Dating over Zoom? Don’t be surprised if those online sparks fizzle in person

Let’s not get ahead of ourselves… Peter Dazeley/The Image Bank via Getty Images

Sheril Kirshenbaum, Michigan State University

For those dipping their toes into the dating pool during stay-at-home orders, it’s been like swimming in a version of Netflix’s reality series “Love is Blind.”

In the show, contestants must get engaged before ever actually meeting one another in person. And while a lockdown engagement might be a bit extreme, it’s entirely possible that two people have grown to really like one another over the previous weeks and months. Maybe it started with a match on a dating app, followed by flirting over text. Then came regularly scheduled Zoom dates. Perhaps they’ve even started envisioning a future together.

Now, as states start to ease restrictions, some may have broached taking the next step: an in-person rendezvous.

What are the chances that their online connection will lead to true love?

In my book, “The Science of Kissing,” I describe how compatibility requires engaging all of our senses. And absent the touch, taste and smell of a potential partner, people dating online during quarantine have essentially been flying blind.

Muzzled neurotransmitters

Human attraction involves the influence of cues that evolved over millions of years.

On a traditional date in a restaurant or move theater, we actively gather details about someone by walking side by side, holding hands, hugging and – if things get far enough – kissing. These experiences send neural impulses between the brain and body, stimulating tiny chemical messengers that affect how we feel. When two people are a good match, hormones and neurotransmitters bring about the sensations we might describe as being on a natural high or experiencing the exhilaration of butterflies. Finding love isn’t rocket science – it’s anatomy, endocrinology and real chemistry.

One of the most important neurotransmitters involved in influencing our emotions is dopamine, responsible for craving and desire. This natural drug can be promoted through physical intimacy and leads to the addictive nature of a new relationship. Of course, dopamine is just one player in a chemical symphony that motivates behavior. Intimate encounters also promote the release of oxytocin, which creates a sense of attachment and affection, and epinephrine, which boosts our heart rate and reduces stress. There’s also a decrease in serotonin, which can lead to obsessive thoughts and feelings about the other person.

In fact, one study showed that people who report that they’ve just “fallen in love” have levels of serotonin similar to patients suffering from obsessive-compulsive disorder. This chemical cocktail can even lead to trouble sleeping or a loss of appetite – symptoms people often attribute to meeting “the one.”

Our noses also play a powerful role in who we fall for. The famous “sweaty t-shirt experiment” reported that a man’s natural scent may influence how women choose a partner. The women in the study nearly always expressed a preference for the odor of men who differed genetically from them in immune response to disease. Scientists theorize that selecting someone with genetic diversity in this region, called the major histocompatibility complex, could be important for producing children with flexible and versatile immune systems.

A kiss can make or break it

While a man’s natural scent may not be something women consciously notice early on in a heterosexual relationship, getting up close and personal can serve as a kind of litmus test for a couple. A kiss puts two people nose to cheek, offering a reliable sample of smell and taste unrivaled by most other courtship rituals. Perhaps that’s one reason a 2007 University of Albany study reported that 59% of men and 66% of women have broken off a budding romance because of a bad first kiss.

Complicating matters, factors that typically grab our attention in person are less obvious to recognize in a witty profile or photo. Studies of online dating behavior reveal superficial features are correlated with the level of interest an individual receives. For example, short-haired women do not tend to get as much attention from men as those with long, straight hair, while men who report a height of six-foot-three or six-foot-four fare better than their peers at interacting with women. The initial focus on appearance promotes pairing based on characteristics that aren’t significant in lasting relationships, compared with more important factors for long-term compatibility, like intimacy and shared experiences.

Still, at a time when many of us are feeling more isolated than ever, online dating does offer some benefits. Quarantine has encouraged men and women to take additional time to learn about each other prior to meeting, sparing the anxiety of rushed physical intimacy.

For some couples, a real-world date will kindle the spark that began online. Many others will realize they’re better suited as friends.

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Sheril Kirshenbaum, Associate Research Scientist, Michigan State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

This article was originally published on The Conversation

Death By 1,000 Clicks: Where Electronic Health Records Went Wrong

The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief.

Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death.

Monachelli’s husband sued Stowe, the federally qualified health center the physician worked for. Owen Foster, a newly hired assistant U.S. attorney with the District of Vermont, was assigned to defend the government. Though it looked to be a standard medical malpractice case, Foster was on the cusp of discovering something much bigger — what his boss, U.S. Attorney Christina Nolan, calls the “frontier of health care fraud” — and prosecuting a first-of-its-kind case that landed the largest-ever financial recovery in Vermont’s history.

Foster began with Monachelli’s medical records, which offered a puzzle. Her doctor had considered the possibility of an aneurysm and, to rule it out, had ordered a head scan through the clinic’s software system, the government alleged in court filings. The test, in theory, would have caught the bleeding in Monachelli’s brain. But the order never made it to the lab; it had never been transmitted.

The software in question was an electronic health records system, or EHR, made by eClinicalWorks (eCW), one of the leading sellers of record-keeping software for physicians in America, currently used by 850,000 health professionals in the U.S. It didn’t take long for Foster to assemble a dossier of troubling reports — Better Business Bureau complaints, issues flagged on an eCW user board, and legal cases filed around the country — suggesting the company’s technology didn’t work quite the way it said it did.

Until this point, Foster, like most Americans, knew next to nothing about electronic medical records, but he was quickly amassing clues that eCW’s software had major problems — some of which put patients, like Annette Monachelli, at risk.

Damning evidence came from a whistleblower claim filed in 2011 against the company. Brendan Delaney, a British cop turned EHR expert, was hired in 2010 by New York City to work on the eCW implementation at Rikers Island, a jail complex that then had more than 100,000 inmates. But soon after he was hired, Delaney noticed scores of troubling problems with the system, which became the basis for his lawsuit. The patient medication lists weren’t reliable; prescribed drugs would not show up, while discontinued drugs would appear as current, according to the complaint. The EHR would sometimes display one patient’s medication profile accompanied by the physician’s note for a different patient, making it easy to misdiagnose or prescribe a drug to the wrong individual. Prescriptions, some 30,000 of them in 2010, lacked proper start and stop dates, introducing the opportunity for under- or overmedication. The eCW system did not reliably track lab results, concluded Delaney, who tallied 1,884 tests for which they had never gotten outcomes.

The District of Vermont launched an official federal investigation in 2015.

The eCW spaghetti code was so buggy that when one glitch got fixed, another would develop, the government found. The user interface offered a few ways to order a lab test or diagnostic image, for example, but not all of them seemed to function. The software would detect and warn users of dangerous drug interactions, but unbeknownst to physicians, the alerts stopped if the drug order was customized. “It would be like if I was driving with the radio on and the windshield wipers going and when I hit the turn signal, the brakes suddenly didn’t work,” said Foster.

The eCW system also failed to use the standard drug codes and, in some instances, lab and diagnosis codes as well, the government alleged.

The case never got to a jury. In May 2017, eCW paid a $155 million settlement to the government over alleged “false claims” and kickbacks — one physician made tens of thousands of dollars — to clients who promoted its product. Despite the record settlement, the company denied wrongdoing; eCW did not respond to numerous requests for comment.

If there is a kicker to this tale, it is this: The U.S. government bankrolled the adoption of this software — and continues to pay for it. Or we should say: You do.

Which brings us to the strange, sad, and aggravating story that unfolds below. It is not about one lawsuit or a piece of sloppy technology. Rather, it’s about a trouble-prone industry that intersects, in the most personal way, with every one of our lives. It’s about a $3.7 trillion health care system idling at the crossroads of progress. And it’s about a slew of unintended consequences — the surprising casualties of a big idea whose time had seemingly come.

The Virtual Magic Bullet

Electronic health records were supposed to do a lot: make medicine safer, bring higher-quality care, empower patients, and yes, even save money. Boosters heralded an age when researchers could harness the big data within to reveal the most effective treatments for disease and sharply reduce medical errors. Patients, in turn, would have truly portable health records, being able to share their medical histories in a flash with doctors and hospitals anywhere in the country — essential when life-and-death decisions are being made in the ER.

But 10 years after President Barack Obama signed a law to accelerate the digitization of medical records — with the federal government, so far, sinking $36 billion into the effort — America has little to show for its investment. KHN and Fortune spoke with more than 100 physicians, patients, IT experts and administrators, health policy leaders, attorneys, top government officials and representatives at more than a half-dozen EHR vendors, including the CEOs of two of the companies. The interviews reveal a tragic missed opportunity: Rather than an electronic ecosystem of information, the nation’s thousands of EHRs largely remain a sprawling, disconnected patchwork. Moreover, the effort has handcuffed health providers to technology they mostly can’t stand and has enriched and empowered the $13-billion-a-year industry that sells it.

By one measure, certainly, the effort has achieved what it set out to do: Today, 96 percent of hospitals have adopted EHRs, up from just 9 percent in 2008. But on most other counts, the newly installed technology has fallen well short. Physicians complain about clumsy, unintuitive systems and the number of hours spent clicking, typing and trying to navigate them — which is more than the hours they spend with patients. Unlike, say, with the global network of ATMs, the proprietary EHR systems made by more than 700 vendors routinely don’t talk to one another, meaning that doctors still resort to transferring medical data via fax and CD-ROM. ­Patients, meanwhile, still struggle to access their own records — and, sometimes, just plain can’t.

Instead of reducing costs, many say, EHRs, which were originally optimized for billing rather than for patient care, have instead made it easier to engage in “upcoding” or bill inflation (though some say the systems also make such fraud easier to catch).

More gravely still, a months-long joint investigation by KHN and Fortune has found that instead of streamlining medicine, the government’s EHR initiative has created a host of largely unacknowledged patient safety risks. Our investigation found that alarming reports of patient deaths, serious injuries and near misses — thousands of them — tied to software glitches, user errors or other flaws have piled up, largely unseen, in various government-funded and private repositories.

Compounding the problem are entrenched secrecy policies that continue to keep software failures out of public view. EHR vendors often impose contractual “gag clauses” that discourage buyers from speaking out about safety issues and disastrous software installations — though some customers have taken to the courts to air their grievances. Plaintiffs, moreover, say hospitals often fight to withhold records from injured patients or their families. Indeed, two doctors who spoke candidly about the problems they faced with EHRs later asked that their names not be used, adding that they were forbidden by their health care organizations to talk. Says Assistant U.S. Attorney Foster, the EHR vendors “are protected by a shield of silence.”

Though the software has reduced some types of clinical mistakes common in the era of handwritten notes, Raj Ratwani, a researcher at MedStar Health in Washington, D.C., has documented new patterns of medical errors tied to EHRs that he believes are both perilous and preventable. “The fact that we’re not able to broadcast that nationally and solve these issues immediately, and that another patient somewhere else may be harmed by the very same issue — that just can’t happen,” he said.

David Blumenthal, who, as Obama’s national coordinator for health information technology, was one of the architects of the EHR initiative, acknowledged to KHN and Fortune that electronic health records “have not fulfilled their potential. I think few would argue they have.”

The former president has likewise singled out the effort as one of his most disappointing, bemoaning in a January 2017 interview with Vox “the fact that there are still just mountains of paperwork … and the doctors still have to input stuff, and the nurses are spending all their time on all this administrative work. We put a big slug of money into trying to encourage everyone to digitalize, to catch up with the rest of the world … that’s been harder than we expected.”

Seema Verma, the current chief of the Centers for Medicare & Medicaid Services (CMS), which oversees the EHR effort today, shudders at the billions of dollars spent building software that doesn’t share data — an electronic bridge to nowhere. “Providers developed their own systems that may or may not even have worked well for them,” she told KHN and Fortune in an interview last month, “but we didn’t think about how all these systems connect with one another. That was the real missing piece.”

Perhaps none of the initiative’s former boosters is quite as frustrated as former Vice President Joe Biden. At a 2017 meeting with health care leaders in Washington, he railed against the infuriating challenge of getting his son Beau’s medical records from one hospital to another. “I was stunned when my son for a year was battling stage 4 glioblastoma,” said Biden. “I couldn’t get his records. I’m the vice president of the United States of America.  … It was an absolute nightmare. It was ridiculous, absolutely ridiculous, that we’re in that circumstance.”

A Bridge To Nowhere

As Biden would tell you, the original concept was a smart one. The wave of digitization had swept up virtually every industry, bringing both disruption and, in most cases, greater efficiency. And perhaps none of these industries was more deserving of digital liberation than medicine, where life-measuring and potentially lifesaving data was locked away in paper crypts — stack upon stack of file folders at doctors’ offices across the country.

Stowed in steel cabinets, the records were next to useless. Nobody — particularly at the dawn of the age of the iPhone — thought it was a good idea to leave them that way. The problem, say critics, was in the way that policy­makers set about to transform them.

“Every single idea was well-meaning and potentially of societal benefit, but the combined burden of all of them hitting clinicians simultaneously made office practice basically impossible,” said John Halamka, chief information officer at Beth Israel Deaconess Medical Center, who served on the EHR standards committees under both George W. Bush and Barack Obama. “In America, we have 11 minutes to see a patient, and, you know, you’re going to be empathetic, make eye contact, enter about 100 pieces of data, and never commit malpractice. It’s not possible!”

KHN and Fortune examined more than two dozen medical negligence cases that have alleged that EHRs either contributed to injuries, had been improperly altered, or were withheld from patients to conceal substandard care. In such cases, the suits typically settle prior to trial with strict confidentiality pledges, so it’s often not possible to determine the merits of the allegations. EHR vendors also frequently have contract stipulations, known as “hold harmless clauses,” that protect them from liability if hospitals are later sued for medical errors — even if they relate to an issue with the technology.

But lawsuits, like that filed by Fabian ­Ronisky, which do emerge from this veil, are quite telling.

Ronisky, according to his complaint, arrived by ambulance at Providence Saint John’s Health Center in Santa Monica on the afternoon of March 2, 2015. For two days, the young lawyer had been suffering from severe headaches while a disorienting fever left him struggling to tell the 911 operator his address.

Suspecting meningitis, a doctor at the hospital performed a spinal tap, and the next day an infectious disease specialist typed in an order for a critical lab test — a check of the spinal fluid for viruses, including herpes simplex — into the hospital’s EHR.

The multimillion-dollar system, manufactured by Epic Systems Corp. and considered by some to be the Cadillac of medical software, had been installed at the hospital about four months earlier. Although the order appeared on Epic’s screen, it was not sent to the lab. It turned out, Epic’s software didn’t fully “interface” with the lab’s software, according to a lawsuit Ronisky filed in February 2017 in Los Angeles County Superior Court. His results and diagnosis were delayed — by days, he claimed — during which time he suffered irreversible brain damage from herpes encephalitis. The suit alleged the mishap delayed doctors from giving Ronisky a drug called acyclovir that might have minimized damage to his brain.

Epic denied any liability or defects in its software; the company said the doctor failed to push the right button to send the order and that the hospital, not Epic, had configured the interface with the lab. Epic, among the nation’s largest manufacturers of computerized health records and the leading provider to most of America’s most elite medical centers, quietly paid $1 million to settle the suit in July 2018, according to court records. The hospital and two doctors paid a total of $7.5 million, and a case against a third doctor is pending trial. Ronisky, 34, who is fighting to rebuild his life, declined to comment.

Incidents like that which happened to Ronisky — or to Annette Monachelli, for that matter — are surprisingly common, data show. And the back-and-forth about where the fault lies in such cases is actually part of the problem: The systems are often so confusing (and training on them seldom sufficient) that errors frequently fall into a nether zone of responsibility. It can be hard to tell where human error begins and the technological short­comings end.

EHRs promised to put all of a patient’s records in one place, but often that’s the problem. Critical or time-sensitive information routinely gets buried in an endless scroll of data, where in the rush of medical decision-making — and amid the maze of pulldown menus — it can be missed.

Thirteen-year-old Brooke Dilliplaine, who was severely allergic to dairy, was given a probiotic containing milk. The two doses sent her into “complete respiratory distress” and resulted in a collapsed lung, according to a lawsuit filed by her mother. Rory Staunton, 12, scraped his arm in gym class and then died of sepsis after ER doctors discharged the boy on the basis of lab results in the EHR that weren’t complete. And then there’s the case of Thomas Eric Duncan. The 42-year-old man was sent home in 2014 from a Dallas hospital infected with Ebola virus. Though a nurse had entered in the EHR his recent travel to Liberia, where an Ebola epidemic was then in full swing, the doctor never saw it. Duncan died a week later.

Many such cases end up in court. Typically, doctors and nurses blame faulty technology in the medical-records systems. The EHR vendors blame human error. And meanwhile, the cases mount.

Quantros, a private health care analytics firm, said it has logged 18,000 EHR-related safety events from 2007 through 2018, 3 percent of which resulted in patient harm, including seven deaths — a figure that a Quantros director said is “drastically underreported.”

A 2016 study by The Leapfrog Group, a patient-safety watchdog based in Washington, D.C., found that the medication-ordering function of hospital EHRs — a feature required by the government for certification but often configured differently in each system — failed to flag potentially harmful drug orders in 39 percent of cases in a test simulation. In 13 percent of those cases, the mistake could have been fatal.

The Pew Charitable Trusts has, for the past few years, run an EHR safety project, taking aim at issues like usability and patient matching — the process of linking the correct medical record to the correct patient — a seemingly basic task at which the systems, even when made by the same EHR vendor, often fail. At some institutions, according to Pew, such matching was accurate only 50 percent of the time. Patients have discovered mistakes as well: A January survey by the Kaiser Family Foundation found that 1 in 5 patients spotted an error in their electronic medical records. (Kaiser Health News is an editorially independent program of the foundation.)

The Joint Commission, which certifies hospitals, has sounded alarms about a number of issues, including false alarms — which account for between 85 and 99 percent of EHR and medical device alerts. (One study by researchers at Oregon Health & Science University estimated that the average clinician working in the intensive care unit may be exposed to up to 7,000 passive alerts per day.) Such over-warning can be dangerous. From 2014 to 2018, the commission tallied 170 mostly voluntary reports of patient harm related to alarm management and alert fatigue — the phenomenon in which health workers, so overloaded with unnecessary warnings, ignore the occasional meaningful one. Of those 170 incidents, 101 resulted in patient deaths.

The Pennsylvania Patient Safety Authority, an independent state agency that collects information about adverse events and incidents, counted 775 “laboratory-test problems” related to health IT from January 2016 to December 2017.

To be sure, medical errors happened en masse in the age of paper medicine, when hospital staffers misinterpreted a physician’s scrawl or read the wrong chart to deadly consequence, for instance. But what is perhaps telling is how many doctors today opt for manual workarounds to their EHRs. Aaron Zachary Hettinger, an emergency medicine physician with MedStar Health in Washington, D.C., said that when he and fellow clinicians need to share critical patient information, they write it on a whiteboard or on a paper towel and leave it on their colleagues’ computer keyboards.

While the Food and Drug Administration doesn’t mandate reporting of EHR safety events — as it does for regulated medical devices — concerned posts have nonetheless proliferated in the FDA MAUDE database of adverse events, which now serves as an ad hoc bulletin board of warnings about the various systems.

Further complicating the picture is that health providers nearly always tailor their one-size-fits-all EHR systems to their own specifications. Such customization makes every one unique and often hard to compare with others — which, in turn, makes the source of mistakes difficult to determine.

Dr. Martin Makary, a surgical oncologist at Johns Hopkins and the co-author of a much-cited 2016 study that identified medical errors as the third-leading cause of death in America, credits EHRs for some safety improvements — including recent changes that have helped put electronic brakes on the opioid epidemic. But, he said, “we’ve swapped one set of problems for another. We used to struggle with handwriting and missing information. We now struggle with a lack of visual cues to know we’re writing and ordering on the correct patient.”

Dr. Joseph Schneider, a pediatrician at UT Southwestern Medical Center, compares the transition we’ve made, from paper records to electronic ones, to moving from horses to automobiles. But in this analogy, he added, “our cars have advanced to about the 1960s. They still don’t have seat belts or air bags.”

Schneider recalled one episode when his colleagues couldn’t understand why chunks of their notes would inexplicably disappear. They figured out the problem weeks later after intense study: Physicians had been inputting squiggly brackets — {} — the use of which, unbeknownst to even vendor representatives, deleted the text between them. (The EHR maker initially blamed the doctors, said Schneider.)

A broad coalition of actors, from National Nurses United to the Texas Medical Association to leaders within the FDA, has long called for oversight on electronic-record safety issues. Among the most outspoken is Ratwani, who directs MedStar Health’s National Center on Human Factors in Healthcare, a 30-­person institute focused on optimizing the safety and usability of medical technology. Ratwani spent his early career in the defense industry, studying things like the intuitiveness of information displays. When he got to MedStar in 2012, he was stunned by “the types of [digital] interfaces being used” in health care, he said.

In a study published last year in the journal Health Affairs, Ratwani and colleagues studied medication errors at three pediatric hospitals from 2012 to 2017. They discovered that 3,243 of them were owing in part to EHR “usability issues.” Roughly 1 in 5 of these could have resulted in patient harm, the researchers found. “Poor interface design and poor implementations can lead to errors and sometimes death, and that is just unbelievably bad as well as completely fixable,” he said. “We should not have patients harmed this way.”

Using eye-tracking technology, Ratwani has demonstrated on video just how easy it is to make mistakes when performing basic tasks on the nation’s two leading EHR systems. When emergency room doctors went to order Tylenol, for example, they saw a drop-down menu listing 86 options, many of which were irrelevant for the specified patient. They had to read the list carefully, so as not to click the wrong dosage or form — though many do that too: In roughly 1 out of 1,000 orders, physicians accidentally select the suppository (designated “PR”) rather than the tablet dose (“OR”), according to one estimate. That’s not an error that will harm a patient — though other medication mix-ups can and do.

Earlier this year, MedStar’s human-factors center launched a website and public awareness campaign with the American Medical Association to draw attention to such rampant mistakes — they use the letters “EHR” as an initialism for “Errors Happen Regularly” — and to petition Congress for action. Ratwani is pushing for a central database to track such errors and adverse events.

Others have turned to social media to vent. Dr. Mark Friedberg, a health-policy researcher with the Rand Corp. who is also a practicing primary care physician, champions the Twitter hashtag ­#EHRbuglist to encourage fellow health care workers to air their pain points. And last month, a scathing Epic parody account cropped up on Twitter, earning more than 8,000 followers in its first five days. Its maiden tweet, written in the mock voice of an Epic overlord, read: “I once saw a doctor make eye contact with a patient. This horror must stop.”

As much as EHR systems are blamed for sins of commission, it is often the sins of omission that trip up users even more.

Consider the case of Lynne Chauvin, who worked as a medical assistant at Ochsner Health System, in Louisiana. In a still-pending 2015 lawsuit, Chauvin alleges that Epic’s software failed to fire a critical medication warning; Chauvin suffered from conditions that heightened her risk for blood clots, and though that history was documented in her records, she was treated with drugs that restricted blood flow after a heart procedure at the hospital. She developed gangrene, which led to the amputation of her lower legs and forearm. (Ochsner Health System said that while it cannot comment on ongoing litigation, it “remains committed to patient safety which we strongly believe is optimized through the use of electronic health record technology.” Epic declined to comment.)

Echoing the complaints of many doctors, the suit argues that Epic software “is extremely complicated to view and understand,” owing to “significant repetition of data.” Chauvin said that her medical bills have topped $1 million and that she is permanently disabled. Her husband, Richard, has become her primary caregiver and had to retire early from his job with the city of Kenner to care for his wife, according to the suit. Each party declined to comment.

An Epidemic Of Burnout

The numbing repetition, the box-ticking and the endless searching on pulldown menus are all part of what Ratwani called the “cognitive burden” that’s wearing out today’s physicians and driving increasing numbers into early retirement.

In recent years, “physician burnout” has skyrocketed to the top of the agenda in medicine. A 2018 Merritt Hawkins survey found a staggering 78 percent of doctors suffered symptoms of burnout, and in January the Harvard School of Public Health and other institutions deemed it a “public health crisis.”

One of the co-authors of the Harvard study, Ashish Jha, pinned much of the blame on “the growth in poorly designed digital health records … that [have] required that physicians spend more and more time on tasks that don’t directly benefit patients.”

Few would deny that the swift digitization of America’s medical system has been transformative. With EHRs now nearly universal, the face and feel of medicine has changed. The doctor is now typing away, making more eye contact with the computer screen, perhaps, than with the patient. Patients don’t like that dynamic; for doctors, whose days increasingly begin and end with such fleeting encounters, the effect can be downright deadening.

“You’re sitting in front of a patient, and there are so many things you have to do, and you only have so much time to do it in — seven to 11 minutes, probably — so when do you really listen?” asked John-Henry Pfifferling, a medical anthropologist who counsels physicians suffering from burnout. “If you go into medicine because you care about interacting, and then you’re just a tool, it’s dehumanizing,” said Pfifferling, who has seen many physicians leave medicine over the shift to electronic records. “It’s a disaster,” he said.

Beyond complicating the physician-patient relationship, EHRs have in some ways made practicing medicine harder, said Dr. Hal Baker, a physician and the chief information officer at WellSpan, a Pennsylvania hospital system. “Physicians have to cognitively switch between focusing on the record and focusing on the patient,” he said. He points out how unusual — and potentially dangerous — this is: “Texting while you’re driving is not a good idea. And I have yet to see the CEO who, while running a board meeting, takes minutes, and certainly I’ve never heard of a judge who, during the trial, would also be the court stenographer. But in medicine … we’ve asked the physician to move from writing in pen to [entering a computer] record, and it’s a pretty complicated interface.”

Even if docs may be at the keyboard during visits, they report having to spend hours more outside that time — at lunch, late at night — in order to finish notes and keep up with electronic paperwork (sending referrals, corresponding with patients, resolving coding issues). That’s right. EHRs didn’t take away paperwork; the systems just moved it online. And there’s a lot of it: 44 percent of the roughly six hours a physician spends on the EHR each day is focused on clerical and administrative tasks, like billing and coding, according to a 2017 Annals of Family Medicine study.

For all that so-called pajama time — the average physician logs 1.4 hours per day on the EHR after work — they don’t get a cent.

Many doctors do recognize the value in the technology: 60 percent of participants in Stanford Medicine’s 2018 National Physician Poll said EHRs had led to improved patient care. At the same time, about as many (59 percent) said EHRs needed a “complete overhaul” and that the systems had detracted from their professional satisfaction (54 percent) as well as from their clinical effectiveness (49 percent).

In preliminary studies, Ratwani has found that doctors have a typical physiological reaction to using an EHR: stress. When he and his team shadow clinicians on the job, they use a range of sensors to monitor the doctors’ heart rate and other vital signs over the course of their shift. The physicians’ heart rates will spike — as high as 160 beats per minute — on two sorts of occasions: when they are interacting with patients and when they’re using the EHR.

“Everything is so cumbersome,” said Dr. Karla Dick, a family medicine physician in Arlington, Texas. “It’s slow compared to a paper chart. You’re having to click and zoom in and zoom out to look for stuff.” With all the zooming in and out, she explained, it’s easy to end up in the wrong record. “I can’t tell you how many times I’ve had to cancel an order because I was in the wrong chart.”

Among the daily frustrations for one emergency room physician in Rhode Island is ordering ibuprofen, a seemingly simple task that now requires many rounds of mouse clicking. Every time she prescribes the basic painkiller for a female patient, whether that patient is 9 or 68 years old, the prescription is blocked by a pop-up alert warning her that it may be dangerous to give the drug to a pregnant woman. The physician, whose institution does not allow her to comment on the systems, must then override the warning with yet more clicks. “That’s just the tiniest tip of the iceberg,” she said.

What worries the doctor most is the ease with which diligent, well-meaning physicians can make serious medical errors. She noted that the average ER doc will make 4,000 mouse clicks over the course of a shift, and that the odds of doing anything 4,000 times without an error is small. “The interfaces are just so confusing and clunky,” she added. “They invite error … it’s not a negligence issue. This is a poor tool issue.”

Many of the EHR makers acknowledge physician burnout is real and say they’re doing what they can to lessen the burden and enhance user experience. Dr. Sam Butler, a pulmonary critical care specialist who started working at Epic in 2001, leads those efforts at the Wisconsin-based company. When doctors get more than 100 messages per week in their in-basket (akin to an email inbox), there’s a higher likelihood of burnout. Butler’s team has also analyzed doctors’ electronic notes — they’re twice as long as they were nine years ago, and three to four times as long as notes in the rest of the world. He said Epic uses such insights to improve the client experience. But coming up with fixes is difficult because doctors “have different viewpoints on everything,” he said. (KHN and Fortune made multiple requests to interview Epic CEO Judy Faulkner, but the company declined to make her available. In a trade interview in February, however, Faulkner said that EHRs were unfairly blamed for physician burnout and cited a study suggesting that there’s little correlation between burnout and EHR satisfaction. Executives at other vendors noted that they’re aware of usability issues and that they’re working on addressing them.)

“It’s not that we’re a bunch of Luddites who don’t know how to use technology,” said the Rhode Island ER doctor. “I have an iPhone and a computer and they work the way they’re supposed to work, and then we’re given these incredibly cumbersome and error-prone tools. This is something the government mandated. There really wasn’t the time to let the cream rise to the top; everyone had to jump in and pick something that worked and spend tens of millions of dollars on a system that is slowly killing us.”

$36 Billion And Change

The effort to digitize America’s health records got its biggest push in a very low moment: the financial crisis of 2008. In early December of that year, Obama, barely four weeks after his election, pitched an ambitious economic recovery plan. “We will make sure that every doctor’s office and hospital in this country is using cutting-edge technology and electronic medical records so that we can cut red tape, prevent medical mistakes and help save billions of dollars each year,” he said in a radio address.

The idea had already been a fashionable one in Washington. Former House Speaker Newt Gingrich was fond of saying it was easier to track a FedEx package than one’s medical records. Obama’s predecessor, President George W. Bush, had also pursued the idea of wiring up the country’s health system. He didn’t commit much money, but Bush did create an agency to do the job: the Office of the National Coordinator (ONC).

In the depths of recession, the EHR conceit looked like a shovel-ready project that only the paper lobby could hate. In February 2009, legislators passed the HITECH Act, which carved out a hefty chunk of the massive stimulus package for health information technology. The goal was not just to get hospitals and doctors to buy EHRs, but rather to get them using them in a way that would drive better care. So lawmakers devised a carrot-and-stick approach: Physicians would qualify for federal subsidies (a sum of up to nearly $64,000 over a period of years) only if they were “meaningful users” of a government-certified system. Vendors, for their part, had to develop systems that met the government’s requirements.

They didn’t have much time, though. The need to stimulate the economy, which meant getting providers to adopt EHRs quickly, “presented a tremendous conundrum,” said Farzad Mostashari, who joined the ONC as deputy director in 2009 and became its leader in 2011: The ideal — creating a useful, interoperable, nationwide records system — was “utterly infeasible to get to in a short time frame.”

That didn’t stop the federal planners from pursuing their grand ambitions. Everyone had big ideas for the EHRs. The FDA wanted the systems to track unique device identifiers for medical implants, the Centers for Disease Control and Prevention wanted them to support disease surveillance, CMS wanted them to include quality metrics and so on. “We had all the right ideas that were discussed and hashed out by the committee,” said Mostashari, “but they were all of the right ideas.”

Not everyone agreed, though, that they were the right ideas. Before long, “meaningful use” became pejorative shorthand to many for a burdensome government program — making doctors do things like check a box indicating a patient’s smoking status each and every visit.

The EHR vendor community, then a scrappy $2 billion industry, griped at the litany of requirements but stood to gain so much from the government’s $36 billion injection that it jumped in line. As Rusty Frantz, CEO of EHR vendor NextGen Healthcare, put it: “The industry was like, ‘I’ve got this check dangling in front of me, and I have to check these boxes to get there, and so I’m going to do that.’”

Halamka, who was an enthusiastic backer of the initiative in both the Bush and Obama administrations, blames the pressure for a speedy launch as much as the excessive wish list. “To go from a regulation to a highly usable product that is in the hands of doctors in 18 months, that’s too fast,” he said. “It’s like asking nine women to have a baby in a month.”

Several of those who worked on the project admit the rollout was not as easy or seamless as they’d anticipated, but they contend that was never the point. Aneesh Chopra, appointed by Obama in 2009 as the nation’s first chief technology officer, called the spending a “down payment” on a vision to fundamentally change American medicine — creating a digital infrastructure to support new ways to pay for health services based on their quality and outcomes.

Dr. Bob Kocher, a physician and star investor with venture capital firm Venrock, who served in the Obama administration from 2009 to 2011 as a health and economic policy adviser, not only defends the rollout then but also disputes the notion that the government initiative has been a failure at all. “EHRs have totally lived up to the hype and expectations,” he said, emphasizing that they also serve as a technology foundation to support innovation on everything from patients accessing their medical records on a smartphone to AI-driven medical sleuthing. Others note the systems’ value in aggregating medical data in ways that were never possible with paper — helping, for example, to figure out that contaminated water was poisoning children in Flint, Mich.

But Rusty Frantz heard a far different message about EHRs — and, more important, it was coming from his own customers.

The Stanford-trained engineer, who in 2015 became CEO of NextGen, a $500-million-a-year EHR heavyweight in the physician-office market, learned the hard way about how his product was being viewed. As he stood at the podium at his first meeting with thousands of NextGen customers at Las Vegas’ Mandalay Bay Resort, just four months after getting the job, he told KHN and Fortune, “People were lining up at the microphones to yell at us: ‘We weren’t delivering stable software! The executive team was inaccessible! The service experience was terrible!’ ” (He now refers to the event as “Festivus: the airing of the grievances.”)

Frantz had bounced around the health care industry for much of his career, and from the nearby perch of a medical device company, he watched the EHR incentive bonanza with a mix of envy and slack-jawed awe. “The industry was moving along in a natural Darwinist way, and then along came the stimulus,” said Frantz, who blames the government’s ham-handed approach to regulation. “The software got slammed in, and the software wasn’t implemented in a way that supported care,” he said. “It was installed in a way that supported stimulus. This company, we were complicit in it, too.”

Even that may be a generous description. KHN and Fortune found a trail of lawsuits against the company, stretching from White Sulphur Springs, Mont., to Neillsville, Wis. Mary Rutan Hospital in Bellefontaine, Ohio, sued NextGen (formerly called Quality Systems) in federal court in 2013, arguing that it experienced hundreds of problems with the “materially defective” software the company had installed in 2011.

A consultant hired by the hospital to evaluate the NextGen system, whose 60-page report was submitted to the court, identified “many functional defects” that he said rendered the software “unfit for its intended purpose.” Some patient information was not accurately recorded, which had the potential, the consultant wrote, “to create major patient care risk which could lead to, at a minimum, inconvenience, and at worst, malpractice or even death.” Glitches at Mary Rutan included incidents in which the software would apparently change a patient’s gender at random or lose a doctor’s observations after an exam, the consultant reported. The company, he found, sometimes took months to address issues: One IT ticket, which related to a physician’s notes inexplicably deleting themselves, reportedly took 10 months to resolve. (The consultant also noted that similar problems appeared to be occurring at as many as a dozen other hospitals that had installed NextGen software.)

The Ohio hospital, which paid more than $1.5 million for its EHR system, claimed breach of contract. NextGen responded that it disputed the claims made in the lawsuit and that the matter was resolved in 2015 “with no findings of fact by a court related to the allegations.” The hospital declined to comment.

At the time, as it has been since then, NextGen’s software was certified by the government as meeting the requirements of the stimulus program. By 2016, NextGen had more than 19,000 customers who had received federal subsidies.

NextGen was subpoenaed by the Department of Justice in December 2017, months after becoming the subject of a federal investigation led by the District of Vermont. Frantz tells KHN and Fortune that NextGen is cooperating with the investigation. “This company was not dishonest, but it was not effective four years ago,” he said. Frantz also emphasized that NextGen has “rapidly evolved” during his tenure, earning five industry awards since 2017, and that customers have “responded very positively.”

Glen Tullman, who until 2012 led Allscripts, another leading EHR vendor that benefited royally from the stimulus and that has been sued by numerous unhappy customers, admitted that the industry’s race to market took priority over all else.

“It was a big distraction. That was an unintended consequence of that,” Tullman said. “All the companies were saying, This is a one-time opportunity to expand our share, focus everything there, and then we’ll go back and fix it.” The Justice Department has opened a civil investigation into the company, Securities and Exchange Commission filings show. Allscripts said in an email that it cannot comment on an ongoing investigation, but that the civil investigations by the Department of Justice relate to businesses it acquired after the investigations were opened.

Much of the marketing mayhem occurred because federal officials imposed few controls over firms scrambling to cash in on the stimulus. It was a gold rush — and any system, it seemed, could be marketed as “federally approved.” Doctors could shop for bargain-price software packages at Costco and Walmart’s Sam’s Club — where eClinicalWorks sold a “turnkey” system for $11,925 — and cash in on the government’s adoption incentives.

The top-shelf vendors in 2009 crisscrossed the country on a “stimulus tour” like rock groups, gigging at some 30 cities, where they offered doctors who showed up to hear the pitch “a customized analysis” of how much money they could earn off the government incentives. Following the same playbook used by pharmaceutical companies, EHR sellers courted doctors at fancy dinners in ritzy hotels. One enterprising software firm advertised a “cash for clunkers” deal that paid $3,000 to doctors willing to trade in their current records system for a new one. Athenahealth held “invitation only” dinners at luxury hotels to advise doctors, among other things, how to use the stimulus to get paid more and capture available incentives. Allscripts offered a no-money-down purchase plan to help doctors “maximize the return on your EHR investment.” (An Athena­health spokesperson said the company’s “dinners were educational in nature and aimed at helping physicians navigate the government program.” Allscripts did not respond directly to questions about its marketing practices, but said it “is proud of the software and services [it provides] to hundreds of thousands of caregivers across the globe.”)

EHRs were supposed to reduce health care costs, at least in part by preventing duplicative tests. But as the federal government opened the stimulus tap, many raised doubts about the promised savings. Advocates bandied about a figure of $80 billion in cost savings even as congressional auditors were debunking it. While the jury’s still out, there’s growing suspicion the digital revolution may potentially raise health care costs by encouraging overbilling and new strains of fraud and abuse.

In September 2012, following press reports suggesting that some doctors and hospitals were using the new technology to improperly boost their fees, a practice known as “upcoding,” then-Health and Human Services chief Kathleen Sebelius and Attorney General Eric Holder warned the industry not to try to “game the system.”

There’s also growing evidence that some doctors and health systems may have overstated their use of the new technology to secure stimulus funds, a potentially enormous fraud against Medicare and Medicaid that likely will take many years to unravel. In June 2017, the HHS inspector general estimated that Medicare officials made more than $729 million in subsidy payments to hospitals and doctors that didn’t deserve them.

Individual states, which administer the Medicaid portion of the program, haven’t fared much better. Audits have uncovered overpayments in 14 of 17 state programs reviewed, totaling more than $66 million, according to inspector general reports.

Last month, Sen. Chuck Grassley, an Iowa Republican who chairs the Senate Finance Committee, sharply criticized CMS for recovering only a tiny fraction of these bogus payments, or what he termed a “spit in the ocean.”

EHR vendors have also been accused of egregious and patient-endangering acts of fraud as they raced to cash in on the stimulus money grab. In addition to the U.S. government’s $155 million False Claims Act settlement with eClinicalWorks noted above, the federal government has reached a second settlement over similar charges against another large vendor, Tampa-based Greenway Health. In February, that company settled with the government for just over $57 million without denying or admitting wrongdoing. “These are cases of corporate greed, companies that prioritized profits over everything else,” said Christina Nolan, the U.S. attorney for the District of Vermont, whose office led the cases. (In a response, Greenway Health did not address the charges or the settlement but said it was “committing itself to being the standard-bearer for quality, compliance, and transparency.”)

Tower Of Babel

In early 2017, Seema Verma, then the country’s newly appointed CMS administrator, went on a listening tour. She visited doctors around the country, at big urban practices and tiny rural clinics, and from those front-line physicians she consistently heard one thing: They hated their electronic health records. “Physician burnout is real,” she told KHN and Fortune. The doctors spoke of the difficulty in getting information from other systems and providers, and they complained about the government’s reporting requirements, which they perceived as burdensome and not meaningful.

What she heard then became suddenly personal one summer day in 2017, when her husband, himself a physician, collapsed in the airport on his way home to Indianapolis after a family vacation. For a frantic few hours, the CMS administrator fielded phone calls from first responders and physicians — Did she know his medical history? Did she have information that could save his life? — and made calls to his doctors in Indiana, scrambling to piece together his record, which should have been there in one piece. Her husband survived the episode, but it laid bare the dysfunction and danger inherent in the existing health information ecosystem.

The notion that one EHR should talk to another was a key part of the original vision for the HITECH Act, with the government calling for systems to be eventually interoperable.

What the framers of that vision didn’t count on were the business incentives working against it. A free exchange of information means that patients can be treated anywhere. And though they may not admit it, many health providers are loath to lose their patients to a competing doctor’s office or hospital. There’s a term for that lost revenue: “leakage.” And keeping a tight hold on patients’ medical records is one way to prevent it.

There’s a ton of proprietary value in that data, said Blumenthal, who now heads the Commonwealth Fund, a philanthropy that does health research. Asking hospitals to give it up is “like asking Amazon to share their data with Walmart,” he said.

Blumenthal acknowledged that he failed to grasp these perverse business dynamics and foresee what a challenge getting the systems to talk to one another would be. He added that forcing interoperability goals early on, when 90 percent of the nation’s providers still didn’t have systems or data to exchange, seemed unrealistic. “We had an expression: They had to operate before they could interoperate,” he said.

In the absence of true incentives for systems to communicate, the industry limped along; some providers wired up directly to other select providers or through regional exchanges, but the efforts were spotty. A Cerner-backed interoperability network called CommonWell formed in 2013, but some companies, including dominant Epic, didn’t join. (“Initially, Epic was neither invited nor allowed to join,” said Sumit Rana, senior vice president of R&D at Epic. Jitin Asnaani, executive director of CommonWell countered, “We made repeated invitations to every major EHR … and numerous public and private invitations to Epic.”)

Epic then supported a separate effort to do much the same.

Last spring, Verma attempted to kick-start the sharing effort and later pledged a war on “information blocking,” threatening penalties for bad actors. She has promised to reduce the documentation burden on physicians and end the gag clauses that protect the EHR industry. Regarding the first effort at least, “there was consensus that this needed to happen and that it would take the government to push this forward,” she said. In one sign of progress last summer, the dueling sharing initiatives of Epic and Cerner, the two largest players in the industry, began to share with each other — though the effort is fledgling.

When it comes to patients, though, the real sharing too often stops. Despite federal requirements that providers give patients their medical records in a timely fashion, in their chosen format and at low cost (the government recommends a flat fee of $6.50 or less), patients struggle mightily to get them. A 2017 study by researchers at Yale found that of America’s 83 top-rated hospitals, only 53 percent offer forms that provide patients with the option to receive their entire medical record. Fewer than half would share records via email. One hospital charged more than $500 to release them.

Sometimes the mere effort to access records leads to court. Jennifer De Angelis, a Tulsa attorney, has frequently sparred with hospitals over releasing her clients’ records. She said they either attempt to charge huge sums for them or force her to obtain a court order before releasing them. De Angelis added that she sometimes suspects the records have been overwritten to cover up medical mistakes.

Consider the case of 5-year-old Uriah R. Roach, who fractured and cut his finger on Oct. 2, 2014, when it was accidentally slammed in a door at school. Five days later, an operation to repair the damage went awry, and he suffered permanent brain damage, apparently owing to an anesthesia problem. The Epic electronic medical file had been accessed more than 76,000 times during the 22 days the boy was in the hospital, and a lawsuit brought by his parents contended that numerous entries had been “corrected, altered, modified and possibly deleted after an unexpected outcome during the induction of anesthesia.” The hospital denied wrongdoing. The case settled in November 2016, and the terms are confidential.

More than a dozen other attorneys interviewed cited similar problems, especially with gaining access to computerized “audit trails.” In several cases, court records show, government lawyers resisted turning over electronic files from federally run hospitals. That happened to Russell Uselton, an Oklahoma lawyer who represented a pregnant teen admitted to the Choctaw Nation Health Care Center in Talihina, Okla. Shelby Carshall, 18, was more than 40 weeks pregnant at the time. Doctors failed to perform a cesarean section, and her baby was born brain-damaged as a result, she alleged in a lawsuit filed in 2017 against the U.S. government. The baby began having seizures at 10 hours old and will “likely never walk, talk, eat, or otherwise live normally,” according to pleadings in the suit. Though the federal government requires hospitals to produce electronic health records to patients and their families, Uselton had to obtain a court order to get the baby’s complete medical files. Government lawyers denied any negligence in the case, which is pending.

“They try to hide anything from you that they can hide from you,” said Uselton. “They make it extremely difficult to get records, so expensive and hard that most lawyers can’t take it on,” he said.

Nor, it seems, can high-ranking federal officials. When Seema Verma’s husband was discharged from the hospital after his summer health scare, he was handed a few papers and a CD-ROM containing some medical images — but missing key tests and monitoring data. Said Verma, “We left that hospital and we still don’t have his information today.” That was nearly two years ago.

By Fred Schulte and Erika Fry, Fortune

The Other Woman

Have you ever walked into a church meeting and thought to yourself: ” Wow, Susan looks beautiful….maybe I should buy the same make-up?”
Or why did John choose her as his wife, she looks so ordinary?
Or did you hear a woman preach and thought – why can’t I preach like her?

I will be the first to acknowledge guilt. Often times I struggle to except the reality of who I am. Even though it starts a cycle of criticism in my life, I often struggle to get rid of discontentment thoughts flashing red in my mind, leaving me powerless against the force of negativity that tries to steal my peace in Christ.

The other woman has been a topic of controversy from the beginning of time. Eve could not compete, and decided to give in to the devaluing thoughts that the snake so eagerly dished up for her on a fruit platter. She just couldn’t believe that she was good enough. Since the garden of Eden Satan has used his deception and lies to make women feel less than they ought to be, and the way he does it is very effective.

The other woman has become the measuring stick by which we judge everything we do and everything we are – and if we don’t live up to these impossible standards of perfection, we feel bad. When we feel bad, we start a new diet, enrol for a new course or go for a make-over – anything to help us feel less uncomfortable next to the other woman.

We can never just feel GOOD about ourselves, because there’s always something wrong or out of place. No matter how much we achieve, there is always room for improvement.

Dear woman of God, when did we start believing we are not good enough? Men celebrate us, yet I still meet married women who can’t receive love because they have stretch marks and would rather like to keep the light switched off. There are photos of women everywhere, billboards and advertisements – even the world is captivated by us – yet we still lack confidence.

When did we start discerning women according to the flesh and not the spirit? When did our friends become the other woman?

As women of faith we should not allow our thoughts to be infiltrated with the filth of comparison and idealism. We are not called to think of ourselves as victims, but victorious and righteous in Christ. We are saved to reign over the spirit of comparison and not be distracted by the devil’s devices to cause disunity in the church. Our focus should be to pray, bless, embrace and love ourselves and our friends. We are empowered to not let the other woman steal our intimacy with Jesus. Discontentment does not come from the Father, but from the enemy who is trying to rob us of our identity in Christ.

Through Jesus we are no longer under the curse of Eve, where we can’t help but to eat the fruit of deception. We don’t have to continuously feel as we have to become wiser or more beautiful, and we don’t have to allow the snake to entice us with the same lie he imprisoned Eve with: Did God really say… are good enough? This lie is the first of many, and not welcome in a household of faith. God redeemed us from wanting and longing. He satisfies our mouth with good things, and He covers us with His love and acceptance. Nothing can separate us from His love – not even the other woman.

Lets trample on the snake – crush his head, and live in the victory, love and acceptance of Jesus Christ, with no other woman dictating our thought life and no other agenda except to love ourselves and others.

Ps 139:13-18 (Amp)

For You did form my inward parts; You did knit me together in my mother’s womb.
I will confess and praise You for You are fearful and wonderful and for the awful wonder of my birth! Wonderful are Your works, and that my inner self knows right well.
My frame was not hidden from You when I was being formed in secret [and] intricately and curiously wrought [as if embroidered with various colors] in the depths of the earth [a region of darkness and mystery].
Your eyes saw my unformed substance, and in Your book all the days [of my life] were written before ever they took shape, when as yet there was none of them.
How precious and weighty also are Your thoughts to me, O God! How vast is the sum of them!
If I could count them, they would be more in number than the sand.

Laetitia is a writer, wife, business woman and teacher, exploring truths about the gospel through real-life experiences, always pointing to the goodness and grace of God. Her passion is to help others be crowned with the wisdom of God’s glory, especially women.

Abstinence is a Good Thing

Christina Sizemore is a real life example of how abstinence can work and how it is a good thing. At the age of 14 through the prompting of her church, her youth group, her family, and a commitment through Teen Mania, Christina made a commitment to herself and to God to abstain from sex until marriage. She was able to keep this commitment through junior high, high school, college, and even through a marriage engagement that was called off.

Christina is now married to a wonderful man, who honored that commitment with her. She shares her testimony, “There are guys that have that same commitment, but just because you have that same commitment doesn’t mean it is easy.” She admits that being in a relationship with someone that has that same commitment helps, because it makes it easier in times when you are weak.

“There are times when it is not easy,” and just saying, “I won’t put myself in that position,” doesn’t always work. Christina suggests that having this commitment in your heart, prayer, and other things besides just ‘not putting yourself into the place’ is what she has used to help her through the abstinence years. She assures all, “Waiting is worth it.”

Abstinence can become a commitment even if you have had sex. One of Chris’ friend’s husbands told his wife, “Had I known you were going to be my wife, I would have waited for you.” The gift of sex is a wonderful gift to give your husband or wife. The idea that your future husband or wife is very special, sharing this specialness by waiting can help you when you are trying to abstain.

It is easy to say, “But we are getting married,” and try to justify premarital sex, but Christina explains her situation. “I was engaged to another man, I had a dress, I had a venue, we were going through marriage counseling when I called off the wedding. That happens to real people. I didn’t sleep with him and I am glad I didn’t because he was not my husband. It doesn’t matter if you are engaged or planning on getting married,” Chris states, “You are not married until you are married. My virginity is something that I am giving up to someone who does not deserve it, if they are not my husband.”

Christina’s mom, Bridgette Mongeon encouraged and expected the commitment from Christina. When she would tell others what her daughter was trying to do many, many people thought the idea was ludicrous. One person said that they believed they their son you should “try on the shoe.” “I was livid,” states Bridgette. “My daughter is not a shoe. She is an incredible, precious woman. It bothered me even more that this was a woman who was the mother of a boy my daughter was dating. What values had she instilled in her son?”

Boundaries can’t be pushed. Each time you let down one boundary you get closer to what you don’t want to do. And Chris says there were people she was accountable to, and people who were praying for them as a couple. “I’m not sure they were praying ‘don’t let them have sex,’ but I know people were praying for us.” Bridgette assures her daughter, “Yes, we were praying don’t let them have sex, sometimes when I knew you were alone, I would pray that you would feel uncomfortable, or I would pray one would be strong when the other was weak.” She also let her daughter’s betrothed know what her expectations were of him. “There was no mincing words, they knew what I expected of her, they were sure to know that I understood her commitment and that if the betrothed respected their relationship, and a future relationship, he would respect that commitment as well.”

As a couple there were times when one person would have to be strong when the other was tempted or weak. “That is why it is important to have someone who has made that same commitment,” states Christina. When you have someone who is just waiting because you are waiting, they figure maybe you have changed your mind, and then they don’t help you through your weakness.” Helping with your partners abstinence is a loving and honoring thing to do for one another, it demonstrates character. She does state, “There is an end to the wait. If you wait until after you are married, you can have all of the sex you want. It is worth the wait.”

But people don’t believe that she had not had sex. It is not a common thing and she had to try to convince some people who have asked.

Bridgette states, “We are numb to it, premarital sex is expected and it is accepted.” But she suggests that parents change their minds, gain some courage, and tell their children, “I expect you not to have sex.” Give them something to live up to. Be open about the topic of sex, let them talk about it and encourage open communication, but let them know what you expect of them.

Christina agrees that having parents that are open to talk about sex is imperative. “Don’t let it be an uncomfortable experience. Talk about the biology, your own experiences, and it is important for kids to know it is important to talk about it.” She also assures us that 14 was not too young to discuss such things. Some kids are having sex as young as in the 6th grade.

It is our biological nature to want to reproduce. It is almost unnatural for us to not have sex, and kids need to know that. But Bridgette suggests that dating couples should also discuss their feelings that go with abstinence. A man may feel like he is less of a man, if he does not pursue sex, a women may wake up one morning and feel like she is less desirable. There is a psychological assurance that must go along with abstinence. Communication will help to make it easier.

What if you are having sex in a relationship and decide that is not how you want the relationship to continue? Christina suggests accountability and if your partner is not willing to hear what your heart’s desire is for abstinence, perhaps you should think twice about staying with that person. They might just not be the one for you. The commitment has to be between the two of you with God. An individual commitment as well as one made together. Abstinence is not easy, but it is also not impossible, and it can make a relationship stronger. In Chris’ opinion, “It is so worth it.”

by Bridgette Mongeon  

What we’ve learned from working at home

The recent transition to widespread working from home has shown that the experience has been both educational and eye-opening for many. Working at home means learning to cope with distractions, space constraints, managing time with family and learning new skills. And, according to new consumer research, it has also meant reassessing what is most important.

A nationwide survey conducted by Wakefield Research on behalf of LG Electronics reveals the many ways working from home has challenged and surprised Americans.

Connecting with loved ones

The most striking survey results show the importance of close relationships. Social distancing has caused many to reassess who is most important to them, and how much they may have taken friends and family for granted.

The global health crisis has turned socializing into a more deliberate act. More than half (53%) of homebound people said they felt closer to loved ones than before the outbreak, and 27% even said that they felt much more connected than before.

When asked what they want to do first when the crisis is over, the top answer was to visit loved ones, followed by going out to a meal.

Managing work-life balance

For many people, juggling priorities and obligations was difficult even before the switch to remote working. But having to work at home has shined a brighter spotlight on how we cope and find a healthy work-life balance.

Here are some of the tricks people have discovered:

  • Half said they take frequent short breaks to balance work and home responsibilities.
  • 37% are starting work earlier, while 17% are starting work later to manage schedules better.
  • 35% are learning to keep their whole household to a schedule.
  • 23% use visual cues (like signs) to let others know when they’re working.

Mastering technological challenges

Most people affected by the crisis say they have had to master (or learn from scratch) how to complete their work entirely from home, including the new norm of conducting video conferences from somewhere in their home.

Technology has been crucial to this adaptation. Almost half (47%) have discovered a new app or service they say they now can’t live without — especially video chat apps that have helped them learn how to communicate better with colleagues and loved ones.

As one might expect, a majority of respondents admitted to making conference calls from a common area in their house. However, some said they were stuck calling from a makeshift workspace in a lesser-used part of home. One-fifth of respondents admitted to calling from a basement or attic, while others said they took work on the go. The research shows 18% have called from their cars, and perhaps most surprisingly, 12% admit taking work calls in the bathroom.

For many, the time they’ve spent working at home has helped them appreciate how successfully technology has kept them connected on all fronts, including their work and personal lives.

Reevaluating life’s priorities

Overall, the experience of working from home has had everyone reassessing what — and who — is most important to them. Among those who said they’ve discovered new apps, digital services or technology, many said that they were spending significant time using it for family or relationship management.

An overwhelming number of survey respondents said that they plan to continue at least one of their new practices even after returning to a “normal” work situation, including:

  • 39% plan to do more cooking.
  • 43% said they’re likely to arrange more family dinners.
  • 39% also said they would do more video chatting.

As a result of spending some more time at home, many have been rethinking their priorities, with nearly half considering buying or using fewer things. Some (16%) have thought about beginning a new career, and others are considering starting their own business (14%).

No matter what your work-from-home experience has been, chances are it’s changed your attitudes about work and family life — and how to balance the two — in ways that will stay with you long into the future.

The LG WFH Survey was conducted by Wakefield Research among 1,000 U.S. adults, working from home due to COVID-19, between April 10 and April 15, 2020, using an email invitation and an online survey.

Now’s the Time to Teach At-Home Nutrition

(Family Features) With a lot of parents facing the challenge of keeping housebound kids happy and healthy, this is the perfect time to teach kids the basics of nutrition and eating right.

Consider these simple suggestions from Melanie Marcus, MA, RD, health and nutrition communications manager for Dole Food Company.

  • Healthy Snack Time Taste Tests – Sometimes it feels like kids can snack all day long on easy-to-grab crackers, chips or cookies. Next time they reach into the snack pantry, try incorporating a taste test or food critic activity to encourage something different and more nutritious.
  • Purposeful Playtime – Many households have a play kitchen or some kind of play food. Use this as an opportunity to act out how to create a healthy kitchen with activities like making salad, setting the table, peeling bananas and washing dishes. This can help young children become more independent, learn what to expect and grow into little helpers at family mealtime.
  • Sensory Activity – One idea that can work for school and at home is making a sensory box. Simply place a fruit or two inside a tissue box and have children put their hands inside then try to guess which fruit it is by feeling it.
  • Recipes for Fun – If you’re preparing a meal, it could be a good time to teach children of reading age how to review a recipe. Evaluating ingredients to learn how food transforms from raw to cooked or how a dish is created can help kids learn kitchen skills. For example, try this fun, fruity recipe for Kids with Almond Toast.
  • Food Groups Focus – Get kids involved in making dinner by setting a rule that each food group must be represented. Give them a warmup activity by asking which food groups are found in family favorites like chicken soup, lasagna or meatloaf. Asking kids to guess which ingredients are used in these dishes and identifying which food group each ingredient belongs to can help them understand dietary balance. Find more at-home tips in the free, downloadable Healthy Eating Toolkit from the nonprofit organization Action for Healthy Kids.
  • Reading Time – From food labels to children’s books to cookbooks, there are plenty of reading materials to choose from that reinforce healthy eating habits. Exposing children to fruits and vegetables outside the kitchen is a subtle way to show that nutritious ingredients are part of everyday life.
  • Explain the Bathroom Routine – Make sure to wash hands and explain that this is a way of washing away germs to stay healthy. Also explain why brushing teeth is important by reminding children that food can get stuck in teeth and cause cavities.

Find more kid-friendly recipe ideas at plus nutritional tips, free printables and other healthy fun on Facebook, Pinterest, Twitter and Instagram.

“Kids” with Almond Toast
Total time: 10 minutes
Servings: 4

4 slices whole-grain bread
6 tablespoons unsalted almond butter
2 teaspoons honey (optional)
1 DOLE(r) Banana, peeled
2 Dole Strawberries, trimmed and halved
4 chunks (1 1/2 inches) fresh Dole Tropical Gold Pineapple
2 Dole Blackberries
2 teaspoons toasted flaxseed (optional)

Toast bread slices. Spread with almond butter and drizzle with honey, if desired.

To make “kids”: Cut eight slices and 32 matchsticks from banana. Arrange one strawberry half and one pineapple chunk on two slices toast; arrange remaining strawberry halves and blackberries on remaining slices. Place one banana slice “head” at top of each piece of fruit and arrange four banana matchsticks around each “kid” for arms and legs. Sprinkle flaxseed along bottom edges of toast under kids’ feet, if desired.

Photo courtesy of Getty Images (mother and daughter)

The Dream (a true story about demons,drugs and the spirit of offense)

One night a lady from our church had a dream, in the dream she saw an evil spirit cowering in a corner. He was actually trembling with fear as he looked at her.

While looking at her, another evil spirit appeared, he was much larger and more sinister than the other.

With heated anger and rage, the larger spirit yelled, “Why did you let her go? Why did you let her go?” They began to talk to each other and she awakened from the dream.

The larger spirit was angry because after many years of crack cocaine addiction, she was finally free and attending church.

Deliverance from drugs was just the beginning of all the great things God would do for her. Within six months she was married and lived in a beautiful home.

But these blessings were short lived.

Shortly after getting married, she became offended by a statement someone made at church. The statement really bothered her so she stopped attending church. She also stopped associating with church members, including her own family members.

Her life began spinning out of control. She filed for divorce and started using drugs AGAIN.

She spent time in jail and after getting out of jail, she moved to another state and there learned she had throat cancer.

Remember before she awakened the demons were talking. They were creating a plan to get her back. One of the main tools evil spirits use against believers is “offense”.

When we become offended we stop talking and spending time with other people. There is safety in unity and communion with other believers as the spirit of God resides in ALL believers. It is His Presence in us that causes demons to flee. It is His divine counsel and wisdom that defeats Satan’s evil plans and strategies.

Evil spirits recognized the spirit of God in Jesus Christ the Son of Man.

Evil spirits also recognized and obeyed the disciples. This made the disciples happy but Jesus told them not to be happy because evil spirits obeyed them but to be happy their names were written in heaven. (Luke 10:20)

Evil spirits recognized genuine apostles and fake apostles. They obeyed genuine apostles but caused physical harm to the phony apostles. (Acts 19:13-16)

Remember when Abraham and a small army rescued Lot after he was captured by an army led by four kings. (Genesis 14:1-16)

We can rescue our brothers and sisters from the hands of the enemy with prayer.

If we need to be rescued from the hands of the enemy we can’t remain estranged from other Christians.

Remember, Joshua 23:10  One man of you shall chase a thousand: for the LORD your God, he it is that fighteth for you, as he hath promised you. 

Come Out Of That Mental Prison

Jesse did not think he was much of a speaker. He stuttered a lot since he was a child, especially when he was nervous. This was something he was conscious of and felt embarrassed about. But he could not say opportunity. Two weeks ago he was invited to share something positive with inmates  at the prison where he served a twelve year sentence.

Jesse whispered a silent prayer asking God for his help as he alighted his vehicle.  He became very emotional as he entered the prison gate.  After security checks, he was escorted to a room with prison guards and inmates. He  greeted the guards and chatted briefly  with  some of his former inmates .

The moment came, it was Jesse’s turn to speak. He began his presentation nervously; afraid to make eye contact, head down reading from his notes. He told of a conversation he had five years ago with an elderly lady. This woman was a regular visitor to the prison, but he only agreed to speak with her a few days before he was released.

He recounted that at first he told her he was not into the religious mumbo jumbo stuff. However, what she shared with him gave him more than a glimmer of hope, even though at that time he acted as though her words had no affect on him. 

As Jesse continued he became more relaxed and confident. He took his eyes from his notes, lifted his head, looked to his attentive audience  and spoke from his heart.

This is what Jesse said, “I want to say to you the same thing this elderly woman said to me. My friends, do not live in two prisons. In other words you are already in a physical prison, but you do not have to live also in a mental prison.

A mental prison where you allow your past mistakes to keep you bound. Perhaps not all of you are in a mental prison. But to the ones who are, I want to encourage you to step out of that mental prison. Today if you have limited yourself I challenge and encourage to set a goal, be the best you can be.  

Friends make use of the resources available to improve your lives. Step out of that mental prison; go finish that high school diploma, go ahead get the degree, go polish your talents and abilities, write that poem, that song, play that instrument, sing, and dance. Each one of you have a God- given talent. Go on learn something new. Go write that person who you need to apologize to, the one you hurt. Do not be afraid of rejection. Go ahead feel remorse it does not make you a weak person. 

Go on reach out to your son, your daughter. Go on forgive your father, your mother, that person who hurt you, yes the one who abandoned you, the one you took the fall for ,who has never visited you, those who lied on you, yes the one who abused you. Forgive them.  

Forgive yourself. Go ahead love yourself. Stop feeling guilty about loving yourself. Stop punishing yourself. Take care of yourself,  pay attention to your health, ask to see the prison doctor. Inspite of what you have done. You have a purpose. You have potential. You can still make a positive contribution right here; starting in the lives of each other.

Friends, I use to think very little of myself. I  thought I would never be able to speak in front of an audience. I thought I would never be able to move pass the fact that I committed a crime. Here I am! I came out of that mental prison.

Join me! Yes I have struggled, but I found a friend in the Lord Jesus Christ. This same Jesus who said I do not condemn you, go and sin no more to the woman caught in adultery. This woman was brought to Jesus by her accusers. They wanted him to pronounce judgment upon her, but Jesus showed her mercy. Jesus is saying to you that he does not condemn you even if the accusations made against you are true.

Jesus offers you forgiveness because he died for your sins and mine. He offers you the gift of salvation (deliverance) so that sin and sinful desires will no longer dominate you. My Friends, you can  experience mental and spiritual freedom in this physical prison.”

Jesse ended by saying, “Friends, I encourage you to reach out to Jesus. He is reaching out to you… Jesus loves you and he cares about you.” 

 By Tesse Wilson  

All good gifts come from the Lord. Tesse is happy to be gifted by the Lord to write. It is her prayer that her writings will bless, encourage and inspire others. Thank God for his Spirit who gives inspiration and his grace which enables her. 

Article Source:

Cold Eggs Never Killed Anyone

I have taken on this season of being a stay at home mom and wife with a sense of purpose … I really do believe that this is exactly where God wants me right now.

So in that spirit , I have obeyed God with a small but never the less a calling to get up early and make my family a hot breakfast and read from the book “Jesus Calling” … I know it may not seem like a big thing but when my bed is all nice and cozy and with fall rolling in and it staying darker longer … being the first one out of bed when I don’t have a time card to punch … really does take a bit of a push … I’m not bleeding or agonizing or in any sort of pain … but it is an effort on my part.

So with this “gift” that I am giving to my family I guess I sort of imagined everyone would come running downstairs as soon as they could to get their hot breakfast I labored over and just gloat about what a wonderful wife and mother I am.

So when I noticed my husband and then my son started coming down later and later each day and it started getting to be a routine that I was serving them cold eggs … it started to get a little under my skin. Not in a big way but just in that little annoying voice that says ” it does not even matter what you do … serving them breakfast is not really any big deal ” .

So I decided to say something … but not really in a direct way but kind of a read-through-the-lines type of way … like “well you must like eating cold eggs because it seems you are just getting later and later every morning.”

Well , my timing sucked. Because for whatever ingenious reasoning I had I decided to say this the morning of my husbands birthday. Now , I did not rant or rave or make a hissy … but you know it was just the “tone” and very soon after I realized I set the tone for the day … on my husband’s birthday.

My husband is not perfect by any means, nor am I , but I can tell you one thing … he is a great man who I am proud of. He tells me I am beautiful , he supports all my decisions , he works hard , he is a dedicated and responsible man and father … I am blessed to have him.

Did I feel a little erked he did not skip down the stairs to eat my hot breakfast singing my praises … well , yes. But luckily , I have a God who allowed me to see how silly and pretty darn critical I was being … so I get up early and I make breakfast … I will continue to do so and I won’t do it for any reason other than it is my small way of giving back to God and to my family. If the eggs are cold when they come down … they will get the picture and realize if they want a hot breakfast they better come down earlier . After all , no one ever died over cold eggs and in the big scheme of things it really does not matter.

We have the power to speak life into others … I am reminded to chose my words and refrain my tongue when it does not serve a higher purpose … I certainly can not do this on my own ability but pressing into God I can. It is a small thing, I know … but the small things all really add up to big things and make our life what it is. I want to , I desire to make those small moments matter … after all my words will have more impact on my family than my eggs.

My family and I recently moved across the US from NV to CT.  This has brought about great change in our lives as well as in my own personal walk with God. I have re-discovered an old love of mine in this process - writing. I appreciate your feedback. Thanks for reading.

Article Source:

Sound financial tips during COVID-19 uncertainty

(BPT) – The current COVID-19 financial landscape is unpredictable, causing anxiety for people of all ages. With layoffs, unexpected medical expenses, and an ever-changing and uncertain economy, it’s easy to worry.

“Now more than ever is the time to take an active approach with your finances to position yourself for success,” says Danielle Seurkamp, CFP. “Knowledge is power during unpredictable times.”

Andy Mardock, CFP, agrees. “Emotions are running high with coronavirus concerns. Being informed helps you resist gut reactions driven by emotion so you don’t make a move you later regret.”

Both Seurkamp and Mardock are members of the National Association of Personal Financial Advisors (NAPFA), an association of fee-only financial advisors who adhere to a fiduciary standard. Together they offer important financial tips to empower you to make wise financial decisions today and in the future:

Budget and be proactive

Create a budget and identify which bills are locked-in and which are discretionary. Then decide what can and can’t be cut. For those who have lost significant income, contact providers as soon as possible to explore options.

“Many companies are waiving late fees, establishing payment plans or deferring payments,” says Mardock. Foreclosures and evictions have been suspended in many cases. Contact your financial institution for relief on mortgages and other loans in the form of payment deferrals or forbearance to ease the pressure. For business owners, review the rules of CARES Act loans as well as the requirements for loan forgiveness to ensure you’re taking care of both your employees and your company.

Manage medical costs

Medical costs including over-the-counter drugs and menstrual care items are now considered a deductible medical expense. Seurkamp says you should consider using money in your flexible spending account on these items to reduce the burden on your monthly income. COBRA insurance premiums can also be paid using money in an HSA.

Get your stimulus check

“If you haven’t filed a tax return for 2018 or 2019, file one as soon as possible to qualify for a stimulus check provided by the federal government as part of the CARES Act,” says Seurkamp. “If your 2019 income was lower than 2018 or you added a child to your family last year, file your 2019 return now to potentially qualify for a higher stimulus check.”

Access emergency funds

If needed, use emergency cash or sell bonds to fund your living expenses. Now is also a good time to use low-interest debt like a home equity line of credit for cash needs if necessary.

“Try to avoid selling stock to create cash right now since values are down,” advises Mardock.

Use retirement savings cautiously

The CARES Act stimulus package makes it easier to dip into retirement savings to fund short-term living expenses. The 10% penalty on early IRA distributions has been suspended for up to $100,000 of COVID-related withdrawals. The amount that can be borrowed from a 401(k) has been doubled from $50,000 to $100,000 and the repayment terms have been relaxed.

“You can use these resources to cover essential expenses but resist the urge to use retirement savings for discretionary spending,” says Seurkamp. “Remember, you will either have to pay back what you borrowed or eventually pay tax on the withdrawals. Furthermore, to create cash in a 401(k) to withdraw, you will almost inevitably have to sell stocks when values are depressed, locking in losses.”

Limit media time

It’s important to be informed, but easy to become fatigued by watching negative financial news over and over. Once you’re informed, turn off the financial news, suggests Mardock. It will always be there when you come back. Moments to recharge and refocus are a necessary component of making smart financial decisions.

Consider virtual guidance

“If you’re feeling overwhelmed or have questions, set up a virtual meeting with a financial advisor,” says Seurkamp. “There are a variety of fee models for financial planning, including hourly, project-based and subscription offerings.” Most advisory fees are based on the complexity of the client’s financial situation, which alleviates issues around affordability.

In addition, as part of the group’s community response, some members of NAPFA are offering pro-bono assistance to those whose incomes are in jeopardy. This includes access to basic information about unemployment, tax waivers, lender moratoriums and more.

Even one hour with a financial advisor can help bring you peace of mind and some tangible next steps.

Visit for more consumer tips and resources.

7 Facts to Know About God

He Frustrates the Plans of Those Against Him:

 The LORD bringeth the counsel of the heathen to nought: he maketh the devices of the people of none effect.(Psalm 33:10)

He Creates with Spoken Words:

 As soon as he spoke the world was created; at his command, the earth was formed. (Psalm 33:9)

 And God said, Let there be light: and there was light.(Genesis 1:3)

He is Faithful:

God is faithful, who has called you into fellowship with his Son, Jesus Christ our Lord.(1 Corinthians 1:9)

He is Not the Author of Confusion:

 For God is not the author of confusion, but of peace, as in all churches of the saints.(1Corinthians 14:33)

He is Longsuffering:

The Lord is not slack concerning his promise, as some men count slackness; but is longsuffering to us-ward, not willing that any should perish, but that all should come to repentance.(2Peter 3:9)  

He is Holy:

But as he which hath called you is holy, so be ye holy in all manner of conversation;(1Peter 1:15)

Because it is written, Be ye holy; for I am holy.(1Peter 1:16)

He is Merciful:

The LORD is merciful and gracious, slow to anger, and plenteous in mercy.(Psalm 103:8) 

He Loves the World and Everyone in It:

For God so loved the world, that he gave his only begotten Son, that whosoever believeth in him should not perish, but have everlasting life.(John 3:16) 

 For God sent not his Son into the world to condemn the world; but that the world through him might be saved. (John 3:17 )

Your Kids Carry Seeds Of Greatness; Do Not Give Up On Them by Daniel Dela Dunoo

In my relatively short life, I have observed a couple of young men and women who were once my school mates; many struggled through school. Some were downright academically poor where as others made consistently poor grades because they were simply not serious with their academics; they seemed a hopeless bunch. A couple of years down the line, I am more than impressed by what they have made of their lives. I look at their lives now but see no correlation between what they once were and what they are now. As a matter of fact, it will seem as though such individuals have always been smart, intelligent, serious minded and purpose driven.

When the names of some of the world`s great achievers are mentioned, many assume these persons were actually geniuses from childhood. Many think such individuals had very bright and promising beginnings. And yes, some obviously had great beginnings. However, there are also scores of famous and well accomplished personalities who were once considered unintelligent. For some, authority figures in their sphere of contact who should have known better actually thought they were hopeless to such an extent that it will be impossible for them to amount to anything in life. In this piece I have opted to briefly share the remarkable stories of six of such individuals. It is hoped that kids, parents, teachers and society at large will find these stories inspiring, thought-provoking and instructive.

Albert Einstein: A world-renowned scientist, theoretical physicist and the 1921 Nobel Prize winner for Physics. Reliable records reveal that as a boy Einstein`s grades were so poor that a teacher asked him to quit, saying, “Einstein, you will never amount to anything.”

Ludwig Van Beethoven: He was one of the most celebrated classical music composers of all time. His music teacher once said of him, “as a composer, he is hopeless.” He lived to prove his teacher`s opinion of him wrong.

Thomas Edison: He was a prolific inventor and an entrepreneur par excellence. He is especially world famous for his invention of light bulb. As a boy, his academic performance was so poor that he was told by his teacher that he was too stupid to learn anything.

Isaac Newton: He is one of the most celebrated scientists and mathematics to have ever walked on this plane of life. While in grade school as a kid, he was so weak academically that his teachers gave up on improving his grades.

Brian Tracy: A bestselling author, top sales speaker, trainer and consultant. He is also the founder and president of Brian Tracy International. He writes of his days in high school: “I didn`t graduate from high school. In fact, I behaved so badly in high school that I was suspended and eventually expelled from three different schools.”

What is the lesson in all this? These notable achievers and several others like them refused to accept the humiliating labels that were placed on them and refused to settle for what seemed to have been their lot. They broke free from the stereotypical mold and charted noble courses for themselves. I wish to submit that a persons current status or quality of life isn`t final; change is the only constant. Consequently, no parent should ever give up on his or her ward. No teacher should ever give up on his or her pupils and students. Students and pupils should never give up on themselves and should never look down on their peers. Within every human being are seeds of greatness. With the right environment, these seeds will germinate, grow and blossom.

Daniel Dela Dunoo is a I am a freelance writer/editor, blogger & a published author and holds a Bachelor of Arts degree in Theology from the University of Wales, UK. 
Email: Blog: /

A Spring Salad Celebration

A Spring Salad Celebration

(Family Features) Fresh fruits and veggies are often the flavors of spring, and you can bring them all together by celebrating National Salad Month with a homemade masterpiece.

This Steamboat Willie Green Apple Waldorf Salad, created in honor of Mickey Mouse’s 90th anniversary, is perfect for adopting a diet rich in produce with green apples, pineapple, blueberries, grapes, celery and, of course, salad greens. With all the fresh flavor, including Dole’s 50/50 Salad Blend – a robust and balanced blend of delicate baby greens and lettuces: tender baby spinach, peppery radicchio and invigorating arugula and chard – it’s an ideal recipe to honor National Eat More Fruits and Vegetables Day.

Large salads like this make for a nutritious yet filling meal for the whole family and can be enjoyed nearly any time of day as a lunch, appetizer, snack or even as a main course at the dinner table.

Find more easy-to-make recipes, kid-friendly activities, inspiration for families spending time together at home and more at

Steamboat Willie Green Apple Waldorf Salad

Total time: 10 minutes

Servings: 8

3/4       cup fat-free Greek yogurt

2 teaspoons Dijon mustard

16        ounces chopped, cooked chicken

1          cup chopped green apple

1          cup DOLE® Blueberries

1          cup Dole Red Grapes, halved

1          cup chopped, fresh Dole Tropical Gold Pineapple

1/2       cup Dole Celery, cut into chunks

1          tablespoon freshly chopped mint

1          package (5 ounces) Dole 50/50 Salad Blend

1/4       cup chopped pecans or walnuts (optional)

In medium bowl, stir yogurt and mustard. Stir in chicken, apples, blueberries, grapes, pineapple, celery and mint. Toss to evenly coat.

Pour salad blend onto serving platter. Arrange chicken mixture on salad blend and sprinkle with pecans or walnuts, if desired.

Tips: Can be served as salad or spooned onto tortillas and rolled up for wraps. Amount of yogurt dressing can be adjusted based on personal preference.

7 Things to Know About Angels

May Take on Human Form:

Hebrews 13:2  Be not forgetful to entertain strangers: for thereby some have entertained angels unawares.

Serve as Advocates for Children:

Matthew 18:10  Take heed that ye despise not one of these little ones; for I say unto you, That in heaven their angels do always behold the face of my Father which is in heaven.

Sent to Serve/Help Followers of Christ:

Hebrews 1:14  Are they not all ministering spirits sent forth to minister for those who will inherit salvation? 

Psalm 34:7  The angel of the LORD encamps all around those who fear Him, And delivers them.

Walk Throughout the Earth Gathering Intelligence:

Zechariah 1:10  And the man who stood among the myrtle trees answered and said, “These are the ones whom the LORD has sent to walk to and fro throughout the earth.” 

Zechariah 1:11  So they answered the Angel of the LORD, who stood among the myrtle trees, and said, “We have walked to and fro throughout the earth, and behold, all the earth is resting quietly.” 

Job 2:2  And the LORD said to Satan, “From where do you come?” Satan answered the LORD and said, “From going to and fro on the earth, and from walking back and forth on it.”

Serve as Invisible Leaders on Earth:

Daniel 10:12  Then he said to me, “Do not fear, Daniel, for from the first day that you set your heart to understand, and to humble yourself before your God, your words were heard; and I have come because of your words. 

Daniel 10:13  But the prince of the kingdom of Persia withstood me twenty-one days; and behold, Michael, one of the chief princes, came to help me, for I had been left alone there with the kings of Persia.

Ephesians 6:12  For we do not wrestle against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this age, against spiritual hosts of wickedness in the heavenly places.  

Should not be Worshipped:

Revelation 22:8  And I John saw these things, and heard them. And when I had heard and seen, I fell down to worship before the feet of the angel which shewed me these things.

Revelation 22:9  Then saith he unto me, See thou do it not: for I am thy fellowservant, and of thy brethren the prophets, and of them which keep the sayings of this book: worship God.

Rejoice When Sinners Repent:

Luke 15:10  Likewise, I say unto you, there is joy in the presence of the angels of God over one sinner that repenteth.

How to take charge of your mental health

Our nation is sharing in an experience with the COVID-19 crisis that will serve to reshape the future of our communities, our work, our families, and each and every individual. With so much attention focused on the diagnosis and treatment related to the virus, we recognize that those feelings of isolation, depression, anxiety, and even substance use may impact substantially more of us than a COVID-19 diagnosis.

Nearly half of American adults report that the COVID-19 crisis has affected their mental health, according to recent polling by the Kaiser Family Foundation. Meanwhile, Mental Health America’s (MHA) free, anonymous screening tools have seen a 70% increase in individuals taking their anxiety screen, and a 64% increase in the number of people taking their depression screen between January and April of this year.

During this public health emergency, it is important to take care of ourselves, support one other and spread the message that “you are not alone.”

You are not alone

The National Alliance on Mental Illness (NAMI) is partnering with Anthem Inc., one of the nation’s largest health benefits companies, on a month-long campaign focused on reminding all of us that ”You Are Not Alone.“ May is National Mental Health Month, and together, NAMI and Anthem, Inc. are focused on the power and necessity of maintaining social connections and well-being during a time when many are physically distanced from each other.

As NAMI CEO Daniel H. Gillison, Jr. shared, “Especially during this time of isolation, uncertainty and tragedy, it is vital that no one feels alone in their mental health journey.”

He continued, “The COVID-19 crisis not only shines a spotlight on our need for social connectedness, but also our need for real mental health resources. To support individuals during this crisis, NAMI is raising awareness to change our fragmented mental health system into one that serves everyone, so people can get the care they need.”

“Caring for ourselves — physically and emotionally — is critical to improving lives and communities,” said Dr. Prakash Patel, executive vice president and president of Anthem, Inc.’s Diversified Business Group. “During this challenging public health crisis, it’s important to know there are resources out there, whether through your employer, healthcare provider or community organizations, to help us get through this difficult time. Taking care of our mental health is just as important as our physical health. This month is a great reminder to take care of ourselves, as well as each other.”

Caring for yourself, caring for others

To take charge of your mental health during the current crisis:

  1. Care for yourself. Recognize the importance of “me time” and carve out a part of each day to do something that rejuvenates yourself — listen to a podcast, do yoga, connect with a friend, or just go outside for a breath of fresh air.
  2. Seek help if you need it. Talking to a friend or family member is a good start, but professional mental health services may also be necessary. The earlier people seek help, the better their results. While going to see someone in person may not be possible, telehealth offers a way to talk to a professional while practicing physical distancing. If you are thinking about harming yourself, contact the National Suicide Prevention Lifeline, which can provide free and confidential emotional support in times of crisis.
  3. Explore community resources. There are many valuable and often underutilized resources available. These include Employee Assistance Programs (EAP), which are offered by many employers and include free therapy sessions and telehealth, as well as digital resources, like the mental health resource site, Psych Hub. And you can contact NAMI for nationwide peer-support and resource referrals, by phone (800-950-NAMI) or email (
  4. Support one another. Caring for others is one way to care for yourself. Call an older adult who may be experiencing loneliness, text a friend who’s working long hours, or join your family or friends for a video dinner. A simple gesture can go a long way for you and for them.
  5. Talk about it. Let people know that they are not alone. Your experience matters. Taking time for yourself? Share your #MeMinutes, whether on social media, using the hashtag, or with others in your community. Sharing your own self-care routine may encourage others to care for themselves, too.

Sharing your personal experience engages others and fosters acceptance and awareness around mental health, and encourages others to take the steps to access treatment and support during difficult times. You are not alone.

For more information, visit

Dysfunctional Families: How to Take Care of Your Children in the Midst of Dysfunction

If you are in a dysfunctional marriage and have children, you have a dysfunctional family. Few things cause as much pain, anguish, anger, guilt, fear, anxiety, and frustration as seeing your children hurting. You want good things for your children. “Which of you, if his son asks for bread, will give him a stone? Or if he asks for a fish, will give him a snake?”(Matthew 7:9)

Yet due to the dysfunction in the home, you may find yourself doing or allowing things that you are ashamed to admit hurt your children. Each of the following things directly touches on typical problem areas with children in dysfunctional families.

Follow this list of “dos and don’ts” in order to take care of your children.

Don’t assume you understand what is going on with your children; instead ask open questions. It is easy to assume why your child is acting a certain way, but there are a lot of feelings and reactions in a dysfunctional family that affect the way children act and you aren’t a mind reader. Here are some examples:”What are you thinking?” “Why did you do that?” and “What is bothering you?” You give your child a chance to speak truth and you get information about your child.

Don’t use labels; instead, describe the behavior. Labels are confining and shaming. They stick children with images that shape their future behavior and self-esteem. It doesn’t help your child to do better, because it doesn’t define what needs to change. With all of the emotional intensity in a difficult marriage, it is easy to resort to pressuring your child to change with shame-based labels rather than taking the time to teach about behavior, but it isn’t in your child’s best interest.

Don’t break promises; instead, keep the promises you make. Dysfunctional families have lots of ups and downs and promises tend to get broken. Even if your spouse doesn’t keep a promise, you keep your part. And as much as possible, keep schedules and routines. Dysfunctional families are filled with distrust and inconsistency. Children need consistency to feel secure. Do your part to make them secure.

Don’t rely on your children to meet your emotional, physical, spiritual, and relational needs; instead, figure out ways to take care of yourself. Children do not need to carry a parent. The tendency is for a lonely or troubled parent to go to a mature, responsible child to talk or to have the child take care of things around the house. Encourage your child to be a child; find an adult to talk to; and don’t let your child assume adult responsibilities.

Don’t use your child as a go-between to your spouse; instead,keep your child out of your relationship with your spouse. With the relationship problems, come communication problems. Whether your spouse is angry, sarcastic, withdrawn, punitive, passive, abusive, indirect, or rude, you probably don’t like communicating with him/her. The way many dysfunctional parents solve this is to use the child to communicate for them. They send the child to bring messages to the other spouse. The problem with this is that the dysfunctional communication continues, it is just directed at the child and makes the child the recipient of all the negative toxicity and emotions. Don’t use your child as a mediator or go-between. Take the responsibility to communicate with your spouse without bringing your child into it.

Don’t dump your toxic emotions on your child; instead,take care of your own toxic emotions. The tendency of all human beings is to displace their negative emotions onto someone else. In dysfunctional families, an unhappy spouse is often an unhappy parent. If your spouse is angry with you, you will likely be angry with your children. If your spouse puts you in a bad mood, you will show your children your bad mood and direct it at them. This isn’t fair to your children who assume that they did something wrong to make you feel the way you do. Find a way to deal with your toxic emotions, so you can have a relationship with your children that reflects how you really feel about them-and it isn’t the way you feel about your spouse.

Don’t ignore their physical, mental, emotional, spiritual, and relational needs; instead, prioritize their needs even if your spouse doesn’t. It isn’t uncommon for dysfunctional parents to be so consumed with their own marital problems that they ignore the needs of their children in extreme or subtle ways. Your children need you to be a good parent and they need all their needs met. You need to purpose to pay attention to your children by forcing yourself to take your mind off the marital problems. Look at your child and assess what the needs are and then figure out how to meet them, whether your spouse does or not. And don’t be afraid to tell them about God and pray with them. It doesn’t make you a hypocrite to show them a relationship with God just because your marriage isn’t good and you aren’t perfect.

Don’t ignore verbal, emotional, and spiritual abuse; instead, protect them from abuse. If your spouse is abusing you, then he/she is probably abusing the children in the same way. It can be difficult to manage this dilemma, because protecting them may mean leaving the relationship and that brings additional problems. It certainly means that you need to get educated about the abuse and find a way to set boundaries. It also means you may not be able to leave your children alone with your spouse. One of the problems with an abusive spouse is that in a divorce, you have to prove the abuse to keep the parent from getting his/her share of custody. This isn’t an easy dilemma and you will probably need professional help to maneuver it.

Even if you can’t change everything in your dysfunctional family, you can change the way you take care of your children in the midst of the dysfunction.

Next, if you need more practical tips and Biblical truths to help you change your relationships, get my FREE “15-Day Relationship Challenge” designed to give you back the power over your life. Just click here:

Source:Article Source: http://www.faithwriters.comCHRISTIAN WRITERS

AG Nessel Warns of Websites Selling Coronavirus-related Products That Never Arrive


LANSING – Attorney General Dana Nessel issued an urgent consumer alert today to notify Michiganders of another online retailer that is taking advantage of consumers looking to buy products like hand sanitizer and face masks during the coronavirus disease 2019 (COVID-19) crisis. 

Nessel’s office recently received a complaint from a concerned Michigan consumer about a website called OkHomeOnline selling face masks, alcohol-based cleaning wipes, hand sanitizer, toilet paper and other products in high demand during the COVID-19 pandemic.  

The consumer reported being charged for a purchase, but never received the order. Later attempts to check the order status were unsuccessful when the website could no longer be accessed.  

The Attorney General’s office found that multiple complaints were available online with consumers going through the exact same situation as the Michigan resident. They placed the order only to find that the website disappeared. Furthermore, the phone numbers and addresses listed for the “company” appear to be stolen from other businesses that do not make or sell coronavirus-related products.  

“Consumers should always be careful when shopping online, but being cautious is especially important in a time like this when public anxiety is high and scammers are looking to profit off fear,” Nessel said. “Researching the product and the seller before you make a purchase is never a bad idea, and it can help shoppers from falling victim to these predatory practices.” 

This website is not the first online COVID-19 scam the Attorney General’s office has encountered. In mid-April the office announced it was issuing court-authorized subpoenas in its investigation into a Muskegon County business, EM General, for similar business practices of failing to provide consumers with their purchased products. That investigation is still underway. 

As the COVID-19 pandemic persists, it’s likely consumers will continue to seek products through digital retailers, which highlights the importance of shoppers being aware of potential scams.  

Before ordering from a new or unfamiliar online store, consumers should consider doing the following: 

  • See if the company has reviews online. Search for the company in a search engine with terms like “review,” “complaints” or “scam.” 
  • Pay by credit card. If there are any issues with the purchase, consumers may be able to dispute the purchase with the credit card company and may have protections available under federal law.
  • Review AG Nessel’s Online Shopping Tips consumer alert and more alerts under the Shopping for Products and Services category.  

Additional warnings on how to avoid purchasing non-existent personal protective equipment (PPE) and other COVID-19-related products are available from the Federal Bureau of Investigations and the Federal Trade Commission

Consumers can file a complaint online or by calling the Attorney General’s Consumer Protection tip line, 877-765-8388. Hours of operation are between 8:30 a.m. and 4:30 p.m. Monday through Friday.     

Is it God vs Science or God and Science

Someone shared a video with me of Chris Cumo saying the number of deaths in New York were down because “We brought the numbers down, God did not do that, fate did not do that, destiny did not do that.”

A friend whose newborn granddaughter required surgery praised God when it appeared the surgery was successful. Unfortunately, appreciating this act of God riled one of the nurses. The nursed glared at her and said, “How can you say God did this when you see the doctors taking care of her?  The doctor’s performed the surgery God didn’t.”

My question is, why does it have to be God or man? And why not God and Man? Is it possible that God and man are working together to do great things?

Since God breathed into the nostrils of man during the creation process, God is in man. They are working together. This seems to be the message scripture wants to relay to us.

God breathed into the nostrils of man and man became a living soul (Genesis 2:7).

After Cain left the Garden of Eden, he built a city (Genesis 4:17). From Cain’s family line, we have the development of stringed and pipe instrument (Genesis 4:21), tools of bronze and iron (Genesis 4:22) and raising livestock (Genesis 4:20).

How did Cain and his family know how to build a city, create musical instruments, or tools?

Perhaps the answer is found in the book of Exodus, here God says to Moses, concerning Bezaleel, “I filled him with my Spirit, I have given him wisdom and made him a skilled craftsman who can create objects of art with gold, silver, bronze, stone, and wood.” (Exodus 31:3)

King Solomon is known as the wisest and richest man of the East.  Scripture says, God gave Solomon wisdom, but did it come automatically?

He composed over a thousand songs. He spoke about plants, animals, birds, reptiles and fish (1 Kings 4:32) Did he write songs or speak about plants and animals because he received daily messages or heavenly downloads from God?

I’m sure there were times he received divine revelations from God but he also studied and researched written texts (Ecclesiastes 12:9-12). He spent many hours studying and researching just like today’s top leaders, researchers, authors and composers. Although God granted him wisdom and riches, he worked hard to obtain them.

It’s been said man may obtain knowledge, but God gives him the wisdom to use the knowledge. For example, man may have facts and data but with God’s wisdom he will know how to effectively use the data.

Solomon diligently worked to create a great life for himself and earned the right to boast about his accomplishments.

Noted accomplishments:

I made my works great, I built myself houses, and planted myself vineyards. 

I made myself gardens and orchards, and I planted all kinds of fruit trees in them. 

I made myself water pools from which to water the growing trees of the grove. 

I acquired male and female servants, and had servants born in my house. Yes, I had greater possessions of herds and flocks than all who were in Jerusalem before me. 

I also gathered for myself silver and gold and the special treasures of kings and of the provinces. I acquired male and female singers, the delights of the sons of men, and musical instruments of all kinds. 

So, I became great and excelled more than all who were before me in Jerusalem. Also, my wisdom remained with me. 

Whatever my eyes desired I did not keep from them. I did not withhold my heart from any pleasure, for my heart rejoiced in all my labor; And this was my reward from all my labor. (Ecclesiastes 2:4-10)

After boasting about his accomplishments, this famous accomplished artist, engineer, botanist and zoologist encouraged readers to remember their (Ecclesiastes 12:1, 6).

He advised them to remember God in their youth but especially before the silver cord is loosed (before they die) and the Spirit (breath) God gave (loaned) them returned to him. (Ecclesiastes 2:24-25) 

It’s O.K. to acknowledge your accomplishments, Paul did it in the New Testament; saying He worked harder than All of the other apostles, but he quickly acknowledged that God helped him.  (1 Corinthians 15:10)

So, acknowledge your accomplishments or even boast about them but don’t leave God out. For your mental capacities are in his hands (Daniel 4:28). As a matter of fact, your very breath comes from him and he can take it back when He wants to. (Luke 12:16-21).

Although Luke 12:16-21 is a parable, it highlights a sharp contract between Solomon and the rich man. Both built good lives for themselves both decided to enjoy their lives, eating, drinking and being merry. One remembered God the other did not. (Strong’s Bible Dictionary says remember is to be mindful).

It appears to be a simple matter of choice, as you go about your life, making a name for yourself, building great businesses, curing diseases, developing life changing technologies, solving the world’s problems, be mindful of God.

It’s not God or man or science verses God. It’s God and Man, God and science working together to make the world a better place.

The Main Reason People Don’t Reach Their Goals

Perhaps, many of us don’t reach personal or business goals because we are double-minded. As the Apostle James noted in an often quoted scripture. ” A double-minded man is unstable in all his ways.” (James 1:8)

According to Thayer’s & Strong’s Greek Dictionaries, double-minded means, vacillating in opinion or purpose, divided in interest, wavering, uncertain, doubting.

Double mindedness is “Uncertainty caused by never letting a decision rest, but going over it again and again, until opportunity is lost, and nothing is done.”

Some of us are over- thinkers. We think things to death. While continuously looking at the pros and cons, we come up with more cons than pros. And what happens? Absolutely nothing!

So, opportunities and chances to advance simply fade away.

In Matthew 25:14-30, an employer gave his employees gold/talent to invest. He gave one talent to an employee, but he chose not to invest it. He buried it in the ground for safe keeping because he did not want to risk losing it.

Perhaps he was an over thinker. He researched various opportunities, talked them over with family and friends. He weighed the pros and cons but could not decide what to do because he was afraid about what could happen. So he hid the talent in the ground.

The other two employees doubled their money because they went to the marketplace and began trading immediately. They quickly weighed the pros and cons. They researched various opportunities and invested the money.

A balanced approach is needed when pursuing goals. We cannot be hasty or hesitant.

Haste may lead to loss but perhaps loss via hesitation has a more devastating effect. Because the act of hesitating may become habitual, resulting in an unstable mind-set leading to an unstable life. The consistent doubt and uncertainty may rob us of peace, confidence and a stack of missed opportunities.

Due to the Pandemic many of us have the chance to make new goals and plans for a new future.

Will we immediately invest our time and talents wisely to write books, make informational videos, start a blog or podcast, revamp a business, or reach out to care for others?

We also have the choice to be hesitant, worried about the future and burying our talents; consuming instead of producing.

Fear No Evil?

In Safe in the Shepherd’s Arms, Author Max Lucado noted sheep need protection from adders. Adders are small brown snakes that live underground, they pop out of the ground to bite sheep on their noses.

The small bite on the nose will cause an infection and the sheep may die. To prevent adders (snakes) from popping out of holes and biting sheep, the shepherd pours oil inside their holes. This prevents them from sliding out and biting unsuspecting sheep.

When we remain under the shepherds care the Holy Spirit prevents the serpent (that ole devil) from sliding out of his hole! He can’t get to us, to bite us.

In John chapter seventeen, Jesus prayed for his disciples, asking God to protect them from Satan (John 17:15).

He said, He was not praying for the world but for those God had given Him. (John 17:9)

As we look around and see the world in turmoil, fearful thoughts and emotions will try to attack us. 

We must diligently reject them because fearful thoughts and emotions may cause us to make unwise decisions. Hence, the serpents goal! To get us out of the will of God.

If we follow the Holy Spirit’s guidance rejecting fear and trusting the word of God, the serpent can’t bite us.

Therefore God tells us “Do not call a conspiracy everything this people calls a conspiracy; do not fear what they fear, and do not dread it.” (Isaiah 8:12)

Don’t fear what the world fears nor dread what they dread but fear God instead!

To fear God is to respect or revere Him. Solomon said, “The fear of the LORD tendeth to life: and he that hath it shall abide satisfied; he shall not be visited with evil.” Proverbs 19:23

If we fear the Lord and follow the Good Shepherd we should fear no evil (Psalms 23:4)!

For He has given His angels charge over us to keep us in all our ways (Psalms 91:11).

By S.E. Miller

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