The Gaffney Ledger from Gaffney, South Carolina • A4

I have cold feet; just cold toes all probably heard the expression cold as it pertains to someone losing their courage when it comes to doing something iving a speech or erforming in front of rowd rather ot. Just before he was go on stage, he got cold My research attributes the expression to writer Stephen Crane. In his 1896 book, A girl of the he wrote, knew this was the way it would be. They got cold I suppose stage fright might be similar in that respect, but people get cold feet for a number of other reasons. For instance, got cold feet right now and it has nothing to do with not wanting to do something or cold feet are literal.

Actually, more cold toes than cold feet. According to multiple sources, there are numerous causes for this condition and after reading about each one I have concluded that 90 percent of them could be my problem. Several doctors have checked my circulation and determined that IS NOT the cause. I thought it might be the heavy, cotton socks I wear that cause my feet to sweat, which in turn create a chilling effect. So, I changed to some thinner socks (thanks Santa!) but that has not helped.

Santa also surprised me with a Serta Luxury Electric Foot Warmer, which now occupies a space beneath my desk. It helps, but every time I get up I have to put my shoes on. Since I get up and walk around the building fairly ofter, it becomes rather a nnoying. I will probably take it home to use while elaxing in my recliner. nce I settle in there, I rarely get up.

I have also used packaged foot warmers. like the hand warmers you shake up and put in your pockets or gloves to keep you hands warm except they fit in your shoes. The even have a little sticky part to keep them in place. These inventions work quite nicely if you can stand the uncomfortable feeling of having something in your shoes. The good news about my condition is that it usually only occurs from November to April.

Coincidentally, usually the time frame when I get a cold, such as is my current status. This has gotten me to thinking about all the ways we use the word How can you a a and all of the other phrases using the term? Cold war. Cold-blooded. Cold-natured. Have a cold personality.

Turn a cold shoulder The word is used in many other ways, and none of them seem to be positive. There is one instance I can think of when we react favorably when we hear the word During the hot summer days, we all enjoy something cold to drink. Can you think of any other case where cold evokes a favorable response? Cold weather used to not bother me too much. even played golf when the temperature was below freezing. No more.

adopted the John Wall 50-90 rule: play golf when under 50 or over 90. Apparently not alone when it comes to my dislike of cold weather. Why else would automakers have developed heated seats? Or remote start so the car will be warm when you get in it? That tells me millions, millions I tell ya, are just like me. But then there are those who are seemingly unaffected by cold weather or some who actually like it. Case in point: Some folks wear shorts and sandals in the winter.

And some prefer to live above the Mason-Dixon line. not 100 percent against cold weather. One decent snow each year is acceptable. In fact, I am already preparing for one this year. I cut a sledding trail down the hill though the pasture in front of our house, so if it does snow, the snow will lay on the cut trail and make for perfect sledding.

And even better, right outside our front porch, which will enable me to watch others from the warmth of my living room! enjoying the mostly warm weather we have experienced thus far, but my toes are still cold. Thing is, probably be complaining in the summer about it being too hot, but at least my toes will be warm. not going outside until the temperature is above my age. Anonymous a a i i a HEIR IEW EDGER OLUMNIST ATTENTioN PoSTMASTER The Gaffney Ledger, established Feb. 16, 1894 (USPS 212-760) is published three times weekly by The Gaffney Ledger, 1604 Baker Gaffney, S.C.

Periodicals postage paid at Gaffney, S.C. POSTMASTER: Send address changes to: The Gaffney Ledger, P.O. Box 670, Gaffney, S.C. 29342. UEST OLUMNIST WE WANT YoUR PHoToS READERS oN THE RoAD FEATURE The next time you go out of town, take a copy of The Gaffney Ledger along and snap a photo of yourself your group reading it so we can use it in our On The feature.

E-mail your digital photos to: or CoDYSoSSAMoN Ledger Publisher S.C. school superintendent should be appointed Molly Spearman, South elected superintendent of education, has no illusions about her job being on the state ballot and, in fact, she supports making the position appointive and part of the cabinet. Spearman, a former legislator and before that a classroom music teacher and assistant principal, has joined Gov. Nikki Haley in urging legislators to support legislation setting up a statewide refer- ndum. he S.C.

Constitution makes he education superintendent elect ive, so approval is neces- ary to change the position to appointive. In 2014, South Carolina voters approved amending the constitution to take the adjutant general off the ballot. South Carolina continues to popularly elect more positions than other states. The commissioner of agriculture, for example, is still elected. Only 13 states elect a superintendent of education.

or one example, Illinois made i ts of public i appointive with a pproval of an updated constitution following a 1970 constitutional convention. The Haley-Spearman letter came prior to the governor being chosen ambassador to the United Nations by president-elect Donald Trump. This appointment is subject to U.S. Senate approval, which is expected. With that, Lt.

Gov. Henry McMaster will become governor for the remaining two years of term. The letter to lawmakers points out the current divided leadership structure: of moving the state forward with a common ision for education priorities, this divided leadership structure can result in incompatible positions, a lack of coordination and fragmented accountability for failures in our Pre K-12 education The superintendent oversees the 82 school districts in the state, and a $2.4 billion budget. In the past, governors and education superintendents have been of different political parties. Gubernatorial candidates may address on the campaign trail, but they have very little power to make any of it says Sen.

Chip Campsen of Charleston. Campsen has legislation to place the question before voters. This year the House approved a joint resolution for a referendum, but it was blocked in the Senate is Spearman says. have been going on for more than 50 years. debated it a long, long Better cohesion between the governor and superintendent is one of the advantages of an appointed superintendent.

Spearman and Haley have a good working relationship, but Spearman can see where that might not be the case. Running a statewide campaign is costly and it may be more difficult to find qualified candidates. Currently, no qualifications are required for superintendent candidates, and qualifications would be added for an appointed superintendent, as well as Senate approval, which may be helpful in passing legislation in 2017. The General Assembly has long held the share of power, and legislators typically want to give the governor more power. It is indeed time for this modest piece of reform in governance and we urge area legislators to support placing the question on the ballot.

a Doctors selling out for sandwiches A recent study in the journal JAMA Internal Medicine shows that drug companies are bribing doctors with food to prescribe their expensive, brand-name medicines. At least the way been reported in the media. Dig deeper into the study, however, and it becomes clear that doctors selling out for sandwiches. no proof that i ndustry-sponsored meals drive prescribing ehavior. In fact, the relationships between harmaceutical sales representatives and hysicians may actually benefit patients.

The study reported that physicians who received even one industry-sponsored meal were more likely to prescribe the brand-name medicine that was being promoted. Receipt of additional meals was associated with greater increases in relative brand-name prescribing rates. And receipt of costlier meals was associated with increased target drug prescribing for 3 of the 4 drugs studied. These findings were based on flawed methodology. The study examined physician prescribing over the entire year of 2013 but only looked at meals provided in the last 5 months of 2013.

As the authors conceded, findings reflect an association and not necessarily Indeed, it is hard to fathom how lunch in October could have persuaded a physician to prescribe a particular drug the previous February. The overwhelming majority of the studied physicians did not receive any industry-sponsored meals promoting the studied drugs. Among those that did, nearly all had a single meal. The notion that the pharmaceutical industry is buying off physicians en masse is hyperbole. are reports of industry largesse.

The average values of the spon- ored meals for the 4 study drugs ranged from hardly lunch a the Four Seasons. When the authors arbitrarily set the threshold for expensive meals at $20 they presumably found costlier meals were associated with increased prescribing. But this claim was based on for selected physicians who are most likely to prescribe rather than actual probabilities for all physicians. And close examination of the study graphs only showed significant differences in prescribing based on meal cost for 1 of the 4 drugs, not 3 out of 4 as claimed by the authors. This new study is not the first to connect drug industry gifts and physician prescribing behavior an editorial accompanying the study cited 2 recent publications.

But the link was as tenuous in those studies as in this new one. The first was a 2011 Massachusetts study which found a positive association between industry payments and higher rates of prescribing brand- name statins. But it was only significant for physicians who received at least $2,000 from industry and the effect was miniscule for every $1,000 in payments received, the brand-name statin prescribing rate increased 0.1%. In the second study, ProPublica looked at 2014 contemporaneous payment and prescribing data and found that physicians who received any kind of industry payment, even just meals, had higher rates of brand- name prescribing. But the study link payments for specific drugs to increased prescriptions for those drugs.

Nor did the study link payments by particular companies to increased prescriptions of those drugs. As authors acknowledged, have not causal link is certainly a plausible reverse causation here that drug companies give money to physicians who already are heavy brand-name Physicians who eschew interactions with pharmaceutical representatives could be under-prescribing brand-name drugs and harming their patients. Industry-sponsored meals are merely an entry point for drug representatives to present product information to physicians. If that presentation is truthful there is no harm. The new authors admitted, events where industry-sponsored meals are provided affect prescribing by informing physicians about new evidence and clinical guidelines, then the receipt of sponsored meals may benefit patient There are many reasons brand-name drugs are prescribed.

Well-fed physicians are not among them. i i a i i i a a A i a i I i i a i i a i i i a a 2 9 1 9 1 3 a i a i EL i NbERG PAGE 4 WEDNESDAY, 2016 THE GAFFNEY LEDGER perspective.