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Friday, December 30, 2016

Factors In Choosing An Apartment

Are you looking for an apartment? I would like to share some friendly reminders to consider when looking for an apartment to rent:

Condition of the Apartment - Take a walk around the apartment. Inspect areas that need immediate repairs, repainting, etc. Make sure you check all the rooms. Remember that safety is very important. Ask someone who knows about wiring to check the apartment. Try to find out if the apartment conforms to safety regulations (example: presence of fire exit).

Cleanliness - Check for signs of possible pest problem. You would not want to make the mistake of renting a place infested with cockroaches or worse rats.

Size - Its always advisable to find a place ideal for the number of people who are going to live in it. Overcrowding is never a good idea.

Parking - This is a big consideration if you own a car. It is better to rent apartments that include safe parking areas.

Security - Renting a place that provides security is a great disadvantage. Take note that this feature often means higher rental fees.

Proximity to Important Places - It is preferable to find a place that has access to nearby market, school (especially for those who have kids) and hospital. It is a big advantage to live near your work place.

Take note that finding the ideal apartment may take time. Avoid being impulsive. Dont be too excited to rent the first apartment you visit. It is good to have some choices. When you find a few apartments interesting, you can compare them to find the one that suits you the most.

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Early Warning Signs that your Liver is sluggish and toxins are being stored in your fat cells

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Ear Infection In Dogs Symptoms

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Images of Ear Infection In Dogs Symptoms

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In either case, but more often with infection, the ear canal skin swells and may become painful or tender to touch. Classification Edit. In contrast to the chronic otitis externa, acute Because the symptoms of external otitis lead many people to attempt to clean out the ear canal (or ... Read Article

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Zika Could Spread in Southern Europe This Summer MedlinePlus

Zika Could Spread in Southern Europe This Summer: MedlinePlus

MedlinePlus Trusted Health Information for You

Zika Could Spread in Southern Europe This Summer

Conditions will be ripe for transmission via Aedes aegypti mosquito, study warns

By Robert Preidt

Tuesday, June 14, 2016

TUESDAY, June 14, 2016 (HealthDay News) -- The Zika virus could spread in southern Europe this summer if its introduced to the region by infected travelers, researchers warn.

Zika is transmitted by the Aedes aegypti mosquito, which is present in southern Europe. An analysis of a number of factors, including temperatures and air traveler patterns, suggests that parts of southern Europe may be at risk for Zika outbreaks between June and August.

"We know warm climates create the kind of conditions suitable for mosquito-borne illnesses to spread," said study author Joacim Rocklov. He is a researcher in the unit for epidemiology and global health at Umea University, in Sweden.

While most people only suffer mild symptoms after being infected with the Zika virus, infection during pregnancy can cause a devastating birth defect known as microcephaly, where babies are born with abnormally small heads and brains.

The vast majority of Zika infections have occurred in Latin America, and Brazil has been the epicenter with an estimated 5,000 cases of microcephaly.

"The presence of established Aedes mosquito populations, the warmer climate and the coinciding peak flow of air travelers [from Zika-affected areas in the Americas] into Europe is a triage making southern Europe fertile ground for Zika," Rocklov explained in a university news release.

The study was published June 10 in the journal EBioMedicine.

While Zika is typically spread via the bite of the Aedes mosquito, there is increasing evidence that the virus can also be transmitted through sex, possibly even oral sex.

In light of that, the World Health Organization advises couples who are trying to have children and live in Zika-affected areas to consider delaying pregnancy to avoid having babies born with birth defects.

The new guideline replaces an earlier one that suggested women planning to become pregnant should wait at least eight weeks before trying to conceive if they or their partner live in -- or are returning from -- Zika-affected regions.

There have been no reports of Zika-induced microcephaly contracted in the United States. But two babies have been born in the United States with the birth defect after their mothers contracted the virus while traveling during pregnancy in countries where Zika is active.

U.S. health officials have said they expect to see Zika infections in Gulf Coast states such as Florida, Louisiana and Texas as the summer mosquito season picks up.

SOURCE: Umea University, news release, June 10, 2016

HealthDay

News stories are provided by HealthDay and do not reflect the views of MedlinePlus, the National Library of Medicine, the National Institutes of Health, the U.S. Department of Health and Human Services, or federal policy.

More Health News on:: Zika Virus

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Finding the Best Cataract Surgeons in Massachusetts

To find the best cataract surgeons requires a little bit of work and investigation but is always worth it. Finding an eye surgeon who is a cataract specialist can help you to be confident that you are getting the most current information, thoughts and techniques to deal with your cataracts.

Ask People You Trust for a recommendation. Ask your friends, co-workers and family-but most importantly ask you primary care physician who they would go to or who they would send a parent to for cataract surgery.

Don’t Limit Yourself to Insurance Lists. Just because a cataract surgeon is “in network” isn’t a reason to use them if you are able to identify a top cataract surgeon you wish to go to who isn’t listed. Paying a slightly higher co-pay or deductible may be very worthwhile to get the cataract surgeon of your choice. If the best cataract surgeon in your area happens to be in the insurance list then you are all set.

Use the Power of the Internet. Take a minute to search “cataract surgeons in (insert your town/city/state)” or “best cataract surgeon in (insert your town/city/state)”. This will at least give you a starting place to begin creating a list of eye surgeons to investigate further.

Visit the Cataract Surgeon’s Web Site. Once you have compiled a list, visit their web sites and get a feel for their practice culture and philosophy. While a web site by itself can’t tell you much about surgical skills, it can tell you about how well he or she presents information and explains detail to patients. This is important in how comfortable you may feel in that practice.

Schedule a Consultation and Meet the Cataract Surgeon. The only sure fire way to find out if you are comfortable and get a sense of trust from a cataract surgeon is to schedule a consultation and meet the surgeon personally. They should be able to clearly explain your eye health and vision as well as the cataract procedure and answer any questions you have in understandable language and terms. Whether or not you find the right cataract surgeon right off the bat it is never inappropriate to………

Get a Second Opinion. Making a decision about eye surgery is a big deal. Getting to a place where you feel confident, relaxed and comfortable is important.

If you or someone you know has a cataract or wish to learn more about cataract surgery, please call D’Ambrosio Eye Care at 800-325-3937. You may also request an appointment at facebook.com/dambrosioeyecare.

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Preventing Legionnaires’ Disease in Healthcare Facilities Part 2 How Our Legionella Experiences Shaped our Prevention Approaches Safe Healthcare Blogs CDC

Preventing Legionnaires’ Disease in Healthcare Facilities Part 2: How Our Legionella Experiences Shaped our Prevention Approaches | Safe Healthcare | Blogs | CDC

Preventing Legionnaires’ Disease in Healthcare Facilities Part 2: How Our Legionella Experiences Shaped our Prevention Approaches

June 16, 2016 by CDCs Safe Healthcare Blog

Guest Author: John Letson, Vice President Plant Operations, Memorial Sloan Kettering Cancer Center

Memorial Sloan Kettering Cancer Center (MSK) has a 470 inpatient bed hospital, outpatient clinics, and research facility headquartered on the upper east side of Manhattan, with additional outpatient treatment centers in Brooklyn; Long Island; Westchester County, New York; and New Jersey. The well-being of our patients is the primary concern of all doctors, nurses, and staff. The at-risk patients at MSK basically are in two groups. First, cancer patients receiving chemotherapy, including those with combinations of factors placing them at greatest risk, e.g. a patient who smokes and has respiratory issues in addition to having a cancer for which they are receiving chemotherapy. Second, bone marrow transplant patients. The majority of patients diagnosed at MSK with community acquired Legionella in the past have been bone marrow transplant patients. As cancer care continues to move to more outpatient treatment plans, all building owners need to be cognizant of the dangersLegionella poses. It is important to be proactive in preventing the bacteria from propagating in building water systems to preserve the health and safety of everyone.

For more information about MSK and background on our successful Legionella water management program, read my blog entry.

EXPERIENCE CHANGES THE APPROACH

One of the most feared environmental scenarios in healthcare, would be to have a Legionellaoutbreak. In addition it can be quite alarming when one encounters an “outbreak” of consistently positive environmental cultures. MSK has not experienced any Legionella “outbreaks” where tests show consistent levels of positive colony forming units at many multiple distal sites and buildings. But, MSK has had instances when we had a number of positive Legionella test culture results near locations where patients tested positive for Legionella. The resultant circumstances are the same whether wide spread in a general population or isolated in an at-risk population. The resources required during any outbreak scenario will vary. So here is a brief history of MSK’s experience with positive culture results and the ensuing changes that occurred in mitigation response activities, long term mitigation activities, and the evolution of testing and monitoring.

In 1999 MSK experienced a Legionella positive patient at the same interval as a positive environmental shower culture result and a timeline that suggested it was hospital-acquired. The patient was a bone marrow transplant patient and the Legionella types from the patient and shower were the same. At the time it could not be proven that the patient’s disease was hospital-acquired. Following this event, in 2000, MSK selected and implemented copper-silver ionization as a long term mitigation methodology on the potable hot water system in all in-patient areas. We also adopted a zero tolerance for anyLegionella in any water system. As a result of this long term mitigation strategy, positive cultures were eliminated for the next seven years until November 2007, when multiple environmental test culture results came back grossly contaminated for Legionella. This was strange because we went from no positive cultures to such a high level in a short period, so we sent samples to the same lab for retest; as well as to a second, different lab. The same lab (as the previous samples were sent to) report came back contaminated again, but the new lab report came back all negative. We performed mitigation anyway, retested (results negative again), and returned to service. MSK changed labs following this event. This experience validated the importance of using a lab knowledgeable in testing protocols for Legionella or one listed as being CDC ELITE certified.

MSK experienced another positive culture on September 2, 2010. We performed mitigation in this case sanitizing the affected potable water tanks, and retested which came back negative, and were returned to service. While we did not make the correlation at the time, this positive culture was attributable to heavy rain activity during the end of August 2010.

Another positive culture occurred almost one year later. There was one positive culture on September 7, 2011, and one positive case at the same time; both Legionella pneumophila serogroup one. We performed mitigation, retested which came back negative, and returned to service. On subsequent NYC Department of Health Pulsed Field Gel Electrophoresis (PFGE) the testing showed the serogroup in the environmental culture and patient culture were different, so the case was concluded as community-acquired. Similar to the previous event we noted increases in positive cultures in potable water tanks following heavy rain. This was observed at times following heavy thunderstorms or in this instance hurricane activity. This was thought due to the increased runoff and turbulence into open water reservoirs and settling ponds. The runoff which may have washed and disturbed bacteria and organic material from soil and Legionella from biofilms into the source water. Increased organics and pathogen content overwhelms oxidizing biocides and other water purification methods, permitting some bacteria to survive and enter the water system. The positive environmental cultures of September 7, 2011 were directly attributable to hurricane Irene which hit the New York area in late August. As a result, we now test potable water storage tanks a week to ten days after heavy rain events over two inches in order to provide proactive mitigation if required.

There are additional affects an institution could experience based on positive patient cases of Legionella; even if the case is community-acquired. So how does an event change views and practices around potable water safety? Patients and staff have a lack of confidence in the potable water source and utility. Mitigation and extended monitoring is required to reinforce that water is safe when others feel it may not be. Everyone feels at risk—not just the patient. Our experience is staff become highly sensitive and concerned about the level of risk from the water supply.

LONG TERM REMEDIATION

As stated earlier, in 2000 MSK adopted and maintained a zero tolerance policy for Legionella. We adopted the policy in conjunction with implementation of copper-silver ionization on the potable hot water in all in-patient areas. Any positive culture at minimum requires a retest and in some cases enhanced mitigations of hyper-chlorination and flushing, increased ionizer levels, and a second retest to confirm effectiveness. We accomplish and maintain this policy by continually performing:

Risk analysis is done in conjunction with the infectious disease department to identify potential sources of bacteria and outline monitoring and mitigation responses.
Regular mitigation and maintenance including potable tank cleaning, riser flushing, cooling tower cleaning and chemical water treatment. In the case of cooling tower water treatment, we maintain the zero tolerance due to our patient population instead of under the 1000CFU/liter OSHA standard.
Copper-silver units require regular cleaning, monitoring (testing), maintenance, and occasional repairs to be continually effective. We rebar our units every 18 to 24 months. The copper-silver units in our view are the closest thing to plug and play you can get.
Regular testing is key to the success or failure of any water treatment program. It qualifies the effectiveness of any mitigation and enables a proactive response to a positive culture.
Monitor and qualify new construction; new construction areas are a potential source of Legionella due to water being shut off for extended periods creating dead legs and any dirt or debris that may be left in the piping during construction activities. MSK’s process is to flush, sanitize, and test prior to placing new piping in service.

TESTING, TESTING, TESTING

Testing is key to success. We have always advocated testing of water systems including potable water tanks, random potable water distal sites, specifically hot water in showers, and cooling towers. Some states mandate testing dependent on patient population. State of NY requires quarterly water system testing where immune-compromised and transplant patient populations undergo treatment. In our experience in the past 16 years, testing has served to exonerate MSK when serogroup between patient case and cultured distal sites did not match.

Let your testing evolve to suit your conditions. MSK’s testing began and evolved as follows:

Potable water tanks were originally tested annually, which evolved to quarterly to be consistent with all other testing. Following two sequential years of a positive culture in 2010 and 2011, we now do weekly testing for a month following a rain event in excess of 2 inches or a hurricane as it was determined that there were elevated counts following major runoffs.
Random potable hot water at shower distal sites began and remains at quarterly intervals. Copper-silver ionization systems continue to provide outstanding results since installed in 2000. At that time, distal site random cultures previously consistently positive became negative in just two weeks and have remained that way since. We take both a bulk water sample and a swab at each site and send out 20 sites per quarter.
We do additional potable water samples for copper and silver levels once a month to ensure the levels are maintained within range.
Cooling towers began quarterly; we changed to monthly from June to September as we kept getting positive cultures in the 3rd quarter. Monthly testing during the cooling season allows mitigation to be more real-time and has eliminated most September positives.
All testing is completed at a 3rd party lab. We use one of the most well recognized labs on the east coast.

ASHRAE 188 defines a systematic approach similar to what has been done effectively at MSK for the past 16 years.

The CDC’s toolkit, Developing a Water Management Program to Reduce Legionella Growth & Spread in Buildings, reinforces and breaks down ASHRAE 188 into practical action based guide to help building and healthcare providers develop new policies and methodologies to proactively prevent this disease. Having gone through these steps years before, due to our patient population, MSK does not view the standard as added work or responsibility, only a reaffirmation that what we have done here for years is the right thing to do.

June 16, 2016 by CDCs Safe Healthcare Blog

Healthcare-associated infections

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Birthday Present in November

I have THE BEST HUSBAND EVER. Like, ever ever.

See those 6 red lights in the middle of the picture?

Thats my @ss warmers. Joel bought me aftermarket seat heaters for my birthday and he finally had a spare moment to work on installing them. And he got it all done over the weekend. I really thought my car was going to be half out of commission for like a month, but he managed to pull it all off in just 2 days!

And let me tell you....it was just in time. Its *BAD WORD* cold outside. Best birthday present of all time. Fitting since its from the best husband of all time.

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CONTROL YOUR ANGER FIRST IMPRESSION IN KIDS

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Symptoms Of Cataracts In Eyes

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Pictures of Symptoms Of Cataracts In Eyes

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Find Kardus

Friday, December 30, 2016

Factors In Choosing An Apartment

Factors In Choosing An Apartment

Thursday, December 29, 2016

Early Warning Signs that your Liver is sluggish and toxins are being stored in your fat cells

Early Warning Signs that your Liver is sluggish and toxins are being stored in your fat cells

Wednesday, December 28, 2016

Ear Infection In Dogs Symptoms

Ear Infection In Dogs Symptoms

Tuesday, December 27, 2016

Zika Could Spread in Southern Europe This Summer MedlinePlus

Zika Could Spread in Southern Europe This Summer MedlinePlus

Zika Could Spread in Southern Europe This Summer

Finding the Best Cataract Surgeons in Massachusetts

Finding the Best Cataract Surgeons in Massachusetts

Preventing Legionnaires’ Disease in Healthcare Facilities Part 2 How Our Legionella Experiences Shaped our Prevention Approaches Safe Healthcare Blogs CDC

Preventing Legionnaires’ Disease in Healthcare Facilities Part 2 How Our Legionella Experiences Shaped our Prevention Approaches Safe Healthcare Blogs CDC

Preventing Legionnaires’ Disease in Healthcare Facilities Part 2: How Our Legionella Experiences Shaped our Prevention Approaches

Birthday Present in November

Birthday Present in November

Monday, December 26, 2016

CONTROL YOUR ANGER FIRST IMPRESSION IN KIDS

CONTROL YOUR ANGER FIRST IMPRESSION IN KIDS

Symptoms Of Cataracts In Eyes

Symptoms Of Cataracts In Eyes