controversy http://pr-medicine.org/ http://pr-medicine.org/
Develop programs based on clinical interventions with proven effectiveness. Those treatments that fit evidence-based practice guidelines are certainly more likely to be funded in the managed healthcare environment. Describe programs in language that demonstrates clinical compassion, but also provides enough business-plan detail to demonstrate some measurable cost savings or (better yet) the generation of income. In market-driven managed healthcare one will be increasingly constrained to justify treatment programs with proven outcomes that benefit most patients and at the same time. At stendra the same time, one can sometimes show that clinical effectiveness and compassion are 'marketable features' that reflect well upon the organization or system. In the United Kingdom of Great Britain, the NHS 'socialised medicine' seems just as bound to cost-control measures as American healthcare in the private sector. In all cases the consistency index of the most parsimonious trees was higher for the data set without the intraspecifically variable base positions, which resulted in less most parsimonious trees than the data sets with intraspecifically variable base positions included. The combined COI+ITS data set without intraspecific variation resulted in the lowest number of most parsimonious trees, i. Shelf zonation: Onshore-offshore (On-Off) as derived from the commonly inherited Offshore (Off) only. Onshore (On) only was not observed. In the latter case the Bray-Curtis similarity index is equivalent to the Sorenson similarity index ( Clarke and Gorley, 2006). Arkiv Kemi 10, 183. Partition equilibria of indium halide complexes. Recueil des Travaux Chimiques des Pays-Bas 75, 743. Some relationships among the stabilities of metal complexes. Recueil des Travaux Chimiques des Pays-Bas 75, 763. On equilibria with polynuclear complexes. People need to understand the difference between individual racism and institutional racism. Individual racism is not a big deal these days. They don't need to be, because our institutions are. I hope they understand that. The goal is to write in order to not be wrong..
The Jew and the Carrot » Blog Archive » Nutritional Assistance, the Food Movement, and You (and me, and the Farmer’s Market) - Voice of the New Jewish Food Movement
I grew up in a generally middle class neighborhood in the North West Bronx, and all of the bodegas (that’s a corner store, for you non-New Yorkers) accepted food stamps and EBT cards. According to the radio program, for stores, it’s pretty easy to apply. Despite the fact that there must have been enough demand to necessitate our more-ample-than-usual selection of markets to accept all this government scrip, we made free and easy fun of government food hand outs. I remember “government cheese” being synonymous with anything processed, cheap and nasty. It was synonymous with lunch room food, another domain of the USDA’s nutrition programs, and with being poor, a category that many of my elementary school friends were a part of, though at the time it seemed they weren’t aware.
When I started working at the farmer’s market in Union Square, we accepted EBT cards, a kind of ATM card for purchasing food with your SNAP money. I remember being surprised the first time a person came up with their arms full of grass-fed steaks and sausages, lacto-fermented pickles, farm-ground organic whole wheat bread and lots of questions about what would freeze well, then paid for it all with an EBT card. Gone, I suddenly realized, are the days when nutritional assistance meant mandatory government cheese. For a moment I was judgmental, I was thinking, I can barely afford to eat this, and I work here, then I realized what a good thing it is that this guy was spending his money on high-quality food, both for his health and for mine. He was taking USDA dollars that might have gone to subsidizing soy and corn, either directly or through the purchase of products containing those things, and putting them straight into the coffer of a sustainable farmer.
He’s a success story. FNS (food and nutrition services) has been developing programs like their checks for use at farmers markets and their fresh fruit and vegetable program, (though Grist doesn’t think much of the USDA’s new school lunch czar) and pushing their core nutritional principles, in an effort to improve the nutrition of its constituents. WIC California is holding a webinar on May 27th to discuss the new variety of foods available as part of the WIC (women, infants and children) program. You can sign on to learn more.
If you listen to the radio program above, you’ll find that the conversation quickly turns away from middle class folks on the dole, and onto how to get benefits if you need them. It discusses the ways in which SNAP both supports and undermines working poor people, and talks about how to find a guide through the red tape in applying.
On the message board, it’s a whole different story. As often happens on the internet, the world pours forth its racists and class snobs to give their unabashed opinions, one particularly New Yorkish commentor complains about having to wait too long in line behind people trying to buy things on their benefit cards. It does take a while – I found that out on the other side of the counter, running EBT cards through the credit card machine, punching in pins and checking balances, having garbled, multilingual, hand gesture conversations regarding how to use the two-dollar checks provided for use only at farmers markets, only for fresh produce, only for whole two dollar amounts. At Hawthorn Valley we had about eight languages between all the staff, and very supportive managers, and it still slowed things down. But who cares? Not our other customers, they came back despite the wait.
Other, saner, commentors considered the efficacy of a nutrition program that can’t police what foods people buy with their EBT (you’re not allowed to buy alchoholic beverages, but you can buy a cart full of chips and donuts). It’s a double bind though. I remember that first pang of resentment that this guy gets to eat steak when I’m on potatoes and onions, but if he’d been buying chocolate covered minidonuts and a gallon of bright blue corn syrup-water punch, I’d have been twice as judgemental. At least the latter judgementalism was born out of wanting to see people spending their money on more deserving companies and buying nourishing foods. The former’s nothing but snobbery, wanting that customer to stay in ‘his place’, which, after years of throwing around government cheese in the schoolyard, seemed somehow lower than mine. As usual, it took a direct human interaction to see my stupid prejudices clearly, and to see through them.
There’s been an argument over elitism built in to the sustainable foods movement since its inception. Better tasting, more nourishing food, has always been available for a price, but the food movement goes forward on the premise that we want that food available to everyone, including low-income people in urban areas. There has been a constant effort by many members of the movement to keep food accessible. Low income CSA shares exist from Brooklyn to Washington State, and Just Food runs cooking demonstrations at the farmers markets in New York to teach patrons what to do with their veggies. Community Gardens in underserved neighborhoods and food deserts target the nutrition and education of their local communities, just to name a bare minimum of the outgrowth of ideas on how to apply this movement to the health of the whole country.
And as always, there’s a push and shove between the necessity to provide food to everyone, the need to pay farmers a living wage that recompenses and dignifies the work that they do, and the tension between an idea that those with more should pay more and the American “I worked for it, it’s mine” ethic. Judaism has lots to say on tithes and gleaning, but they’re rules for a more direct agricultural system, where consumers can gather straight from the field. Despite a sense that we’ve left those laws behind, we tithe even more than ten percent to taxes. The interviewees on NPR’s radio segment talk about how efficient an economic stimulus the SNAP program really is, despite common perceptions that it’s wasteful. It’s a support for all kinds of people, too, including food activists -one of my friends who grew up in a back-to-the-land community remembers food stamps being a huge support for her family when their non-traditional business and family models didn’t produce the hard cash they needed.
I’m interested in the experiences of our readers with Food and Nutrition Service programs. Are you using them, or have you in the past? Have you assisted folks using them, administered them, sold food to FNS constituents, lobbied for them? Do you have a program with similar goals outside of the federal matrix? What do you think the role of these food programs is in the natural and sustainable foods movement, and how do you think we go about changing public opinion on the FNS programs? Do you agree that the buying power of FNS beneficiaries could conceivably strengthen small farmers, and how would you make that a reality? Like an endless field of GM corn, I’m all ears.