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drgaellon · 1 year ago

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There was a seismic shift in medical ethics in the 1990s, away from the paternalism of the past and towards a new emphasis on patient autonomy.

There is an information asymmetry in the doctor-patient relationship in most cases. It is our job to educate the patient adequately to allow them to make an informed decision. It is enormously frustrating, as a doctor, to be able to see that a patient just doesn’t get it and is making a decision from bad information, inadequate understanding, or false beliefs. If the patient understands the potential negative outcomes of refusal, that is their prerogative. It’s when they DON’T understand the consequences of their choices that things get dicey.

In New York, when a patient refuses treatment, we are forbidden to treat them, even if they don’t/can’t understand the consequences of their decision, unless (a) we get an order from a judge to treat over objection (hard to get and takes two weeks or more), or (b) the doctor judges that a delay may put the patient’s life or health at permanent risk, or (c) a failure to treat may result in immediate harm to the patient or others (i.e. you can sedate a patient who is swinging at nurses, even without consent).

We should always provide the best care we can within the limits of the boundaries set by the patient. For example, I teach now that we should avoid the concept of the “discharge against medical advice.” We have a “shared decision making” discussion and document that the patient is making a decision to leave based on other priorities (priorities with which we, as the medical team, disagree). This happened with one of my patients recently; we documented that it was explained that oral antibiotics were a distant third-line therapy and very likely to fail, potentially resulting in heart damage, heart failure, and possibly death - and then proceeded to prescribe the oral antibiotics anyway, because it was better than letting the patient leave with nothing at all (which is what we would have done 25 years ago when I was in training).

As to things you don’t want withheld from you - if I, as the doctor, feel that the treatment you are requesting is clinically inappropriate, I cannot provide it. Doing so is unethical, and often constitutes malpractice, even if you’re asking for it. As with the AMA discussion, if you are asking for an alternative treatment to the one I’m offering, even if it’s a less-effective substitute, that’s qualitatively different from asking for a treatment I know to be ineffective, or worse, actively harmful. Ivermectin for COVID comes to mind - if you want that, proven to be useless, to the exclusion of the treatments we know work, I’m not going to give it. The risk of side effects outweighs the (non-existent) benefit. In my case above, the risk of no-treatment-at-all outweighs the risk of bad outcome from inadequate-but-better-than-nothing treatment (note the difference between inadequate and ineffective in these examples).

Are there biases in how we decide what’s appropriate or not? Of course; doctors are human, too, and humans have biases, overt and covert. We try to teach awareness and avoidance of bias, especially implicit bias, but it’s notoriously hard to retrain, especially when there are systemic/structural biases that reinforce those implicit personal biases.

Medically speaking, informed consent does not just apply to things you want done to you or for you, it also applies to things that you don't want done to you or things you don't want withheld from you.

I don't think a lot of people realize that, and I don't think a lot of medical professionals want to acknowledge that, because it means they would have to reevaluate the ethics of denying treatment to patients. Also they would have to reckon with their patients' agency and right to self-determination. Both of those things really freak some medpros out.

#medicine #treatment #implict bias #medical ethics

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treeexptwit95 · 8 months ago

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Tree Expert Witness

Understanding Tree Appraisal: The Importance of Hiring an Arborist Consultant

Introduction

Trees are not just majestic features of our landscapes; they are vital contributors to our environment, providing oxygen, shade, and habitat for wildlife. However, assessing the value of trees, whether for insurance purposes, property evaluations, or legal disputes, requires specialized knowledge and expertise. This is where tree appraisal comes into play, and the role of an arborist consultant becomes indispensable. In this article, we delve into the significance of tree appraisal and why hiring an arborist consultant is essential for accurate assessments and informed decision-making.

Understanding Tree Appraisal

Tree appraisal involves assigning a monetary value to trees based on various factors such as species, size, condition, location, and overall contribution to the property or environment. This appraisal serves multiple purposes, including insurance claims, property evaluations, taxation, litigation support, and urban planning.

Factors Considered in Tree Appraisal

Species and Size: Different tree species have varying values based on factors such as growth rate, rarity, and aesthetic appeal. Additionally, larger trees typically command higher appraisal values due to their greater environmental benefits and visual impact.

Condition and Health: The health and condition of a tree significantly influence its appraisal value. Healthy trees with robust structures and minimal defects are valued higher than those suffering from diseases, pests, or structural weaknesses.

Location and Surroundings: Trees situated in prime locations, such as urban areas or scenic landscapes, often have higher appraisal values due to their contribution to property aesthetics, shade provision, and environmental benefits.

Environmental and Ecological Benefits: Trees provide numerous ecological services, including air purification, carbon sequestration, and wildlife habitat. These ecosystem services are considered in tree appraisal to reflect the broader societal and environmental value of trees.

Replacement Cost: In some cases, the cost of replacing a tree with a similar species and size is used as a basis for appraisal, especially in instances of tree damage or loss.

Importance of Hiring an Arborist Consultant

Specialized Knowledge and Expertise: Arborist consultants possess specialized training and expertise in tree biology, health assessment, risk evaluation, and appraisal methodologies. Their in-depth understanding of tree anatomy, physiology, and ecology enables them to conduct thorough assessments and provide accurate appraisals.

Objective Evaluation: Arborist consultants offer an objective and impartial evaluation of trees, free from personal biases or conflicts of interest. Their assessments are based on scientific principles, industry standards, and professional ethics, ensuring reliable and trustworthy results.

Risk Management: Trees pose potential risks to property and human safety, especially when diseased, damaged, or structurally compromised. Arborist consultants can identify hazardous trees, assess their risk levels, and recommend appropriate mitigation measures to minimize liability and ensure public safety.

Legal Support: In legal disputes involving tree damage, encroachment, or liability issues, arborist consultants provide expert testimony, technical reports, and litigation support to assist attorneys, insurers, and property owners in resolving conflicts and reaching fair settlements.

Maximizing Tree Value: Arborist consultants help property owners maximize the value of their trees by providing recommendations for proper care, maintenance, and preservation. Their expertise ensures that trees receive adequate attention and protection, thereby enhancing their longevity and overall contribution to the environment.

Conclusion

Tree appraisal is a complex process that requires careful consideration of various factors to determine the value of trees accurately. Hiring an arborist consultant is essential for conducting thorough assessments, mitigating risks, and making informed decisions regarding tree management and conservation. By leveraging their specialized knowledge and expertise, arborist consultants play a crucial role in preserving the ecological, aesthetic, and economic value of trees in our communities. Whether for insurance claims, property evaluations, or legal disputes, investing in professional arborist services ensures that trees are valued and managed responsibly for the benefit of present and future generations.

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treeappra875 · 9 months ago

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Tree Appraisal

Understanding Tree Appraisal: The Importance of Hiring an Arborist Consultant

Introduction

Understanding Tree Appraisal

Factors Considered in Tree Appraisal

Replacement Cost: In some cases, the cost of replacing a tree with a similar species and size is used as a basis for appraisal, especially in instances of tree damage or loss.

Importance of Hiring an Arborist Consultant

Conclusion Tree appraisal is a complex process that requires careful consideration of various factors to determine the value of trees accurately. Hiring an arborist consultant is essential for conducting thorough assessments, mitigating risks, and making informed decisions regarding tree management and conservation. By leveraging their specialized knowledge and expertise, arborist consultants play a crucial role in preserving the ecological, aesthetic, and economic value of trees in our communities. Whether for insurance claims, property evaluations, or legal disputes, investing in professional arborist services ensures that trees are valued and managed responsibly for the benefit of present and future generations.

#Tree Appraisal

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the-rings-system · 5 years ago

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You mentioned on your recent livestream that being diagnosed with DID/OSDD can lead to discrimination in terms of organ donations, adoption, etc. Could you provide your sources? I'd like to show them to our therapist. Thank you.

Tw: ableism, organ donations, adoptions.

If you check the description, we wrote about discrimination in organ donations there. For those who didn’t see, here’s what we wrote in the description:

On being denied organ donations with a DID diagnosis: Here's a 2017 paper that gives a review of psychiatric patients being denied organ donations/transplants and argues that it is unethical to block these communities from receiving lifesaving operations (however, there’s no concrete evidence of change since this paper has been published 3 years ago): https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-017-0235-4 "More than 50% of cardiac programs recognized a number of psychosocial conditions as an absolute contraindication to transplantation, including: active schizophrenia (defined as schizophrenia with active psychotic symptoms), a recent suicide attempt, a history of multiple suicide attempts, current suicidal ideation, and medical noncompliance. Both active schizophrenia and current suicidal ideation were also listed as absolute contraindications for at least half of renal and liver transplant programs." Many of these centers don't even recognize DID as it's own disorder, instead lumping DID folks in with personality or psychotic disorders. "The variability of respondents’ opinions also highlights the presence of inter-institution inconsistency, creating disparity in the treatment of similarly situated individuals across transplant centers, and raises questions about the extent to which current practices follow the recommendations of professional associations."

Here's a 2020 paper detailing how a woman with DID who had been through years of specialized treatment and achieved healthy multiplicity was blocking from donating her kidney due to DID, because she chose to not integrate: https://www.sciencedirect.com/science/article/pii/S0033318220300025 "Following the initial evaluation, members of the living donor team met to discuss the case and next steps. Given the concerns for possible lack of reliability in her narrative, we obtained Mrs. A's permission to speak with her treaters and spouse to gather further history. The psychiatric team also reached out to local expert DID clinicians to discuss the case and risk assessment." "According to our review of the literature, factors in Mrs. A that predicted a better postdonation outcome included her history of intensive, specialized treatment for DID, and the lack of conflict among her self-states, with all of them reportedly in agreement with donation. The lack of integration of these self-states, however, may have predisposed her to increased symptomatology were she to donate. Her long-term sobriety and absence of suicidal or self-injurious behaviors, as well as apparent occupational and relationship stability, suggested a general higher degree of psychosocial functioning. Her history of participating in altruistic activities indicated that her current decision-making capability and behavior were in line with consistent values, as well as indicating a capacity for higher level defense and adaptive coping mechanisms." "She had gone through 3 surgeries for various medical conditions and tolerated these well, which was felt to be reassuring." "During the psychiatric assessment, she maintained her central personality for the duration of the session, was able to demonstrate a clear and consistent choice, and conveyed an appropriate understanding and appreciation of the risks and benefits of renal donation, with adequate manipulation of the relevant information. She also endorsed adequate financial and social support in place such that donation would be feasible for her from a logistical perspective." Regardless, she was still denied due to "The general sense of unease this individual provoked among the members of the [organ donation] treatment team despite her having some reassuring characteristics and protective factors, illustrates the need for clearer guidelines for assessing individuals for altruistic renal donation." TLDR: Can you imagine after years of receiving therapy, being sober, being in recovery, having a stable healthy relationship, having healthy internal communication, volunteering humanitarian aid in war-torn areas (she reported this) and then showing up to donate your own kidney - and after multiple interviews with you, your spouse, and every doctor under the sun - still being denied because "you haven't integrated and your disorder makes us uneasy." I have no words. I can't imagine the hoops you'd have to jump through to receive a transplant if that's how many barriers she faced trying to give one.

On adoption: A lot of our knowledge comes from working within groups/organizations that focus on helping folks with severe/highly stigmatized mental illness. However, a simple google search yields plenty of results! https://www.mdedge.com/psychiatry/article/76413/practice-management/adoption-mentally-ill-individuals-what-recommend “Because child adoption laws vary from state to state, there are no established criteria for determining the eligibility of an individual with a history of mental illness. The success of a child adoption by an individual with a history of mental illness will depend on state laws and the policy of the adoption agency. Some U.S. states and territories (Alaska, Arizona, California, Kentucky, North Dakota, and Puerto Rico) regard parental mental illness as “aggravated circumstances.”

https://www.adoptuskids.org/adoption-and-foster-care/overview/who-can-adopt-foster/people-with-disabilities “We also know that many parents with disabilities feel discriminated against when undertaking the adoption process.” “Parents with disabilities are more likely to lose custody of their children after divorce, have more difficulty in accessing reproductive health care, and face significant barriers to adopting children. The National Council on Disabilities has documented societal biases and systems barriers that affect parents in a report called Rocking the Cradle.” https://www.ncd.gov/publications/2012/Sep272012/Ch10 (This one just keeps going) “Adoption horror stories are all too common for prospective parents with disabilities. The adoption system is riddled with de facto and de jure discrimination that prevents countless prospective parents with disabilities from adopting. Examination of domestic and international adoption practices reveals that reforms are urgently needed across the broad spectrum of adoption practices and procedures.” “Despite the ADA and Rehabilitation Act, prospective adoptive parents with disabilities regularly encounter barriers erected by discrimination and bias. According to Elizabeth Bartholet, Harvard Law School professor and one of the nation’s leading experts on adoption, “Discrimination is the name of the game in adoptive parenting. Those who procreate live in a world of near-absolute parenting rights. Those who would adopt have no rights. They must beg for the privilege of parenting and do so in a state-administered realm that denies them both the right to privacy and the civil rights that we have come to think of as fundamental. Differential treatment on the basis of age, race, religion, and disability has been outlawed in almost all areas of our communal lives in the United States. Increasingly the law forbids discrimination on the basis of marital status and sexual orientation. It is only in the area of adoption that our system proclaims not simply the right to discriminate on all these bases but the importance of doing so. It is not just the prospective parents who are treated shabbily, but also the children, in whose best interests the system is supposedly designed.” Dave Shade says, “The adoption process is complex, and because it frequently involves personal judgments by parents, social workers, judges, and other adoption professionals, it is fraught with the opportunity for discrimination.” “Despite the ADA mandates, research demonstrates that a significant number of adoption agencies continue to categorically deny prospective parents with disabilities. In 2010, researchers from Northwestern University completed a study that examined the experiences of prospective adoptive parents who were cancer survivors.[736] The study was aimed at the attitudes of the adoption agencies. Of the 27 agencies that were interviewed, 7 admitted that certain medical conditions would prevent people from adopting through their agency. They cited a variety of illnesses and medical conditions that included “contractible diseases; AIDS; active, life-threatening diseases; use of antidepressants; terminal illnesses that shorten lifespan; conditions that require a large amount of narcotics that render the person unconscious; substance addiction; and severe mental conditions like schizophrenia... The researchers concluded, “Although existing legislative documents such as the Americans with Disabilities Act (ADA) protect cancer survivors’ rights to adopt a child, these protections are largely inconsequential in practice…. [The] network of adoption agencies working with potential parents in the U.S. is characterized by fundamental variability and ambiguity…[and] the current adoption system permits informal prejudice in practice that likely varies from one agency to the next.” “In addition to categorically denying prospective parents with disabilities, domestic adoptions frequently engage in other discriminatory practices. Bartholet says that prospective adoptive parents are subject to an unspoken “ranking system.” That is, the domestic adoption system ranks prospective parents in terms of relative desirability, “using factors that reflect the system’s bias in favor of a biologic parenting model, as well as a socially traditional family model.” Pursuant to this ranking system, “Heterosexual couples in their late 20s or early 30s with apparently stable marriages are at the top of the ladder. These are the people who can, if they are not infertile, produce children, and who should in the system’s view be parents. Single applicants and those in their late 30s and 40s are placed lower on the ladder, along with people with mild disabilities. Gays, lesbians, and those who are significantly older or seriously disabled are generally excluded altogether.” “However, some states specifically deny prospective parents with disabilities the opportunity to adopt. As recently as December 2011, Virginia erected an enormous impediment by approving regulations that allows adoption agencies to discriminate against prospective adoptive parents based on six categories, including disability.” “Conclusion: Around the world, countless children are waiting for their forever homes. At the same time, many people with disabilities want to provide a loving and nurturing home and family for children. Ignorance, stigma, and misconceptions are forestalling harmonious solutions. The result is devastating: Children spend many years in deplorable conditions in foster care and orphanages, while people with disabilities are robbed of the opportunity to welcome these children into their homes and hearts.”

Here’s a long paper published in 2017 about discrimination in adoption for folks with disabilities, based in Australia: https://www.mdpi.com/2075-471X/6/3/15/pdf

We’ve also talked with older members of the mental health community who directly know people who’ve had prison sentences be unjustly extended due to a diagnosis of schizophrenia/DID, but I’m too exhausted to find sources that back that up. I’m sure with a couple google searches you could easily find information on discrimination towards psychiatrically disabled folks in the law system as well.

We have also has multiple friends with DID diagnoses (3 within our circle) be denied or nearly denied transgender medical care (either hormones or surgery) after their diagnosis of DID was made known to their doctors. One friend ended up getting back on hormones after a months of “proving” that they were trans with their DID specialist (but they’re unsure whether they’ll be able to access surgery). Again, too exhausted to find “real” sources for this one other than the pain of my community.

As we talked about, we’ve also been gently sat down by older DID community members to have the conversation about “hey, you’re young and full of spirit and that’s great, but you need to be aware that your youtube channel might impact your ability to get a job and other things.” And considering that research shows 80% of folks with schizophrenia are unemployed, even thought 70% would prefer to work, discrimination is still rampant. You can be fired from your job for being gay, you can be fired from you job for having DID.

Sorry that’s a lot, stay safe, and remember: diagnosis can come with a lot of downsides. Talk through it with your therapist on whether it’s the right choice for you, and really think about how it can impact your future.

#silver.speaks #long post #tw ableism #tw organs #?#tw adoption #Anonymous #ask

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woman-loving · 4 years ago

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Selection from "Widening the Dialogue to Narrow the Gap in Health Disparities: Approaches to Fat Black Lesbian and Bisexual Women's Health Promotion," Bianca D.M. Wilson, in The Fat Studies Reader, ed. Esther Rothblum and Sondra Solovay, 2009.

Although the relationships between weight and health are unclear, major systemic factors experienced by many Black lesbians and bisexual women, such as racism, anti-fat discrimination, sexism, poverty, violence, and heterosexism, are powerful detractors from health (physical, emotional, and mental) and should be considered in a meaningful way as targets for public health intervention. The health consequences of various intersecting oppressions on the lives of Black lesbians and bisexual women can be understood and addressed at individual, interpersonal, and systemic levels. At the individual level, it may be fruitful to examine empirically the moderating effects of psychological stress due to the experience of intersecting forms of oppression on the physiological health of fat Black lesbian and bisexual women. That is, what are the psychologically mediated health effects of discrimination due to being a fat, Black, sexual minority woman? Drawing from the broader research on the psychophysiological effects of stress, Black scholars have studied the direct relationships between racism and various indicators of health among African Americans (see Bowen-Reid & Harrell, 2002, for review; see also Clark, Anderson, Clark, & Williams,1999). Through these studies, they have illustrated that in addition to genetics and behavior, structural forces such as discrimination and systemic oppression affect health, potentially through the physiological effects of stress (McEwen & Seeman, 1999). An ecologically valid approach to fat Black lesbian and bisexual women’s health would avoid a narrow focus on weight loss and expand the levels of analysis to identify additional important factors affecting health within this community. Once we commit to studying the effects of contextual factors on health in African American and lesbian/bisexual women’s communities, thereby expanding a medical model that is currently neither focused on nor equipped to address systemic factors associated with health, we will increase our capacity to develop effective health promotion programs. Public health researchers and interventionists can work with community, health, and social psychologists, as well as community organizers, to promote oppression coping and resistance strategies that optimize our chances of buffering the physiological effects of systemic discrimination due to size, sexuality, race, and gender.

Research that accounts for the effects of oppression on the lives of fat Black lesbian and bisexual women through physiological responses would the hopefully also lead to contextually focused interventions that directly target structural roots of oppression that serve as barriers to those women’s wellness. Such interventions may be in the form of legislative and political action, such as targeting discriminatory health insurance company policies that deny insurance to people who are categorized as overweight or obese regardless of other markers of health. These policies leave many fat Black lesbian and bisexual women un- or underinsured (which is particularly troubling because these individuals are already at high risk for being underinsured as Blacks, sexual minorities, and women). Other forms of structural interventions include culture work through the arts to raise awareness and encourage critical dialogue about the ways that fat Black lesbian and bisexual women exhibit health in their everyday resistance to oppression. Although suggesting these strategies for social change is not in and of itself innovative on my part (as I have borrowed these ideas from the many activists in my life), it would require a radical shift in current public health strategies to view environmental, power structure, and cultural change as equally, if not more, important work than discrete health behavior change. For example, over twelve years ago Angela Davis (1994), in her essay “Sick and Tired of Being Sick and Tired: The Politics of Black Women’s Health,” advocated for structural health interventions that increased access to health care and opportunities for overall well-being, such as the eradication of poverty and the creation of a universal health care system. Specific to the effects of racism on health, but relevant to the study of the effects of multiple forms of oppression on Black lesbian and bisexual women’s health, Krieger (2003, p. 197) similarly argued, “The point is that neglecting study of the health impact of racism means that explanations for and interventions to alter population distributions of health, disease, and well-being will be incomplete and potentially misleading, if not outright harmful.”

For fat Black lesbian and bisexual women, it is important to note that in addition to racism, we must also negotiate the realities of heterosexism (Eliason & Schope, 2001), sexism (Krieger & Fee, 1994), and anti-fat bias (Harvey & Hill, 2001) within the health care system. The fact that fat Black lesbian and bisexual women sit at the intersections of all these marginalized identities cannot be overlooked in our efforts to acknowledge the ecology of our health care experiences. Typically, however, larger-than-average weight among Black women is viewed as a symptom of the deleterious effects of other forms of oppression, and the effects of anti-fat bias within society (including within the health professions) on Black women’s health are often ignored. I have heard numerous fat Black lesbian and bisexual women say that health providers willingly ignore their reported symptoms and concerns, choosing instead to reduce all health complaints to symptoms of their weight or a combination of being Black and fat. Anecdotally, this type of dismissive and frustrating experience that fat patients have with their health providers appears to lead to poor care, and in many cases patients eventually choose to stop accessing the health care system altogether. Research claiming that weight is highly predictive of the health statuses of people of any group systematically discriminated against by health providers is incomplete without an analysis of the confounding effects of low-quality healthcare. To what extent does poor treatment in health care systems due to size, race, gender, or sexuality account for previously identified correlations among weight, disease, and death for fat women? How do problematic, as well as positive, experiences with health care providers affect health care access rates among fat Black lesbian and bisexual women? In turn, do limited health care access behaviors in response to negative experiences with providers predict future health problems? These are some of the questions that researchers would be asking if they approached the study of health among fat people without an anti-fat bias and if they considered the full ecology of fat Black sexual minority women’s health care. Research addressing questions like these can also help inform health provider–focused interventions designed to reduce negative biases against any and all of the communities to which fat Black lesbian and bisexual women belong.

Currently, there are various forms of cultural competency trainings that have been designed to address heterosexist, racist, and sexist policies and procedures in the health care system. A next step would be to develop and disseminate trainings that also address the stigma experienced by fat people, particularly because contemporary fat prejudice is partially justified through medically based arguments (Campos, 2004). With adequate health care and freedom from oppression, what would fat Black sexual minority women’s health look like? A paradigm shift whereby health is truly constructed as a sociocultural phenomenon as much as a physiological one would lead to systemic-level interventions in which social justice work becomes a viable form of public health intervention.

Neither Placating nor Destroying Black Lesbian Women’s Culture

Though moving toward a social change paradigm in public health is an ideal that I hold, I recognize that this may be, at the least, a slow-moving shift. Given this, we still must determine appropriate ways to pursue various forms of individual-level interventions that promote health and well-being in Black women’s communities. I argue that our efforts to target health behaviors, however, should be grounded in the cultural values of Black sexual minority communities. Research suggests that both African American and lesbian communities, separately and at their intersections, have greater appreciation for women of larger-than-average sizes than that of the dominant, patriarchal, Euro-centered, heterosexist society. African American women have been found to exhibit lesser levels of body dissatisfaction as compared to White women, despite being generally heavier than White women (Celio, Zabinski, & Wilfley, 2002; see also Lovejoy 2001, for review). Also complementing the perspective that “big” is or can be beautiful, my own anecdotal experiences in Black communities have illustrated that heavier women have often been noted to be associated with health by the use of the term “healthy” to describe larger-than-average, attractive women. Similarly, lesbian participants in body image research have reported lower levels of body dissatisfaction as compared to heterosexual females (Owens, Hughes, & Owens-Nicholson, 2003; Rothblum, 2002). Although these studies’ representations of African American and lesbian communities as accepting of large body sizes may not fully capture the complexity of esteem and body image among these groups, the empirical literature does suggest that there may be existing cultural values among these minority groups that support a higher value of body size diversity than found in mainstream U.S. culture.

As such, the relationship between the public health industry and African American and lesbian communities’ culturally based values regarding body image is at a contentious place. Although many African American lesbians may appreciate body diversity and even view larger bodies as healthy, we are constantly confronted with the medical industry’s view of our large bodies as inherently diseased and problematic. Several researchers examining weight among African American women and lesbians have called for culturally specific approaches to health promotion efforts that take this tension into account, but their intent appears to be to identify ways to sensitively get Black women to be thinner (Lovejoy, 2001; Yancey, Leslie, & Abel, 2006). Yet scholars have not adequately provided evidence that smaller bodies will equal greater health among African American or sexual minority women, which would justify the risk of changing a community’s healthy norms toward body diversity. Though the practice of culturally grounding health promotion work may involve challenging cultural norms and values that promote illness and disease transmission (Wilson & Miller, 2003), the goal of public health work should not be to convince a group of people that their sense of themselves is inherently unhealthy and problematic. Rather than a focus on weight loss, an approach that balances cultural beliefs of beauty and health with well-intended health promotion messages to encourage healthy nutrition intake and physical activity would be most appropriate. For example, health promotion programs that facilitate all Black lesbian and bisexual women, not just those who are fat, to maintain physically active lives and to eat foods that help them maintain that lifestyle would be a start in the right direction. This type of program communicates the importance of nutrition and activity in the lives of all people, and does not make erroneous assumptions of health status based on weight, categorizing fat women as “needing” healthy foods and exercise while categorizing thin women as “fine the way they are.”

#lgbtq #health #fatphobia #black women #women of color #fat women #bianca dm wilson

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fairfieldthinkspace · 5 years ago

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Coronabias and the Fat Tail

Philip Maymin, PhD

Professor of analytics and director of the Master's in Business Analytics program at the Fairfield University Dolan School of Business.

Originally published by Essentia Analytics.

Behavioral science has done a marvelous job of pointing out the mistakes most human beings make in estimating probability, and the extent to which we are influenced by each other, in making irrational decisions.

As a form of criticism and a prod for clearer thinking, these discoveries are invaluable. However, whereas behavioral science does a great job of describing human decision-making in light of normal (good and bad) events, we must be careful when applying it to “fat tail” events, like a global pandemic.

We should all, at the very least, be aware of our biases – we can control our own behavior, provided we can see it for what it is. But the behavioral insights we’re referring to are based on robust, appropriate data about the past. For those trying to predict human behavior in the context of coronavirus, that data isn’t easy to come by.

Behavioral scientists (and politicians, for that matter) who assume that the public is behaving irrationally would do well to consider that they themselves are falling prey to a form of meta bias: an ironic application of the curse of knowledge and the illusion of control, manifest in the assumption that people are idiots.

Nowhere has this been more evident than in the case of the current pandemic. From the start — though their tone has moderated over the last few days — experts were jumping over themselves to explain how overblown our fear is and how foolish we are to stock so much toilet paper.

Perhaps it is these experts, and not the rest of us, who are “coronabiased.”

“I am not scared of COVID-19,” infectious disease expert Abdu Sharkawy of the University of Toronto recently wrote. “What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world.”

In a similar vein, legal scholar and Harvard law professor Cass Sunstein confusingly wrote, “At this stage, no one can specify the magnitude of the threat from the coronavirus. But one thing is clear: A lot of people are more scared than they have any reason to be. They have an exaggerated sense of their own personal risk.” One wonders how a threat with literally unspecified magnitude in one sentence can suddenly become exaggerated by the next.

But fear of coronavirus is not irrational. Individual people can see the potential for this infectious disease to incur tremendous damage to their own lives, as well as to global economies – it’s got fat-tail event written all over it. Some people will have jumped straight to preparing for the worst case scenario, and some will have started by assuming the best case. As new data come in from trusted sources, we are all adjusting our behavior and making decisions under uncertainty, not just about the spread of the disease but about the knock-on effects on our day-to-day lives.

Calling people irrational for being more afraid of coronavirus than they are of car accidents misses the point that these are two very different risks: the worst day ever of car accidents, while sad, won’t change much about the world. The worst day ever of coronavirus can paralyze a country, a continent, or a global economy. That’s the fat tail – and it’s not irrational to prepare for it, when you’ve seen evidence pointing in its direction.

One of the few people who consistently makes this point is Nassim Nicholas Taleb, author of The Black Swan and numerous other books and mathematical articles that prove a variety of facts about tail risks. One of his major findings, which goes some way to justify human behavior in light of coronavirus, is that whatever worst case we have seen so far is, it’s nothing compared to what might come next.

For investors, perhaps our most important lesson is to separate our market behavior from our personal behavior. If you can remain rational and detached in evaluating market conditions, then go home and stock up on toilet paper, that’s much better than the other way around.

In times like this, when other aspects of our lives are being disrupted, it is especially difficult to stick to your investment process. It’s worth having a close look at how your process has held up to times of massive uncertainty and paradigm changes — for example, the 2016 US election and Brexit. In those cases, did we stick to our investment process? Did we override it? Which approaches turned out better, and why?

It’s important and valuable to spot and predict behavioral biases in yourself and others, but it’s counterproductive to infer that humans are stupid or automatons. People are indescribably brilliant. Human knowledge is, in fact, the only possible source for a solution to the coronavirus.

#Phil Maymin #Fairfield University #coronavirus #fat tail

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dailyhealthynews · 3 years ago

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WHO reports; how can Artificial Intelligence hold great promise for improving healthcare and medicine delivery worldwide?

According to the World Health Organization, Artificial Intelligence (AI) holds great promise for improving health and medical care worldwide, but only if ethics and human rights are prioritized in design, delivery and application (WHO). The WHO report Ethics and Governance of Artificial Intelligence for Health is the result of two years of deliberations by a group of global experts appointed by the WHO.

“Like any new technology, artificial intelligence has immense potential to improve the health of millions of people around the world, but like any technology, it can also be exploited and harmed,” said Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization. This significant new research provides a valuable roadmap for countries to take advantage of AI while limiting their risks and avoiding their pitfalls. “

Also read: Digitization of the healthcare industry

Artificial intelligence can and is used in some wealthy countries to improve the speed and accuracy of disease diagnosis and screening; to help with clinical care; Strengthening health research and drug development; and support a variety of public health interventions, such as disease surveillance, outbreak response and health system management.

AI has the potential to empower people to better control their own health care and better understand their changing needs. It could also help resource-poor countries and rural regions, where patients often have limited access to medical or healthcare professionals, to close gaps in access to health services.

However, the latest report from the World Health Organization, dated June 28, warns against overestimating the health benefits of AI, especially when it comes to the essential investments and actions required for universal health coverage. He also mentions obstacles and threats such as the unethical collection and use of health data, algorithms inherent biases and the risks of AI to patient safety, cybersecurity and the environment.

While private and public sector investment in the development and deployment of AI is critical, the unrestrained use of AI drives the rights and interests of patients and communities into the financial goals of tech companies or government interests in terms of surveillance and social control subordinate. The study also notes that systems trained primarily on data from people in high-income countries may underperform when applied to people in low- and middle-income countries.

Therefore, AI systems need to be carefully designed to reflect the diversity of socio-economic and health situations. They should be accompanied by training on digital skills, community engagement and awareness, especially for the millions of health workers who need digital literacy or retraining when their roles and functions are automated and who are grappling with machines that may have a The challenge is decision-making and the autonomy of providers and patients.

WHO recommends the following principles as the basis for AI regulation and governance to reduce the risks and maximize the opportunities associated with the use of AI for health:

In the health care context, this means that people should be in control of health systems and medical decisions; Privacy and confidentiality should be preserved, and patients must provide valid informed consent through an appropriate legal framework for data protection.

AI technology designers must meet regulatory standards for safety, accuracy and effectiveness for well-defined use cases or indications. Measures for quality control in practice and quality improvement in the application of AI must be provided.

Ensure transparency, explainability and comprehensibility. Transparency requires the publication or documentation of adequate information before any AI technology is designed or deployed. This data needs to be freely accessible to allow meaningful public participation and debate about how the technology is created and how it should or should not be used.

Develop a sense of responsibility and responsibility. While AI technologies are capable of performing certain tasks, it is the responsibility of stakeholders to ensure that they are used under acceptable conditions and by appropriately qualified individuals. Individuals and groups harmed by algorithm-based decisions should have access to effective channels for challenge and remedy.

Ensure inclusiveness and equity. Inclusion requires that AI for health should support the widest possible fair use and as equitable access as possible, regardless of age, gender, poverty, race, ethnicity, sexual orientation, skills or other characteristics protected by human rights.

Promote responsive and long-term AI. AI applications should be evaluated continuously and transparently by designers, developers and users to see whether AI is responding effectively and appropriately to expectations and requirements.

In addition, AI systems should be developed in such a way that they have a low environmental impact and increase energy efficiency. Governments and businesses should prepare for anticipated workplace disruptions such as: B. Training for healthcare workers to adapt to the use of AI systems and likely job losses due to the use of automated systems.

Summary

item name

WHO reports; How can artificial intelligence have great potential for improving healthcare and drug delivery worldwide?

description

This significant new research provides a valuable roadmap for countries on how to take advantage of AI while limiting its risks and avoiding its pitfalls. “

author

TPT news bureau

Editor’s name

THE POLITICS TIMES

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source https://dailyhealthynews.ca/who-reports-how-can-artificial-intelligence-hold-great-promise-for-improving-healthcare-and-medicine-delivery-worldwide/

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maryswaysofseeing · 4 years ago

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Money, Power, Education (2/22)

For Monday’s class, the readings focused on how public schools receive their funding. The New Teacher Book provides some foundational stats as well as more nuanced insight about education’s depraved financial situation. In his piece School Funding Basics, Stan Karp states that state and local sources provide for 90% of school funding while federal funding only covers about 10%. This obviously largely impacts the students of poorer distracts. Sometimes the funding is so lacking that it’s not only unethical but actually illegal. Because funding is based on politician’s whims and biases and not actually student or school staff need, there is a lot of room to rob from education. On top of that, the “over-reliance on local property taxes also contributes to funding inequalities [...] with different tax bases” aka as long as so much of school funding is tied to private property taxes there will always be a gap in the quality of education in low-income, medium-income and high-income areas. This 90-10 (statelocal - federal) funding model is so problematic it makes me wonder what would happen if we flipped it so it was 90% federal funding and 10% state, local. Would we see the poorer states rise to meet the richer states? Not only does this mostly affect poorer, browner and blacker schools but it also majorly affects students with special needs. When reading through the history of policies that affect those with special needs such as FAPE, IDEA and others, the government has been slow and conservative when pushed to give more than the bare minimum. This reading also reminds me of Endrew F vs Douglas County Schools where Endrew’s parents were advocating that IDEA should grant their autistic school an education “appropriate” to his ability not just an “adequate” one that takes the least amount of resources/money. Unfortunately The School won the case and Endrew’s parents put their son in a private school that better supported his growth. But not all parents can afford to do that. The slashes to public budget make way for gross privatization which further stunts resources and puts communities in a type of capitalistic chokehold. Opportunistic politicians profit off of this systemic failing. Cuomo has cut billions off the budgets of the schools with the highest needs for a decade now. During the pandemic when schools were getting much-needed additional funding from the CARES Act, he slashed their regular education budget so to cancel out the additional help in the time of a crisis. Bill Deblasio has mandated a school hiring freeze for the last few years to pull tenured teachers out of purgatory at the expense of students learning needs. There is hope though, like the teachers in Chicago, we must continue to fight in solidarity. The other essay in The New Teacher Book, “Aren’t You on the Listserv?” goes into the reasons and remedies of the disparity in who’s parents are represented in school involvement. The majority of white people involved in this diverse school reminds me of the “Nice White Parents” podcast and how a small group of white parents took over the PTA of a mostly black school in Brooklyn. The teacher and author implements a bunch of strategies to make involvement more equitable and finds a lot of success! One thing she did was to make every home notice in both spanish and english and to put spanish on top. I thought this was cool and also made me realize my own small bias- whenever I fill out online forms I expect USA to be on the top of an otherwise alphabetized country list... and this is just one small way it is engrained in me the false narrative of US superiority.

#thenewteacherbook #cuomo education #social justice education

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goosegoblin · 7 years ago

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while we’re at it, imma just list all my discourse-inducing opinions here to get it out of my system

feel free to ask for clarification, unfollow, ignore, etc etc. as long as you aren’t a dick, i’ve got no problems with any of that <3

- asexual + aromantic people are part of the LGBT+ community

- drag isn’t inherently transphobic

- trans women are women and TERFs are bad people

- you can want/ work towards a cure for a condition while respecting people with that condition. it’s sure as shit not ableist to want a cure for your condition

- ableism doesn’t get enough attention and is left out of many social justice movements

- mentally ill ppl need to stop silencing the struggles of physically ill/ disabled ppl for the sake of making a point (i.e. those comics/ videos that show people telling physically disabled people to just ‘walk it off’ or ‘just try yoga’ to try and highlight how wrong it is to do that to mentally ill people)

- ideally, we should all work towards eating less meat and fewer animal products. you aren’t a bad person for not doing this, but you are kind of an asshole if you mock vegetarians/ vegans

- climate change is a fuck-off huge problem and we all need to be panicking about it a lot more than we are

- people with paedophillia who have never offended and want to get better deserve help and support, not hatred and death threats

- OCD is still very poorly understood and rarely portrayed correctly by the media and I really wish there was more shown of the obsessive side of it

- using mental illnesses as adjectives (’can we change the volume to an even number? sorry, I’m OCD about that’; using ‘anorexic’ to mean ‘skinny’; misuse of the term ‘psychotic’) is a bad thing to do. it’s not language evolving, it’s misusing terms in an offensive way that belittles mental illness

- the mental illness advocacy movement needs to push awareness of less ‘acceptable’ conditions. i want stuff on psychosis, bipolar disorder, severe OCD, personality disorders, intermittent explosive disorder, addictions, binge-eating disorder. i’m sick of advocacy being for skinny white girls in big grey jumpers with anxiety and depression. don’t get me wrong, those girls deserve support (hell, i am one of them). but goddamn, advocacy cannot work by putting your ‘prettiest’ issues forwards and hiding the ones at the back that are harder to dress up

- i’ve basically never encountered a well-written anorexic character (bar maybe Tix from MMFD) and I very much wish people without eating disorders would do a LOT more research before attempting to write them

- asking for a source/ fact-checking is in no way a bad or offensive thing. ‘jfc couldn’t you just google it?’ doesn’t work when the burden of proof is on you

- feminism is equal rights for all genders. men’s problems deserve help & attention, but not in a way that overrides or ignores women’s problems. the same is true of the opposite. that being said, feminism focuses on women because more often than not, it’s women are being looked down on and treated poorly.

- donald trump is a dangerous and stupid man and i really can’t believe he is the president, what the literal fuck

- the tories are dangerous and i loathe theresa may

- calling women whores, sluts etc is slut-shaming and basically never necessary. ‘bitch’ is a hilarious word when used appropriately (see: Aaron Paul, Glenn Howerton) and is awful in its standard use of meaning ‘any woman who dares speak her mind’. i prefer to reserve the use of ‘cunt’ for people who have hit a significant level of evil. there are very few people who have met this for me, but katie hopkins is one

- the daily mail should be shut the fuck down

- brexit is an awful fucking idea

- if you cannot take care of a pet adequately for whatever reason, you should take action to get the pet to a home where it can be taken care of well. pets are a privilege, not a right.

- there is no real need for white people to have a significant voice in discussions about racism

- pornography is like alcohol: in an ideal world, it wouldn’t really exist/ be used, but we aren’t in that world. most people can use it in moderation and not have a problem with it; some people become addicted to it, and they deserve support to overcome that.

- addiction is a disease and addicts deserve support & help. you can become addicted to essentially anything, and making fun of people for their addictions makes you kind of shitty

- mental illness is an explanation for poor behaviour, not an excuse. if you did a fucked-up thing due to anxiety or depression or mood swings, you still need to accept responsibility and apologise

- if alcohol and tobacco are legal, weed should be legal. legal does not mean ‘this has no risks and everyone should do it’- it means people should be able to make their own choices about whether or not they want to use it, based on actual fact and reason and not heavily biased anti-drug sources

- family is chosen. ‘blood’ and ‘shared DNA’ means very little. you are under no obligation to ever stick with an abuser.

- prostitution has always existed and always will. it should be legalised and regulated, and the people working in it should be protected

- the demonisation of sex workers is very fucked up. you can’t demand a service (e.g. watching porn) while demonising/ belittling the people who provide it (see also: fast food service)

- if two consenting adults want to do something in private, they can go ahead and do it. i’m not into policing how people fuck. if a grown woman wants to get tied up and spanked, it’s patronising and offensive for me to start lecturing about how her childhood and mental illness might have influenced her choices.

- incest ships weird me out, but like, you do you.

- marketing food as ‘guilt-free!’ or ‘sinful...’ is gross and implies eating is a moral choice, which it never is

- goat’s cheese is awful. just awful.

- you can basically cook anything and everything at 200C

- crocs are the worst shoes to ever be invented

- skyler white deserved so much better

#a whole lot of wank for ts

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m7-hacertanrikulu-blog · 8 years ago

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What I knew & What is new

I consider myself as a knowledgeable person. I also consider myself as a humble, modest person with a good sense of humor. Being knowledgeable for me means acknowledging that there are no limits to knowledge. My attitude is to improve my aptitude to observe and listen to anyone and to learn from everyone since nobody knows everything but everybody knows something.

I’ll dedicate this entry to share some of the knowledge I’ve gained as an intern at ICDC in the last weeks and hope you keep an open mind to take some of it in. Besides, it is in my deep intention to inform all and inspire some to become active volunteers to support ICDC’s main mission to protect breastfeeding through monitoring industry’s compliance with the Code. I hope I haven’t lost any readers up to this point.

Code Summary

I would like to give you a short summary of the Code which will give you a good overview of its AIM, SCOPE and CONTENT. This will basically enable you to obtain fundamental monitor skills to report Code violations back to IBFAN-ICDC.

AIM

The aim of the Code and subsequent resolution is “to contribute to the provision of safe and adequate nutrition for infants and the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing distribution”.

I want to stress one important fact right away: The Code does not stop or prevent companies from selling products covered by the s Scope of the Code. The Code only BANS companies to promote these products.

SCOPE and Definitions

The Scope applies to all breastmilk substitutes or any foods being marketed or otherwise represented as a partial or total replacement for breastmilk. It also covers feeding bottles and teats.

A breastmilk substitute should be understood to include any milks …, in either liquid or powdered form, that are specifically marketed for feeding infants and young children up to the age of 3 years including follow-up formula and growing-up milks.”

Therefore, the Scope includes following products

Infant formula (for infants age 0 - 6 or 12 months)

Follow-up milks* (normally marketed for children 6-12 or 24 months)

Growing-up milks* (normally marketed for babies 12 – 36 months)

Bottle-fed complementary foods*

Foods and beverages such as cereals, jarred foods, juices, infant teas and mineral water that are represented as suitable to be fed to infants less than 6 months old*

The Code also applies to feeding bottles and teats!

Remember: World Health Assembly Resolution 54.2. (2001) urges member states “to strengthen activities and develop new approaches to protect, promote and support exclusive breastfeeding for six months as a global public health recommendation …and to provide safe and appropriate complementary foods, with continued breastfeeding for up to two years of age or beyond.

Complementary food means any food, whether manufactured or locally prepared, suitable as a complement to breastmilk or to infant formula

A Picture is literally worth a 1000 Words.

Products within the white field of the curve that are marketed or presented as a partial or total replacement for breastmilk for infants and young children up to 3 years, are considered as a breastmilk substitute and are covered by the Code.

Products within the blue field are complementary foods, as long as they are NOT promoted for infants below six months. These products are NOT covered by Scope of the Code.

The Code and the resolutions are intended to be adopted as a minimum requirement. Therefore, IBFAN encourages national governments to enforce laws that go beyond the minimum standard and extend the Scope of the Code.

Points 3 to 10 of the 10-point summary (see attachment below) are essential for you to recognize and define Code violations. In the following brief version of the comprehensive monitoring report Breaking the Rules 2014, you can see many examples of Code violations.

You Wanna Bet?

I bet the majority has only skimmed everything so far. I DON’T blame you. It’s very technical and not personal at all - if you feel this is boring, just scroll down for nice pictures :) I won’t be offended.

HOWEVER, I would like to challenge some of my peers who are spread all over the world interning in different organisations. I’d like to reach to you, particularly those who live in low and middle-income countries and work in health care facilities. I’m calling on you to be more involved in ICDC’s mission to protect breastfeeding through monitoring industry compliance. It would be incredible to see GNH students contribute actively to ICDC’s success by sending in violations you discover in your surroundings.

To all of you out there in India, Nepal, Sri Lanka, Bangladesh, Burkina Faso, Uganda, Zambia, Barbados, Chile, Mexico, Thailand and Philippines, LISTEN UP! I’m particularly keen on your involvement- I know that you know who I’m talking about, there’s no need to list names here.

Violations can be send in a very quick and easy form through this website: https://vnhih.enketo.kobotoolbox.org/webform You only need to fill out a few fields and submit it. Remember to take pictures and upload them. Code violations of interest are “Promotion to mothers and in shops” (BTR, 2014:10), Promotion in healthcare facilities and to healthcare workers (BTR 2014:18) as well as Labels (BTR, 2014:27). Just click the titles and have a look at the examples.Do not hesitate to get in touch with me if you have questions.

Enough technical, I’ll continue with lectures on the Code another time.

Let’s get a bit personal and look at what I have been doing so far?

My main occupation in the office is the next global monitoring report Breaking the Rules, 2017 (BTR). This includes comprehensive research on the biggest manufacturers and distributors of breastmilk substitutes and establishing company profiles and overall marketing trends. Further tasks I’m in charge of, include assessing marketing policies of various companies and demonstrating how they differ from the Code and how companies basically find their way to bypass the Code.

I have also been responsible for specific case reports. This involves analysing violations that have been sent by volunteers and collected throughout the last 3 years, assessing trends and reporting which tools and marketing strategies are commonly used by certain companies in certain countries. Right now, I’m focusing on Russia and Turkey where violations occur often due to weak Code implementation. IBFAN’s monitoring capacity may never match with the variety of reckless strategies that companies use to undermine recommended breastfeeding practices for the sake of profit, but the amount of whistle-blowing resulting from monitoring reminds companies that they are being watched. This pushes them to behave better and by IBFAN’s experience they do! I really feel useful and highly appreciate being part on holding companies to account and naming and shaming them for their endless and relentless tactics to influence the behavior of vulnerable groups for the sake of money. It of course boils my blood to be exposed to such ignorant, money-oriented and aggressive opponents, however it also raises my passion to find ways to have an impact on improving children’s lives through fair, sound and legitimate regulations and laws.

I’m also allowed to make use of my expertise as a Public Health Nutrition student to bring a new way to assess marketing strategies of companies. This includes analysing studies used by various companies as a reference for nutritional claims. These are rarely based on sound scientific evidence resulting in biased conclusions and nutritional claims on products. My academic supervisor Aileen Robertson, a Public Health Nutritionist herself and an expert in international research, has been a great help supporting me with her expertise and input. I look forward to yield some results from my ongoing analysis.

Speaking of great supervisors, I would like to mention my supervisor here on the ground: Joo Kean Yeong. She has been impressing me with her dedication and commitment to her work as well as her strong ethical values representing IBFAN-ICDC’s mission. Joo Kean is the legal advisor of the ICDC and has been allowing me to act both backstage and on stage.

Backstage, I have been allowed to help analyzing and reviewing different draft laws we have received to provide legal and technical advice whether these laws reflect the aims and principles of the Code and subsequent WHA resolutions. These past weeks, I helped to review two draft laws from Europe: the UK and Romania and it was interesting to see the different processes the initiators of these draft laws have to undergo to give effect to the Code at the national level given the different social and legislative framework the two countries have.

These tasks have been valuable opportunities to understand how laws are initiated and how long it takes until these laws come into effect. Basically, how hard policy is or as Aileen would say, “Guys, it’s tough!”.

I also get to act on stage, taking some minor supporting roles: 2 weeks ago, I had the chance to accompany Joo Kean to Kuala Lumpur. ICDC was invited as an advisory capacity to participate at an internal meeting at the Department of Nutrition of the Ministry of Health. The meeting was arranged to discuss improved Code implementation and how this could in future intersect with the country’s obligations under WTO.

It was very exciting to sit among government officials who are in charge of policy making. Studying in theory how hard it is to draft and implement policies is one story, experiencing it in real is a whole new chapter. This experience was just confirming the importance of collaboration among all participants. It was also a good example to observe how common it is that even within the same ministry, officials work in their own silos, disconnected from eac other sectors and representing only their own views within their own expertise.

The chairperson was very receptive and supportive of the subject matter. I was also allowed to speak up and share my thoughts and expertise on the impact of marketing on consumption behaviour and could also comment on issues such as the meaning of Codex Alimentarius as a global reference for national food safety and international food trade (Thanks Alexandr Parlesak!) The next meeting has been arranged in one month and the ICDC will continue to support the group with advice and help if needed.

“Knowledge is of no value unless you put it in real practice” (Anton Chekhov)

At the moment, I’m getting ready to hold a training session for a group of health workers (doctors, nurses, midwifes) on the Scope of the Code. This is a great opportunity to share my knowledge with professionals who are important agents to protect breastfeeding from inappropriate promotion of foods for infants and young children. I’ll tell you how it went next time and call it a day for today.

I hope you have the feeling that you know a bit more than you knew before. I’d be grateful if you shared your knowledge with many more aiming to provide a better present that makes the future worth living.

Getting ready to for an internal meeting at the Ministry of Health in KL

Discovering KL with locals.

Jungle in the middle of the city.

Penang, the island that has been hosting me for the last weeks.

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edentreesarboriculture · 5 years ago

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A Step by Step Guide to Hiring an Arborist

If your trees need attention, you aren’t sure how to go about it, you don’t know what your legal obligations are or you’re unsure who you should hire - then this is the article for you.

1. What is the real issue with your trees?

Though sometimes it is obvious what the issues are, often there is more to it. Trees are large living structures that are complex and require a trained eye to see best what is going on. Trees are assets when adequately cared for. Sometimes what appears to be the problem isn’t always the issue. Identifying what the REAL concern is paramount. With the right information at the start, you can save yourself time, heartache and ultimately money by getting to the source of the issue and the subsequent options to solve it. An expert arborist takes into consideration many aspects while assessing the REAL issues. Whether it is identifying the type of tree, the common traits (roots, growth, potential size when mature, health and structural integrity), the position on the property in relation to your house, soil conditions, whether the tree will block gutters and pipes, even views; or if your trees are exposed or protected from strong winds and storms.

2. Tree Lopper vs Qualified Arborist, What is the difference?

Many people may not know this, but your standard “Tree Lopper” is not required to hold any formal qualifications to carry out tree services in Queensland... Yep, this is certainly something you should be aware of as pretty much anyone with a chainsaw could legally provide you tree services. Needless to say, a Tree Lopper can do a lot of lasting damage to your valuable trees within a short space of time. So what is the difference between a Qualified Arborist and a regular Tree Lopper? Tree Lopper The “tree lopper” has probably worked as a labourer on a crew in the past, for several years. They have picked up enough knowledge to tackle small to medium size projects with a low degree of confidence. In many cases, they will not have the funding to purchase or maintain modern equipment, will not be able to present you with current public liability insurance, will not have workers comp, will not have his vehicles and equipment insured and will most likely (but not always) have a cheaper quote. This is because they have no formal education on tree management, this could lead to INCORRECT advice relating to your tree situation and the solutions and practice they offer. Qualified Arborist A fully qualified arborist holds a minimum AQF Cert 3 Arboriculture (National Course Code: AHC30816) where he has not only had the experience of spending many years on a tree service team but also holds formal training in all aspects of dismantling trees safely and arboricultural knowledge relating to species and condition of your trees. The Cert 3 Arborist can provide you with extensive expertise with accurate advice about your needs An Arborist should be able to present the following on request: • Current Public Liability Insurance Certificate • Workers Comp documents • Vehicles and equipment insurance papers • QF Cert 3 Arboriculture You should also look for the following: • Condition of the worker’s equipment • Online reviews, Facebook, google my business, yelp. • Check their website and social page for proof of previous works, testimonials etc.

3. Seek Council Approval .. it pays to Check

Once the real issue has been identified. Council approval is the next step - In South East QLD the Council’s there have differing regulations on what the property owners can and can’t do with their trees. Information can be found by calling your local council or clicking the appropriate link below. Here you will find what trees are exempt from vegetation protection orders and do not require approval. For all protected vegetation (trees) you will need to submit an application to your local council before any work takes place. Brisbane Council Logan City Council Redland City Council Gold Coast City Council Moreton Bay Council Ipswich City Council Scenic Rim Regional Council Here are some examples of reasons for removing trees on private property: • Dead trees • Dangerous / Hazardous trees • Branches falling • Diseased Trees • Weed Trees (some councils have a list of these trees that can be removed) • Significant damage to propertyDA Approved • building plans The reasons below are generally unfit for tree removal: • Tree(s) reaching over the house, powerlines, pool • or children’s play area • Trees blocking a view • Falling debris, leaves, dead branches and leaves. • Shade issues made by trees • Trees planted by you • Exotic trees Development Application: If the tree(s) are being removed to support a development you would need to specify this on your application and usually submit supporting evidence that there is no other way for the development to proceed without removing the trees. This would be done using a AQF Cert 5 Consulting Arborist who will provide you with an Arborist Report.

4. Provide a Written and Detailed Quote

Obtaining a detailed written quote may seem the obvious outcome with most trades people, but very often the unprofessional “tree lopper” will give you a verbal quote based from a brief discussion, that may have left out some important details. Furthermore, they may say half-way through the job that certain things were not included (Green waste removal for example) and try to charge you extra halfway through the job. Or not carry out the work to your intended desire. The reality is it takes effort and understanding to provide a detailed written quote so everyone is on the same page.

5. Modern Maintained Machinery & Equipment

Professional tree service companies invest hundreds of thousands of dollars to acquire the right equipment to safely and efficiently work with your trees. This machinery requires very high ongoing maintenance costs. This critically important part of the service as all machinery and tools work hard and needs to be maintained at the highest level. From ropes, slings and pulleys right up to large wood chippers, mini loaders, stump grinders and trucks, every component play a vital role in safely and professionally pruning and removing trees. A poorly maintained harness could see a worker fall from a tree, likewise poorly maintained ropes and slings could see a large branch smash through a roof, a car or damage other structures below. When you get your tree work quotes, be sure to know that a suspect tree lopper with an unusually low quote is probably skimping on maintenance costs somewhere along the line and this is just another element of risk you should take into consideration before choosing your tree service provider. Check your providers’ recent social posts and other web media to try to get a feel if they are using modern, well-maintained equipment or if it is dated and looks dangerous.

6. Safety & Insurance

As you can imagine, the tree service industry is considered dangerous when you think of all the things that could go wrong. Branches and tree trunks are extremely heavy, often weighing many tons and only experienced arborists know how to bring them to the ground safely. Often there is more than one technique that could be used to bring down a tree, and you will find the arborist with the much cheaper quote may be sacrificing the safer method for the faster way to save time and money. Usually, the more reliable process will take a little more time or require the use of heavy equipment such as cranes, cherry pickers etc. All of which add money to a quote. On the flip side, paying a little extra to have the job done the right way may avoid more considerable costs such as getting a branch through a roof, damage to your driveway or even worse personal injury resulting from negligence. The sad reality is people have died from having tree work carried out at their properties, both the property owners and tree workers. This should never happen. The industry standards and training are in place, so it does not. Professional arborists are passionate about keeping their crews and the public safe and the Urban Forest healthy and flourishing. Safety is paramount in our industry as the risks are high. Crew supervisors are trained and required to go through a detailed safety audit process upon arrival to a job, then having all staff briefed and made aware of any potential risks, as well as having all staff sign off before commencing any physical work. Weekly safety meetings that all staff are required to attend is common practice, where discussions on any potential risks that may have presented through the week and how they can be mitigated in future. The massive contrast between the professional Tree Service Company and the untrained Tree Lopper is ever increasing.

7. Testimonials & References

In this day and age Testimonials and references are a normal part of life. Like checking out a movie on Rotten Tomatoes before watching it or reading through some Google My Business reviews before choosing a Restaurant. Well, the tree industry is no different. A reputable Tree company will have plenty of positive reviews and testimonies on both their website and online platforms, like, GMB (Google My Business), Facebook and Yelp. Social proof is a great way to help build trust. Check out the Company’s Website. Company Website: Here you should find certificates of currency, qualifications, insurance documents etc. You should also see plenty of images showing previous jobs, and previous customer tesitominals. Google Reviews: This is a wonderful source of reviews as customers must be personally logged into their google accounts independently to leave a review. This means the result cannot be manipulated easily by the tree company giving you a less biased result. People are usually pretty lazy or find it difficult to leave google reviews, so many times you will not see a great deal of reviews on a tree company, but if people get bad service they become more motivated to leave a bad review. Knowing this, if you see a google tree business page with plenty reviews and very high ratings, you have a good chance that they are a reputable provider. Facebook page: A great palce to see images of the company at work doing similar work and see other customer reviews. ABN Look Up: Check out there ABN to verify the company has not liquidated by using the ABN online Yelp Reviews: These reviews work similar to google my business reviews but on a different platform. Users must have an account and be logged in to leave a review. The only downside with yelp is you may see minimal reviews as it is not as popular as google my business. Some other places you could look for verification if available are Word of Mouth Twitter, Instagram, are they a member of 3rd party certifier organisations such as Arborculture Australia, Google search “xxTreecompany + Reviews”. lookup.Learn More here: A Step by Step Guide to Hiring an Arborist. as seen on https://edentrees.com.au

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topmixtrends · 7 years ago

Link

IF WE HAVE LEARNED anything from this past presidential election, it is this: that many of us are not adequately equipped to grasp the complexity of what is usually referred to as Middle America. Despite the cottage industry of long-form think pieces that has emerged in an effort to explain the relationship between Donald Trump’s electoral successes and rural America, authored by many of the intellectual voices of our time, we seem to be no nearer an answer to such political conundrums than we were in November. This genre of writing even has a name now: The Reaching-Out Industry. For Timothy Donnelly, the Reaching-Out Industry “has spawned podcasts, books, and TV shows. They share common traits: eschewing (tiresome, predictable) point-by-point debates and stripping things down to a basic level: help us understand you.”

While Donnelly’s ire is directed mostly at liberally authored television programs and cable news shows such as The Van Jones Show and Sarah Silverman’s I Love You, America, it can also be applied to blog posts, long-form analyses, monographs, and book reviews not unlike this one:

I do think there is a genuine desire at work here […] [b]ut once the reaching-out is done, the result isn’t surprising. Biases, right wing fear-mongering, and whitelash combined with a visceral hatred for Hillary Clinton to produce Trump’s victory.

In light of such succinct, if not subtly sarcastic observations, what is left to be said? What is the collective purpose of such think pieces and monographs? To better understand their respective subjects? Or, perhaps, to enact a type of religious-political catharsis by way of academic analysis and peer-reviewed publication?

For Robert Wuthnow, much has been said about the rural America that supported Trump in last year’s election, but very little of it is worth reading because it cares little for the role of community within rural communities. While Wuthnow may appear on paper to be a liberal due to his position at Princeton University, as he admits in his epilogue, he is a native son of sorts who has returned to familiar soil in hopes of cultivating insight and perspective of those otherwise interpellated as the political retrograde. For all intents and purposes, he has achieved such a feat with The Left Behind: Decline and Rage in Rural America, yet not exactly for the reasons he may think.

Wuthnow’s central argument is that in order to better understand what he identifies as the “moral cultures in rural communities,” we must first consider rural communities collectively as explicitly moral communities, and, as such, products of larger moral orders. For him, a moral community is “a place to which and in which people feel an obligation to one another and to uphold the local ways of being that govern their expectations about ordinary life and support their feelings of being at home and doing the right things.” Much of the misunderstanding that has taken place in both journalistic and academic accounts of such lifeways has unfolded largely due to a lack of communal context.

Wuthnow bases most of his analysis on three fictitious rural settings, appropriately named Fairfield, Newborough, and Gulfdale, which in turn reflect larger socio-economic and demographic tendencies of uniquely rural environments. Over the course of his research, the various locales (Midwestern, New England, and Southern respectively) provided Wuthnow with upward of one thousand interviews with individuals such as town managers, clergy persons, mayors, farmers, factory workers, and homemakers. Wuthnow argues that if contemporary observers had a better understanding of rural “norms, expectations, and habits” as part of a broader moral community, then there would be less need to try and “understand them” in terms other than their own. “A first measure of understanding for those who live in cities and suburbs […] is to step momentarily inside these communities before articulating disagreements — and certainly before denouncing millions of our fellow citizens as hopelessly deranged.” What do such individuals actually think about politics, race, and American public life? Do they really vote against their own economic self-interests, as many of us have argued? What, then, are such folk thinking?

Not unlike Arlie R. Hochschild’s subtitle, Anger and Mourning on the American Right, Wuthnow’s own subtitle uses explicitly emotional diction to capture the sentiments of rural Americans: decline and rage. Other texts have recently begun to use the word resentment to describe the religious-political force animating much of today’s version of American populism, yet for Wuthnow this usage cuts in both directions. “The moral outrage of rural America is a mixture of fear and anger,” he contends. “The fear is that small town ways of life are disappearing. The anger is that they are under siege. The outrage cannot be understood apart from the loyalties that rural Americans feel toward their communities.”

While some of the rituals, practices, and beliefs discussed by Wuthnow may not be morally or politically correct (one of his chapters is titled “Bigotry”), his usage of moral community speaks to a larger sacred canopy that contextualizes virtually everything that takes place within rural communities. In this sense, Wuthnow’s intent is to reveal how rural lifeways orient their participants to the myriad worlds around them across the United States. “Understanding the variations and central tendencies of rural voters requires spending time listening and trying to see the world through local eyes,” Wuthnow argues. “As is true of any other segment of our nation, rural lives are complex.” For many, such complexity possesses very little intellectual merit because it usually sounds racist or bigoted, or at least it is assumed to sound as such. What, then, is this complexity of which Wuthnow speaks? And what are its sources?

Wuthnow first explains the current sources of socio-economic struggle for those living in rural areas, and then describes how rural communities have responded, and for what reasons. We first learn about rural communities as moral communities, followed by chapters on “Present Dangers” and “Makeshift Solutions.” In describing what he calls “the culture of small towns,” Wuthnow delves into the daily movements of those struggling to find work or commute-able employment and health care in order to better understand the conditions within which they make their lives livable. Once in the proverbial thick-of-it, all-too-familiar socio-economic similarities begin to emerge between largely white rural communities and largely black and brown urban communities. “Drugs and crime that resulted from drugs were an outlet for people in their communities who felt they were stuck and going nowhere. It was similar, they thought, to problems in inner-city neighborhoods where unemployment, under-employment, and poverty rates were high.”

Unlike much of the contemporary analysis directed at rural Americans, however, Wuthnow’s treatment is rendered thickly enough as to reveal a dense network of expectations, common-sense obligations, and relationships that are anything exclusively white or inherently racist. The fact that Wuthnow decided to name the last chapter of his text “Bigotry” speaks to his awareness of such ways of thinking, but he is much less willing to assume such characterizations as part of his academic analysis. Instead, he explores how notions of community both challenge and cultivate racist and anti-racist behavior in rural communities. In many instances throughout the book, “complex” is an understatement: “I just want to have more freedom,” one of Wuthnow’s interviewees responded, “but I don’t know how to get it.”

In general, Wuthnow’s arguments reflect much of the current and past work on the United States’s culture wars by arguing that one of the sources of rural moral outrage is the “culture gap” that seemingly separates Washington from the rest of rural America. While we know a great deal about the affluent, urban-centered cultures of certain areas of DC, New York, or Los Angeles, we know much less about the individuals to whom Wuthnow spoke, beyond the traditional hyperbolic headline. Regardless of such marketing demands, describing a “rural ethic” amid numerous “trouble with Kansas” arguments makes Wuthnow’s project more important for us to consider. “The anger toward specific policies and officeholders is nested within this larger sense of Washington being at odds with the moral communities in which people live,” Wuthnow contends. “Deficit spending is contrary to ordinary people living within their means. Government wastefulness is the antipathy of hometown thrift.” Once seen in this cultural light, one’s self-interests take on much more value than simply socio-economic value; in many ways, rural voting patterns reflect less the decisions of solitary individuals, and more the commitment to maintaining a way of life — complex as it is.

These cultural divisions have lent themselves to dual-purposes in the recent past: politicization and polarization on behalf of culture war. As Wuthnow points out, there is nothing inherent within a given topic of political deliberation that makes it an “issue” at best, or a “hot button issue” at worst. His treatment of rural lifeways illustrates how a form of cultural warfare impinges upon daily conversation in rural communities and churches.

Abortion was something they needed to talk about, most of the clergy said. And it could be talked about in church without the conversation ever having to be explicitly political. As a pastor in Texas explained, “I preach about abortion as a theological issue. I don’t have to turn around then and vote Republican.”

While much has been said about the benefits of single-issue advocacy in the public square since the 1960s, such means cut in both directions — they bring something important to the surface at the expense of virtually everything else, including one’s daily interactions with fellow citizens. In this way, Wuthnow’s interviews reveal just how corrosive American cultural warfare has been on behalf of largely conservative political expediency. “What most concerns me every day is dealing with people,” the pastor explained. “No matter what the issue is, how it affects the person is a heck of a lot more important than ‘the issue.’” As such, cultural warfare has not replaced discussions of GDP with abortion or same-sex marriage, but instead has recalibrated American politics itself to be more conducive to hyperbolic headlines and social media consumption. In fact, one need look no further than this past presidential election to see the fruits of such labors from America’s heartland.

In short, the decline and rage of Wuthnow’s subtitle can be best explained thusly: combine a severe lack of trust in the political process with calculated campaigns engineered by professional political strategists and you get what we currently have today — a populace thoroughly divided against itself for reasons largely unbeknownst to itself. A more productive direction for future commentary would be less concerned with those “voting against their self-interests,” and more with who exactly has made politics about the self-interests of those voting in the first place. In this regard, divisions between liberal and conservative would begin to lose their analytical traction in favor of investigations that foreground political alienation and apathy as the most serious of threats to a democratic polity on a mass scale.

As such, the true value of Wuthnow’s analysis is that it allows us to witness how citizens first internalize and then reflect the political directives that suffuse their daily lives to the detriment of democracy itself. “It is the socially uprooted and unattached members of all classes who support [totalitarian] movements first and in the greatest numbers,” argued fellow sociologist William Kornhauser. This means that “unattached intellectuals, marginal members of the middle class, isolated industrial and farm workers have been among the major social types in totalitarian movements.”

Thanks to Wuthnow’s rich observations, we are able to address and understand what truly confronts us as a nation: the triumph of mass society through mass politics in the name of the “little guy.” Little did we know that such a person would also have the hands to match.

L. Benjamin Rolsky is a research fellow in Religion Studies at Lehigh University.

The post “Little Guy” America appeared first on Los Angeles Review of Books.

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ournewsupdate-blog · 7 years ago

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Software program Piracy

Computer software PIRACY We regularly hear reports concerning the price to the software business of computer software piracy, but would be the claims to become taken at face value? Statistics are notoriously biased towards what the author is attempting to say.

Types of Computer software:

You'll find 3 basic forms of jamb cbt software, though these do have their own subsections, as will likely be discussed later: 1. Industrial computer software, bought using a licence for a single or far more computer systems. This commonly is coupled with some kind of support and typical updates to patch errors etc. In some cases a brand new version from the application is offered at a reduced price as "update". This kind of application is normally comparatively costly and is typically created to cover specific industrial purposes. The huge exception could be the various sets of "office" software program, that are designed for use in the industrial atmosphere, but can naturally be equally utilised for several tasks at residence. One of the most prevalent application in this category is, of course, text editing. The majority of the other classic "office" applications, which include calculations and data bases are only of limited use within the domestic environment, even though they'll be made use of in some situations, especially now that the much more computer-literate generation is increasing.

two. Simplified or "lite" versions in the commercial application. These are intended principally for tiny companies and enterprises that usually do not need the total capabilities of, say, a 3-D modelling system, but should be in a position to view such documentation and prepare compatible drawings. Again, the "office" atmosphere was a long time not represented within this sector, but has lately started to become out there. These will also come with a single or many, but restricted licence and now mainly be registered with the manufacturer. three. Cost-free or "open source" application. This can be made for general distribution and has no unique limitations as to use, except that it might not be changed in any way. Naturally, such software has its limitations, but may serve really adequately for a lot of purposes. Practically all forms of application are to be identified within this category. 1 notable application distributes the software program to study its documents freely, but charges for the application to produce the documents. This policy is arguably the motor behind its ride to a position as sector common, because you could often be certain that he receiver can decipher what ever is sent, without having lengthy discussions about compatibility and versions. Clearly, there might be no piracy of goods that fall in to the third category, except for changing from the code or reuse from the code for other purposes, but this does not appear to become a major problem in the moment, so we will concentrate our focus around the very first two categories. Both of those categories include computer software that is definitely copied and distributed either totally free of charge or for any nominal fee. Naturally, the complete versions in the computer software are preferred, however the simplified versions are also to become identified, depending on what exactly is out there.

Sorts of Application Pirate This puts our computer software pirates into two categories of their very own:

1. Those that knowingly use a copy of software program "borrowed" from function or supplied by good friends, who probably acquired it by the identical means.

2. Those who prepare copies of software from an original and sell it at a low value via internet auctions or on marketplace stands. Their shoppers may possibly, in many instances, be unaware that the software has been pirated and simply be pleased to acquire a application package at a bargain value. Some will probably be really properly conscious of your actual source, but nevertheless prepared to take this suggests of saving income.

Composition with the Groups: So who's to be located in these two groups?

1. This group is extremely widely ranged and consists of college kids, folks practicing at home using the corporation software program, many private persons with an interest in computer systems who will attempt anything which is no cost and, possibly, really modest companies. Lots of schools will provide their students with copies of software program licensed for the college to enable them to complete homework or study to work with it for technical subjects. A student finishing a technical college with tiny or no understanding of the technical computer software utilized in their business won't simply discover employment, so a blind eye is turned in several schools to this practice. Schoolwork is normally essential to be written on computer as of late, and once again, that is only genuinely doable if some kind of text computer software is accessible. People that use organization computer software at home to play with or for their youngsters to finish homework are also a big group. The personal computer has become a a part of our way of life inside the western hemisphere, and a lot of people are enthusiastic about the possibilities opened by the modern day generation of potent number-crunchers. The days of mainframe computer systems costing numerous thousands of dollars just isn't gone, however the smaller laptop or computer inside a network has taken over in numerous places, so the qualified application that would earlier have necessary a mainframe connection and a complete basement complete of equipment will now run happily on a home pc. There may well be a loss of speed, but who cares? The vast majority of those people know complete nicely that what they may be performing is just not allowed, but consider this as a very minor matter, and would laugh at any suggestion that they really should acquire the software program officially. The few organizations that also do that are saving dollars that they most likely don't have, in spite of being aware on the dangers.

2. The group of those who copy application and distribute it for sale as being genuine are working just for profit, taking benefit with the simplicity from the method plus the high rates of genuine application. The common public is just not conscious in the penalties for this sort of action and is frequently unsure about recognising the genuine report. Other products inside the consumer marketplace are out there from many producers as essentially identical merchandise, so why should this not be the case with computer software? Incredibly numerous are merely duped into acquiring what they see as a affordable alternative to a brand-marked item.

Expenses of Application Piracy: So what are the true costs for the application providers?

In most circumstances, school and college students wouldn't be in a position to pay the expenses for the expensive commercial application they use in technical subjects, as well as the schools and colleges are certainly not within a position to provide this to them no cost of charge. Most schools have licences for software to become used around the premises, but this isn't available for the students at household. Theoretically, they are going to use the computers at school to complete function and practice, but this really is normally not achievable as a result of a lack of resources, or classrooms locked as a result of vandalism. The only technique to resolve the issue is for the schools to basically distribute the application to their students around the basis of it getting only for their use. There's no licence and no direct upgrade possible. Generally, although illegal, this technique operates quite effectively. Schools try to copy upgrades and patches for their students, mostly effectively. The snag for the matter is that we educate persons in that this really is completely acceptable practice, regardless of it getting illegal. No-one would consider of insisting or perhaps checking that drop-out students erase the computer software and no longer use it, but that is most likely relatively nicely assured by the fact that they've dropped out in the initially location!

Options to Software program Piracy: Student Application: Low-Cost Software program: One particular of the best-known software firms has recently began to sell a slightly simplified version of their software in a student package, stating that this isn't for commercial use. Naturally, this can be becoming distributed to everyone devoid of regard to their accurate status as student or not! Nevertheless it's a definite move within the appropriate direction. Offering an economical option would be the initially step towards a remedy for this challenge. The high-quality is good and it contains all the usual attributes that are required. Other businesses also supply cost-free software program for student use, but this is in most cases pitifully inadequate and just not up to the job and no preparation for later industrial practice. It remains to become seen how far the availability of reasonably priced student software program will influence sales on the commercial item. One of the components presumably behind this move could be the basic attitude that the present software program is perfectly adequate and can be utilised for any length of time without having being replaced. Considering the fact that several software houses have distanced themselves from the notion of upgrade application for older versions at a reduced price, this attitude will possibly result in sales of your complete industrial software to be limited to new systems, and not as an improvement on older systems.

The new wave of student software program is probably intended to bridge this gap somewhat by giving further revenue. Regardless of whether the fears from the others that the production of a student version at greatly reduced price will reduce into their sales of the full, industrial version will prove to become right, or the alternative view that they are complementary solutions will prevail will remain to be observed.

Advantages of Student Use: It's undoubtedly true that a person who has trained on one sort of software program will have a tendency to stay loyal to it as far as firm policies allow and that this can be a definite motivation to purchase a type of computer software, therefore the policy in the schools is unlikely to become challenged or pointed out publicly. Nevertheless, there isn't any purpose for forcing our youth into criminal activity! Giving a remedy that permits individuals to work with these applications through instruction legally really should be a priority for the computer software homes that may bring some income within the short term, and possibly additional inside the long term. A single from the issues inside the computer branch has generally been the emphasis on quick term results and fast profits, but this attitude will have to modify soon to allow for these factors.

"Fun " Use: Once again, the people who use the firm application at residence for fun cannot actually be seen as a risk for the income of a software enterprise. They would just devote their time otherwise in the evenings if they didn't have this possibility! The matter only then becomes problematic once they start making operate privately for other companies. This would then absolutely be a matter for concern, each for the producers of the computer software and other firms inside the very same branch, who've to calculate the fees of computer software into their prices.

Geographical Variables: The problem can also be geographically diverse. Most of the software program packages originate, at the least on paper, from the Usa. The prices in Europe have a tendency to be 1.five to 2 times larger, without having thinking about sales tax of any type, that is normally higher in most European nations. Whilst this might not be of consequence for the run of low-cost software program, it really is a considerable difference when complex design and style or technical applications are thought of. This price differential is usually explained by greater help charges or translation costs, but these factors alone can't be the full purpose. A modify within this policy would almost certainly help to cut down the amount of use of copies in the industrial field at the very least. Splitting software program packages into easily-upgraded components would also allow smaller companies to purchase what they require immediately and then add the extra options in time as and when required.

Causes for Software Piracy: Computer software piracy is legally a crime, nevertheless it is a crime that's nonetheless acceptable in our society. Incredibly tiny has been carried out to combat it for any quantity of reasons. One particular cause is that it really is pretty much universal amongst customers of computers. Many of us "need" an application once per year and do not wish to spend the at times horrendous price for the industrial licences. Firms have created no actual try to combat it until now, because this is a form of free marketing, plus the benefits of possessing it available to students have already been pointed out above. It is actually only now, when the earning curve start to tip downhill that this is noticed as a threat to enterprise existence. In reality it is somewhat very simple to produce something incredibly difficult to copy. Impossibility is often a dream within the pc world nowadays!

Concluding Remarks: That criminal activity really should be hindered and software piracy is, broadly speaking, theft, is rather correct, however the remedy isn't just to seek out and punish wrong-doers, but to seek out a resolution for all these groups of people who, for one explanation or other, want to make use of the application, but cannot, or is not going to, uncover the means of paying the present market cost. An imaginative solution to this dilemma could properly be the break-through that a corporation needs to make itself known in each and every household, offered the item is appropriate.

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ourcommonbowl-blog · 7 years ago

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Missing Nimâmâ

Inderpal Chatha, Christian Smith, Keanen Schnoor and Nicole McCall

Missing Nimâmâ (2015) is a fictional children’s storybook written by Melanie Florence – who is a Toronto based writer of Cree and Scottish heritage, and illustrated by Francois Thisdale – who is an award winning illustrator of several highly acclaimed picture books. Written in free verse, the text of the book is split up into easily readable paragraphs and the story itself is narrated in alternating voices. The story directly follows the life of an Indigenous girl named Kateri whose mother went missing during her childhood. She is taken care of by her grandmother and readers get to witness Kateri transition through different stages of her life without her mother’s physical presence. We chose this book because although the story is fictional, it is based on reality. The unique and not so often talked about subject matter directly relates to the very real issues of gender-based violence and the disappearance and murder of Indigenous women within Canada. This is a great resource that can be used to educate both children and older adults about matters that are often ignored or swept under the rug, in a manner that is deemed to be suitable for the particular audience that will be using it. The storybook as a whole showcases deep affection, loss, tolerance, and encourages the acceptance of circumstances that are outside of one’s control. Further, the book introduces words from the Indigenous language of Cree, which promotes the use of Native American languages and the exploration of Indigenous culture. The fact that the Cree language is used in this story is very powerful because it really helps us connect with the culture of those individuals who had their language and traditions unjustly taken away from them due to colonialism. Overall, Missing Nimâmâ is very well laid out and has the ability to spark the curiosity of any reader. The resource itself is very accessible and can be found through virtually any public library or purchased through retailers such as Amazon and Chapters.

Missing Nimâmâ is a very unique piece of literature that tackles serious issues that affect Indigenous women. As we mentioned before, Kateri – the story’s main protagonist, is a young girl who had her mother taken away from her. After the incident, her grandmother steps in and takes on the role of a nurturer as her main mother figure. When Kateri is young her grandmother explains that her mother is "lost", however when Kateri gets older she is told the truth about her mother. This story really highlights the importance of intergenerational roles in Indigenous culture and also shows the hardships that Indigenous women go through based on gender and cultural inequality. This story also focuses on the aftermath of the individuals that had gone missing and the families that they left behind. This sentiment is shared when author Melanie Florence and illustrator Francois Thisdale accept the Children's Literature Award for their story: "I wrote Missing Nimâmâ to give a voice to the women and girls whose voice was stolen from them through violence," Florence said when accepting the award. "And to give a voice to the women and daughters they left behind."(CBC/Radio Canada, 2017)

Intergenerational roles have an important connection in this story, the author's background, and within the First People's Principles of Learning. Melanie Florence is a writer of Cree and Scottish heritage who resides in Toronto. Her interest in writing about Native themes and characters came from a close relationship with her Grandfather who was of Cree descent (Melanie Florence, 2015). This also explains the intergenerational relationship between Kateri and her grandmother. The idea of learning being something that involves generational roles and responsibilities is also highlighted in the story. Since Kateri’s mother is removed from the family all of Kateri’s life lessons are acquired from her grandmother. The story also explores the heartache that the removal of one generation in a family can have on the member who was removed from their family and the people they left behind as the previous quote from Melanie's acceptance speech mentions. There are also many colorful images in this story that Francois Thisdale manages to convey the leadership role that the elders portray by illustrating the characters as just close-ups of the characters faces to highlight their eyes or the windows to the soul. This is a little jarring at first but also shows that the characters are always looking out for one another's best interest at heart.

The difficult subject matter of Missing Nimâmâ makes this resource one that should be handled with a great deal of sensitivity. However, we feel that if handled appropriately, Missing Nimâmâ has the potential to be an excellent classroom resource, one that can be used across a wide range of grade levels and subject areas. While searching for a resource, our group was drawn to Melanie Florence’s picture book for its ability to speak to a desperate national tragedy in a beautiful and engaging way. The illustrations are stunning, giving hope and light to a devastating issue. The issue of missing and murdered Indigenous women is one that is all too often swept under the rug by both Federal and Provincial governments, the media, and police organizations. Further, it is an issue that is altogether missing from school curricula. While educators have the responsibility to inform and engage students with Indigenous issues such as Residential Schools, missing and murdered Indigenous women are often ignored. Melanie Florence cites Missing Nimâmâ as a book that “gives voice to the voiceless”(CBC Books, 2017). We admire Florence’s dedication to offering a voice and representation to these women who have suffered terrible fates. Ultimately, the issue of missing and murdered Indigenous women is one that Canada must face. Awareness and discussion goes a long way, and can start in our classrooms with our youngest Canadians.

Of course, it is a daunting task for an educator to share such a dark topic with their classes. Teachers, parents, and guardians may feel that it is not necessary to bring awareness of this issue to school-aged students. Melanie Florence addressed this concern in an interview with CBC, stating that “children have the capacity to understand dark issues” and that “[we] don't need to talk down to kids”. She feels that “kids are smarter than we give them credit for”, and that missing and murdered Indigenous women is a topic that can be introduced to children, if done properly (Rogers, 2016). Since Missing Nimâmâ deals with the topic of loss, appropriate resources should be put in place to ensure that students who may feel triggered by this content are adequately supported. Students should be given a safe place to discuss any negative feelings that might arise, such as the school counsellor, Aboriginal support worker, and the teacher. Open communication with parents and administration will further ensure that all members of the learning community are aware of the difficult information that will be shared.

Image retrieved from: https://goo.gl/images/B4pSVk

There are numerous ways that this resource could be integrated into teaching practice. As early as Grade 5, as supported by the B.C. curriculum, Missing Nimâmâ can be utilized in a Social Studies unit. This hypothetical unit would focus on exploring modern mistreatment of Aboriginal peoples in Canada and also the legacy of wrongdoing. The big idea in this unit would be “Canada’s policies and treatment of minority peoples have negative and positive legacies” (“5 Social Studies”). The content would be “human rights and responses to discrimination in Canadian society” (“5 Social Studies”). The curricular competencies would be “mak[ing] ethical judgments about events, decisions, or actions that consider the conditions of a particular time and place, and assess appropriate ways to respond” and “differentiat[ing] between intended and unintended consequences of events, decisions, and developments, and speculate about alternative outcomes” (“5 Social Studies”). Missing Nimâmâ would be a very effective way of beginning this unit. The text is ambiguous enough to encourage students’ questions but informative enough to provide students a cursory background in the mistreatment of Aboriginal people. The text could potentially lead into discussions about the Highway of Tears and associated issues of poverty and discriminatory practices/attitudes. The visual medium of the text provides students an accessible introduction to some challenging and mature themes.

From an elementary perspective, Missing Nimâmâ can be introduced as early as Grade 5. However, the text could be equally utilized in a secondary environment. For example, in Grade 9 Social Studies, Missing Nimâmâ would be compelling way of exploring perspectives on ongoing Canadian systematic discrimination as well as contemporary attitudes/biases towards Aboriginal peoples. In this unit, the big idea would be “disparities in power alter the balance of relationships between individuals and between societies” (“9 Social Studies”). The content would be “discriminatory policies, attitudes, and historical wrongs” (“9 Social Studies”). The curricular competency would be “recogniz[ing] implicit and explicit ethical judgments in a variety of sources” (“9 Social Studies”). Using a resource that could be perceived as a child-oriented picture book in a secondary classroom may seem unorthodox, however, Missing Nimâmâ would provide students nuanced insight into possible Aboriginal perspectives of systematic discrimination. Students could be challenged to consider the ways a child or a family would perceive injustice like the unsolved disappearances surrounding the Highway of Tears and the Downtown Eastside. Missing Nimâmâ is unique because it approaches these issues from a personal and subjective perspective. Additionally, this resource would be very effective in place-based learning because it connects directly with current contentious political issues.

References:

BC’s New Curriculum 5 Social Studies, 2017, https://curriculum.gov.bc.ca/curriculum/social-studies/5. Accessed 23 June 2017.

BC’s New Curriculum 9 Social Studies, 2017, https://curriculum.gov.bc.ca/curriculum/social-studies/9. Accessed 23 June 2017.

CBC Books. (2017, June 19). How Melanie Florence and François Thisdale wrote a picture book about missing and murdered Indigenous women. Retrieved June 29, 2017, from http://www.cbc.ca/books/2016/10/melanie-florence-how-i-wrotemissing-nimama.html

CBC/Radio Canada. (2017). Retrieved June 22,2017 from, http://www.cbc.ca/books/mobile/touch/2016/11/melanie-florence-francoisthisdale-win-30k-td-canadian-childrens-literature-award.html

Florence, M., & Thisdale, F. (2015). Missing Nimâmâ. Richmond Hill, ON: Clockwise Press. Florence, Melanie. (2015) Retrieved June 22,2017 from, http://www.melanieflorence.com/my-story

Rogers, S. (2016, November 21). How Melanie Florence turned the stories of missing and murdered Indigenous women into a children's book. Retrieved June 29, 2017, from http://www.cbc.ca/radio/thenextchapter/esta-spalding-melanieflorence-and-kenneth-oppel-1.3853806/how-melanie-florence-turned-the-storiesof-missing-and-murdered-indigenous-women-into-a-children-s-book-1.3855047

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thishari-blog · 7 years ago

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OT's... "Jacks of all trades"

Me: “I’m an Occupational Therapy student”

Response 1: “So is this building safe for our health?”

Response 2: “Oh…”

Response 3: “What jobs am I legible for?”

I could go on about the varied responses and questions I get asked when I say that I am an Occupational Therapy student. Initially every sinew of my body used to pulsate with blind rage and I couldn’t comprehend the lack of awareness of people for the OT profession…an essential and amazing profession (in my biased opinion).However, I’m starting to get used to the bemused faces and strange responses. I must admit, having to explain what OT is all about is sometimes confusing and difficult for me, even after 4 years of studying the profession, purely because our roles and duties are so diverse. Before I respond, I often have to ask how much time the person has available to listen to the numerable roles of an OT because we are essentially a ‘jack of all trades’. However, the role of an OT is sometimes impacted on by various contextual factors making it difficult for us to actively and truly fulfil such roles.

“Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment” ("WHO | The Ottawa Charter for Health Promotion", 2017). The core foundation of OT is on enabling clients to maximize their functional capacity to participate in daily life activities that are important and meaningful to them thereby enabling them to reach a state of well-being which in turn promotes overall health and wellness. Since our health (good or bad) is a product of what we do or don't do every day, by enabling an individual to engage in these daily meaningful activities, health promotion is achieved. Health promotion is thus embedded in the overall aim/goal of OT meaning that OT’s have and always will play a major role in health promotion.

However, health promotion also goes beyond health care, but so does the scope of Occupational Therapy. In Occupational Therapy we are constantly taught to look at the health of an individual holistically and to utilise holistic and client-centred support and services to address occupational performance issues, activity limitations and participation restrictions. Therefore we don’t just ‘stitch up the wound’, but we make sure that the ‘wound’ doesn’t re-open or become infected and in order to do so, we take steps to ensure that the bio-psycho-social factors of the individual are identified and issues within are addressed. The health promotion that OT’s are involved in can also be more direct or more indirect and this often is reliant on the setting, in terms of a hospital based and community based setting. This ultimately affects the extent of health promotion that is achievable. Since working in the X Community, I have become more aware of and passionate about the role of OT in health promotion. In community settings, you get to see the direct impact of client’s bio-psycho-social factors on the client’s well-being. For example, some client’s that my colleagues and I have seen have not been able to access health care facilities due to lack of access to transport owing to poverty or even environmental constraints. Consequently, through our conduction of home visits, we have been able to directly promote the health and well-being of these individuals by either providing them with intervention or organising transport for them and making environmental adjustments for them to function optimally within their home context, in hospital based settings however, this level of health promotion is not always possible.

Seeing as OT’s have a role in health promotion and advocating for individual’s and community’s well-being and hence empowerment, I believe that OT’s have role in using media as a platform to ‘spread the word’ about health related issues AND about the profession (then hopefully more people will start to understand what OT is all about?). With the rise in the number of media platforms available and used, the use of media will ultimately have far-reaching effects. However, in my opinion, our role in the use of social media is not necessarily directly for the benefit/empowerment of communities that we are exposed to seeing as most of these communities are low socio-economic communities thus many members won’t necessarily have access to social media. I believe that, our role in the use of social media is more for our exposure to new methods, techniques, activities and opinions or views of fellow OT’s around the world and through this our clients are indirectly benefited as we have greater knowledge and exposure to skills that may be beneficial.

The ultimate goal for primary health care, when it was introduced by the Alma Ata Declaration in 1978, was health care for all. Let’s be serious…this is defiantly not the case in South Africa. Despite some progress over the past two decades, South Africa remains far from realising Alma Ata’s aspirations of ‘Health for All’. An amalgamation of factors inequalities in resources, inaccessibility to resources and shortages in the number of health workers (this is one factor that I’m still trying to wrap my head around …seeing as most of the posts for health professionals in the government sector have been frozen?!) continue to limit the achievement of PHC in South Africa today. Although we, Occupational Therapists, have a role in providing health care for all, our ability to fulfil this role is sometime impeded for the above mentioned reasons.

However, there are some principles of primary health care that we as OT’s are able to implement via our various roles. The principles of the primary health care include equity in health service delivery, access to affordable and appropriate services, empowerment of people, and sustainability of service provision.

In terms of access to affordable and appropriate services, the placement of OT graduates (community service OT’s) and fourth year OT students in community based settings has ultimately contributed to ensuring that individuals in need of our services have access to them thus reducing exclusion and social disparities in health but this doesn’t been that it has eliminated such disparities. For example, when OT students are in community settings, we conduct home visits which reflects the fulfillment of our role in ensuring accessibility to health care. However, not all people in need of our services are seen to (owing to the large ratio of client’s to students) reflecting in equitability in health service delivery. Also, when we, OT students, leave the community during holiday or exam periods, there is ineffective carry over and continuity of care for these individuals thus making the services provided relatively unsustainable.

OT’s, being the innovative people that we are, are able to create something out of nothing. Don’t believe me? Where have you ever seen or thought of using a toilet paper roll or pool noodle as a splint? The adaptability and innovative nature of our profession ensures that the services that we provide are appropriate and affordable for our clients. In this way we are able to implement and fulfil this principle of PHC.

So OT’s have a role in PHC, the extent to which the role is and can be fulfilled, in the South African context is still questionable. For further information refer to: http://www.scielo.org.za/scielo.php?pid=S2071-29362016000100023&script=sci_arttext&tlng=en

http://bmcfampract.biomedcentral.com/articles/10.1186/1471-2296-13-67

Occupational therapists have the skills and knowledge in health promotion, chronic disease management, lifestyle interventions, and adaptive equipment to benefit clients accessing primary care (Leclair et al., 2010).However, the context in which our services are provided has an impact on our ability to fulfil all our roles adequately. So whilst we have diverse roles… we are still somewhat shackled to the context in which we perform our roles.

References:

Alberta. (2016). Alberta's primary health care strategy.

Leclair, L. L. (2010). Re-examining concepts of occupation and occupation-based models: Occupational therapy and community development. Canadian Journal of Occupational Therapy, 77(1), 15-21.

Naidoo, D., Van Wyk, J., & Joubert, R. W. E. (2016). Exploring the occupational therapist’s role in primary health care: Listening to voices of stakeholders. African Journal of Primary Health Care & Family Medicine, 8(1), 1139. http://doi.org/10.4102/phcfm.v8i1.1139

WHO | The Ottawa Charter for Health Promotion. (2017). Who.int. Retrieved 25 May 2017, from http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html

‘Declaration of Alma Ata’, Report on the international conference on primary health care, World Health Organisation, September 1978, http://www.who.int.

Singh, S., & Dookie, S. (July 02, 2012). Primary health services at district level in South Africa: a critique of the primary health care approach. Bmc Family Practice, 13, 1, 1-4.

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sherristockman · 7 years ago

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The War on Chiropractic Must End to Improve Painkiller Addiction Dr. Mercola By Dr. Mercola In the U.S., painkiller addiction is so rampant that 91 Americans die every day from an overdose of prescription opioids or heroin.1 Prescription opioids such as oxycodone (OxyContin), hydrocodone (Vicodin), morphine and methadone are widely prescribed for pain relief. Initially, they were intended to treat severe pain following surgery or injury or pain due to illnesses such as cancer. However, they're now increasingly prescribed for many types of pain, including chronic back pain or pain from osteoarthritis. Opioid prescriptions nearly quadrupled in the U.S. between 1999 and 2013, despite reported pain levels remaining stagnant. Meanwhile, the CDC reports, "Deaths from prescription opioids — drugs like oxycodone, hydrocodone and methadone — have more than quadrupled since 1999," rising right along with the numbers of prescriptions.2 The problem with opioids is that many people start taking them for mild to moderate pain, only to develop a tolerance, which means you need to take more to get the same relief. Physical dependence can also develop, leading to symptoms of withdrawal if you try to cut back or quit the drugs cold turkey. Ironically, opioids can even lead to an increased sensitivity to pain, causing patients to reach for more and more of the drugs. Addiction and overdose, which can be fatal, are all-too-common next steps. In fact, up to 1 out of 4 Americans receiving long-term opioid prescriptions struggle with addiction, according to the CDC.3 FDA Calls on Doctors to Rethink How They Treat Pain In 2016, the CDC released updated guidelines for prescribing opioids for chronic pain. Notably, they listed non-opioid therapy as the preferred treatment for chronic pain.4 In an Education Blueprint for Health Care Providers released in May 2017, the U.S. Food and Drug Administration (FDA) similarly proposed changes in how doctors treat pain. Specifically, the FDA urged them to get information about non-drug options including cognitive behavioral therapy, physical therapy, chiropractic care and acupuncture,5,6 noting: "A number of nonpharmacologic therapies are available that can play an important role in managing pain, particularly musculoskeletal pain and chronic pain. HCPs [health care providers] should be knowledgeable about the range of available therapies, when they may be helpful, and when they should be used as part of a multidisciplinary approach to pain management." It's about time. According to a study published in the Annals of Internal Medicine and funded by the National Institutes of Health (NIH), patients with neck pain who used a chiropractor and/or exercise were more than twice as likely to be pain-free in 12 weeks compared to those who took medication.7 So, too, is the case with acupuncture. researchers concluded that acupuncture has a definite effect in reducing chronic pain such as back pain and headaches — more so than standard pain treatment.8 Many Physicians Have Little Training on How to Treat Pain The FDA's proposed guidelines are long overdue, as a 2013 study revealed new physicians learn shockingly little about how to treat pain, despite it being one of the most common, and most debilitating, medical conditions around. The study, which surveyed undergraduate medical schools in Europe, found that even when compulsory pain courses are in place, they represent just 12 hours of the six-year program — or 0.2 percent.9 Further, most of the schools actually have no required courses on pain that all students must take. This means that 12 hours of pain study represents a best-case scenario; at 82 percent of medical schools without compulsory pain courses, the students may be receiving even less or no pain training at all. Even when the pain courses are compulsory, there is no consistency in what topics are covered, and most of the schools included only classroom-based teaching, not practical-based or placement-based teaching that could offer future physicians valuable hands-on experience. The researchers called for a major overhaul to address the urgent public health need to adequately manage chronic pain. With no other knowledge of how to treat pain, most physicians treat it with prescription painkillers, and now we have an epidemic of prescription drug abuse and related deaths. Why Ending the War on Chiropractic Is Essential The fact that the FDA highlighted chiropractic care as an option health care providers should be familiar with when it comes to treating pain represents a major step forward — one that has the potential to save lives if it means people can resolve their pain using chiropractic instead of prescription drugs. Unbeknownst to many, there has been a systematic and deliberate campaign by the American Medical Association (AMA) to destroy complementary medicine like chiropractic care. In 1984, the U.S. Supreme Court found the AMA guilty of an illegal conspiracy to contain and eliminate the chiropractic profession, and ordered the AMA to cease its illegal boycott of chiropractors. The belief that chiropractors are dangerous or selling a bogus treatment persisted for decades, even as a sizable portion of low back pain patients (more than 30 percent, according to one study) sought out chiropractic care.10 Now, as research continues to confirm its benefits, even public health agencies are taking notice. For instance, a study published in JAMA revealed, "Among patients with acute low back pain, spinal manipulative therapy was associated with modest improvements in pain and function and with transient minor musculoskeletal harms."11 In April 2017, meanwhile, the American College of Physicians (ACP) released new guidelines for the treatment of chronic low back pain, which suggest clinicians and patients should select non-pharmacologic treatment, such as acupuncture, massage, superficial heat or spinal manipulation.12 The potential benefits of the latter are finally catching on, including among some conventional physicians. Dr. Aaron Carroll, a professor of pediatrics at Indiana University School of Medicine, wrote in The New York Times:13 "A physician like me might suggest any number of potential treatments and therapies [for low back pain]. But one I never considered was a referral for spinal manipulation. It appears I may have been mistaken. For initial treatment of lower back pain, it may be time for me (and other physicians) to rethink our biases. Spinal manipulation — along with other less traditional therapies like heat, meditation and acupuncture — seems to be as effective as many other more medical therapies we prescribe, and as safe, if not safer." Chiropractic Offers Benefits Beyond Pain Relief One of the major benefits of choosing chiropractic over a drug solution is that the former can help relieve your pain while offering you whole-body benefits. For instance, research by Dr. Dean Harrison and others suggests chiropractic treatments can help prevent progressive spinal degeneration, i.e., osteoarthritis or disc disease. Just like regular dental care will prolong the useful life of your teeth, getting regular chiropractic treatments can do the same for your spine. Further, contrary to popular belief, chiropractic can be used to optimize wellness, not just treat pain. According to Dr. Billy DeMoss, a chiropractor with a practice in Newport Beach, California, "Chiropractic is like brushing your teeth." It's something you need to do on a regular basis to maintain the life of your spine, because regular activities, such as chronic sitting, can contribute to its functioning less than optimally. Granted, some chiropractors focus primarily on pain and injuries and do not have the full skill set required to address issues like allergies or disease. So it's important to make sure the chiropractor you choose has the appropriate vitalistic philosophy and is skilled at providing pain relief as well. While many will only consider chiropractic when they have back or neck pain, the point to remember is that its scope actually goes far beyond that. DeMoss said: "I try to get people to understand that your nervous system and your brain control every function of your body. When we have a condition in chiropractic we call subluxation, which is misalignment or dysfunction in the spine as far as mobility is concerned, it can cause nerve interference, which will interfere with the expression of intelligence that flows over the spinal cord and nerves. It can contribute [to] not only causing pain that most people perceive as a chiropractic problem but also can cause organs not to function 100 percent." Why You Should Be Wary of Back Surgery If you're not offered a prescription drug to treat your back pain, many conventional health care providers will turn to offering surgery like spinal fusion or epidural steroids. Dr. David Hanscom, an orthopedic surgeon with a practice in Seattle, is unusual in that he tells most of his patients they don't need surgery. He's written a book detailing his novel approach to chronic pain treatment, called "Back in Control: A Surgeon's Roadmap Out of Chronic Pain." According to Hanscom: "There's maybe a 20 percent to 25 percent success rate of spinal fusion for back pain. And the downside of a failed spine surgery is terrible. It's really bad. These people are condemned to live their entire lifetime, 30 to 40 more years, in chronic pain." Golden State Warriors coach Steve Kerr knows this all too well. He's still on medical leave after having back surgery in 2015 for a ruptured disk. Kerr experienced leaking cerebrospinal fluid (CSF) as a result of the surgery, which led to another surgery. CSF leakages can cause a range of symptoms, from headaches and problems with hearing to balance problems, nausea and vomiting. Kerr told The Washington Post, "I can tell you if you're listening out there, stay away from back surgery. I can say that from the bottom of my heart. Rehab, rehab, rehab. Don't let anyone get in there."14 Epidurals for Back Pain Can Lead to Permanent Disability and Pain Epidural spine injections have a similarly dismal track record for treating back pain. In an excerpt from Cathryn Jakobson Ramin's book "Crooked: Outwitting the Back Pain Industry and Getting on the Road to Recovery," it's explained how such injections can lead to a life of disability and pain:15 "In roughly [6] percent of epidural steroid injections (a number that sounds small but is not, because thousands of injections are delivered every day), the needle nicks the dura mater, the sturdy sleeve surrounding the spinal cord, allowing cerebrospinal fluid to leak out. Typically, this is not terribly serious. It results in a severe headache, which goes away after the patient lies flat for a couple of days … But when the needle actually punctures the dura mater, it's a different story. Then the payload of glucocorticoid and anesthetic may be delivered into a region of fragile nerve tissue called the subarachnoid space. From there, the cerebrospinal fluid, bearing its toxic load, circulates to the brain, where the cortisone solution efficiently strips the insulating (and essential) myelin layer of neurons. One result is 'adhesive arachnoiditis,' a condition so grossly debilitating that neurologist Dewey Nelson described it as akin to 'having a blowtorch up your rectum. It binds the nerves, like gunky cooked spaghetti, and the result is unrelenting pain that may last for a lifetime.'" Tips for Choosing a Wellness Chiropractor If your pain is mild or moderate, it makes far more sense to try noninvasive, non-drug and nonsurgical options for pain relief first. Along those lines, if you're considering chiropractic care, especially a wellness chiropractor who can help you relieve pain while looking out for your holistic health, you'll want to be sure you're choosing a skilled provider. Consider asking a friend or health care provider for a recommendation. A friend who knows both you and the chiropractor may be able to judge whether your health philosophies and personalities are compatible. Also, many chiropractors will agree to a no-cost consultation to determine whether you are a good match. To make this visit as productive as possible, here are a few things to consider: 1. Does the practice focus on vertebral subluxation and wellness? Physical, biochemical, and psychological stress may result in spinal subluxations that disrupt nerve function and compromise your health. If you're looking for a wellness chiropractor, it's essential that this be the focus. Some chiropractors confine their practice to the mechanical treatment of back and neck pain, and this is something you need to be aware of beforehand if you're looking for benefits that go beyond this. 2. Does the doctor "walk the talk?" If he or she is overweight, looks unhealthy, or does not live a healthy lifestyle, this speaks volumes regarding their commitment to wellness. 3. Do the two of you "click?" Do you like each other? Do you communicate well? Avoid a doctor who seems rushed, talks down to you or seems disinterested in listening to your concerns. 4. Does the doctor use objective assessments of nerve function? Since your care is not based just on addressing pain, your chiropractor should be using some form of objective assessment of your nerve function, as spinal subluxations can sometimes be asymptomatic. Noninvasive instruments that measure the electrical activity in your muscles, and/or a thermal scanner that evaluates the function of your autonomic nervous system can be used, for example. 5. What treatment techniques are used? Chiropractic techniques include low-force adjustments by hand and more forceful adjustments using instruments. Ask which technique would be used on you and, if you have a preference, make sure the doctor is willing to use it. Many chiropractors are also trained in other complementary techniques, so ask what else your doctor may have in his or her tool bag. Additional Non-Drug Solutions for Pain Relief The health risks associated with prescription opioids are great and addiction and overdose happen far more often than you might think. So if you have chronic pain of any kind, please understand that there are many safe and effective alternatives to prescription and even over-the-counter painkillers — alternatives that do not carry these steep risks. The pain remedies that follow are natural, providing excellent pain relief without any of the health hazards that pain medications often carry. ✓ Astaxanthin: One of the most effective oil-soluble antioxidants known, astaxanthin has very potent anti-inflammatory properties. Higher doses are typically required and one may need 8 milligrams or more per day to achieve this benefit. ✓ Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice. ✓ Curcumin: Curcumin is the primary therapeutic compound identified in the spice turmeric. In a study of osteoarthritis patients, those who added only 200 milligrams of curcumin a day to their treatment plan had reduced pain and increased mobility.16 In fact, curcumin has been shown in over 50 clinical studies to have potent anti-inflammatory activity, as well as demonstrating the ability in four studies to reduce Tylenol-associated adverse health effects. ✓ Boswellia: Also known as boswellin or "Indian frankincense," this herb contains powerful anti-inflammatory properties, which have been prized for thousands of years. This is one of my personal favorites, as I have seen it work well with many rheumatoid arthritis patients. ✓ Bromelain: This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful. Keep in mind that most of the bromelain is found within the core of the pineapple, so consider leaving a little of the pulpy core intact when you consume the fruit. ✓ Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used a topical preparation for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. ✓ Evening Primrose, Black Currant and Borage Oils: These contain the fatty acid gamma-linolenic acid (GLA), which is useful for treating arthritic pain. ✓ Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmit pain signals to your brain. Dietary Changes and Additional Pain Relief Options When treating chronic pain, you need to look at the underlying causes of the pain. Toward that end, there's a good chance you need to tweak your diet as follows (all tips that can be used alongside chiropractic and other forms of complementary care): Start taking a high-quality, animal-based omega-3 fat like krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they positively influence prostaglandins.) The omega-3 fats EPA and DHA contained in krill oil have been found in many animal and clinical studies to have anti-inflammatory properties, which are beneficial for pain relief. Reduce your intake of most processed foods as not only do they contain sugar and additives, but also most are loaded with omega-6 fats that upset your delicate omega-3 to omega-6 ratio. This, in turn, will contribute to inflammation, a key factor in most pain. Eliminate or radically reduce most grains and sugars (especially fructose) from your diet. Avoiding grains and sugars will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production. That is why eliminating sugar and grains is so important to controlling your pain. Optimize your production of vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain. This satisfies your body's appetite for regular sun exposure.

#VitalityPath

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