Jene Bramel

I'm frustrated, too. But I'm certain that this approach does not work. Whatever you think of the most vocal anti-vax nuts you read on Facebook and Twitter and the other platforms du jour over the past 25 years, the vast majority of the families we have these discussions with every hour of every day are well-meaning folks with reasonable questions. With the occasional rare exception, they ask questions in the best interests of their kids. They are not the enemy. **Frightening them into vaccination does not work. **Reporting them to Child Protective Services is reactionary. This attitude is more likely to foster distrust in medicine. It guarantees a family who truly isn't sure but open to learning doesn't get any vaccinations the next week or month. They're unlikely to ask good questions about whether an antibiotic is truly needed, whether an x-ray is absolutely necessary, or how to handle a sensitive behavioral health problem if you show no willingness to recognize the difference between a family that doesn't truly know what they don't know and a family who believes their "kid is more special than others." And I'm strongly against delayed vaccination and make a concerted effort to show families why it's not best practice. But refusing to recognize that getting a two-month old vaccinated for pertussis and pneumococcus and haemophilus at the expense of delaying the second Hep B vaccination a bit (i.e. agreeing to two vaccines rather than three or four) is better than sending that infant out completely unvaccinated isn't an ever-so-slightly better option isn't smart either.

I still struggle with this. Unfortunately, I believe two things to be true. 1. Dismissing families who refuse or delay vaccinations will not improve vaccination rates. 2. Including unvaccinated and under-vaccinated families in a practice puts all families in the practice at risk. As frustrated as I am with the second concern, I'm still swayed by the first. I may not always be successful at improving vaccination rates in my own practice -- but I know I'm trying rather than risking funneling these families to practices where other providers may not make the same effort. And I feel like I'm seeing the tide turn a bit. I think our practice is successful in getting folks on the fence to choose vaccination. Like you, I'm now getting nearly as many questions from families who vaccinate about what we (and they) can do about families who do not vaccinate. I may have had that discussion once a year previously. I'm seeing more and more folks supportive of vaccination on Facebook and Twitter actively combat misinformation with helpful links and data than ever before. Families now seem to know -- and are sharing with others -- the truth about Wakefield and the facts about mercury/adjuvants/preservatives. Some even have a working understanding of how the number of antigens has greatly decreased (to combat the "there's too many shots" argument). Unfortunately, it's taken yet another measles outbreak for this to happen. But it's happening.

This will depend on how much range of motion he has by midweek. If his throwing motion will be altered or he's not able to protect himself in the pocket, they won't risk him. They'll need to know relatively early to adjust their game plan. Plenty of comps for quarterbacks who have played through low-grade AC sprains without missing time but it's too early to say which side of questionable he's on.

I've been hesitant to reply but I'm hoping to put together defensive positional tiers again this summer. There may not be as much strategy as in previous years. It may just be a short introductory vignette leading into each table of tiers w/ a line of context. I much prefer the underpromise and overdeliver approach. The combined draft board is very likely to continue in future years. We've made two strong IDP hires in the past month to improve the breadth of our coverage this year. I think Joe will be announcing those soon. Whether it's me or one of our new hires, I think the expectation is for the tier series to continue as well. While I don't believe I can continue the RTD -- -- I'm planning on covering defensive injuries more closely this year and we have at least two additions to the inseason IDP offerings I think everyone will really like. I really appreciate the interest in and the kind comments on the tier features. They take a ton of time to produce to my standards and the first set at each position is the most time-consuming and the basis for every adjustment until the end of the preseason. With some luck, the first set will be done by early June.

I'm sorry you feel your expertise was brushed aside. I value everything that comes into my email inbox. I saved our conversation from 2014 because the information you shared on Andre Ellington was very helpful. At your suggestion, we briefly discussed exchanging emails on injury situations and rehab protocols and I expressed my interest. It looks like the conversation ended there. Thanks for your contribution in the Dez Bryant thread. It's great to have knowledgeable folks willing to help out on the message board.

No ostomy is the ####. Great news, Maurile!

I really hope the Eagles find their way to a 4-3 and re-sign Vinny Curry. That may be the best chance for all three linebackers to hold value. All three are so similar, it's hard to project who will play which role, whether 3-4 or 4-3. And they're all under contract (as is DeMeco Ryans). I'd loosely tier them Kendricks = Hicks > Alonso > Ryans. Alonso was always a bit of a mirage to me, with statistics pumped by the Buffalo stat crew and opportunity. I'm nervous about the ACL, too, though he did surprise with what seems to be a stable recovery from the partial tear. Hicks' pectoral issue shouldn't limit him this offseason. I'd play this the same way we played the CHI situation this summer. Pick the player you feel has the most all-around talent or wait and see who seems most undervalued. We should have a better expectation after the Eagles hire a coach. With any luck, we'll get a personnel assessment around draft time. I think we'll see changes in Miami's depth chart, too. For now, I'd roster only Jelani Jenkins, crossing my fingers he finds a way to be much more durable than he's been as an every-down linebacker. Zach Vigil got some run as an up-and-comer at one point, but never cracked the lineup despite injuries to those ahead of him. OTAs will matter here.

The entire front seven is a mess and the coaching situation is unknown. Among the defensive end group, Jason Pierre-Paul and Robert Ayers are not under contract for 2016 and Owa Odighizuwa has durability concerns. But those would be the three I'd consider rostering through the offseason. JPP still has his legs, but I still have a hard time believing he'll be get back to a dominant two-way end with his hand injuries. He'd be a hold in shallow leagues and a sell high if already rostered. OO is a roster hold in leagues where 30 or more DE are on rosters. He's got the most upside of this group. I believe in his talent and ceiling, but the loss of developmental time this year may delay his arrival. I think he's a more skilled and technically ready version of Demarcus Lawrence, who really struggled early this year in his first real snaps as a pro. Ayers is talented enough to produce when given a good volume of snaps, but his ultimate value is dependent on opportunity. And we won't know that for certain until after free agency and the draft.

I don't anticipate getting a full set of tiers out before getting back from the Senior Bowl in late January. And those will be cursory compared to the first full set of tiers I'll do just after the NFL draft, where I give every team and position group some deep thought as my basis for everything to follow in OTAs, camp and preseason. If you guys would like to turn this thread into a discussion of unclear situations, I'm game to contribute my best guesses at 2016. Hopefully, others will as well.

1-4 weeks. Players return when they have enough strength and range of motion to protect their head/neck. Two caveats here. 1. Bengals do not accurately report their own injuries. This could be muscle strain, ligament strain around the spine or stinger. Variable return estimates with each, some closer to four weeks, some much less. 2. Burfict left last week's game to be evaluated, too. If yesterday's injury was aggravation of that neck condition -- and it feels like it probably was -- I'd err on 2-4 weeks over 1-2 weeks. Probably won't know more -- unless Marvin Lewis feels especially generous today -- until the Thursday/Friday practice reports.

My daughter got all of her shots by age 2. You think her chances of getting any of those were significantly higher because we took a few months longer? A lot of FUD being spread IMO. Define significantly higher. In my community, the number of lab confirmed cases of pertussis is well over 100 in the past few months. That's ten times what it was last year. There was a similar outbreak a few years ago. I've seen three cases myself this season. One of those was a grade school aged child who was dropping to the ground pale and choking with coughing spells. The parents had stopped vaccinating their children because they'd been getting "sick" after those doctor visits. The mom was in tears after the diagnosis. She didn't think the risk was high either. I'm very happy your children are fully vaccinated. I appreciate the concern I hear from families who feel that multiple vaccines stress their immune system too much. As Gian has posted, it's well known that the antigenic load from a set of vaccinations is lower than many other situations children are commonly exposed. In fact, parents who bring their children into a doctor's office for additional shot visits because they've spread out shots are exposing their kids to more potential illnesses than they would have by sticking to the schedule anyway. I don't have a website. I'm not selling books. I'm not selling chelators or diet aids. I'm not getting rich providing vaccinations. I'm in this game to advocate for child health. Vaccinate your kids. On time. And make sure they know how to wash their hands well anyway.