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From weightlifting to yoga to running, the St. Louis Public Library has many great books and DVDs to inspire and educate.  A small selection is below, and more can be found by a browse of your favorite Branch's shelves or the Library's online catalog.

Books:
  • Fitness swimming by Emmett Hines
  • Military fitness by Patrick Dale
  • Walking for fitness by Nina Barough
DVDs:
  • Totally ripped core
  • Cardio & strength circuit workout 
  • Killer body by Jillian Michaels

Resolution: fitness

Click here to view: Reading of the Donald J. Trump children's book by Jimmy Kimmel
We don’t win anymore in health care. After repeatedly drilling in our heads that America’s sick care system is a disaster, that those who care for the sick are incompetent and stupid, and that the sick themselves are losers, Meaningful Use was advertised as the means by which technology will make health care great again. The program has been in place for 5 years and the great promise of Meaningful Use is just around the same corner it was back in 2011. The only measurable changes from the pre Meaningful Use era are the billions of dollars subtracted from our treasury and the minutes subtracted from our time with our doctors, balanced only by the expenses added to our medical bills and the misery added to physicians’ professional lives.

Meaningful Use, a metastasizing web of mandates, regulations, exclusions, incentives and penalties, is conveniently defined in the abstract as a set of indisputably wholesome aspirational goals for EHR software and its users, which stands in stark contrast to the barrage of bad news flooding every health related publication, every single day. Health care in America used to be the best in the world, but now our health care is crippled. Meaningful Use of EHR technology will improve quality, safety, efficiency, care coordination, and public and population health. It will engage patients and families, and it will ensure privacy and security for personal health information. With Meaningful Use leading the way, health care will be winning so much that your head will be spinning. You won’t believe how much we’ll be winning.

Be afraid, be very afraid

Bombastic? Laughable? Easily dismissible by educated people? Not so fast. According to Dr. David Blumenthal, president of the Commonwealth Fund, and former National Coordinator for Health IT, “we probably have the worst primary care system in the world”. Yes, worst system in the whole wide world, worse than Niger, Malawi and Somalia. Probably. According to a hobbyist “study” that extrapolates its “results” from a handful of other studies based on an admittedly inaccurate tool intended for different purposes, 440,000 people are killed in hospitals due to preventable errors each year – “that's the equivalent of nearly 10 jumbo jets crashing every week”. Or, with a little more math, half of all hospital deaths, and one in six US deaths, are due to negligent homicide perpetrated by psychopathic doctors and nurses.

How is that for buffoonery? I suspect that the beautiful minds appalled at populist or outright racist fear mongering rhetoric claiming that thousands of Muslims were dancing on rooftops on 9/11 in New Jersey, have zero problems with self-servingly stating that “hospitals are killing off the equivalent of the entire population of Atlanta one year, Miami the next, then moving to Oakland, and on and on”, based on equally valid he-said-she-said evidence. Both virulent strains of outlandish demagoguery are insisting that they, and only they, can keep us safe from things that go bump in the night. Supersizing the ghoulies and ghosties and long-leggedy beasties makes us more likely to relinquish control of our lives to those who might deliver us from terror.

The Meaningful Use program rests on a narrative where medicine is witchcraft, our doctors are murderers, our hospitals are cesspools teeming with death, our citizens are Lemmings unable to wipe their noses, and the machines of the illuminati are our only salvation. When the premise of an action is delusional, one cannot expect the outcomes to be anything but.

Smoke and mirrors

When you read “studies” advertising that Meaningful Use increased the rates of mammography by 90% in three months, you should assume that the only thing that was increased is the rate of ticking boxes for stuff that was not documented before, and practically no material changes have occurred. When you feel vindicated by the 99% rate of patients given a clinical summary after each visit, keep in mind that the vast majority of those summaries were posted to a portal that nobody uses, or just fake-printed to PDF, and the few actually given out were dutifully tossed in the recyclable trash bin. When you read about the billions of dollars in tax money successfully spent on Meaningful Use, you should understand that this is just the tip of the iceberg, and the indirect costs to each and single one of us are larger by orders of magnitude.

For most of us simpleton believers, who mistook fiery demagogues for brave-hearted visionaries, the disappointment is a throbbing daily humiliation, manifesting itself in polite low-energy petitions to powerful bureaucrats to take pity on us and roll back some of the most onerous aspects of the program. There are signs indicative of some forthcoming acts of mercy, but those are as disingenuous as the original false narrative of Meaningful Use. After five years of Meaningful Use of EHR technology, the initial hope has failed to translate into promised change. Or has it?

From its inception, the Meaningful Use program had two sets of requirements. One set defines what EHR vendors must build to stay in business, and another set specifies what doctors and hospitals must do to collect gratuity payments from Medicare. Over time these requirements sets began to diverge. Once clinicians became conditioned to compulsively collect data, overt reporting is being replaced with covert extraction through the backend (i.e. application programming interfaces, or APIs). The Certified EHR Technology mandated by the program was never intended to extend abilities of clinicians as much as it was designed to generate standardized measures of their performance. Administrators and regulators cannot control an industry from afar without incessant measurement and the power to reward and punish individual practitioners. Meaningful Use is designed to enable remote control of medicine, its doctors and the people they serve.

We are not alone

Back in 2001 our rulers identified another field where America was losing big time. Education was a disaster, a huge mess with rampant disparities and across the board low quality. Like health care, education of small children is an ideal place for intervention if your aim is to control populations and increase the value derived from each person. With overwhelming bi-partisan support the ruling class passed the No Child Left Behind Act, mandating that all children are above average by 2014. An avalanche of funding for computers, measurements of schools and teachers and incessant standardized testing of students descended upon our schools. For the last fifteen years, schools were engaged in life and death accountability games of reward and punishment, and our children became merely biometric indicators for school and teacher performance assessments.

As 2014 came and went, with many children still stubbornly below average, with multitudes of teachers still burnt out, and education morphing into a misnomer for the standardized testing doomsday machine consuming all but the rich and privileged, the federal government took a step back and passed the Every Student Succeeds Act of 2015. Leaving aside the downright idiotic terminology used for naming acts of Congress, the new legislation is reluctantly beginning a process to diminish federal control of schools. Considering the cumulative damage to our education system, perpetrated by toxic bureaucratic ineptitude which is  crowding out the ability of real educators to address real problems, this halfhearted attempt may very well be too little too late.

Failure is not inevitable

I don’t know about you, but I am getting tired of having to live up to Winston Churchill’s image of America. We don’t always have to try everything else before we do the right thing. We shouldn’t have to wait fifteen years before declaring that in retrospect Meaningful Use was meaningless. We know now that it is. Removing a few reporting requirements for physicians, while beefing up patient scoring measures, is not enough. Playing with reporting periods at the last minute and granting ad-hoc exclusions to make people shut up, is not enough either. Randomly linking physician fees to Meaningful Use EHRs may be enough, but it’s beyond disgusting.  The Meaningful Use program must end. Plain and simple. And most importantly, the underhanded EHR certification schemes must be halted immediately.

Standardization, quantification, computerization, gamification, engagement, and infantilization of the populace in general, do not produce better educated or healthier citizens. Education reform has failed us on a grandiose scale. Health care reform, to which Meaningful Use is foundational, is based on the same failed concepts as education reform. It will also fail in due course and spectacularly so. It is actually failing as we speak and with the exception of elite institutions, which are benefiting financially from as much health care reform as can possibly be inflicted on the rest of us, we all know it’s failing badly. 2016 presents the perfect opportunity to demonstrate to the entrenched perpetrators that in America accountability is a two way street, and value is a freely defined personal concept.

American health care has been hijacked by very bad people, and it’s time for us to quit being sad little losers who just sit there and bitch. It’s time to take our health care back and it’s high time to deliver to those horrible people the thorough schlonging they so richly deserve. It’s time to make American health care great again.

In 2016, resolve to go out and vote. Vote in the primaries, vote in local and general elections, ignore the propaganda, educate yourself and as old Harry Truman advised us all, vote for yourself, for your own interest, for the welfare of the United States, and for the welfare of the world.

Make Health Care Great Again




Just in time for the holiday season, the NIH’s National Institute on Alcohol Abuse and Alcoholism) has a site with guidelines and tips for healthy and responsible consumption of alcohol.

Smart drinking

Resep Chocolate Lasagna Enak Praktis - Satu lagi desert ciamik yang enak dan lezat buat kamu yang doyan banget sama yang namanya coklat. bernama Chocolate Lasagna, camilan sedap yang biasanya di pakai untuk sajian makanan penutup ini sering juga di sebut Coklat Lasagna. bila di lihat dari asal usulnya, Resep Chocolate Lasagna Asli berasal dari luar negeri. resep chocolate lasagna asli sangat ribet dan banyak bahan-bahan yang tidak tersedia di Indonesia.

Dengan ini muncullah aneka kreasi Chocolate Lasagna yang bahan-bahannya mudah di dapat dan praktis. salah satunya dalah Resep Chocolate Lasagna yang akan kami bagikan kali ini. kami pilihkan yang paling praktis dan mudah untuk di pratekkan, bahkan bagi para pemula sekalipun. namun untuk soal rasanya jangan di tanya, hasilnya enak, lembut dan lumer di mulut loh. jadi bagi kamu yang ngaku choco lover, Resep Chocolate Lasagna ala harianresep.blogspot.com ini wajib dicoba.

Bila berbicara Lasagna, mungkin bayangan kamu langsung tertuju dengan Lasagna Daging Saus Bolognese Ala Italy yang sedap itu ya. buang jauh-jauh pikiran itu, karena Lasagna Chocolate ini bukan terbuat dari bahan utama daging namun coklat. kenapa makanan ini disebut Chocolate lasagna karena terbuat dari coklat yang dikombinasikan dengan cream cheese/krim keju dan beberapa lapisan adonan lainnya yang terdiri dari beberapa layer. bentuknya hampir sama dengan Lasagna Daging, hanya saja untuk Chocolate Lasagna ini kita ganti dengan bahan utama coklat seperti yang sudah kami katakan diatas.

Lapisan tersebut terdiri dari remukan oreo, cream cheese/krim keju, custard coklat atau puding cokelat, kemudian di beri cheese krim lagi dan di taburi toping choco chips/cokelat chip. kalau di lihat sekilas, tampilan Chocolate Lasagna ini mirip sekali dengan Cake Tiramisu. namun untuk rasa lembut cream cheese nya hampir mirip dengan Chesse Cake Lumer yang resepnya sudah kami bagikan beberapa waktu lalu. buat kamu yang penasaran cheese cake lumer, silahkan klik resepnya disini Resep Cheese Cake Lumer Untuk Pemula.

Di Amrik sana, lapisan Coklat Chocolate Lasaga nya mereka sebut dengan puding. berbeda di Negera Indonesia, namanya puding ya puding lembut terbuat dari agar-agar atau jelli yang terbuat dari nutrijel. selain jelli, untuk membuat Chocolate Lasagna bisa diganti dengan Puding Roti ataupun itu yang teksturnya lebih lembut, set dan kenyal. untuk membuat Chocolate Lasagna agar lebih gurih biasanya di tambahi dengan santan. tapi bila kamu membuatnya untuk anak kecil, lebih baik skip saja santan nya agar lebih sehat.

Nah, untuk lebih jelas dari Bahan-bahan dan Cara Membuat Chocolate Lasagna yang enak dan simple nya, yuck disimak resep nya seperti berikut ini.

Resep Chocolate Lasagna dan Cara Membuatnya

Resep Chocolate Lasagna dan Cara Membuatnya

Bahan-bahan Chocolate Lasagna :

  • Oreo cookies anda cream 28 buah (hancurkan)
  • Cream cheese (krim keju) 250 gram
  • Krim kocok (whipped cream) 200 mili liter
  • Gula pasir 6 sendok makan
  • Nutrijel cokelat 1 bungkus
  • Susu bubuk cokelat secukupnya
  • Coklat bubuk 1 sendok makan
  • Gula pasir 10 sendok makan
  • Air 700 mili liter
  • Krim kocok (whipped cream) 100 mili liter
  • Cokelat pekat butiran (Dark Chocolate Chips) secukupnya

Cara Membuat Lasagna Chocolate :

  1. Langkah awal, letakkan oreo yang sudah dihancurkan pada pinggan/wadah/cup/gelas. ratakan, tekan-tekan. bisa juga dengan oreo dicampur dengan butter seperti akan membuat crust layer oreo cheesecake)
  2. Lapisan Cream Cheese : Kocok whipped cream, sisihkan. kemudian kocok cream cheese dengan gula pasir hingga lembut. masukkan whipped cream kocok. aduk hingga rata.
  3. Setelah itu tuang lapisan cream cheese di atas lapisan oreo, ratakan. dinginkan, kurang lebih selama 2 jam agar set.
  4. Lapisan Puding Cokelat : Campur nutrijel cokelat, susu bubuk cokelat dan gula pasir, aduk hingga rata. masukkan air, kemudian tambahkan cokelat bubuk yang sudah dilarutkan dengan air, masak hingga mendidih. aduk teruk hingga adonan puding sampai uap hangatnya hilang dan adonan puding hampir mengental. 
  5. Selanjutnya tuang lapisan puding di atas lapisan cream cheese, ratakan. dinginkan kembali sampai set. 
  6. Langkah berikutnya kocok whipped cream untuk topping, lalu tuang di atas lapisan puding. ratakan.
  7. Terakhir taburkan choco chips di atas whipped cream. dinginkan kembali ke dalam kulkas/lemari es selama 2 hingga 4 jam. semakin lama, semakin baik karena lapisan cream cheese semakin padat dan set.

Agar lebih praktis, kamu boleh menggunakan instan puding mix yang tidak perlu dimasak. selamat mencoba dan berkreasi sendiri dengan Resep Chocolate Lasagna Enak Praktis ini dirumah. buka juga artikel resep lainnya seperti Resep Kue Kamir Special Empuk dan Resep Pisang Goreng Pontianak Kremes yang sayang sekali bila terlewatkan. terimakasih sudah membuka harianresep.blogspot.com, nantikan resep menarik lainnya dari kami. sekian :)

Resep Chocolate Lasagna Enak Praktis

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