives fruit, the fruit does not always ripen.” he said. “The young fruit can fall when there’s wind,” he added. “Life is so unpredictable and uncertain. We can’t do anything with this uncertainty.”