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Lifestyle and habits

The 10 Essentials, Good Judgment and Preparation Will Save More Lives Than Any Technology

When folks in the Northwest learn about outdoor survival, they learn about the “10 essentials”. The list was developed by The Mountaineers as a guide for explorers if they ever need to face these two questions: First, can you respond positively to an accident or emergency? Second, can you safely spend a night—or more—out?

The reality is that today most who enter the wilderness bring along technology in the form of a mobile phone, or as the New York Times article, “When GPS Leads to S.O.S” describes, a P.L.B. or personal locator beacon. Such tools are wise, but they are certainly problematic if their possession leads to imprudent decisions to enter the wilderness unprepared for events that are otherwise predictable to experienced outdoor explorers.

These unnecessary and  inappropriate requests for help, or acts of plain rudeness and stupidity towards the wilderness rescue system are wasteful and costly, but also pose a bigger problem. The article states, “While in some countries like Europe,  inexpensive rescue insurance covers the costs of all rescues, while in others, those rescued must pay for the help, especially when “victims” are thought to have been negligent or to have cried wolf. But in the United States, charging hikers or boaters for unnecessary rescues is an option seldom pursued. “We don’t want people not to call for a rescue because they think they can’t afford it. Then they’re likely to get into deeper trouble and trigger a more dangerous rescue,” says Jeff Sparhawk, public information officer for the Rocky Mountain Rescue Group, a search-and-rescue team based in Boulder, Colo.” Read More…

Professional and volunteer rescuers believe in their missions and want to help, but they put their own lives at risk in the process. The 10 essentials, good judgment and prudence, including the willingness to turn back, well short of the summit or goal will save more lives than any technology. Failure is one of the allures of the outdoors. There is always another weekend or another season to try again, and the journey, not the destination ought to be enough.

 

 

Bloomberg’s Large-soda Ban: Behavioral Economics in Action

Bloomberg’s Large-Soda Ban would prohibit restaurants, delis, sports arenas, movie theaters, and food carts from selling any soft drinks larger than sixteen ounces.

This interesting piece from the financial column of The New Yorker magazine describes an example of behavioral economics in action. The article, “The Economics of Michael Bloomberg’s Large-Soda Ban,”makes the argument that the proposed ban in New York on cups of soda larger than 16 ounces may work by setting and altering expectations of the drinkers. It describes how choices can be framed by the supplier, and in so doing, alter behaviors and consumption.

The article states, “Bloomberg’s proposal makes clever use of what economists call ‘default bias.’ If you offer a choice in which one option is seen as a default, most people go for that default… The soda ban makes sixteen ounces or less the default option for soda drinkers; if they want more, they’ll have to make an extra effort.”

Consider how we are all susceptible to being economically manipulated to buy, by the claim that an item is on sale, and the many other ways that how we view a choice is impacted by the context.  Read More…

Health Care and Cheesecake Factory: Can the former learn from the latter?

By Vanessa Radatus

Illustration by Harry Campbell for The New Yorker

This week, The New Yorker presents a fascinating article that delves into heart of what our health care system needs. Using The Cheesecake Factory as a model, American physician and journalist, Atul Gawande, provides refreshing insight as to how hospitals could learn a thing or two from this service savvy business. After all, who wouldn’t want a healthcare model that guarantees 100% satisfaction with quality and service, all at an affordable price?

Atul Gawande says it nicely: “In medicine, too, we are trying to deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality. Unlike the Cheesecake Factory, we haven’t figured out how. Our costs are soaring, the service is typically mediocre, and the quality is unreliable. Every clinician has his or her own way of doing things, and the rates of failure and complication (not to mention the costs) for a given service routinely vary by a factor of two or three, even within the same hospital.”

So, what can we learn from these flourishing businesses that continue to serve millions while managing efficiency, quality, and cost? For one, we must accept that whether we agree with recent health laws or not, our system needs a new model and fast.  With trillion-dollar healthcare costs only getting higher and a shortage of doctors to treat 30 million newly insured Americans, utilizing key business strategies from successful chains like The Cheesecake Factory may not be a bad idea.

In his article, “Restaurant Chains have Managed to Combine Quality Control, Cost Control and Innovation. Can Health Care?” Gawande takes a close look inside of The Cheesecake Factory’s  strategies to see how the business makes $1.2 billion in yearly revenue while maintaining affordable, high-quality products that always leave customers smiling. He explains that the success secrets behind the business is that instructions are precise, objectives are clear and oversight is tight. “The formula was Business 101: Use the right amount of goods and labor to deliver what customers want and no more. Anything more is waste, and waste is lost profit,” Awande stated.

If our hospitals aimed to reach the same amount of quality, efficiency and positive outcomes as these enterprises do, our healthcare system would not be in its current crisis. Awande proves a good point when he asked Dave Luz, Regional Manager of eight L.A. Cheesecake Factory’s, what he would do if he were manager of a neurology or cardiology unit in a hospital:

“This is pretty obvious. I’m sure you already do it. But I’d study what the best people are doing, figure out how to standardize it, and then bring it to everyone to execute.”

Unfortunately, this is not how medical care works. But new health-care chains are now hoping to do this on a mass scale, Awande says.

“They want to create Cheesecake Factories for health care. The question is whether the clinicians in the operating rooms, in the medical offices, in the intensive-care units—will go along with the plan. Fixing a nice piece of steak is hardly of the same complexity as diagnosing the cause of an elderly patient’s loss of consciousness. Doctors and patients have not had a positive experience with outsiders second-guessing decisions. How will they feel about managers trying to tell them what the “best practices” are?”

After a lengthy yet intriguing look into both the medical and food industry, Awande ends with this final thought for readers: ”

“The critical question is how soon that sort of quality and cost control will be available to patients everywhere across the country. We’ve let health-care systems provide us with the equivalent of greasy-spoon fare at four-star prices, and the results have been ruinous. The Cheesecake Factory model represents our best prospect for change. Some will see danger in this. Many will see hope. And that’s probably the way it should be.”  Read More…

Atul Awande is a highly respected physician and journalist. His writings on the process and practice of healthcare are important. His book “The Checklist Manifesto” is a must read for anyone concerned about health care and hospital quality.

Risk Management: Why a Chef’s Job is Among the Riskiest

 By Vanessa Radatus

Photo credit: Food Network Kitchens/ Wiley, John & Sons, Incorporates

It may not be ranked among the most dangerous profession in U.S, but recent headlines about celebrity chefs and Food Network personalities have got us thinking that being a top chef should be ranked among the riskiest jobs.

Here’s some food for thought. Just this year, celebrity chef and cooking show host, Paula Dean, reluctantly announced that she was diagnosed with type 2 diabetes. Known for her Southern-style, often deep-fried, high calorie recipes, it came as no surprise to those who watch her show.

According to experts, a chef’s lifestyle poses many safety and health risks. Not only is a busy kitchen a dangerous place in general- with sharp knives, hot pans, slippery floors and sanitation issues- but a chef must also constantly taste the food they make leading to high-caloric intake, which can cause obesity, heart disease and diabetes like Paula Deen.

We often hear about high risk jobs like firefighters, police officers, and construction workers, but what if a celebrity chef or TV food host is injured, seriously ill and can no longer perform? How does that affect his or her income? And how does it affect the overall “brand” and the businesses that rely on their name? In a

 recent Risk Management article, “Chopped Chef,” they explain how insurance works for these high profile food connoisseurs.

The article lays it out pretty clearly, proving that a chef’s job is worth protecting, especially if a million dollar brand is involved: “Investors and corporate risk managers generally recognize how dependent these franchises are on the brand of their celebrity chefs. Their response is often to secure large blocks of key person life insurance to protect against an untimely death. But many often ignore the greater risk of injury and forgo disability coverage, which may be a mistake if you realize that replacing these individuals is not as easy as calling up a recruiting agency.”

For this reason, large corporations dependent on personalities such as Martha Stewart, Gordon Ramsay, Rachel Ray, etc, procure key person life and key person disability insurance  in order to protect the wide array of people invested: the company, the employees, the shareholders, the board of directors, production and merchandising partners, etc.

“Chefs also can obtain coverage as a form of personal protection. This was the case for one high-profile celebrity chef in his mid-40s who was updating his financial plan when his new wealth adviser noticed that he failed to maintain disability income protection. With an annual income north of $2 million, the chef wanted to be able to maintain his lifestyle in the event of a disability. A policy was structured with a 90-day waiting period, followed by $100,000 per month of tax-free disability benefits. Coverage was underwritten protecting losses from both accident and illness utilizing a specific occupation policy form that covered the insured if he could not be an “on-air” personality. In all, nearly $15 million of future income was protected at a cost of around $40,000 annually.” Read More…

America’s Deadliest Diseases: How Your Diet May Put You at Risk

The food we eat may be the root to some of our nations most deadly health issues, according to the Wall Street Journal article “The New Science Behind America’s Deadliest Diseases.”

The article states that scientists have linked many diseases such as heart disease, cancer and Alzheimer’s to a condition known as chronic inflammation, and though the foods we eat can contribute to the cause they may also be one of the best medicines.

Here are foods that are proponents of chronic inflammation: How many of these foods end up on your plate each day?

  • Sugar: Sugar-sweetened beverages like soft drinks, fruit drinks and punches are one of the major sources of dietary sugars that many have overlooked. Do you know that drinking a can of Coke is as good as sucking ten sugar cubes?
  • Dairy: To lower your saturated fat intake, limit your consumption of whole and 2% milk; instead, opt for (organic) skim or 1% milk. Other ways to top your cereal include organic soy, almond, rice, hemp, hazelnut, or oat beverages.
  • Refined carbohydrates: Refined grains and products made out of them are almost everywhere. The common ones are: white rice, white flour, white bread, noodles, pasta, biscuits and pastries. A prime example is boxed cereals which contain substantial amounts of added sugar
  • Saturated fats: Feed-lot raised meat, lamb and pork. Opt for organic, naturally fed animals!
  • Trans-fats: Deep fried foods, fast foods, commercial baked goods and those prepared with partially hydrogenated oil, vegetable oils, margarine and vegetable shortening.
  • Alcohol: High consumption of  alcohol has been known to cause irritation and inflammation of the esophagus, larynx (voice box) and liver. Over time, chronic inflammation promotes tumor to grow and gives rise to cancer.

“Inflammation is the body’s natural response to injury and outside irritants. But when the irritants don’t let up, because of a diet of high-fat foods, too much body fat and smoking, for example, the immune system can spiral out of control and increase the risk for disease. Experts say when inflammation becomes chronic it can damage heart valves and brain cells, trigger strokes, and promote resistance to insulin, which leads to diabetes. It also is associated with the development of cancer,” according to findings in the Wall Street Journal article.

Here are some must eat foods that can reduce and fight chronic inflammation:

  • Oily Fish: Foods that are rich in omega-3 are key: Salmon, ahi tuna, sardines and other oily fish
  • Organic, free-range poultry and meat: Organic, free-range animals fed on a natural diet like grasses instead of grains and hormones contain more omega-3 fats, contain high amounts of protein and are lean. When you do eat red meat, choose lean cuts and limit to once a week.
  • Nuts: Nuts have long been linked with less coronary heart disease than other high-calorie foods. on some walnuts, pistachios or almonds. But measure a one-ounce serving (about one-fourth cup) to keep calories in check.
  • Berries: Cranberries, cherries, blueberries, strawberries, pomegranates, .as well as deep red and purple fruits are loaded with antioxidants and free radical-fighting  that are able to block the chemical pathways that create inflammation in the body as well as prevent cancer.
  • Vegetables: Broccoli, asparagus, carrots and many other deep orange and dark green vegetables are loaded with phyto-nutrients to prevent against inflammation as well as cancer and other diseases.
  • Oil and Spices: Olive oil, onion, turmeric, garlic and ginger have chemicals that act as a pain reliever and anti-inflammatory –just like ibuprofen.
  • Tea: All types (without sugar of course) have anti-inflammatory properties if you drink 4-5 cups a day.

Overall, a true anti-inflammatory diet is bright, colorful and fresh.

Are you up for the challenge? See how following an Anti-Inflammatory Daily Meal Plan can change the way you look and feel.

 

Breakfast:

  • Oatmeal sprinkled with strawberries, blueberries and cinnamon

Snack:

  • Grapes

Lunch:

  • Mixed-Green salad loaded with fresh veggies, including broccoli, onions, a sprinkling of walnuts or almonds and fresh-cracked pepper and an olive or canola oil dressing
  • Top your salad with grilled chicken
  • A slice of whole-grain bread or crackers
  • Unsweetened tea

Snack:

  • Cherries, walnuts

Dinner:

  • Grilled salmon with rosemary
  • Sliced fresh tomato drizzled with olive oil
  • Sautéed spinach with leeks and ginger
  • Brown rice
  • Unsweetened tea

Dessert:

  • Apple, sliced and sprinkled with cinnamon, cooked in the microwave or baked in the oven.

The information contained  at www. MCNTalk.com  is provided for informational purposes only and is not meant to substitute for advice from your doctor or health-care professional. This information should not be used for diagnosing or treating a health problem or disease, or prescribing any medication. Always seek the advice of a qualified health-care professional regarding any medical condition. Information and statements provided by the site about dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. MCNTalk  does not recommend or endorse any specific tests, physicians, third-party products, procedures, opinions, or other information mentioned on the Site. Reliance on any information provided by MCNTalk  is solely at your own risk.

What Really Makes Us Fat?

If there’s one steadfast rule in the world of weight loss, it’s that there’s no magic pill to make you thin. And with a wide array of diet information, myths, and fads available to us today, it ‘s nearly impossible to follow the perfect wight loss strategy. So what should we believe?
In a recent New York Times article, author Gary Taubes provides an insightful perspective challenging the misconstrued notion that “a calorie is a calorie.” If that were true, we could all eat 100 calories worth of French Fries instead of 100 calories of carrots and work it off in the same way. But we all know it’s not that simple.
The article, “What really Makes a Fat?” examines two common theories about fat: we get fat because we take in more calories than we expend and/or our body distributes those calories, either for energy expenditure or into fat storage.
Gary Taubes examines a recent study on obesity by Dr. David Ludwig of Boston Children’s Hospital and his collaborators. Taubes explains that the study compared two groups of obese subjects and fed them three different diets: one low in fat and high carbohydrates, another with low glycemic index: fewer carbohydrates in total from beans, non starchy foods and minimally processed sources, and finally te Atkins diet which is low in carbs and high in fat and protein. Taubes explains, “The study confirms that the nutrient composition of a diet can trigger the predisposition to get fat, independent of the calories consumed.” The bottom line: the fewer carbohydrates we eat, the more easily we remain lean. The more carbohydrates, the more difficult.
 “In other words, carbohydrates are fattening, and obesity is a fat-storage defect. What matters, then, is the quantity and quality of carbohydrates we consume and their effect on insulin,” Taubes said. While the media tended to treat the study as another diet trial — what should we eat to maintain weight loss? — it spoke to a far more fundamental issue: What actually causes obesity? Why do we get fat in the first place? Too many calories? Or something else? Read More…

Sedentary Behaviors May Shorten Our Lifespan

Recent studies published by the BMJ Open and American Cancer Society have found that reducing sedentary behaviors could  improve life expectancy in the U.S. With health consciousness at an all time high, most people recognize that maintaining a healthy diet and an active lifestyle is essential to living longer. But the new study suggests that even those who set aside 30 minutes to an hour for exercise each day still isn’t enough.

In a recent Bloomberg article “Sitting Less May Add Two Years to U.S. Life Expectancy,” Peter Katmarzyk, a  professor of epidemiology at Pennington Biomedical Research Center in Baton Rouge, Louisiana, said “It’s not just about getting physical activity in your life. Just because you’re doing 30 minutes of physical activity, what about the other 23.5 hours,” he said. “Don’t just sit the rest of the day.” 

 For those of us who work in an office setting 8-10 hours of the day, this may seem like an unreasonable suggestion.  The good news is we can keep our day jobs and still keep ourselves healthy with a few easy changes to our daily routine, says Katmarzyk. By simply getting up, standing and stretching once an hour or walking down the hall to talk to someone rather than sending an e-mail, we can add years to U.S. life expectancy.

But of course, like any new study, more research must be conducted in order to directly tie how many hours of  sedentary behavior actually contributes to disease and life expectancy. Individual actions such as weight, diet, health and whether someone smokes go together with other factors to determine a person’s life span, said Nancy Copperman, director of public health initiatives at North Shore-LIF Health System in Great Neck, New York. “I wouldn’t bet I would die two years earlier because I sat in the office all day,” Copperman, who wasn’t an author on the study. She did agree that people who sit as part of their jobs “need to take an activity break where we actually get up and walk around.” Read More…

According to a similar Business Week article, “Kill Your Desk Chair- and Start Standing,” a few businesses have taken this finding to heart. By installing standing desks and desks with treadmills, businesses are not only creating a healthier environment but could be preventing worker’s compensation claims. The article explains how Vanessa Friedman, an ergonomics consultant for mid- to large-size companies said most of the businesses that call her to help install standing desks do so after a worker’s compensation claim. “In California, where we are, back injuries commonly cost $60,000. After that, $1,500 on a desk doesn’t seem like a lot to spend,” she says. If sitting disease catches on as a diagnosis, she points out, claims are likely to increase. As more businesses catch on to adapting these modern working environments, it will be interesting to see how both health and work productivity improve. Read More…

Competitive Mothering

Recent months have generated a series of books and related articles on the quandary, enigma, challenge and deceptions that some feel are a component of modern mothering and by extension, parenting. Books, written by those who would appear to be if not active participants in that which they decry, the authors (all women so far), have at least been the beneficiaries of the choices and freedoms that have flowed to them. These choices and freedoms result in large part from decades of feminism, which in turn, is a result of many trends and realities, including reproductive choices that did not exist before the mid 20th century.

 Several months ago, a book by Amy Chua Battle Hymn of the Tiger Mother was excerpted in the Wall Street Journal. A heated debate was sparked in response to Chua’s intense (an understatement) focus on performance of her highly accomplished daughters.

 Begin the trend of responses promoting differnt parenting styles.

 Shortly thereafter, we were treated to a counterpoint by Pamela Druckerman’s book, Bringing up Bebe which  advocated a more parent-centered laissez faire approach to raising successful children.

 Another marked counterpoint to current passions for things organic, pro breast feeding child-centered approach to motherhood is in the book by French author Elisabeth Badinter, The Conflict – How Modern Motherhood Undermines the Status of Women. Among her points include a critique of the “‘radical condemnation’ of alcohol and cigarettes during pregnancy and most important, the mothers who buy into it all.”

 On this point alone or at least the alcohol part, we must stand in solidarity. The science on fetal alcohol syndrome was developed based upon women who consumed significant amounts of alcohol during pregnancy. If we apply common wisdom from the ages to this question of whether alcohol and pregnancy is dangerous, we must conclude that the findings do not support this. The data indicates that billions of women who have enjoyed a drink went on to become pregnant and those who continued to enjoy a drink often while unaware of their pregnant state during the most teratogenic 1st trimester end up giving birth to healthy children. We have progressed from such adult behaviors to a situation where anecdotes of woman close to delivery are being denied requested drinks at restaurants by well-intended servers.

 The latest is a screed from The Atlantic Magazine article “Why Women Still Can’t Have It All,” by Anne-Marie Slaughter, a Princeton professor who took a two year leave to work for the Clinton State Department as the director of policy planning. Her decision to return to her day job is in part due to issues faced as a mother of a 14-year-old son needing her attention.

Common to all of the above is that the authors are accomplished women who can engage in lively intellectual debate on the choices that they have. The debate is healthy and will continue forever, with each generation of parents believing that they have discovered the truth that eluded their parents.

Many in fact have written on the phenomenon of parenting guides over the centuries:

 Bottom line: Parents are anxious about raising kids, theories abound, truths of the past become today’s heresy and publishers and writers will never run out of material.

A Mathematical Challenge to Obesity

From The New York Times, in a conversation with Carson Chow, an investigator at the National Institute of Diabetes and Digestive and Kidney Diseases:
Question: Did you ever solve the question posed to you when you were first hired — what caused the obesity epidemic?

Answer: “We think so. And it’s something very simple, very obvious, something that few want to hear: The epidemic was caused by the overproduction of food in the United States.”

Beginning in the 1970s, there was a change in national agricultural policy. Instead of the government paying farmers not to engage in full production, as was the practice, they were encouraged to grow as much food as they could. At the same time, technological changes and the “green revolution” made our farms much more productive. The price of food plummeted, while the number of calories available to the average American grew by about 1,000 a day.

Chow has a number of other interesting, practical comments:

  • The conventional wisdom of 3,500 calories less is what it takes to lose a pound of weight is wrong. The body changes as you lose. Interestingly, we also found that the fatter you get, the easier it is to gain weight. An extra 10 calories a day puts more weight onto an obese person than on a thinner one.
  • Also, there’s a time constant that’s an important factor in weight loss. That’s because if you reduce your caloric intake, after a while, your body reaches equilibrium. It actually takes about three years for a dieter to reach their new “steady state.” Our model predicts that if you eat 100 calories fewer a day, in three years you will, on average, lose 10 pounds — if you don’t cheat.
  • Another finding: Huge variations in your daily food intake will not cause variations in weight, as long as your average food intake over a year is about the same. This is because a person’s body will respond slowly to the food intake. Read more…

American Pain: The Largest U.S. Pill Mill’s Rise and Fall

This article in Bloomberg Businessweek puts a human face on the opioid crisis – an interview with one of the owners of the largest Florida “pill mill” provider of prescription versions of Oxycontin. Now in jail, Christopher George provides some insight into how pill mills work and just how DEA regulations work and don’t work.

It’s a horrendous problem for society (according to the Centers for Disease Control and Prevention, 14,800 Americans died from overdosing on opioids in 2008, the most recent year data is available—more than the number of deaths from heroin or cocaine), as we’ve frequently noted at MCNtalk in the past. There were 335 million prescriptions for painkillers written in 2011. Is it any wonder some of them were from criminals? Read more…