Sunday, January 23, 2011

Ending Your Fear Of Diabetes

These are the two arms of diabetes. If you are having symptoms of one or the other, call your doctor or 911 immediately, or ask someone to do so for you.

Ketoacidosis is when your body is using fat instead of glucose as fuel, leading to a build up of acids called ketones in your blood and urine.

This occurs when your body has very little or no insulin to allow it use glucose as fuel. In response, the liver secretes glucose to correct the problem, but since there is no insulin in the body glucose is left unused, precipitating hyperglycemia, or abnormally high blood glucose level.

The symptoms of ketoacidosis include abdominal pain, deep and rapid breathing, increased thirst and urination, sweet-smelling or fruity breath, loss of consciousness and nausea. Ketoacidosis usually affect people with type 1 diabetes.

The other arm of diabetes is hypoglycemic coma which causes you to lose consciousness because blood glucose level in the body is abnormally low. Normally the body gets its glucose supply from carbohydrates. A drastic cut in carbohydrates intake, loss of appetite, or the lack of food could precipitate a hypoglycemic coma, as the body seeks to prevent damage to its vital organs.

The symptoms of hypoglycemic coma include confusion, dizziness, headache, double vision, lack of coordination, convulsion or unconsciousness.

When reference is made to diabetes, most people think about type 2 diabetes as 90 to 95 percent of diabetes cases are type 2. But there is also type 1 diabetes which is usually diagnosed in childhood. It occurs when the body produces very little or no insulin; suspected causes are genetics, viruses and autoimmune problems.

There is also gestational diabetes where high blood glucose occurs during pregnancy. Women with gestational diabetes, which may be cause by giving birth to a baby more than 9 pounds, have a higher risk of contracting cardiovascular disease, or type 2 diabetes later in life.

Type 2 diabetes, on the other hand, is usually diagnosed in adulthood. In this type, the pancreas secretes enough insulin, but the muscles, fat and liver cells do not respond to insulin. This is known as insulin resistance. People affected with type 2 diabetes are usually overweight. Family history and genetics, poor diet and low physical activity are other causes of type 2 diabetes.

Testing for diabetes may be done in four ways. Urine analysis is use to find glucose and ketones in the blood and urine. Alone it cannot diagnose diabetes, it should be used with other tests.

Fasting blood glucose level test is performed after the patient has not eaten for at least 8 hours. Blood glucose level higher than 126 mg/dL on two occasions shows diabetes is diagnosed. Between 100 to 126 mg/dL is called prediabetes, or impaired fasting glucose.

Oral glucose tolerance test is usually used to diagnose diabetes during pregnancy. A series of blood glucose measurements are taken after giving the patient a sweet liquid containing glucose. Blood glucose level higher than 126 mg/dL indicates the presence of diabetes.

Random blood sugar test is a non-fasting test, and may be performed regardless of when the patient ate. Several random measurements may be taken during the day. When the measurements vary widely is an indication of the presence of diabetes, as healthy blood glucose levels do not vary widely through out the day.

When diabetes is diagnosed it has to do with the secretion and use of insulin in the body. The digestive system extracts glucose from the carbohydrate foods you eat. Glucose enters the blood stream to be transported by insulin into muscles, fat and liver cells where it is used as fuel for repairing, rebuilding, chemical and electrical processes in the body.

The body's insulin supplier is the pancreas. It is a gland organ located in the abdomen, within the digestive and endocrine systems. The pancreas is both an endocrine gland that secretes insulin, glucagon and somatostatin; and an exocrine gland that secretes pancreatic juices containing digestive enzymes into the small intestine to break down carbohydrates, proteins and fats.

The endocrine section of the pancreas is made up of about a million cells cluster called islets of Langerhans. These are classified by their secretions.

The glucagon cells secrete glucagon hormone to increase blood glucose level, whereas insulin cells secrete insulin that moves glucose into the muscles, fat and liver cells to decrease glucose level in the blood.

The somatostatin cells secrete somatostatin hormone to regulate or stop glucagon and insulin secretion; while the PP cells secrete pancreatic polypetide to self-regulate pancreas secretion activities.

As you can see, these four cell types ensure that the pancreas does not overproduce insulin in the body, as this could lead to insulin resistance; or produce less insulin as this could lead to an abnormally high blood glucose level. Both events could precipitate type 1 or 2 diabetes.

Although the pancreas internal mechanisms keep it preforming well under normal conditions, like other organs of the body, the pancreas is sometimes attacked by diseases. Among these is pancreatic cancer, particularly cancer of the exocrine cells which has a high mortality rate.

Diabetes mellitus type 1 is another deadly pancreatic disease. It is a chronic autoimmune disorder where the body's immune system attacks the insulin secreting cells in the pancreas. Once these cells are disabled insulin secretion is reduced, or cut off leading to diabetes.

Since there is no cure for diabetes, it is like an unwanted lifetime companion. The goal of treatment, therefore, should seek to prolong life, reduce symptoms and prevent diabetes related diseases such as blindness, heart disease, kidney failure and amputation of limbs.

You can accomplish these objectives by blood pressure and cholesterol control, careful self-testing for blood glucose levels, physical exercise, foot care, medication and insulin use, as well as meal and weight control.

Your doctor may tell you to regularly check your blood glucose level at home. Using the right device, you need only a drop of blood to do so. Information gathered from self-testing will help your doctor prevent diabetes related complications, and indicate how well diet, medication and physical exercise are helping to control your diabetes.

When thinking about your health in relation to diabetes, the focus should be on maintaining a  healthy diet and body weight. You will find that more than any other cause, overweight and obesity are the main causes of diabetes.

Overweight and obesity are conditions where the body has more calories and fat than the cells can immediately process. A specialized membrane in the cell called endoplasmic reticulum (ER), which synthesizes proteins and processes fats will signals the insulin receptors to stop responding to insulin to allow it time to process the fat it already has. The unused insulin increases the body's blood sugar level which may lead to a type 2 diabetes.

While diabetes is usually diagnosed in patients over 40, it is now increasingly being diagnosed in overweight and obese children. This is sounding an alarm in the medical establishment, because obesity in American children has doubled since 1968, and it is just a matter of time when diabetes in children will also double.

A teenager or an adult who argues that he or she can do nothing about overweight or obesity has less information than is needed to make such life changing decision. For more information read my article titled, "Is Obesity A Disease or A Choice".

No matter how obese you are, you can reduce your weight. In doing so, you will be helping to reduce the $174 billion in direct medical and indirect costs spent in the U.S. a year on diabetes, while freeing yourself of carrying every where you go the excess weight you don't need, and begin enjoying the richness of your life in full.

Friday, January 14, 2011

How To Combat Sleep Deprivation and Insomnia

If you could remain awake for 72 hours, you would have a lot of work done, but at the end of that time, you would become irritable, unfocused, your reaction time would be slow, and your motivation and energy levels would fall.

If these reactions did not stop you to take a break and sleep, your body would by giving you fever to keep you in bed for a few days. This is the extent sleep is very important to the health and proper functioning of your body that it will force you to sleep, if you didn't do so willingly .

Not getting enough sleep occurs in two ways. Not allowing yourself enough hours to sleep is called sleep deprivation. Having enough hours to sleep, but unable to sleep is insomnia. The end result of both is the same: you are not getting enough sleep. Although, the solution to each will be different.

Solving sleep deprivation can be done easily by changing your lifestyle, your work schedule, or getting proper medical treatment for sleep deprivation related diseases such as diabetes, cardiovascular diseases, obesity and depression.

Insomnia is more difficult to solve. Its symptoms includes, difficulty falling asleep, unable to stay asleep during the night, difficulty returning to sleep, waking up too early in the morning, and feeling tired and drained.

Your first line of defense against insomnia is to check if you are being stressed out by physical discomfort, emotional problems, or an uncomfortable sleeping environment. In many cases, when you find solutions to these problems, your insomnia should go away.

When your insomnia does not go away, the reason may be an underlying disease like obstructive sleep apnea, which makes you stop breathing temporarily and forces you to wake up. This occurs when your tonsils or adenoids located in the passage that connects your nose to your throat becomes enlarge because of overweight or obesity.

Other underlying diseases may include, gastroesophageal reflux (GERD) where the stomach acid moves up into the esophagus producing heart burn. GERD symptoms are worse when lying down, and can interfere with the sleep cycle. Nightmares, narcolepsy and sleep walking can also interfere with the sleep cycle.

Your sleep cycle is the various stages of sleep your body goes through during the sleep-wake period. There is no fixed pattern to the amount of time spent in each stage. 

Stage 1 is the transition to sleep. It lasts for 5 minutes during which the eyes move slowly under the eye lids, muscles activity slows down, and you are easily awakened.

Stage 2 is the first stage of true sleep. It last for 10 to 25 minutes when the eyes movement stops, the heart rate slows down and the body temperature decreases. 

Stage 3 is deep sleep when it is difficult to be awakened, and when awakened you will feel groggy and disorientated for several minutes.

Stage 4 is intense deep sleep. Your brain waves are very slow, blood flow is directed away from your brain and toward the muscles to repair muscles and restore energy depleted during the day. These four sleep stages are called Non-REM sleep, because during these your eyes do not move rapidly under your eye lids.

The REM sleep stage begins about 70 to 90 minutes after falling asleep when dreaming occurs. The eyes move rapidly under the eye lids, breathing is shallow, the heart rate and blood pressure increase, and the arms and legs become still.

The importance of these sleep stages is that if you cannot get past stages 1 and 2 because of a noisy or uncomfortable sleep environment, you will not get to states 3 and 4 where deep and intense deep sleep occurs, when the body does its repair work: building muscles and tissues, secreting growth hormones for growth in children and repairing and growing tissues in adults.

It has been found that sleep deprivation and insomnia lead to deficiencies in the immune system  making the body less able to defend itself against invading microorganisms, and probably the reason you will get fever if you stayed awake, or don't get enough sleep for several days.

According to the National Institute of Health, an average adult needs 7.5 to 9 hours sleep a night to fully restore the mental and physical energies depleted during the day from thinking, creating, walking, lifting and moving things.

Even so, many people believe all they need are 6 hours of sleep a night to have their energies restored for the next day's activities. But, with time they find that their mental sharpness, creativity, productivity, emotional balance and physical vitality begin to fall, as the body struggles to deal with daytime sleeping, reduced concentration, irritability and slow reaction time.

If you are experiencing any of these sleep related problems, you now know why. Increasing the number of sleep hours you get at night will begin to solve these problems. Yet, as I have said, you can increase the number of sleep hours, and still not be able to actually sleep the same number of hours, if you have insomnia.

If you have insomnia, you need to do more than simply increasing the number of  sleep hours. Your sleep environment is an important determinant whether you are able to get past stages 1 and 2 of your sleep cycle, as these stages are when you are sleeping lightly, and easily awakened.

Avoid noises and bright lights. Turning off the television and radio, and removing all physical discomfort will prevent things from happening in your sleep environment that will start you thinking, or require you to get up to find out what is going on.

It commonly known that an effective way to fall asleep is to empty your mind of all thoughts. The problem is even as you struggle to empty your mind of all thoughts, you will be worrying if you are succeeding in doing so. 

However, if you succeed in keeping all thoughts from your mind for at lest 10 to 15 minutes you are more likely to fall asleep, because when the mind is empty it will have nothing to do, and so fall asleep.

Avoid talking about unpaid bills and controversial issues when you are nearing your bed time. By doing this, you will prevent your mind from continuing the discussion while you are attempting to sleep. And when your mind is actively finding solutions to these problems, you cannot sleep

It has been suggested that to get a better night sleep, it is necessary to get in sync with your circadian rhythm, or your natural sleep-wake cycle. This requires that you maintain a regular sleep schedule, meaning going to bed and waking up at the same time each day. While this is possible for some people to do, for others it is not because of their work schedule, or some other demands on their lifestyle.

Forty to 60 minutes of regular physical exercise is very helpful for a good night sleep. You could do this any time during the day, but be sure it is 3 to 4 hours before your bed time.

I will say this about sleeping pills: they should be taken only for short periods. If used for a long period of time, you will have side effects like drug tolerance, drug interactions, drug dependence, your insomnia will get worse when you stop taking them, withdrawal symptoms, and they may mask an underlying disease.

Without sleeping pills, a good night sleep is most likely when you have your spouse or significant other lying beside you, as you go past stages 1 and 2 into deep sleep stages 3 and 4 of your sleep cycle. You will find, however, that merely having someone lying beside you is not a panacea in itself. The quality of the relationship you have with your spouse or significant other is what matters the most.

Yes, I know you didn't expect to find that a good night sleep had something to do with the quality of the relationship with your spouse or significant other. It does, in the sense that if you are in a bitter power struggle with your spouse or significant other, as you lie on the same bed, you are projecting negative thoughts toward each other. This will occur even if you are sleeping in different beds and in different rooms.

When these negative thoughts collide, they create a sleep environment that produces many disturbing questions that demand answers. The effect of this is that you and your spouse or significant other will spend most of the night, if not all of it, finding answers to these disturbing questions, while unable to sleep.

How you solve this problem turns on the adage, "Don't let the sun set on your anger". When you allow the sun to set on your anger, you give your anger enough time to develop roots, and by the next day it would have borne poisonous fruits.

You can avoid producing these poisonous fruits by agreeing with your spouse or significant other to perform a little ritual whenever there is a power struggle crisis. Before you go to sleep, you will tell your spouse or significant other that you have forgiven him or her for any known or unknown things said or done to offend you, and are now putting them in an imaginary manila envelop, and will think about them no more.

Your spouse or significant other will also tell you those same words. When done, the two of you will seal the imaginary manila envelop with a kiss, or some other romantic act and throw the imaginary manila envelop in an imaginary garbage can. 

To make the ritual more real, you may want to have an actual manila envelop, and go through the motion of emptying your minds of all the negative things said and done into it, then seal it and throw it into an actual garbage can.

If the ritual is done honestly, as you lie side by side on your bed, you will be projecting positive thoughts toward each other. And when positive thoughts collide, they create a sleep environment that produces genuine feeling of forgiveness, kindness and love for your spouse or significant other.

If you cannot fall into deep sleep in this comfortable and romantic sleep environment, your sleep problem may have behind it an underlying pathology, and you need to see your doctor immediately.

Sunday, January 9, 2011

From Welfare To Workfare

Those on welfare would tell you they don't like being there. In fact, I would venture to say the majority of them don't want to be there, because a welfare check comes with a social stigma.

Welfare recipients are constantly reminded by the accusatory expression on the faces of tax payers who see them as freeloaders, as people who get money for not working.

Some have argued that the welfare system should be abolished, without a clue as to how the problems that would arise would be solved. If welfare is ended, we will return to the world of Oliver Twist where children went hungry, and mothers knowing there was a demand, sold their bodies for money to feed their children.

This is not to suggest that the welfare system, as it is today is the best we can have. It solves one set of problems, but inadvertently creates another. While children do not go hungry, and mothers are not forced into prostitution; getting money without working has debilitating effects on the minds and bodies of welfare recipients, and their children.

When a person stays home all day, seven days a week watching television, and not engaged in activities that challenge the mind, few neurons synapses are created in the brain. But, when the mind is engaged in challenging activities; in confronting these challenges, more neurons synapses are created in the brain. As more neurons synapses are created, the brain's capacity to learn increases, enhancing its agility, and its ability to solve problems quickly.

Again, when a person stays home all day watching television, he or she has very little motivation to do physical exercise. The result is the body becomes overweight, and gradually becomes obese. Overweight and obesity are known sources of stroke, heart diseases, diabetes, and a myriad of other diseases. The more that overweight and obesity become a problem, the more difficult it will be, owing to limited resources, for the national health system to provide adequate health services to all who need them.

When the children of welfare recipients see their fathers and mothers home all day, yet able to get money to buy food, pay rent and buy clothes, they will be misled into thinking that staying home all day without working is a normal way of life. They will be trapped into emulating their parents, and end up on the welfare system as their parents before them.

Consequently, the aim of the welfare system, which is to prevent children from going hungry, and mothers from becoming prostitutes will be turned on its head. The welfare system  will become a breeding ground for generation upon generation of young men and women expecting to be paid for doing nothing.

In fiscal year 2008 the federal government spent $522 billion, and state governments spent $192 billion on providing assistance to welfare recipients, a total of $714 billion. The figures for 2010 will be slightly higher. However, when you add the cost of administering the welfare system the total amount spent both by federal and states governments rises beyond a trillion dollars a year.

When talking about the welfare system, the program that comes to mind is the Temporary Assistance for Needy Families (TANF) because it is the one that comes up in most welfare discussions. But there are other programs under the welfare umbrella including, Medicaid, Food Stamps, Supplementary Security Income (SSI), Housing and Urban Development (HUD), Head Start, Work Study, Medicare and Social Security.

In 1996 President Clinton with the help of a Republican majority in Congress signed into law the Personal Responsibility and Work Opportunity Reconciliation Act; otherwise known as the Welfare Reform Act. This legislation devolved administration of the welfare system from the federal government to the states.

Among other provisions, the welfare Reform Act stated that all welfare recipients who began receiving assistance from the date of the legislation shall find jobs within a period of two years, after which welfare assistance will be cut off.

It also stated that current welfare recipients shall find jobs with a period of five years, after which welfare assistance will be cut off.

Another provision stated that all mothers receiving welfare assistance shall receive no increase in cash assistance if they had another child. For example, a mother currently on welfare with two children will get no additional assistance for her third child, unless the state legislature decided differently.

If these welfare reform provisions appear draconian, they are the voices in Congress of hard working and tax paying Americans who see the increasing tax burden upon them taking away their ability to provide opportunities for their own children, and the pursuit of happiness.

It is our choice to pursue a planned change in the welfare system, or wait for a blind instrument to cut across the welfare system with no regard for who goes hungry, who loses health care, or who becomes homeless.

The five years period when mothers already on the welfare system should have found jobs ends in 2011. With the unemployment rate hovering around 10%, it is not likely that welfare mothers who have received assistance for five years will have found jobs in 2011. Experts at the highest levels in the federal and state governments are thinking seriously about how to solve this problem which is already at our doors.

I have provided detail of a planned change to the welfare system that gradually moves recipients from the welfare system to a workfare system. Following the change those on the workfare system will get paid only when they work. Although, there will be some who will get paid without working, and these are about 50% of welfare recipients comprising mostly of the disabled and elderly.

The workfare system will work as following. The geographical and political area of operation will be the county. It is small enough to be effectively managed, yet large enough to have a critical mass of welfare recipients to make the workfare system work. Every building that is connected with providing welfare services and checks to recipients will be renamed a workfare building.

A short and simple form will be created and given to all current welfare recipients asking them to tell the workfare system what they can do best. Someone might say he is good at mowing a lawn. Another person might say she is a good painter. Yet another person might say she is a good baby sitter, or a good bricklayer.

The workfare system will collect all the filled in forms bearing the names, addresses and job proficiencies of those who filled them. The workfare system will group the various job proficiencies into job training programs. So that the person who said he is a good lawn mower will be given a mowing machine to demonstrate his proficiency.

When the job is done, the trainer will analyze the mowed lawn, and depending on his or her assessment, determine what level of training this trainee will need to qualify him as a certified lawn mower. The job training period will not exceed four weeks.

At the end of the job training, the trainee will receive a certification card the size of a credit card. The certification card will tell all companies he is assigned to work that he is a certified lawn mower. The same will go for trainees in other job training categories.

When job training and certification have gone on for some time, the workfare system will have available a large number of certified and skilled men and women ready to work.

As this will be a high priority operation, top officials of the workfare system will invite private companies to register for the service categories for which there are trained workfare workers. The private companies will show evidence that they have the financial resources, qualified management staff, and are doing business legally in the county where they are registered.

Next, top officials of the workfare system will through advertisement invite all private companies and individuals in the county to post onto a dedicated workfare website the services they want provided for their companies and homes.

The work assignments, as we shall called them, will be posted to the workfare website the day before. They will be sorted out and put into work assignment categories by the workfare staff. The next morning, the categorized work assignments will be posted onto the workfare website.

The private companies registered with the workfare system will look through the categorized work assignments, choosing those work assignments for which they have the technical skills and experience to perform. As each work assignment is taken, it is removed from the list.

Each private company will be allowed to take only a certain number of work assignments expressed in money value, and could come back during the day to take more work assignments after the ones previously taken have been done. This will prevent private companies from taking more work assignments than they can satisfactorily complete within the agreed period.

Once the private companies have taken their work assignments, they will within one hour, contact the companies or individuals who posted them on the workfare website, for the purpose of agreeing on a price, and completion time of the work assignment.

Where there is agreement, the owner of the work assignment will post onto the workfare website the agreed price, and when the work assignment is to be completed. The private company that will perform the service will also post onto the workfare website the agreed price and completion time of the work assignment.

The workfare staff will compare the two documents from the owner of the work assignment and the private company to determine the number of workfare workers the company will need to perform the work assignment.

There will be a tug of war going on between the private company and the workfare staff as to the number of workers needed to perform a particular work assignment, as the private company seeks to reduce its labor costs with few workers, and the workfare system seeks to prevent the private company from overworking the workfare workers.

When an agreement is reached, the workfare system will select the number of workers with the required skills the private company needs to perform its work assignments for the day. In effect, the workers will be employees of the workfare system hired out to the private company for the day. The hourly rate paid shall not be different from what the private company is paying non-workfare workers doing the same job.

The private company will keep accurate and updated records for all the workfare workers who worked for it in each pay period not exceeding one week. It will make unemployment, retirement, health insurance and disability contributions on behalf of those workers. At the end of each pay period, the private company will write one check with an attached detail for the wages and benefits of all workfare workers who have worked for it.

At the workfare payroll department, the check from the private company along with the attached detail would be allocated to the individual workfare worker's payroll account to determine his or her pay for that week. The workfare system will issue individual payroll checks to the workfare workers after taking into account all deductions including taxes and benefits.

In this way the private company can focus on doing its business, as long as it is able to issue the aggregate weekly checks for work done for it by the workfare workers. What is exciting about the workfare system is that the money paid to the workfare workers will come from private companies and not from the county government, as able body welfare recipients will no longer get paid for doing nothing.

The argument that the workfare system, in soliciting work assignments from private companies and private individuals amounts to unfair competition with private entrepreneurs is mute, because all work assignments received by the workfare system will be done by private companies. The workfare system will perform no work assignments.

Unfortunately, such smoothly run operation seldom happen without some problems. We can foresee a situation in which a workfare worker assigned to a company for a day's work gets angry for whatever reason, and decides not to work, or refuses to take instruction from his supervisor.

Private companies have neither the time nor resources to deal with the problems of a workfare worker who does not want to follow instruction or work. They should not be compelled to deal with such problems. Private companies will have the right to call the workfare office and ask for another worker who is not angry, and willing to take instruction and work.

Highly skilled and experienced psychiatrists and psychologists, employed by the workfare system, who know the human mind and how to influence it in one direction or another will get on the phone with the agitated workfare worker with a plan to remove him from the environment that is agitating him.

He is agitated, and needs not to be told what he's doing is wrong. He needs someone to complain to about how he is being unfairly treated. The psychiatrist or psychologist will say, "Alright Mr. Winters", to choose an arbitrary name, "tell me what happened. I will make a report, and whoever is bothering you will be dealt with according to the law".

Later, depending on the decision of a judge, things might turn out differently for Mr. Winters, especially where there was violence against persons or property. But for now he needs to be convinced that the law is on his side.

During the course of Mr. Winters' statement, the psychiatrist or psychologist will ask at an appropriate time, "Mr. Winters have you had breakfast or lunch yet?" Most likely he will say he has not had lunch.

In response the psychiatrist will say, "Mr. Winters in 15 minutes I will have lunch waiting here for you with your name on it. I need you to be here as quickly as possible because you wouldn't want to eat a cold lunch". The psychiatrist will proceed to describe what the lunch is made of. If the lunch is vividly described, Mr. Winters will start salivating though he has not seen the lunch yet. He will leave the work site, jump into a bus, walk briskly, or sprint to the workfare office as fast as he can.

At the workfare office a hot lunch will be waiting for him. The lunch should be flawless. If he finds the least flaw with the lunch he will think he's being punished for what happened at the work site. It should be a lunch fit to be eaten by the psychiatrist or psychologist.

When Mr. Winters is done his lunch, the psychiatrist and psychologist will talk to him. Where no violence against persons or property was involved, the experts will find out whether he didn't want to work with that particular supervisor, or he simply didn't like the type of work he is doing.

If he didn't want to work with the supervisor, he could be reassigned to a different company under a different supervisor. Now, if he didn't like the job for which he has been trained, he may express this by saying,
 "I don't like the job", or "I don't like to work".

If he didn't like the job, the psychiatrist would say, "Alright Mr. Winters I have another job for you. Take this sheet of paper. I will take you to a very important building. You will stand at a particular spot. Every car that comes through that spot, make a check mark in one of the boxes on the sheet." Other recommended jobs may be a street crossing guard, or a doorman. The point here is to get Mr. Winters into a job where he will need limited supervision to do his work.

Most likely the efforts of the experts will alleviate Mr. Winters agitation, and place him in another work environment where he is less likely to be agitated. This is only one example of problems that may arise under the workfare system.

In handling this and other workfare related problems, the psychiatrist or psychologist should be the first to talk with the agitated workfare worker. Only when there is violence should the police be called in. Even then the police should not come in with handcuffs and guns. They should seek to stabilize the situation, and quickly allow the experts to steer the agitated person in a different direction.

When workers go to the workfare office and clock in, they expect to be assigned jobs for the day. No clocked in workfare worker should wait more than one hour to get a job assignment. Where there are not enough day jobs for the workfare workers, the county government should create city beautification work assignments for the private companies, which in turn will hire workfare workers to do them.

In fact, one may go as far as to suggest that in an extreme case, the county government should pursue a job creation policy that may involve nothing more than digging a hole only to refill it. On the face of it, it may sound absurd, but when we consider the effects of such endeavor, including the opportunity for workfare workers to put their minds and bodies to work, and the setting of good example for the children, it will more than compensate for merely digging a hole only to refill it.

Up to this point, the workfare system will work flawlessly if only men were involved in it, but as it is obvious that women will form a significant proportion of the workfare labor force, it is necessary to add a childcare department to the workfare system.

If workfare mothers are to go out and work hard, they need to be convince beyond a doubt that their children are in a safe and clean environment; that they are interacting with care givers who have been screened, trained and have the right temperament to thoughtfully and gracefully handle the problems of children from all backgrounds.

This is possible only when the administrators of the childcare system race to the top, rather than  to the bottom in terms of the standard of care given to the children. The workfare system should take an in depth look at the range of childcare standards; from the poorest neighborhoods to the wealthiest neighborhoods.

The purpose of this exercise is to find what standard works. Obviously, the standard of childcare in the wealthiest neighborhoods will be the standard to race up to. But while mothers in the wealthiest neighborhoods are paying $300.00 a week for childcare, mothers in the workfare system may have to pay $53.00 a week, depending on their income, for the same standard of childcare.

The workfare system will pay the difference between the $300.00 and $53.00 per week. In other words, the workfare system will subsidized the childcare services provided to workfare mothers. Money that would have gone to pay welfare checks to mothers who got money for doing nothing, will now go to pay highly screened and trained staff with the right temperament to provide top notch childcare services to the children of workfare mothers.

Because these children will be receiving the best childcare money can provide, all children regardless of where they live, their color, ethnic or religious background will have equal opportunity to succeed.

Under this childcare system, when a staff sees a child, she will not see a color or an ethnic background, she will see a child wanting to be loved, cared for, and taught the wonders of the world he or she is only beginning to know.

And no group will be fooled into believing that equal opportunity is a zero sum game where the gain of one group is the loss of another, as we wise up to what President John F. Kennedy said, "a rising tide lifts all boats."

Under this childcare system what will matter the most will be the content of a child's character, to quote our beloved brother Martin Luther King Jr., and how that character could be molded to reach the highest achievement the child is capable of.

And here on God's earth, no child shall be born condemned to a life of perpetual welfare, but all children under the workfare system shall be born to look up, and reach for the stars.