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HEALTHY LIFE STYLES


Life Styles of the Healthy and Humble
The Thoughts of Phillip Gioia MD MPH

Table of Contents
Proteins p 2 
Carbohydrates p 3 
Fats p 3 
Toxins in Fats p 4 
Vitamins p 5 
The Cabbage Family p 6 
Herbs p 6 
Minerals p 6 
Fluoride p 7 
Wheat and Vegetable Fiber p 8 
Table salt p 8 
Overweight p 9 
Extreme Weight Loss p 9 
Alcohol p 10 
Exercise p 10 
Non-Smoking p 11 
Safety p 11 
Peace at Home p 13 
Drugs/Teen Pregnancy/STD's p15 
Skin Protection p 16 
Protection from X-rays p 17 
Protection from Toxins p 17 
Electromagnetic Radiation p 18 

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Healthful Protein Sources From Plants 

About 100 years ago, all but the rich had meat only once a week. The rich were the first to have heart attacks. 

Protein is necessary to keep the muscles and the structure of our body in good shape. Protein is best gotten from plants. The best way to use plant protein is to combine different plants. Such combinations as beans with whole grain rice or macaroni, or whole grain bread with natural peanut butter are good examples. Casseroles with whole grain rice or macaroni with nuts and/or legumes are also good. An excellent book to read on using vegetable or plant protein is: Diet for a Small Planet. Professor Colin Campbell of Cornell University discusses the evidence that shows a diet free of animal protein will help prevent heart disease, and autoimmune disease in his book The China Study. A description of it, comments on the book, and purchase is available from his publisher at The China Study. 
Soybeans are especially high in protein. They are cooked best in a pressure cooker. If they are cooked too rapidly the bean skins will clog up the pressure cooker steam release hole. To be safe always use a pressure cooker with a working safety valve. When combined with rice, they provide a good protein source. 
Especially to be avoided in one's diet are large amounts of hard fat such as the fat on red meat, butter fat or hydrogenated vegetable oil. These fats are associated with heart disease and possibly cancer. These are called saturated fats. Hydrogenated fats or oils such as most hard margarines also cause blocking of the arteries and perhaps cancer of the pancreas. These hydrogenated or trans-saturated oils are often found in the usual kind of peanut butter, many baked goods, and many fried foods. Natural peanut butter lacks the hydrogenation. Partially hydrogenated fats or oils should also be avoided. Children 3 years old and under need more fat for brain development and should breast feed if possible. All people should avoid hydrogenated oils. 

Cured, or smoked meats, such as ham, hot dogs or cold cuts tend to have extra salt which may lead to high blood pressure. These smoked or chemically preserved meats often contain nitrites and may also increase the risk of cancer. Very hot spicy foods may be associated with increased cancer risk. Garlic and onions on the other hand probably protect against cancer and clear the sinuses just as well. 


Carbohydrates: Starches to Replace Sugars

Carbohydrates provide energy for the body. There are two major types of carbohydrates: simple carbohydrates, or sugars; and complex carbohydrates, or starches. 

Since 1900, the sugar consumption per person in our country has increased five times or more. Regular table sugar, or sucrose, is found in large amounts in breakfast cereals, candies, cake, soft drinks, and in many canned or prepared foods. Increased sugar in the diet causes increased dental cavities. Sugar lacks vitamins and minerals and crude bulk. It may lead to constipation, diverticulitis, and possibly colon cancer. Since it lacks bulk, people may more easily become overweight when using it. Thus, it may lead to diabetes, which in adults is related to overweight. 

Starch sources such as rice, potatoes, and bread also provide carbohydrates. These are sources of complex carbohydrates which also provide some vitamins and protein. The starches are absorbed more slowly into the body than the sugars. Thus, eating bread with cheese or natural peanut butter will provide a longer-lasting supply of energy than will eating a candy bar or drinking a soda. Adding cheese or natural peanut butter to the bread will also provide useful protein. 


Fats: Keep to a Minimum

Fats also provide energy for the body. The energy from fats is mostly stored for use when not eating for long periods. About 1 teaspoon of vegetable oil each day does help to keep the skin in good condition. Most diets contain this much or more vegetable oil or unsaturated fat. A teaspoon of fat gives you about 25 calories whereas a teaspoon of carbohydrate only gives you about 12 calories. 

Fats that are liquid at room temperature (unsaturated fats) such as vegetable oils are best for the heart. Hydrogenated vegetable oils tend to be solid at room temperature and should be avoided. Liquid vegetable oils tend to protect the heart. But fat in large amounts may increase the body weight and may be related to colon cancer. Fat causes overweight because it provides concentrated calories that are stored away easily. Cancer may be caused by damage to body cells by oxidized fats. If large amounts of liquid oil are eaten, extra Vitamin E or tocopherol may be necessary. About 200 units of Vitamin E once a week is adequate for most adults. Vitamin E acts as an anti-oxidant for unsaturated fats which oxidize easily. This may help prevent cancer, however too much Vitamin E may increase bleeding and promote autoimmune disease. Eating more liquid or polyunsaturated oil increases the risk of gall stones due to more cholesterol in the bile. Gall bladder disease has become increasingly common in the past 40 years. Olive oil is a monounsturated oil which only slightly lowers the cholesterol but lacks the tendency to produce gall stones. 

Foods which contain much saturated fat are butter, most margarine, deep fried foods (French fries, potato chips, etc.), regular peanut butter, lower priced ground meat, prime ribs, hot dogs, sausage, cold cuts, and cheese. Saturated fats increase blood cholesterol. The body produces its own cholesterol but large amounts also come from eggs and shellfish. High cholesterol levels are associated with heart disease. Children usually have low levels. How high the blood cholesterol levels get depends on an inherited tendency to produce cholesterol, the ratio of saturated to unsaturated fat in the diet, the amount of fiber in the diet, and the amount of cholesterol in the diet. All adults by their 21st year should have their level checked. Children with heart disease in the family should have cholesterol levels checked by their 11th year. Hydrogenated vegetable oils tend to increase serum cholesterol, increase pancreatic cancer risk, and also increase the hardening in the arteries which causes heart disease. Hydrogenated vegetable oils or trans-saturated fats are found in regular peanut butter, many snack foods, cookies, cakes, margarines, and vegetable shortenings. Natural peanut butter lacks hydrogenated fats. 

A good way to avoid fats is to eat protein mostly from plant or vegetable sources which are naturally low in fat. Again the book, Diet for a Small Planet, is a good reference. 

Some fats from cold water seafood may be good for the heart. Eicosopentoic acid (EPA) and docosahexaennoic acid (DHA) found in the fat of cod fish, herring, sardines, seals, and whales may prevent arteries from hardening. Small fish such as herring and sardines will contain less toxic substances. Large fish such as swordfish, tuna, cod, halibut, and lake trout tend to accumulate moretoxins such as PCB's, methyl mercury, dioxin, and pesticides. Pregnant women should probably avoid these fish due to the sensitivity of the fetus in early gestation to toxins. Others should have no more than 2 servings a week of these fish. 


Vitamins:The Right Dose

Fresh fruits and vegetables are the best sources of vitamins. Grains such as whole wheat or brown rice are good for the B vitamins. B vitamins, discovered 40-50 years ago, are now required by law to be put into white bread or breakfast cereals. Vitamins A and D are added to milk. Some new B vitamins such as B6, or pyridoxine, may not be added back to some refined foods. Besides whole grains, brewer's yeast is a good general source of B vitamins (and also chromium). Taking 50 mg or more of vitamin B6 or pyridoxine on a regular basis may cause muscle weakness and thus should be avoided by most people. 

Eating orange or yellow fruits and vegetables or other foods high in natural Vitamin A may prevent cancer, but taking Beta carotene (one of the components of natural Vitamin A) supplements actually increased the risk of cancer in the best large scale done as of yet. Vitamin A is a fat soluble vitamin and as such it is stored in the body. Adequate levels of vitamin A are probably achievable by eating yellow vegetables or fruits only a few times a week. 

Some people need more vitamins than others. There are some diseases that respond to large doses of vitamins, but high doses of Vitamin A, Vitamin D, Vitamin E, Vitamin B6, or Vitamin C are toxic. 

People who smoke or are exposed to other forms of air pollution may benefit from larger doses of Vitamins C and E. Vitamin C doses of 250 mg. per day and Vitamin E doses of 200 units once a week should be adequate for a moderate smoker. Vitamin C usually is also an anti-oxidant. If you have high levels of iron in your body as do about 10% of adults, then taking high doses of Vitamin C will actually cause oxidation and thus may increase aging or cancer risk. High doses of Vitamin C will also increase the risk of kidney stones. Vitamin C or ascorbic acid is best obtained from citrus fruits, citrus juices or peppers. 

Vitamin E or tocopherol whould be avoided if you have a tendency to an overactive immune system or if you have poor clotting. Vitamin E tends to increase immune activity and may aggrevate autoimmune diseases such as lupus or rheumatoid arthritis. In high doses it also inhibits blood clotting. Natural sources of Vitamin E are whole grain foods, vegetable oils, nuts and seeds. 

Folic acid taken early in pregnancy helps to protect against spina bifida birth defects. Folic acid is naturally found in fresh leafy vegetables and fruits. To prevent spina bifida birth defects the folic acid (folate or folacin) intake must be 400 micrograms daily during the first 3 months of pregnancy. This is often before most women know that they are pregnant, therefore any woman trying to conceive a child should be sure to eat a diet high in folic acid or take an appropriate food or vitamin supplement. In the future folic acid will be added to many foods. 


The Cabbage Family

Vegetables in the cabbage family help to stimulate the body's natural defense against air pollution. These vegetables are cabbage, broccoli, onions, and brussel sprouts. Smokers or others exposed to air pollution such as garage mechanics or wood stove owners should be sure to have one of these vegetables at least twice a week. An indole compound in these vegetables helps stimulate the liver's detoxification of polycyclic hydrocarbons found in air pollution. These vegetables also contain natural Vitamin A, Vitamin C, and vegetable fiber. 

Herbs

Herbs or natural plant materials or plant derived substances have much potential in promoting good health. Since it would take a large and probably expensive clinical research trial to approve an herb as a therapeutic substance, herbs are largely unregulated. Their packaging must avoid all health claims. For instance prune juice bottles must not mention the beneficial effect of prune juice on constipation. This is yet another example of The Death of Common Sense (futher described by Phillip K Howard.) Since herbs are unregulated what a packaged herb actually contains or what dried herbs actually are, is unknown unless you know that the supplier is accurate and honest or in the case of dried herbs that you can identify the herb accurately. As mentioned above onions and garlic may prevent cancer. Garlic may also decrease heart attack risk though it may increase bleeding risk slightly due to its effect on decreasing platelet stickiness. The best source for recent scientific herbal information is Herbs of Choice by Varro E. Tyler or his Honest Herbal. 

A common herb to avoid is alfalfa, according to Professor Tyler. In some people it may cause lupus (Systemic Lupus Erythematosis) or SLE. Taking comfrey often may also be dangerous to the liver. 


Minerals

The most well-known mineral is iron. Women with pregnancies or menstrual periods and growing children need extra iron. Good sources of iron are beans, raisins, grapes, beets, grape juice, beet juice, egg yolks, liver, and red meats. Men should avoid getting too much iron since it may increase the risk of liver and heart disease. Since iron is harmful in excess or deficit routine blood work to evaluated iron status in different stages of life such as infancy, young adult, and adult is helpful. 

One problem with a diet high in plant protein is a possible zinc deficiency. Whole grains such as whole wheat, bran, or brown rice tend to inhibit zinc uptake. Zinc is just as necessary for growth as is iron. Zinc is found in oysters and in meat. Whole wheat bread made with yeast allows zinc uptake much better than whole grains only cooked. Yeast contains an enzyme called phytase which keeps the phytate in whole grains from binding the zinc. In one study zinc was associated with the lesions of Alzheimer's disease. Another study showed that zinc possibly interferes with the beneficial effect of Vitamin A on eye disease. Zinc supplements should only be used if you and your doctor are sure that you are zinc deficient. 

Chromium helps the body to handle sugar. Chromium is found in brewer's yeast or in beer. Brewer's yeast tastes bitter but in the powered form it may be added to a commercial breakfast cereal to counteract its sweetness. Perhaps the best source of chromium is acid food cooked in stainless steel utensils. The acid extracts the chromium from the stainless steel. 

Selenium is necessary for life in small amounts. Some people believe that it helps to prevent cancer, but the evidence is very poor. If too much selenium is taken, it may produce hair and nail loss, produce a garlic breath and lead to fatigue. 


Fluoride

Fluoride, when used regularly, helps to prevent dental cavities. In many cities fluoride is added to the drinking water at the treatment plant. There is no fluoride in any water system or well in Cayuga County. Syracuse, Skaneateles, Elbridge, Jordan, Newark, Rochester, the Seneca Army Depot, Romulus, some Seneca County trailer parks and Wolcott have fluoridated water. 

If there is a tendency to dental cavities or caries in your family you should consider the use of fluoride supplements for children from 6 months to 13 years of age. Fluoride drops or chewable tablets used regularly will prevent as many as 50% of cavities. The regular use of fluoride has been studied for 35 years and has been shown to have no adverse health effects except for an occassional allergic reaction and the production of a chalky white discoloration in the teeth called fluoriosis. Delaying the use and decreasing the amount of fluoride supplements decreases the risk of fluoriosis in the permanent front teeth. In Canada fluoride supplements are not recommeded until 3 years of age. In 1996 two studies have shown that frequent fluoride toothpaste use by 1 to 3 year olds is also associated with fluoriosis. If toothpaste is used in toddlers it should only be a small dab of a quarter inch or 5mm or less at most twice a day. Only one study in rats shows a slight bone cancer risk at high doses of fluoride. Bone cancer rates in humans in areas with and without fluoride have failed to show any risk of bone cancer above 1 in 200,000 children. Other studies in other species failed to show any adverse health effects. For these reasons flouride dosage recommendations were decreased in January 1994 and more caution is used at present. 


Wheat and Vegetable Fiber

Wheat bran fiber was in everyone's diet until 200 years ago when Western Europeans and Americans began to afford white bread. Wheat bran fiber helps to keep the stools from getting too hard. In some people with loose stools it may provide some substance and form. The most economic sources of wheat bran are Wheatena and Ralston 100% Whole Wheat Cereal, however these must be cooked which adds energy and preparation costs. Whole wheat flour may be used to make your own bread. 

Some physicians have suggested that the stools or bowel movement should be of a loose, mushy consistency in order to prevent bowel disease such as hemmorhoids or diverticulitis or colon cancer or appendicitis. Fiber in the diet also helps us to eat less calories and to keep the heart in better shape by binding cholesterol in the intestines. Oat, bean, psyllium and rice fiber also lower cholesterol. Psyllium is found in most fiber laxatives. Some people may get irritation of the bowel lining from excessive fiber and may need to eat less than others. 


Table Salt: Sodium Chloride and High Blood Pressure

Most people get enough salt from their food without adding any more. The regular diet contains about 2000 mg. of salt and we only need about 200 mg. At the start of very hot humid weather we may need some extra salt because we lose it in our sweat. The routine extra amount however, is much less than we usually get. Even in hot weather, our bodies soon change to need less salt after a few days. By middle age, 20 percent of Americans have high blood pressure. One half of these people are sensitive to the amount of salt in the diet. When high blood pressure is present for many years, it is hard to stop without medicines. However, if salt is kept out of the diet in those people with only an occasional high blood pressure reading or those with only mildly elevated blood pressure, then the blood pressure may return to normal. (Weight loss, exercise, and relaxation are also often helpful in those people with mildly elevated blood pressure.) 
People with low blood pressure and frequent periods of weakness or fainting may need extra table salt. About 30% of people with chronic fatigue syndrome have responded favorably to increased salt in their diet. When the weather starts to get hot extra salt is needed by these people to replace losses in sweat or perspiration. (For people with normal or high blood pressure only extra water is needed.) 


Overweight

Despite the fear of overweight or obesity by many, it often has few health effects. People with diabetes and with high blood pressure are definitely helped by losing weight. Being extremely overweight may also inhibit breathing or aggravate arthritis. 

When losing weight the best approach is to do so gradually. Rapid loss diets are often followed by rapid gains. Rapid weight changes are probably more stressful to the body than mild obesity. Children may need not lose weight at all, but simply need to grow taller and thus thin out. Adults should lose about 1/2 pound to 1 pound per week. In the first weeks of a diet the body must switch from using blood sugar to using fats for energy. To prevent hypoglycemia or low blood sugar, dieters should eat small amounts of food frequently in the first week of a diet. This change to fat metabolism also causes a loss of fluid in the first weeks, but later the fluid is gained back. Especially the overweight should avoid fats and sugar which have concentrated calories or energy. Saccarhin has never been shown to help in weight loss and it does give the regular eater a small risk of cancer. Nutra Sweet or aspartame is an amino acid which is used as a sweetner. It should be avoided in pregnancy and in children under 5 years old because their brains are sensitive to amino acid imbalances. Some people do get headaches with it. 
The best way to lose weight and keep it off is to exercise regu- larly. Exercise often makes you feel better and helps to your body use insulin better which keeps your arteries in better shape. When sugars or carbohydrates are used in exercise they will fail to go into fat. On the other hand eating large amounts of food when inactive such as before sleep will tend to direct the energy from the food into fat. For those with any tendency to arthritis or joint problems low impact aerobics such as walking, swimming, or dancing are good. Special exercise equipment may be expensive and 50% of the time or more is left unused. 

Women often have more fat or adipose tissue around their hips and thighs due to estrogen hormone effect. This is not associated with diabetes, but fat on the arms and stomach area is associated with diabetes in both men and women. 


Extreme Weight Loss

Losing too much weight is dangerous. Teenage women are at risk for anorexia nervosa or the continual loss of appetite even to the point of starvation. Usually the young women start to lose some extra weight but are unable to stop losing even when they have gone past their ideal weight. Bulimia is the disease where the patient eats large amounts of food but then makes themself throw up. Purging is the disease where the patient takes large amounts of laxitives to keep their food from being properly digested. Purging and Bulimia may cause severe salt imbalances in the body and death. If these occur please contact a physician. 


Alcohol

Some people will get liver disease if they have four drinks or more of beers, cocktails, glasses of wine, scotch, or whiskey each day for a few years. Women are more susceptible to liver disease. Alcohol is most dangerous when combined with driving. One drink may cause impairment of driving ability especially if the drinker is overtired or is on certain medication. The alcohol enters the blood stream much more rapidly if taken on an empty stomach. Alcohol may effect the ability to do difficult tasks even up to 48 hours after the last drink. The effect of a drink is much more on a smaller person. A child might become severely effected by only 1/2 drink. Children especially, but adults also, may get low blood sugar if a drink is taken on an empty stomach. 

Alcohol is addictive. The tendency to alcoholism does run in families. About 1 percent of the people in the United States are alcoholics. These people and their families should avoid alcohol. About 10% of teens have drinking problems to the point where alcohol interferes with their school and social life. Alcohol also increases the risk of mouth, throat and breast cancer. Breast cancer risk increases with  just 1 drink a week for women.

Non-alcoholic beer avoids the ill effects of the alcohol and gives the benefits of yeast and carbohydrates, however it may still make you sleepy due to the hops in the beer. Hops is an herb that by itself may act as a sedative. 


Exercise

How big and strong our muscles are is in part dependent on how much we use them. In order to have a heart with extra strength, the heart should be exercised two to three times a week. The heart is a muscle which pumps our blood. When walking fast, climbing stairs, running, swimming, or bicycling, the heart has to pump more blood and gets more exercise. If a flabby, inactive heart is suddenly exercised, it may get injured. Therefore, a regular pattern of exercise with slowly increased challenges to the heart is best. Age and build also effect the muscle strength. Appropriate exercise for some is not appropriate for others. After age 19 years our joints start to deteriorate. The cartilage which covers the ends of the bones in the joints wears down, therefore for long term fitness low impact aerobic exercise may be best. Walking, dancing, swimming, or cross country skiing may help you feel better without causing excessive joint or injury wear and tear. 
People who exercise may note a decrease in body weight. This is in part due to using up more calories in exercise and in part to being less able to eat immediately after vigorous exercise. Exercise also causes the body to be more sensitive to insulin thus decreasing blood sugar and preventing diabetes. For thin people exercise may increase their weight by increasing their muscle size. Steroids do not help the average athlete at all. Anabolic steroids do cause behavior problems and increase cancer risk. They also may make a young teen shorter. 

Play activities in safe places such as playgrounds help children and adults to feel better and relax. During exercise and sleep much subconscious thinking occurs. This helps the brain and body adjust to changes and prevent stress. 


Non-Smoking: The Only Way

Smoking cigarettes is the largest preventable cause of disease and death in the developed countries of the world. It causes heart disease, strokes, lung and other cancers, SIDS, decreased birth weight, respiratory illnesses, emphysema, and chronic bronchitis. In adults side stream or environmental tobacco smoke cause heart disease and increase lung cancer risk. For infants tobacco smoke in the environment causes an increase risk of SIDS (Sudden Infant Death Syndrom) or crib death, otitis media or ear infections, food allergies, asthma, and severe respiratory illnesses. 

Nicotine in cigarettes acts as a mild stimulant for many people. This seems to be fairly safe by itself but the hydrocarbon pollutants in the cigarette smoke causes cancer and the carbon monoxide in the smoke causes heart disease. Chewing tobacco is causes gum and tooth disease and cancer. Until a safer form of nicotine is found coffee, tea or chocolate may be safer forms of mild stimulants. 


Safety: Injury Prevention

Injuries don't just happen, they are caused. The way you live and act may reduce your chance of injury. Wearing a seat belt in the car will reduce your chance of injury from a collision 90% of the time. Having safety car seats for children isn't just the law but also saves lives. Infants should never sit in a rear facing car seat with an air bag in front of it. When the air bag opens up in a collision it will push the infant seat backwards causing an injury to the infant. Just after children outgrow their safety seats and are about 40 inches tall or more they may use seat belts. Using a pillow or cushion underneath the child will help the seat belt to catch on the pelvic bones instead of catching under the ribs and damaging the liver or spleen. Adding shoulder straps to the safety belt helps prevent back injuries & spleen or liver injuries. The back seat in a passenger car is safer than the front seat generally. Using shoulder straps in the back seat is best. Children from 3 to 7 years old who are too big for a child safety seat may use a special booster seats which adjusts the car shoulder straps so that they work properly for the smaller child. These booster seats/shoulder strap adjustors usually work best for children between 40 and 60 pounds. If the shoulder strap irritates the child's neck simply putting a cloth or towel around it helps. 

Some cars are safer than others. Narrow wheel based cars with a high center of gravity such as the Suzuki Samuri or the Volkswag- on beetle of the 1950's to 70's tend to tip over easily. Smaller cars do save on gas but may give less protection if not designed properly. Divided highways with limited access are safer but are expensive to build. The car and driver should be in optimal condition for driving. The car well inspected and the driver well rested. Long distance trips by plane or train are usually safer than by car. 

Deer whistles may prevent collisions with animals. They are small whistles that are mounted on your car in the path of moving air. When the car is going 30 miles per hour or more they make a very high pitched sound that is heard by animals such as deer but not by humans. 

Falling off bicycles is the most common cause of severe head injury in children 5 to 15 years old. Bicycle helmets will help to prevent concussions and brain injury. NY State law prohibits children less than 1 year old from riding as a passenger on a bicycle. Children 1 to 14 years old who ride on a bicycle must wear a proper helmet. When roller skating or blading helmets are also helpful and are now also legally required for youngsters. Bike helmets may be used for these activities also. 
All Terrain Vehicles or ATV's are often associated with serious injuries. Close adult supervision and the use of strong helmets are recommended. The three wheel variety should be avoided completely if possible due to its instability. 

Smoke alarms save lives by warning people about the presence of toxic fumes before they are suffocated. Some fires produce little smoke early on but do produce much heat at first. Heat detectors are also very helpful. For full fire protection, both smoke alarms and heat alarms should be used. Escape plans help during the panic of a real fire. Chain ladders that latch onto window sills are available for families with only one means of escape from a second floor. Fire extinguishers for home use may help in handling small fires. Keeping matches out of reach of toddlers and keeping burning cigarettes out of beds and couches will help prevent fires. Most cigarettes are made so that they keep burning even if they are dropped. 

Chemicals or medicines taken by curious children may cause serious illnesses. Lye or Draino in the mouth or throat may cause permanent scarring. Methanol or dry gas may cause blindness. Gasoline or kerosene in the lungs may cause a severe pneumonia. Inhaling baby powder in excess causes pneumonia. Breathing in even small amounts of talc over years may cause cancer. Overdoses of otherwise safe medicines such as aspirin or Tylenol may cause death. In the event of a poisoning call me or the Syracuse, NY poison control (ph. 315-476-7529 or 1-800-252-5655) and keep on hand Syrup of Ipecac. It causes vomiting and may be used with medicine overdoses to keep the medicine from reaching the blood stream. Do not use it when lye or Drano has been swallowed. 

Electrical energy may cause burns and even death. Battery operated toys are generally safe but household current may be lethal. Hair dryers even when shut off may electrify water if dropped into a full sink or bathtub. Outlets are available that automatically shut off if this occurs (GFI or ground fault interrupter outlets). Household plugs may be dangerous if probed with a knife or screwdriver. Plug covers may help deter the toddler. The safety GFI outlets will detect these shorts and stop current flow. Also beware of stepping on frayed or worn electric extension cords. 


Peace at Home or Violence Prevention

About one-half of all murders are committed by relatives or friends of the victim. Child abuse causes more deaths in children over the age of 6 months than any other problem. Clearly it is important to love your enemies even if they are your friends or relatives. Many societies raise their children without violence. Discipline or guidance is required by the child but forceful coercion is not. When spankings or slappings are used on a child it teaches the child that it is allowable to hit people that you love. It teaches the child that harming or hurting a person to change the person's behavior is something that the child may do, perhaps to a sibling or friend. If any child is at risk from violent care takers please try to help the child by calling NY State Protective Services (ph. 1-800-342-3720)or directly discussing the problem with the parents. Spouse abuse should not be tolerated since it is dangerous and teaches violence to children. If the child or adult is in immediate danger intervene if possible and call the local police. Beware!! these are dangerous situations with many policemen dying each year from investigating family violence. Humor or distraction is the best approach rather than confrontation. 

In their pastoral letter on peace the U.S. Bishops have given guidelines for a "just war". Violence is only justified if these seven conditions are met: 

  1) There must be a just cause. Is someone's life or limb in 
  danger if you do not act forcefully?

  2) You must act to be helpful. Are you hitting the family member 
  to show your power over them or are you doing it for their good?  

  3) Your cause must be greater than your opponents. Are you 
  hitting your child for messing up a room when there is nowhere  
  else to play and the room may be cleaned easily?

  4) You must try the peaceful alternatives. Did you ask the child 
  to pick up the room and reward the child when done?

  5) You must have a good probability of success. Is your opponent 
  over 6'6" and 300 lbs. and you much less?

  6) Is the good obtained from the violence worth the harm done by 
  the violence. Is the anger and hate generated by hurting or 
  humiliating your child worth the little the child learns about 
  how you like to have a neat room?

  7) The decision must be made by a responsible person. Are you 
  upset or over tired?

Parents should feel good about themselves. Being a parent is the most important job in our society. Parents who feel bad about themselves often pass these feelings on to their children. Feeling good about yourself also helps the body in fighting infections and cancer. If you feel bad most of the time, ask for help. 
Sexual abuse of children often occurs when parents or relatives are unable to enjoy themselves without taking advantage of innocent children. People who force sex on other people need counseling. 

Abused children have a high risk of premature parenthood, prostitution, drug abuse, and mental illness including suicide and depression. These children need protection from further abuse and often need professional counseling. 


Good Parenting: How to Prevent Drug Abuse/Teen Pregnancy/Delinquency/STD's

The best way to prevent these is by giving your infant and toddler a good feeling about themselves. This positive self image will help protect them from slipping into the easy fix or quick solution. It will give them strength to reach the best goals. Peace at home (see above) will build peace in our children and in our community. 
Teaching by example works best. Parents should work on things that they believe are important and enjoy their lives. Positive rewards or compliments for work well done helps in getting a person to change their habits and to feel good about themselves. Often children and adults have reading, math, attention, geometry, music, art, or other learning problems. About 5 to 10% of people have a difficult time reading even with a good learning environment. About 50% of normal high school students have neurolgic deficits in memory, visual perception, or other abilities important to learning. Only 5% of the students are unable to compensate for their learning deficit by their strengths. This 5% is recognized by their poor school achievment. In school as in home we should recognize our strengths and develop them. If we are unable to correct our weaknesses we should compensate when possible. With a voucher system for school payment parents and students would be able to reward good teachers and schools. This empowerment would help develop good self esteem in students and parents. 

Children like adults dislike nagging and badgering. Simple rewards such as an extra smile or extra hugs or reading a special story or an extra playtime with the child are best. Usually children like attention from their parents more than anything else. When bad behavior occurs it should be ignored and the child should be given less attention. A cool frown is better than getting upset and giving the child more attention. Putting the child in a corner or in a room away from the parents is good. 

Children who feel good about themselves and have a cautious interest in the world will likely negotiate adolescence well. If your child or teenager is often sad or tired, depression may be present. This often is followed by drug or alcohol or sexual experimentation. The teenager often tries these in order to make themselves happier but often ends up in worse shape. Everyone should be aware that sexual contact or IV drug abuse may lead to a fatal case of AIDS. Crack cocaine or inhaled cocaine may be fatal to some even on their first use. At the first signs of depression help should be offered to the teenager to avoid serious problems. 
Sexual desires in young and old adults are part of life. If ignored they may lead subconsciously to abusive or exploitive relations. St. Paul suggests that sexual desires be controlled through marriage in a mutually satisfying relationship or be wholely given up in abstinence for the complete dedication of oneself to your God. Presently many teens experiment with intimate relations without protection from psychologic or biologic exploitation. In St Paul's days gonorhea was a crippling sexually transmitted diseases(STD). From 1492 the STD syphillis has caused much death and disability. These diseases are now treatable but since 1979 AIDS or autoimmune deficiency syndrome has become the most significant STD threat. AIDS is caused by the HIV or human immundeficiency virus. People may be infected by HIV for years before they become sick. While they have the HIV they are contagious by sexual or blood contact. The current standard test for HIV only checks for antibodies to HIV which may take up to 6 months to develop after a person starts to carry HIV. For more on HIV see the AMA or American Medical Association's home page. If a person picked up HIV in the past 6 months that person could test negative for HIV and still be contagious for HIV by sexual or blood contact. Other common STD's are chlamydia, herpes and hepatitis B. Chlamydia is very common and may cause problems with sterility in women through fallopian tube scarring. It is treatable but since it often fails to cause much pain it may be hard to detect. Herpes or herpes simplex is a virus which may cause frequent painful sores. Medication helps decrease the pain but fails to get rid of the virus. Hepatitis B may cause chronic or fatal liver disease in 10% of the adults that get it. There is a vaccine to prevent getting Hepatitis B from blood or sexual contact. 


Skin Protection 

Exposure of the skin to sunlight increases the risk of skin cancer. This is why skin cancers often occur on the face. Increased skin pigmentation decreases the penetration of sunlight through the skin and thus decreases the risk of skin cancer. The ultraviolet part of sunlight causing cancer and sun burns penetrates clouds and is reflected off snow and water. Thus even indirect sunlight may be harmful. Glass usually filters out the ultraviolet part of sunlight and thus prevents sunburns and cancer. Sunscreen lotions should be used by fair skinned people. Severe sunburns even in children may increase later skin caner risk. Presently sunscreen may only be used after 6 months of age. Before 6 months, reduced exposure is necessary. Special sun protective clothing is also now available. Be especially careful in early spring on the first sunny warm days before a natural protective tan occurs and in mid summer or mid-day or on very clear days when the sun rays are very strong. If atomospheric ozone levels continue to decrease the sun rays will continue to get stronger. 


Protection from X-Ray Radiation

Every year we are exposed to about a tenth of a rad of x-ray radiation from the sun and natural radiation from rocks. X-ray radiation causes cell damage but at low doses our body usually readily repairs itself. At higher doses the damage may go unrepaired and lead to cancer. A chest x-ray gives only one half of a tenth of a rad of radiation but skull x-rays may give up to two tenths of a rad. Therefore we try to use x-rays only when needed. 
Radon is a radioactive or x-ray emitting gas present in some rocks in our area. Houses built on rocks or with much exposed dirt in the basement should be checked for radon. Especially dangerous are houses free of drafts or air leaks since they may trap radon from gas flowing into the basement. The New York State Department of Health has a phone number (1-800-458-1158) for ordering radon detection kits for about $30 each. 


Protection from Toxins

Toxins are present in foods, in the air and in the water. We usually handle small amounts well but larger amounts may lead to cancer, nerve damage, or birth defects. Cadmium is a metal found in leafy vegetables, cigarettes and road dirt. In large amounts it may cause kidney damage or birth defects. 

Lead is a metal found in many processed foods, in old painted surfaces, in roadside dust, and in newsprint. In large amounts it causes nerve damage or birth defects. Lead paint should never be scraped, sanded or melted off walls or woodwork. These procedures tend to release lead into the air and dust of a house exposing all residents to a lead hazard. To get rid of lead paint remove or cover completely wall boards, window frames or wood work. For small areas paint stripping with a thorough wet mop clean up may be adequate. Once lead is in the body garlic may help the body excrete it, but first more lead must be kept from getting into the body. By itself the body will get rid of small amounts of lead each day. Zinc is a metal which protects against the harmful effects of lead and cadmium. Iron also protects against lead. If there is any question of a lead toxicity risk blood tests for lead are routinely done in toddlers. 

Aflatoxin is produced by mold growth on corn, peanuts, or wheat. Low quality crops grown in periods of drought or flooding must be tested carefully if used at all. Premium brand peanuts may be worth the extra price. Raw mushrooms contain cancer causing toxins. These may be inactivated by cooking the mushrooms. Pesticides such as ethylene dibromide (EDB) or Captan are present in some foods and may cause cancer. The commonly used red food dye, nitrsomines found naturally in some foods such as beer and also in meats with nitrites added, uraldehydes in fermented beverages, saccharin, and the preservatives BHT and BHA are all mild cancer causing agents. Eating organic food offers some protection but the food must be mold free and grown on soil low in lead and cadmium. 
Househould products such as gasoline, paint or paint thinners cause cancer, blood problems or nerve damage when used with poor ventilation often. Deodorant antibacterial soaps may cause nerve damage in sensitive adults and infants and should only be used if chronic infection problems exist. 


Protection from Electromagnetic Radiation

Research in the past ten years has shown that electrical currents or the flow of electricity in wiring near our bodies may cause lymphomas. To decrease this potential risk, avoid getting too close to tv's, computer terminals or videogames. Also avoid using turned on electric blankets. Water bed heaters should be turned off when you or your child are in the water bed. Outside, avoid playing near high voltage electric lines. Wire mesh screens may be placed in front of computer displays or cathode ray termi- nals (CRT's) to help increase visual clarity and to shield you from the electromagnetic radiation. Many new CRT's have built in electromagnetic shielding. Electromagnetic waves may effect the brain by suppressing the melatonin production and this then eliminates the beneficial effects of melatonin to the body. 

please email comments or questions   

Index 

Aflatoxin p 17 
AIDS p 15 
Alfalfa p 6 
Alcohol p 10 
Anorexia Nervosa p 9 
Anti-Oxidant Vitamins p 5 
Anti-Oxidants in Fats p 3 
Beta Carotene p 4 
Bishops' Letter p 11 
Blood Pressure p 7 
Brewers' Yeast p 4 
B-Vitamins p 4 
Cabbage p 5 
Cancer Prevention p 2, 5, 16, 17, 18 
Cabbage p 5 
Electromagnetic Radiation p 18 
Fats p 3 
Fiber in Diet p 8 
Meat Preservatives p 2 
Non-Smoking p 11 
Sun Protection p 16 
Toxins p 17 
Vitamins p 5 
X rays p 17 
Carbohydrates p 3 
Car Safety Seats p 11 
Cavities p 3, 7 
Sugar p 3 
Fluoride p 7 
Child Abuse p 11 
Chromium p 5 
Cholesterol p 3 
Deliquency p 12 
Drug Abuse p 12 
Eicosopentoic Acid p 3 
Electromagnetic Radiation p 15 
Exercise p 8 
Fats p 2 , 3 
Fiber p 8 
Fish p 3 
Fluoride p 7 
Garlic p 6 
Heart Health p 2, 3, 5 
Exercise p10 
Fats in Diet p 3 
Proteins in Diet p 2 
HIV p 15 
Hydrogenated oils p 3 
Humor (healthful!) p 13 
Iron p 6 
Iron Toxicity p 5 
Minerals p 6 
Mushrooms p 17 
Oils in the diet p 3 
Overweight p 9 
Peace p 13 
Peanut Butter p 3 
Peanut Butter Toxinp 17 Proteins p 2 
Radon p 18 
Salt p 8 
Selenium p 6 
Sexually Transmitted Diseases (STD's) p 15 
Smoking p 11 
Sodium Chloride p 8 
Soybeans p 2 
Starch p 3 
Sugar p 3 
Teen Pregnancy p 15 
Tooth Decay and Sugar p 3 
Tooth Decay and Fluoride p 7 
Toxins p 17 
Violence Prevention p 13 
Vitamins p 5 
Yeast diet supplement p 5 
Zinc p 6 
Zinc and Lead p 17 
PG 10/20/90 pcg 9/96 




Sweet Decisions

At the time of the winter solstice we traditionally turn to sweets. They are good for energy to keep us warm, thinking and moving. They are bad for getting us overweight, tooth decay, heart disease and diabetes. One hundred years ago the average person in the United States ate just 5 pounds of sugar per year. Now the average is up to 100 pounds of sugar per person per year. One hundred years ago under- weight was a major problem in the United States. Now about 1 in 3 of us are overweight. For the past century we have subsidized sugar and corn syrup succeeding in making them relatively cheap and plentiful. The rational or logical person would stop subsidizing sugar to help prevent disease and further government deficits. If this failed we might even tax sugar and/or high sugar foods.  

Even with the backing of the Medical Society of the State of New York and the New York State Department of Health, and with severe budget deficits the tax on sugared beverages failed to get approved by the State Legislature. The United States farm bill still subsidizes sugar and corn syrup. Obviously we are illogical. 

We have to admit that we are animals. We do have the capacity to be logical but when it comes to feelings we often act on basis of ancient tendencies that made sense thousands of years ago. Even babies become content and smile when given sugar. Before manufactured and refined foods the only sweet things were fruits and some vegetables. Humans have lost the ability to produce Vitamin C. Only humans that ate fruits and vegetables or ancient sweet things that contained Vitamin C would have survived. Thus we like sweets. Starting about 5,000 years ago we discovered how to refine sugar. The process was very expensive so only the rich could afford it. The rich were the first to experience the problems of overweight. For the past century with efficient food manufacturing and the subsidies now all of us may get high sugar foods and their problems. With diseases from sugar and budget deficits increasing rapidly you would think we could get over it – our sweet addiction. 

We have to admit yet another inconvenient truth; we are social animals of territory. We are associated with resources and other people. We protect our physical possessions and group members fiercely. These people of the sugar territory are protecting their home and money through politics and the media. They lobby, advertise to voters, and work to get their friends on expert panels. In our ancient past with hunting and gathering we needed strong groups of people with leaders to help us survive in the wilderness. Now our territories extend into money, ideas, and digital ownership. Group identity is so strong that it often makes it impossible to see the truth as noted in cognitive dissonance and ethnocentrism. So not only do we need to overcome our sweet addiction but also the territory of sugar.  

As sweet liking social territorial yet rational animals we might find a more sophisticated solution: perhaps the sugar app or application. Through a state regulated monopoly we would have a secure and private smart phone that would apply taxes to sugar foods for people that were overweight and more taxes if they also had high blood pressure or diabetes or heart disease. Health insurance cost might also increase for wealthy people paying for their own insurance. For farmers subsidies would be given out for health promoting foods and environmentally friendly farming.  

Happy winter solstice from Phillip Gioia




Need 2 Know/Hide   From The Way: Knowledge Balances Territory and  Compassion

Section I. Visions of Health Knowledge

Chapter 1. Smallpox Scenarios 

#1 The Present or Recent Past- 
The United States of America (USA) is has vaccinated military and medical frontline responders to smallpox. Many people with fever and a hard white rash on their arms and legs start appearing in the Midwest. Alert physicians and nurses suspect smallpox and immediately isolate the sick and contact the Centers for Disease Control and Prevention for a definitive diagnosis
(http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp). The diagnosis is made within 24 hours. All known contacts are vaccinated within the next 2 days. Overseas reports of smallpox cases start to come in. Simultaneously a massive attack on the Internet by computer viruses shuts down the Internet for a few hours and slows down communication for days. Cases continue in contacts that were not vaccinated and containment of new cases is again done with immunization with smallpox vaccine of contacts of the new cases. In communities with many cases smallpox vaccine is offered to everyone. About 30% of the smallpox patients and about 1% of vaccinated contacts die from poor immune systems or severe eczema. Many are severely ill and some become disabled with brain and eye damage. Overseas the disease spreads in the poorly developed countries of the world where the health care resources are limited. The World Health Organization (WHO) begins to mount an effort to contain and eliminate smallpox once again as in the 1970's. Before it succeeds hundreds of millions of people die. 

#2 The Future with Improved Knowledge and Security Systems -
The United States of America (USA) has finished its final phase of voluntary smallpox vaccination. A few people with fever and a hard white rash on their arms and legs start appearing in the Midwest. Alert physicians and nurses suspect smallpox and immediately isolate the sick and contact the Centers for Disease Control and Prevention [ http://www.bt.cdc.gov ] for a definitive diagnosis. The Health and Security Network (HaSN) quickly determines that all the people with the rash lack any smallpox vaccination within the past 10 years. The definitive diagnosis is made within 24 hours. All known contacts are vaccinated within the next 2 days. The HaSN electronic records of death in a nearby area of the Midwest show a cluster of smallpox deaths at the same time. Using secure HaSN instant messages, phone messages, or home visits; local public health workers immediately contact all people that were close to the patients sick with smallpox that lack vaccination. The HaSN is used to rapidly find all the non-vaccinated contacts. At the same time their local health departments and health care providers are notified by the HaSN to plan for vaccination within the next day. Few people die since contact vaccination is complete and there are few cases after the initial ones. This limits the number of vaccines that need to be given to people with poor immune systems or severe eczema.  
With the use of the HaSN the untreated people that died with smallpox at home were found to be a group of people that often associated. People that sometimes dealt with them noted that had an extreme admiration for living things including viruses. A new computer virus is unleashed shutting down the non-secure Internet for days. The HaSN easily copes with the computer virus using traps and limited access to its registered computers. With the HaSN records members of the group who traveled overseas were tracked and the information given to the WHO (World Health Organization) and the health agencies of the countries of travel. Immunization of contacts is begun immediately and members of this group promoting the smallpox virus are isolated to prevent further spread of the smallpox. The group members that volunteered to carry the smallpox used veils, scarves, hoods and winter masks to avoid people noting their typical smallpox rash.  

#3 The Future with a Comprehensive Knowledge and Security Integrated System -
The United States of America with the United Nations (UN) has just implemented its International Health and Security Network (IHaSN). Computer hackers from a small area of the Midwest have been attempting to break into the world smallpox reserve computer security system. The hackers plan to authorize smallpox virus for research work with a new anti-viral medicine to be done at the Centers for Disease Control and Prevention (CDC) in the USA. The CDC's last batch was destroyed to help decrease security problems and costs. Associates of the hackers have been contacting foreign governments and groups hostile to the USA to try to buy smallpox virus to use to spread the disease. They say they want to destroy the USA. The FBI/CIA cooperative and Interpol do investigation. The fingerprints used for the Internet access and the computer identification codes match those of friends and community members associated with people in the underground Virus Liberation Movement (VLM). Secure Internet access at this time requires a fingerprint reader, a user identification, and a matching secure personal identification number (PIN) using a registered computer.  

At the same time the group has used the identities of their the unsuspecting others to make phone and letter contacts. All phone calls at this time require an electronic user identification number and a matching PIN. Letters require a unique barcode for the sender along with an encoded PIN. Receiver addresses are also bar-coded. Postal computers record and track all mail and parcels. Receivers may block letters from some addresses, and for security may only accept mail or parcels from senders who also know their special receiver PIN and have it encoded on the letter or parcel. 

The VLM plans to release smallpox back into the environment. This will help let the virus reach its full potential. They also plan to release large number of computer viruses into the electronic environment. These will be blocked from all registered computers on the state protected International Health and Security Network by anti-virus traps and programs within the network. The Virus Liberation Movement hopes to attack the wild old Internet remnants and the unvaccinated of the world to let the viruses live. The VLM gained access to registered and secure computers of unsuspecting friends and acquaintances. By the time the VLM has found one rogue organization to give them the smallpox virus, Interpol has tracked them down and arrested them with the virus shipment. The smallpox release is prevented. Some at large members of the VLM upset at their failure with real viruses release the computer viruses into unregulated parts of the Internet causing damage to computer networks in developing countries without the latest computer virus protection. New secure identities to prevent further breaches in their Internet, phone and postal security are given to the unsuspecting associates of the VLM with stolen security access. Developed countries work to improve security in the developing world to help maintain international communication, health and commerce. 

Natural disasters may also produce similar scenarios. If a lethal strain of bird influenza develops containing it and controlling it would be very difficult with today’s information systems but with improved comprehensive health information technology it would be possible.  


Chapter 2. Your Choice

Which scenario would you like? Throughout the centuries of our existence there has been benefits to knowledge and to secrecy. There have also been many abuses of both. In this book I would like to review the history of knowledge and secrecy. To discuss past and present choices and make recommendations for future choices that may help our species and environment survive in the best possible state. Our species now must make major decisions regarding information processing. Our information technology revolution is forcing us to chose between an efficient and powerful integrated information network with tremendous potential for benefits and abuses, or to continue with fragmented, disintegrated, redundant systems which will be hard to use and abuse. Both choices have benefits and dangers. How the choices are implemented will be very important. The integrated system must be strictly controlled and protected to prevent abuse by the powerful controllers of the system or from any possible intruders. With the integrated data system automated and high security review of data by a select few with explicit directives and limits determined by a legislative directive subject to judicial review would be best. With the continuation of our separate data systems trusted observers and regulators must constantly review the fragmented systems to make them useful at all for health and security. Our inability to use these separate data systems to prevent the 9/11 2001 terrorist attack bodes poorly for continuing this system in its present state. First I will briefly discuss the smallpox scenarios.  

In the first scenario taking place in the present/ recent past people with smallpox that present to physicians will be detected at about the time the smallpox virus becomes infective. At the end of 2002 experts believe that the virus will unlikely spread to other casual contacts until the typical smallpox rash becomes easily visible during a routine examination by a physician or other well-trained health care provider. In the NBC TV show ER broadcast at the end of the spring 2002 season the smallpox virus was shown to spread to ER staff when the smallpox infected patient first got a fever 2 to 4 days before the typical rash appears. This sometimes occurs if the infected person shares food or drink or kisses another person (http://www.bt.cdc.gov/agent/smallpox/overview/disease-facts.asp). Most experts believe that smallpox infected patients with fever but without the rash would rarely transmit the smallpox virus to ER staff, healthcare workers, casual acquaintances or passersby. This is consistent with the ability to contain natural smallpox in the 1970's with programs that just vaccinated known contacts of the smallpox infected. Vaccinating contacts within 3 to 4 days of contact with the virus is able to prevent severe smallpox. The sooner the vaccination is done after contact the better. Vaccinating within 72 hours (3 days) of contact is most effective, but even up to 96 hours (4 days) still prevents most of the severe disease  
( http://www.bt.cdc.gov/agent/smallpox/basics/index.asp ). Even with this limited period of contagion tracking the path of infectious person and finding all the contacts is very daunting in our mobile society. Especially of the person was contagious while in a school, concert, church, subway, train station, bus terminal or airport. If the person knowingly concealed the illness and tried to expose the maximum number of mobile people before dropping from the illness the task to vaccinate all exposed within 3 to 4 days of exposure would be nearly impossible. Our data systems on travel and contacts is insufficient to quickly document and find these contacts. We could only hope that the number of concealed ill was small and we soon discovered all the non-concealed cases and their contacts. At present we must plan on about 30% of the unvaccinated smallpox infected dying. This is the rational for the current plan of President Bush to offer smallpox vaccination to the general public in the year 2004. This would cause 1/3 of the vaccinated to get ill enough to miss work in 7-10 days from the smallpox vaccine, 1 in 1000 people to become severely ill with hospitalization, and 1 in a million to die, but would protect the survivors for 10 years from a concealed exposure to smallpox.  

 Unless we know the future chance of smallpox exposure we are unable to accurately tell whether the risk of the vaccine is more or less than the risk of disease or death from smallpox. Only by gathering more information on smallpox, terrorists external/internal, travel, communications and resource or money flows will we better able to plan and prepare. To better survive and use our resources we must decrease the number of unknown variables. For a discussion of a proposed National Health Information Infrastructure [NHII] see the work of the National Committee on Vital and Health Statistics [NCVHS] web page (http://ncvhs.hhs.gov ) and its report on the NHII (http://ncvhs.hhs.gov/nhiilayo.pdf ). At the same time we must decrease the number variables known to the terrorists to make their actions and planning less successful. When we gather information it should just be available on a need to know basis with the high level information systems protected by identification that is linked to unique body markers. These systems will take time and money but they will guard the health of the community and the privacy of the individuals. As at present for sensitive information on sexually transmitted diseases, inherited genetic tendencies, and behavior problems; security to prevent disclosure must be strong. Penalties for wrongful disclosure must be severe and enforced. When we spend time entering our identification codes, using our smart cards, swiping through bar codes, and then entering our PIN (personal identification code) and/or placing our fingerprints on a machine reader we must feel the information is used only for the good of ourselves and the community. When we need to enter a high security area or have a large money or property transfer we may need further levels of verification with perhaps pattern analysis of our face or iris (the biologic shutter around the pupils of our eyes). For the highest levels of security pattern analysis of our retina (the back of our eye seen through our pupil) or DNA analysis may be necessary. Machines that communicate through the Internet, phone networks, and radio networks should be uniquely registered with identifiers hardwired into their silicone chips. Intel tried to do this with computers a few years before September 11, 2001 causing a huge outcry from those afraid of losing their privacy. When knowledge for public protectors becomes critical to our survival we should reconsider this option. Computers, phones, cell phones, radios, PDA's (personal data assistants) and all communicating machines or appliances with phone, radio or Internet connections should be identified. Again public information stores must guarded with information just available with a need to know basis. Parents of young children might have access to know their whereabouts and activities, but neighbors or friends would have none unless explicitly granted by the person or their guardian. I am sure that on reading this most of our USA citizens would think this would never happen due to the extreme right to privacy in the USA. Many might think it would be helpful to the public good but would never get enough political support to come about. Of course some would rather get smallpox and die than give their acquaintances any chance of learning about parts of their lives that they want hidden. This is often related to a deep need of many to be protected from shame. I believe that with proper protections against terrorists, unauthorized access, strict redundant security, and absolute privacy for individual matters and feelings that have little effect on the community a comprehensive information system may work and be politically acceptable in the USA. Even the staunch supporter of civil rights and privacy, Harvard Law Professor, author and crusader Alan Dershowitz would support a national identifier system if it were done correctly (http://www.law.harvard.edu/faculty/directory/facdir.php?id=12 ). He discusses this in his book Why Terrorism Works (2002). He would rather have people being investigated intelligently based on accurate and meaningful information rather than broad categories now used for police surveillance profiling such as race, dress, ethnicity or type of car driven. In that same book Professor Dershowitz discusses when it might be necessary and socially acceptable to resort to torture to prevent mass catastrophes. Better data systems would help prevent the possible use of torture that causes shame in our souls of civility and often produces questionable results.  

At present we are ill prepared for another internal attack as the Oklahoma City Bombing by Tim McVeigh in April 1995 (http://www.cnn.com/US/OKC/bombing.html ). Our only improvement in surveillance is the temporary legislation known as the USA Patriot Act of 2002 allowing the FBI to examine credit card records. This may easily be circumvented by using credit cards that are stolen or with false identities. The recent credit card theft ring in Long Island demonstrates how easy and lucrative this practice is (http://www.usnews.com/usnews/nycu/tech/articles/021209/9identity.htm ). Clearly for homeland and financial security we need better identification financial and legal transactions. Similarly we must be able to identify the smallpox viruses spreaders. Often false identities are used for health insurance fraud (http://cms.hhs.gov/states/fraud/default.asp ) or to avoid embarrassment involvement in diagnosis and treatment of sexual transmitted disease or psychiatric illness (http://www.ianr.unl.edu/pubs/consumered/g1368.htm ). To protect confidentiality we might allow patients to have multiple identities so that they would be comfortable getting essential lifesaving medical care without the fear of losing their privacy. For national security purposes each identity would be connected in the highest security area of the national integrated database. Friends, neighbors, community members, employers and insurers would lack any access to the linked data. If a person had a diagnosis of smallpox, anthrax, Human Immunodeficiency Virus (HIV) or other contagious deadly disease only public health and law enforcement investigators at the highest security levels would be able to link the data. We are better prepared for foreign attacks by screenings at airports, border crossings and customs, though passports can too easily be stolen or forged. Automobile driver's licenses have similar limitations. Both might be improved with the use of a smart card with coded information on personal information with access only through a PIN and fingerprint, facial pattern or iris pattern recognition. For high security purposes the information could be verified on line from a secure data repository within seconds. This on line check would verify that the person wanting to use a high security transportation, building or gain access to secure information was presently authorized to do so and free of any public health, financial, or criminal risk to others. For privacy the security personnel would only be given information on the need to know basis. So a person with HIV would certainly be free to travel on public transportation but if giving blood the blood bank computer would be told privately that blood would be discarded without any one at the donor location or blood bank having to know the reason. Friends and acquaintances at the blood site would lack any access to the information. If the person being screened is found to have a warrant for a violent crime then local security personnel may be quietly informed of pertinent details and best plan for decreasing the risk to all the public at the location.  

The developing countries of the world without our health care and information infrastructure will be hard hit if smallpox escapes to their populations. The resources of WHO (The World Health Organization) and the developing countries will be severely challenged. Smallpox might smolder for years in these countries with large disruptions occurring in health, culture, travel, transportation, and commerce which are all now global in many ways. To cope with these challenges developing countries with foreign aid as needed might develop simple efficient integrated data systems based on affordable technology that would best direct limited resources and help development. As hardware and wireless technology costs fall developing countries without wires may use open source software such as Linux to fill the information void with public systems that are easily usable, secure, and affordable. International agreements would be needed to share information on a need to know basis. Data would be kept within each country and only given to computers in other countries when the person travels. Contagious disease or criminal history may then preclude certain activities or travel but only officials who must be involved in risk reduction would be informed of the nature of the problem.  
In the second scenario we have implemented better tracking of people traveling on public transportation and using health services. Public health organizations are then better able to find contacts of infectious disease and prevent further spread of the disease. Police organizations are then better able to find the criminals spreading the disease and limit their criminal impact. The second scenario however lacks the means to effectively prevent disease and crime. 
 In the second scenario criminals, terrorists, pranksters, and hooligans are still allowed to use electronic and mail communications to perpetrate their damage to our society. We would likely continue to have bomb threats causing disruptions to businesses and schools. In NY State laws have been passed with severe penalties for such behavior with little help. The present mail system, that continues to use much of the same security that Ben Franklin gave it in the 1700's, lends itself to spreading disease and dangerous materials. Computer viruses, fraud, pornography, Internet attacks and electronic junk mail or spam clog the Internet making it more difficult and expensive to use for legitimate individuals and businesses. Our electronic world is like the Wild West where people must defend themselves. The Bush Administration in October 2002 says that private corporations and individuals must provide for their own security (http://www.landfield.com/isn/mail-archive/2002/Sep/0083.html , http://www.whitehouse.gov/pcipb ). 

This is a necessity at present, but lacks efficiency and effectiveness. Even the most conservative and liberal agree that government has an essential role in police protection. Since our future is in electronic information and commerce, government must police and regulate this environment. We accept the rules of the road and traffic regulations for our cars and trucks. Why fight them for our Internet communications and commerce? We accept being taxed to pay for our streets, roads, and superhighways. Why fight them for our information byways and superhighways that will make our country and world safer and more efficient? We accept the need to register cars, trucks, and buses. Why fight the registration of connected electronic devices such as phones and computers that might bring schools, businesses, or the defense department to disaster? We license and regulate professional and businesses that are located in our state. Why fail to provide secure identification and licensing for them when they operate electronically in our homes, businesses, and public networks? We prevent pollution of world with contagious disease and toxic substances. Why allow our machines for knowledge and business to be infected and damaged thereby threatening our health and economics? Just as we have set up infrastructures in the earth environment for communication, travel, transportation, economics and health we must also set up infrastructures in the electronic environment. Few of us would accept phones, train, airlines, or mail systems that fail to interact. Why do we accept failures in accounting systems, medical record systems, immigration and criminal justice systems that then fail to protect us from fraud, contagious disease, and crime because of their inability to communicate to the public servants that need to know?  

Bill Gates in Business @ the Speed of Thought (http://www.microsoft.com/billgates/speedofthought ) and Alvin Toffler in POWERSHIFT 
  http://www.amazon.com/exec/obidos/ASIN/0553292153/ref=ase_thewhythingsdont/104-0213690-2499931#product-details believe that easy access to knowledge at anytime and anyplace is a key to our future well being. Bill Gates simply sees knowledge as essential to good management and business practices. Alvin Toffler sees knowledge as the key at present to controlling society. Knowledge as communicated will influence social choices and also makes the other means of social control: violence and wealth, more effective. Both see that we must progress beyond the period of mass production, mass religion, and bureaucracy to more flexible organizations through which information flows freely to where it is needed. Bill Gates sees within organization e-mail as helping out. He accepts e-mails from anyone in Microsoft and uses the information to make his organization better. From the anti-trust trouble he got into by writing down in his e-mail his ideas on eliminating Microsoft's competition, he probably needs to appreciate more the need to conceal. The e-mail archives were used against him and Microsoft in the government's anti-trust case involving the Windows operating system. This illustrates the need to hide. Alvin Toffler notes that informal social contacts and structures as among Japanese executives that start training in their corporation in the same year also help. The failure of the USA intelligence agencies to prevent the 9/11 2001 attack may in part be blamed on the lack of such broad electronic or informal means of communication. Of course without appropriate security electronic communications might be used against the USA by terrorists gaining special information that show weaknesses in our defenses or by spreading misinformation. For our health and security we need more offensive (promoting physical and financial health), and defensive (protecting people and groups) information and must block terrorists and criminals from access to useful information. 

To change our private and public sectors to be more adaptive with the use of new information and knowledge systems will take much time, money and political will. Bill Gates discusses at length the conflicts between the financial and information technology (IT) people within private organizations. Financial experts with like to see the IT departments make money or at least minimize their expenses. The IT people are usually a support service which contributes parts of functions to money making parts of the organizations. Often it is difficult to account for how much income they produce for the corporation. Other departments that use them often wish to underestimate the value of IT to avoid sharing income with the IT department. As a society we are poor at dealing with the value of ideas or intellectual property. Our Gross National Product (GNP) and our International Trade Deficit often fail to adequately account for income that we make on movies, music, and entertainment. Bill Gates notes that even his huge corporation must avoid over reaching. Data and information systems should start with limited achievable goals. Alvin Toffler notes that bureaucrats in old businesses of the mass production era and in old government departments often control through limiting access to information in their departments to others. Information and analysis from these private or public departments is usually provided after a time delay, sometimes with special payments to the department, and often with view or opinions of the chief bureaucrat being built into the report. Accessible data and analysis systems available to other employees, stockholders or concerned citizens threaten the control of these bureaucrats. 
Much of our evolution from vertebrates on to mammals and primates has involved territoriality. This allows for the allocation of resources for survival such as food and shelter. The territories serve to distribute species member individually or as in mammals in groups to certain areas that may support their growth and reproduction. Some of the bureaucratic and political behavior may be explained by this tradition. Often shame and pride mediate the protection of territories both physical and intellectual.  

Donald Nathanson in Shame and Pride explores in depth how we frequently use these affects and associated emotions subconsciously but fail to recognize them consciously (http://www.behavior.net/column/nathanson/bio.html ). We know from infancy to have shame if we are unable to do some task. Often parents and/or teachers use this to control us as we grow. When shame becomes associated with guilt or emphasized in our early childhood we suffer pain whenever we experience shame. This often keeps us out of areas that bureaucrats would like to control. Those who are shame sensitive tend to stay within their own territory where they will make few errors, feel competent, are comfortable and have pride - our home. Unfortunately our world is changing rapidly and we now must often venture into new intellectual territory. Only those who may tolerate failure and are willing to explore the unknown may go gladly into the future and adapt willingly. Much of our fear of computers and data systems is due to the shame we get when the machine or system fails to work as we expect it to. When systems become useful, stable, and easy to use then even the faint of heart will take advantage of the new knowledge.  

In the third scenario we have implemented the security in communication gaining the ability to prevent an attack on the public. Our danger now is in allowing the control over communications to protect those in power from the scrutiny of the public. Free speech must continue to be protected to give the public the ability to react to and correct the misuses of power. If electronic communications are properly used free speech may be increased. Computers may know who posts information but only if there is a clear and present danger or definite intent to cause harm would the information be given to those with the highest security clearance. Cases that are uncertain or unclear would have be disclosed on court order. On going surveillance would only be done with a warrant. Records of who has seen such private documents would be unalterable and maintained along with the documents. To facilitate this copies of such records might be kept in the highest security areas in the administrative and judicial branches of government. With secure and accurate tamper proof records rogue elements both within and outside the government may be monitored and regulated by high security administrators and judiciary with legislative direction.  
Another danger with knowing so much is in being forced to implement laws that many people are unable to obey. Our economy now depends on about 5 to 10 million illegal immigrants or aliens who do work that citizens of the USA fail to do. Many farm laborers, restaurant workers, domestic workers, or heavy laborers come from other countries and work without current legal authority. We must incorporate them into our society legitimately by giving them some acceptable status. Illegal drugs and illegal drug dealers should be easier to track. If we are still unable to cut the demand for these drugs to zero we may consider severely regulating and limiting the current illegal drugs. We might then tax them and more easily prevent the drug profits from getting into the hands of terrorists and other criminals. Money from taxes might be used for drug use prevention and treatment of the addicted. This may also be applied to the abuse and addiction to legal drugs such as alcohol and tobacco. Similarly the abuse of sexual contacts in prostitution, at home, in institutions or in spreading sexually transmitted diseases may be prevented and treated for the public protection. Public information systems may also be used for helping to prevent and treat nutrition and exercise problems. Confidential secure e-mail or phone calls may be used to help remind adults or parents of children with vitamin deficiencies or calorie excesses or exercises deficiencies of the need to adjust their habits for better health. 

Development of a secure health information system may help in solving the financial and quality crisis in health care and business. It also may provide for the key to providing quality health care for the uninsured. With a national health information system containing basic information on health care costs and health problems state governments may better analyze health problems and find health care that lacks/has cost effectiveness. Basically if we pay more for health care than its benefits are worth we will have a net loss on health care. If we pay for health care that saves us money by decreasing future expenses for complications or preventable diseases we will all gain. Government may then mandate cost effective care for all residents of our country with coverage through employment and/or taxes. With a secure national health information system the responsible person will know before getting care what services or drugs will be covered. People or employers may opt for insurance or other coverage for health care services that lack proven cost effectiveness. A national board will continually review the art and science of medicine to make change coverage for health care new services are shown to be cost effective or old services are show to lack cost effectiveness in the new environment or as diseases change. At one time routine chest x-rays were cost effective when we had many people with tuberculosis in our country but as the number of people with the disease decreased the benefit of doing chest x-rays also decreased. At present it is hard for businesses or insurance companies to manage such a program since many businesses change insurance companies year to year and many prevention programs only have a benefit over 5 to 10 years. For instance paying to help a 30 year olds to stop smoking costs money now but will give most benefits for decreasing heart disease risk over 1 year or more, and lung cancer risk over 5 years or more from the start of the program. A good health data system should also help decrease claim and administrative costs by helping to automate information processing and data exchange. Current insurance companies would be able to use the one state regulated system making it easier for health care providers to contact and communicate with the many insurance companies throughout the country. Just as in the other information sectors privacy must be protected. Health care providers and payers would be limited to get patient information on a strict need to know basis. Patients or there responsible caretaker would have to authorize patient information access to the health care provider. Providers would be protected from liability if only given incomplete information. Patients would have a secure identity (perhaps with a smart card) with a PIN and/or fingerprint confirmation for record access to be regulated by them and/or their caretaker.  

Once basic public data systems in health, education, finance, government and security are working then information and knowledge may be used to improve our society. In health computers may be used to reduce errors in medications and diagnoses. The Institute of Medicine (IOM) and the Agency for Health Care Research and Quality (AHRQ) have written extensively on how this might be done (http://www.ahcpr.gov/qual/errorsix.htm ). Education achievement may be evaluated continually and resources directed as needed. Financial markets will be more trustworthy with open and transparent accounting systems viewable by all, and protection from identity fraud. Government may measure citizen needs and resources in real time with improved responsiveness to the needs of individuals and communities. Security systems may adjust according to strategic importance of intellectual resources, geographic locations, or sectors of the economy.  



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