Unbelievable how much corn we grow in this country, and how the free market forces have attempted to shape the inelastic demand of human hunger into a profitable enterprise that can sustain continuous growth. Also fascinating how artificially low oil prices have supported this bubble of energy intensive agriculture. Not going to be pretty when it bursts.
Wednesday, June 8, 2011
Monday, April 25, 2011
The Long Lonliness by Dorothy Day
Interesting historical insights, but poorly written in a really rambling style.
At least I know who Dorthy Day is now...
Saturday, April 2, 2011
International Service Corps for Health
This is a great idea!
some quotes
"Cuba provides an imperfect but
potentially informative example
of the dividends of "exporting"
doctors. Having put key principles
into practice domestically,
particularly the principle that
health care is a right and is essential
to economic and social
development — albeit with unclear
results for its own population's
health — Cuba extended
this mandate to international
public service. The country hoped
to focus on bridging gaps in the
health care workforce and invested
invested
in training and educating
local professionals in developing
countries. The impact has been
noteworthy: between 1999 and
2004, Cuban foreign-service workers
increased doctor visits in resource-
poor communities by 36.7
million, provided health promotion
outreach for millions of
underserved
people, and taught
900,000 medical education courses
to local personnel."
some quotes
"Cuba provides an imperfect but
potentially informative example
of the dividends of "exporting"
doctors. Having put key principles
into practice domestically,
particularly the principle that
health care is a right and is essential
to economic and social
development — albeit with unclear
results for its own population's
health — Cuba extended
this mandate to international
public service. The country hoped
to focus on bridging gaps in the
health care workforce and invested
invested
in training and educating
local professionals in developing
countries. The impact has been
noteworthy: between 1999 and
2004, Cuban foreign-service workers
increased doctor visits in resource-
poor communities by 36.7
million, provided health promotion
outreach for millions of
underserved
people, and taught
900,000 medical education courses
to local personnel."
Monday, February 28, 2011
Treat the Patient, not the CT Scan by Abraham Verghese
The advantages and dangers of computers
the "ipatient" vs. the real patient
how physical exam skills are atrophying as American physicians increasingly just rely on technology.
"But all that training can be undone the moment the students hit their clinical years. Then, they discover that the currency on the ward seems to be "throughput" — getting tests ordered and getting results, having procedures like colonoscopies done expeditiously, calling in specialists, arranging discharge. And the engine for all of that, indeed the place where the dialogue between doctors and nurses takes place, is the computer."
http://www.nytimes.com/2011/02/27/opinion/27verghese.html?pagewanted=2&_r=1
the "ipatient" vs. the real patient
how physical exam skills are atrophying as American physicians increasingly just rely on technology.
"But all that training can be undone the moment the students hit their clinical years. Then, they discover that the currency on the ward seems to be "throughput" — getting tests ordered and getting results, having procedures like colonoscopies done expeditiously, calling in specialists, arranging discharge. And the engine for all of that, indeed the place where the dialogue between doctors and nurses takes place, is the computer."
http://www.nytimes.com/2011/02/27/opinion/27verghese.html?pagewanted=2&_r=1
Hot Spotters by Atul Gwande
http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPage=all
1% of patients account for 30% of costs
Really inspiring ideas.
Improve care for the most costly patients.
That will bring overall costs down.
That really makes sense considering how prevention can reduce emergency costs.
The idea of health coaches really stood out.
This is taken from the international arena of community health workers.
Also, Dr. Brenner used many of the community mapping ideas widely used in international development.
The analysis of data is vital in improving care.
Use insurance billing data or EMS data to find out where patients come from and then go find out why these patients are not receiving adequate care.
Each ER visit is a failure in the web of society, whether a result of crime, transportation, lack of access, drugs or economic circumstances.
Another great idea is the salaried doctor office. Doctors paid for their time, not for procedures.
This results in better outcomes.
Team approach to care, with nurses, front desk staff and health coaches included.
Nurses as case managers in medical home model.
Calling, following up, being like the patients mother.
1% of patients account for 30% of costs
Really inspiring ideas.
Improve care for the most costly patients.
That will bring overall costs down.
That really makes sense considering how prevention can reduce emergency costs.
The idea of health coaches really stood out.
This is taken from the international arena of community health workers.
Also, Dr. Brenner used many of the community mapping ideas widely used in international development.
The analysis of data is vital in improving care.
Use insurance billing data or EMS data to find out where patients come from and then go find out why these patients are not receiving adequate care.
Each ER visit is a failure in the web of society, whether a result of crime, transportation, lack of access, drugs or economic circumstances.
Another great idea is the salaried doctor office. Doctors paid for their time, not for procedures.
This results in better outcomes.
Team approach to care, with nurses, front desk staff and health coaches included.
Nurses as case managers in medical home model.
Calling, following up, being like the patients mother.
Friday, February 18, 2011
Helene Gayle, guest speaker at bmc
CARE CEO Helene Gayle Accepts 2011 Hepburn Medal
More than 200 guests watched President Jane McAuliffe present the 2011 Katharine Hepburn Medal to Helene Gayle, president and chief executive officer of the international humanitarian organization CARE, in honor of her efforts to fight global poverty and reduce the transmission of HIV/AIDS
Saw her speak at BMC. Really inspiring.http://news.brynmawr.edu/?p=7955
Sunday, January 30, 2011
An Imperfect Offering by James Orbinski
A general account of James's service in MSF.
The descriptions were rambling and long, but the overall ideas were solid.
By giving examples of the many political failures that lead to humanitarian crises, Orbinski argues that MSF is correct in maintaining separation from political powers while still speaking out on behalf of all victims. He argues that there must be a humanitarian response to humanitarian crises and a political response to political crises.
Examples include:
Rwandan genocide fueled by colonial divide and conquer strategies. Then the incredible failed international response due mainly to the US's reluctance to become involved following our embarrassing exit from Mogadishu.
Balkan war of the 90s and the Clinton policy of tying humanitarian aid to military action.
And many others. Interesting book but could have expressed the same things in many fewer pages.
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