i like to dig into your situation at homewhether it is your boyfriend, your girlfriend,
an affair, a husband a brother. whatever itis so i go deeper asking you questions to see where its the pattern i go behing or overthe whole history so they can see the pattern and see why it is it that your relationshipits not working and then i'll provide you the best tips and tools before i do a reading.in my approach which work i can't
everyone thinks kids are awesome, but parents know the truth. kids are total dicks. babies may seem cute, but they're actually the worst. they sh*t little pouches. they cry constantly. they can't even walk or talk for a whole f**king year. it's like playing the most boring game of charades, except you're never gonna win. (ok. three words. um, first word...) think you can be a parent? one baby can burn through 5,000 diapers in under three years. guess who gets to clean that up? thats $1,200 and 166 hours spent on baby poo. with that time and money, you could master archery. you like sleep? then don't have a f**king kid. first two years, parents can expect to lose 730 hours of sleep. (ugh! stop it!) that's 30 days of your life you're never ever gonna get back. you're gonna look like sh*t, and you're gonna feel like sh*t.
*valley girl voice* but anything for love right? obviously you can't put a price tag on love. but lets say you had to by the time your kid is 18, you'll have spent an estimated $240,000. do you know what you could buy with that money? *money burning* a boat? probably. *fire extinguisher sprays*. maybe a couple boats? i don't know. and that's before college tuition. and guess what? college is just the beginning. 59% of adults, age 18 to 39, are still financially dependent upon their parents in some capacity. all that and little johnny couldn't be bothered to buy you g*d damed flowers for your g*d damned birthday? what a dick!
so kids, be grateful to your parents. it's a miracle they've put up with your shit for this long.
and parents, you're amazing. thank you. we seriously don't deserve it. *cheery, upbeat music*
hi, i'm justin from reach out australia, which is an online service to help young people find practical tools and support to get through tough times. if you're like me, i'm sure the internet's one of the first places you go when you need help or information. and that's no different to people who are looking for help when things might be tough. if you're struggling with an issue, you can feel really overwhelmed,
so the last thing you want to do is sift through a ton of information, and if you're not computer literate, finding your way to the right information is going to be a lot harder. so the problem we'd love for you to help us solve is how do we use technology to help those people
who really need our help but aren't tech-savvy? we need a bunch of clever people to think outside the box and help us come up with a solution
that can help thousands of struggling young people.
if you’re a parent, there’s one thingyou should know: your kids won’t be kids forever. that’s probably obvious…or on some days,maybe even comforting. but eventually, they will move out, find careers,maybe start a family of their own. on average, you’ve got about 936 weeks fromthe time your child was born until they grow up and move on to what’s next. it goes by fast. and the responsibility to shape their futurecan seem overwhelming. after all, you can’t make a toddler share.
you can’t force a child to have faith. you can’t compel a teenager to make smartdecisions. but there is something you can do. and you can start this week. in don’t miss it, the new book by reggiejoiner and kristen ivy, you’ll find what you need to do more with the time you have—thingsyou can do every week that will give you momentum
in your kid’s life. don’t miss what you need to know as a parent,so your kid won’t miss what they need most in their first 1,000 weeks.
to find out more, visit dontmissitbook.orgtoday.
a policy adviser for the canadian secularalliance and volunteer at the cfi. he has a degree in mathematics (computer science)with a minor in drama and speech communication from the university of waterloo and an mbafor science and technology from queen's university. he writes about secularism, religon, politics,ethics, free speech, and more at opinionsquestions.blogspot.ca. leslie, take it away. and thanks to my fellow panelists with somegreat presentations. i wanted to start with asking just a verygeneral question of "what is secularism?" and i have a fairly short answer althoughit can be a rich topic in and of itself. as a political principle, the canadian secularalliance defines it as government neutrality
in matters of religion. in other words, governmentshould neither support nor suppress religious expression among its citizenry. as you might expect from a policy advisorto the canadian secular alliance, i agree wholeheartedly with this contention. todayi will talk about the importance of secularism, highlight a specific canadian policy that in my opinion (and in the opinion of the canadian secular alliance) should be discontinued, and then broaden my focus to encompass a much wider view of theworld. in the next fifteen minutes, i will discuss canadian law, international effortsthat would impact all of us, and finally i hope to convince you that secularism is anecessary, but nowhere near sufficient, principle for a just and stable society.
to start with, let's openly acknowledge that,overall, canada does very well on the secular front, and furthermore, is generally movingin the right direction. from in recent decades removing restrictions on interfaith andinterracial marriage to liberalising divorce laws; from the establishment of the charterof rights and freedoms as the constitution of canada, thereby enshrining freedom of conscience among other things,to formally recognizing gay marriage as equal in all respects to heterosexual unions; overtime, we are moving more and more to a society informed by secular values. and i think wi need to re recognize this, and furthermore celebrate it. this is a good time to be living here. but we must also acknowledge that we do notyet live in a truly secular society. but in most cases, the exceptions, though still substantial,are rooted in tradition. such is the case
with prayers opening proceedings at municipal councils; which is still common practice across the country that veronica spoke of earlier. the discriminatory publicly funded schoolsystems in ontario are grounded in obsolete clauses in the province's constitution as garry did an excellent job of highlighting. we must always remember that while freedom of speech is a fundamental human right, as justin said, freedom from offense is not. another historical artifact, albeit one withsignificant consequences for canadian society, has to do with our charity law. according to thecanada revenue agency, an organization must pursue at least one of the following fourgoals in order to be designated a charity: one: the relief of povertytwo: the advancement of education three: other purposes to benefit the community that courts deem charitable; or
four: the advancement of religionthe first three items on the list are in accordance with a general understanding of the term "charitableactivities". whether and how the last criterion benefits society is far from clear. a bit of history: in 1891, the british houseof lords ruled on what constitutes a charity in a dispute between the tax authorities andthe moravian church. they developed a common law test, based on the preamble of the 1601statute of charitable uses (also known as the statute of elizabeth). this ruling isthe basis for the canadian government's determination of which organizations are deemed to be charitablein nature. perhaps it is time for canada to reconsider whether a decision made in thenineteenth century in another country, itself based on the introduction
of a law more than four hundred years old,is the best foundation for taxation practises in 2012. yet we must acknowledge some traditions die hard. in a letter received by the canadian secular alliance on july 27, 2012, jim flaherty, federal minister of finance, stated, and this is a direct quotation, "charitable status for the advancement of religion is based on the presumption that religion provides people with a moral and ethical framework for livingand plays an important role in building social capital and social cohesion." end quote. i, for one, would challenge that presumption.in my experience, there is a high correlation between deeply held religious belief on theone hand and opposing the rights of women,
the rights of homosexuals, the right to freespeech, and the right of freedom of conscience on the other. furthermore, this phenomenonis not limited to canada - i submit that strong religious sentiment can have a significantdetrimental effect on any society, as recent decades in ireland, india and israel demonstrate,to pick among countries starting with a single letter. (it is important however to note,that the faithful do not have a monopoly on misogynist and censorious views that leadto social strife.) one of many causes. but we are not talking about here in canada is not just a fine philosophicaldistinctions or abstract positions with little practical impact on canadian society. mr.flaherty's unchallenged assumption significantly distorts fiscal policy today in canada.
the canadian secular alliance obtained fromthe canada revenue agency a detailed list of charitable tax deductions made in 2007.now, all charities must declare what percentage of their efforts are dedicated to the four categories of recognized charitable activities. according to their submissions to the canadian revenueagency, over 26,000 canadian registered charities did nothing beyond promoting the advancementof religion. this is nearly one-third of all charitable organizations in canada! not oneof them declared that they spent any time, effort, or money feeding the hungry, clothingthe naked, or educating the illiterate. in total, they received nearly 14 billion dollars in donations in 2007, andthe canadian government granted them tax credits of nearly 1.2 billion dollars.
that is over one billion dollars every yearof government subsidies for religious proselytising. that is roughly thirty dollars for every canadian citizen. now, either these funds are completely wasted, or they are having a significant impact on canadian society - perhaps not its improvement. in either case, might these fundsbe redirected to serve more productive goals? clearly, despite the progress canada has made,secularists still have work to do to apply secular principles to canadian governance,and to ensure canadians do not lose the freedoms we currently enjoy that stem from secularpolicies. but we cannot for a moment believe that ourefforts should stop at our borders. let us move from canadian regulations to the realmof international law, and attempts to codify
freedom from offense as a global norm. as justin mentioned, the organization of islamic cooperation has been agitating in the international community forover a decade to ban speech offensive to muslims and other religious groups. of course, the question as was hinted at the question period a few moments ago, is not whether there should ever be restrictions on expression. no country provides for completely unlimitedfree speech. even the united states, with its famous first amendment, has several significantlimitations on expression - the canonical example being that it is illegal to falselyyell "fire!" in a crowded movie theatre (from supreme court justice about a century ago, oliver wendell holmes.) most people support the placing limits on unfettered speech. some widely accepted examples include limited and well-craftedlaws regarding slander and libel, truth in advertising, and uttering death threats.
so, given that reasonable limits exist on speech,the question is: do mocking religious figures or making other blasphemous utterances falloutside the bounds of acceptable expression? no. the attempts of the oic to classify satireas hate speech, and related efforts, have impacts on canadians just as much as argumentswithin our own parliament. we cannot be blind to them, and we must act. similarly, secularism itself is not a defaultposition even in democratic nations. though it has not been used in decades, canada stillhas a blasphemy law on the books, punishable by up to two years imprisonment. in 2009,ireland passed a law that makes "publication
or utterance of blasphemous matter" an offensesubject to a maximum fine of €25,000. the arab spring is replacing several autocraticregimes with democratically elected but illiberal and/or islamist governments. there are many and complexfactors behind the fact that dictators were generally more secular than their electedreplacements - but the point is if we truly respect freedom of conscience as a fundamentalhuman right, there is much work to be done in the world. certainly one's ire should be raised whenreligious dogma is upheld in the face of contrary evidence, or when governmental policy is usedto buttress the faithful of one creed at the expense of those belonging to other groups. including those with no belief in the supernatural.
but religion is far from the only exampleof ideology trumping facts. and many of the most pressing issues facing our world todayhave nothing to do with religious zealotry or a violation of secular principles. though some religious folk may welcome therapture and thus dismiss climate change, humans are cooking the planet with our ever-increasingemissions of greenhouse gases, especially carbon dioxide, almost entirely for secularreasons: an all too familiar litany of fear, economics, political expediency, and humanshort-sightedness. the 2008 financial meltdown in the united states, that quickly spread globally, had everything to do with greed and fraud. wall street made huge profits not by increasing efficiencies,but by maximizing economies of externalities.
a greater commitment to secular principles,if possible, would have done nothing to avert or reduce the impact of the real estate andfinancial crash. the economic crises facing the eu and soonjapan have nothing to do with undue religious influence in the halls of political power. our current agriculture and animal husbandrypractices are almost perfectly designed to evolve a superbug that could wipe out a significant portion of humanity. and this is being done for entirely for the most secular of reasons. since the first human evolved, plant and animalspecies have been going extinct at an unprecedented rate.
we have polluted huge swathes of the earth'sland and water to such an extent that significant areas our planet's surface are inhospitableto any form of life. little (if any) of this damage was done withreligious motivations at its core. none was committed violating any purely secular principle. so although secularism is important - andmore than that, i believe it to be essential - it is also not enough. not nearly enough,not by a long shot. most of the key crises we face today as a species, as a global society,have nothing or at most little to do with religion. secular governance is nowhere nearenough to produce peaceful, stable, sustainable societies.
we should not waver for a moment in our commitmentto secular governance. but we should also not forget for a second that there is muchelse that needs our attention as well. we must resist all dogmas, whether they bereligious, economic, political, philosophical or even scientific. all areas of human endeavourare open to scrutiny, question, and refinement. furthermore, no single approach works acrossall domains. science would fail miserably if its findingswere subject to a majority vote. peer review would be a horribly inefficientway to run a corporation. unregulated capitalism has proven to be adismal failure if environmental protection and sustainability is a desired outcome.
yet in their appropriate domains nothing wehave tried as a species to date has surpassed democracy, free markets, and peer review. consider this: maybe there is something betterthat we simply haven't tried yet. at a minimum, we need to be open to the possibility, orelse this - what we see today, here, now - is as good as it gets. even more than that, as good asit can get. and i, for one, emphatically do
not believe that to be true. let our legacy be that we bequeath upon ourcollective descendants a better, more just, more sustainable world than the one we inheritedfrom our ancestors. thank you.
conscious parenting is actually kind of i want to say the opposite of traditional parenting but it's extremely different in traditional parenting. we have enough in the society with the child on the bottom and we dictate to the child what to do what not to do. we fix the child and they got to obey. ok but in conscious parenting its kind of
i want to call it if the spiritual growth through parenting. so it's kind of parenting the mask on top of it. as the parents grow up side-by-side by their children they grow spiritually how does that work? so the conscious parent does not fix the child. observes, is nonreactive and when she's actually triggered by that misbehavior by the
child, does two or three things. first of all pauses, figures out 'why am i getting triggered? questions, have an inquiry why am i getting triggered and by going through the process of psychological process you will always find out that the reason that we're getting triggered it actually going back to the childhood and the memory in childhood usually when they were 0 - 6
years old and a little bit older. so first of all pauses, why am i getting triggered, allow space. doesn't want to fix the child and and somehow allow the child to find its path. it doesn't mean she or he is permissive, not not unconscious, and not a permissive parent but allow the space for self to figure out what's going on
and find the right solution the right action without getting triggered, without getting reactive, without yelling without punishing, without putting kids in timeout so all the traditional ways and
timeouts which is i think we're all doing a lot in traditional parenting, is not acceptable in conscious parenting.
[chatting] interviewer: so what is the one word that you would use todescribe the nfl? girl 2: fat.girl 4: men girl 3: americagirl 1: i’m going to go with america too. interviewer: so this is a psa that the nflwill be putting out during the super bowl. -ad starts- interviewer: alright, so will you say yourscores? girl 1: sevengirl 2: ten girl 3: nine point fivegirl 4: te-- woah--ten
girl 5: ten girl 1: i know i heard about that, but itwasn’t an—i didn’t realize it was just an ad—i thought it was just an…interviewer: that’s a real 911 call. girl 1: well i think it’s really smart…what she did. girl 2: that’s so scary. even though thismessage is super powerful and really devastating, i think that if they actually wanted to dosomething and um they would have to, you know, fire these men that have,um, abused their wivesas-as anyone probably would be like in a normal work place. girl 3: like the way they filmed it, theymade it seem so real, so that’s why you
like get this feeling—like this gut feeling—oflike terror kind of.
girl 4: the nfl --should-- could do a better job of viewingtheir players as normal like people—they’re kind of like glorified in a kind of way. girl 1: it’s kind of like telling them like,“we don’t tolerate this. this is not okayâ€
>> anncr: discussing the issuesthat make phoenix a world-class city. now, "on the issues." >> welcome to "on the issues." i'm phoenix city councilwomankate gallego. on today's show, you will learnabout the somali american united council of arizona, and hearfrom a local woman about her journey to become a fosterparent. first, there's a health clinicin phoenix that is one of a kind
in terms of the population itserves. here to tell us more is dr.krista johnson-agbakwu, founder and director of the refugeewomen's health clinic at maricopa integrated healthsystems. welcome to the show. >> thank you so much for havingme. >> can you tell us a little bitabout the clinic? >> sure, so the clinic waslaunched in october of 2008, really in response to thegrowing needs to serve the
ever-increasing refugeepopulation here in the valley. many people may not know, butarizona is one of the leading host states for newly-arrivedrefugees being resettled for humanitarian reasons from aroundthe world. we have a population of over63,000 who have been resettled here since 1978, and 80% of allrefugees are resettled here in maricopa county. and that makes about 50,000 thatwe serve here. and so our health system,maricopa integrated health
system, has really taken thelead in championing our clinic, because we are the first of itskind here in the state of arizona, and we're leading thenation in terms of being a model of best practices for refugeewomen's health. since we started in 2008, we'vebeen able to grow to now serve over 5,000 refugees since webegan, coming from 43 different countries across sub-saharanafrica, southeast asia, and the middle east, speaking about 36different languages. some of our largest populationsare from somalia, iraq, burma,
otherwise known as myanmar, andwe're having increasing new arrivals from the democraticrepublic of congo, which has really be ravaged by systemicconflict, and rape as a weapon of war, so we have many womenwho are coming who are survivors of sexual and gender-basedviolence. so we've created a safe spacefor refugees where we're creating an environment that'swelcoming. we have a full-time staff ofinterpreters, who we call cultural health navigators,because they are bi-cultural.
they are multilingual. they speak about 13 languagesof our most common populations that we serve. and they really are the bridgebetween our refugee communities and our health care system, andhoping to bridge some of those gaps to increase access to careand continuity, and really to build trust with our patients. and we've really shownremarkable growth in terms of the impact we've had on some ofthe known challenges.
a lot of these women have nothad opportunities to go to school in the countries wherethey've come from, and have very low literacy, not just inenglish, but even in their own native language. so we strive to do a lot of workto enhance their literacy using a lot of direct communication,a lot of audiovisual aids, and just really close partnershipswith our staff working to help them understand how to navigatethe health care system. >> wonderful.
we are so lucky to have thisone-of-a-kind clinic and to have you in our district. can you tell me a little bitabout your background and how you came to this work? >> sure. so my parents were alsoimmigrants from jamaica, and i grew up in connecticut, wherethey were very much involved in the community, very sociallyactive, and really responsive to the influx of caribbeanimmigrants who were also
struggling and adjusting to lifein the u.s. and that really had a mark on mefrom a very young age, and i think that really led me to havea passion for service and for community outreach andmobilization. and throughout my training, wheni was a college student at johns hopkins university, i had theopportunity to take a course back in 1995, 1996, in "women inprecolonial africa," where i was first introduced to the practiceof female genital mutilation, otherwise known as femalegenital cutting.
and that pretty much became thedefining moment for what is my current career, in that i wasable to spend the semester researching the issues, thecultural issues and history around this cultural practice. and then when i went on tomedical school in new york, at weill medical college ofcornell, i was able to work with a nonprofit agency in new yorkcity, working, doing a lot of community advocacy and educationfor newly-arrived african immigrants who had undergonefemale genital cutting.
and that really is whatdetermined my desire to pursue obstetrics and gynecology, andover the years, i've been able to really build upon my passionto improve advocacy and policy directives around caring forvulnerable populations. and throughout my training, iwas able to further hone my skills in conducting research,and also engaging communities. my most recent fellowship was arobert wood johnson clinical scholars program out of theuniversity of michigan where i was able to work very closelywith the somali immigrant
community in columbus, ohio. i worked with over 500 women,examining some of the barriers they've experienced in accessingcare, and that's what led me to want to launch out on my own tosay, "okay, i know what the issues are. i know what the challenges arearound trust and patient-provider communicationand cultural nuances and misunderstandings around genitalcutting," and i thought, "why don't i try to start a clinic ofmy own, where we can become a
best-practice model on improvingcare?" and so at maricopa integratedhealth system, our department of ob/gyn, our chair, dr. deancoonrod, also had a shared vision, because they werestruggling for years with some of the cultural challenges andbarriers around serving this unique population. and so in 2008, we started fromthe ground up and really building an infrastructure toprovide support and improve the quality of care, as well asteach the next generation of
physicians, medical students,nursing students, residents in training, to become culturallycompetent and knowledgeable about how to engage inculturally sensitive dialogue with patients so that we canprovide quality care, address the language needs, improvetheir health literacy, and really empower women and supporttheir reproductive health care. and so it's been an amazingjourney, and our hospital has been tremendously supportive. we've made significantmilestones in terms of improving
and reducing our c-sectionrates. our c-section rates are amongthe lowest that we've seen, and we've been gathering data on themore than 500 deliveries that we've had, and we're showingthat women are really coming into care earlier, and arereally developing better understanding about westernmedicine, which is often very foreign. preventive health, westernmedicine, is often a very new concept for women and theirfamilies, and really trying to
bridge some of those gaps toreally improve their outcomes. >> that's wonderful. reproductive health is adifficult situation for people, even in the medical system withwhich they're familiar, so it's fabulous that you're reachingout to people and making what is a difficult time much, mucheasier. >> thank you. >> we're lucky to have you. can you tell us a little bitabout the maricopa integrated
health care system, the systemthat you're a part of? >> yes. so it is the only safety nethospital, public hospital here in the state, and its missionhistorically has been to serve the underserved population. so it's a very unique niche, andwe are the leading teaching hospital in the state, and sothere is a responsibility to not only provide excellent qualitycare to very vulnerable populations, but also to serveas a training ground for health
professionals, physicians,nurses, social work, various health fields. and with that teachingenvironment, there are supervised opportunities forlearning with direct hands-on patient care, and our refugeepopulation is a perfect example of that. we've been able to engage manyof our ob/gyn residents in training in direct projectsinvolving our patients and our surrounding refugee community,which has been a wonderful
learning experience for ourtrainees, as well as for the patients and communitiesthemselves. and so i think we serve a veryunique mission, and now we're being recognized nationally forthe impact that we're having and the model that otherinstitutions are seeking to replicate in other regions ofthe country. >> i understand you just cameback from a national conference. >> it was the north americanrefugee health care conference. it's the fourth annualconference engaging
practitioners and providers ofrefugee health services from a myriad of different disciplines,not only here in america, but in canada, and we even had visitorsfrom australia and other international regions of theworld. and this really is an annualconference that brings together these various specialties totalk about what are we doing to improve refugee health in aninterdisciplinary fashion, whether it's talking about thechallenges with pediatric populations, with mental health-- ptsd, which is post-traumatic
stress disorder, and depressionare very huge where there are concerns regarding the highnumber of bhutanese suicides that are occurring among newarrivals. and then we also look at some ofthe challenges around women's health. and so over the three-dayconference, there are many different presentationsdiscussing some of these challenges, but also models ofcare that are working. and i was a keynote speaker forthis event, which was a
tremendous honor, and i was ableto really set the platform for the conference, talking aboutsome of the global challenges, not just here domestically, buton an international base in terms of what's happening in therefugee camp settings, as well as upon resettlement here in theunited states, and some of the vulnerabilities women areexposed to, and survivors of. so it was an amazingopportunity. also, there are opportunitiesfor networking with the centers for disease control and theoffice of refugee resettlement,
and all of the other majorstakeholders who are involved in resettling populations acrossthe united states. >> wonderful, and it's a lot ofstakeholders coming together. i'm glad our phoenix firstresponders, including our firefighters, are learning moreand more about your clinic, so that we can make sure that weare getting our residents to the clinic that can help them most. >> oh, yes. we've had really greatpartnerships, actually, with the
fire department and paramedics,because there's a lot of our patients, because of the lowlanguage proficiency and literacy, they're not able tocall for help if they need to get to the hospital in a timelyfashion, say, if they're in labor. so over the years we'vepartnered closely with our fire department and paramedics interms of giving patients little cards that says, "i am receivingcare at maricopa medical center. please take me there."
and if it's safe, often theparamedics are able to bring them to our hospital, which alsoensures that continuity of care, because we can meet theirlanguage needs. we know their history. we have their records, and thathas really been instrumental in closing some of those gaps wherethey might otherwise have not been able to make it to thehospital. so that's a perfect example ofour wonderful partnerships that we've had within our community.
>> well, it was so good to haveyou on the show today. thank you for the hard work thatyou are doing, and for all the women who you've helped. >> coming up next, we will learnabout the somali american united council of arizona. keep watching "on the issues." >> my life is full ofstatistics. thing is, i could have droppedout of school and become one myself.
but i didn't, because i hadpeople that believed in me. here's another statistic, 7,000students drop out every school day. that's one every 26 seconds. it's time that students knowthat we believe in them. >> anncr: inspire a studentand share your message of support at boostup.org. >> welcome back to "on theissues." i'm councilwoman kate gallego.
we are continuing our focus onsomali refugees in arizona. joining me now is the presidentand ceo of the somali american united council of arizona,dr. mohamed ali abukar. thank you for being here. >> thank you so much. i really feel honored andprivileged to be here today on the show, and i thank you forthe opportunity. we appreciate the work you havedone on behalf of the somali community and arizona as awhole.
could you tell us a little bitabout your personal story and how you came to phoenix? >> my background effectively isthat i hold several degrees -- several degrees from italy andunited states, bachelor's, bs, master's degrees from italy andunited states, certificate of journalism, and a ph.d. in public administration,emphasis in international extension management. back home, i was chairman of thenational protection and general
manager of the largest eastafrican program for poverty education and food securityprograms. in 1991, we had the civil war insomalia. i was not at all willing toparticipate in that civil war, and 1995 i'd been grantedpolitical asylum in the united states, and then hired by theutah state university, teaching four courses, graduate courses,and advising the department head on international extensionmanagement, and international development issue.
and that is logan, northern partof utah. in 2004, while i was shovelingsnow just to get my car out of the garage -- logan, northernpart of utah, is very cold and lot of snow --while i was shovelling the snow just to get my car out of thegarage, i had my heart attack which took me to one bypass. and i'd been told to move to awarm place, and i said, "where is the warmest place close toutah?" i'd been told that phoenix isone of the best, and in 2005 i
moved to arizona, phoenix. when i came here, i have seenthe necessity and the importance that my community that were inneed of an assistant in their process of resettlement, properresettlement and integration, and become productivelaw-abiding citizens, and that's where effectively i establishedthe somali american united council. i'm the founder and president ofthe somali american united >> can you tell us a little bitabout the somali community in
arizona? >> we have really very largecommunity in arizona, and for several years, one of the topsarriving refugees, including effectively somalia, congo,bhutanese, burmese, and iraqi are the topas effective. we have 11,000 somali refugees,about 5,000 who came straight from the refugee camps, andeffectively 6,000 have moved from other states. like myself, i moved from utah.
and here, effectively, most ofthem are coming from nomadic and semi-nomadic society. as you are aware, somalia iseffectively 60% are nomads, 20% are resettled farmers,and 20% are urban. so the number of the refugeesthat came in united states are mostly illiterate in alllanguage. no rule of law in the nomadicarea, and in the resettled area, effectively people are notfriend to law enforcement. so when they are arriving herein united states, they need lot
of support and lot of help andlot of education, to become productive law-abiding citizensand have a proper resettlement here in united states. i'm glad you're here to helpthem. can you tell us a little bitmore about the council some of your success stories? in 2005, that's when we haveestablished the somali american united council, and the maingoal was effectively to help our refugee here, and in themeantime, heal the wounds that
have been created by the civilwar in somalia. the civil war in somalia is in1991, effectively by a culture of impurity, lack ofreconciliation, have resulted to a civil war. somalian civil war, powerstruggles based on tribalism, and as everyone is aware thattribalism and religious extremists are always orcontinuously fueling interconflict and strugglefor internal power. so most of the people who havesuffered these civil war issues,
they were the most vulnerablewere the female. and they went througheffectively torture. they went through rape. seeing the most close person tothem killed in front of them, and that's when they move intorefugee camps in neighboring country. even there, they were notfeeling safe. mostly, they're affected by posttraumatic stress disorder. they felt effectively freedomand opportunity just when they
arrive in the united states. so they have to be guidedthrough all the program. we are, in the somali americanunited council, we are really indeed the catalyst and bridgefor our community for the proper process, and positiveness andintegration with our community. the services that we providethere are case management, translation, job readiness andjob placement, education, effective parenting education,esl classes, citizen classes, woman empowerment program,sewing program, breast cancer
outreach program, preventionof -- the measures for tb test, effective educating our peopleto voluntarily be tested. and then education for properinteraction with the law enforcement and how to build apartnership with the law enforcement. effectively, the other programthat we do, it is senior assistance, youth enrichmentdevelopment program, after-school tutoring programs,soccer or sports program. so we are helping our people.
when we are talking about thetutoring, effectively most of the family that arrives here arecoming from nomadic society, and nomadic society, they've neverbeen in the schooling. and there are kids who are 12years, 15 years, 14 years old, they go straight to high school,and they have never touched a pen. so the drop rate is very high. and we are establishing ourprogram in our center, a tutoring program for afterschool for helping these people
to become successful in theireducational program. thank you so much for joining ustoday. it's been a pleasure having you. up next, we will hear the storyof one woman's journey to become a foster mother. [music] >> welcome back to "on the issues." joining me now is mia stewart toshare her story of becoming a foster parent.
>> thank you for having me. >> we celebrated foster parentawareness month in may, and recognized the 15,000 studentsin the foster system. thank you for your work to helpaddress this issue. could you give us a little bitof your story as a foster parent? >> my journey was kind of animpromptu. my relatives were placed in mycare in the latter part of 2013, and so therefore, that caused meto do the foster caring portion
of it as well as the licensingportion all at the same time, without any additional trainingprior to the placements. >> and tell us about theexperience. was it a positive one? do you see opportunities forpolicymakers to improve? >> oh, yes, definitely. there's plenty of room forreinforcement and to make changes. you have to ensure that yourheart is ready to receive the
children, and that you'resteadfast on that mission. there are a lot of communityresources, faith-based organizations, that support themovement and the information provided to foster parents thatwant to gird up the whole system here in arizona to ensure thatthe children are provided for, and given a safe haven at thesame time. >> do you think the stateprovides enough resources to foster parents? >> they provide resources, butthe information pertaining to
the route you should take to getthe resources is the difficult portion. you have to be able to tap intothose resources on your own most of the time, or have differentavenues to take to ensure that you can get those differentresources. if it's something that's inblack and white on paper that you could get a packet, it wouldbe easy. it's like a road map. but instead, you have to try totap into different areas and
contact different individuals toensure that you have the information needed. >> and can you tell us why youthink it's important for people to become foster parents? >> because it's a way to giveback. i'm a third-generation fosterparent, and i was able to witness my family give back tothe community and assist those in need. not all children will bepermanent placements, but it's a
wonderful feeling to know thatyou can assist a family and those children in their time ofneed, just to fill in that gap until the parents or their lovedones can get back on track and receive their children back intotheir homes. and with so many children outthere, and you have individuals like myself that are single buthave time and have the heart and have the energy and theresources to do so, it's a blessing to be able to standthere and love someone and provide that care in a time ofneed.
well, foster and adoptiveparents are true heroes and our community, and thank you forstepping up. for people who can't or who arenot ready to become foster parents, but who want to supportfoster parents, is there anything they can do? there's boot camps available,like the community walk that we had pertaining to may, which isfoster care month. you can come out and assist withtying the ribbons. you can assist throughout thecommunity and arizona when you
have children that want to havetutors. if you're in an educationalfield, you could become a tutor. if you're an individual that'sathletic, you might want to become a sport athletic withthem to assist them on the sport end, and going to their eventsas a cheerleader for the kids. you may not necessarily have tobecome a foster parent, but you can definitely volunteer atdifferent areas where children are available, and give theparents a break or that added pat on the back to tell themthat it's okay, and you have an
additional support system hereto gird you up in your time of need. >> it was a pleasure for me tobe part of tying the ribbons on washington this year, the 15,000ribbons to recognize the 15,000 youth. can you tell us a little bitabout that tradition and what it symbolizes, how it drawsattention to the issue? >> well, the ribbons symbolizeeach child that's in foster care.
so when you rode down jeffersonand you saw those ribbons that were placed, that representedthat there was a child for each ribbon that was in care,and that there was a family. if they were not placed with afamily, they were either in a group home, but they were out ofhome care children. and there's still children outthere that need assistance, and it gave you an eye-opener whenyou can visually see that this is something that is needed. these children, we don't chooseour parents, just like we don't
choose our foster parents. but it's our choice is if weopen up our homes and our hearts to them, and it's a wonderfulthing to be able to give back and see visually how much it isthat the help is needed and where it's needed. >> there's a lot of youth. it was a very powerful vision ofjust how many 15,000 is. well, thank you so much. i really appreciate you joiningus here today.
any final words before we break? >> my final word is that everychild out there deserves an opportunity to have that specialhug and that special love, and no one knows what journey youmay play in a child's life. >> well, thank you for steppingup and for being a hero to our community. we really have appreciatedhaving you here today. >> well, thank you. it's a pleasure to be here.
>> that's all the time we havefor this month's "on the
if you have any questions orcomments about the show, please call my office at 602-262-7493,or visit phoenix.gov/district8. we'll see you next time "on theissues." closed caption productions - www.ccproductions.com -
[music playing] i remember when my little ones firststarted sitting up on their own and then crawling. we had so much fun together. it was when play really startedto feel like play. they're changing so fast,and learning so much. and playing with your baby is a greatway to help them develop motor skills, discover the world around them, andstart communicating with others. there are so many games andfun activities to play.
but here are three that were favoritesof mine, and how they helped my children develop. as they get a little older, your babystarts developing some fine motor skills which helps them controltheir hands and fingers. sensory bag is a game that helps themdevelop these motor skills, and it stimulates their senses to helpwith brain development. sensory bag is a fancy namefor what it sounds like-- a cloth or a sturdy paper bag filledwith lots of objects that are fun to
touch, hear, see, and smell,but too big to swallow. make sure it's big enough to holdmultiple items, and has a way to keep your baby from seeing inside. a pillowcase can work in a pinch. we would take turns feeling aroundinside of the bag and pulling an object out. then we'd play with the object for awhile and put it back into the bag. my kids love trying to imitate me, soi'd pull out something first, and then they would try and pullout the same object.
my children learned to love stories atan early age, and they still do. it was fun when they started makinganimal sounds and other noises along with me as i read to them. not only did they enjoy it, but seeingand hearing the stories helped them make all kinds of new connectionsin their brain. and even if you feel silly doing it,that baby talk voice is actually helping them understand words betterand learn language faster. so try to use lots of varietyin your voice when you read. they'll love it, andit's good for them.
my kids enjoyed books full of varioustextures, and they were especially fond of flap books. we made our own by cutting pictures outof magazines and then gluing flaps of paper over the top of them. they loved the anticipationand discovery. i tried to make my voice reallydramatic as i read it to them. her dad and i would act out ourstories with hand puppets made out of old socks. old white socks, decorated as much oras little as you like, work great.
we would have the puppets talk to ourkids, tickles them, kiss them, hug them, and sing and dance. babies need a variety of experiences. it helps them discover more about theirworld and it helps their brains make new connections. a variety of movement isgood for them, too-- snuggling, working, walking aroundtogether, and even dancing or health and development. we danced with our little ones a lot,even before they started walking.
i would hold them and dance andsing around the room, and they would laugh and laugh. they also enjoyed bouncing on my yogaboard, keeping time with the music. they just seemed to love moving theirlittle bodies in any way that they could, and i love the timei got to spend with them. once they started pulling up, i'd findthem holding onto the couch or a chair and dancing. so i started putting onmusic during playtime. it seemed to get them moving, andit always got me smiling.
once my kids got more active and mobile,i looked for a nappy that would keep them dry and move withtheir body as they played. i found some great ones. they were soft and comfortable, they fitgreat around the legs and tummy, they had stretchy sides, andthey were super absorbent. so my little ones were freeto explore their world. ok. thanks for letting me share someof my favorite games and
activities with you.
i'm sure you're discoveringyour own unique favorites. i'd love to hear about them. visit pampers youtube channelfor more parenting tips.
imagine wanting to tell the doctor about yourchild's health needs, but not having the words. imagine waiting all day for another familymember to come home so you could go to the store for groceries. imagine wanting to give yourchild a better life and not knowing how to do that in the new complex culture of lifein the united states. when i accepted the position of director of the family literacyprogram of alameda i had no idea what i was getting into. the program existed on paperand targeted emigrants from the local community. my job was to make it a reality. i wonderedwhat a white lady like me who grew up in a small steel town in western pennsylvania hadin common with families of different backgrounds from all around the globe. i could not imaginethe challenges of their lives. i could not
imagine the loneliness of being in a strangenew country. i could not imagine what it would take to build this program. i discovered thatit would take the families, families from many countries, cultures and languages. theycame in search of english and a school for their young children. they found a communitythat reminds them of how they felt in their
homeland. they found teachers who are interestedin their cultures and their customs. they found teachers who share helpful ideas ontheir child's growth and their development. they built relationships of trust with otherswho share common experiences even though they are from many diverse countries and cultures.they found a new family. imagine the possibilities.
female narrator: thank youfor joining our session "what is health informationtechnology and meaningful use?" this is the first learningmodule in a three-part series to provide informationand guidance around health informationtechnology, or health it. the other sessions titlesin this series are: "key roles in implementing "a certified completeelectronic health record," or ehr,
and "key rolesin maintaining and optimizing your certified complete ehr." workingin a community health center or other safety-net setting, you will encountervarious technologies being used to improve patients' health. we want to introduce youto health it and help you understandits role in your organization. this module has been developedas an orientation to health it
for staff working in safety-nethealth care settings, such ascommunity health centers, federally qualifiedhealth centers, and freestanding clinics. these modules are designed for usein a variety of settings. in an organizationthat is already live on an ehr, these modules can enhance the new employeeorientation process.
alternately, this sessioncould serve as an orientation module for a team that is embarkingon their ehr implementation. finally, health centers focusing on the cmsmeaningful use incentive program would also benefitfrom this module. before we begin,please take a few moments to pause this sessionand discuss these two questions with your team.
this will helpfacilitate discussion about the topicsthat are about to be presented. first,in your own words, define healthinformation technology. then list three technologiesyou use today. these questions were createdto test your knowledge of these conceptsbefore they're presented. the screen will flash firstwith the questions, and we'll give youa couple of moments
to jot your answers down. you'll be able to checkif your answers are correct. thank youfor taking the time to answerthese pre-module questions. question 1: meaningful use is a statewideinitiative that is aimed at better connectinghealth insurance companies to beneficiaries. true or false?
question 2: the hitech,or health information technology for economicand clinical health act, allocates billions of dollars toward the developmentof health care it and is a part of arra, the american recoveryand reinvestment act. the goals of meaningful use are: to improve quality,safety, efficiency,
and reductionof health disparities; to engage patientsand families; to improve care coordination; or d: all of the above. question 4: what does "cms" stand for? question 5: which programs are underthe cms ehr incentive program? select all that apply:
medicare,medicaid, blue cross blue shield, and united health care. question 6: there are certain core,menu set, and clinical quality measuresthat need to be met in order to receiveincentive payments. question 7: geomapping is a process usedby physicians and researchers
that uses softwareto help better understand our environmentand protect us as a community. and the final question,question 8: telemedicine is the practiceof using technologies to search for healthysupplements in space. let's take a lookat your pre-module answers. this is false. it is a national initiative that is aimedat promoting responsible use
of a certified complete ehr to ultimately improvehealth care and reduction of costs. which is the american recoveryand reinvestment act. this is true. question 3: and d: all of the above. the answer is d. it is the centers for medicareand medicaid services.
question 5. the answer is a and b,medicare and medicaid. in orderto receive payments. is this true or false? and it's true. and that is true. the answer is a. question 8: this answer is false.
telemedicine is the useof telecommunication and information technologies in order to provide clinicalhealth care at a distance. we will look at healthinformation technology, or health it, from three differentperspectives at a health center: the patient, the provider, and a health centeradministrator.
each employee will sharehow her job function relates to our learning objectivesin this session. they will help usdefine health it, identify waysin which it is used by patientsand health care practitioners, and understandthe meaningful use initiative and its impact on health it. in today's world,technology can be used to communicate, to inform,and to educate.
it helps us with allof the following: keeping in touchwith our family and friends; getting updates on the latestnews, sports, and politics; sharing pictures; and downloading musicand videos. technology connects usto the world. as you will learn, technology is becomingincreasingly important and accessibleto clinicians and patients.
it gives providerslegible documentation, securely storespatient information, and provides a mechanismto better coordinate care. the term "health informationtechnology," or health it, is a broad conceptthat encompasses an array of technologies to store, share,and analyze health information. health information technologyincorporates the use of computer hardwareand software
to privately and securely store,retrieve, and share patient healthand medical information. health it can be usedby everyone to better communicate with yourprovider or health care team, to learn and share informationabout your health, and to take actions that willimprove your quality of life. more and more,health care providers are using health itto improve patient care. using health it,everyone has a role
on the teamthat promotes staying healthy. the american recoveryand reinvestment act, otherwise known as arra, was signedon february 17, 2009. title xiii of arra, called the health informationtechnology or hitech, allocated $19.2 billion towardthe development of health it. this act seeksto bolster health it
to improve the deliveryof health care in the us by incentivizingthe implementation of certified completeelectronic health records. and it provides standardsto use ehrs in a meaningful way. with various provisionsand regulations, the act provides assistance,tools, and resources for health care providersto allow for the implementationand utilization of electronic health records.
this was a major initiative in transformingour health delivery system, and it's had a tremendous impacton health centers. the goalsof meaningful use are and to reducehealth disparities; to improve care coordination, improved populationand public health; and to assure adequate privacyand security protections for personal health information.
this is directly in alignmentwith our goals as community health centersand safety-net providers. what is the vision forthe stages of meaningful use? the three stagesof meaningful use include ambitiousbut achievable goals that enableeligible professionals to make incremental progress in adopting and implementing a certified completeelectronic health record.
stage 1 consistsof transferring data to the ehr and being ableto share information, including electronic copies and visit summariesfor patients. we want to focus on ensuring that we are capturingthe data electronically. stage 2 includes standardssuch as online access for patientsto their health information
and electronic healthinformation exchange, or hie,between providers. are we providing quality care as efficiently and effectivelyas possible? and stage 3focuses on demonstrating that the quality of health carehas been improved. are patientsactually getting better? depending on the organization, eligible professionals,
eligible hospitals, and critical access hospitals qualify for incentivesfrom medicare or medicaid. there are differencesin the requirements and the levelof incentive dollars that can be earnedbetween the two programs. the meaningful use initiative incentivizescertain health care workers as eligible professionals.
some examplesof eligible professionals include physicians,advanced nurse practitioners, dentists,and physician assistants who deliver services in a federally qualifiedhealth center or rural health clinic that is ledby a physician assistant. you can learn moreabout the ehr incentive programs from the centers for medicareand medicaid services,
or cms. the meaningful useinitiative calls for eligible professionalsto meet certain core, menu set,and clinical quality measures examplesof core measures include recording vital signs and generatingclinical visit summaries. examples of menu set measuresinclude implementingdrug formulary checks
and submitting dataelectronically to immunization registries. examples of clinicalquality measures include appropriate testingfor children with pharyngitis and prenatal care:screening for hiv. health center staff,including the front desk, medical assistants, nurses,and providers, must work togetherto achieve these goals. your organizationwill assist you
in getting the trainingyou need to understand and performon these measures. let's meeta group of individuals who've been impactedby health it and bythe meaningful use program. meet roberta,dr. johnson, and star from southeastcommunity health center. each of them are consumersof health information technology in some capacity.
today they will talkabout health it from their ownunique perspective. please meet roberta, a patient at southeastcommunity health center. our physician is dr. johnson, and our administrator is star. she's the electronichealth record manager. - hi, everyone,i'm roberta. i started hearingabout health it a few weeks ago
from my provider's office. there was a bigcountdown calendar in the waiting room, along with flyers describingwhat was coming up. staff wore pins that said,"ask me," so i could talk with anyoneabout how my paper chart would be convertedinto an electronic chart. the biggest changethat i noticed was that computerswere set up in every exam room,
and the nurses and providerswere using it during my visit. i actually satnext to the doctor and watched him pull upall my information into the computer. i was able to seewhat kinds of labs and tests i would need in the future. pretty cool. when i sawmy daughter's pediatrician at the health center,
he pulled up her growth chartright on the screen. at the end of the visit, he asked me to getthe visit summary from the ma, and it actually includedall of her growth percentiles and listed out the parentingand child development topics we had discussedduring our visit. i can't believe all of thiswas with one click of a button. the health center staff and i discussedadditional electronic tools
that are available to help memanage my family's health. through the health center'spatient portal, which is a new technologythey are using, i can sign into a secure site and request an appointment, update my health history, or send a questionto my provider. i can even seemy daughter's immunizations and whether or notshe's due for one.
i also have an appthat reminds me when i needto take my daily medications. i'm testing this out, and it seemsto work pretty well. i'm hearingthat patients living far away are receiving adviceand treatment from my doctors. the nurse informed me that thiswas called telemedicine. i think it's great that otherpeople in other served areas can reach good care virtually.
it's exciting to see how muchhealth care is changing. - hi there,my name is sarah johnson, and i have been a physicianat southeast community since i started hereduring my residency. our health centersimplemented a certified electronichealth record approximately 18 months ago. a certified complete ehr is an electronic versionof the patient's medical history
that is maintainedby the provider over time and may include all of the keyadministrative/clinical data relevant to that person's careunder a particular provider, including demographics,progress notes, problems, medications,vital signs, past medical history,immunizations, laboratory data,and radiology reports. as a clinicianand the ehr clinical champion, my primary focuswas on the design
and implementationof our new system, thinking throughhow it would impact patients and the quality of carewe deliver. it took a core teamof dedicated individuals to reviewall of our current processes, otherwise known as workflows, and go througha redesign process. we discussed how our workwould be documented in an electronic chart
and how we could usethe new ehr to communicate betteras a team. it wasn't an easy transition, but our team has continuedto meet regularly and optimize our useof the system. i am so glad to haveimmediate access to the patients' records. no more hunting aroundfor that paper chart. i can also viewimportant information
on a single graphor flow sheet. this provides me,at a glance, an overall pictureof patients' health. i can show graphsof important information to my patients,like their body mass index. over time,it helps us make decisions about what to doto stay healthy. the ehr allows meto quickly create and run reportson specific patient populations.
i am able to seehow many of my patients are due for a mammogramor physical exam. i can contact them and make surethey make an appointment. i also make surethat i provide my patients with clinical visit summary. these summariesare an overview of what we talked aboutduring the visit. not only am i meetingone of the core measures for meaningful useby giving it to them,
but my patients benefitfrom having a written copy of their care plan and what they are due forin the future. there are so many benefitsof an ehr. for example,with fully functional ehrs, all members of the teamhave ready access to the latest information, allowing for more coordinatedpatient-centered care. the information gatheredin the primary care setting
can be more quickly transmittedto an emergency department, potentially alerting to a patient'slife-threatening allergy so the treatment can beadministered appropriately, even if the patientis unconscious. a patient can log onto his record and see the trend of the labresults over the last year, which can help motivate himto make his medications and keep upwith the lifestyle changes
that have improvedthe numbers. the lab results run last weekare already in the record to tell the specialistwhat she needs to know, minimizing the needto order duplicate tests. the clinician's notesfrom the patient's hospital stay can help informthe discharge instructions and follow-up care and enable the patientsto move from one care settingto another more smoothly.
i know that the meaningful useincentive program is important for documenting and giving patients accessto information electronically. certified completed ehrs help us not onlyto improve patient outcomes, but we use ehrs as a tool for enhancing our ongoingquality improvement efforts. the objectives of our qualityimprovement committees have evolved over time sinceadopting the certified ehr.
the quality improvement teamis comprised of key team members from all clinical departments, for their work directly impactsthe measures we are monitoring. through the ehr, we are ableto pull real-time data routinely to trackimportant core measures and see how individualclinicians perform over time, in addition to tracking ouroverall patient health outcomes. we document our effortsmade to improve those numbers so we are able to see whatinterventions are successful
and which are not successful. the ehr helps tell ushow well we're doing. as a provider,i want to ensure that my team has documentedthe proper demographics, that we have reviewed problems, that medications and allergiesare updated at each visit, and that we talk to patients about the importanceof quitting smoking. we not only review our itemsbecause it is required.
we do itbecause it is necessary to improveour patients' health. our health centeris very focused on the meaningful useinitiative. i'm an eligible professional, meaning that my health centercan receive additional funds to support health it if i meet certain measuresof the program. the goal of the program
is to help meand other users of the ehr record accuratehealth information and adopt systems that will ultimately improvehealth outcomes. in our center,the meaningful use program has just been rolled into our ongoing qualityimprovement initiatives. to bolstermy health center's success in the meaningful use program,
i have to understand the intentof the program and the measures, i have to knowwhere to document those measures exactlyin the chart, and i have to monitorhow i'm doing my running real-time reports to see if i'm meetingthose measures. it's been an incredible journeywatching my health center go live on our certifiedelectronic health record. now we're constantly tryingto find new ways
to improve its usefor our benefit. - hi,my name is star, and i led the ehr implementationteam at my health center. i worked with key staffon this project for several months. during this time, we discussed the roleof the ehr in our clinic, what functionalityis available, how it supports us,
and, most importantly,how it helps our patients. we reviewed and redesignedhealth center processes, or workflows,to make them more efficient. it was importantthat the health record was accessibleto our patients, so the patient portalwas a perfect solution. now that that that systemis in place, the real workand fun begins. maintenance of the certified ehris quite like a car.
for a car to run smoothly, there are certain thingsthat have to happen: check the engine, test the brakes, make sure the oil is changed, fill up the gas tank, and, of course,you have to drive the car. for our ehr to continueto be a useful tool, our team still comes together
to discuss what's workingand what needs to be improved. topics often includereviewing the budget to see what other technologieswould benefit us, training both newand current users, changing workflowsto make them more efficient, reviewing the clinical templatesthat our providers use, and talking about useof new features, called secondaryfunctionalities, like electronic prescribing.
if i am doing my job well, our clinicianswill become meaningful users of the electronic health record. as the ehr manager,i have an important role in my health center'smeaningful use initiative. i completed attestation that our health centerhas adopted, implemented, or upgradedto a certified complete ehr. i know and understandthe intent
behind the meaningful usemeasures. i help to train providerson where to document so they can meet the measures. i create and run reportsspecific to meaningful use. the reports i run can be donein real time. a certified ehr allowsfor real-time data analysis to identify opportunitiesfor interventions and proactive outreach attempts for individualswho haven't come in
for important preventive care, such as mammogramor pap smear. and finally, i submitthe meaningful use data to the government, meeting all deadlines,of course. narrator: as we heardfrom our patient, provider,and ehr manager, there are so many healthinformation technologies currently used today.
certified complete ehrspromote comprehensive and legible documentationof patient health. telemedicine allows patientsand providers to communicate with expertsin distant locations. patient portalsare used by patients to type in their ownhealth information, retrieve their health records, and communicatewith their care teams. e-prescribing comes in handy
for the providersand patients alike. providers can send and receiveprescription requests to pharmacies, which creates efficiencies through avoidinglost prescriptions, reducing errorsdue to handwriting, and minimizing the number of faxed prescriptionrenewal requests showing upin the provider mailbox.
patients benefit as wellwith this technology once they establisha preferred pharmacy. other technologiesare available to help improve patient care. personal health toolshelp patients track their fitnessor medication schedule. there are apps availablefor your smartphones for that. health-relatedinformational websites can be used to learn aboutand improve health.
you do want to make surethat it's a trusted website. healthfinder.govis an example of one of those good,secure sites. email and text messages can remind patientsabout appointments or help managecertain chronic conditions. and online communitiescan help people connect with one anotherto try to maximize good health, such as during pregnancy,
or to respond to concernsabout poor health. through online communities, you can share information with and emotionally supportothers facing similar concerns about a particular diseaseor disability. finally,there are other types of health information technologybeing used today to protect us as a community and to understandour environment.
one such process,called geomapping, requires use of a software tool to look at the correlation between food accessin an area and how that will affectdiet-related diseases like obesity or diabetes. or public health professionalsuse it when reviewingenvironmental disasters or an incidence of a disease,like cancer, nearby.
it is always goodto remember how our papermedical records looked. we have gone from this to this. certified complete ehrs exist in attempt to organizeour health documentation and make it readableand reliable for all caregivers. with a certified complete ehr, we can pull useful dataout of the record
to share it with the care team,clinicians, and other health center staff. it makes a big differencewhen we share this type of patient-leveland population-level data with all members of the team. they see the impacttheir work has on how patientsare improving. let's face it: health information technologyis awesome.
so where can you goto get started? please check outsome of the following links to learn more abouthealth information technology and meaningful use.
thank you for joining us. please make sure to check outour other education modules on implementationand maintenance of a certified completeelectronic health record.
so then the question is — if you're goingto go to mediation, do you wanna go, just the two of you, or do you want to bring lawyers?and there's pros and cons to whether you want to have your lawyers come to mediation withyou or if you want to go by yourselves. some people just decide that they think theycan work through the issues themselves. they don't have very complicated assets; they havebasically mutually decided to divorce. they feel very comfortable coming up with a custodyplan for their children. now, that said, if you go to a mediator, andespecially some people think if you go to a lawyer/mediator that they're going to giveyou legal advice, like tell you what might be your separate property, or --um-- questionsabout alimony or maintenance. maybe you go
in and you don't realize that you could qualifyfor alimony or spousal maintenance. it's not really the job of that lawyer/mediator totell you that for mediation in the pure sense of the word. so don't go to a lawyer/mediatorlooking for legal advice if you're just going to go without lawyers. lawyers rarely go to mediations with mentalhealth workers for parenting plans; those are usually more collaborative process betweenthe mental health professional and the parties. that's why the mental health mediators canbe really helpful with that, because they're very patient about going through what bestfor your kids. so, sometimes you need — sometimes you needa lawyer to either coach you before you go
to mediation, or most people, or a lot ofpeople, actually, bring their lawyers to mediation. and there's a certain mediation style forthat. and its always a good idea to consult with a lawyer before you do anything, evenif you just go buy and hour or two of a lawyer's time, because there's issues that you mightnot see, that you should really address. and if you see there's an issue that you canmake a separate property claim about your house, but you just choose not to, at leastyou knew going into the mediation that you had that option. i have people come to me pretty frequentlywho say, "my husband and i are going to go to mediation. i need to know what my rightsare. i want to know what my divorce rights
are. i want to know about the divorce process."or maybe they come in and they just say... i actually had a women come in the other daywho didn't realize that since she had — owned a house in europe, and she sold that houseand bought a house here, and she and her husband had been living in that house for a few years,didn't even occur to her that the equity in their house — which was a lot — was opento a separate property claim on her part. so she was getting ready to go to one of thosemediators who didn't have any training in the legal perspective, and we were able towork through how she could make her separate property claim. so we went through that wholesituation so when she got to the mediator, she had an understanding of the laws in ourstate as they pertained to her situation.
so, that's mediation process if you have alawyer as a coach outside of the process. then there's mediation where you bring yourlawyers, and in those mediations, it's typically a situation where you don't sit all togetherin the same room. you are in... this kind of mediation - is called -- it's technicallymore of a settlement conference. so you and your lawyer would be in one room, and yourhusband and his lawyer would be in another room and the mediator, who's typically inthis case either a retired judge or a lawyer, goes back and forth between the rooms andtries to work with the parties sort of independently and separately to compromise. so there's alittle bit of compromise here, and bring an offer over to this room, and there's a littlebit of compromise here, bring an offer back
over to this room. and then the lawyer/mediatorwill come up with some ideas, "well, how about if we do this?" sometimes when you're in amediation, you may want to bring with you — like a — a cpa who can help you figureout the tax consequences of any decisions you might be making. there's other kinds ofexperts you may want to either consult before you go and --um-- have them available to youby phone. but for now, what i want you to remember is, when you get to mediation, youshould be very prepared. you should know exactly what your assets are. you should know kindawhat you think is appropriate in terms of a parenting plan. and even if you're in amediation where you have your lawyer and their lawyer and you're all in separate rooms, youknow — sometimes these rooms look like these
huge conference rooms with you know, laptops,and spreadsheets and the cpa is there and maybe a parenting evaluator might be availableby phone, or there might be a vocational person. so, it turns into a very collaborative processfor you and your team, and then your husband and his team is over in another room and there'sa lot of back-and-forth. so that's when you go to mediation with lawyers. so when you trying to decide — one thingthat drives what kind of mediation you want to go to — has a lot to do with the complexityof your situation. and situations can be complex because of the finances. or they can be complexbecause of challenges with your parenting plan. so, if you have financial complexities,that's usually regarding... maybe you own
a business, maybe you need retirement planning— um — spousal maintenance and alimony is always a big deal. when you have to doa lot of negotiating to come to a place where you make a decision about alimony or spousalsupport. so, one last thing i want to say about mediationis, that is in most states, at the end of a mediation or settlement conference, um — there'san opportunity to sign a binding contract. and in most states, that's a binding contractthat you can't really go back on. so you've got to find out in your state if that's thecase, but if you're going to go do a mediation and if you get tired and you let the otherside pressure you into accepting a settlement that might not be in your best interest, sometimesit's almost impossible to unravel that settlement.
and i don't know how it is in your state becausei don't practice there, but i do know in many states, in most states, there are legallybinding contracts that get signed in mediation that you're stuck with. and so — you shouldfind that out before you go to mediation, certainly find out if that's the case in yourstate because you want to know exactly what you're going to be signing at the end theprocess. which doesn't mean you have to sign it — it means... a lot of people go to mediation,and then they want to walk away and go back and talk to their lawyer, and that's perfectlyok, but a lot of people get pressured under the circumstances. so those are the types of mediation and alternativedispute resolution. and again, there's arbitration,
which is where a professional makes the decisionfor you. there's mediation, where it's a facilitated process and the parties actually make theirown decision, either by sitting in the same room with each other and working through theirissues — or being in separate rooms and having the mediator going back and forth betweenrooms, helping to come to a settlement. and then there's the mediation/arbitration, whichpeople call med/arb, which is where you do the back-and-forth thing, either in the sameroom together with your mediator or in separate rooms with your mediator going back and forth.and at the end of the med/arb session — and it might take a couple of sessions and youmight come back several times — but at the end of it all, if there are some things thatyou haven't been able to resolve, you turn
that over to the arbitrator, who makes thedecision — and in most jurisdictions, those decisions — you enter those in court andthey become legally binding decisions. so as you can tell, there's a lot of homeworkyou have to do before you get to mediation. and one of the biggest cautions i can giveyou is — some people come into the divorce process and they really just want to get done.they really don't want to go through anything ugly, they don't want to have — in a bigfight. you don't have to have a big fight just to get a good result. what you have todo is you have to be educated, and you have to empower yourself. and that's the whole purpose of this divorganizeseries that we're putting together — is
to give you the resources and give you theability to spot the issues that are important in your case, so by the time you get to themediation session, you should have a very good idea of exactly what you've got, andexactly what the issues are, and exactly how you think a fair resolution would be.
hello, i'm dr. felicia, and i'm here to speakto you about how to arrange vacation time after divorce. now, very often, each parentwants to take their child with them to the, a vacation, a summer vacation. and sometimesyou have conflicting times when you, vacations may fall at the same time. this is very importantto work out ahead of time. if you're lucky, you'll do it at the time of the divorce andit becomes part of your divorce papers. what many parents do, is use alternate years. forinstance, on odd years, the mother has the child for vacations, and on even years thehusband takes the child for vacations. they may do the same thing with christmas and newyear's vacation, thanksgiving. one parent may get the odd years and one parent may getthe even numbered years. and, that way, it's
all pre-set and pre-established, and bothparents get to share in the child's welfare. where you have difficulty is when each parentwants the same time, and that's obviously not going to happen. ah, hopefully both ofyou will co-operate with this. if you have
it pre-set and pre-planned and adhere to thatplan, you'll all have a much happier child in the long run. and, i think that's whatwe all look for, mostly for the benefit of the child. i wish you luck in your extendedfamilies and in your future endeavors, good luck and god bless.
i’ve been spending my life trying to putthe pieces together of how attachment unfolds. and in fact, i had a wonderful opportunityof taking a whole year off just to be able to study all the attachment theories throughoutthe ages, actually, and see how it is that attachment is meant to happen. and it’sa beautiful story, really. i’ll try to tell it very quickly and very simply. in the firstyear of life, a child does attach through wanting to be with, to be in sight, in smell,in hearing, in touch. but by the second year of life a new way of attaching should openup in which the child wants to be liked, not only with, but liked. and this is the keyto language acquisition, to stamping out form on their behavior; it’s a key to so manythings. if that goes well, the third part
by the third year, a child becomes preoccupiedwith belonging and becomes preoccupied with loyalty to be on the same side as which isa different way of closeness, to take the same side, to serve and obey. and that’swhen the obedience instincts begin to be there. by the fourth year of life, you should seein a child a huge quest for significance – to matter, because he feels close now when heis dear to those that he’s attached to. now if everything unfolds properly, the fifthyear is incredible. the limbic system, the command center or the amygdala of the commandcenter, the limbic system, the emotional brain pulse – all of it stops and the child giveshis heart to whomever he is attached to. he falls in love. and he’s deeply emotionallyattached to his kitten, to his grandma, to
anything that is there. and this is amazing.and it’s so important because when the child develops at that level, that’s a stage forthe rest of parenting. we cannot parent children whose hearts we do not have. we can’t parenteven our grandchildren whose heart we do not have. or our adult children. this is absolutelyessential. so children need to fall deeply into attachment and we need to make it easyfor them. the last stage is a very interesting stage. if it’s safe to attach, there’sno defendedness emotionally, then the child actually wants to share all that is withinhis heart. and so the 6-year-old is busy telling her secrets, and not to have any secrets thatdivide. this is the beginning of psychological intimacy, which should characterize our marriagesand our best friendships. and so we’ve got
all kinds of intimacies: with, like, belonging,mattering, our heart, emotional intimacy and then finally psychological intimacy. and thisis a context in which children are meant to be raised. so the beginning – the infancyand toddler – is just the beginning of a wonderful unfolding and development of thecapacity for a relationship.
they're decisions none of us want to make-- but what do we do-- when making health care decisions for a loved
one? "methodist hospital" is hosting "health care decision" day today. alissa willard joins us now
live-- with how doctors want us to prepare for the worst. good morning alissa! dave and serese-- right-- not
exactly a peppy topic for our thursday morning-- but healthcare officials here at methodist say having
advanced directives-- which include our powers of attorney and living will established now before an illness or
something unexpected happens is important. jessica kent survived "hodgkins' lymphoma" as a child-- and is
undergoing chemotherapy for breast cancer. she says-- making sure her family understands what she
wants her care to be like-- eases a lot of worried minds. " having to make that type of decision that's pressure enough.
to have external pressure from family members or from media or from groups that have their own agenda, that would be a terrible thing.
and i want my mom to have the freedom to make the right decision without that type of pressure." to break it down-- your "power
of attorney for health care" would be the person you want speaking for you-- if you can't do that yourself.
and the "living will"-- indicates what you want to happen in certain medical situations-- like if you're put on life
support. methodist doctors will help patients with those decisions here at 162nd and dodge-- and at "jennie
edmundson hospital" in council bluffs. coming up at 5-30--- we spoke with a chaplain at methodist-- about who shouldn't be
making these
decisions. reporting live, a-w, wowt -6- news.
hi, i'm stacey from stacey jane's nappy cakesand i just want to share with you how kindergym can fill your toddler’s need for physicalactivity. parenting a toddler can be a lot of fun, butit can zap your energy and your creativity. have you ever thought that it is possiblefor your toddler to enjoy? and benefit from physical activity, without draining your lastounce of energy or creativity? the answer can be kindergym. physical activity for toddlers plays a vitalrole in their development. kindergym for toddlers can be a productiveway to meet your kid’s needs for physical activity and more, and here’s why:it is anchored on the principle of exposing
children to a variety of fun and learningactivities that encourage the use of their motor skills. being a multi-movement based program, it isdesigned with the purpose of assisting in the development of a child’s motor skillsand coordination. it also aims to enhance their spatial awareness,improve their strength and flexibility, and boost their self-confidence and creativity. the physical activity for toddlers and otheryoung children under 5 years old are age-appropriate and safe. the activity areas are generally non-competitive,positive and stimulating.
the activities geared towards the physicalempowerment of your child are critical in laying the cornerstone of a lifetime of positivityand productivity – all this while having fun. you or your child’s caregiver can participatein the activities and have fun with your toddler – crawling, running, sliding, using trampolines,bars, and a variety of equipment. the activities will not just be fun and empoweringfor your child. it also empowers you... as you get to discovera lot of things about your child. there is more to kindergym than just providingphysical activity for toddlers. kindergym for toddlers is a proactive wayof helping them grow into a happy and balanced
child as it promotes their holistic development– physically as well as cognitively, socially and emotionally. if you like this video give it a thumbs up,comment below and hit and subscribe button to receive more like it in the future.
ok, let's talk about asynchrony. we can have two different asynchrony types. one is a timing asynchrony and one is flow assist asynchrony. the timing asynchrony happens when the ventilator overcomes the neuroventilatory inspiratory time of the patient. and the flow asynchrony is something like a lack of proportionality in the adequacy of assistance. now we can try to record if with high pressure support level we can see some asynchrony with this patient. let's wait a second and then let's look at the edi signal. and let's see if we can see something on the edi curve.
ok. recording. of course asynchrony is much more evident with a higher level of pressure support. and asynchrony means morbidity increase, longer stay on ventilator, longer stay on icu, a hugerisk of ventilator associated pneumonia, so we have to avoid asynchrony in the ventilatory assistance of our patient. example of flow assist asynchrony: low edi but higher pressure support level. and an example of timing asynchrony: the starting of the ventilator is not the start of neural inspiration bythe patient and the cycling of ventilator is good, but the triggering is not good enough. and then an example of autotriggering:
no trigger from the patient, but triggerfrom the ventilator. and this is another one: no trigger from the patient trigger from the ventilator, autotriggering.
this one is an example of a small diaphragm activity but timing asynchrony again. autotrigging again. flow assist asynchrony is small, not a huge delay in opening the valve, but a small effort from the diaphragm and triggering the ventilator.
and this embarrassing episode is just thebeginning of a sequence of embarrassing events that will occur as the israelites move fromegypt towards the land that's been promised to them. most of these episodes will occurin the book of numbers, and they involve the rebellion of the people in some way, generallygod's fury in reaction to that rebellion, moses' intervention usually on behalf of thepeople, and god's appeasement. the book of numbers recounts the itinerary of the israelitesthroughout the 40 years of their wanderings and encampments around the sacred tabernacle.the tabernacle always moves in the center of the tribes, and they're positioned in certainspecific positions around the tabernacle as they move. they stay at sinai for a year,i believe, in the text, before they begin
their movement, and numbers contains somelaw, and much narrative material. the material tells of god's provision for the people inthe desert, but it also tells of the israelites' constant complaining, and rebellion. the israelitesrebel against moses and god, and they long for egypt. there are several times when godthreatens to exterminate them, but moses manages to dissuade him. in numbers 14, for example,when the israelites complain again, god is determined to destroy them, and moses intervenes,and the intervention leads to a compromise. god swears that none of the adults who witnessedthe exodus -- with the exception of joshua and caleb, who did not join in the rebellion -- none of the adults who witnessed the exodus would see the fulfillment of god's salvation,and enter the promised land. this means the
israelites will have to wander for 40 yearsin the desert until all of those who left egypt as adults pass away, leaving a new generationthat hasn't really tasted slavery, to enter the land and form a new nation. the book ofnumbers, i think, is most remarkable for the relationship that it describes between mosesand god. i love reading these particular stories, and just hearing the dialogue between them,and imagining it, because the two of them alternate in losing patience with the israelites,and wishing to throw them over. but each time the one convinces the other to be forbearing.the relationship between moses and god is a very intimate one, very much like a husbandand wife, who are working together as partners and parenting a difficult child. they're partnersin the preparation of israel for their new
life, readying israel for life in god's landas a nation, as a people. i'm going to just give you two examples of the way moses andgod act as a check upon each other. the first excerpt is from numbers 14, and it shows moses'ability to placate the wrath of god. now, in this story, the israelites express greatfear. they've just heard a report from a reconnaissance team that scoped out the land, and they comeback and say: oh, boy, you know, it looks really bad--and that they think that the chancesof conquering the promised land are very, very slim. the whole community broke intoloud cries, and the people wept that night. all the israelites railed against moses andaaron. "if only we had died in the land of egypt," the whole community shouted at them,"or if only we might die in this wilderness!
why is the lord taking us to that land tofall by the sword? our wives and children will be carried off! it would be better forus to go back to egypt!" and they said to one another, "let us head back for egypt." å¯ the presence of the lord appeared in thetent of meeting to all the israelites. and the lord said to moses, "how long willthis people spurn me, and how long will they have no faith in me despite all the signsthat i have performed in their midst? i will strike them with pestilence and disown them,and i will make of you a nation far more numerous than they!" but moses said to the lord, "whenthe egyptians, from whose midst you brought up this people in your might, hear the news,they will tell it to the inhabitants of that
landå¯. if then you slay this people to aman, the nations who have heard your fame will say, 'it must be because the lord waspowerless to bring that people into the land he had promised them on oath that he slaughteredthem in the wilderness.' therefore, i pray, let my lord's forbearance beå¯ abounding inkindness; forgiving iniquity and transgressionå¯. pardon, i pray, the iniquity of this peopleaccording to your great kindness, as you have forgiven this people ever since egypt." and the lord said, "i pardon, as you haveaskedå¯." so note god's offer to start all over againwith moses. this is a pattern with this god, you know--create, gets upset, a flood wipesthem out, let's start again, oh, still not
too good, let's choose one person, abraham,see how that goes; oh, disappointed, let's go with moses--so this is a bit of a pattern.but moses refuses to accept the offer, and instead he defends the israelites, and heaverts their destruction. he appeals primarily to god's vanity: what will the neighbors thinkif you destroy them? they'll think you couldn't fulfill your promise. they'll think you'renot the universal god of history. but the roles are reversed in the following passage,and this is where the text blows hot and cold. in fact, there's a rabbinic image, there'sa rabbinic tradition that talks about this period of time, and has god and moses talking,and god says: listen, between the two of us, whenever i blow hot, you blow cold, or wheni pour hot water, you pour cold, and when
you pour hot, i'll pour cold, and togetherwe'll muddle through, and get through here. the israelites won't be wiped out. but inthis next passage, which is numbers 11, moses is the one who is impatient with the israelites'constant complaints and lack of faith, and he's ready to throw in the towel. i'll justread this last passage. the riffraff in their midst felt a gluttonouscraving; and then the israelites wept and said, 'if only we had meat to eat! we rememberthe fish that we used to eat free in egypt okay, we were slaves, but the food was free,you know? i just love that line. we used to eat this fish free in egypt. å¯the cucumbers, the melons, the leeks, theonions, and the garlic. now our gullets are
shriveled. there is nothing at all! nothingbut this manna to look at!' å¯ moses heard the people weeping, every clanapart, each person at the entrance of his tent. the lord was very angry, and moses wasdistressed. and moses said to the lord, "why have you dealt ill with your servant [me],and why have i not enjoyed your favor, that you have laid the burden of all this peopleupon me? did i conceive all this people, did i bear them, that you should say to me, 'carrythem in your bosom as a nurse carries an infant,' to the land that you have promised on oathto their fathers? where am i to get meat to give to all this people, when they whine beforeme and say, 'give us meat to eat!' i cannot
carry all this people by myself, for it istoo much for me. if you would deal thus with me, kill me rather, i beg you, and let mesee no more of my wretchedness!" then the lord said to moses, "gather for meseventy of israel's elders of whom you have experience as elders and officers of the people,and bring them to the tent of meeting and let them take their place there with you.i will come down and speak with you there, and i will draw upon the spirit that is onyou and put it upon them; they shall share the burden of the people with you, and youshall not bear it alone. so again, hot and cold. and in many ways, moses sets the paradigmfor the classical prophet. he performs this double duty. he chastises and upbraids theisraelites for their rebellion and failures.
when he's turning and facing the people, he'son their case. but at the same time, he consoles the people when they fear they've driven godaway irreparably, and when he turns to face god, he defends the people before god. hepleads for mercy when they do in fact deserve
punishment--and he knows they deserve punishment.he even says as much, but please [he says] have mercy. at times he expresses his frustrationwith the difficulty of his task, and resentment that it's been assigned to him. but we'llconsider the character and the role of moses in much greater detail when we reach the bookof deuteronomy.
