How to Keep a Terminally Ill Patient at Home – making it

#care of terminally ill patient

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Keeping The Terminally Ill Patient At Home
(Making It Happen)

If your loved one wishes to stay at home up till the very end, then you need to make that wish clearly known to your RN casemanager, the social worker, your physician and any other hospice staff who inquires about your wishes. If there are other family members available to help out, discuss this decision with each other, and make sure that all family members are working together toward your goal.

Hospices can provide services which help during part of the day. At the Routine Home Care Level of Care, the hospice would be sending out Home Health Aides to help with bathing, dressing, basic bedside care and activities of daily living. They can sometimes send out home service aides to help with housework or cooking and other tasks. Volunteers from the community who serve at your hospice can also spend time with your loved one, freeing up time for you to go out if needed, or just to get a break from caregiving. The RN casemanager and other nurses will be visiting periodically during the week to evaluate your loved one’s condition, monitor for any changes, and to make sure your loved one is getting the medications and services needed meet his or her needs.

However, in some cases, you should be prepared for hospice staff who might attempt to convince you to bring your loved one to the hospice facility. While this may be appropriate for some patients, if you really want to keep your loved one home, you can. You, as patient or family/caregiver, have rights to choose to stay home, and nobody can force you to enter a facility against your will. However, if you do choose to stay home, then you need to mobilize all resources and assistance you can muster to help make it happen. A good first step would be to ask the hospice RN and the medical social worker if she or he knew of other community resources where you could get help to care for your loved one.

What can the family do to help keep their loved one home?

The family members can make a schedule of when each family member will be there to provide care so that all hours are covered.

You can ask for help from your local church or synogogue. Sometimes it is necessary to be willing to let others help out, if you are to succeed in keeping your loved one in the home.

You can ask for help from friend or acquaintances.

You can directly hire extra help. Help can come from nursing agencies or other sources. For example, if your loved one does not need nursing care all the time, then you could hire sitters from agencies or even directly hire people from the community. Some people put an ad in the newspaper letting people know that they would be hiring a helper and specifying the hourly wage they would directly pay to helpers. Many colleges and universities have employment centers for their students who are seeking part-time or full-time work. The students can often work hours that others may not be willing to take, and they usually do not need as high a wage as household bread-winners who are trying to support a household and family.

Whether you have the immediate family care for the patient or relatives, or close friends, you will probably need assistance of many sorts. If the family can come together and work together, that is the very best circumstance.

The hospice must meet the care needs of the patient and family unit. 1 The services which are required to be provided include family needs for support and counseling. If symptoms go out of control and the patient experiences uncontrolled severe pain or other symptoms, then the hospice must provide, in most circumstances, what is called continuous nursing care in your own home. which is around the clock nursing at home, provided by licensed nurses more than 50% of each day, with the rest of the care provided by home health aides. 2

A Registered Nurse (not an LPN) must personally visit the patient to assess his or her condition each day. If the patient’s symptoms are brought under control, then continuous care may be discontinued. However, if symptoms remain out of control, the RN may continue to have nursing staff provided around the clock in your home. After three days the hospice will re-evaluate whether continuous nursing care in the home can be continued. Continuous nursing care may also be provided when the patient is actively dying and very near the end.

The hospice will help you learn how to care for the patient at home. The Registered Nurse will teach you about the medications to be given and how to give them. If you have questions about your loved one’s care after normal business hours, you can always call the hospice’s on-call nurse. Whatever the situation, the hospice staff are experts in handling the types of situations that come up. There is much information available that can help you keep your loved one at home. Read whatever literature the hospice provides and ask questions. Discuss your wishes among yourselves as a family and with the hospice staff. The more you communicate, the better the outcome will be.

1 According to federal regulation 42 CFR 418.58(c) the hospice’s Plan of Care must state in detail the scope and frequency of services needed to meet the patient’s and family’s needs.

2 42 CFR 418.204 states that, Nursing care may be covered on a continuous basis for as much as 24 hours a day during periods of crisis as necessary to maintain an individual at home. A period of crisis is a period in which the individual requires continuous care to achieve palliation or management of acute medical symptoms. 42 CFR 418.82 states that Nursing services must be directed and staffed to assure that the nursing needs of patients are met. The hospice must meet your needs for nursing care!





Hospice Patients Alliance – When It is Inappropriate to Have PRN Medical

#end stage copd hospice

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Allowing PRN Orders for Morphine
May Result in Untimely Death
For COPD Patients

Morphine is an opioid medication often used to relieve severe pain in cancer and some other diseases. When prescribed by a physician appropriately for relief of pain, it is a blessing to those whose symptoms are relieved, and to the families of those patients who had suffered watching their loved one in agony. When the patient has severe pain, hospices aim at achieving good pain control as one of their top priorities.

Because morphine is regularly prescribed in hospices for relief of pain and suffering, physicians and nurses come to rely on its power to relieve pain and promote a death without suffering. A death with symptoms well-managed is one important aspect of what is called a “death with dignity.”

Patients in hospice who have diseases without severe pain may not need morphine for comfort. Some take other analgesics and some take none. But patients who have Chronic Obstructive Pulmonary Disease or “COPD” may especially be sensitive to the adverse effects of morphine. COPD patients have breathing difficulties and anxiety which can sometimes be lessened by very small dosages of a sedative and/or a very small dosage of morphine. However, given in too high a dose, morphine can seriously interfere with a patient’s ability to breathe. In fact, anyone who is given a dosage of morphine which is much higher than they are accustomed to, may stop breathing.

One of morphine’s main adverse effects is slowing down the respiratory rate, i.e. respiratory depression. If the dosage of morphine is too high for what the patient is accustomed to, the respiratory depression can become severe and actually stop the breathing periodically for a few seconds or many seconds. This pattern of breathing where the patient stops breathing (skipping breaths) and then starts breathing again is termed “apnea.” Apnea commonly occurs as a result of the terminal illness and the dying process, when certain metabolic changes occur in the patient’s body. If the breathing is stopped completely without restarting, the patient dies. Because COPD patients have compromised breathing already. very inefficient breathing, overly high doses of morphine can quickly cause these patients to stop breathing.

Hospice Patients Alliance has received many, many reports from families about patients with COPD who were given morphine in dosages higher than they were accustomed to receiving. who died shortly after getting those morphine dosages. Most of these patients were given these dosages of morphine by nurses in the hospice setting. In all the cases reported, the physician had ordered that the morphine might be given “as needed” or “PRN” within a certain range and at a certain frequency of time intervals between doses given.

Giving a medication “as needed” requires a careful assessment of the patient’s vital signs, pain level and need for the medication being considered. When a physician writes a PRN order for morphine, most nurses are very dedicated to assessing the patient’s actual needs and doing everything possible to meet those needs by administering the medication as needed. But in the case of COPD patients, the need for extra vigilance in determining the appropriate dosage is very urgent. Pharmacy and drug references, such as the Physicians Desk Reference and morphine package inserts warn about the dangers of giving too high dosages of morphine to COPD patients. The package inserts and the Physicians Desk Reference even write that morphine is “contraindicated” in general for COPD patients. However, when a patient is truly terminal, some of the rules of prescribing medications are adjusted to meet the needs of the patient. In the terminal COPD patient, morphine is sometimes ordered by the physician to be given in very small dosages.

If the physician orders the morphine to be given on a PRN or “as needed” basis, when the patient has COPD, and allows a shorter frequency of administration than that needed for the previous dosage to “wear off” or be metabolized, the concentration of morphine actually in the patient’s blood may increase beyond a therapeutic level, causing severe adverse effects, even respiratory shutdown. If you have a loved one with COPD in a hospice care setting and if you are concerned that he may be euthanized before his natural time of passing on, then it is wise to request that the physician NOT write a PRN order for morphine. If the morphine is actually helping your loved one to breathe better, and is comforting, then you may wish to request the physician to consider ordering the morphine on a fixed dosage and schedule, determined by the physician only, not the nurse.

If you have concerns that your loved one may be medically killed or euthanized in a hospice setting, you should discuss these concerns with the physician and request that PRN orders for morphine not be used. If the physician refuses to do so, you may be able to determine whether the physician is sympathetic to your concerns about euthanasia or not. If you believe the physician is determined to euthanize your loved one, involuntarily, or without your knowledge, then you always have the right to change physicians or to change hospices. Any time that you have concrete evidence that a nurse or physician is acting to euthanize your loved one, the patient, or the patient’s representative may act to change the physician and hospice to a setting that will provide true hospice care.

Real hospice care is NOT about hastening the death of a patient. It is about providing relief from distressing symptoms, supporting the patient and letting them know that they are valued and loved. Hospice patients necessarily choose not to try to cure the terminal illness, because all efforts to cure the disease are believed to have failed and further efforts are believed to be of no use in curing the disease, i.e. the physician has determined that no efforts would succeed in any case. That does NOT mean that treatment for a urinary or respiratory infection is to be withheld, or that food and water are to be withheld if the patient can absorb them. Withholding food and water is a form of euthanasia for the patient who is not already actively dying! Withholding appropriate treatment for an infection when the patient is not actively dying is also a form of euthanasia!

Giving overly high dosages of morphine to a COPD patient, or a patient with another terminal illness, is a form of euthanasia. By being alert, discussing your concerns with the physician and hospice staff and acting promptly to prevent overly high dosages of morphine from being administered, you can save your loved one from an untimely death. Removing your loved one from a setting that is bent on euthanizing your loved one may be the only way to save them from being medical killed.

There are many nurses and physicians who would never even think of doing such a thing, but unfortunately, there are many who would. Surveys and research into the attitudes and practices of physicians and nurses reveals that a significant percentage of nurses and physicians believe that euthanasia is acceptable. If you don’t agree, then you must act to protect your loved one. The best protection is to know what medications are being given, what effect the medications have, what dosages are being given (by being there if possible when they are given) and knowing why the medications are being given. If your instincts tell you that something is not right, act promptly to check with someone you trust who is a nurse, pharmacist or physician who can give you some feedback and further information.

PRN orders for morphine may be totally inappropriate for COPD patients who do NOT have severe pain!

Permission is granted to share these articles with others, to print them, or post them on other websites so long as credit
is given to the author and Hospice Patients Alliance with a link to this original page.





Hospice and How It Can Help the COPD Patient AND Caregiver –

#end stage copd hospice

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Hospice and How It Can Help the COPD Patient AND Caregiver

Hospice can be an invaluable resource for people with end-stage COPD and their overworked, overwhelmed caregivers. But before I get into that, let me apologize. I’m writing 3 posts today, and they’re all a bit on the depressing side, because they deal with death.

I don’t mean to remove all hope for people fairly new to COPD as they read these posts. There are many opportunities for hope and a certain quality of life, even after a diagnosis of COPD. But it’s also a fact that COPD is a chronic, progressive illness for which there is no cure. Eventually, death does become a reality. It can take years, but it will happen at some point. So, while it’s important to live life to the fullest as long as you can, it’s also important for both patient and caregiver to prepare for what is coming in the future.

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So, this post is about how hospice can help, and the sooner it is initiated once the end is approaching, the better. Unfortunately, many people do not get referred to hospice (or are not ready to accept it) until far too late. And at that point, there may not be time for hospice staff to do what they are so good at. easing the way to a dignified, peaceful death.

My mom was referred to hospice during a recent hospitalization. and it turned out to be far too late. Although I have said that she was “dying for the last 2 years” more than once, in the end, she deteriorated so rapidly that we weren’t even thinking hospice before she went into the hospital. And then it was too late for her (or us) to reap the benefits, for the most part.

Hospice is a concept of care that provides comfort and support (on several levels) to patients and caregivers when traditional medical care can no longer prevent death from coming on, usually within a few weeks or a few months.

Hospice is a team-oriented approach that neither prolongs life nor hastens death. According to the Hospice Foundation of America, “the goal of hospice care is to improve the quality of a patient’s last days by offering comfort and dignity.”

Hospice care is not just about providing physical care, though that is certainly included. It’s also about the emotional, social, and spiritual impact of the disease and of the dying process.

Hospice does not usually refer to a place. 80 percent of hospice care is provided in the patient’s home. The emphasis is on enhancing comfort and reducing any pain or distress.

When the doctor says that nothing more can be done to improve or even maintain respiratory function, and that death is likely within the next one to six months, then hospice should certainly be considered. Hospice doesn’t mean giving up. it means making a conscious choice to focus on the quality of your life in your last days and then to go out on your own terms!

When you accept hospice, though, you are accepting that you will no longer be accepting life-sustaining or invasive treatments, except in the case of an emergency. It also entails acknowledging “Do Not Resuscitate” (DNR) status. In other words, if your heart or lungs stop working, you do NOT want emergency personnel to initiate treatment that would get things going again.

However, if you were to fall and hit your head or if you broke a bone, then emergency treatment for those would be acceptable, even if you are on hospice.

Once you go on hospice, you are not a prisoner. You CAN change your mind and go off of it. But you can only do that once or twice. So do not take the decision about hospice lightly. Make sure you are ready.

What Does Hospice Offer?

As I’ve already stated, hospice can be beneficial both to the patient and to the caregiver. I have been a COPD caregiver for more than 4 years, and it takes a toll. So, even if patients are willing to “go it alone”, keep in mind how helpful hospice can be to your caregivers.

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Most people who have hospice have Medicare health insurance, but both Medicaid and private insurance also often will cover hospice care in qualified people. Here are the hospice services typically covered by Medicare:

  • Nursing care and case management
  • Physician oversight sometimes home visits
  • Home health aide bath services
  • Medical appliances, medication, and supplies
  • Spiritual, dietary, and other counseling
  • Trained volunteers for patient companionship caregiver respite
  • Social work services
  • 24/7 on-call availability

Most people think of hospice in relation to cancer patients, but it can also be helpful to a respiratory patient. As death approaches in someone with COPD, breathing gets harder and harder and air hunger, fear and stress can develop.

Hospice nurses can help tweak oxygen levels and delivery methods, along with morphine and other medicines to control this air hunger and emotional stress. How much will that contribute to a more peaceful, gentler COPD death?

How to Learn More About Hospice

The Hospice Foundation of America website has lots of information about hospice, such as their Myths and Facts About Hospice page and their Hospice Stories section.

You can also talk with your doctor about hospice, and/or talk with the staff at one of the local hospices in your area. You should be able to find them listed on the Web or in the yellow pages of a phone book. Local hospitals may have their own hospices or be able to refer you to one as well.

My Personal Hospice Experience

My mom was diagnosed with COPD back in December 2005. Although she went on oxygen, for a couple of years, she still seemed pretty healthy. Then, in February of 2007, she developed pneumonia and was hospitalized. At that time, her doctor suddenly referred her to hospice, telling us it was not just for dying patients (which is not really true).

At that point in time, neither mom or I was prepared to think of her as imminently terminal, but we accepted hospice and they initiated services that seemed more like traditional homecare than anything else. Unfortunately, about 6 weeks later, mom’s femur broke and hospice was cancelled so she could have the leg surgically repaired.

2007 was a rough year, with 5 hospitalizations in total. On the 4th one, we thought we were going to lose Mom, but by 2008, she was on the mend and over the next year got better and better, often not really even needing her oxygen. Hospice was a distant memory.

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Towards the end of 2009, Mom’s breathing started to gradually worsen and I started wondering how much longer she could go on. But she soldiered on, adapting to every little change. Her current doctor talked about hospice when Mom started to ask questions about what the end would be like, but it still didn’t seem like time.

Then, in early November of 2011, Mom just suddenly decompensated, breathing-wise, and had to be hospitalized. Within a week, the doctors decided her lung deterioration was so far advanced, there was nothing more to be done, and started to prepare her to come home to die, which is what Mom wanted so badly.

A hospice referral was initiated, and they helped us with the whirlwind of preparation to bring Mom home on 12 LPM of oxygen (2 concentrators!), a CPAP machine, and kinds of other equipment and medication. It felt like we were setting up an at-home hospital room.

Mom came home on her birthday, and it was a joyful day for her, though also exhausting and with a few scary moments for both her and me. The hospice nurse spent 4 hours with us, getting us situated and setting up support services for the future. I was grabbing that lifeline, as the thought of being chained to my home 24/7 (Mom couldn’t be left alone) was pretty overwhelming and terrifying.

We thought we had at least 3 months to prepare and deal with the dying process. But Mom had other ideas. She passed away early the next morning. In the end, all that the hospice team was able to do for us was set things up and then to come out and pronounce her so that we didn’t have to call the police or coroner. Those things were great, but there is so much more hospice could have done for us, had there been more time.

So, our experience was that first we got hospice way too early and then in the end, way too late.

If you are starting to sense that your life is coming to a close, at least start thinking about hospice and what it can do for you and yours. Don’t wait until the end is right there before you take action!

Published On: December 08, 2011





How to Perform a Mail Merge in Word 2010 (with Pictures) #merge


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How to Perform a Mail Merge in Word 2010

How to Overline Characters in Microsoft Word

How to Mail Merge in Microsoft Word

How to Add Page Numbers or Page X of Y Page Numbers in Word

How to Add Clip Art to Microsoft Word

How to Insert a Line in Word

How to Add Font in Microsoft Word

How to Turn a Scanned Document Into Microsoft Word Document

How to Rotate Text in Microsoft Word

How to Remove a Blank Page in Word

How to Add a Footnote to Microsoft Word


SAP Cloud Computing #sap #cloud #computing, #sap #cloud #computing #solution, #sap #cloud


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WFTCloud offers SAP, ERP Cloud computing solutions & systems! WFTCloud.com offers SAP on the cloud computing solutions, services & systems including Cloud ERP & CRM on-demand solutions at an unmatched cost. Utilize WFT’s expertise for SAP cloud computing solutions including Cloud ERP & CRM on-demand solutions for your business. Call Now.

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© Copyright 2013. WFTCloud. All rights reserved.


Bay area it companies #bay #area #it #companies


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Homepage

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SaaS – Software As A Service – Free Gartner Research #saas #customer


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Gartner defines software as a service (SaaS ) as software that is owned, delivered and managed remotely by one or more providers. The provider delivers software based on one set of common code and data definitions that is consumed in a one-to-many model by all contracted customers at anytime on a pay-for-use basis or as a subscription based on use metrics.

Free Gartner Research. Information 2020 Beyond Big Data

The cloud model for business applications is having more varied and more far-reaching effects on organizations than was originally foreseen. This Gartner Special Report highlights new and recent research to guide CIOs and applications leaders in adapting their IT strategy to this business reality.

SaaS business applications offer different approaches to modification than on-premises solutions, requiring application managers to adapt their customization strategy. Selecting the right application and minimizing modifications becomes more important in the cloud.

September 27, 2016

Moving IT services to Infrastructure as a service (IaaS), platform as a service (PaaS) and software as a service (SaaS) cloud providers profoundly affects the roles and responsibilities of IT. IT Infrastructure Professionals (ITIPs) and managers must think about their roles, hone new skills and build a strategy for staying relevant in the forthcoming IT landscape.

Cloud hosted applications need data protection similar to on-premises data. Although IaaS/SaaS providers (AWS, Azure, Office 365) offer excellent data resiliency, most do not offer native backup. This webinar helps you build a strategy for the protection and recovery of cloud applications and data.


Reliability – Redundancy: Understanding the High-Availability Data Center – The Data Center


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Reliability Redundancy: Understanding the High-Availability Data Center

written by Chris Alberding April 21, 2016

High availability in the data center refers to systems and components that are continuously operational for a long time. It typically means the systems have been thoroughly tested, are regularly maintained and have redundant components installed to ensure continuous operation.

How does a data center ensure reliable power? What level of redundancy is necessary for a high-availability data center? These are two critical issues that weigh on the minds of data center and IT leaders. Why? Because they understand that uninterrupted power is the lifeblood of their operations. And they know the devastating effects an unplanned outage can have on the well-being of their organizations.

Downtime can result from a power outage, equipment failure, natural disaster, human error, fire, flood or a wide range of other causes. It can lead to lost revenue, customers, productivity, equipment and brand loyalty. As a data center or IT leader, your goal is to provide continuous operation of your facility under all circumstances. Many factors contribute to data center reliability. People, processes and equipment all play a huge role in increasing availability.

Data center managers address reliability by implementing many measures, such as hiring and training the right staff members and developing, implementing and testing proven procedures. They also make sure the data center infrastructure has built-in redundancy and reliability—for power, network connectivity, fire detection, moisture detection, lightning protection, sophisticated monitoring systems, generator and UPS backup systems, fire-detection and fire-suppression systems, moisture-detection systems, and lightning protection.

To create higher levels of redundancy, for example, you can configure servers to switch responsibilities to a remote server when needed. This backup process is referred to as failover. Failover is a backup method that uses a secondary component to take over functioning whenever the primary component becomes unavailable. Secondary components can assume operation during scheduled maintenance or when an unexpected power outage occurs.

Failover techniques make systems more fault-tolerant and are necessary to ensure constant availability of mission-critical operations. When a primary component offloads tasks to a secondary component, the procedure is seamless to end users.

In addition to configuring failover components, high availability also involves good design factors. All aspects of data center infrastructure must be evaluated for durability, beginning with a thorough understanding of each component’s metrics as published by the manufacturer, including capacity limitations and life expectancy.

Let’s examine three systems areas that data center managers should consider when looking to improve reliability.

Redundant Systems and Components

Providing redundant systems and components can help eliminate single points of failure in the IT infrastructure. But each data center manager must determine the appropriate level of redundancy for their operation. A thorough analysis is needed to arrive at an effective redundancy strategy.

Certainly, incorporating redundancy into a data center operation is critical. Achieving 100 percent redundancy, however, comes with a hefty price tag. And it’s important to note that high levels of redundancy don’t always mean a system is more reliable. Although this point may seem counterintuitive, increasing component redundancy creates a much more complex infrastructure. As complexity increases, management of the infrastructure becomes more challenging. Working with local data center experts can help you arrive at the right redundancy strategy for your organization.

Backup Systems

Backup systems include the proper configuration of generator units and uninterruptible power supply (UPS) systems. In a generation system, every available generator unit can be programmed to start automatically during a loss of utility power. As long as sufficient fuel is available, the generators power the entire data center load until the utility power source is restored.

When regular power is restored, the generators transfer the load back to the utility and stop operating. The transition to and from the backup-generator power is seamless when configured properly. The most effective designs will incorporate the necessary generators to supply power, as well as backup generators should any one unit fail.

Redundancy should also be built into the UPS system so that one failing module won’t affect the overall capacity of the system. Both generator and UPS systems can be configured for automatic and manual power transfer. Automatic transfer is critical during unexpected outages. Manual transfers are used for scheduled maintenance and testing of data center equipment and procedures without interfering with normal operations.

Detection and Monitoring Systems

Although cyber-attacks get the bulk of publicity, environmental factors can be equally devastating to IT equipment and data center facilities. To minimize the impact of downtime, a data center operation must integrate detection systems. These systems can alert you to a problem before it becomes a crippling event.

Detection and monitoring systems will monitor environmental factors such as the following:

  • Temperature: Sensors will measure the heat being generated by equipment as well as the air-conditioning system’s intake and discharge.
  • Humidity and moisture: Sensors ensure high moisture levels won’t corrode electronic components and low levels won’t cause static electricity. They also monitor for leaks inside cooling equipment, leaks in pipes and flooding from a disaster.
  • Airflow: Sensors ensure air is properly flowing through racks and to/from the air-conditioning system.
  • Voltage: Sensors detect the presence or absence of line voltage.
  • Power: Monitoring systems measure current coming into the facility and determine when electrical failures occur.
  • Smoke: In addition to advising data center personnel of a potential fire, smoke alarms can also be configured to report directly to the local fire department.
  • Video surveillance: Real-time surveillance of data center activities, especially in sensitive areas, provide data center managers with a first-hand look of what’s going on in the facility, including who’s entering and exiting.

To meet an organization’s requirements and avoid costly consequences, data centers must deliver continuous uptime. Any unplanned downtime, even for just a few minutes, can disrupt your business operations and result in dire consequences. Even installing the best equipment available on the market cannot guarantee business continuity. A high-availability, reliable data center requires redundant designs, the right configuration of backup systems and advanced monitoring systems.

About the Author

Chris Alberding is the Vice President of Product Management at FairPoint Communications. a leading provider of advanced communications technology in northern New England and 14 other states across the U.S.

Reliability Redundancy: Understanding the High-Availability Data Center was last modified: April 21st, 2016 by Chris Alberding


Cyber Security Europe 2017 – Cyber Security Europe #ip #expo, #ip #expo


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Securing the Digital Enterprise

Global Head of Security Research

James Lyne is global head of security research at the security firm Sophos. He is a self-professed ‘massive geek’ and has technical expertise spanning a variety of the security domains from forensics to offensive security. Lyne has worked with many organisations on security strategy, handled a number of severe incidents and is a frequent industry advisor. He is a certified instructor at the SANS institute and often a headline presenter at industry conferences.

Lyne is a big believer that one of the biggest problems of security is making it accessible and interesting to those outside the security industry. As a result, he takes every opportunity to educate on security threats and best practice always featuring live demonstrations and showing how the cyber criminals do it.

Lyne has given multiple TED talks, including at the main TED event. He’s also appeared on a long list of national TV programs to educate the public including CNN, NBC, BBC News and Bill Maher.

As a spokesperson for the industry, he is passionate about talent development, regularly participating in initiatives to identify and develop new talent for the industry.

Global VP Security Research

Rik Ferguson is Global VP Security Research at Trend Micro. He brings more than seventeen years of security technology experience to this role. Ferguson is actively engaged in research into online threats and the underground economy. He also researches the wider implications of new developments in the Information Technology arena and their impact on security both for consumers and in the enterprise, contributing to product development and marketing plans.

Ferguson writes the CounterMeasures blog and is the lead spokesperson for Trend Micro. He is often interviewed by the BBC, CNN, CNBC, Channel 4, Sky News and Al-Jazeera and quoted by national newspapers and trade publications throughout the world. Ferguson also makes a regular appearance as a presenter at global industry events. In April 2011 he was formally inducted into the InfoSecurity Hall of Fame.

Rik Ferguson holds a Bachelor of Arts degree from the University of Wales and is a Certified Ethical Hacker and CISSP-ISSAP in good standing.

Chief Research Officer

Mikko Hypponen is a worldwide authority on computer security and the Chief Research Officer of F-Secure. He has written on his research for the New York Times, Wired and Scientific American and lectured at the universities of Oxford, Stanford and Cambridge.

Principal Security Strategist

Wendy Nather is Principal Security Strategist at Duo Security. She was formerly a CISO in the public and private sectors, led the security practice at independent analyst firm 451 Research, and helped to launch the Retail Cyber Intelligence Sharing Center in the U.S. A co-author of the “Cloud Security Rules,” she was listed as one of SC Magazine’s Women in IT Security Power Players in 2014.

Graham Cluley is an award-winning security blogger, researcher, podcaster, and public speaker. He has been a well-known figure in the computer security industry since the early 1990s when he worked as a programmer, writing the first ever version of Dr Solomon’s Anti-Virus Toolkit for Windows.

Since then he has been employed in senior roles by companies such as Sophos and McAfee.

Graham Cluley has given talks about computer security for some of the world’s largest companies, worked with law enforcement agencies on investigations into hacking groups, and regularly appears on TV and radio explaining computer security threats.

Graham Cluley was inducted into the InfoSecurity Europe Hall of Fame in 2011.

RSA, a Dell Technologies Business

Rohit Ghai most recently served as president of Dell EMC’s Enterprise Content Division (ECD), where he was instrumental in setting a compelling vision, transforming go-to-market and revitalizing the portfolio for the digital era through strategic partnerships and acquisitions. Ghai was responsible for all aspects of the ECD business, including setting strategic vision, sales and services, channel strategy, product development, marketing, finance, support and customer success.

Previously, Ghai was chief operating officer of ECD, and responsible for the division’s strategy, development and marketing of all products and solutions. He joined EMC in December 2009 to run product development.

He has more than 20 years of experience in IT in both startup and big company settings, with expertise in digital transformation in highly regulated markets, and knowledge across software, and systems and security. Ghai joined Dell EMC from Symantec, where he held a variety of senior engineering and general management roles. Previously, he was at Computer Associates in a number of senior management roles in the BrightStor and eTrust business units, and led the CA India operations as chief technology officer. Ghai joined CA through the acquisition of Cheyenne Software – a startup in the backup and data protection space.

Ghai holds a master’s degree in Computer Science from the University of South Carolina and a bachelor’s degree in Computer Science from the Indian Institute of Technology (IIT), Roorkee.

Cyber Security Europe 2016 Highlights


Apple and Cisco Are Fast-Tracking the Mobile Enterprise #strategic #it #solutions


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Announcing the Cisco Security Connector

Every day I talk to companies who are looking for ways to use mobility to transform the way they do business. While this kind of revolution brings huge benefits — cost savings, better insight, and competitive advantages — it also introduces new requirements around network performance, collaboration between user groups, and security. Today I’m thrilled to share the latest innovation that we are currently developing: the Cisco Security Connector app for iPhone and iPad in the enterprise.

What’s Next from Apple and Cisco

It’s hard to believe it’s been a year since we announced the first set of solutions from the Apple and Cisco partnership. We started off by seamlessly integrating enterprise calling, prioritizing business critical applications, and optimizing the Wi-Fi experience for iPhone and iPad on Cisco networks. Today, I’m pleased to give you a glimpse into the next wave of incredible experiences from Apple and Cisco.

Visibility, Control, and Privacy for iOS

Coming this fall

Employees are on the go, and cyber security is a critical concern for businesses as they enable employees to work anywhere. Apple and Cisco are partnering to deliver the deepest level of visibility, control, and privacy for iOS devices. This enables organizations to rapidly adopt iOS for their work force, eliminates roadblocks due to audit concerns, and provides ubiquitous control in case of a security incident.

Effortless Meetings

Pressed for time? Cisco Spark and WebEx meetings have never been easier or more productive on your iPhone or iPad. With our newest integrations for iOS 11, users will be able to tap to join meetings directly from calendar notifications and seamlessly share their screens. It’s collaboration on the go like never before.

Integrating Business Collaboration

Cisco and Apple are combining industry-leading enterprise collaboration services and intuitive end user experiences to greatly improve how people work together. In addition to developing an effortless mobile meeting experience, Cisco uses iOS APIs to directly integrate with iPhone for a native calling experience. Users are enabled with the best experience and IT teams can maximize existing investments. Everyone wins.


BULLETPROOF TRAINING INSTITUTE, it training institute.#It #training #institute


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it training institute

It training institute

MBBS is a physician and internationally-renowned leader in the development of human potential. Mark is the medical director of Bulletproof 360 and Head of the Bulletproof Training Institute, provider of the world’s premier coach training program for high-performance and human potential development.

It training institute

Founder of Bulletproof 360 and author of the New York Times bestsellers the Bulletproof Diet and Head Strong, Dave is widely regraded as one of the world’s leading biohackers. Dave is the host of the #1 health podcast, Bulletproof Radio and founder of the 40 Years of Zen Brain Training facility.

It training institute

is a coach, teacher, speaker and writer. Alongside his other professional qualifications, Rod is an International Coach Federation credentialed Positive Psychology coach having trained with Robert Biswas-Diener and is a qualified Mindfulness-Based Stress Reduction teacher with the Center for Mindfulness at UMass Medical School. He’s been coaching and mentoring for almost two decades, teaching for over 3 decades and has had a meditation practice for even longer. Rod is the Head Coach Trainer @ the Bulletproof Training Institute.

It training institute

Has been teaching for 25 years, and has more than a decade of coaching experience. Ronit is a Professional Certified Coach through the International Coaching Federation. She has a BA in Political Science from UCLA, a double MA in Teaching Writing and English Literature from HSU, and a Certificate in Teaching English as a second language.

It training institute It training institute It training institute It training institute

BULLETPROOF COACH TRAINING PASADENA, USA – COMMENCES OCTOBER 11TH 2017

ENROLL before sept. 25TH and RECEIVE $10,997 IN BONUSES!

Jay Abraham’s ‘Power Practice Program’. $5000 value!

Jay Abraham’s ‘Creating Your Own Business Success 2.0’ Course. $5000 value!

“Jay is one of the greatest business and marketing minds I’ve ever known” (Stephen R Covey).

“Jay is a Genius. He’s a very, very special man” (Tony Robbins).

3-Day 2017 Bulletproof Conference Ticket. $500 value!

Special Pre-Training Webinar with Dr. Mark. $300 value!

8-Week Mindfulness Training Program. $197 value!

ICF TRACK

BULLETPROOF COACH TRAINING

REGULAR TRACK

BULLETPROOF COACH TRAINING

You will still receive the bonuses if you sign up before September 23rd!

BULLETPROOF COACH TRAINING SURFERS PARADISE, AUSTRALIA – COMMENCES NOVEMBER 11TH 2017

ENROLL before SEPT 26TH and RECEIVE 10,497 USD IN BONUSES!

Jay Abraham’s ‘Power Practice Program’. 5,000 USD value!

Jay Abraham’s ‘Creating Your Own Business Success 2.0’ Course. 5,000 USD value!

“Jay is one of the greatest business and marketing minds I’ve ever known” (Stephen R Covey).

“Jay is a Genius. He’s a very, very special man” (Tony Robbins).

Special Pre-Training Webinar with Dr. Mark. 300 USD value!

8-Week Mindfulness Training Program. 197 USD value!

ICF TRACK

BULLETPROOF COACH TRAINING

REGULAR TRACK

BULLETPROOF COACH TRAINING

You will still receive the bonuses if you sign up before September 23rd!

Can’t make it to Pasadena or Australia?

Pre-register for our New York City, Coach Training which commences February 24-25, 2018.

TESTIMONIALS

“I have been, and continue to be, blown away by the wealth of knowledge and the practical way it has been presented in this coaching course! I have a feeling of immense gratitude for it and just want to recognize the individuals involved in making this experience possible! Thank you Dave Asprey, Mark Atkinson, Rod Francis and the entire Bulletproof team!” –Mike Hallowell

“It is so natural the way everything unfolds. I now have a better understanding of why I do what I do. I express my core qualities and suddenly, I really start to resonate with my students. They respond effortlessly and I start to feel the connection of group flow… Thanks for working so hard to create great content for all of us! It is remarkable!” –Jason Hooper

“When I signed up for the BP coaching program… I honestly had no idea how awesome this would be. I have never been so excited and happy in all my life, as I am pouring myself into all of it. I gave my first talk to a tech company on Mindfulness last Thursday and I loved it! I am giving it again next week to a group of lawyers in Washington, DC. In September I have been asked to speak for 4 days to a group of from YPO (Young Presidents Organization) spouse retreat… I honestly just wanted to thank you all for being such a huge influence in my life and many others… I thank you all from the bottom of my heart, it has improved my life tremendously.” –Lynn Fernandes

refund policy

If you withdraw from our training, the following policy will decide the level of re-compensation due to you. Please note repayment amounts are entirely dependent upon the notice period prior to the commencement date of your training. The training commences with the two-day workshop.

· 31+ days before the start of the training – a full refund (minus a $250 non-refundable registration fee and any financial transaction costs eg Paypal, card or bank transfer fees) will be provided.

· 15-30 days – a 50% refund (minus any financial transaction costs eg Paypal, card or bank transfer fees) will be provided.


What Olympian Michael Phelps learned from hitting bottom #make #it, #leadership, #make


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What Olympian Michael Phelps learned from hitting bottom: I ve seen the darkest of the dark

The most decorated Olympian in history, Michael Phelps is by any measure a great success. A legend, even. But he has not always been happy.

Phelps’ first trip to the Olympics was in Sydney, when he was just 15 years old. He didn’t win any medals, but it was clear from his first appearance that the tall, skinny kid with long limbs had tremendous potential in the pool.

In Athens in 2004, Phelps took home six gold medals and two bronze. In Beijing in 2008, Phelps won gold eight times. And in London in 2012, Phelps won four gold and two silver medals.

But Phelps’ rise to the top of his sport was not without stumbles. Phelps was arrested for a DUI when he was only 19, and in 2009, Phelps was criticized after a photo came out of him smoking a bong.

In 2014, Phelps was again arrested for drunk driving. The champion of three Olympic games who had accumulated 22 medals fell into a deep depression.

At times, he even felt suicidal.

“I’ve seen the darkest of the dark. And there are days where I didn’t want to be here,” Phelps, now 31, tells CNBC.

“I ve seen the darkest of the dark. And there are days where I didn t want to be here.” -Michael Phelps, Olympic swimmer

These days, though Phelps is better, he still struggles, and he’s frank about that.

“I’m not perfect. Nobody is. I will be the first one to admit a mistake when it’s made. That’s the only way you are able to move on and learn from that mistake,” says the swimmer. “By no means has my life been absolutely perfect.”

Phelps has turned a corner, though. He feels more stable now than he was a couple of years ago. Nine out of 10 mornings, he says he wakes up happy. Before his time in the treatment center, Phelps says there were periods of his life where he would wake up in a bad mood six out of 10 days.

“I will be the first one to admit a mistake when it s made. That s the only way you are able to move on and learn from that mistake.” -Michael Phelps, Olympic swimmer

“Being able to come out of the other side and just to work and learn things about me that I never knew, I didn’t want to know at that point — you know, I think it changed my life,” he says.

In Rio last year, Phelps added six medals to his stack, bringing his tally of Olympic medals to 28, and making him the most decorated Olympian in history. Phelps is a husband and new father, and he is launching his business career, which he aims to model after Michael Jordan’s.

For example, Phelps spoke to CNBC from the New York City showroom of direct-to-consumer mattress brand Leesa. with which he has recently entered into a four-year brand partnership.

Michael Phelps transitions from swimming to sleeping Wednesday, 8 Feb 2017 | 1:49 PM ET | 05:32

Going forward, Phelps hopes his personal struggles, as well as his athletic successes, can be an inspiration to others.

“I look back at things that I’ve been able to accomplish and everything that I have, and I’m just so happy with where I am in life,” says Phelps.

Olympic hero Michael Phelps says the secret to his success is one most people overlook

5 daily habits Olympian Michael Phelps swears by

Michael Phelps has 28 Olympic medals. His new goal: Be Michael Jordan


Identity Theft Monitoring and other paid protection Services #identity #theft #monitoring, #identity


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For-Profit Identity Theft Services

At IdentityTheft.info, we believe everyone can protect themselves from identity theft by taking advantage of the information provided throughout our web site. However, we recognize there are consumers who may prefer the convenience and assistance of using a for-profit or a non-profit business or agency offering professional identity theft prevention, protection and recovery services and products. If you seek a non-profit agency to assist you, please visit our non-profit category .

As recently as five years ago, there were very few for-profit firms offering services and products specifically designed to protect consumers from identity theft or, if victimized, to assist them in recovering from the crime. Today, there are dozens of companies offering a wide-range of services from credit monitoring, to the placement of fraud alerts, to opt-out services, to identity theft insurance and recovery services.

As with all consumer decisions, you should take the time to investigate the identity theft product or service you are interested in to be sure it actually accomplishes what you require. Many firms selling identity theft products and services offer a tiered approach where you pay higher fees for additional levels of service. But, the additional layers of service and the additional expense may be unnecessary depending upon your needs. So, consider any offer carefully in light of your specific requirements.

Available For-Profit Services:

NOTE: www.IdentityTheft.info does not endorse the below products/services and is not affiliated with them in any way.

Identity Theft Prevention and Survival – Offers a variety of identity theft related services and products

Debix – Offers a variety of identity theft related services and products

Identity Guard – Offers a variety of identity theft related services and products

Trusted ID – Offers a variety of identity theft related services and products

LifeLock – Offers a variety of identity theft related services and products

Pre-Paid Legal Services – Offers a variety of identity theft related services and products

Equifax – Offers a variety of identity theft related services and products

Experian – Offers a variety of identity theft related services and products

TransUnion – Offers a variety of identity theft related services and products

Identity Truth – Offers a variety of identity theft related services and products

ID Watchdog – Offers a variety of identity theft related services and products

Loud Siren – Offers a variety of identity theft related services and products


Statutes & Constitution: View Statutes: Online Sunshine #it #degree #worthless


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832.05 Giving worthless checks, drafts, and debit card orders; penalty; duty of drawee; evidence; costs; complaint form.

(1) PURPOSE. The purpose of this section is to remedy the evil of giving checks, drafts, bills of exchange, debit card orders, and other orders on banks without first providing funds in or credit with the depositories on which the same are made or drawn to pay and satisfy the same, which tends to create the circulation of worthless checks, drafts, bills of exchange, debit card orders, and other orders on banks, bad banking, check kiting, and a mischief to trade and commerce.

(2) WORTHLESS CHECKS, DRAFTS, OR DEBIT CARD ORDERS; PENALTY.

(a) It is unlawful for any person, firm, or corporation to draw, make, utter, issue, or deliver to another any check, draft, or other written order on any bank or depository, or to use a debit card, for the payment of money or its equivalent, knowing at the time of the drawing, making, uttering, issuing, or delivering such check or draft, or at the time of using such debit card, that the maker or drawer thereof has not sufficient funds on deposit in or credit with such bank or depository with which to pay the same on presentation; except that this section does not apply to any check when the payee or holder knows or has been expressly notified prior to the drawing or uttering of the check, or has reason to believe, that the drawer did not have on deposit or to the drawer’s credit with the drawee sufficient funds to ensure payment as aforesaid, nor does this section apply to any postdated check.

(b) A violation of the provisions of this subsection constitutes a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083. unless the check, draft, debit card order, or other written order drawn, made, uttered, issued, or delivered is in the amount of $150, or its equivalent, or more and the payee or a subsequent holder thereof receives something of value therefor. In that event, the violation constitutes a felony of the third degree, punishable as provided in s. 775.082. s. 775.083. or s. 775.084.

(3) CASHING OR DEPOSITING ITEM WITH INTENT TO DEFRAUD; PENALTY.

(a) It is unlawful for any person, by act or common scheme, to cash or deposit any item, as defined in s. 674.104 (1)(i), in any bank or depository with intent to defraud.

(b) A violation of the provisions of this subsection constitutes a felony of the third degree, punishable as provided in s. 775.082. s. 775.083. or s. 775.084.

(4) OBTAINING PROPERTY OR SERVICES IN RETURN FOR WORTHLESS CHECKS, DRAFTS, OR DEBIT CARD ORDERS; PENALTY.

(a) It is unlawful for any person, firm, or corporation to obtain any services, goods, wares, or other things of value by means of a check, draft, or other written order upon any bank, person, firm, or corporation, knowing at the time of the making, drawing, uttering, issuing, or delivering of such check or draft that the maker thereof has not sufficient funds on deposit in or credit with such bank or depository with which to pay the same upon presentation. However, no crime may be charged in respect to the giving of any such check or draft or other written order when the payee knows, has been expressly notified, or has reason to believe that the drawer did not have on deposit or to the drawer’s credit with the drawee sufficient funds to ensure payment thereof. A payee does not have reason to believe a payor does not have sufficient funds to ensure payment of a check solely because the payor has previously issued a worthless check to him or her.

(b) It is unlawful for any person to use a debit card to obtain money, goods, services, or anything else of value knowing at the time of such use that he or she does not have sufficient funds on deposit with which to pay for the same or that the value thereof exceeds the amount of credit which is available to him or her through an overdraft financing agreement or prearranged line of credit which is accessible by the use of the card.

(c) A violation of the provisions of this subsection, if the check, draft, other written order, or debit card order is for an amount less than $150 or its equivalent, constitutes a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083. A violation of the provisions of this subsection, if the check, draft, other written order, or debit card order is in the amount of $150, or its equivalent, or more, constitutes a felony of the third degree, punishable as provided in s. 775.082. s. 775.083. or s. 775.084.

(5) PAYMENT NO DEFENSE. Payment of a dishonored check, draft, bill of exchange, or other order does not constitute a defense or ground for dismissal of charges brought under this section.

(6) “CREDIT,” “DEBIT CARD” DEFINED.

(a) The word “credit” as used herein shall be construed to mean an arrangement or understanding with the drawee for the payment of such check, draft, or other written order.

(b) As used in this section, the term “debit card” means a card, code, or other device, other than a check, draft, or similar paper instrument, by the use of which a person may order, instruct, or authorize a financial institution to debit a demand deposit, savings deposit, or other asset account.

(7) REASON FOR DISHONOR, DUTY OF DRAWEE. It is the duty of the drawee of any check, draft, or other written order, before refusing to pay the same to the holder thereof upon presentation, to cause to be written, printed, or stamped in plain language thereon or attached thereto the reason for the drawee’s dishonor or refusal to pay it. In any prosecution under this section, the introduction in evidence of any unpaid and dishonored check, draft, or other written order having the drawee’s refusal to pay stamped or written thereon or attached thereto, with the reason therefor as aforesaid, is prima facie evidence of the making or uttering of such check, draft, or other written order, of the due presentation to the drawee for payment and the dishonor thereof, and that the same was properly dishonored for the reasons written, stamped, or attached by the drawee on such dishonored check, draft, or other written order. As against the maker or drawer thereof, the withdrawing from deposit with the drawee named in the check, draft, or other written order of the funds on deposit with such drawee necessary to ensure payment of such check, draft, or other written order upon presentation within a reasonable time after negotiation or the drawing, making, uttering, or delivering of a check, draft, or written order, payment of which is refused by the drawee, is prima facie evidence of knowledge of insufficient funds in or credit with such drawee. However, if it is determined at the trial in a prosecution hereunder that the payee of any such check, draft, or written order, at the time of accepting such check, draft, or written order, had knowledge of or reason to believe that the drawer of such check, draft, or other written order did not have sufficient funds on deposit in or credit with such drawee, then the payee instituting such criminal prosecution shall be assessed all costs of court incurred in connection with such prosecution.

(8) COSTS. When a prosecution is initiated under this section before any committing trial court judge, the party applying for the warrant shall be held liable for costs accruing in the event the case is dismissed for want of prosecution. No costs shall be charged to the county in such dismissed cases.

(9) STATE ATTORNEYS; WORTHLESS CHECKS; FORM OF COMPLAINT. The state attorneys of Florida shall collectively promulgate a single form to be used in all judicial circuits by persons reporting a violation of this chapter.

(10) CONSTRUCTION; PAYEE OR HOLDER; INSUFFICIENT FUNDS. For the purposes of construction of this section, a payee or holder does not have knowledge, express notification, or reason to believe that the maker or drawer has insufficient funds to ensure payment of a check, draft, or debit card solely because the maker or drawer has previously drawn or issued a worthless check, draft, or debit card order to the payee or holder.

History. ss. 1, 2, ch. 28096, 1953; s. 1, ch. 61-284; s. 1, ch. 61-185; s. 981, ch. 71-136; s. 1, ch. 79-98; s. 9, ch. 84-297; s. 9, ch. 86-161; s. 42, ch. 88-381; s. 6, ch. 89-303; s. 5, ch. 91-211; s. 61, ch. 92-82; s. 1303, ch. 97-102; s. 15, ch. 2001-115; s. 15, ch. 2004-11.


UTSA Extended Education #university #of #texas #san #antonio, #education, #online #learning, #six


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Continuing Professional Education

Lean Healthcare Fundamentals

Leaders and staff learn key Lean principles such as waste, 5S, flow, standard work, A3 problem solving, balanced work and Lean layout and how to apply these principles to their workplace.

Learn More

Advanced Placement (AP) Summer Institute

Under the guidance of College Board, UTSA welcomes hundreds of AP teachers from across the country to 24 workshops covering math, science and the humanities.

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IT Security Training Programs

UTSA understands the evolving cyber threat and the need for educational resources. We offer courses in cybersecurity, and prep courses in Network+, Security+ and Certified Information Security Systems Professional.

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Paralegal Certificate Program

The Paralegal Certificate Program is designed and taught by practicing attorneys to prepare students to be knowledgeable, ethical and effective assistants to attorneys while emphasizing legal areas where paralegals are most in demand.

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Registered Behavior Technician

This training program is based on the Registered Behavior Technician Task List and is designed to meet the 42-hour training required for competency certification for the RBT credential.

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Six Sigma and Lean Thinking

These courses are theory and practice-oriented, suitable for company executives, directors, and upper level managers who wish to sustain enterprise-wide lean transformation. Yellow, Green and Black Belts are offered.

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Occupational Safety and Health (OSHA)

All courses are held at UTSA’s Downtown Campus and provide quality training facilitated by OSHA authorized instructors. Courses can be applied towards a professional certificate from the UT- Arlington’s Region VI OSHA Education Center.

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Strategic Advocacy Campaigns Workshop

The Strategic Advocacy Campaign Workshop Series will provide participants an opportunity to focus on the elements, methods and tactics required to conduct a successful and strategically well-planned advocacy campaign.

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Graduate Record Examination (GRE)

Workshops include over 21 hours of instruction on powerful test-taking techniques and reviews on previous examination materials/questions in a classroom format.

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Graduate Management Admission Test (GMAT)

Two full-length practice tests to measure your results are included: a pre-diagnostic at the beginning of the workshop and post-diagnostic towards the end.

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Law School Admissions Test (LSAT)

The cost of the course includes 40 hours of classroom instruction, all workshop materials (textbook and workbook) and pre and post-diagnostic exams.

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Scholastic Aptitude Test (SAT)

Workshops include over 21 hours of instruction on powerful test-taking techniques and reviews on previous examination materials/questions in a classroom format.

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Review test preperation workshop policies, discounts offered and registeration and refund information.

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Online Instruction Center

Online short courses are self-paced and follow an asynchronous learning model. You may complete the course sooner than the standard six week timeframe. Online short course are traditionally six weeks or less.

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Online Career Training Center

Preparing for a career change? Try our extensive catalog of career training programs in Healthcare, Business, Information Technology, Media Design and more!

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English for Researchers

English for researchers will enable beginning and intermediate English speakers to develop the vocabulary and grammar necessary to communicate with other researchers.

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Difficult Conversations in the Workplace

Our simple, easy-to-follow model can help you execute a win/win for all parties; resolving your issue AND preserving or building a relationship. The program leads you through the process to gain confidence addressing sensitive topics.

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Narrative Non-Fiction Writing

Narrative Non-Fiction Writing focuses on the development of short form essay writing for adult learners who wish to learn how to craft a first- or third-person account of a real life event.

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Conversational English in the Workplace

Don’t let a language barrier keep you from getting the job you want. San Antonio and Central Texas are prime areas for job seekers to have bilingual skills, so you can’t afford to miss this opportunity.

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Course Registration Information

The following information are general guidelines to our registration processes. For more specific registration information, please visit the specific offering you wish to attend.

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Lean Healthcare Fundamentals

Leaders and staff learn key Lean principles such as waste, 5S, flow, standard work, A3 problem solving, balanced work and Lean layout and how to apply these principles to their workplace.

Experience the cost saving benefits: an increase in overall revenues and patient satisfaction scores and defraying costs in supplies, labor, and overtime.

Latest News

Lean Six Sigma Courses Now Open for Individual Registration

Lean and Six Sigma, two methodologies evolved separately, share the same ultimate goal, which is to answer voices of customers by achieving process excellence. While Lean is famous for its continuous pursuit of perfection, Six Sigma provides a structured data-driven methodology to achieve world-class operational capability.

UTSA’s Advanced Placement Summer Institute Increases Offerings in 2017

This year, the UTSA APSI is comprised of nineteen course subjects focused on college-level curriculum including biology, calculus, physics, statistics and studio art. Teachers will participate in a four-day program that emphasizes hands-on, high impact learning through course activities, labs and field trips.

What we do

Innovation

Extended Education remains a top tier resource for professional learners through continuous origination and development of contemporary courses and programs designed for the knowledge economy.

Accessibility

We seek to create continuing professional education opportunities by harmonizing UTSA faculty skill sets with the demands of professional learners in San Antonio and South Central Texas communities.

Excellence

We make a promise to empower our constituency by providing globally-focused educational opportunities that lead to the growth of economic prosperity and intellectual capital in the community.


What to Do When Your Poop is Dark Green #what #does #it


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What Does Dark Green Poop Mean?

Why are we here?

Are we alone in the universe?

Why is my poop green?

The first two questions are a bit beyond the purview of this site, but the last one can be answered quite readily.

Dark green poop may be surprising or alarming upon your first encounter, but it actually has a very simple biological explanation and, as far as the brilliant rainbow of feces is concerned, is not normally a cause of significant concern. There are also certain steps you can try taking when your poop is green in order to prevent a reoccurrence. But we’re getting ahead of ourselves. Let’s start with the basic question and move on from there.

What Causes Green Stool?

Understanding why you have dark green feces first requires knowing why it’s normally brown in the first place. Poo is a mix of undigested food, bile, bacteria, and dead blood cells. The brown coloration happens during the stool’s journey through the digestive tract where intestinal bacteria break down and feast on the leftover bile and other cell detritus it contains. The underlying process is surprisingly complicated but the main takeaway here is that poo is normally greenish until exposure to intestinal bacteria, where turns it brown.

It’s also important to distinguish between dark green stool (1 ) in adults and any dark green poop from a baby. During the first few days of life, an infant will pass dark green stool known as meconium. This is normal and is the result of waste that was accumulated during gestation. Meconium usually persists for several days until the baby begins breast or formula feeding, at which point it will start to turn yellow over time. Dark green poop in a breastfed baby or one being bottle-fed is therefore not normally a cause for alarm.

Now that the preliminaries are out of the way, let’s look at what dark green poop might mean.

Excess Nutrition

Sometimes, the color of your poo has less to do with your own body and more with what you’re eating. Consuming large amounts of green, leafy vegetables like kale or broccoli can sometimes result in your poo appearing dark green. Iron-rich foods such as beans or meats will produce a similar effect and may leave you with a dark green, almost black poop. This is more easily seen in the dark green poop a two month old might have if they are fed iron-fortified milk. In all of these cases, the underlying mechanism is the same. There is a biological limit to how much of any nutrient your body can make use, of and anything leftover can get excreted, dyeing the resulting poo. Iron supplements or supplements that contain chlorophyll or fructose can also cause green stools.

Food Coloration

Food dyes are generally not absorbed by the body and will get excreted along with other waste. If you have recently eaten a large number of foods that use green coloring (such as promotional St. Patrick’s Day treats), you may find yourself producing green stool over the following days. How susceptible someone is to food coloring will vary from one individual to the next. It’s fully possible, for instance, for you and a friend to eat the same dyed foods but for only one of you to have a green poo as a result.

Medication

Antibiotics, particularly the powerful ones that get prescribed for major infections, are capable of reducing the levels of bacteria in your intestinal tract. As mentioned earlier, these are the same bacteria responsible for why poo normally appears brown and their loss means your feces can’t be processed as thoroughly during its trip through the body. Due to this, green stool is a known side effect of some antibiotics.

Gastrointestinal Distress

Anything that causes food to move too quickly through the intestines can produce green stool since this cuts down on the amount of time it can be processed. This means that any situation capable of causing severe diarrhea, such as food poisoning, salmonella, a parasite, or irritable bowel syndrome, would also be able to produce dark green bowel movements. In other words, anything capable of aggravating your bowels will also be capable of producing dark green diarrhea.

Cleansing

A colon cleanse is a type of home treatment some individuals use to try and flush “toxins” from the body. Cleanses come in numerous varieties but typically employ some combination of supplements, enemas, and/or laxatives. Since colon cleanses essentially force-evacuate your bowels, it’s possible for them to produce green stool by virtue of triggering a bowel movement prematurely, before feces has been properly processed.

Pregnancy

It’s also possible to have dark green poop while pregnant. During pregnancy, a woman’s body produces more blood, and if she doesn’t get enough iron, she could become anemic. If that happens, she might then take iron supplements, a side effect of which is black or green poop. Iron supplements can cause other discomfort, such as constipation, so it may be in the best interest of pregnant women to increase their iron intake through diet, by consuming liver, red meat, and leafy greens.

Treating Dark Green Poop

Anyone can be affected by dark green poop; toddlers and adults alike. Treatment for dark green poo begins with identifying what the actual cause was. Fortunately, this is not a difficult task. Meconium is easy to rule out simply by asking whether the person was born recently.

Similarly, you should be able to remember whether or not you recently engaged in a colon cleanse (enemas are kind of hard to forget). If you suspect antibiotics or a nutritional supplement are involved, it’s best to consult with your doctor on how this can be determined. It’s strongly inadvisable to discontinue an antibiotic without your doctor’s approval since you were likely prescribed that medicine for a good reason.

Lastly, conditions such as food poisoning or irritable bowel syndrome come with other associated symptoms that can help identify them. In these instances, the green stool is likely accompanied by diarrhea, stomach cramps, nausea, vomiting, or other signs of digestive disagreement.

Once your cause is identified, treatment becomes relatively simple:

  • Meconium goes away on its own, so time is the only remedy needed.
  • Talk to your doctor about switching to a new, less severe antibiotic to give your intestinal bacteria time to recover.
  • Over-enthusiastic eating of green foods or iron-rich items can be curtailed with simple diet adjustments, as can any indulgence in overly-dyed treats.
  • Food poisoning requires bed rest, maintaining fluid intake, and easing in to bland foods once you’re able to keep them down. Most food poisoning cases resolve within a few days with or without treatment.
  • Avoid giving yourself a colon cleanse.

When to See Your Doctor

A one-off incidence of green stool is rarely a cause for concern and can be safely ignored. If you find that you are having recurrent or repeat episodes of green bowel movements, however, a doctor’s appointment may be in order.

Often, an exam for green stool will involve some questions about any recent dietary or lifestyle changes that may be affecting digestion and the stool itself may get examined if nothing can be ruled out.

One important thing to keep in mind is that although most causes of green stool are benign, this does not stop green stool from occurring alongside other more problematic situations.

If your stool seems to have mucus or blood in it (bright red or tarry, almost black) or is very watery, medical attention may be advised. This also applies if you experience rectal pain, intermittent bouts of constipation, fever, or loss of appetite. These symptoms should always be paid attention to and investigated regardless of whether you have dark green poop or not.

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About the Author, Browse Victor’s Articles

Victor Marchione, MD received his Bachelor of Science Degree in 1973 and his Medical Degree from the University of Messina in 1981. He has been licensed and practicing medicine in New York and New Jersey for over 20 years. Dr. Marchione is a respected leader in the field of smoking cessation and pulmonary medicine. He has been featured on ABC News and World Report, CBS Evening News and the NBC Today Show and is the editor of the popular The. Read Full Bio »


BI Skills and Experience #athena #it #solutions


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Skills and Experience

BI and Analytics

  • Data discovery
  • Data visualization
  • Data preparation, blending and wrangling
  • Dashboards and storyboards
  • Reporting
  • Desktop, cloud and mobile deployments

Data Integration and ETL

  • Database and file integration
  • Big data integration
  • Cloud integration
  • Application integration
  • Hybrid integration
  • Data quality and cleansing
  • On premise, cloud and hybrid deployments

Data Management and Quality

  • Data governance
  • Master Data Management (MDM)
  • Enterprise information management
  • Metadata management

Database

  • Relational
  • Columnar
  • OLAP
  • NoSQL (column, document, key value and graph)
  • Hadoop
  • Semi-structured data such as XML and JSON

Data Modeling and Database Design

  • Dimensional modeling
  • Hybrid/advanced dimensional modeling
  • ER modeling
  • Data profiling
  • Reverse engineering

Data Source Systems for BI and Data Integration

We design BI and data integration solutions that access data from a wide variety of source systems.

  • ERP applications
  • CRM applications
  • Supply chain management applications
  • Financial budgeting, forecasting and planning applications
  • Industry-specific applications in higher education, insurance, financial services, life sciences and healthcare
  • Big data (data hubs and data lakes)
  • Semi-structured data such as XML and JSON

Business Experience

We have designed solutions for a wide variety of business initiatives including:

  • Enterprise BI, dashboards, reporting and analysis
  • Self-service BI and analytics
  • Replacing spreadmarts and data shadow systems
  • Operational BI and ERP reporting and analytics
  • Predictive analytics
  • Data governance
  • Enterprise Data Warehouse (EDW)
  • Modernizing BI and data warehousing
  • Big data
  • Revitalizing multiple data warehouses, data marts and other reporting databases
  • Customer Data Integration (CDI) or “one view of the customer”
  • Corporate Performance Management (CPM) and balanced scorecards
  • Customer Relationship Management (CRM)
  • Supply Chain Management (SCM)

Six trends shaping the outsourcing industry #it #outsourcing #trends


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Six trends shaping the outsourcing industry

September 11, 2016

It’s all change for the industry’s most fundamental concept. Business process outsourcing is changing into business process management, as partners stop thinking about their relationship as a buyer-vendor and more as a union of minds. “Gone are the days when outsourcing or the acronym BPO was synonymous with cost-cutting or labour arbitrage,” says Keshav R. Murugesh, group chief executive of outsourcer WNS Global Services and current chairman of the Indian outsourcing association Nasscom BPM Council. “Today, it is about partnering to drive better business outcomes leveraging the domain expertise of the partner, high-end technology and analytics. It is about partnering to ride disruptive business trends, which is a complete change from the humble beginnings of outsourcing for cost efficiencies alone. Thus, the change in terminology as well – it is business process management now: managing processes efficiently and smartly to drive sustainable and profitable business growth.”

The buccaneering spirit of adventure flows through the outsourcing world. New markets and new cities are always being brought into the mainstream. A chat with the top brass quickly turns into a world geography lesson. “We’re definitely seeing new locations being used for outsourcing,” says Aruna Jayanthi, chief executive of business services at Capgemini. “We’ve recently opened a new centre in Russia – not many outsourcing providers have a base there, but we expect it to become a key location in the near future. Guatemala is also coming up strong as a nearshore option for the United States, as both the Spanish and English language skills there are fantastic. Manila, although more of a traditional location, will still hold gravitas as a centre for outsourcing excellence. But we see less of the classic call centre operations as there is a big transformation taking place in that space, and they are increasingly becoming omnichannel with interactions happening via e-mail, messaging and social platforms.”

Austerity continues to drive the search for lower costs and higher efficiencies across government. For local government that means more outsourcing. Paul Tombs, head of public services at Zurich Municipal, observes: “Recent years have seen a clear trend in local government towards outsourcing. Even though public-sector spending has decreased, the value of outsourced contracts signed by councils has sky-rocketed. In just the first six months of 2016, their value increased by 84 per cent.” His source for those numbers is the arvato Outsourcing Index. “We also know from our own research, the Zurich Municipal New World of Risk report, that local authorities spend around 25 per cent of their annual expenditure – a total of around £45 billion – on procuring goods and services from third parties. Some larger councils are outsourcing up to 60 per cent of their services,” he says.

The days of 20-year government deals are over. These days the trend is for three to five-year contracts, with plenty of get-out clauses. One of the keys to this shift is the prominence of the Crown Commercial Service, introduced in 2010 by Francis Maude at the Cabinet Office and chief procurement officer Bill Crothers. The Crown Commercial Service was set up to train civil servants to negotiate contracts as ferociously as any private-sector body. “We are moving away from… the days when a major service integrator could charge us £30,000 to change a logo on a webpage,” declared Mr Maude. No IT contract was to exceed £100 million without good reason. When government departments think about outsourcing deals, the Crown Commercial Service is on hand to offer support. Chief executive of Serco’s UK central government division Kevin Craven notes a definite change: “They have gone even more into the need to be intelligent clients, writing intelligent contracts. They’ve got a standard of supplier and behaviour they want to see. They are being quite tough at enforcing that – much tougher clients.” The next trend is to push for more public contracts to be open-book.

Hackers and malware aren’t going away. In fact, the threat from cyber attacks is multiplying. In 2015 the number of spear-phishing campaigns targeted at employees rose 55 per cent, while ransomware rose 35 per cent, according to Symantec. The security institute AV-Test recorded more than 390,000 new malicious programs each day. As a result companies are struggling to cope. “With many companies unable to fill key cyber-security roles, we will see an increase in businesses outsourcing security,” says Raj Samani, chief technology officer for Europe, the Middle East and Africa at Intel Security. “Our Hacking the Skills Shortage report highlights how organisations plan to address the international shortage of cyber-security skills. Certain skills are in high demand. Our research found that the most desirable skills are intrusion detection, secure software development and attack mitigation.”

A common boast of outsourcing is that tasks are more than delegated; they are streamlined, automated and re-engineered. Today the industry is focusing on that step-change mentality more than ever. For example, robotic process automation experts Genfour were asked to help utility company Co-operative Energy cope with mundane tasks such as change of occupier notifications. Genfour did more than assume the role. It developed an automatic processing system in seven days, which mapped on to the Co-operative Energy’s existing systems. Hayley Gibson, industrial queries team manager at Co-operative Energy, says the system slotted into the team, processing five times the amount of work a week. “Quite a few of the team were getting to the point where they couldn’t go on much longer working these hours, so I think it actually saved our team,” she says. Stories like this will keep the outsourcing industry growing, no matter the economic weather.


2016 Discover Student Credit Card Review: Important Advice #discover #student #card #review,discover


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Discover Student Credit Card Review 2016

by CreditCardForum Staff

Getting your first credit card as a college student may not be easy. In fact, because students often have a limited credit history, the cards aimed at them aren t usually the best when it comes to rewards. However the Discover student cards are different. Here are three reasons why

Reason #1: Way better rewards

There are two Discover cards designed for students: Discover it for Students and Discover it chrome for students. Here s what the Discover it® for Students is giving for rewards

  • 5 percent cash back in categories. You get new categories every quarter that you can sign up for.
  • 1 percent on everything else. You will always get at least 1 percent on everything else you buy.

As for the Discover it® chrome for Students, it s offering:

  • A permanent 2 percent cash back on up to $1,000 in spending each quarter on combined gas station and restaurant purchases
  • 1 percent cash back on all other purchases

Reason #2: More benefits than most student cards

Both Discover student cards offer the following

  • Purchase Protection. In my opinion this is one of the most useful credit card benefits. With it, the eligible purchases made with your Discover card are protected for the first 90 days against theft or accidental damage, up to $500 in coverage per purchase.
  • Extended Product Warranty. On eligible purchases, Discover gives you an additional year of coverage on your existing warranty of 36 months or less. So let s say you buy something, like a brand new iPad from the Apple store, that comes only with a one-year manufacturer s warranty. In addition to that, you will have one year extra through Discover for no additional cost.
  • Return Protection. Ever try to return something but the store won t take it back because more than 30 days have gone by since the purchase? The nice thing about this benefit is that you can return any qualifying purchase to Discover within 90 days for up to a $500 refund, even if the store won t take it back. Keep in mind though that just like any return, you have to give back the item in like-new condition.
  • $0 Fraud Liability Guarantee. Don t worry about getting scammed, because if your card or account number is ever used fraudulently, you won t be responsible for those charges.

Reason #3: The fees are fair

  • No annual fee. Yep that s right, you get all the above benefits for no additional cost.
  • No over-limit fee. You won t get charged a fee if you go over your credit limit.
  • No foreign transaction fees. Many credit cards will charge you up to 3 percent extra when making purchases outside the U.S. That goes for purchases made when you are physically outside the U.S. but sometimes also for purchases you make online from overseas merchants. With Discover, however, you can use your card anywhere in the world without paying those fees (assuming the merchant accepts Discover).
  • No pay-by-phone fee. Need to make a payment by phone using your checking account? Some cards will charge you $5 or $10 bucks to do this, but not Discover.
  • Free FICO score on your monthly statement. This card gives you your real FICO score from TransUnion on your monthly statements. Considering the fact that you probably got a credit card to build your credit, being able to monitor your progress for free is a huge perk. That score would otherwise cost you $20 every time you check it.
  • No late fee on your first late payment. Normally, late payments can cost you up to $35 a pop. But with this card, at least you get one freebie. That s definitely helpful during college finals when you may forget.
  • No interest rate increases for paying late. A lot of cards will jack up your APR if you ever pay late. This one won t do that.

Compare the student credit cards for yourself

Worried about your card not being accepted? Discover is accepted at more than 94 percent of the top 2,000 internet retailers and more than 8 million businesses. You can use them almost everywhere that takes Visa and MasterCard.

Best Sign-up Offers (updated January 2016)

You won t find these promotions everywhere, but I m listing both here so you can choose the one that s best for your needs.

Discover it® for Students:
Offer #1: Get a 0 percent intro APR for 6 months on purchases. After that, it s a standard variable purchase APR of 13.24 percent to 22.24 percent.

Discover it® chrome for Students:

Oh yeah, and here s some important advice you not know about credit cards. In fact, a lot of old people don’t even know these things:

#1 – Build credit even without a balance
One of the reasons people start getting into debt is because they think it’s actually good for their credit score to have a balance. But this is completely wrong and doing so can actually harm your credit!

There is a huge difference between carrying a balance (allowing a balance to carry on past the due date and paying interest) and reporting a balance (having a balance when your billing cycle closes). When your billing cycle closes each month, the amount due is what’s reported to the credit bureaus. If you then pay that reported balance in full, you won t have to pay interest, and you ll get all the credit-building benefits.

So if you are regularly using your Discover card, you have the ability to build your credit… carrying a balance into the next billing cycle (and paying interest on it) offers absolutely no benefit to your credit score.

#2 – Carrying a large balance may hurt your credit
Even though you should let a balance report each month, keep it small.

The percentage of your credit limit you use – known as credit utilization – is factored into your FICO credit score. Having high utilization is actually bad. Banks like people that have a lot of credit but don’t use it! With the FICO formula, using above 30 percent of your credit limit may negatively affect your credit core.

The simple solution? Once you get your student credit card, always stay below 30 percent of your credit limit. Make multiple payments each month to keep it below that mark.

#3 – A better score means cheaper student loans
Let’s be honest here… college tuition is out of control! If you’re going to be taking out more loans to finish your degree, of course you want to get the best interest rate possible. Well, whether you get a good rate or bad rate depends on your credit score and history.

This is why it’s so important to not screw up with your new Discover student credit card, or any credit account for that matter. Use your cards responsibly – pay your bills on time and in full, and keep your credit utilization in check (as discussed above). Doing this will help build up your credit and you will be thankful for that when it comes time to get a loan.

Advertiser Disclosure
The credit card offers that appear on this site are from credit card issuers from which CreditCardForum.com receives compensation. This compensation may impact how and where products appear on this site, including the order in which they may appear within listing categories. CreditCardForum.com does not include all credit card offers that might be available to consumers in the marketplace.

Editorial Disclosure
Opinions expressed here are author’s alone, not those of any bank, credit card issuer, airlines or hotel chain, and have not been reviewed, approved or otherwise endorsed by any of these entities.

User Generated Content Disclosure
Forum member posts, comments and responses are not provided or commissioned by the bank advertiser. Responses have not been reviewed, approved or otherwise endorsed by the bank advertiser. It is not the bank advertiser’s responsibility to ensure all posts and/or questions are answered.

Join us


Bed And Breakfast Blackpool, Accommodation Blackpool, Guest House Blackpool, b b Blackpool

#windsor hotel

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Welcome To The Windsor Hotel

A warm welcome to the Windsor Hotel in Blackpool. Graded 3 Diamonds by the AA for guest accommodation. we offer bed and breakfast and service with a genuine smile. We have rooms with four poster, twin and double beds as well as family and single rooms available. Please note that all our rooms are en-suite.We have high standards within the hotel and as such we have a good growing reputation on Tripadvisor.

“The Small Hotel With
The Big Reputation”

About The Windsor Hotel

The Windsor Hotel Blackpool prides itself in offering comfortable clean rooms, good food and friendly service whilst providing value for money for all our guests. We’ll do our best to ensure you get the most out of your stay whilst you are at our hotel making you want to return.

Bed Breakfast facilities include wireless internet access throughout the hotel for those with a laptop, a licensed bar if you’ve put the kids to bed or deserve a well earned drink after walking around all day.

The Windsor is conveniently located in the South Shore area of Blackpool and within easy reach of all the resorts major attractions including:

Blackpool Tower
Pleasure Beach
The Sandcastle
South Pier
Funny Girls Show
Various other Casinos, Bars And Clubs

Bedroom Facilities

  • En-suite rooms
  • Fresh linen and towels
  • Complimentary toiletries
  • Hospitality tray
  • Flat screen televisions with Freeview
  • Free Wi-Fi
  • Hair dryers and ironing facilities available.

Guest Reviews





Platform as a Service – PaaS – Gartner Cloud Computing #paas #vendors,


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A platform as a service (PaaS) offering, usually depicted in all-cloud diagrams between the SaaS layer above it and the IaaS layer below, is a broad collection of application infrastructure (middleware) services (including application platform, integration, business process management and database services). However, the hype surrounding the PaaS concept is focused mainly on application PaaS (aPaaS ) as the representative of the whole category.

Plus FREE Gartner Research on Big Data. Information 2020 Beyond Big Data Analytics

Strategic adoption of PaaS is increasing, while PaaS vendors are continuing to innovate and introduce change. Application leaders responsible for architecture and infrastructure should understand cloud platform market trends to exploit them for competitive advantage.

The cloud is a platform of continuous innovation, rapid change, business opportunity and vendor hype. Over 200 specialist and generalist PaaS offerings are represented in this comprehensive market analysis, designed for IT leaders guiding their organizations to cloud competence and excellence.

September 27, 2016

Moving IT services to Infrastructure as a service (IaaS), platform as a service (PaaS) and software as a service (SaaS) cloud providers profoundly affects the roles and responsibilities of IT. IT Infrastructure Professionals (ITIPs) and managers must think about their roles, hone new skills and build a strategy for staying relevant in the forthcoming IT landscape.

Application leaders must understand the trends in application platforms to choose and plan new solutions, platform technologies, cloud services, architecture directions, skills, policies and organization models – with confidence. Informed readiness today will translate to business competitive advantage tomorrow.


Hosted Cloud Telephony – Managed IP Telephony Service #cloud #telephony, #enterprise #telephone


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Cloud-based IP Telephony

Cost savings

The traditional voice landscape involves expensive in-house infrastructure: The ubiquitous ‘tin box’ telephone system bolted onto the wall which – following sometimes considerable upfront expense – comes with a nasty catch in the hidden expenditure of upgrade, maintenance and running costs.

Our managed Cloud telephony service model is different: There are no upgrade or maintenance charges. It’s a straightforward monthly licence fee on a per user basis. A simple pay-as-you-go model with a compelling punch line – a new IP telephone system for about the same price as the maintenance charges on your old one. There’s no ISDN line rental charges and no maintenance or upgrade charges, just a significantly reduced predictable monthly charge.

  • Enterprise-grade hosted IP telephony phone system
  • PSTN connectivity included – no need for separate ISDN lines
  • Improved business continuity – instantly reroute calls in the event of a site outage
  • Full integration of mobile and home-workers
  • Integrated call recording
  • Integration with our Unified Communications service
  • Central administration portal for customer managed adds, moves and changes
  • 99.99% availability SLA and 24/7 technical support

It solutions companies #it #solutions #companies


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Wofür stehen wir?

Marken zu kreieren, zu führen und ein Gesicht zu geben kann etwas Magisches haben. Vor allem, wenn Designer und Markenberater mit Herzblut am Werk sind und sich mit Leidenschaft jeder Aufgabe widmen. SOLUTIONS steht für die Verbindung von Markenstrategie und Design, welches verzaubert und überrascht, mit einem scharfsinnigen Blick auf das „Gesamte”.

„Do the Magic”-Button drücken …

Beck’s

Seit mehr als 2000 Jahren trinken Menschen Bier. Weil es ihnen schmeckt. Und auch, weil sie damit ein bestimmtes Lebensgefühl verknüpfen. Welches das ist, bestimmt heute im Wesentlichen das Image der Biermarke. Und das wird nicht nur durch die klassische Werbung, sondern auch über die Verpackung transportiert. Denn die eigentliche Kaufentscheidung trifft der Kunde am Regal, am so genannten Point of Sale.

Unsere Aufgabe:
Von zwei Säulen sollte die Marke Beck’s zukünftig getragen werden, so die Entscheidung von Anheuser-Busch InBev: Zum einen gibt es die Reihe der starken Biercharaktere, zum anderen die Biermischgetränke – adressiert an unterschiedliche Zielgruppen und damit optisch auch unbedingt zu trennen, so die Aufgabenstellung an SOLUTIONS.

Unsere Herangehensweise:
Nachdem SOLUTIONS bereits Beck’s Gold ein maskulineres Äußeres verpasst hatte, war es bei den Biermixen viel mehr die Aufgabe, das Design klar abzugrenzen, ohne aber die Beck’s-Identität aus den Augen zu verlieren. Die Markenführung soll deutlich erhalten bleiben, bei einer klar differenzierten Optik, um darüber unterschiedliche Zielgruppen und Verwendungsanlässe zu adressieren.

Nicht nur die entsprechenden Umverpackungen wie Sixpacks, Logipacks und Dosen und hat SOLUTIONS dem neuen Design angepasst, sondern darüber hinaus auch einer Innovation des Mix-Segments ein attraktives Gesicht geben.

Bereits seit 2005 ist Anheuser-Busch InBev Kunde von SOLUTIONS. Es ist insbesondere die enge Zusammenarbeit, die auch schon zum Erfolg bei anderen Marken, wie z. B. bei Haake-Beck und Löwenbräu, geführt hat. Auch in diesem Fall führt das gemeinsame Wirken zu einer perfekten Einpassung des Design-Relaunchs in die Gesamtkampagne.

Das Ergebnis:
Kann sich sehen lassen. Denn es hat zu einer signifikanten Absatzsteigerung der Beck’s-Produkte geführt. Und erst dann sind wir zufrieden.


MS Access Helpdesk Ticketing System #it #helpdesk #ticketing #system


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Manage And Support Your Helpdesk Ticket Requests

The MS Access helpdesk ticketing system is suitable for a small or a medium sized business. Designed to fit with your existing Microsoft Office products such as Excel, Outlook and Word. An all round simple Access database solution designed to record ticket support requests and improve business efficiency.

* Employee tracking
* Record users computer details, networks, login information
* Record library loans for books
* Inventory
* Assign technicians to each task, record priority, date status
* Record ticket problem, action taken, audit trail
* Graphical overview of tasks for each technician
* Add solutions to built in knowledge base with the added ability to email the solution to the user
* Record common problems and open ticket calls
* Record appointments, tasks and send email from within MS Access to MS Outlook
* Book courses
* View graphical statistics on ticket problems by department, technician
* Record orders for computer related supplies and email suppliers
* Built in contacts database
* Great selection of management reports
* Create a knowledge base of common problems and solutions

Hi Paul,
I ve been playing with the system and think it is a very well-designed application.
Thanks!
IBM PC Institute
IT Program Manager Team Lead

I enjoyed your program. We would like to buy it your program is great this is exactly what I was Looking for. with a little help from you it will be perfect
Kfir Benjamin
HeliOss Communications Israel Ltd.

Manage Your Support Ticket Requests

You can tailor the MS Access helpdesk ticketing system any way you want or we can do it for you, saving you time, effort and reducing costs.

* MS Office compatible
* Works with MS Access 97, 2000, XP, 2003
* User manual and support provided
* Can be tailored to your organization
* Easy to use, effective and gets the job done
* Source code included
* Computer help desk software that supports your business needs and is simple to use

Download A Trial And Try It For Yourself

Trial Edition For MS Access 2000,2002,2003,2007,2010

Order The Full Version For Only $59.99 Instant Delivery


Wenn: IS NURSING SCHOOL WORTH IT? #is #nursing #school #worth #it


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Snap Chat: ashleylh24

Important Pieces of Online Registered Nurse Programs

You have an interest in becoming a nurse. Practical nurses are a considerable part numerous health care teams. It is required for the graduate nurse to utilize each of the tools available to ensure success at passing. Consequently, in situation you are looking for out whether you have exactly what is had to end up being a registered nurse, you should understand that there are a great deal of things that you have to think about. Many bedside nurses start at rather near to the precise same wage, irrespective of education.

Work wellness nursing ensures a wide variety of chances as well as you might decide to create your living for a clinician, teacher, business director or specialist. Nurses are the biggest group of workers within the NHS as well as a considerable part of the health and wellness care market. In a little method you may be the only nurse in the region, whilst if it s a bigger surgical treatment you re likely to share responsibilities with other method nurses.

Important Pieces of Online Registered Nurse Programs

With the healthcare market seeing an elevated requirement for nurses on account of the nation s aging population, the demand for nursing trainers likewise has higher. For people who choose to put in the occupation of useful nursing there are a few demands which have to be satisfied. From that point, legal doctor might delight in an incredibly healthy independent way of life. The professionals likewise reported this upward relocation isn t expected to continue in the forseeable future.

New Questions Regarding Online Registered Nurse Programs

The perfect area to get a preoccupied residential or commercial property is ForeclosureDataBank.com. Therefore, you will have to understand where you wish to apply. Then you re by yourself. In the u.s.a, there has never been an enhanced demand for high quality trained as well as informed nurses as well as RN experts as well as with a small luck as well as some difficult work as well as by complying with a number of the important guidance you will see you can increase your possibility of discovering the nursing scholarship you need as well as need for your upcoming profession in nursing. The chances in nursing are broad as well as varied so it s crucial to research different capabilities as well as certifications you should obtain if you have an interest in a specific expert field. It s likewise a good idea to have the capability to get all the useful experience which you have to prepare you enough for the work ahead of you. There are loads of tasks which are offered for a skilled nurse specialist.

It s true that you will produce more cash for a nurse specialist than you would as a RN, however you re going to do the task extremely difficult for that cash. You should select if you ll have sufficient cash to complete either program. Particular advantages of breast milk include offering all the power as well as nutrients required for the first months of living. There are numerous advantages to becoming a nurse legal assistant, however there are a couple disadvantages as well.

As for anyone who s freelance, starting your personal personal method implies you will have to have a deal with over the business matters of your operations together with the health care procedures. There are a number of training as well as academic options for those seeking to go after professions as medical assistants. Picture, then, that you re a new trainer as well as you ve just signed on.

As a new instructor, you are going to discover ways to efficiently supply the trainee with comments. As an example, the trainee may have found a new ways to navigate a search for a specific term in web small company administration degrees. By choosing this college, Michigan trainees can spend less as well as introduce a brand-new profession in only a year. Each trainee is anticipated to take part in class discussion. Furthermore, a number of on the internet trainees utilize monitored internships so regarding discover the hands-on training they want.

College is such place where you can begin your right profession. Normally, the neighborhood college utilizes a mixed method to education. Without college preparation it isn t possible to find across outstanding colleges. Clearly, saving $32,238.00 is an essential decision point, however before you instantly choose the neighborhood technical college, you should ask yourself the previous concern. Some institutions now need physical chemistry. Medical assistant institutions should be certified by the most appropriate bodies or organizations.

You might likewise choose to go after master s degree for a Nurse. You will have to show that you hold no less than a master s degree within the field to which you re applying. Adopting a web nursing degree might be outstanding experience if you examine routinely, since then it is possible to finish your program in less time when compared with the typical level. You are able to get a program average as well as a break down of exactly what you ve made every week.

About Me

Wenn Tousignant

I am Wenn W. Tousignant, Patient Care Director of Allyn Hospital with passion in cooking, nursing, health care, nursing school, and music. I believe that the need to keep ourselves healthy is the key to every success. As a director of patient health care services are responsible for maintaining an environment that ensures that patients are cared-for properly and provided with the highest quality health care services. Overall, it is expected that I keep patient care running smoothly while staying within budget. View my complete profile

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Atlanta History Center #it #schools #in #atlanta


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Do It For The Culture!

Explore! Learn! Play!

This One s for the books

Welcome explorers of the world! If you’re looking for history, knowledge and adventure, you’ve come to the right place. The Atlanta History Center is located in one of Atlanta’s most vibrant communities where the stories and mysteries of our region thrive. Our 33-acre experience features award-winning exhibitions, historic houses, enchanting gardens, interactive activities and a variety of year-round adult and family programs. With ticket admission, our guests enjoy complimentary parking and all-inclusive access to Atlanta History Center destinations.

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Location

Atlanta History Center
130 West Paces Ferry Road NW
Atlanta, GA 30305

Hours

Upcoming Events

Summer History Camp: Crime of the Century – Sold Out
Mon, Jun 5, 2017, 9:00am – Fri, Jun 9, 2017 at 4:00pm

Summer Writing Camp: ​Mystery in the City: Whodunit? – Sold Out
Mon, Jun 5, 2017, 9:30am – Fri, Jun 9, 2017 at 5:00pm

Lisa Wingate, Before We Were Yours
Mon, Jun 5, 2017, 7:00pm

Jacqueline Woodson, Another Brooklyn
Thu, Jun 8, 2017, 7:00pm

Member Perk: Researching Your Family History with Military Records
Sat, Jun 10, 2017, 10:30am – 12:00pm

Summer History Camp: Empire Unknown
Mon, Jun 12, 2017, 9:00am – Fri, Jun 16, 2017 at 4:00pm

From Our Blog

About Us June 01, 2017

Anna Rose Gable believes in doing it for the (agri)culture! She s our Urban Agriculturalist and has a fascinating story to tell!

Collections May 29, 2017

This Memorial Day we honor our veterans by hearing from Col. Robert Certain, who bravely fought during the Vietnam War.

About Us May 26, 2017

Our Manager of Collections takes you through what it s like behind the scenes when prepping for an exhibit.

Atlanta History May 19, 2017

One hundred years ago the Great Atlanta Fire of 1917 destroyed 300 acres of the city. The Fourth Ward would never be the same.

About Us May 11, 2017

Last week, two trucks carrying the latest addition to the Atlanta History Center rolled up on our property with a very special delivery!

About Us May 10, 2017

Meet Kate Whitman, Vice President of Public Programs! Having worked here 14 years, Kate has helped our organization’s programs grow and diversify.


Hospice Care: What it is and how to find it #book #hotel

#find a hospice

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Palliative Care Center

What Is Hospice?

During the course of your illness, you may come to realize that treatments meant to cure or slow your disease are no longer working. Although it’s a difficult decision, you’ve concluded that the burdens of aggressive treatment outweigh any benefits, and you’re unwilling to endure any more discomfort or risk of harm.

Instead, you’d rather spend your remaining time with family and friends. Maybe you yearn to reflect on your life and create a legacy for your loved ones, such as a journal or a videotaped message. Perhaps you need to put your financial affairs in order, or seek spiritual guidance as death nears.

Despite your illness, the quality of each day still matters to you. You want relief from pain, from shortness of breath, and from other symptoms so that you can focus on the matters dearest to you, including saying good-bye to your loved ones.

That’s when hospice. or end-of-life care, may help.

Hospice is a type of palliative care. but differs in important ways. Palliative care serves anyone who is seriously ill, not just those who are dying. Palliative care itself doesn’t seek to cure, but provides pain relief and symptom management, and addresses the emotional and spiritual needs of patients and families. Many patients receive palliative care while they’re still pursuing a cure.

Hospice also provides wide-ranging care and support to patients and families. However, hospice patients stop curative treatments, although they still receive medications to manage pain and other symptoms. Hospice serves people with a life-expectancy of six months or less because of cancer. dementia. heart disease. lung disease. and other illnesses.

Hospice emphasizes quality of life and patient involvement in decision making. A hospice team typically includes a doctor, nurse, social worker, counselor, chaplain, home health aide, and trained volunteers. They work together to meet a patient’s physical, emotional, and spiritual needs.

Hospice is for family members, too. It can provide respite care, bereavement counseling, and help with practical matters such as transportation and household duties.

Eligibility for Hospice

You’re eligible to enter hospice care if your doctor states that you have a terminal illness and that death can be expected in six months or less if your illness follows its normal course. However, you may stay in hospice beyond six months if your doctor and the hospice team certify that you still have only a short time to live.

Bear in mind that hospice isn’t always a permanent choice. For example, some elderly patients with failing kidneys choose hospice rather than undergo dialysis. But they can still change their minds, leave hospice, and pursue dialysis after all. Or if a patient’s illness improves, he or she can leave hospice and return later.





How long does it take to become a consultant? Become a Consultant


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How long does it take to become a consultant?

How long does it take to become a consultant? When considering making the leap into consulting, many people want to know how long it will take to establish their business. In other words, how much time does it take before you can rely on a steady income?

With a well-organized office and a stack of business cards at the ready, many consultants feel prepared to work. But next comes the most crucial step: finding clients. How long it takes to become a consultant depends on how quickly you are able to build your list of clients.

How long does it take to establish your own business?

Every consultant is unique, so the time it takes to get established can vary.

Some new consultants need to invest substantially in networking and relationship building. Whereas other consultants have a wealth of experience and contacts, which helps them hit the ground running.

In my course, Become a Consultant: How to Make the Leap . I take students through a detailed sample marketing plan which gives insight into the level of marketing and networking required to successfully run your own business.

Can I jump-start my business and become a consultant overnight?

Some people are not satisfied with the answer to the question, How long does it take to become a consultant?

Although it s not the norm, it is certainly possible to become a consultant overnight.

A number of consultants choose to purchase turn-key businesses, which are already in operation. When considering this option, it s important to steer clear of work from home scams.

How long does it really take to become a consultant?

So how long does it take to become a consultant? The answer rests with you!

The key to success is to build your network and implement your marketing plan in order to connect with your target market.

Because no matter how glossy your business cards are, they can t help you unless they re placed in the hands of potential clients. So get out there and start building your client list!

Want help in making the transition to consulting? Enroll in the official Consultant Journal course Become a Consultant: How to Make the Leap. With audio and written lessons, 25 exercises, discussion forums and more, you ll have mentorship in your journey to consulting.


What is a medical home? Why is it important? #hotels #in #san

#home medical care

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What is a medical home? Why is it important?

The medical home is a concept first introduced by the American Academy of Pediatrics (AAP) in 1967. In its initial version, the AAP defined the medical home as the center of a child’s medical records. At the time, the care of children with special health care needs was the primary focus of the medical home concept. Over time, however, the definition of the medical home has evolved to reflect changing needs and perspectives in health care.

The modern medical home expands upon its original foundation, becoming a home base for any child’s medical and non-medical care. Today’s medical home is a cultivated partnership between the patient, family, and primary provider in cooperation with specialists and support from the community. The patient/family is the focal point of this model, and the medical home is built around this center. Another key factor is that the focus of the medical home has shifted to include all children and adults, not just children with special health care needs. In the 2002 revision (PDF – 45KB) of its 1992 statement (PDF – 32KB) on the medical home, the AAP reiterated and enhanced its explanation of the medical home’s crucial characteristics. These guidelines stress that care under the medical home model must be accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective. In 2007, the AAP joined with the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and the American Osteopathic Association (AOA) to form the Joint Principles of the Patient Centered Medical Home . Under this collaborative effort, the characteristics of the medical home have been defined within these 7 principles:

1. Personal physician:

  • Each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care.

2. Physician directed medical practice:

  • The personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients.

3. Whole person orientation:

  • The personal physician is responsible for providing for all the patient’s health care needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care for all stages of life; acute care; chronic care; preventive services; and end of life care.

4. Care is coordinated and/or integrated:

  • Across all elements of the complex health care system (e.g. subspecialty care, hospitals, home health agencies, nursing homes) and the patient’s community (e.g. family, public and private community-based services). Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.

5. Quality and safety are hallmarks of the medical home:

  • Practices advocate for their patients to support the attainment of optimal, patient-centered outcomes that are defined by a care planning process driven by a compassionate, robust partnership between physicians, patients, and the patient’s family.
  • Evidence-based medicine and clinical decision-support tools guide decision making.
  • Physicians in the practice accept accountability for continuous quality improvement through voluntary engagement in performance measurement and improvement.
  • Patients actively participate in decision-making, and feedback is sought to ensure patients’ expectations are being met.
  • Information technology is utilized appropriately to support optimal patient care, performance measurement, patient education, and enhanced communication.
  • Practices go through a voluntary recognition process by an appropriate non-governmental entity to demonstrate that they have the capabilities to provide patient centered services consistent with the medical home model.
  • Patients and families participate in quality improvement activities at the practice level.

6. Enhanced access to care:

  • Is available through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician, and practice staff.
  • Appropriately recognizes the added value provided to patients who have a patient-centered medical home. The payment structure should be based on the following framework:
  • It should reflect the value of physician and non-physician staff patient-centered care management work that falls outside of the face-to-face visit.
  • It should pay for services associated with coordination of care both within a given practice and between consultants, ancillary providers, and community resources.
  • It should support adoption and use of health information technology for quality improvement;
  • It should support provision of enhanced communication access such as secure e-mail and telephone consultation;
  • It should recognize the value of physician work associated with remote monitoring of clinical data using technology.
  • It should allow for separate fee-for-service payments for face-to-face visits. (Payments for care management services that fall outside of the face-to-face visit, as described above, should not result in a reduction in the payments for face-to-face visits.)
  • It should recognize case mix differences in the patient population being treated within the practice.
  • It should allow physicians to share in savings from reduced hospitalizations associated with physician-guided care management in the office setting.
  • It should allow for additional payments for achieving measurable and continuous quality improvements.

The Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA) has identified specific criteria to establish whether a child’s health care meets the definition of a medical home. This criteria include:

  • Whether the child has at least one personal doctor or nurse who knows him or her well and a usual source of sick care;
  • Whether the child has no problems gaining referrals to specialty care and access to therapies or other services or equipment;
  • Whether the family is very satisfied with the level of communication among their child’s doctors and other programs;
  • Whether the family usually or always gets sufficient help coordinating care when needed and receives effective care coordination;
  • Whether the child’s doctors usually or always spend enough time with the family, listen carefully to their concerns, are sensitive to their values and customs, provide any information they need, and make the family feel like a partner in their child’s care;
  • Whether an interpreter is usually or always available when needed.

A medical home is an important mechanism for uniting the many segments of a child’s care, including behavioral and oral health, to accomplish these goals. Furthermore, Drs. David Kibbe of the American Academy of Family Physicians and Joseph Kvedar of the Center for Connected Health at Partners HealthCare believe that the medical home model of care works synergistically with participatory medicine (PDF – 455KB) models in which the active role of the patient is emphasized.

Developed by the Health Resources and Services Administration as a resource for health centers and other safety net and ambulatory care providers who are seeking to implement health IT.





CARES Community Aging and Retirement Services #it #project #managment


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CARE is currently offering wellness programs in:
TRINITY, HUDSON, ELFERS/NEW PORT RICHEY, LARGO and LAND O LAKES
Please see below for complete descriptions of the programs CARES offers.

Any questions about our wellness programs please call 1-888-718-2110

PLEASE WATCH THE FOLLOWING VIDEO from Pinellas County Government / Pinellas County Connection TV
Produced by the Area Agency On Aging Of Pasco-Pinellas County Aging on the Suncoast

Most of us recognize that wisdom comes with age, but the need for learning does not go away as we get older. In fact, as technology and education continue to move forward in leaps and bounds, incredible advances have been made in health and wellness. For longevity’s sake, you owe it to yourself to stay informed.

Helping You Stay Informed

CARES Wellness programs have been keeping seniors healthy, happy and safely in their homes for over 20 years. These programs are designed for seniors and their caregivers because education is the key to success. Contact us now to get started today.

CARES Wellness Programs Include:

CARES Evidence Based Wellness Programs:

  • Active Living Every Day (ALED): This wellness program is offered one hour a week for twelve weeks. It is designed to help people overcome barriers that lead to physical inactivity. Participants will learn step-by-step tools that will help make behavioral changes to positively affect their health. The ALED workshop encourages participants to create their own action plan with activities that can be easily added to their daily routines. ALED is an evidence-based program that has been proven effective to produce lasting, positive change built with small successes through lifestyle management. The program is FREE. Class size is limited and you must pre-register. CALENDAR
  • The Diabetes Self-Management Workshop(DSMP): This wellness program is offered two hours once a week for six weeks. Subjects covered include: 1) techniques to deal with the symptoms of diabetes, fatigue, pain, hyper/hypoglycemia, stress, and emotional problems such as depression, anger, fear and frustration; 2) appropriate exercise for maintaining and improving strength and endurance; 3) healthy eating 4) appropriate use of medication; and 5) working more effectively with health care providers. Participants will make weekly action plans, share experiences, and help each other solve problems they encounter in creating and carrying out their self-management program. Physicians and other health professionals both at Stanford and in the community have reviewed all materials in the course and it has proven to be effective in enhancing the quality of life for those dealing with Type 2 Diabetes. The program is FREE. Class size is limited and you must pre-register. CALENDAR
  • Tai Chi: Moving for Better Balance. This wellness program is offered for one hour twice a week for twelve weeks. The Tai Chi program results from years of scientific research and study by the Oregon Research Institute and focuses on prevention of falls by regular practice; Tai Chi will improve one’s balance and reduce the likelihood of falling. There are eight single forms in the program, all of which are derived from the traditional, well-known, 24-Form Yang Style Tai Chi but tailored to community adults who wish to improve balance and mobility. All forms adhere to the fundamental principles of traditional Tai Chi and involve weight-bearing and non-weight-bearing stances, posturally correct body alignment, and multiple, coordinated movements executed in a continuous, circular, and flowing manner. Performance of the forms is closely synchronized with natural breathing, that is, each single movement coordinates with the inhale and exhale breathing cycle. The eight single forms are arranged in a sequential order, following a progression from easy to more difficult. Each of these forms can be performed and practiced repeatedly as a single movement or in combination as part of a routine. The program is FREE. Class size is limited to 20 people and you must pre-register. CALENDAR
  • A Matter of BalanceWellness Program: This wellness program is offered for two hours a week for eight weeks. The sessions consist of group discussion, problem–solving strategies, videos and gentle physical exercise. Older adults learn positive coping methods to reduce fear of falling and remain active and independent. A Matter of Balance helps participants become more confident about managing falls by believing that they can increase their strength, find ways to reduce falls, and protect themselves if they do fall. In addition, participants report that they have increased the amount they exercise on a regular basis. The program is FREE. Space is limited and you must pre-register. CALENDAR
  • Healthy Eating Every Day (HEED) This wellness program is offered for one hour a week for fourteen weeks. The goal is to help people improve their health and quality of life. This program is designed to help people improve the quality of their diets. It is a total dietary pattern approach to build cognitive and behavioral skills around healthy eating. All foods can be part of a healthy diet. HEED is based on current nutrition recommendations and helps people to learn to use lifestyle-management skills and develop and maintain healthy eating habits. It meets one hour per week for 14 weeks. The program is FREE. Class size is limited and you must pre-register. CALENDAR
  • Living Healthy Chronic Disease Self-Management (CDSMP): This wellness program is offered for two hours, once a week, for six weeks. People with different chronic health problems (such as hypertension, COPD, heart disease, diabetes, arthritis, etc.) attend together. Workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with a chronic diseases themselves. Subjects covered include: 1) techniques to deal with problems such as frustration, fatigue, pain and isolation, 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance, 3) appropriate use of medications, 4) communicating effectively with family, friends, and health professionals, 5) nutrition, and, 6) how to evaluate new treatments. Classes are highly interactive and space in limited
    The program is FREE. Space is limited and you must pre-register. CALENDAR


What Is A Nursing Care Plan and Why is it Needed? #biltmore

#hospice nursing care plans

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What Is A Nursing Care Plan and Why is it Needed?

In nursing school, there is probably no more hated class assignment than the nursing care plan. They re assigned for every type of class, for intensive care patients, in mental health, and even for community care. Nursing students stay up all night preparing patient-specific care plans for the next day s clinical, but why is this agony inducing tool still used so universally?

  • Care plans provide direction for individualized care of the client. A care plan flows from each patient s unique list of diagnoses and should be organized by the individual s specific needs.
  • Continuity of care. The care plan is a means of communicating and organizing the actions of a constantly changing nursing staff. As the patient s needs are attended to, the updated plan is passed on to the nursing staff at shift change and during nursing rounds.
  • Care plans help teach documentation. The care plan should specifically outline which observations to make, what nursing actions to carry out, and what instructions the client or family members require.
  • They serve as a guide for assigning staff to care for the client. There may be aspects of the patient s care that need to be assigned to team members with specific skills.
  • Care plans serve as a guide for reimbursement. Medicare and Medicaid originally set the plan in action, and other third-party insurers followed suit. The medical record is used by the insurance companies to determine what they will pay in relation to the hospital care received by the client. If nursing care is not documented precisely in the care plan, there is no proof the care was provided. Insurers will not pay for what is not documented.

The purpose of students creating care plans is to assist them in pulling information from many different scientific disciplines as they learn to think critically and use the nursing process to problem solve. As a nursing student writes more plans, the skills for thinking and processing information like a professional nurse become more effectively ingrained in their practice.

The exact format for a nursing care plan varies slightly from place to place. They are generally organized by four categories: nursing diagnoses or problem list; goals and outcome criteria; nursing orders; and evaluation.

As defined by the the North American Nursing Diagnosis Organization-International (NANDA-I). nursing diagnoses are clinical judgments about actual or potential individual, family or community experiences or responses to health problems or life processes. A nursing diagnosis is used to define the right plan of care for the client and drives interventions and patient outcomes.

Nursing diagnoses also provide a standard nomenclature for use in the Electronic Medical Record (EMR), allowing for clear communication among care team members and the collection of data for continuous improvement in patient care.

Nursing diagnoses differ from medical diagnoses. A medical diagnosis — which refers to a disease process — is made by a physician and will be a condition that only a doctor can treat. In contrast, a nursing diagnosis describes a client s physical, sociocultural, psychologic and spiritual response to an illness or potential health problem. For as long as a disease is present, the medical diagnosis never changes, but a nursing diagnosis evolves as the client s responses change.

The goal as established in a nursing care plan — in terms of observable client responses — is what the nurse hopes to achieve by implementing nursing orders. It is a desired outcome or change in the client s condition. The terms goal and outcome are often used interchangeably, but in some nursing literature, a goal is thought of as a more general statement while the outcome is more specific. For example, a goal might be that a patient s nutritional status will improve overall, while the outcome would be that the patient will gain five pounds by a certain date.

Nursing orders are instructions for the specific activities that will perform to help the patient achieve the health care goal. How detailed the order is depends on the health personnel who will carry out the order. Nursing orders will all contain:

  • The date
  • An action verb like monitor, instruct, palpate, or something equally descriptive
  • A content area that is the where and the what of the order, for example, placing a spiral bandage on the left leg from ankle to just below the knee
  • A time element will define how long or how often the nursing action will occur
  • The signature of the prescribing nurse, since orders are legal documents.

Finally, in the evaluation. the client s health care professionals will determine the progress towards the goal achievement and the effectiveness of the nursing care plan. The evaluation is extremely important because it determines if the nursing interventions should be terminated, continued or changed.

To help students learn and apply their knowledge, educators often add one more category to care plans. The rationale is the scientific reason for selecting a specific nursing action. Students may be required to cite supporting literature for their plan and rationale.

Care plans teach nursing students how to think critically, how to care for patients on a more personal level, not as a disease or diagnosis. They help teach how to prioritize care and interventions. They are a necessary evil of nursing school, tried and true for teaching future nurses not to care, but how to provide care that will improve the client s health status.

Sample Careplans

Please browse and bookmark our free sample careplans below. Our careplan library has been utilized by over 100,000 visitors.

Featured Schools Nursing Healthcare Programs





Apache2 Ubuntu Default Page: It works #hotel #offers

#st francis hospice raheny

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This is the default welcome page used to test the correct operation of the Apache2 server after installation on Ubuntu systems. It is based on the equivalent page on Debian, from which the Ubuntu Apache packaging is derived. If you can read this page, it means that the Apache HTTP server installed at this site is working properly. You should replace this file (located at /var/www/html/index.html ) before continuing to operate your HTTP server.

If you are a normal user of this web site and don’t know what this page is about, this probably means that the site is currently unavailable due to maintenance. If the problem persists, please contact the site’s administrator.

Ubuntu’s Apache2 default configuration is different from the upstream default configuration, and split into several files optimized for interaction with Ubuntu tools. The configuration system is fully documented in /usr/share/doc/apache2/README.Debian.gz. Refer to this for the full documentation. Documentation for the web server itself can be found by accessing the manual if the apache2-doc package was installed on this server.

The configuration layout for an Apache2 web server installation on Ubuntu systems is as follows:

  • apache2.conf is the main configuration file. It puts the pieces together by including all remaining configuration files when starting up the web server.
  • ports.conf is always included from the main configuration file. It is used to determine the listening ports for incoming connections, and this file can be customized anytime.
  • Configuration files in the mods-enabled/. conf-enabled/ and sites-enabled/ directories contain particular configuration snippets which manage modules, global configuration fragments, or virtual host configurations, respectively.
  • They are activated by symlinking available configuration files from their respective *-available/ counterparts. These should be managed by using our helpers a2enmod. a2dismod.a2ensite. a2dissite. and a2enconf. a2disconf . See their respective man pages for detailed information.
  • The binary is called apache2. Due to the use of environment variables, in the default configuration, apache2 needs to be started/stopped with /etc/init.d/apache2 or apache2ctl. Calling /usr/bin/apache2 directly will not work with the default configuration.

By default, Ubuntu does not allow access through the web browser to any file apart of those located in /var/www. public_html directories (when enabled) and /usr/share (for web applications). If your site is using a web document root located elsewhere (such as in /srv ) you may need to whitelist your document root directory in /etc/apache2/apache2.conf.

The default Ubuntu document root is /var/www/html. You can make your own virtual hosts under /var/www. This is different to previous releases which provides better security out of the box.

Please use the ubuntu-bug tool to report bugs in the Apache2 package with Ubuntu. However, check existing bug reports before reporting a new bug.

Please report bugs specific to modules (such as PHP and others) to respective packages, not to the web server itself.





Skilled Nursing Care: What Is It? #cape #may #motels

#nursing home care

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Skilled Nursing Care: What Is It?

Truth be told, most people don t think about skilled nursing care until an aging parent, spouse or other family member needs more help than a caregiver can provide.

Skilled nursing care facilities, commonly referred to as nursing homes. are licensed healthcare facilities that are inspected and regulated by a state s Department of Health Services.

They offer long- and short-term care for individuals who need rehabilitation services or who suffer from serious or persistent health issues, such as Alzheimer s disease, that are too complicated to be tended to at home or at an assisted living facility .

What to Expect from Skilled Nursing Care

Nursing homes provide custodial and skilled nursing care 24/7. Skilled nursing care involves trained professionals performing services that are needed temporarily due to an injury or illness, including:

  • a nurse attending to a post-operative wound or dispensing and monitoring intravenous medications
  • a physical therapist working with a resident to rectify strength and balance issues
  • a speech therapist assisting a resident in reclaiming their ability to communicate following a stroke
  • an occupational therapist helping a resident to become independent again, particularly when it comes to dressing, personal hygiene and eating

A skilled nursing care facility also provides:

  • pharmaceutical, laboratory and radiology services
  • social and educational activities
  • laundry services
  • limited transportation
  • end-of-life or hospice care
  • respite care

Some facilities are specially designed to accommodate seniors suffering from Alzheimer s or Parkinson s disease, dementia or respiratory ailments. Staff also provide custodial or personal care that focuses on helping residents with activities of daily living. such as:

  • bathing
  • dressing
  • personal hygiene
  • eating
  • maneuvering in and out of bed and/or walking
  • incontinence

Not all nursing homes offer these services. Families should visit several facilities to find the one best suited to their loved one s needs.

Skilled Nursing Care vs. Assisted Living

Choosing between skilled nursing care and assisted living can be difficult. A skilled nursing care facility may be needed if your family member requires:

  • round-the-clock nursing care, particularly if the senior might stray if left unsupervised
  • assistance with meals, personal hygiene, medications and portability
  • more help than the family or present caregiver can provide or the senior can no longer live alone

Assisted living communities are recommended when the senior does not require much medical care but they do need more assistance than can be provided in their home. Assisted living facilites:

  • allow residents to live independently in their own apartment
  • provide meals, housekeeping and transportation services whether it be to the store, hairdresser/barber or a medical appointment
  • have a scheduled calendar of events for residents and their families that includes arts and crafts, current events and field trips
  • assist with dressing, personal hygiene and medications
  • have a resident doctor and/or registered nurse on staff

Resources for Skilled Nursing Care

For more information on skilled nursing care, visit these websites:

Find Skilled Nursing Care

If you are trying to find skilled nursing care for a loved one, we can help. Our directory lists thousands of nursing homes nationwide to help you find skilled nursing care near you.





Oj simpson wrongful death #oj #simpson #book,nicole #brown #simpson,norman #pardo,oj #simpson #if


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O.J. Simpson’s Former Manager Norman Pardo Says O.J. Was Paid $600,000 To Claim He Wrote ‘If I Did It’

O.J. Simpson’s close friend and former manager claimed Tuesday that Simpson did not in fact write the controversial book “If I Did It,” which explores how Simpson would have hypothetically carried out the murders of Nicole Brown Simpson and Ron Goldman if he had actually committed the crime.

Simpson’s longtime associate Norman Pardo joined HuffPost Live’s Marc Lamont Hill on the 20th anniversary of the infamous police chase that grabbed the attention of millions as Simpson led the pack in his white Ford Bronco. During the interview, Pardo claimed Simpson only agreed to claim authorship of “If I Did It” for a $600,000 payout.

“If I Did It” was originally announced in 2006 and was planned to coincide with a television interivew, but the project was scrapped in November of that year by NewsCorp and its subsidiary ReganBooks amid intense public criticism. In July 2007, the family of Ron Goldman acquired rights to the book and announced they would publish it in an effort to satisfy what Simpson owed them for the 1997 wrongful death suit against him.

Pardo told HuffPost Live that Simpson had no part in writing the book:

I remember when that book was coming out. O.J. called me. He said, ‘Here’s the deal,’ because it was in the news that he was going to do an interview. I said, ‘O.J. don’t do it, it’s stupid.’ He said, ‘Hey, they offered me $600,000 not to dispute that I [wrote] the book.’ He said, ‘That’s cash.’ I said, ‘They’re going to think you wrote it.’ He said, ‘So? Everybody thinks I’m a murderer anyway. They’re not going to change their mind just because of a book.’

So who was actually behind the words in “If I Did It”?

“A ghostwriter for [the book’s publisher] wrote the book. [O.J.] was going to do an interview to say, ‘I wrote the book, blah blah blah,’ and they give him money,” Pardo said.

See the full HuffPost Live conversation with O.J. Simpson’s former manager below.

ALSO ON HUFFPOST:


Free invoice template – SJD Accountancy #accountancy,limited #company,contractor #accountants,contractor #limited #company,accountants,freelancer #accountants,consultants,london,tax,inland


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FREE Invoice Template

Whether you are a multinational limited company or a single person sole trader it is important that you have a structured approach to your invoicing or you may lose track of what payments you are waiting for.

Invoicing your clients is a fairly straightforward and simple process, provided you have a good invoice template to work from.

You should keep a record of all the invoices you have sent out along with when you received payment in order to keep track of your finances.

Please use the below template which is based on a VAT rate of 20%:

Invoice Template

Please use the below template which is based on a VAT rate of 17.5%:

Invoice Template

If you are thinking of buying one of the many online accounting software packages, we’d advise you to read this report first.

If you do choose to set up a limited company. which is exactly what our other 15,000 contractor and freelancer clients have done, you may like to chose SJD to help form your company. Last year alone, more than 3,000 contractors formed their Limited company on our website.

SJD Accountancy

SJD Accountancy are the UK’s largest specialist provider of fixed fee, Limited company accountancy services to contractors; we’ve been acting for contractors across the UK since 1992 and have more than 15,000 clients.

We are the only national specialist firm of contractor accountants with offices nationwide. SJD Accountancy has more qualified staff than any other firm in our market with qualifications from the following major tax and accountancy bodies – ATT, AAT, CTA, ACCA, CA, ACA and FCCA.

  • Unlimited face to face meetings. This is a unique service only SJD Accountancy offers – unlimited face to face meetings across the UK – tax is complicated and sometimes only a meeting will do.
  • UK’s Largest contractor accountants with more qualified staff. No call centres, no outsourcing, no automated call handling. Simply telephone, email or meet your own dedicated accountant face to face.
  • Money back service guarantee . All your telephone calls and emails will be answered the same day or we will make a full refund of that months fee.
  • Outstanding reputation. We have won more awards for customer service and accountancy excellence than any other firm in our market, including: Best Acc ount ant for Contractors, Accountant of the Year and Best Professional Service Team to name just a few.
  • All inclusive low cost fixed fee accountancy package which includes completion of accounts*, payroll bureau, dividends and corporation tax computations, personal taxation, free bookkeeping software, your own dedicated accountant* and all company returns for a fixed fee starting from £120 plus VAT per month. Check our packages for more detail.

Form your own Limited company with SJD – our same day online company formation service includes company bank account set up, VAT/PAYE registration and advice on optimum share structure.

You may also find the following pages, guides and case studies useful:

  • Take home pay calculator – How much could you be taking home
  • Contractor FAQ – All your frequently asked questions and their answers
  • First time Contracting or Freelancing? – A summary of the alternatives along with pros and cons
  • Choosing a contractor accountant – The factors to consider when choosing an accountant
  • Step-by-step Guide to Contracting – Download a FREE copy of our guide
  • Limited or Umbrella? Can’t decide? – We help you decide which is best for you
  • Guide to Contracting – All the best guides to contracting in one place
  • Expenses Guide – Know exactly what you can claim
  • Umbrella company guide – Everything you ever wanted to know about umbrella company services
  • IR35 Guide – A great plain English guide to IR35

*If you would like us to complete your company year end accounts we simply ask that you have been a client of SJD for one year or have made 12 monthly payments. All accountants are part or fully qualified.


When to Call Hospice – How to Know It s Time #best

#when to call hospice

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When to Call in Hospice

Hospice care is often seen as a last-resort option�one to use when the patient no longer can benefit from traditional medical care. The fact is that approximately twice as many older Americans end their lives in hospital care now than they did ten years ago�but hospice care is still seen as a last resort. If it was brought in sooner, it could do patients more good.

Hospice care is generally designed to help patients who know they are dying control their pain, stay comfortable, and get their social, emotional, and spiritual needs met in a supportive environment.

However, studies show that more and more, hospice care is being used as the option of last resort for patients who receive very aggressive hospital care during their final days�care that may not be appropriate.

For many patients and families, hospice care may be a better option earlier in the care process�skipping the aggressive intensive care that often occurs at the end of life.

How to Know When It’s Time to Arrange for Hospice

  • When your doctor says there are few other options. Usually, the doctor and the patient decide together when it is time for hospice care. In general, hospice care is recommended when the patient has approximately six months to live if the illness follows its natural course. But the timing can be different for different patients.However, hospice is primarily designed for end-of-life care. Hospice care should be considered when the doctor is saying there is little else to be done, but before a health emergency puts you in the critical care ward at the hospital.
  • When living at home is no longer an option. If you or a loved one has been living at home while managing a terminal disease, the health situation has continued to decline, and living at home has become impossible, it may be time to consider hospice care. Hospice can be helpful for those who can no longer manage activities for daily living, such as chores, cooking, showering, dressing, and basic hygiene tasks, and who have no one to help them on a regular basis�or those who need the type of round-the-clock medical care that a family member is not qualified to provide.
  • When your pain cannot be managed effectively at home. If you or a loved one is in a great deal of pain from a terminal disease and pain medication needs have become overwhelming, it may be time to consider hospice care. In hospice, trained medical professionals monitor patients� pain and can closely observe them, making it possible for pain medication to be more carefully adjusted to accommodate the patient�s changing needs.

Choosing hospice is never easy. However, hospice care can make the difference between a stressful, negative end-of-life situation and one that is more comfortable. Consider asking your doctor about hospice care sooner�for yourself or for a loved one�and hopefully, you�ll be able to get the care you need.

Additional Home Health and Hospice Resources

Elder Options of Texas
Copyright 2001-2016
All Rights Reserved

DISCLAIMER: Links to other websites or references to products, services or publications do not imply the endorsement or approval of such websites, products, services or publications by Elder Options of Texas. The determination of the need for senior care services and the choice of a facility is an extremely important decision. Please make your own independent investigation.





EventLog Analyzer – SIEM Log management software #eventlog #analyzer, #log #analyzer, #event


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Know every bit of your network

Trace the origin of security attacks

Manage compliance with
your eyes closed

Detect anomalies in real-time

Protect your data- it’s child’s play

EventLog Analyzer is an IT Compliance Log Management Software for SIEM

  • Over 70 out-of-the-box event correlation rules for proactive threat management.
  • Pinpoints breach attempts, insider threats, policy violations, and more without any manual intervention.
  • Flexible drag-and-drop correlation rule builder allows users to define attack patterns therefore facilitating proactive security threat mitigation.
  • Includes out-of-the-box reports that help meeting the stringent requirements of regulatory mandates such as HIPAA. GLBA. PCI DSS. SOX. FISMA. ISO 27001, and more.
  • Create custom reports to adapt and comply to the developing regulatory acts of the present and future.
  • Collects logs from heterogeneous sources such as Windows servers and workstations, Linux and Unix systems, network devices, applications, threat intelligence solutions, vulnerability scanners and more at a centralized location.
  • Deciphers any log data regardless of the source and log format with its custom log parser.
  • Supports both agentless and agent based log collection methods.
  • Centrally track all changes and get real time alerts when files and folders are created, accessed, viewed, deleted, modified, and renamed.
  • Get a complete audit trail that answers the ‘what, when, where and how’ of all the changes that happen to files and folders in real time.
  • Collects and analyzes all activities of privileged users.
  • Get detailed report with logon and logoff activity information of privileged users.
  • Get precise user access information such as which user performed the action, what was the result of the action, on which server it happened and track down the user workstation from which the action was triggered.
  • Searches cover more than just the routine options and enable quick detection of network anomalies, abnormal user activities, system or applications errors, security incidents, and more.
  • Conduct a search using Wild-cards. Phrases. Boolean operators, Grouped searches and Range searches .
  • Get real-time SMS and email alerts whenever a network anomaly occurs. You can even run a script to remediate the alert condition.
  • 500+ predefined alert criteria across Windows, Unix/Linux, application, and network device infrastructure increases operational efficiency by eliminating the need to set alert profiles for known indicators of compromises.
  • Easily drill down to the raw log data and conduct a root cause analysis to find out the exact log entry that caused security incidents.
  • Various search options enable you to generate forensic reports from both the raw and formatted logs
  • Automatically archives all machine generated logs, system logs, device logs application logs to a centralized repository.
  • Encrypts the event log archive files to ensure the log data is secured for future forensic analysis, compliance and internal audits.

Linus, Essop & Associates Forensic Services L #forensic #it #services


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Executive Summary

Our Firm

Linus, Essop & Associates Forensic Services L.L.C. (LEA Forensic Services) is led by Partners who promote excellence in forensic services internationally. We are specialists in the prevention, detection and response to fraud and corruption.

Team

Our team come highly experienced with local and international experience in forensic investigations and other risk advisory services across different industries gained from the Big Four firms / Global Consulting Firms, Police, Military, Intelligence, Security and Private organisations. Our Partners hold senior positions in local and international professional investigation bodies:

  • International Institute of Certified Forensic Investigation Professionals (IICFIP)
  • Association of Internal Control Practitioners (AICP)
  • International Institute of Certified Forensic Accountants (IICFA)
  • Ghana Anti-fraud Professional (GAPA)

Our Commitment

We provide high quality service delivery to our clients that will assist in identifying and solving critical issues pertaining to fraud, corruption, financial irregularities and in other areas related to forensic services.

Our Service Offerings

Our forensic specialists promotes excellence in forensic services internationally. Our forensic services cover forensic investigations, forensic accounting, forensic business intelligence, forensic computer technology, forensic data analytics, fraud risk management and other services such as investigation training.

News Highlights

Our Firm is accredited by the International Institute of Certified Forensic Investigation Professionals (IICFIP) to offer the IICFIP Master of Science in Forensic Accounting and Criminal Investigation (MSc. FACI).

Our Partners made history by hosting the “Forensic Open Day”, an event first of its kind in Cameroon. This serves to remind us all just how important our work is at the IICFIP in uniting with the Cameroonian and international community to fight fraud and corruption. This special event was attended by high profile guests namely, Chief Justice Yap Abdou – President of Cameroon Criminal Court and Madam Laurentine Bikoi – Director of Investigation at Cameroon National Anti-Corruption Commission.


Big Rig Truck Driving Videos #big #rig #truck #driving #video #playlists #for


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Video Library

Trucking Video Playlists compiled from youtube. Features Trucks and Truck Driver’s from around the world.

Includes the USA, Australia, Canada, UK, Netherlands, Russia, Poland, Germany, Mexico, Sweden, France and other countries.

There are several Video Playlists – Some contain many videos, over 20, others only a few. Once the first video is started it will continue to play all videos in the chosen playlist. Click your playlist choice below.

Big-Rig Trucker Training Videos – Learn how to shift 10-speed through 18-speed manual transmissions. See How to backup into narrow docks, How to handle truck tire blowouts and how to drive in traffic. Find out what Truck Driving Jobs are really like, the good and the bad.

Perils of Speed Limiters in Big Rig Trucks Videos – See the dangerous effects of Speed Limiters that large trucking companies Don’t want you to know about. Truck Driver’s know how speed governors work in the “Real World”. Very Revealing.

Videos – Chain Up A Big Rig. Learn from an experienced, professional, Trucker. Just How Do You Chain Up a Big Rig 18 Wheeler. Veteran Truckers Show you how. When you have to chain-up going over Donner Pass, it’s good to know how put chains on your truck. Truckers call it “hanging Iron”.

Always Remember to keep your chains tight. The tighter they are, the FASTER you can run “I could hit 60 or 70mph if the chains fit good and were tighter than your bosses wallet.” Have fun playing in the snow.

Custom Big Rig Truck Pictures – Video Slideshow with Music. See some of the most unique Class 8 Custom Trucks and Truck Engines, like a 24 Cylinder Detroit Motor that puts out over 3,400 Horsepower, Ungodly!

FasterTruck’s Road Train Videos – Videos of Road Trains. The most efficient way to move large amounts of freight over long distances where Railroads Fear to Tread. See Road Trains in Action from countries including Australia, Canada, USA and Mexico. Includes Triples, Turnpike Doubles, B-doubles. Speed Up Road Trains Here

Global Truckers Videos – Meet Truck Drivers from around the world. Watch them Driving their trucks and doing their jobs. These are the people that make the world go around. See some beautiful scenery and experience some interesting situations that truckers get involved in. Learn what being a trucker is all about.

Video Library


Houston Managed IT Services #managed #it #services #houston


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Houston Managed IT Services

As technology becomes more integrated into every part of any business, ensuring that your Houston IT support is able to offer optimal benefit to your company is vital to smooth operations and growth. At ICS, we are ready to provide complete IT management to keep every aspect of your Houston business functioning at its best, from secure data storage to daily activities and even to protect your business in the event of a disaster.

Our Houston IT services cover all types of technology, including:

  • Security Assessments and Consulting to help ensure your data is safe from cyber threats, whether they originate from Houston, Austin, San Antonio or anywhere else in the world
  • Disaster Recovery and Avoidance to not only recover from disasters, but to avoid them all together
  • Data Backup and Restore to make sure your files are always available and protected from Ransomware and other disasters
  • Management for your servers whether they are in the Houston IT cloud or in your office
  • ICS provides full support for your desktop, laptops and mobile devices with our Houston Managed IT Services
  • Managed Wireless data networks to ensure our Houston customers have secure, manageable and business grade WiFi
  • Smartphones can be managed and secured

What sets our Houston Flat Fee IT Support apart?

At ICS, our IT department is made up of skilled IT professionals who are experienced in their field and fully dedicated to helping you with any of your IT needs. Before we enter into any agreements, we perform a thorough analysis on your current system and what your businesses may need in the present or future. This helps us spot any potential costs that may pop up and protect you from unexpected surprises. This consultation approach allows us to completely discuss your unique IT needs with full disclosure that you can feel confident in.

Whether you need Houston managed IT services for a small, medium, or large business, our IT staff understands that every business requires different resources and solutions. We want to create a solution that is specifically tailored to give you the best results.

We are proud to offer support and services for a number of trusted brands such as HP, Dell, Microsoft, Toshiba, and others to ensure complete comfort with any forms of technology. We are interested in forming a lasting, trusted relationship with your business through communication and consistent reliability. With expertise in all of the most up-to-date technology and years of experience in some of the most enduring brands, we are ready to offer trusted assistance.

Since 1986, our local office has operated right here in Houston, we are ready to offer timely onsite engineering and support from our professionals.

Here are just a few of the ways in which our managed IT services in Houston can benefit your business:

Choose Trusted Houston IT Support

If you’re interested in learning exactly what ICS can do for you, contact us today and speak with one of our knowledgeable staff. We’re ready to implement the perfect Houston IT management plan to help your business grow.

ICS Houston Office


List of Outsourcing Companies in the Philippines #it #companies #philippines


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For the past four years now, the Philippines had consistently earned top spots in Tholon s Top 100 Outsourcing Destinations, which ranks outsourcing cities around the world, moving to the second spot in this year s iteration of the rankings.

And although India is maintaining its dominant position in the rankings, trend suggest that the traditionally smaller markets can overtake behemoth rivals.

Cell center services are the largest percentage of the outsourcing market in the Philippines, although higher-end outsourcing services such as Web design, software development, and animation are starting to take hold.

Finance and accounting are also gaining ground as the Philippines push on to become regional and global hub for corporate backroom operations.

Check out our compiled List of Outsourcing Companies in the Philippines. And don t forget to leave a comment if you find this list useful!

Rob Rawson is a co-founder of Staff.com . a global recruitment platform where you can access very talented staff at affordable rates. They also have a technology called Time Doctor which is software to improve productivity and help keep track and know what your team is working on, even when working from home.

Rob resides in Sydney, Australia but can also be found in major cities around the globe, like Paris, Kiev or San Francisco.

Over 700,000 fresh graduate Filipinos are being produced in the country every year. However, 2 out of 5 of them are having a hard time landing on a job for 18 months to 2 years after their long study journey. A big part of the reason is due to lack of job experiences.

EntryLvl is a job portal for fresh graduates and college students. All job posts are entry-level positions and on-the-job trainings. This way, companies will never expect you to possess tons of years of job experiences.

We know how it feels to get rejected because we lack of job experiences, we ve been there. So come and register at http://www.entrylvl.com. together we will create a community that attracts top-notch companies and get you hired for the first time.

Oportunity should always equal to everyone.

Hello
am from Techno Source IT, we design the web sites and android applications, with affordable prices we can design your sites, we have good team to design your Web Sites, we are looking for client who can give projects to us.

Duncan Elliott says:

For Virtual Staff you might want to consider http://www.ExpertTeam.tv which has the added advantage of zero-cost to access.

simon miller says:

My name is Simon and I m the Business Development Manager here in nexus-trading
I heard a lot about the talent pool in this area and its time for us to give it a chance and move our operations there.
The main reason we are considering this move is the call center hopping attitude back in Manila.
Ive been managing different types on campaigns in Manila for a long time now and the attitude there is not something I like. I m sure you are well aware of it. From what I ve heard the situation is different in other regions
Let me tell you a bit about our current main campaign.
Im willing to start small with about 10 agents that will conduct sales and support tasks of life style products.
The dialing hours for this campaign will be in grave yard shift since the majority of our clients are USA based
The most suitable agents for this type of campaign need to have at least 6 months of sales experience, preferred in credit card pulling type of campaigns.
We are providing commissions on top of the basic salaries the agents are getting so its very rewarding campaign for the team .

Please review the details above and if its something you can accommodate lets talk later on today, I would like to hear more about your center.

thanks for sharing, but i want to tell if you have need to data entry outsourcing services, faithecommereservices is best company that provide best service to the client.

Outsourcing services perfectly is a awesome trend which many companies are following as a service. The Web designing companies in Mumbai are even outsourcing the services to the clients in various domains. Just like Philippines lets wish even our nation will increase its glory in providing outsourcing facilities.

Kim Crisostomo says:

Tony Biscontri says:

Hello my name is Tony Biscontri my Group is based in Davao City Philippines we are a small outsourcing company.

We offer personalized outsourcing we are building a good group of staff that are trained in our client systems.

Currently we are working in the Social Media Lead generation industry our system is Automated we do all the work for the client and we act has your Social Media PA..
Example is
We can do this for has low as $49(USD) per month using our System.
You will get the following
Setup and running of Zukul Account
Setup and Running of Facebook Account
Setup and Running of LinkedIn Account
Setup and Running of Social Sniper
Setup and Running of Capture Pages.
Setup and Running of Autoresonder .
Weekly reports and results.

We use The Zukul system but can also use your current system once we know that system all data entry and reports we do for you.

I m Belle from JUTSU. We specialize in Graphic Design, Web Development, and SEO/SMM. If you are looking for any design or development services, please don t hesitate to contact me. Kindly visit our portfolio: http://www.designjutsu.com/portfolio
Looking forward to hear from you soon!

Thank you so much.

JR Quinsay says:


Software Update Microsoft Security Essentials (MSE) #it #essentials #virtual #desktop


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[Software Update] Microsoft Security Essentials (MSE) 4.10.0209.0 Now Available for Download

UPDATED on Nov 29, 2016: Release of Microsoft Security Essentials 4.10.0209.0 version.

Microsoft has upgraded its free anti-malware utility “Microsoft Security Essentials ” (MSE) to version 4.10.0209.0. Microsoft Security Essentials provides real-time protection for your PC that guards against viruses, spyware, and other malicious software.

MSE is simple to install, easy to use, and is automatically updated to protect your PC with the latest technology. It runs quietly and efficiently in the background so that you are free to use your Windows-based PC the way you want without interruptions or long computer wait times.

Comprehensive protection —Microsoft Security Essentials helps defend your computer against spyware, viruses, worms, Trojans, and other malicious software.

Easy to get, easy to use —Microsoft Security Essentials is available at no cost, there’s no registration process that requires billing or personal information collection. It installs after a quick download and Genuine Windows validation and then stays automatically up-to-date with the latest protection technology and signature updates.

Quiet Protection —Microsoft Security Essentials doesn’t get in your way. It runs quietly in the background and schedules a scan when your computer is most likely idle. You only see alerts when you need to take action.

MSE is absolutely free and can be used in Windows Vista and Windows 7. Both 32-bit and 64-bit versions are supported.

You should uninstall other antivirus software already running on your PC before installing Microsoft Security Essentials. Running more than one antivirus program at the same time can potentially cause conflicts that affect PC performance.

You can download it using following link:

You must be using genuine Windows to install MSE.

Thanks to our reader “Vinay Godara” for the update.

NOTE: This article is updated whenever a new version of Microsoft Security Essentials is released. So keep checking this page regularly.


Raya Hotels: Where service is anything you want it to be #motels

#balmoral hotel

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Located on Durban’s Golden Mile with the beach on its doorstep The Balmoral hotel is a short walk away from the shopping and business district, the International Convention Centre and the uShaka Marine World which features the largest Dolphinarium in Africa.

Fully renovated, The Balmoral still reflects its historic and stately faпїЅade to make it one of Durbans most elegant venues along the Golden Mile Beachfront.

Our fully licensed Waterfront Restaurant leads out onto The Waterfront Terrace where you can relax and enjoy sundowners whilst overlooking the vibrant Golden Mil.

The Balmoral boasts 95 elegantly appointed, fully equipped large bedrooms being categorised as Executive Sea facing; Superior Sea facing; Standard Double Sea facing ,Disabled; Standard Twin Non Sea facing; Studio Non Sea facing.

Number of rooms 95, Seafacing Rooms 36, Kings / Doubles 47, Twins 46, Accessible Rooms 2, Non Smoking Rooms 15, Number of Floors 3, Check in time 14h00, Check out time 11h00, Reservations must be guaranteed with a major credit card, with cancellation at least 24 hours prior to arrival.

Guest Room Amenities

Remote Control TV with selected Channels, Air conditioning, Electronic Door lock, Full Bathroom amenities, Hairdryer, Tea Coffee Facilities, Iron Ironing board on request, Electronic Safe, Internet access points in Sea Facing rooms.

Secretarial Service, Concierge, Jockey undercover parking, Room Service, Laundry Dry Cleaning, Babysitter on request, Multilingual Staff, Currency Exchange, Airport Shuttle.

The BalmoralпїЅs facilities include:

пїЅ Conference Banqueting venues to accommodate 10 пїЅ 150 people
пїЅ Breakaway rooms
пїЅ Restaurant catering strictly HALAAL
пїЅ Terrace with a relaxed atmosphere overlooking the Golden Mile

With a total meeting and pre-function space of over 250sqm, The Balmoral is able to cater for a wide variety of functions, conferences, promotional events, Weddings and banquets.

Our modern spacious conference rooms are comfortably equipped with state of the art equipment including, Real Time Video Conferencing facilities. Corporate meetings event planning are carefully orchestrated via our RAYA MEETING CONNECTION.

Standard Equipment included in Conference Packages:

пїЅ Overhead Projector screen
пїЅ Flipchart Whiteboard
пїЅ Television
пїЅ Notepads, pens, cordials mints
The stylish Waterfront Restaurant that flows onto The Waterfront Terrace, prepares some of DurbanпїЅs finest cuisine and is the perfect venue for entertaining business colleagues, Wedding receptions and other celebrations. Whilst being fully licensed all foods served are strictly HALAAL.

Enjoy sundowners or coffee and snacks on the elegantly appointed Waterfront Terrace which overlooks DurbanпїЅs

The Balmoral, after being renovated, features two seaside conference venues: The Edinburgh Windsor Suites. The Balmoral’s conference / banqueting team is well experienced with all the details. from meeting planning to menu development.

Introducing the Meeting Concierge

In this age of electronic customer service, there are some things that voice e-mail cannot replace. Like a real person at your side whose single goal is making your meeting a success. Our meeting concierge will anticipate your needs take care of all your requests – even last minute ones.

The Balmoral, an obvious choice for those using the international conference centre, was redesigned to suit the varying needs of its guests. Indeed a splendid selection of single, twin, double or family rooms, as well as accessible rooms are available.

Each room has the following features:

пїЅ TV with remote control and selected satellite channels
пїЅ Message service
пїЅ Daily newspaper on request
пїЅ Individual air conditioning
пїЅ Electronic doorlocks (Vingcard System)
пїЅ Full bathroom amenities
пїЅ Turndown available on request
пїЅ Iron and Ironing Board on request
пїЅ Wake up call service
пїЅ Hair dryer
пїЅ Tea and Coffee making facilities
пїЅ Built in Electronic Safe
пїЅ Pen and general stationery
пїЅ Sleeper couch in Executive rooms
пїЅ All rooms – internet ready

Conveniently located on Durban’s “Golden Mile” beachfront, overlooking the famous Gunston 500 North Beach and the Entertainment Promenade. The Balmoral is a short walk away from Durban’s shops, town cnetre and The Oceans Sports and Conference Centre.

Metered Taxi from Durban International Airport
Hotel Shuttle from Durban International Airport. (Book in advance)

Guest Room Information

пїЅ Number of rooms 95
пїЅ Seafacing Rooms 36
пїЅ Kings / Doubles 47
пїЅ Twins 46
пїЅ Accessible Rooms 2
пїЅ Non Smoking Rooms 15
пїЅ Number of Floors 3
пїЅ Check in time 14h00
пїЅ Check out time 11h00
Reservations must be guaranteed with a major credit card, with cancellation at least 24 hours prior to arrival

Guest Room Amenities

пїЅ TV with remote control and selected sattlite channels
пїЅ Message service
пїЅ Daily newspaper on request
пїЅ Individual air conditioning
пїЅ Electronic doorlocks (Vingcard System)
пїЅ Full bathroom amenities
пїЅ Turndown available on request
пїЅ Iron and Ironing board on request
пїЅ Wake up call service
пїЅ Hair dryer
пїЅ Tea and Coffee making facilties
пїЅ Built in Electronic Safe
пїЅ Pen and general staionery
пїЅ Sleeper couch in Exceutive rooms
пїЅ Seafacing rooms – internet ready

Guest Services and Shops

пїЅ Full service Business Centre
пїЅ Worldroom – Internet Cafe
пїЅ Concierge
пїЅ Jockey Undercover Parking Service
пїЅ Laundry Dry Cleaning
пїЅ Babysitting arranged
пїЅ Free Parking (Coach and Car) outside
пїЅ Room Service
пїЅ Multilingual Staff
пїЅ Secretarial Support Services
пїЅ Currency exchange

The Balmoral is situated opposite Seaworld and the Entertainment Promenade where one will find several swimming pools and a kids entertainment centre with a multitude of funfare rides. Internet access Sporting activities nearby includ golf, squash, gymnasium, surfing, angling, sailing, scuba diving, bowling, body boarding, horseracing and yachting.

Nearby Points of Interest

International Conference Centre, Durban Art Gallery, NSA Gallery, Kwa Muhle Museum, Maritime Museum, The Playhouse Company (theatre and dance), Seaworld, Umgeni River, Bird Park, Various Art Centres, Street Markets, Durban Cultural Centre, Durban’s Water Wonderland, Animal Farm, Phezulu Safari Park.

Meeting and Banquet Facilities

Total Meeting Space 126 sqm
Maximum Meeting Space 72 sqm
Pre-function Space 50 sqm
Facilities located on the ground floor

Fully Serviced Video Conferencing
Full Meeting Concierge Services
Corporate meeting and event planning via RAYA MEETING CONNECTION
Theatre / Tours / Transportation Service.





How to Look for a Hotel Room With a Jacuzzi in It

#hotels with jacuzzi in room

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How to Look for a Hotel Room With a Jacuzzi in It

In-room Jacuzzi tubs are often scaled down version of commercial tubs. (Photo: Jupiterimages/Photos.com/Getty Images )

Related Articles

To some travelers, nothing beats the simplicity and relaxation offered at day’s end by a soak in a private, in-room Jacuzzi tub. While many properties offer hot tubs, spas and Jacuzzis in public areas, finding a room with such an amenity is not as easy. In-room Jacuzzis are often found as an amenity in romantic resorts and high-end suite properties, but don’t count them out completely from individual boutique or chain hotels.

Locating the Amenity

Step 1

Identify a regional area where you’d like to stay. Search Internet websites of suitable hotel properties within that area by selecting specialty amenities from the website’s reservation requirements checklist. If the site is lacking that feature, check the hotel room amenity list or room photographs. You can also search using keywords. Type in the location, the words “hotel” and “Jacuzzi” or “hot tub” to narrow your search.

Step 2

Search for hotels or resorts in large metropolitan areas or those that advertise features for couples, luxury in-room amenities, in-room spa features or suites. Most properties that have the unique feature highlight that fact somewhere on the property website or in print advertising. Check with the local visitors and convention bureau for additional guidance if you are not able to locate a property online.

Step 3

Call the individual hotel directly to see if in-room Jacuzzi tubs are offered in any of its rooms. Don’t rely on website descriptions, general reservation hotlines or non-affiliated reservation services for this information. On-site reservations or general hotel staff are more apt to know the exact features of each individual room.

Step 4

Ask the staff for a list of available room numbers that offer in-room Jacuzzis. Make certain the room listed has a fully functioning Jacuzzi, not just a deep bath tub.

Step 5

Make your reservation requesting one of the specific rooms. Note your confirmation number and the name of the agent that gave you the Jacuzzi information. Take that information with you upon hotel check in.

Tip

  • Many hotel properties are going green, which means cutting back on general hotel water use. Deep bath tubs and Jacuzzi tubs are being replaced with showers as a means of saving water and for guest safety. If you find a hotel room with a Jacuzzi, inquire as to future bath remodeling plans. This is especially important for reservations made far in advance of your travel dates. If you are choosing a hotel based on an amenity, you want to make sure that amenity is viable for your dates of travel.

References

About the Author

Kimberly Kilmer began her writing career in 1990. With work published in breed-specific canine magazines, she is also a pet columnist for Healthcare Traveler, a staff writer for Metropolitan Magazine and an online writer concentrating on recreational pursuits, travel and dogs. Kilmer holds a Bachelor of Science in recreation from West Virginia University.

Photo Credits





Getting a Cheap Hotel: Does It Matter What Booking Site You Use?

#hotel booking website

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There are countless hotel booking sites out there, but how do you decide which one to use? They all deliver a wide range of search results when you re looking for a hotel, and it s hard to tell if there are any differences. I decided to do some testing and find out which sites offer the best deals.

As much as I love hostels and other forms of cheap accommodation, there is something nice about the luxuriousness of hotels. They are clean and quiet, feature comfy beds, strong showers, and lots of soap I can take for later.

But luxury comes at a price. Hotels certainly aren t cheap and I hate spending a lot of money for a room I am only going to be in for a few hours. It s why I mostly avoid hotels—I don t think they are a good use of money (and there are far better accommodation options out there ). If I m not in a hostel, you can usually find me at a cheap guesthouse or at an Airbnb.

But I ve been traveling a lot for work lately, and with the seemingly endless hotel booking sites out there, I decided this was a good time to do some testing. Does it matter which site you use to book a hotel?

I also picked five cities to research: London, Los Angeles, Paris, NYC, and Seattle. I picked bookings close to the current date of research as well as far in advance, on both weekdays and weekends. (I did my research end of March, which is why the dates are different than what you d expect from a post published in early May.)

I searched six booking websites: Expedia. Hotels.com. Booking.com. Hotwire. Priceline. and a new one called TravelPony in two, three, and four star categories. Below are the data tables with the lowest price shown (Priceline rates are based on their search listings, not the bidding section of the site). If you re not interested in the raw data, just skip ahead.

Seattle, WA





Hospice Care: What it is and how to find it #cheap #hotel

#find a hospice

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Palliative Care Center

What Is Hospice?

During the course of your illness, you may come to realize that treatments meant to cure or slow your disease are no longer working. Although it’s a difficult decision, you’ve concluded that the burdens of aggressive treatment outweigh any benefits, and you’re unwilling to endure any more discomfort or risk of harm.

Instead, you’d rather spend your remaining time with family and friends. Maybe you yearn to reflect on your life and create a legacy for your loved ones, such as a journal or a videotaped message. Perhaps you need to put your financial affairs in order, or seek spiritual guidance as death nears.

Despite your illness, the quality of each day still matters to you. You want relief from pain, from shortness of breath, and from other symptoms so that you can focus on the matters dearest to you, including saying good-bye to your loved ones.

That’s when hospice. or end-of-life care, may help.

Hospice is a type of palliative care. but differs in important ways. Palliative care serves anyone who is seriously ill, not just those who are dying. Palliative care itself doesn’t seek to cure, but provides pain relief and symptom management, and addresses the emotional and spiritual needs of patients and families. Many patients receive palliative care while they’re still pursuing a cure.

Hospice also provides wide-ranging care and support to patients and families. However, hospice patients stop curative treatments, although they still receive medications to manage pain and other symptoms. Hospice serves people with a life-expectancy of six months or less because of cancer. dementia. heart disease. lung disease. and other illnesses.

Hospice emphasizes quality of life and patient involvement in decision making. A hospice team typically includes a doctor, nurse, social worker, counselor, chaplain, home health aide, and trained volunteers. They work together to meet a patient’s physical, emotional, and spiritual needs.

Hospice is for family members, too. It can provide respite care, bereavement counseling, and help with practical matters such as transportation and household duties.

Eligibility for Hospice

You’re eligible to enter hospice care if your doctor states that you have a terminal illness and that death can be expected in six months or less if your illness follows its normal course. However, you may stay in hospice beyond six months if your doctor and the hospice team certify that you still have only a short time to live.

Bear in mind that hospice isn’t always a permanent choice. For example, some elderly patients with failing kidneys choose hospice rather than undergo dialysis. But they can still change their minds, leave hospice, and pursue dialysis after all. Or if a patient’s illness improves, he or she can leave hospice and return later.





A Vision for Palliative Care in Canada – It – s Time

#canadian hospice palliative care association

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A Vision for Palliative Care in Canada – It s Time to Raise the Bar

Published on June 08, 2010

Press Release – Canadian Hospice Palliative Care Association (CHPCA)

The Canadian Hospice Palliative Care Association (CHPCA) is calling on the federal government to take action on the recommendations made by The Honourable Sharon Carstairs, P.C. in her report, Raising the Bar: A Roadmap for the Future of Palliative Care in Canada, tabled today in the Senate of Canada

“Despite some remarkable gains we have observed over the years, there is still much more to be done to ensure that every Canadian has access to quality hospice palliative and end-of-life care regardless of where they live,” stated Sharon Baxter, Executive Director, CHPCA. She continues, “Currently in Canada, at best there is still at least 70% of Canadians who do not have access to palliative care, and with an aging population, the health care system must be prepared to meet the increasing demand.”

Canada’s population is aging and combined with increasing numbers of chronic diseases, the demands for hospice palliative care will continue to grow. Seniors make up the fastest-growing age group. In 2003, an estimated 4.6 million Canadians were 65 years of age or older, a number that is expected to double in the next 25 years. By 2041, about one in four Canadians is expected to be 65 or over.

“The CHPCA strongly supports the vision and recommendations laid out in this report,” stated Wendy Wainwright, President, CHPCA. “All too often patients are not being referred to palliative care early enough to truly benefit from the available services. Hospice palliative care includes physical, psychological, social, spiritual and practical support to people with life-threatening illnesses, and to their families. It focuses on what people need and want at any given time, both prior to death and during bereavement.”

According to a recent study of deaths in Western Canada, approximately 90% of deaths could benefit from palliative care. “These figures are eye opening and shine a light on the critical need to focus on the lack of access to palliative care in Canada and the importance of improving it,” continued Ms. Wainwright.

The report offers a vision for palliative care in the future. One that is “intensely human and caring. It is not synonymous with death – it is about life, about the proper care of someone who is alive, someone who still has days, months, or years remaining to their life.” Realistic and attainable goals are described while the recommendations provide a roadmap to achieving these goals.

To realize a society where all Canadians have access to quality palliative care services the reports states that Canada needs to:

  • develop a culture of care that overcomes the limitations imposed by a death-denying society;
  • undertake a serious capacity-building exercise, comprising the full spectrum, from significantly increased research activities and knowledge translation, to improved and consistent education and training, to modernizing our health human resources plans to meet emerging needs;
  • adapt systems and programs to facilitate support for caregivers;
  • integrate services so that patients and caregivers can transition from one care setting to another; and
  • improve leadership at the federal government level, provincial and territorial government level and community level.

The report makes 17 recommendations addressed to the federal government, the provincial and territorial governments and to the community. For more information on the recommendations and for a complete copy of the report, visit: http://sen.parl.gc.ca/scarstairs/PalliativeCare/PalliativeCare_e.asp

“Quality palliative care is the right of every Canadian, yet not every Canadian can access these services at a time when they and their families need it most,” explained Ms. Baxter. The CHPCA looks forward to hearing the government’s response to this report, and anticipates that action will be taken on many of the recommendations. The CHPCA continues to be committed to working with the various stakeholders and striving to offer leadership in the pursuit of excellence in care for persons approaching death so that the burdens of suffering, loneliness and grief are lessened.

The CHPCA congratulates Senator Carstairs on her 15 years of dedication to the palliative and end-of-life care in Canada. She has been a true leader and champion in the area of end-of-life care.

The CHPCA is the national voice for hospice palliative care in Canada. Advancing and advocating for quality end-of-life/hospice palliative care, its work includes public policy, public education and awareness. Established in 1991, its volunteer Board of Directors is composed of hospice palliative care leaders and volunteers from Canadian provinces and territories as well as members-at-large.

For more information:

Canadian Hospice Palliative Care Association

Phone: 613.241.3663 ext. 229





What is a medical home? Why is it important? #hotel #finder

#home medical care

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What is a medical home? Why is it important?

The medical home is a concept first introduced by the American Academy of Pediatrics (AAP) in 1967. In its initial version, the AAP defined the medical home as the center of a child’s medical records. At the time, the care of children with special health care needs was the primary focus of the medical home concept. Over time, however, the definition of the medical home has evolved to reflect changing needs and perspectives in health care.

The modern medical home expands upon its original foundation, becoming a home base for any child’s medical and non-medical care. Today’s medical home is a cultivated partnership between the patient, family, and primary provider in cooperation with specialists and support from the community. The patient/family is the focal point of this model, and the medical home is built around this center. Another key factor is that the focus of the medical home has shifted to include all children and adults, not just children with special health care needs. In the 2002 revision (PDF – 45KB) of its 1992 statement (PDF – 32KB) on the medical home, the AAP reiterated and enhanced its explanation of the medical home’s crucial characteristics. These guidelines stress that care under the medical home model must be accessible, family-centered, continuous, comprehensive, coordinated, compassionate, and culturally effective. In 2007, the AAP joined with the American Academy of Family Physicians (AAFP), the American College of Physicians (ACP), and the American Osteopathic Association (AOA) to form the Joint Principles of the Patient Centered Medical Home . Under this collaborative effort, the characteristics of the medical home have been defined within these 7 principles:

1. Personal physician:

  • Each patient has an ongoing relationship with a personal physician trained to provide first contact, continuous and comprehensive care.

2. Physician directed medical practice:

  • The personal physician leads a team of individuals at the practice level who collectively take responsibility for the ongoing care of patients.

3. Whole person orientation:

  • The personal physician is responsible for providing for all the patient’s health care needs or taking responsibility for appropriately arranging care with other qualified professionals. This includes care for all stages of life; acute care; chronic care; preventive services; and end of life care.

4. Care is coordinated and/or integrated:

  • Across all elements of the complex health care system (e.g. subspecialty care, hospitals, home health agencies, nursing homes) and the patient’s community (e.g. family, public and private community-based services). Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.

5. Quality and safety are hallmarks of the medical home:

  • Practices advocate for their patients to support the attainment of optimal, patient-centered outcomes that are defined by a care planning process driven by a compassionate, robust partnership between physicians, patients, and the patient’s family.
  • Evidence-based medicine and clinical decision-support tools guide decision making.
  • Physicians in the practice accept accountability for continuous quality improvement through voluntary engagement in performance measurement and improvement.
  • Patients actively participate in decision-making, and feedback is sought to ensure patients’ expectations are being met.
  • Information technology is utilized appropriately to support optimal patient care, performance measurement, patient education, and enhanced communication.
  • Practices go through a voluntary recognition process by an appropriate non-governmental entity to demonstrate that they have the capabilities to provide patient centered services consistent with the medical home model.
  • Patients and families participate in quality improvement activities at the practice level.

6. Enhanced access to care:

  • Is available through systems such as open scheduling, expanded hours and new options for communication between patients, their personal physician, and practice staff.
  • Appropriately recognizes the added value provided to patients who have a patient-centered medical home. The payment structure should be based on the following framework:
  • It should reflect the value of physician and non-physician staff patient-centered care management work that falls outside of the face-to-face visit.
  • It should pay for services associated with coordination of care both within a given practice and between consultants, ancillary providers, and community resources.
  • It should support adoption and use of health information technology for quality improvement;
  • It should support provision of enhanced communication access such as secure e-mail and telephone consultation;
  • It should recognize the value of physician work associated with remote monitoring of clinical data using technology.
  • It should allow for separate fee-for-service payments for face-to-face visits. (Payments for care management services that fall outside of the face-to-face visit, as described above, should not result in a reduction in the payments for face-to-face visits.)
  • It should recognize case mix differences in the patient population being treated within the practice.
  • It should allow physicians to share in savings from reduced hospitalizations associated with physician-guided care management in the office setting.
  • It should allow for additional payments for achieving measurable and continuous quality improvements.

The Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA) has identified specific criteria to establish whether a child’s health care meets the definition of a medical home. This criteria include:

  • Whether the child has at least one personal doctor or nurse who knows him or her well and a usual source of sick care;
  • Whether the child has no problems gaining referrals to specialty care and access to therapies or other services or equipment;
  • Whether the family is very satisfied with the level of communication among their child’s doctors and other programs;
  • Whether the family usually or always gets sufficient help coordinating care when needed and receives effective care coordination;
  • Whether the child’s doctors usually or always spend enough time with the family, listen carefully to their concerns, are sensitive to their values and customs, provide any information they need, and make the family feel like a partner in their child’s care;
  • Whether an interpreter is usually or always available when needed.

A medical home is an important mechanism for uniting the many segments of a child’s care, including behavioral and oral health, to accomplish these goals. Furthermore, Drs. David Kibbe of the American Academy of Family Physicians and Joseph Kvedar of the Center for Connected Health at Partners HealthCare believe that the medical home model of care works synergistically with participatory medicine (PDF – 455KB) models in which the active role of the patient is emphasized.

Developed by the Health Resources and Services Administration as a resource for health centers and other safety net and ambulatory care providers who are seeking to implement health IT.





When to Call Hospice – How to Know It s Time #how

#when to call hospice

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When to Call in Hospice

Hospice care is often seen as a last-resort option�one to use when the patient no longer can benefit from traditional medical care. The fact is that approximately twice as many older Americans end their lives in hospital care now than they did ten years ago�but hospice care is still seen as a last resort. If it was brought in sooner, it could do patients more good.

Hospice care is generally designed to help patients who know they are dying control their pain, stay comfortable, and get their social, emotional, and spiritual needs met in a supportive environment.

However, studies show that more and more, hospice care is being used as the option of last resort for patients who receive very aggressive hospital care during their final days�care that may not be appropriate.

For many patients and families, hospice care may be a better option earlier in the care process�skipping the aggressive intensive care that often occurs at the end of life.

How to Know When It’s Time to Arrange for Hospice

  • When your doctor says there are few other options. Usually, the doctor and the patient decide together when it is time for hospice care. In general, hospice care is recommended when the patient has approximately six months to live if the illness follows its natural course. But the timing can be different for different patients.However, hospice is primarily designed for end-of-life care. Hospice care should be considered when the doctor is saying there is little else to be done, but before a health emergency puts you in the critical care ward at the hospital.
  • When living at home is no longer an option. If you or a loved one has been living at home while managing a terminal disease, the health situation has continued to decline, and living at home has become impossible, it may be time to consider hospice care. Hospice can be helpful for those who can no longer manage activities for daily living, such as chores, cooking, showering, dressing, and basic hygiene tasks, and who have no one to help them on a regular basis�or those who need the type of round-the-clock medical care that a family member is not qualified to provide.
  • When your pain cannot be managed effectively at home. If you or a loved one is in a great deal of pain from a terminal disease and pain medication needs have become overwhelming, it may be time to consider hospice care. In hospice, trained medical professionals monitor patients� pain and can closely observe them, making it possible for pain medication to be more carefully adjusted to accommodate the patient�s changing needs.

Choosing hospice is never easy. However, hospice care can make the difference between a stressful, negative end-of-life situation and one that is more comfortable. Consider asking your doctor about hospice care sooner�for yourself or for a loved one�and hopefully, you�ll be able to get the care you need.

Additional Home Health and Hospice Resources

Elder Options of Texas
Copyright 2001-2016
All Rights Reserved

DISCLAIMER: Links to other websites or references to products, services or publications do not imply the endorsement or approval of such websites, products, services or publications by Elder Options of Texas. The determination of the need for senior care services and the choice of a facility is an extremely important decision. Please make your own independent investigation.





How to Look for a Hotel Room With a Jacuzzi in It

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How to Look for a Hotel Room With a Jacuzzi in It

In-room Jacuzzi tubs are often scaled down version of commercial tubs. (Photo: Jupiterimages/Photos.com/Getty Images )

Related Articles

To some travelers, nothing beats the simplicity and relaxation offered at day’s end by a soak in a private, in-room Jacuzzi tub. While many properties offer hot tubs, spas and Jacuzzis in public areas, finding a room with such an amenity is not as easy. In-room Jacuzzis are often found as an amenity in romantic resorts and high-end suite properties, but don’t count them out completely from individual boutique or chain hotels.

Locating the Amenity

Step 1

Identify a regional area where you’d like to stay. Search Internet websites of suitable hotel properties within that area by selecting specialty amenities from the website’s reservation requirements checklist. If the site is lacking that feature, check the hotel room amenity list or room photographs. You can also search using keywords. Type in the location, the words “hotel” and “Jacuzzi” or “hot tub” to narrow your search.

Step 2

Search for hotels or resorts in large metropolitan areas or those that advertise features for couples, luxury in-room amenities, in-room spa features or suites. Most properties that have the unique feature highlight that fact somewhere on the property website or in print advertising. Check with the local visitors and convention bureau for additional guidance if you are not able to locate a property online.

Step 3

Call the individual hotel directly to see if in-room Jacuzzi tubs are offered in any of its rooms. Don’t rely on website descriptions, general reservation hotlines or non-affiliated reservation services for this information. On-site reservations or general hotel staff are more apt to know the exact features of each individual room.

Step 4

Ask the staff for a list of available room numbers that offer in-room Jacuzzis. Make certain the room listed has a fully functioning Jacuzzi, not just a deep bath tub.

Step 5

Make your reservation requesting one of the specific rooms. Note your confirmation number and the name of the agent that gave you the Jacuzzi information. Take that information with you upon hotel check in.

Tip

  • Many hotel properties are going green, which means cutting back on general hotel water use. Deep bath tubs and Jacuzzi tubs are being replaced with showers as a means of saving water and for guest safety. If you find a hotel room with a Jacuzzi, inquire as to future bath remodeling plans. This is especially important for reservations made far in advance of your travel dates. If you are choosing a hotel based on an amenity, you want to make sure that amenity is viable for your dates of travel.

References

About the Author

Kimberly Kilmer began her writing career in 1990. With work published in breed-specific canine magazines, she is also a pet columnist for Healthcare Traveler, a staff writer for Metropolitan Magazine and an online writer concentrating on recreational pursuits, travel and dogs. Kilmer holds a Bachelor of Science in recreation from West Virginia University.

Photo Credits