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Viewing: Blog Posts Tagged with: health, Most Recent at Top [Help]
Results 1 - 25 of 437
1. She Doesn’t Live Here Anymore

And so, the wheel turns. My eldest has moved to college. Although my Lovely Wife (LW) tells me we have to keep her room intact because she will still come home, I remember that I never lived at home after I left for college. I am somewhat sad about that, but we’ve been prepping for this and hoping she would take flight someday. It’s just hard to watch the baby condor drop off the ledge knowing the perilous plunge that awaits.

I’m taking it pretty well, actually. LW, not so much. Everything in the house seems to remind her that one of her babies has left the nest. Tears, oh there have been tears. I don’t understand tears, nor do I deal with them very well. I remind LW that she’s always got me… forever…  Somehow, that doesn’t seem to help.

After moving our collegian, we had to take our little patient in for treatment where she and mom stayed a few days. While they were gone, I happened into the pantry and realized LW must not have been there since baby condor left. If food packaging could form a face, every piece of junk food in there conspired to draw our missing daughter – even to me and I’m oblivious to the most obvious of things.

This was bad! I couldn’t let LW see this, she would cry for days. It all had to go, but the cheapskate in me said I also couldn’t throw out all of the food. Only one option remained. A 24 hour binge of Munchos and Dr. Pepper.

Have you ever read the nutrition label on those things? DON’T! You can gain 3 pounds just from holding the bag too long. They don’t list things by proportion, otherwise the label would read something like this:

Lard 70%image

Air 27%

Salt 2.5%

Potatoes 0.5%

How they bond the ingredients I will never know. Anyway, I polished off the first bag for breakfast and washed it down with three Dr. Peppers. I checked the remaining inventory and was disheartened to discover that LW must have decided to stock up to try to lure the girl to forsake college and stay with us. Either that or she suspected a Y2k15 disaster and wanted to be prepared. Our pantry was like a saferoom.

This is where having many offspring should pay off! I enlisted the help of the remaining children. When I explained the dilemma, I got more “Oh, Dad” eye rolls than the average game of nine-ball. One took a Dr. Pepper before she left, so I was down to hoarder’s surplus minus one. Alone, I dug in for the day.

In the late evening, I was sure a trip the emergency room was in order. The pantry was reverting back to a faceless state, and my stomach was screaming something in Idahoan. I was sweating a substance that looked like maple syrup, which can’t be good. I put in a call to Poison Control where a kind gentleman told me there was no known toxicity in the combination, but urged me to go to the hospital if I felt light-headed. That’s the last thing I remember before passing out amongst the crumbs of the last bag.

When I came to, it was time to go and pick up LW and the youngest. I used the shower squeegee to remove the syrup-sweat and when I arrived, they were ready to go. The trip home was uneventful, I successfully hid the tick and slurred speech caused by sugar intake. While I was unloading the car, LW stopped me.

“Where are the snacks for the party?”

I shrugged my shoulders and grunted. I didn’t ask ‘what party’, I’m sure I’d been told.

“The pantry was full of them.”

“I dunno,” I replied without making eye contact.

“Well, we need more for the party Saturday. Can you go to the store?”

“Uh, sure.”

They say never go to the store hungry. I went full! And I bought $57 worth of Dr. Pepper and Munchos, feeling bloated and quite resentful. Even after all the sweets, this was a bitter pill to swallow.


Filed under: It Made Me Laugh

7 Comments on She Doesn’t Live Here Anymore, last added: 8/21/2014
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2. She Doesn’t Live Here Anymore

And so, the wheel turns. My eldest has moved to college. Although my Lovely Wife (LW) tells me we have to keep her room intact because she will still come home, I remember that I never lived at home after I left for college. I am somewhat sad about that, but we’ve been prepping for this and hoping she would take flight someday. It’s just hard to watch the baby condor drop off the ledge knowing the perilous plunge that awaits.

I’m taking it pretty well, actually. LW, not so much. Everything in the house seems to remind her that one of her babies has left the nest. Tears, oh there have been tears. I don’t understand tears, nor do I deal with them very well. I remind LW that she’s always got me… forever…  Somehow, that doesn’t seem to help.

After moving our collegian, we had to take our little patient in for treatment where she and mom stayed a few days. While they were gone, I happened into the pantry and realized LW must not have been there since baby condor left. If food packaging could form a face, every piece of junk food in there conspired to draw our missing daughter – even to me and I’m oblivious to the most obvious of things.

This was bad! I couldn’t let LW see this, she would cry for days. It all had to go, but the cheapskate in me said I also couldn’t throw out all of the food. Only one option remained. A 24 hour binge of Munchos and Dr. Pepper.

Have you ever read the nutrition label on those things? DON’T! You can gain 3 pounds just from holding the bag too long. They don’t list things by proportion, otherwise the label would read something like this:

Lard 70%image

Air 27%

Salt 2.5%

Potatoes 0.5%

How they bond the ingredients I will never know. Anyway, I polished off the first bag for breakfast and washed it down with three Dr. Peppers. I checked the remaining inventory and was disheartened to discover that LW must have decided to stock up to try to lure the girl to forsake college and stay with us. Either that or she suspected a Y2k15 disaster and wanted to be prepared. Our pantry was like a saferoom.

This is where having many offspring should pay off! I enlisted the help of the remaining children. When I explained the dilemma, I got more “Oh, Dad” eye rolls than the average game of nine-ball. One took a Dr. Pepper before she left, so I was down to hoarder’s surplus minus one. Alone, I dug in for the day.

In the late evening, I was sure a trip the emergency room was in order. The pantry was reverting back to a faceless state, and my stomach was screaming something in Idahoan. I was sweating a substance that looked like maple syrup, which can’t be good. I put in a call to Poison Control where a kind gentleman told me there was no known toxicity in the combination, but urged me to go to the hospital if I felt light-headed. That’s the last thing I remember before passing out amongst the crumbs of the last bag.

When I came to, it was time to go and pick up LW and the youngest. I used the shower squeegee to remove the syrup-sweat and when I arrived, they were ready to go. The trip home was uneventful, I successfully hid the tick and slurred speech caused by sugar intake. While I was unloading the car, LW stopped me.

“Where are the snacks for the party?”

I shrugged my shoulders and grunted. I didn’t ask ‘what party’, I’m sure I’d been told.

“The pantry was full of them.”

“I dunno,” I replied without making eye contact.

“Well, we need more for the party Saturday. Can you go to the store?”

“Uh, sure.”

They say never go to the store hungry. I went full! And I bought $57 worth of Dr. Pepper and Munchos, feeling bloated and quite resentful. Even after all the sweets, this was a bitter pill to swallow.


Filed under: It Made Me Laugh

0 Comments on She Doesn’t Live Here Anymore as of 8/21/2014 10:25:00 PM
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3. Why are sex differences frequently overlooked in biomedical research?

By Katie L. Flanagan


Despite the huge body of evidence that males and females have very different immune systems and responses, few biomedical studies consider sex in their analyses. Sex refers to the intrinsic characteristics that distinguish males from females, whereas gender refers to the socially determined behaviour, roles, or activities that males and females adopt. Male and female immune systems are not the same leading to clear sexual dimorphism in response to infections and vaccination.

In 2010, Nature featured a series of articles aimed at raising awareness of the inherent sex bias in modern day biomedical research and, yet, little has changed since that time. They suggested journals and funders should insist on studies being conducted in both sexes, or that authors should state the sex of animals used in their studies, but, unfortunately, this was not widely adopted.

Even before birth, intrauterine differences begin to differentially shape male and female immune systems. The male intrauterine environment is more inflammatory than that of females, male fetuses produce more androgens and have higher IgE levels, all of which lead to sexual dimorphism before birth. Furthermore, male fetuses have been shown to undergo more epigenetic changes than females with decreased methylation of many immune response genes, probably due to physiological differences.

The X chromosome contains numerous immune response genes, while the Y chromosome encodes for a number of inflammatory pathway genes that can only be expressed in males. Females have two X chromosomes, one of which is inactivated, usually leading to expression of the wild type gene. X inactivation is incomplete or variable, which is thought to contribute to greater inflammatory responses among females. The immunological X and Y chromosome effects will begin to manifest in the womb leading to the sex differences in immunity from birth, which continue throughout life.

MicroRNAs (miRNAs) regulate physiological processes, including cell growth, differentiation, metabolism and apoptosis. Males and females differ in their miRNA expression, even in embryonic stem cells, which is likely to contribute to sex differences in the prevalence, pathogenesis and outcome of infections and vaccination.

man woman

Females are born with higher oestriol concentrations than males, while males have more testosterone. Shortly after birth, male infants undergo a ‘mini-puberty’, characterised by a testosterone surge, which peaks at about 3 months of age, while the female effect is variable. Once puberty begins, the ovarian hormones such as oestrogen dominate in females, while testicular-derived androgens dominate in males. Many immune cells express sex hormone receptors, allowing the sex hormones to influence immunity. Very broadly, oestrogens are Th2 biasing and pro-inflammatory, whereas testosterone is Th1 skewing and immunosuppressive. Thus, sex steroids undoubtedly play a major role in sexual dimorphism in immunity throughout life.

Sex differences have been described for almost every commercially available vaccine in use. Females have higher antibody responses to certain vaccines, such as measles, hepatitis B, influenza and tetanus vaccines, while males have better antibody responses to yellow fever, pneumococcal polysaccharide, and meningococcal A and C vaccines. However, the data are conflicting with some studies showing sex effects, whereas other studies show none. Post-vaccination clinical attack rates also vary by sex with females suffering less influenza and males experiencing less pneumococcal disease after vaccination. Females suffer more adverse events to certain vaccines, such as oral polio vaccine and influenza vaccine, while males have more adverse events to other vaccines, such as yellow fever vaccine, suggesting the sex effect varies according to the vaccine given. The existing data hint at higher vaccine-related adverse events in infant males progressing to a female preponderance from adolescence, suggesting a hormonal effect, but this has not been confirmed.

If male and female immune systems behave in opposing directions then clearly analysing them together may well cause effects and responses to be cancelled out. Separate analysis by sex would detect effects that were not seen in the combined analysis. Furthermore, a dominant effect in one of the sexes might be wrongly attributed to both sexes. For drug and vaccine trials this could have serious implications.

Given the huge body of evidence that males and females are so different, why do most scientific studies fail to analyse by sex? Traditionally in science the sexes have been regarded as being equal and the main concern has been to recruit the same number of males and females into studies. Adult females are often not enrolled into drug and vaccine trials because of the potential interference of hormones of the menstrual cycle or risk of pregnancy; thus, most data come from trials conducted in males only. Similarly, the majority of animal studies are conducted in males, although many animal studies fail to disclose the sex of the animals used. Analysing data by sex adds the major disadvantage that sample sizes would need to double in order to have sufficient power to detect significant sex effects. This potentially means double the cost and double the time to conduct the study, in a time when research funding is limited and hard to obtain. Furthermore, since the funders don’t request analysis by sex, and the journals do not ask for it, it is not a major priority in today’s highly competitive research environment.

It is likely that we are missing important scientific information by not investigating more comprehensively how males and females differ in immunological and clinical trials. We are entering an era in which there is increasing discussion regarding personalised medicine. Therefore, it is quite reasonable to imagine that females and males might benefit differently from certain interventions such as vaccines, immunotherapies and drugs. The mindset of the scientific community needs to shift. I appeal to readers to take heed and start to turn the tide in the direction whereby analysis by sex becomes the norm for all immunological and clinical studies. The knowledge gained would be of huge scientific and clinical importance.

Dr Katie Flanagan leads the Infectious Diseases Service at Launceston General Hospital in Tasmania, and is an Adjunct Senior Lecturer in the Department of Immunology at Monash University in Melbourne. She obtained a degree in Physiological Sciences from Oxford University in 1988, and her MBBS from the University of London in 1992. She is a UK and Australia accredited Infectious Diseases Physician. She did a PhD in malaria immunology based at Oxford University (1997 – 2000). She was previously Head of Infant Immunology Research at the MRC Laboratories in The Gambia from 2005-11 where she conducted multiple vaccine trials in neonates and infants.

Dr Katie Flanagan’s editorial, ‘Sexual dimorphism in biomedical research: a call to analyse by sex’, is published in the July issue of Transactions of the Royal Society of Tropical Medicine and Hygiene. Transactions of the Royal Society of Tropical Medicine and Hygiene publishes authoritative and impactful original, peer-reviewed articles and reviews on all aspects of tropical medicine.

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4. What are the costs and impacts of telecare for people who need social care?

By Catherine Henderson


In these times of budgetary constraints and demographic change, we need to find new ways of supporting people to live longer in their own homes. Telecare has been suggested as a useful way forward. Some examples of this technology, such as pull-cord or pendant alarms, have been around for years, but these ‘first-generation’ products have given way to more extensive and sophisticated systems. ‘Second-generation’ products literally have more bells and whistles – for instance, alarms for carbon monoxide and floods, and sensors that can detect movement in and out of bed. These sensors send alerts to a call-centre operator who can organise a response, perhaps call out a designated key-holder, organise a visit to see if there is a problem, or ring the emergency services. There are even more elaborate systems that continuously monitor a person’s activity using sensors and analyse these ‘lifestyle’ data to identify changes in usual activity patterns, but these systems are not in mainstream use. In contrast to telehealth – where the recipient is actively involved in transmitting and in many cases receiving information – the sensors in telecare do not require the active engagement of participants to transmit data, as this is done automatically in the background.

Take-up of telecare remains below its potential in England. One recent study estimated that some 4.17 million over-50 year olds could potentially use telecare, while only about a quarter of that figure were actually using personal alarms or alerting devices. The Department of Health has similarly suggested that millions of people with social care needs and long term conditions could benefit from telecare and telehealth. To help meet this need, it launched the 3-Million Lives campaign in partnership with industry to promote the scaling-up of telehealth and telecare.

Senior woman on phone

The hope held by government and commissioners in the NHS and local authorities is that these new assistive technologies not only promote independence and improve care quality but also reduce the use of health and social care services. To decide how much funding to allocate to these promising new services, these commissioners need a solid evidence base. In 2008, the Department of Health launched the Whole Systems Demonstrator (WSD) programme in three local authority areas in England engaged in whole-systems redesign to test the impacts of telecare (for people with social care needs) and telehealth (for people with long-term conditions).

The research that accompanied the WSD programme was extensive. It included quantitative studies investigating health and social care service use, mortality, costs, and the effectiveness of these technologies. Parallel qualitative studies explored the experiences of people using telecare and telehealth and their carers. The research also examined the ways in which local managers and frontline professionals were introducing the new technologies.

Some results from these streams of research have been published with more to come. From the quantitative research, three articles were published in Age and Ageing over the past year. Steventon and colleagues report on the use of hospital, primary care and social services, and mortality for all participants in the trial – around 2,600 people – based on routinely collected data. Two papers report the results of the WSD telecare questionnaire study (Hirani, Beynon et al. 2013; Henderson, Knapp et al. 2014). The questionnaire study included participants from the main trial who filled out questionnaires about their psychological outcomes, their quality of life, and their use of health and social care services.

The most recent paper to be published in Age and Ageing is the cost-effectiveness analysis of WSD telecare. Participants used a second-generation package of sensors and alarms that was passively and remotely monitored. On average, about five items of telecare equipment were provided to people in the ‘intervention’ group. The whole telecare package accounted for just under 10% of the estimated total yearly health and social care costs of £8,625 (adjusting for case mix) for these people. This was more costly than the care packages of people in the ‘usual care’ group (£7,610 per year) although the difference was not statistically significant. The extra cost of gaining a quality-adjusted life year (QALY) associated with the telecare intervention was £297,000. This is much higher than the threshold range – £20,000 to£30,000 per QALY – used by the National Institute for Health and Care Excellence (NICE) when judging whether an intervention should be used in the NHS (National Institute for Health and Clinical Excellence 2008). Given these results, we would, therefore, caution against thinking that second-generation telecare is the cure-all solution for providing good quality care to increasing numbers of people with social care needs while containng costs.

As with any research, it is important to understand how to best use the findings. The telecare tested during the pilot period was ‘second generation’, so conclusions from this research cannot be applied, for instance, to existing pendant alarm systems currently in widespread use. And telecare systems have continued to evolve since this research started. Moreover, while the results summarised here relate to the telecare participants and do not cover any potential impacts on family carers, there is some evidence that telecare alleviates carer strain.

These findings inevitably raise further questions. What are the broader experiences of those using telecare? What makes a telecare experience positive? And what detracts from the experience? Who can benefit most from telecare? Some answers will emerge as we look across all the findings from the WSD research programme. We also need to look forward to findings from new research, such as the current trial of telecare for people with dementia and their carers (Leroi, Woolham et al. 2013). The ‘big’ question is not whether we should implement a ‘one-size fits all’ solution to meet the increasing demands on social care but for whom do these new assistive technologies work best and for whom are they most cost-effective response.

Catherine Henderson is a researcher at the London School of Economics. She is one of the authors of the paper ‘Cost-effectiveness of telecare for people with social care needs: the Whole Systems Demonstrator cluster randomised trial’, which is published in the journal Age and Ageing.

Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.

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5. The Meaning of Maggie by Megan Jean Sovern | Book Review

Readers will instantly fall in love with Maggie. Her narrative voice is smart, funny and clever, which makes her a highly entertaining, endearing, complex, triple threat.

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6. A revolution in trauma patient care

By Simon Howell


Major trauma impacts on the lives of young and old alike. Most of us know or are aware of somebody who has suffered serious injury. In the United Kingdom over five-thousand people die from trauma each year. It is the most common cause of death in people under forty. Many of the fifteen-thousand people who survive major trauma suffer life-changing injuries and some will never fully recover and require life-long care. Globally it is estimated that injuries are responsible for sixteen-thousand deaths per day together with a large burden of people left with permanent disability. These sombre statistics are driving a revolution in trauma care.

A key aspect of the changes in trauma management in the United Kingdom and around the world is the organisation of networks to provide trauma care. People who have been seriously hurt, for example in a road traffic accident, may have suffered a head injury, injuries to the heart and lungs, abdominal trauma, broken limbs, and serious loss of skin and muscle. The care of these injuries may require specialist surgery including neurosurgery, cardiothoracic surgery, general (abdominal and pelvic) surgery, orthopaedic surgery, and plastic surgery. These must be supported by high quality anaesthetic, intensive care, radiological services and laboratory services. Few hospitals are able to provide all of the services in one location. It therefore makes sense for the most seriously injured patients to be transported not to the nearest hospital but to the hospital best equipped to provide the care that they need. Many trauma services around the world now operate on this principle and from 2010 these arrangements have been established in England. Hospitals are designated to one of three tiers: major trauma centres, trauma units, and local emergency hospitals. The most seriously injured patients are triaged to bypass trauma units and local emergency hospitals and are transported directly to major trauma centres. While this is a new system and some major trauma centres in England have only “gone live” in the past two years, it has already had an impact on trauma outcomes, with monitoring by the Trauma Audit and Research Network (TARN) indicating a 19% improvement in survival after major trauma in England.

Young attractive female doctor looking x-ray photos

Not only have there been advances in the organisation of trauma services, but there have also been advances in the immediate clinical management of trauma. In many cases it is appropriate to undertake “early definitive surgery/early total care” – that is, definitive repair of long bone fractures within twenty-four hours of injury. However, patients who have suffered major trauma often have severe physiological and biochemical derangements by the time they arrive at hospital. The concepts of damage control surgery and damage control resuscitation have emerged for the management of these patients. In this approach resuscitation and surgery are directed towards stopping haemorrhage, performing essential life-saving surgery, and stabilising and correcting the patient’s physiological state. This may require periods of surgery followed by intervals for the administration of blood and clotting factors and time for physiological recovery before further surgery is undertaken. The decision as to whether to undertake early definitive care or to institute a damage control strategy can be complex and is made by senior clinicians working together to formulate an overview of the state of the patient.

Modern radiology and clinical imaging has helped to revolutionise modern trauma management. There is increasing evidence to suggest that early CT scanning may improve outcome in the most unstable patients by identifying life-threatening injuries and directing treatment. When a source of bleeding is identified it may be treated surgically, but in many cases interventional radiology with the placement of glue or metal coils into blood vessels to stop the bleeding offers an alternative and less invasive solution.

The evolution of the trauma team is at the core of modern trauma management. Advances in resuscitation, surgery, and imaging have undoubtedly moved trauma care forward. However, the care of the unstable, seriously injured patient is a major challenge. Transporting someone who is suffering serious bleeding to and from the CT scanner requires excellent teamwork; parallel working so that several tasks are carried out at the same time requires coordination and leadership; making the decision between damage control and definitive surgery requires effective joint decision-making. The emergence of modern trauma care has been matched by the development of the modern trauma team and of specialists dedicated to the care of seriously injured patients. It is to this, above all, that the increasing numbers of survivors from serious trauma owe their lives.

Dr Simon Howell is on the Board of the British Journal of Anaesthesia (BJA) and is the Editor of this year’s Postgraduate Educational Issue: Advances in Trauma Care. This issue contains a series of reviews that give an overview of the revolution in trauma care. The reviews expand on a number of presentations that were given at a two-day meeting on trauma care organised by the Royal College of Anaesthetists in the Spring of 2014. They visit aspects of the trauma patient’s journey from the moment of injury to care in the field, on to triage, and arrival in a trauma centre finally to resuscitation and surgical care.

Founded in 1923, one year after the first anaesthetic journal was published by the International Anaesthesia Research Society, the British Journal of Anaesthesia remains the oldest and largest independent journal of anaesthesia. It became the Journal of The College of Anaesthetists in 1990. The College was granted a Royal Charter in 1992. Since April 2013, the BJA has also been the official Journal of the College of Anaesthetists of Ireland and members of both colleges now have online and print access. Although there are links between BJA and both colleges, the Journal retains editorial independence.

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7. Body Mind Therapies for the Bodyworker

Body Mind Therapies for the Bodyworker
Author: Kathy Gruver, PhD, LMT
Publisher: Infinity Publishing
Genre: Health
ISBN: 978-0-7414-8142-9
Pages: 198
Price: $15.95

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Buy it at Amazon

Massage therapy is a wonderful way to pamper and nurture our bodies. But what if there are ways to incorporate deeper levels of healing during a session? Kathy Gruver explores these options in Body Mind Therapies for the Bodyworker.

A massage session doesn’t only have to work on the body. Massage therapists can also use stress reduction, affirmations, and visualization with a client, as well as many other healing techniques such as Reiki and aromatherapy, which can be used simultaneously. And should the client be open-minded, other non-massage therapies may be used.

Traditional medicine often ignores the powerful alternative healing options we have available to us, but Gruver reminds us that these should always be used with caution. Serious medical conditions are best treated by a doctor, and there are quacks selling snake oil to the unwary. But this book shows how to carefully use these remedies which often help in the healing process. Although some techniques are only discussed briefly, websites are provided for the practitioner who is looking for more information. Body Mind Therapies for the Bodyworker provides a nice overview of options available to any massage therapist interested in expanding her healing practice.

Reviewer: Alice Berger


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8. Is the past a foreign country?

By Eugene Milne


My card-carrying North London media brother, Ben, describes himself on his Twitter feed as a ‘recovering Northerner’.

In my case the disease is almost certainly incurable. Despite spending a good deal of last year in cosmopolitan London — beautiful, exciting and diverse as it is — I found myself on occasions near tears of joy as my feet hit the platform at King’s Cross.

“I need to know I can be at the coast or in miles of open countryside within 20 minutes,” I told Ben.

“I need to know I can get Vietnamese food at 3.00 a.m.,” he replied.

While mine is clearly the healthier individual craving, the gulf in population health outcomes between the North and South of England, or, perhaps more accurately, between the provinces and the capital and its South Eastern sprawl, remains as wide as ever.

On examining the distribution of age-standardised mortality for Nomenclature of Territorial Units for Statistics regions, the United Kingdom remains the most starkly unequal of European nations. This is starkly illustrated in our new analyses of the North South divide in England, when compared with the experience of East and West Germany following the fall of the Berlin Wall. After that great political upheaval, notably for women, life expectancy in East Germany began to climb rapidly. Twenty years on, it is indistinguishable from that of the former West Germany.

In contrast, the gap between the North East of England and London, which in 1990 was similar to that between East and West Germany, remains just as wide in the most recent figures. Of course, life expectancy has risen markedly in both countries and their regions; modern North East English life expectancy is significantly higher than that which obtained in 1990 for West Germany. But the English failure to narrow its inequality gap despite overt national efforts signals that those efforts are simply too light-touch to be effective.

600px-Angel_of_the_north,_Gateshead

As Johan Mackenbach has commented, in reflecting on the English strategy from 1997-2010:

“it did not address the most relevant entry-points, did not use effective policies and was not delivered at a large enough scale for achieving population-wide impacts. Health inequalities can only be reduced substantially if governments have a democratic mandate to make the necessary policy changes, if demonstrably effective policies can be developed, and if these policies are implemented on the scale needed to reach the overall targets.”

Of course, fundamental to this problem is economics. The wealth of London and the South East in comparison to, well just about anywhere else in the UK, is now extraordinarily stark. London now feels more alien to my Northern sensibilities than much of Europe, and the reason is not people but cash.

The difference is illustrated rather well by the contrasting artistic expectations of the South Bank Centre — close by the Waterloo offices of Public Health England, for whom I worked last year — and the Culture budget of the City of Newcastle — for whom I now work as Director of Public Health.

On consecutive days in 2013, the Guardian and BBC reported the Southbank Centre’s unveiling of its £100m redevelopment plans (6 March), having made a successful first stage bid for £20m from the Arts Council, and Newcastle City Council was reported (7 March) as having cut its £2.5m culture budget by 50%. This comparison could equally be drawn in many other ways: for transport and infrastructure, investment in business, development of academic institutions (why did the Crick Institute need to be in King’s Cross?). And it all matters because, despite the cleaner air and wide open spaces, the English provinces and in particular the North, are losing out — on culture, mobility, urban environment, jobs, and crucially on health.

The English North has many charms, both for its natives and many who come upon its joys by accident (see this delightful, recent New York Times piece). For too many, however, it remains a place of shorter and poorer lives. The German experience suggests that it need not be so.

Prof. Eugene Milne became Director of Public Health for Newcastle upon Tyne earlier this year, after working nationally for Public Health England as Director for Adult Health and Wellbeing. He is an Honorary Professor in Medicine and Health at the University of Durham, and joint-editor, with his colleague Prof. Ted Schrecker, of the Journal of Public Health. He has research interests in health improvement, inequalities and ageing.

The Journal of Public Health invites submission of papers on any aspect of public health research and practice. We welcome papers on the theory and practice of the whole spectrum of public health across the domains of health improvement, health protection and service improvement, with a particular focus on the translation of science into action. Papers on the role of public health ethics and law are welcome.

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Image credit: Angel of the North, Gateshead, by NickyHall5. CC-BY-SA-3.0 via Wikimedia Commons.

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9. Inequalities in life satisfaction in early old age

By Claire Niedzwiedz


How satisfied are you with your life? The answer is undoubtedly shaped by many factors and one key influence is the country in which you live. Governments across the world are increasingly interested in measuring happiness and well-being to understand how societies are changing, as indicators such as GDP (gross domestic product) do not seem to measure what makes life meaningful. Indeed, some countries, such as Bhutan, have measured national happiness for many years. In the World Map of Happiness below, the countries in green (such as Sweden) have the highest satisfaction. The blue countries are less happy than the green, followed by the pink and orange, and finally the red countries (such as Russia) have the lowest satisfaction. The map conjures up all sorts of interesting questions, like what would the map look like if only older or younger people were included or does happiness vary much within a country?

World of Happiness map

A U-shaped relationship between age and life satisfaction is often reported, meaning that people are happiest in their 20s and their 60s. But what are the factors that help older people achieve high life satisfaction? Research in this area is particularly important as a result of increasing life expectancy and growth in the proportion of older people. Measuring average well-being is only one side of the story, however. Countries which have high levels of overall life satisfaction may have large inequalities between the richest and poorest in society.

What type of country fosters a more equitable distribution of well-being? This is the focus of our paper recently published in Age and Ageing. We studied the influence of socioeconomic position on life satisfaction in over 17,000 people aged 50 to 75 years old from 13 European countries participating in the Survey of Health, Ageing, and Retirement in Europe (SHARE). To measure socioeconomic position, we used a number of different measures that reflected their position in society at different stages of their life. By looking at their relative position in their own country’s social hierarchy, we created a scale that enabled comparison between countries and across the life course measures. From childhood, we looked at the number of books people reported they had when they were aged 10 years old, a measure of the family’s cultural and economic resources. Education level was used as a measure of early adulthood social position and current wealth was taken as a measure of economic position at the time of the survey. We grouped countries into four categories based on the characteristics of their welfare policy and looked at whether socioeconomic inequalities in life satisfaction varied by the type of welfare state a country fits into.

Intriguingly, we found that Scandinavian (Sweden and Denmark) followed by Bismarckian countries (Germany, Belgium, Switzerland, the Netherlands, Austria, and France) had both higher life satisfaction and narrower differences in well-being between those at the top and bottom of society. Scandinavian countries are traditionally characterised by their high levels of welfare provision, universalism, and the promotion of social equality. Bismarckian countries are characterised by welfare states that maintain existing social divisions in society, in which social security is often related to one’s earnings and administered via the employer. Southern (Greece, Italy, and Spain) and Post-communist (Poland and the Czech Republic) countries, which tend to have less generous welfare states, had lower life satisfaction and larger social inequalities in life satisfaction. The number of books in childhood was a significant predictor of quality of life in early old age in all welfare states, apart from the Scandinavian type, and the relationship was particularly strong among women in the Southern countries. On the whole, however, inequalities in life satisfaction were largest by current wealth across the majority of welfare states.

Our findings have important implications, especially given the welfare policy changes taking place across Europe and the growth in wealth inequalities. It raises questions about how future generations of people are going to experience their early old age. Will average well-being and inequalities between the richest and poorest change as less welfare support is available? What will be the impact of increases in the retirement age? It is clear that these are urgent questions which affect us all and that the policies governments pursue are likely to shape the answers.

Claire Niedzwiedz (@claire_niedz) is a final year doctoral researcher at the University of Glasgow’s Institute of Health and Wellbeing and is part of the Centre for Research on the Environment, Society and Health (CRESH). They tweet at @CRESHnews. She is the author of the paper ‘The association between life course socioeconomic position and life satisfaction in different welfare states: European comparative study of individuals in early old age’, published in the journal Age and Ageing.

Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.

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Image credit: Satisfaction with Life Index Map coloured according to The World Map of Happiness, Adrian White, Analytic Social Psychologist, University of Leicester. Public domain via Wikimedia commons

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10. Poking Fun at the Enemy

One can learn so much from children. Too often, in our haste to exercise control of every situation, we grown-ups unfortunately root out their innate curiosity and creativity. We drive from point A to point B without noticing the roadside art, whim, and fancy of the trip that is not lost on the childish mind. There is joy to be had in every journey.

I have recently learned you can poke fun at even the vilest of enemies. If you haven’t had a run with my current foe, hold on – cancer will find you somewhere. I don’t wish it on anyone, but unfortunately it worms its way into everyone’s life at some point whether through family or acquaintance. The Myers clan is relatively new at this contest. There is no rule book or instruction manual that I can find. No article 7, subsection 34b that tells us we can’t fight this demon with a joke and a smile.

Sometimes, you have to laugh to keep from drowning in tears. While my bald, frail daughter lays in what was formerly my bed, at times, she seems to find ways to make us smile.

Take for instance a little wresting match with her sister when she attempted to apply a surprise atomic wedgie, but was blocked by the classic counter: the roll onto the back. Rather than move to a frontal assault, she poked her lip out and meekly proclaimed, “But I have cancer.”

With that, her sister waved the white flag, accepted defeat, and soon left the room to repair the damage to her drawers in private.

*****

Just the other day while urging her to drink more water to avoid dehydration and the inevitable trip back to the hospital, I declared, “If you don’t take a drink I’m going to sit on you.”

Her immediate response, “The doctor says you can’t sit on chemo patients.”

Touche, young one! Touche!

*****

 

Yes, we might be behind shoddy castle walls with little defense besides a catapult and barnyard animals, but we have our smiles and cheery hearts. The enemy can’t take that away.

Now leave before I taunt you a second time!

 


Filed under: Learned Along the Way

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11. How to prevent workplace cancer

By John Cherrie


Each year there are 1,800 people killed on the roads in Britain, but over the same period there are around four times as many deaths from cancers that were caused by hazardous agents at work, and many more cases of occupational cancer where the person is cured. There are similar statistics on workplace cancer from most countries; this is a global problem.  Occupational cancer accounts for 5 percent of all cancer deaths in Britain, and around one in seven cases of lung cancer in men are attributable to asbestos, diesel engine exhaust, crystalline silica dust or one of 18 other carcinogens found in the workplace. All of these deaths could have been prevented, and in the future we can stop this unnecessary death toll if we take the right action now.

In 2009, I set out some simple steps to reduce occupational exposure to chemical carcinogens.  The basis was the recognition that the overwhelming majority of workplace cancers from dusts, gases and vapours are caused by exposure to just ten agents or work circumstances, such as welding and painting  (see chart). Focusing our efforts on this relatively short priority list could have a major impact.

Many of these exposures are associated with the construction industry. Almost all are generated as part of a process and are not being manufactured for industrial or consumer uses, e.g. diesel engine exhaust and the dust from construction materials that contain sand (crystalline silica).

The strategies to control exposure to these agents are well understood and so there is no need to invent new technological solutions for this problem. Use of containment, localized ventilation targeted at the source of exposure and other engineering methods can be used to reduce the exposures. If further control is needed then workers can wear personal protective devices, such as respirators, to filter out contaminants before they enter the body.

There are also robust regulations to ensure employers understand their obligations to employees, contractors and members of the public, both in Britain through the Control of Substances Hazardous to Health  (COSHH) Regulations and in the rest of Europe via the Carcinogens and Mutagens Directive.

We know that as time goes on, most exposures in the workplace are decreasing by between about 5% and 10% each year. This seems to be true for many dusts, fibres, gases and vapours, and it is a worldwide trend.  There is every reason to believe this is also true for the carcinogenic exposures we are discussing. This means that over a ten-year period the risk of future cancer deaths is may drop by about half.  If we could increase the rate of decrease in exposure to 20% per annum then after 10 years the risk of future disease should have decreased by about 90%.

However, during the five years since my article was published, very little has been done to improve controls for carcinogens at work. Recent evidence from the Health and Safety Executive (HSE), the regulator in Britain, shows widespread non-compliance at worksites where there is exposure to respirable crystalline silica. Most people are still unaware of the cancer risks associated with being a painter or a welder and so no effective controls are generally put in place. There have been no effective steps taken to reduce exposure to diesel engine exhaust, or most of the other “top ten” workplace carcinogens. What is the barrier preventing change?

In my opinion, the main issue is that we don’t perceive most of these agents or situations as likely to cause cancer.  For example, airborne dust on construction sites, which often contains crystalline silica and may contain other carcinogenic substances, is considered the norm. Diesel soot is ubiquitous in our cities and we all accept it even though it is categorized as a human carcinogen. In my paper I complained that there were ‘no steps taken to reduce the risk from diesel exhaust particulate emission for most exposed groups and no particular priority given to this by regulatory authorities.’ Nothing has changed in this respect. We need an agreed commitment from regulators, employers and workers to change for the better.  Perhaps we need to consider requiring traffic wardens to wear facemasks and encourage painters to work in safer healthier ways. At least we should take a fresh look at what can reasonably be done to protect people.

We know that since 2008 the number of road traffic deaths in the United Kingdom has decreased by about a third and downward time trend seems relentless.  Road traffic campaigners have envisaged a future of zero harm from motor vehicles. Similarly we know that the level of exposure to most workplace carcinogenic substances is decreasing. Can we not also consider a future world where we have eliminated occupational cancer or at least reduced the health consequences to a tiny fraction of today’s death toll? It will be a future that our children or their children will inhabit because of the long lag between exposure to the carcinogens and the development of the disease, but unless we act the danger is that we never see an end to the problem.

As a first step we need to have en effective campaign to raise awareness of the problem of workplace cancers and to start to change attitudes to the most pernicious workplace carcinogens.

John Cherrie is Research Director at the Institute of Occupational Medicine (IOM) in Edinburgh, UK, and Honorary Professor at the University of Aberdeen. He has been involved in several studies to estimate the health impact from carcinogens in the workplace. He is currently Principal Investigator for a study that will estimate the occupational cancer and chronic non-malignant respiratory disease burden in the constructions sector in Singapore. In 2014 he was awarded the Bedford Medal for outstanding contributions to the discipline of occupational hygiene. He is the author of the paper ‘Reducing occupational exposure to chemical carcinogens‘, which is published in the journal Occupational Medicine.

Occupational Medicine is an international peer-reviewed journal, providing vital information for the promotion of workplace health and safety. Topics covered include work-related injury and illness, accident and illness prevention, health promotion, occupational disease, health education, the establishment and implementation of health and safety standards, monitoring of the work environment, and the management of recognised hazards.

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Image credit: Graph provided by the author. Do not reproduce without permission.

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12. Stepping Outside

DSC_0083

I just put a second coat of stain on half of my deck. It’s been three years since I moved into this place, and until this summer, my backyard remained unfurnished and unused, which is a shame because it was one of my favorite features of my townhouse. This summer I committed and purchased patio furniture from IKEA, but once I laid everything out, I realized that the deck floor was coated with years of mucky grime and algae. After giving it a much needed scrubbing; once the wood dried, the deck also needed staining and sealing. My virgo sun couldn’t let the work go unfinished.

IMAG3498

Oddly enough, I always tend to begin big manual projects at the end of a book. Right now I am putting the finishing touches on my next project with Lee and Low, and like my deck, now that the spreads are completed, I am noticing little things that need adjusting (this is of course before I turn it in and have my editor and art director notice other little things that need tweaking). Fortunately, this book is 80% digital, so unlike my other books, making changes won’t mean completely redoing spreads. On the opposite side of that coin, I can tweak until the cows come home if I let myself.

Working on books is not always fun for me. It’s work, and like all jobs, you have great days and really sucky days (when you wish you had become an accountant). I find that exercise and manual labor give me more good days than bad. When I was finishing work on Bird, I compulsively decided to paint my half of my Brooklyn apartment. Now, with this new project, I am creating a backyard oasis. There’s something to be said about getting outside of my head (which is often messy and filled with cobwebs and dark spooky shadows) and completing a small to medium-sized project to help propel me through the end of a book. I wish I could channel that energy into cleaning my house, but that is never a small project.

The virgo in me loves to work, loves to complete things, loves to help people, and loves to be good at stuff. I was born under a productive and communicative sign –  along with Michael Jackson (MJ FOREVER!!!), Beyonce, soccer champion Ronaldo, and Mother Teresa. When I am not allowing myself time to go outside and play, I become paranoid, stressed, and a bit depressed. I also indulge heavily in sugar (honeybuns give me life!) which leads to weight gain, which leads to lethargy, which kills productivity, which then makes me a crazy person. Summer is a time for renewal. I run and do yoga 5-6 times a week, put down the carbs (okay, most of the carbs) and celebrate the outdoors. It’s also the time when I can fully focus on my art and finish projects. This cycle of growth, productivity, and then self-destruction is one that I am vehement about changing for myself.

As I get older, I aim to be active throughout the year. Many of us artists, though wonderful and creative, can fall into cycles of sadness, self-doubt, and inactivity easily. We work in isolation sometimes also live in isolation. Stepping outside of our heads and selves is key to staying positive and creative. Taking care of our physical bodies is crucial to keeping things in balance. Namaste homies!

Welcome to my blog SCBWI members! I hope you find some of these posts to be of use~

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13. The Art of Adding Humor. Even When You Probably Shouldn’t.

We owe the same kind of hilarious grace to our characters and our young readers. We ask so much of them and it’s only right to give them every emotion in equal measure.

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14. You Deserve a Vacation

There’s no reason not to take a vacation when you can book Cheap Bahamas Cruises From Fort Lauderdale.

Did you know that 87% of Americans say that if they had the time and money they would take a vacation? But in reality, they have a problem when it comes right down to taking it even though they have earned paid time off from work.

According to a study put on Marketplace, in 2012, most working Americans never took 9 of the total vacation days that they earned. Cruise and Tours Center in Miami Beach, FL, offers such affordable vacation packages that money should not be an excuse.

Cruise and Tours Center offers Bahamas For Fun discount vacation packages to the popular destinations of the Grand Bahamas Islands in the Caribbean. Choose one of our day cruises, overnight and multi day accommodations in the Grand Bahamas, or Bahamas split cruises.

As Americans continue to feel pressured to stay at work instead of taking their due vacations, Bahamas For Fun Vacation Packages are ready for booking to relieve them of the stress that being over worked puts on them.

The fact of the matter is that vacations benefit the employee and their employer. It has been proven time and again that employees that take time off are better employees. A vacation allows them downtime to relax and get refreshed. They return to work recharged, happy, and ready to go. Employee productivity is higher when vacation time is taken on a regular basis.

There are a variety of venues in the magnificent resort islands throughout the Grand Bahamas for everyone—families, couples, and singles. No matter which package you choose, Cheap Bahamas Cruises From Fort Lauderdale ensures your experience is positive.

Bahamas For Fun makes it so easy and affordable for any resident or tourist of Miami or Fort Lauderdale. Your complete vacation is arranged and reserved. We even provide transportation to and from your location or hotel to the port.

You can customize an island escape and book a 2 to 5 night stay on land. Upon arrival, unwind on the white sand beaches, enjoy a water attraction like parasailing or deep sea diving, or select one of the many available tours.

Call a tour operator at Cruise and Tours Center at 305.397.8170 (toll free 1.888.300.9565). You can also book right online at bahamas4fun.com, or email us at info@Bahamas4Fun.com

Book your Cheap Bahamas Cruises From Fort Lauderdale today and become a happy employee by taking the vacation that you deserve.

 

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15. Survive! Inside the Human Body | Series Review

Combining science and graphic novels is a fantastic way to capture and satisfy the natural curiosity and interest of early and middle readers. The Survive! Inside the Human Body trilogy presents a fun and practical way to introduce complex human biology concepts to readers interested in learning more about the digestive, circulatory and nervous systems.

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16. The Ebola virus and the spread of pandemics

By Peter C. Doherty


A recent New York Times editorial by author David Quammen highlighted the seriousness of the current Ebola outbreak in Guinea, but made the point that there is no great risk of any global pandemic. That’s been generally true of the viruses that, like Ebola, cause exudative diathesis, or bleeding into the tissues, and present with horrific symptoms. There’s a whole range of such infections caused by a spectrum of different virus types. These pathogens are generally maintained asymptomatically in wildlife “reservoir” species, including fruit and insectivorous bats, monkeys, field mice, and various other rodent species. Breathing dust contaminated with dried mouse feces can lead, for example, to infection with the Sin Nombre hantavirus that caused a recent outbreak in Yellowstone National Park. Others (like Ebola) may “jump” across to us from bats and are then transmitted between people following contact with contaminated human blood and other secretions.

Ebola virus.

Ebola virus virion.

From the pandemic aspect, the most dangerous we’ve seen to date is the SARS coronavirus that, in 2002, came out of nowhere to kill some 800 people in the Asia/Pacific region and also caused cases in Toronto. Spread via the respiratory route or by hand-to-face transmission following contact with contaminated surfaces this virus would, if it had emerged prior to the 19th century development of the germ theory of infectious disease, have gone on to cause a continuing human problem. As it was, once the virologists had identified the virus and worked out its mechanism of spread, instituting rigorous sanitation procedures (especially hand washing) and practicing  “barrier nursing” (latex gloves, face masks, disposable gowns) with afflicted patients led to the disease essentially “burning out” in humans. Authorities in the Middle East are, though, keeping a close watch on the closely related MERS coronavirus, which has caused a few human cases and may be maintained in nature as an asymptomatic infection of Egyptian tomb bats and camels. Could the MERS-CoV be the source of  “The Curse of the Mummy’s Tomb”?

Even in the absence of specific antiviral drugs and vaccines, modern science protects us by defining the problem so that public health and medical professionals can take appropriate counter-measures. Still, though such viruses do not generally change their mode of transmission to spread readily by the dangerous respiratory route (we can’t choose when and where to breathe!), the basic message is that the price of freedom (from such infections) is constant vigilance. That’s why government agencies like the CDC and the US Public Health Service are so important for our defense. So far, the “worst-case” pandemic scenario for any hemorrhagic fever virus is that portrayed in the movie Contagion. Hopefully, a catastrophe of such magnitude will remain in the realm of fiction, but we do need to keep our guard up.  The much more immediate and likely pandemic danger is always, so far as we are aware, from the influenza A viruses.

Peter C. Doherty is Chairman of the Department of Immunology at St. Jude’s Children’s Research Hospital, and a Laureate Professor of Microbiology and Immunology at the University of Melbourne. He is the author of The Beginner’s Guide to Winning the Nobel Prize: Advice for Young Scientists, Their Fate is Our Fate: How Birds Foretell Threats to Our Health and Our World, published in Australia as Sentinel Chickens: What Birds Tell us About Our health and the World, A Light History of Hot Air and Pandemics: What Everyone Needs to Know.

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Image: Ebola virus virion. Public domain via Wikimedia Commons.

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17. Hospital 101 for the Incurably Immature

My girls have grown accustomed to it, but their friends constantly remark on my maturity level, which isn’t high. My personal favorite was a comment from a friend of the eldest, who said, “Your dad is like, 7!” Very true. So with all of the time we are spending at the hospital now, I have developed a list of things my childish mind WANTS to do.

1. Every day we walk past a sleep study area to get to our room. I yearn to yell, beat on the walls, and bang pots and pans to wake everyone up.

2. My daughter has a bright-red diode sometimes hooked to her finger that measures her blood oxygen level. I am literally dying to turn the lights off and stick it in my nose and play Rudolf the Red-Nosed Reindeer. She has told me in no uncertain terms that this is unacceptable and her word is law right now.

_MG_13173. I want to drape a stethoscope around my neck and diagnose someone. I don’t really want to barge into a room and play doctor. I just want to find someone, take their vital signs, and prescribe rest and that they lose five pounds before I ask for my co-pay.

4. There are so many things to ride around her that it is killing me. With the wide halls and automatic doors, an epic race seems in order. I picture it a little bit like Mario Kart.Operation_Room,_Kitchener_Hospital_Brighton,_searching_for_a_bullet_(Photo_24-7)

5. I want to run out of our room and yell something like, “Code Blue! Stat!” I don’t know what would happen, but everyone seems to fly into a dither on TV.

6. Get a lab coat and join the doctors on their rounds. I could be some travelling expert from Albania and mutter things that make no sense when it is my turn to examine the patient.

 

 

I haven’t done any of these things yet. Every time I get a 7 year-old notion, my 46 year-old mind overrules it. Thus far. While this wonderful place heals the sick, there is no hope of them helping me, the incurably immature.

 

Photo credit: By Alex Proimos (Flickr: The Stethoscope) & H. D. Girdwood

 


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18. Get Rid of Pest Problems, Call Control Exterminating Company

Pest control in New York NY is no easy task for you to take on by yourself. You need a reliable exterminator that understands that your health and property are top priority.

Located in the heart of Manhattan is the Control Exterminating Company and we’ve been helping landlords, building owners, management firms, and New York residents get rid of their pest problems for years. Pest control in New York NY is critical to your everyday living.

Let’s face it, when you realize you have pests, it can be quite alarming; we know you don’t want them hanging around any longer than they have to. Your pest problem is very important to us. No need to wait, you can ask for our same day or next day service. We take your pest concerns seriously and understand that sooner is better.

“Thorough and reassuring” is what one customer said about our exterminating service. We are a team of locally owned, experienced exterminators, whose owner previously supervised New York City Housing Authority’s, Pest Control Division. So you know you are in good hands.

Our previous NYC clients are our best critics. Here’s what some had to say: “The total ease of mind they gave us was priceless; they solved our nasty [bedbug] problem and their customer service was fantastic.”

“Control Exterminating came to my rescue and took care of a severe roach and silverfish problem…most importantly, they took care to ensure my dog would be safe from any chemicals used.”

The Control Exterminating Company is your resource for Pest Control in New York NY. Don’t let pests embarrass you when they show up unexpectedly, like the roaches recently falling from the ceiling at a sushi restaurant, or rodents overtaking a deli. We service restaurants, delis, and more.

In our 40 years of business, Control Exterminating Company has seen millions of pests come and go, whether you are a commercial or residential property, pests are not particular. We use a treatment with little to no odor, and EPA approved. If you prefer a “green” solution, we have a green alternative. Our treatment is fast and safe!

Don’t hesitate to call (212) 696 4164; you will be connected directly to owner, Barry Kimmel. Whether you are experiencing problems with roaches, rodents, bedbugs, or other bugs and insects, call for an evaluation, you won’t be disappointed in our work, and we have affordable solutions. Find us at controlexterminating.com.

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19. Shaking Hands with your Urologist

My first experience with Dr. P was a week after we discovered our surprise forth pregnancy. I found myself seated uncomfortably on the metal table being interrogated by a very contemplative man half my height, but with an IQ obviously twice mine. He spoke with a fairly thick accent and seemed dubious of my procedure of choice.

Dr. P, “Missa Myers, you seem very young. How old are you?”

Me, “I’m thirty-four.”

Dr. P, “How old your wife?”

Me, “She’s thirty-three.”

Dr. P, “Oh, that very young. You sure you want this?”

Me, “Yes Doctor, I’m sure.”

Dr. P, “You know, this permanent. You might want reversal, but it maybe not work.”

Me, “I know. I’m sure.”

Dr. P, “Your wife sure? She know?”

Me, “Yes, she knows.”

Dr. P, “Okay, you sure. Just one more time I ask, because you maybe not go back?”

Me, “Dr. P, we just found out we were pregnant with our fourth child.”

Momentary pause for contemplation.

Dr. P, “Oh. In that case, why you not come see me sooner?”

He checked a box on his form and left. The procedure came a few weeks later. I’ll mention no specifics except to say that once I was prepped and ready, the quiet, secluded corner room seemed to turn into Grand Central Station. Nurses, accountants, inspectors, magazine vendors, interns, dog walkers, board certifiers, and I think a few pharmaceutical sales reps all of the sudden had important business in my room. Finally the good doctor came and did his work. I left hoping to never see Dr. P again. No offense, but I thought seeing him again meant a fifth bundle of joy. I was wrong.

My second trip to see him came after experiencing some discomfort during a long run. Until then, I had no idea that Urologists did everything! When I went back to the very same room, there sat my friend, Dr. P. who remembered me distinctly.

“How your baby?” Dr. P asked.

Me, “She’s doing great. Six years old now.”

Dr. P, “How old are you?”

Me, “I just turned forty.”

Dr. P, “You know, Missa Myers, we start thinking about prostate health at this age…”

 

I’ll leave the rest to the imagination. Based on my experience with Dr. P, I have some advice for men.

First, when your Urologist asks you your age, consider consider the ramifications of the question.

Second, when you are greeted by your friendly Urologist, remember that his hands have been places that my dog’s nose only dreams about.

 

A_handshake

 

I poke fun at my interaction with Dr. P, but men’s health issues are not a laughing matter. Fortunately, I only had a couple of kidney stones that were easily blasted out. Get checked when it is time to get checked, men. Others are counting on you!

 


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20. A Chat with Asperkids™ Author Jennifer Cook O’Toole

Jennifer Cook O’Toole is founder of Asperkids™, a multimedia social education company focused on making life for children and families with Asperger’s profoundly positive and purposeful.

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21. Where were you?

Where were you when you first heard the sound? Good sounds – your husband’s voice, your baby’s giggle, the words “I love you?” Do you remember? Can you picture the scene and surroundings?

I experienced a condensed courtship with my wife because I was briefly called back to service during Desert Storm. I don’t recall the first expression of the four- letter L word in our relationship. I know it came, and stuck. I have said it to her every day for nearly twenty-two years. I say it every night to my girls and sometimes in front of other people, much to their chagrin.

I wish I remembered the first time I said it, though.

I will never forget the first time I heard the word Cancer as it related to my family. I was in the hospital just a week ago when it was introduced to me, while my little girl lay sleeping nearby. The doctor actually used the words “oncological event” before I made him dumb it down for me. Cancer.

I held my wife in my arms as she collapsed into a puddle. Doesn’t cancer affect other families? Why would he be saying this word? I felt an instant dislike for this man, but my mind clouded to nothing. My wife’s head heaved in my chest. I couldn’t think in more than three word bursts. I have no idea how long we stood that way. I was roused only by the sound of a man pushing a cart way down at the end of the hall. The wheel squeaked as he carried out his task and I remember thinking, “How can he be pushing that? Doesn’t he know? It doesn’t matter where that squeaky cart is! Why isn’t he stopping?”

It was then I realized this isn’t everyone’s diagnosis. It is Kylie’s and ours: our family’s, our friends and network of support. But the rest of the world will continue to march on around us.

I will add a link to Kylie’s Caring Bridge at the end of this post because I won’t allow cancer to dominate my writing. It will peak its evil head in from time to time, I have no doubt. But I won’t allow it to take over my life, steal my joy, soil my faith, or crush my little girl.

It took a while to determine the enemy. Until then, we’ve been punching at shadows. Now we start to take it out. We are at the beginning of a long road, but there is hope. Kylie knows what is going on, she is scared. We cried together and prayed. She has decided that this is happening because God must have a really big, great plan for her. I don’t know if I could have gotten to those words so quickly at twelve – she’s just chock-full of amazing.

image

The picture I added is one of Kylie as Annie in her school play a couple of years ago. She is an incredible actress and I can’t wait to see her on stage again.

Because our minds are reeling right now, the verse we’ve been holding onto is Romans 8:26

Likewise the Spirit also helps in our weaknesses. For we do not know what we should pray for as we ought, but the Spirit Himself makes intercession for us with groanings which cannot be uttered.

Thank you for your prayers and words of encouragement, friends. I have to go now, the bell just sounded for round one…

 

http://www.caringbridge.org/visit/kyliemyers

 


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22. Beginning the Green Smoothie Phase of My Spring Cleaning

As you may have been able to tell from my recent photos and posts, I was skiing up until a few days ago. Just arrived home to the desert where it’s already 92 degrees. It’s a little . . . jarring. Dogs are looking at me like, “What the–?” and while they’re busy shedding as much of their fur as possible–I’ll be able to knit a new Labrador in about a week–I’m taking my own measures to adjust to the almost summer.

It’s a two-phase action plan: Clean my house, clean my body.

Believe it or not, the body part of it is much simpler. All I have to do is switch out of winter eating mode (soups, sandwiches, pastas, sweets, sweets, more sweets) and turn to my old friend the green smoothie.

Also known as Baby Poop.

Why Baby Poop? Because if you saw the way one of my green smoothies has traditionally looked–dark brown, sometimes brownish-red, with hints of green flakes–you’d say, “Yeah, good luck with that, think I’ll have a salad.” But for some reason, I’ve been out of the salad mood for about a year now. Can’t explain it. So I’m just going with it.

The thing that’s going to banish the baby-poopedness look of my smoothies from now on is that tomorrow I’ll be getting this nifty machine that actually has a proper motor. I discovered while skiing that that’s been the whole problem with my green smoothie life. I just haven’t had enough power.

I made that discovery by watching someone else make one for me. The things she put in there! (To be discussed below.) And by the time she poured it into a cup, the liquid was this beautiful, light green, and instead of tasting gritty and *good for me,* it tasted smooth and delicious, more like a dessert. Which, see above re: winter diet, sold me.

But even better, the smoothie fixed me.  Day after day I’d stumble into that place, start croaking out ingredients–”Dates! Cashews! Oh my gosh I’m about to pass out–coconut! More fat! Bring it!”–and the lovely proprietoress, Gretchen, would keep adding and adding (see below) and then give me basically a cup full of green medicine.

I have never recovered from a big physical effort more quickly and more deliciously. That’s what I’m saying. That’s why I’m trekking down the Green Smoothie Way.

I’ll be experimenting with new recipes as I go, and I’ll post some of the best ones here, but let’s start with the Skiing Kicked My Butt recipe that got me through:

  • Big handful of unsalted cashews
  • Normal handful of unsalted sunflower seeds
  • One heaping teaspoon peanut butter
  • Big handful of dates (about 5)
  • One banana, preferably frozen to give the drink some thickness
  • Big handful of strawberries, also preferably frozen
  • Normal handful of blueberries (optional–makes the color a little weirder, but tastes good)
  • Two heaping teaspoons cacao (unsweetened cocoa powder will do) (also optional, but wow)
  • One teaspoon coconut (optional, but yum)
  • Three huge leaves of kale or Swiss chard, stems and all, ripped into pieces and layered on top
  • About 1/2  to 1 cup of peach, pear, or apple juice
  • About 1 1/2 cups pure water–start with 1 cup, then add more as you assess the thickness. Some people like their smoothies thicker, some more liquidy. You’re the boss.

I tried this in my regular blender, but no. Baby poop. I’ll take a photo of the proper green smoothie once I try it with my new machine tomorrow. You’ll see. Fresh and spring-looking.

Onward, green smoothiers!

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23. Is a Peel Right for My Skin?

 

The truth is that, there is a chemical peel for every skin type. A chemical peel can help your skin tone, the texture of your skin, reduce fine lines and wrinkles, shrink large pores, lighten freckles and reduce the appearance of scars, as well as lighten the appearance of hyper-pigmentation and sun damage and even reduce the appearance of acne. There are many types of chemical peels, and each one is designed either for a specific skin type or to alleviate a specific problem.

The reported benefits of a peel are extensive but, is a peel right for you? The only way to determine if you should get a Chemical Peel in Atlanta GA, is to go in for a consultation with a specialist. Talking to a professional at The Slender Spa Med can help you make an educated decision.

A professional can tell you about the types of peels that they offer and recommend the right one for your specific skin and needs. The Slender Spa Med has one of the most comprehensive self-improvement spas in the field. In chemical peels they offer both Physician’s Choice and Skinceuticals brand peels. With these two brands they can offer anything from a micro peel to an entire body peel, and everything in between.

During a consultation you will meet with a medical professional, and you will discuss exactly what you want and expect from a chemical peel. You will discuss your skin and your skincare history. A skilled esthetician will conduct an examination of your skin and recommend the treatment that best suits your needs. The final decision will, of course, be yours.

Receiving a chemical peel is a big decision. It can potentially change your life. Imagine having the skin that you have always dreamed of having. Your skin can be free of dark spots, or large pores. You can reduce the appearance of those ugly pimples, or make those unsightly acne or chicken pox scars fade. Your skin can regain that youthful glow and warm vitality, and with it you can have improved self-confidence and perhaps even a new lease on life.

It all starts with a simple consultation to find out what treatment is best for you. There is no time like the present to seize the future. Make an appointment today for a Chemical Peel in Atlanta GA, and find out what is in your future.

The post Is a Peel Right for My Skin? appeared first on Jessabella Reads.

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24. Green Smoothie of the Day: Chocolate Banana Strawberry Pineapple (Etc.)

Chocolate Banana Strawberry Pineapple (Etc.) Green Smoothie

Chocolate Banana Strawberry Pineapple (Etc.) Green Smoothie

Here’s today’s experiment:

  • 1 handful sprouts
  • 2 large Swiss chard leaves
  • 3 dates
  • 4 frozen strawberries
  • 1 frozen banana
  • 3 frozen pineapple chunks
  • 1 heaping Tablespoon peanut butter
  • 2 heaping teaspoons cacao
  • About 1 cup water (up to the Nutribullet fill line)

Taste review: Looks like a chocolate smoothie, tastes a little more gardeny than that. I started with just half a banana and no dates, and it wasn’t sweet enough. I think I could have gotten by with just one teaspoon of cacao. I’m kind of sick of the taste of dates. Will be looking for other ways to sweeten. But overall, not bad! And very, very filling.

Health review: After just a few days of one green smoothie a day, my skin already looks so much better–healthy and clear in a way it hasn’t for months. And my digestion: wow. I won’t go into detail, but let’s just say it’s meeting my need for spring cleaning.

The key, though, is these smoothies have to taste good. This is a voluntary activity and if it’s not fun I won’t do it. Which is why I’m experimenting with flavors. And why I’m reporting to you about those experiments, so that if you’re in the green smoothie mood, you can do it in an enjoyable, non-punishing way. Because we’re against punishment here on the blog.

Carry on, Greenies!

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25. Potty Training Books for a Diaper-Free Existence

And then there's potty training. It's a world unto itself, with special videos, portable potties, stickers, colorful underwear, and, of course, books. But the pay-off is huge: a diaper-free existence. We're big readers in our household, so why not read about it, too?

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