Showing posts with label small. Show all posts
Showing posts with label small. Show all posts
Small Local Program Big Results Who Cares If D C Is Tied Up in Knots
Sunday, April 20, 2014
While the national mainstream media focuses on Obamacares dimming prospects, internecine Republican conflicts over the merits of a government shutdown, pugnacious Democratic debates over government price controls and who should take credit for the drop in health care cost inflation, check out this local city paper article on the One Simple Idea (that) Could Revolutionize Health Care. As the reporter pointed out, there was no press release, no touting and no awards. Simply results.The DMCB agrees.
Barbara Schneider and her team work with Philadelphia health insurer Keystone Firsts community outreach and care coordination programs to intervene on the "sickest of the sickest" diabetics. These are 35 patients who are admitted on average more than twice a month. Patients who are on a first-name basis with all the local emergency rooms nurses on all the shifts. Patients who live in run-down boarding houses on a good day. Patients who are lucky if their blood sugar is only 600 mg%. Were talking hundreds of thousands of dollars in health care costs.
Dr. Schneiders lay community health workers (more info on the science here) are seeing these individuals in parking lots, McDonalds, row homes and halfway houses to cajole, coach, text, call, shuttle and haggle with patients, families, social workers, pharmacists and insurers to dismantle barriers one patient at a time. If a patient isnt ready to stop abusing drugs, that doesnt mean he cant be taught to use a glucose meter. While living circumstances may be chaotic, that doesnt mean she cant use a cell phone instead of just going to the emergency room.
As Dr. Gawande noted in his The New Yorker article about the super-utilizers, those kinds of interventions can add-up significant savings.
While Keystone has yet to release an analysis on the impact on claims expense for these patients, a cursory review of the data shows emergency room visits have been cut by a third, while inpatient stays declined by more than half. Even with the DMCBs limited background in analytics, it suspects that when the return on investment is finalized, Keystone will conclude that the program was an unqualified success.
To the DMCB, this is what its all about. Washington DC can continue its partisan scorched earth battles while, in the meantime, small regional community minded health insurers like Keystone First are figuring out how to do right by patients using novel programs like this.
Image from Wikipedia
Small Braid Rolls Eggless Clove Leaf Eggless Lion House Rolls
Thursday, April 10, 2014
Our this months Baking Partners challenge was to make either dinner rolls with eggs or eggless dinner rolls. Swathi of Zesty South Indian Kitchen,the brain child of this monthly baking event shared us 7types of dinner roll shapes and asked us to try atleast 3 among them. I chosed to make both eggless and rolls with eggs for this months challenge. I tried the small braid rolls with eggs while for eggless version i went for clove leaf rolls and lion house rolls.
I followed exactly as the original recipe of dinner rolls with egg which Swathi send to us through mail,but i made a small change in the eggless version dinner rolls ingredients, the original recipe without egg had potato starch or cooked potato since i dont want use it, i skipped it and went for custard powder. Addition of custard powder gives a wonderful colour to my eggless dinner rolls and tastewise we didnt found anything different,my kids just enjoyed thoroughly when i served these dinner rolls along with cream cheese and a bowl of warm soup.However i enjoyed thoroughly this challenge as i like to play with yeast.
Small Braid Rolls:
5cups All purpose flour
1no Egg
1/4cup Sugar
1+1/2tsp Salt
2tbsp Dry yeast
2/3cup Milk powder
2cups Warm water
1/3cup Butter
Mix the water,milk powder together until the milk powder get dissolves.
Add the yeast to the mixture,then add the sugar,salt,butter,egg and the flour, mix everything and knead for a while, its will be sticky.
Now add the 2more cups of flour and knead for another few minutes to get a stiff dough. Finally add a cup of flour and knead again, the dough will be soft and not too sticky.
Transfer this dough to a greased bowl and keep in warm place for 2hours until they double their size.
Sprinkle the counter with a flour and put the dough on the flour.
Flatten the dough as rectangular disc, cut small rectangular disc from the rolled disc.
Make three slits to the small rectangular disc without disturbing the top of the disc, make the braid as show in the video.
Video for Small Brain & clove leaf rolls
Once the braid is ready, keep it again in warm place. Preheat the oven to 350F and brush the small braid rolls with egg yolk and bake for 20-25minutes until the crust turns brown.
Clove Leaf Rolls (Eggless)
Lion House Rolls (Eggless)
For Eggless Rolls:
4cups All purpose flour
2tsp Instant year
1/4cup Custard powder
1cup Lukewarm milk
2tbsp Sugar
1tsp Salt
4tbsp Butter
1/4cup Milk + 1tsp sugar for brushing
Take the flour,salt,sugar,yeast,custard powder and butter in a bowl..
Mix everything well,now add the lukewarm milk and knead everything as a soft dough, again knead to dough for few more minutes until they turns elastic.
Keep in a warm place until they double their size.
Punch the dough and prepare rolls with the shapes as you desire.
Simply roll the dough and pinch down three small balls from dough,place them to a muffin mould and keep aside to double their size,this is clove leaf roll.
Roll the remaining dough as a rectangular disc, cut it in the middle and cut them as small sized rectangular disc, and roll over them, arrange in a greased plate to rise until they double their volume, this is lion house rolls.
Watch here for Lion house rolls
Preheat the oven to 350F, mix the milk and sugar for brushing and brush the dinner rolls on the top.
Bake for 20-25minutes or until the turn turns golden brown.
Let them cool completely and enjoy with your favourite spread.
);I followed exactly as the original recipe of dinner rolls with egg which Swathi send to us through mail,but i made a small change in the eggless version dinner rolls ingredients, the original recipe without egg had potato starch or cooked potato since i dont want use it, i skipped it and went for custard powder. Addition of custard powder gives a wonderful colour to my eggless dinner rolls and tastewise we didnt found anything different,my kids just enjoyed thoroughly when i served these dinner rolls along with cream cheese and a bowl of warm soup.However i enjoyed thoroughly this challenge as i like to play with yeast.
Small Braid Rolls:
5cups All purpose flour
1no Egg
1/4cup Sugar
1+1/2tsp Salt
2tbsp Dry yeast
2/3cup Milk powder
2cups Warm water
1/3cup Butter
Mix the water,milk powder together until the milk powder get dissolves.
Add the yeast to the mixture,then add the sugar,salt,butter,egg and the flour, mix everything and knead for a while, its will be sticky.
Now add the 2more cups of flour and knead for another few minutes to get a stiff dough. Finally add a cup of flour and knead again, the dough will be soft and not too sticky.
Transfer this dough to a greased bowl and keep in warm place for 2hours until they double their size.
Sprinkle the counter with a flour and put the dough on the flour.
Flatten the dough as rectangular disc, cut small rectangular disc from the rolled disc.
Make three slits to the small rectangular disc without disturbing the top of the disc, make the braid as show in the video.
Video for Small Brain & clove leaf rolls
Once the braid is ready, keep it again in warm place. Preheat the oven to 350F and brush the small braid rolls with egg yolk and bake for 20-25minutes until the crust turns brown.
Clove Leaf Rolls (Eggless)
Lion House Rolls (Eggless)
For Eggless Rolls:
4cups All purpose flour
2tsp Instant year
1/4cup Custard powder
1cup Lukewarm milk
2tbsp Sugar
1tsp Salt
4tbsp Butter
1/4cup Milk + 1tsp sugar for brushing
Take the flour,salt,sugar,yeast,custard powder and butter in a bowl..
Mix everything well,now add the lukewarm milk and knead everything as a soft dough, again knead to dough for few more minutes until they turns elastic.
Keep in a warm place until they double their size.
Punch the dough and prepare rolls with the shapes as you desire.
Simply roll the dough and pinch down three small balls from dough,place them to a muffin mould and keep aside to double their size,this is clove leaf roll.
Roll the remaining dough as a rectangular disc, cut it in the middle and cut them as small sized rectangular disc, and roll over them, arrange in a greased plate to rise until they double their volume, this is lion house rolls.
Watch here for Lion house rolls
Preheat the oven to 350F, mix the milk and sugar for brushing and brush the dinner rolls on the top.
Bake for 20-25minutes or until the turn turns golden brown.
Let them cool completely and enjoy with your favourite spread.
Why Cant A Single Small Physician Owned Group Enter Into A Shared Savings Contract
Sunday, March 23, 2014
Here’s one of the better questions that was emailed after the webinar was concluded:
What shared savings arrangements can happen on a small scale, for example a 4 doc office?
The (gently edited) DMCB reply:
None.
The month-to month variability in the insurance claims (think 95% confidence intervals) from a small practice makes it practically mathematically impossible to confidently compare an observed dollar amount to a target dollar amount.
There are methods that can be applied to diminish the variability (such as censoring “excess” claims and using “risk adjustment”) but, at the end of a fiscal year, a lack of documented savings could be the result of either a) poor care coordination or b) an “underpowered” or mathematically suspect claims analysis. The skeptical insurer will say it was the former and the screwed docs will say it was the latter. When that happens, docs lose.
This is an example of the “law of large numbers” and why the shared risk arrangements in Medicare ACOs have to be based on a minimum of “5000” persons. By having that many observations, the variability is blunted and measures of central tendency hold up in an actuarial basis.
And then there are the two policy implications. First of all, shared risk contract involving a relatively small practice is perilously close to the bad old days of capitation and HMOs, vs. the approach of spreading accountability across a large system that is armed with all the requisite care coordination resources A four person group can’t match that. Secondly, the insurers have little interest in putting together a payment system that could financially cripple a four person clinical practice, especially if its primary care.
The DMCB will examine accountable-like arrangements for a small group practice in a future post.
Cooking for Small Children 15 Hows Whens and … Honey Please Put That Cleaver Down
Monday, February 10, 2014
Yesterday, I asked parents* how they managed to cook with small children around the house. See, I babysat my two young (adorable, crystal-eyed) cousins last week, and couldn’t figure out where you might fit any slicing, sautéing, or saucing into the schedule. How did they not starve? How did their mom maintain her sanity? Is it okay to sit them in front of Snow White while you chop a cucumber?
Sweet readers, you came through like gangbusters.
As of this morning, we had 41 voluminous, information-packed comments from a plethora of parenting experts (a.k.a. parents). I included as many as I could in this post, editing only for length. The funny thing is, I’d give this advice to anyone, old or young, childless or childful, who is attempting to eat more wholesomely and frugally.
So, here they are: 15 strategies for feeding your small children without resorting to GoGurt or checking yourself into an asylum. As always, the comment section is open if you’d like to add anything.
1) Follow the Annie Jones Rule.
Many readers agreed with our first commenter, Annie Jones, whose advice could be summed up in a single sentence: “Basically, you just do it.”
2) Don’t worry about entertaining.
Babysitting and parenting are very different, in that moms and dads don’t have to supervise their children every second.
3) Keep ‘em where you can see ‘em.
Of course, if your children are younger and/or prone to hitting their heads on pointy things (*cough cough*), it helps to have them in your view.
4) Immobilize them.
By this, I mean “put them in a high chair,” not “shoot them with tranquilizer darts."
5) Cook when you can – especially naptime.
Ahh … those blessed two hours when children are totally unconscious. You can breathe, go to the bathroom, and maybe even chop a vegetable.
6) Get the timing down.
Every family lives by its own schedule, but setting a routine when a spouse is around and the kids are sedate (Note: not sedated) will help everyone in the long run.
7) Get the kids involved.
It ain’t no urban legend: When children pitch in with their own food prep, they’ll be more invested in their eating. Plus, it’s a good babysitting trick.
8) Enlist your spouse or a helper.
Four hands are better than two. Unless they’re all coming out of the same person. Then it gets kind of weird.
9) K.I.S.S.
If brevity is the soul of wit, than easy meals are the souls of parental sanity. Keeping things simple and quick will make everyone a little grinnier.
10) Don’t cook separate meals for them.
As a non-parent, this one surprised me the most, but in a good way. Bring on the osso bucco, junior.
11) Embrace the slow cooker.
All the flavor of braising with only a fraction of the mess. Plus, you can walk away from it for eight hours.
12) Explore big batch and weekend cooking.
Have a few hours to yourself? Start making some kid meals. It’s like meditation, but with meatballs.
13) Menu plan.
It works for everybody, whether you’re a single Brooklyn blogger or a ma of eight.
14) If all else fails, turn to Nickelodeon.
This does not make you a bad person. If anything, it makes you a really good person who wants to feed your kids right.
15) Don’t panic. It gets easier. I think. Maybe not.
I’ll let the commenters take it from here.
ADDITIONAL REFERENCES
Again: Best. Readers. Ever.
*Uh, actually, when I initially wrote the question, I addressed it to “moms” instead of “parents.” I try to keep it gender neutral here, because men and women should be equally invested in child raising and home affairs. That was just a huge oversight, and I apologize.
~~~
If you like this piece, you might also enjoy:
Sweet readers, you came through like gangbusters.
As of this morning, we had 41 voluminous, information-packed comments from a plethora of parenting experts (a.k.a. parents). I included as many as I could in this post, editing only for length. The funny thing is, I’d give this advice to anyone, old or young, childless or childful, who is attempting to eat more wholesomely and frugally.
So, here they are: 15 strategies for feeding your small children without resorting to GoGurt or checking yourself into an asylum. As always, the comment section is open if you’d like to add anything.
1) Follow the Annie Jones Rule.
Many readers agreed with our first commenter, Annie Jones, whose advice could be summed up in a single sentence: “Basically, you just do it.”
- Hillary: What Annie Jones said…
- Shris: Yeah, what Annie Jones said.
- Gabrielle: I agree with Annies comment. You just do it, and you make it a priority.
- TJ: I agree with the ‘just do it’. The first battle starts in your head, so don’t defeat yourself before starting!
- Heather: Ditto to Annie Jones.
- Kristen@TheFrugalGirl: I have 4 kids and I ditto Annie.
- Todd: The "just do it" answers speak to the reality of parenting. … There are nights where we eat cereal for dinner (which is also fun), but for the most part, you find ways to integrate your family into "life"; its no fun keeping them separate.
2) Don’t worry about entertaining.
Babysitting and parenting are very different, in that moms and dads don’t have to supervise their children every second.
- Amiyrah: I think when you are a babysitter compared to a parent, you think you just have to make it all work for the kid and move as fast as possible. When you are a parent, that aint the case.
- Kate Krebs: Its not your job as a parent to entertain your kids 24/7. Your job is to raise healthy, capable adults. That means providing good meals for your kids, and teaching them to entertain themselves quietly while you cook.
- Amy: When theyre in their own space, they can play unsupervised with a toy for a while from an astonishingly young age. Kids dont spontaneously combust when not directly observed, most of the time. :)
3) Keep ‘em where you can see ‘em.
Of course, if your children are younger and/or prone to hitting their heads on pointy things (*cough cough*), it helps to have them in your view.
- Rapha: I set up a play area in the kitchen - my daughter plays with her tool bench and the lazy susan is full of her cups/bowls as well as her kitchen toys.
- Lacey: We have a chalk board in the kitchen, which helps.
- Jennifer: The little baby usually sits in a bouncer in the kitchen (& at this point is usually sleeping). Also crayons at the table generally keep my older daughter occupied for a while.
4) Immobilize them.
By this, I mean “put them in a high chair,” not “shoot them with tranquilizer darts."
- Anonymous: The high chair - she can come in the kitchen, sit in her chair and "chop" ingredients, and be out of harms way.
- Hillary: My babies played on mats nearby when they were tiny and then in the kitchen "cooking," and now, sometimes my toddler watches or cooks with me on a chair strategically placed away from knives and the stove.
- Shris: As they get interested, you perch them on a stepstool/highchair in a safe spot so they can watch. Give them a little bite or pinch or taste of whatever youre adding to the dish to keep their interest.
5) Cook when you can – especially naptime.
Ahh … those blessed two hours when children are totally unconscious. You can breathe, go to the bathroom, and maybe even chop a vegetable.
- Kate E.: Nap time (or a quiet time when the child gets older) is essential for getting things done.
- Jen: Nap time is mostly dedicated to prepping dinner. Or making sauces to freeze, etc.
- Amybee: One thing that works for me is to cook after my kid is in bed for the evening. … Ill make the next nights supper, then all we have to do when we get home from work and school is pull it out and pop it in the microwave.
6) Get the timing down.
Every family lives by its own schedule, but setting a routine when a spouse is around and the kids are sedate (Note: not sedated) will help everyone in the long run.
- Erinlaughs: I think the most important thing is knowing what you can accomplish. We get home at 5:00 and need to be eating by 5:30 or so.
- Gabrielle: I aim for dinner on the table between 5:30 and 6, when my husband comes home. This insures that well be finished with dinner by 6:30, the kitchen will be cleaned by 7 (or earlier), and my child can be in bed between 7:30 and 8. But were flexible when we want to be.
- Hannah @CookingManager: Use a timer, not only to remind you when food is done, but for the next step. (and reset the timer if the food isnt done yet!)
7) Get the kids involved.
It ain’t no urban legend: When children pitch in with their own food prep, they’ll be more invested in their eating. Plus, it’s a good babysitting trick.
- Julie: Get them involved in safe but meaningful ways during meal prep. It is worth the extra time it WILL take to do it.
- Debbie: My 4yo does pretty well with a butter knife and a pile of mushrooms.
- Lindsey: The older one likes to hold the recipe card and pour out what I measure. I can also have him fetch ingredients from the pantry and lower shelves of the fridge.
- Todd: My 9-, 7-, and 5-year-olds all love to help in the kitchen. One will pour bread crumbs while another cracks an egg into the ground beef that the third is mixing with her hands (and they LOVE getting in there with their hands).
8) Enlist your spouse or a helper.
Four hands are better than two. Unless they’re all coming out of the same person. Then it gets kind of weird.
- Marcia: At 18 months...yeah, I wasnt doing much cooking. I waited until spouse got home to start it.
- Shris: If you have a housemate/partner/spouse/other, enlist them in kid-watching while you cook. … [Or] make *them* cook.
- Rachel: What works for me is serving the kids early - around 5:30 or so - and cooking our dinner after and eating later. That way my husband is home and he can hold the baby while I focus on the food.
9) K.I.S.S.
If brevity is the soul of wit, than easy meals are the souls of parental sanity. Keeping things simple and quick will make everyone a little grinnier.
- Milehimama: I have 8 children, age 1-12 … I dont prepare dishes that require constant, lengthy supervision. So Ill make rice - but not risotto. Its not difficult to find 5 minutes to measure water and grains and put it on for a boil, but standing at the stove for a long period of time just isnt going to happen.
- Debbie: Develop an arsenal of super-quick recipes. Bonus points if theyre pantry based.
- Jen: I do a lot with roasting vegetables, things I can start on the stove quickly and let simmer.
- Anonymous: Frozen spinach cubes (cooked spinach and cream cheese blended to puree) and sweet potato cubes, perfect for adding to sauces, in pizza or pasta, quesadillas, etc. for a little added boost of nutrition and no added cooking time/effort.
- Anonymous #2: Breakfasts are the hardest. Everyone is hungry RIGHT NOW and even cooking an egg takes too long. We keep it simple and marginally healthy - yogurt, cereal, toast, etc.
- Amy: Lunch is a sandwich and chips and fruit, or mac and cheese, or soup and grilled cheese.
- Katie Krebs: We keep alot of fruit on hand. It makes a good, healthy snack and doesnt require cooking.
- Lyn: I make a Kiddie Sampler Platter, which takes 5 minutes. Basically, little bits of things I know she will like on one plate and mostly finger food: rolled up slices of deli turkey or ham, pieces of fruit, a little bunch of grapes, applesauce, grape-size tomatoes, baby carrots, slices of bell pepper, avocado, cheese, a mini bagel with cream cheese, crackers, etc.
10) Don’t cook separate meals for them.
As a non-parent, this one surprised me the most, but in a good way. Bring on the osso bucco, junior.
- Gabrielle: I use to serve one dinner to my toddler and another dinner for my husband and I. I dont purchase fish sticks, chicken nuggets, and french fries because these become the fallbacks of many families with picky children.
- Ashley: Im a registered dietitian who works with families on limited incomes … Definitely only make one meal, not two separate meals for kids and adults. Offering kids "adult" foods over and over is helpful for dealing with picky eating behaviors.
- Rapha: If we were eating something like sweet potato curry, she would eat the sweet potato pureed. Now at age 3 she always eats what we eat - and shes an amazing eater as a result because she knows if she doesnt eat dinner she doesnt get anything else.
- Jen Blacker: I have a 19 month old … When we go out to dinner, if the place has crappy food to choose from on the kids menu, I just order off of the adult for him ... He eats what he can, then the rest is for leftovers.
11) Embrace the slow cooker.
All the flavor of braising with only a fraction of the mess. Plus, you can walk away from it for eight hours.
- Kathleen Bakka: I make my homemade spaghetti sauce and meatballs in the evening after he goes to bed so that I can just turn the crock pot on in the morning for a fantastic homemade dinner meal.
- DRosa: Good easy slow cooker recipe - slice up some chicken strips, pour in a can of coconut milk and a little thai red curry, let cook all day, serve over rice with steamed spinich. Get a rice cooker with a timer and you are golden.
12) Explore big batch and weekend cooking.
Have a few hours to yourself? Start making some kid meals. It’s like meditation, but with meatballs.
- Anonymous: I do the time consuming meals on the weekends when Im not working. And I make enough so we can eat it one night during the week.
- Anonymous #2: Sunday afternoons are a nice quiet time for me to help do some prep work.
- Anonymous #3: I can slow cooker a pork shoulder with some salsa and we have several nights of burritos, nachos, tacos, etc.
- Anonymous #4: [We] plan to have leftovers revamped from our weekend cooking … We may roast a chicken on Sunday and then plan to have chicken quesidillas one night (super quick to throw together) and chicken soup another (stock made over the weekend after roasting).
- Heather: I would do an entire box of whole wheat pasta tossed with olive oil and store it in the fridge. I could scope out as much as I needed for a meal and add goodies like chopped veggies, cheese, etc.
- Myrnie: We make a batch of goodies every week- cookies, brownies, muffins, etc. for snacks and when theyre gone, theyre gone.
- Sarah May: I often use church potlucks or family gatherings as an excuse to prepare something new or special. This lets me satisfy my fancy-cooking urges without stressing about it every day!
13) Menu plan.
It works for everybody, whether you’re a single Brooklyn blogger or a ma of eight.
- Jen Blacker: I plan what my family eats on a menu and stick to it. It saves us money and I create the menu with the sales going on at the grocery store. Its not difficult at all to feed your kids the right way.
- Erinlaughs: Menu plan! I cant stress that enough. It saves me every night.
- Kristen@TheFrugalGirl: Menu planning seriously saves my sanity.
- RaeBerry: Menu planning is the only way to survive.
14) If all else fails, turn to Nickelodeon.
This does not make you a bad person. If anything, it makes you a really good person who wants to feed your kids right.
- Marcia: At age 3 ... I used Dora the Explorer. I admit it. 1/2 hour is all I needed to get things going.
- Shris: Turn on their favorite video or TV show or whatever, and let them zombie-fy for a half hour while you get the dinner done. This is, of course, the least favorite option, but it works really well.
- Craftevangelist: All these other moms are super heroes. My TV goes on to a kids station at 4:00 if I need to focus on making dinner. Often, Im still interrupted and the kids love to "help" (usually in an effort to get a snack of what were preparing).
15) Don’t panic. It gets easier. I think. Maybe not.
I’ll let the commenters take it from here.
- Kathleen Bakka: I remember feeling very overwhelmed when he was first born and my husband feeling slightly jilted when it came to meals- but you get used to it and you begin to streamline your prep and meals.
- Amy: Seriously - kids start off small and immobile and sleepy, and they very g-r-a-d-u-a-l-l-y get mobile and require higher levels of attention. Its not like theyre born needing help with their homework. You come to that over a period of time, and there are lots of stages in between.
- DRosa: It isnt like it gets better. Monday night tennis, Tuesday baseball, Wednesday tennis, Thursday baseball, Friday the inevitable sleepover. By the time we pull in from work, we often have 45 minutes to eat and be out the door. And we only have two.
ADDITIONAL REFERENCES
- Heather: The book Child of Mine, Feeding with Love and Goodsense changed my life. I am so glad I found it when my son was an infant.
- Lindsey: For little little ones, realbabyfood.info is a good resource.
- Gabrielle: I used a cookbook that a friend gave me, called Cooking for Baby, a Williams Sonoma publication. I also erred to Wholesomebabyfood.com for ideas and recipes (and a great chart with age appropriate foods).
- Also, look for Debbie’s cookbook, due next year from Harper Collins. Her blog, Words to Eat By, is one of my dang favorites.
Again: Best. Readers. Ever.
*Uh, actually, when I initially wrote the question, I addressed it to “moms” instead of “parents.” I try to keep it gender neutral here, because men and women should be equally invested in child raising and home affairs. That was just a huge oversight, and I apologize.
~~~
If you like this piece, you might also enjoy:
- The Hour: How 60 Minutes a Week Can Save Hundreds of Dollars on Food
- Need a Weekly Meal Planner, a Grocery List, or Price Books? We Have 36 of ‘em.
- Understanding the Childhood Obesity Epidemic, Part 1: Causes and Effects
How Small Business Is Helped By Obamacare and Large Businesses Will Be Less Able to Compete Against Them
Sunday, February 9, 2014
 |
| Small business points at its competitor |
Since the DMCB formed its own corporation more than 5 years ago, it has certainly participated in "protean" business relationships. Once things get underway, the DMCB often discovers that of the many prominent organizations that it does business with really consist of a small core office populated by a few owner-founders, a single administrative aide and one or two payroll folks who oversee the outsourcing of everything else. While the term "protean" is certainly novel, the DMCB thinks distributed, adaptable and organic business networks have been around for years.
But the WSJ editorial opens a window into an underappreciated consequence of Obamacare and the underlying assumptions of the central planners who run Washington DC. The DMCB doesnt necessarily think its bad, but it sure is interesting.
Read on.
While the Affordable Care Act (ACA) was intended to link employment and health insurance, what it has really done is handed many small nimble interlocked businesses another leg-up against their large traditional mainframe competitors. For example, one colleague pointed out to the DMCB that "new" pharma companies are really marketing departments that outsource manufacturing that, in turn, outsources supply management that outsources I.T. that outsources its cloud services. Its the only way they can compete.
The new economics of health insurance will only accelerate similar trends in other manufacturing and service sectors of the economy. Toss in the ability of people and capital to move and work across borders and the picture becomes even more dynamic. And in the meantime, Washington DC continues to implement the ACA with a legacy of large companies buying comprehensive health insurance for its employees.
Little did anyone anticipate that the ACA would hamper the success of American big business.
Image from Wikipedia
Trypophobia phobia of small holes
Wednesday, February 5, 2014
Trypophobia, phobia of small holes - Lately a lot of people talk about trypophobia or phobia of small holes. But you know, in these conditions in the medical field does not actually exist. So what is it trypophobia?
According to Urban Dictionary, is defined as the fear of trypophobia small hole or asymmetrical shape that makes a person feel itchy and tingling all over his body and feeling uncomfortable.
Some images such as honeycomb, lotus seeds, coral, bubbles, or fungus also erred to as an object that can trigger trypophobia on someone.
The word itself trypophobia discovered since 2005 which is a combination of the words trypo (Greek) which means the hole and phobias. Even so, in fact, the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders does not recognize the condition as a real phobia.
Meanwhile, who is a psychologist Martin Antony of Ryerson University in Toronto also mentioned that medical experts generally avoid using words from Latin or Greek to name a disease.
However, Antony did not wonder if a lot of people claim to suffer trypophobia directly after seeing the pictures with lots of small holes. According to him, the fear of someone actually can come from anywhere.
"Fear and disgust is contagious. Technically, almost all of the things that trigger disgust reactions usually also raises the fear of a disease," said Antony, as quoted from Popular Science.
Antony went on to explain that the most likely repulsion arising from the hole saw is full of objects subconscious reaction that occurs because of a fear of a particular disease. Examples conditions chickenpox scars that make the skin of small spots pretty nasty.
If you also feel a trypophobia, try to eliminate any negative thoughts about it. Then you are claiming normal and fine, do not force other friends to see images with a lot of holes.
As for you who do not know or are curious, you should not try to googling and typing trypophobia in the search field. Trust me, its nasty.
According to Urban Dictionary, is defined as the fear of trypophobia small hole or asymmetrical shape that makes a person feel itchy and tingling all over his body and feeling uncomfortable.
Some images such as honeycomb, lotus seeds, coral, bubbles, or fungus also erred to as an object that can trigger trypophobia on someone.
The word itself trypophobia discovered since 2005 which is a combination of the words trypo (Greek) which means the hole and phobias. Even so, in fact, the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders does not recognize the condition as a real phobia.
Meanwhile, who is a psychologist Martin Antony of Ryerson University in Toronto also mentioned that medical experts generally avoid using words from Latin or Greek to name a disease.
However, Antony did not wonder if a lot of people claim to suffer trypophobia directly after seeing the pictures with lots of small holes. According to him, the fear of someone actually can come from anywhere.
"Fear and disgust is contagious. Technically, almost all of the things that trigger disgust reactions usually also raises the fear of a disease," said Antony, as quoted from Popular Science.
Antony went on to explain that the most likely repulsion arising from the hole saw is full of objects subconscious reaction that occurs because of a fear of a particular disease. Examples conditions chickenpox scars that make the skin of small spots pretty nasty.
If you also feel a trypophobia, try to eliminate any negative thoughts about it. Then you are claiming normal and fine, do not force other friends to see images with a lot of holes.
As for you who do not know or are curious, you should not try to googling and typing trypophobia in the search field. Trust me, its nasty.
Violence as a small increase womens risk of thyroid disease
Monday, January 13, 2014
Violence as a small increase womens risk of thyroid disease - Violence perpetrated on children not only a bruised scar lost in a matter of weeks, but also other issues that will be there until they are adults.
A study revealed that women who experienced physical abuse as children have an increased risk of thyroid disease more than women who did not experience physical abuse as a child.
"We found a significant association with thyroid disease in women who have experienced violence in childhood," said lead researcher Esme Fuller Thomson, professor of the University of Toronto;s Faculty of Social Work, as reported by U.S. News .
Thomson explained that first they thought it must be related to stress, smoking, drinking alcohol, and other factors related to violence as a child. But in fact, after accounting for all factors, the researchers found that the risk is still quite large, namely 40 percent in women who have experienced violence as a child.
These results were found after researchers analyzed data from 13,000 adults in Canada. More than 1,000 women are known to experience physical violence before the age of 18 years and about 900 women said they had thyroid disease.
Loriena Yancura, assistant researcher from the University of Hawaii explained that the possibility of it is influenced by the trauma experienced by women due to physical abuse as a child. Trauma then change the way their bodies respond to stress to adults and are associated with thyroid.
A study revealed that women who experienced physical abuse as children have an increased risk of thyroid disease more than women who did not experience physical abuse as a child.
"We found a significant association with thyroid disease in women who have experienced violence in childhood," said lead researcher Esme Fuller Thomson, professor of the University of Toronto;s Faculty of Social Work, as reported by U.S. News .
Thomson explained that first they thought it must be related to stress, smoking, drinking alcohol, and other factors related to violence as a child. But in fact, after accounting for all factors, the researchers found that the risk is still quite large, namely 40 percent in women who have experienced violence as a child.
These results were found after researchers analyzed data from 13,000 adults in Canada. More than 1,000 women are known to experience physical violence before the age of 18 years and about 900 women said they had thyroid disease.
Loriena Yancura, assistant researcher from the University of Hawaii explained that the possibility of it is influenced by the trauma experienced by women due to physical abuse as a child. Trauma then change the way their bodies respond to stress to adults and are associated with thyroid.
Small children can get pregnant this medical reason!
Friday, January 10, 2014
Small children can get pregnant, this medical reason! - A shocking news came from a girl named Daphne who successfully gave birth to her first baby at the age of 8 years (now age 9 years) in the State of Jalisco, Mexico.
As quoted by The Sun (6/2), the father of her unborn child was aged 17 years. And now the boys were reportedly still escape. The cases recorded motive child sexual abuse and rape.
However, the big question is how could a child get pregnant at a young age. Following his medical explanations!
Pregnancy at a young age can only happen when a child is experiencing what is called precocious puberty - menstruation occurring at a very early stage.
This condition can be caused by head injuries, which can cause brain or pituitary gland starts releasing sexual hormones that appeared a few years earlier.
Once puberty starts, children will experience breast development, pubic hair growth, and menstruation. Another cause of this condition, including genetic problems, diseases that damage the brain, or even tumors that release hormones.
Early puberty is more common in girls than boys, and can affect children at the age of five years or more. Those who experience puberty early are more often associated with a number of medical problems associated with bone growth, as well as social issues.
However, certain treatments can stop the release of hormones and also restore the physical changes that have occurred - which allows children to have a more normal childhood.
As quoted by The Sun (6/2), the father of her unborn child was aged 17 years. And now the boys were reportedly still escape. The cases recorded motive child sexual abuse and rape.
However, the big question is how could a child get pregnant at a young age. Following his medical explanations!
Pregnancy at a young age can only happen when a child is experiencing what is called precocious puberty - menstruation occurring at a very early stage.
This condition can be caused by head injuries, which can cause brain or pituitary gland starts releasing sexual hormones that appeared a few years earlier.
Once puberty starts, children will experience breast development, pubic hair growth, and menstruation. Another cause of this condition, including genetic problems, diseases that damage the brain, or even tumors that release hormones.
Early puberty is more common in girls than boys, and can affect children at the age of five years or more. Those who experience puberty early are more often associated with a number of medical problems associated with bone growth, as well as social issues.
However, certain treatments can stop the release of hormones and also restore the physical changes that have occurred - which allows children to have a more normal childhood.
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