When you fly a lot for work, as I do, you check your frequent-flier mile balance often, to provide data for competitive commiseration. “Eighteen flights this year already, fourteen hotel nights in eleven different hotels,” a friend e-mailed me, in victory, earlier this month. You also compulsively track your frequent-flier “status” levels, to mark your progress toward becoming a trusty in the prison of weekly air travel. And so, last month, when my United Airlines app told me that my status—as a customer, as a flier, as a man—had changed, I did a delighted double take. United had made me a member of Global Services, its apotheosis of a frequent flier. But even as I tried to remember the advertised perks (free tickets? free back rubs?), I was beginning to sense some symptoms.
My status was good only for 2016, which meant that I would be relegated to a lower level if I didn’t keep up the pace of ticket purchases. So, not twenty minutes after achieving my new status, I found myself calling the Global Services help desk and asking how much it would cost to change a frequent-flier award ticket to a bought one. (Global Services veterans had warned me never to lose the chance to “earn” miles, and instead to use frequent-flier points for other people’s flights.) I then asked my wife for permission to spend five hundred and sixty dollars for a flight that I already had a free ticket for. She told me I was insane. But I wasn’t insane. I knew others similarly afflicted. I had Global Services Maintenance Anxiety Disorder.
GS-MAD afflicts only a small sliver of the frequent-flying élite. As a precondition, you have to be extremely loyal to United, either because you have a soft spot for incessantly played “Rhapsody in Blue” (and I like a Gershwin tune, how about you?) or, more probably, because the airline has a hub near your home. You also have to fly a lot. Global Services is a level above another status tier, Premier 1K, that requires you to fly an annual cumulative distance equal, more or less, to four times the circumference of the earth. With Premier 1K and the Platinum, Gold, and Silver MileagePlus status levels, you can track your progress with each flight. It’s a logical system of inputs and outputs, like dieting, except instead of being rewarded for skipping a fudge nut sundae, you’re credited for flying to Peru. But the diabolical marketing genius of Global Services is that, as St. Paul said of grace, it cannot be earned by works. It is a gift. And God, in this case, is an algorithm of United Airlines.
Absent posted guidelines, road-warrior message boards are filled with speculation about why certain travellers receive Global Services. Is it a measure of dollars spent? Segments flown? Behavior? Maybe United is watching us all, and you weren’t elevated because someone noticed you wiping Doritos dust off your fingers on the armrest in 17C. Maybe United is reading this essay. Maybe by writing this I am committing an unpardonable sin, akin to a Scientologist mafia underboss penning a memoir. Or maybe United will be pleased by the publicity and invite me to an even more secretive status level—Solar System Services, here I come.
The benefits of Global Services start with the straightforward: special entrances, at certain airports, that let you skip the line at security; dedicated phone numbers to lively, responsive, competent United agents; first called to board the plane (“Out of my way, Premier Silver peons”); upgrade priority if a first-class seat is available. (On my first flight with Global Services, I still flew Economy Plus, just in time to take advantage of the free stroopwafels that United has started serving, which was convenient because I’ve always hated paying for my own stroopwafel.)
Other perks seem to be from a different era, like the Mercedes-Benz GL at the Newark Airport that will drive you, if your connection is tight, from one plane to the next, as though you’re the French ambassador or an especially violent supercriminal. And then there are perks that might be myths: one Global Services member told me that if you want a seat, United will kick another passenger off the plane. As I listened, I had visions of a grandmother tossed to the tarmac because a McKinsey consultant had to attend to an emergency case of corporate inefficiency.
Urban legends notwithstanding, the benefits are real enough. Everyone, I assume, would rather sit in first class than coach. The seats are wider. Alcoholism is nourished. First-class United passengers even get a dedicated literary-ish magazine, in case they can’t find other opportunities to read Joyce Carol Oates. But I’ve observed that the manifestations of GS-MAD are completely out of proportion to the perks.
One friend of mine always seemed to be dedicating two per cent of his mind to strategies to maintain his Global Services status. When, as a peer, I finally mentioned this to him, he corrected me: ninety-eight per cent of his mind was occupied with Global Services, with only two per cent left for everything else. Every November, he and a band of fellow-GS-MAD sufferers compare dollars spent and miles flown, speculating, like hard cases leaning on the rail of a horse track, on whose status will be renewed the following year. Another acquaintance, in danger of losing her status, appealed to United for mercy, writing to the airline that she deserved a break because she had had a baby mid-year. United granted her an exception. Three years later, she asked again, for the same reason. But perhaps to protect America from being overrun by MileagePlus anchor babies, the company replied that it gives only one exception every five years.
The costliest manifestations of GS-MAD are unnecessary year-end trips, called “mileage runs” in the frequent-flier community, which are cousins to the flights Walter Kirn’s protagonist in “Up in the Air” takes to meet his goal of a million lifetime miles. I asked around to find the highest amount anyone had heard of being spent on mileage runs: the winner was fifteen thousand dollars, by a friend of a friend, in a month. Another friend told me about his own bottoming out, in the pre-Global Services era, when, in an attempt to achieve the highest status level at Continental before it merged with United, he took advantage of a temporary quirk. At the time, Continental, engaged in a route war with Southwest, was flying connecting flights between Houston’s two airports. Just shy of the requisite number of flight segments, my friend flew three round trips in one day without ever leaving town. The planes were filled with others doing the same, like some mile-oholic version of “The Iceman Cometh.”
We live in an era of behavioral psychology, and our contemporary conclusion is that human beings, most of the time, are absurd, but predictable machines. As such, best-seller lists are filled with psychological explanations for conduct like GS-MAD. The endowment effect—we hate to lose what we already have—seems particularly apropos. There is also, of course, status anxiety, the inextinguishable desire for higher and more. Flying a lot on a commercial airline can’t help but remind the most “successful” customers of their position in the vertiginous hyperbolic tail of American income inequality: comfortably positioned across the gap between the one per cent and ten per cent; less so across the one between the one per cent and the 0.001 per cent (the type of people who own their own planes).
But for most of us, I suspect, GS-MAD arises because there is something of the consolation prize in being part of Global Services. While very-frequent-flier status may raise romantic visions of someone breakfasting in Buenos Aires and supping in St. Moritz, most Global Services members are probably like me: business travellers who visit Chicago or Houston a lot. Spending large amounts of time in a metal tube for work isn’t fun, but if you have achieved recognized excellence at it, it may distract you from the time you spend doing that rather than summiting the Rockies or learning how to flamenco.
So I’ve decided to fight GS-MAD before it becomes incurable. I sent Mr. Ninety-Eight Per Cent the Global Services luggage tags that United had sent me, telling him I wouldn’t be needing them where I was going. (“You killing yourself, man?” he asked. “No, just going back to the stroopwafel seats.”) I began reminiscing fondly of Delta’s terminal at LaGuardia, which has more outlets than an Apple store and really good snacks. I told myself that we are all obligated to prove that sometimes human beings are more than absurd, predictable machines. I resolved to fly because I needed to go somewhere, not to earn.
Still, it’s possible that, come December, you’ll find me curled up in 4B, in self-loathing, on a round-trip mileage run to Ulaanbaatar.
Air charter International
Cabin smoke forces evacuation of JAL flight
Several passengers were injured during an evacuation of a Japan Airlines flight after smoke filled the cabin during a snowstorm.
The Fukuoka bound flight was on the taxiway at Chitose Airport when it was ordered back due to heavy snow.
At this point the pilot reported engine trouble and 'a strange odour and smoke were detected inside the cabin,' a JAL spokesman said.
Local media reported an engine fire but this has not been confirmed by the airline.
The plane's 159 passengers and six crew members were evacuated via chutes with at least four people taken to hospital, according to the airport's emergency services.
The Kyodo news agency reported the engine first stalled after sucking in snow and an explosive sound was heard when the pilot tried to restart it.
Air Ambulance Doctor
Detecting pulmonary embolism (PE) is a major problem at the ED. Final diagnosis often is made by CT-scan. Due to specialisation in emergency medicine emergency physicians might perform better than internal medicine physicians in detecting PE. To confirm this hypothesis, a single center retrospective cohort-study was performed.
During the three-month periods (march till may) 2007 and 2008 the findings in all patients undergoing pulmonary CT at our emergency department were reviewed. The investigations were attributed to emergency physician (EP) or internal medicine physician (IP). Negative and positive investigations were evaluated, and the number of patients treated by the respective group were calculated. Statistical analysis was performed by the Students-T-test, and probability levels of 5% were accepted as significant.
ResultsIn 2007, a total of 2847 patients attended for medical problems. 576 were treated by EP (20.23%). In 2008, 2408 patients searched for medical problems and 625 (25.95%) were attended by EP. EP ordered a total of 34 pulmonary CT 2007 and 35 in 2008. 17.64% (2007)/22.86% (2008) of these resulted in the diagnosis of PE. IP ordered a 77 (2007) and 64 (2008) pulmonary CT, with positive findings in 12.98% (2007)/10.93% (2008). EP ordered pulmonary CT for 5.9% (2007)/5.6% (2008) of their patients, whilst IP performed CT-scans in 3.39% (2007)/3.59% (2008) (p = 0.0108). This means that EP have a higher index of suspicion for the diagnosis of PE at the emergency department (1.74 (2007)/1.56 (2008).
CT-scans were positive in 1.04% (2007)/1.28% (2008) for the EP, and in 0.43% (2007)/0.39% (2008) for the IP (p < 0.01). EP are more accurate in detecting PE at the emergency department (OR 2.43(2007)/3.26(2008).
At the hospital including the emergency department were 14.29% (2007)/14.15% (2008) of CT-scans positive. No significant difference could be found between the positive findings for all the hospital compared to the EP (p = 0.38) or IP (p = 0.27).
Emergency physicians seem to have a higher index of suspicion for PE than internal medicine physicians and are more accurate in detecting PE at the emergency department. Compared with the total of our university hospital, emergency physicians are at least comparable in diagnosing PE.
Constipation has a high prevalence rate (>30 %) in psychiatric patients with psychotropic drugs. Common pharmacological and non-pharmacological interventions for constipation might have longer-term negative and adverse effects that would outweigh their short-term efficacy in symptom reduction. This randomized controlled trial aims to investigate the effect of self-administered acupressure for the management of constipation, in hospitalized psychiatric patients.
Seventy-eight patients were recruited in matched pairs in terms of gender, age and laxative use from five acute psychiatric wards in Hong Kong. Each of these matched pairs of patients was randomly assigned to either a self-administered acupressure (n = 39) or a sham group (n = 39), using computer-generated random numbers. After baseline measurement, the intervention and sham group received the same training in self-administered acupressure and supervised practice once per day for 10 days, except light pressure on non-acupoints was taught to the sham group. The acupoints chosen for acupressure included Zhongwan (RN12), right and left Tianshu (ST25), right and left Quchi (LI11). Participants’ symptoms and quality of life regarding constipation were measured at baseline and immediately and 2 weeks after completion of the interventions with constipation assessment scale and patient assessment of constipation quality of life questionnaire, respectively.
After 2 weeks follow-up, participants who had received self-administered acupressure indicated significantly greater improvements in both symptom severity (P = 0.0003) and quality of life (P = 0.0004) when compared with the sham group.
The psychiatric patients with constipation who practiced self-administered acupressure for 10 days improved their symptom severity and perceived quality of life immediately and 2 weeks after completion of the intervention in comparison with the sham group.
Trial registration: The trial was registered with the ClinicalTrials.gov (Reg. No: NCT02187640)
Constipation is a common and chronic physical health problem worldwide. In Hong Kong and the United States, the prevalence of constipation in the general population is about 14.3 and 12.0–19.0 %, respectively , . Untreated constipation can have severe consequences such as fecal impaction and bowel obstruction, which may lead to extended periods of hospitalization, or even premature mortality , . Constipation contributes to 13.7 million days of restricted activities and 3.4 million days of bed disability each year in the United States and several other developed countries –. More than $725 million per year is spent on laxatives for management of constipation in the United States ; similar high costs related to this disorder have been reported in Hong Kong and many Western countries.
More than one-third of psychiatric patients who take psychotropic drugs (e.g., antipsychotics and antidepressants) suffer from constipation. The high rate of constipation among psychiatric patients may result not only from the side effects of psychotropic drugs (mainly the inhibitory effects of anticholinergics on acetylcholine), but also from patients’ limited exercise, sedentary lifestyle, negative symptoms (e.g., abolition and social withdrawal), loss of energy, poor mental state, poor dietary practice, and insufficient fiber intake. Psychiatric patients with constipation may feel embarrassed about seeking medical consultation and health advice and/or lack the initiative to change their unhealthy lifestyle and behaviors, resulting in negative consequences for their daily lives and health.
The most common pharmacological and non-pharmacological interventions for constipation can produce short-term symptom relief. Although pharmacological therapies such as laxatives can stimulate bowel movement, these medications may produce many long-term side effects (e.g., metabolic disturbances and hepatotoxicity) that can far outweigh their therapeutic effects of symptom reduction. Non-pharmacological interventions can be categorized as traumatic (e.g., acupuncture) or non-traumatic (e.g., auriculotherapy, reflexology, behavioral therapy, and abdominal massage). Recent evidence suggests that acupuncture is effective in relieving symptoms of constipation. However, acupuncture is a traumatic intervention, which may limit its clinical application as an alternative treatment. Non-traumatic and complementary therapies, such as auriculotherapy, behavioral therapy, and reflexology, have been seldom used or found ineffective in the treatment of constipation. In one randomized controlled trial, abdominal massage therapy decreased the severity of constipation and increased bowel movement after 8 weeks, but this did not lead to a decrease in laxative intake.
A number of other non-pharmacological complementary therapies with self-administrable procedures have been recommended for managing constipation in people with chronic illness. Acupressure is the application of pressure to specific acupoints on the body and is believed to open up the flow of qi, the energy that restores balance to the human body. Acupressure has been shown to be effective in the management of acute and chronic diseases, such as breathlessness in patients with chronic obstructive pulmonary disease, nausea and vomiting in cancer patients undergoing chemotherapy, and pain in those with dysmenorrhea Acupressure can improve symptoms of constipation in people with stroke and neurological disorder as well as older people residing in care homes for the aged . However, there is limited evidence of the effects of acupressure in treating medication- and/or lifestyle-induced constipation in hospitalized psychiatric patients.
A “stepped care” system has recently been proposed to enhance both the efficiency and effectiveness of treatment for chronic health problems. The stepped care approach to patient care comprises a sequence of treatment options offered to patients, ranging from low-intensity and less expensive, optimal interventions to more complex and intensive approaches, depending on what is deemed necessary and beneficial for individual patients. In the stepped care system, the self-help approach to illness management is a treatment approach that offers user-friendly, convenient, and less expensive interventions. In addition to reducing treatment costs, self-help treatments or interventions may also enhance the self-care ability and self-efficacy of service users, especially those with chronic illnesses. Chinese medicine practitioners have developed and validated standardized manuals and procedures for acupressure as a user-friendly way to guide self-application of the technique among adult psychiatric patients.
This randomized controlled trial aims to investigate the efficacy of self-administered acupressure in treating constipation in hospitalized psychiatric patients. Such patients often experience major psychological distress because of symptoms of constipation. The constipation assessment scale (CAS) is a universal assessment tool with good reliability and validity for a diverse patient population with constipation. The CAS has demonstrated satisfactory internal consistency, good test–retest reliability, and significant contrasts between cancer patients with constipation and healthy controls. In addition, severe constipation can result in reduced life satisfaction. The symptom-specific patient assessment of constipation quality of life questionnaire (PAC-QoL) is commonly used to assess perceived quality of life in relation to the life impacts of constipation in hospitalized psychiatric patients. This scale has demonstrated good internal consistency, test–retest reliability, and construct validity in patients with chronic constipation. The Chinese versions of the CAS and PAC-QoL (Additional file 1) used in this trial were validated and indicated satisfactory content validity, and satisfactory levels of equivalence with the original version, test–retest reliability, and internal consistency in a pilot study of 20 Chinese adult psychiatric patients with constipation.
This was a randomized controlled trial with a repeated-measures sham-group design and was conducted between April and November 2013. A flow diagram of the study procedure is presented in Fig. 1, according to the CONSORT statement. The controlled trial was registered with the ClinicalTrials.gov.
1. Recruitment, retention and group allocation of participants during the study
In the absence of previous similar research on acupressure for constipation in psychiatric patients, the sample size calculation was based on Cohen’s standard medium effect size (f = 0.40 with 80 % power at 5 % alpha level) for healthcare and behavioral studies, taking into account an expected 20 % attrition rate. It was calculated that 39 participants per group (78 participants in total) would be required for analysis of variance tests on the main study outcomes (symptom severity and quality of life), as calculated with G*Power version 3.13 (free download from MacUpdate at http://www.macupdate.com/apps). Seventy-eight eligible adult psychiatric patients volunteered to participate in this study. These patients were recruited over 6 months from five adult psychiatric wards in one 1000-bed regional mental hospital in Hong Kong. A few patients (n = 6) refused to participate or were not selected because of lack of interest in participating or time constraints. Participants had been admitted to the hospital for acute psychiatric treatment (e.g., psychotropic medication) and rehabilitation before discharge.
Criteria for participation in this study included being: (1) Hong Kong Chinese residents, aged between 18 and 64; (2) willing and mentally competent to learn about, and engage in, self-care and acupressure, as assessed and recommended by the attending psychiatrists; and (3) diagnosed with constipation under the Rome III diagnostic criteria . In relation to these criteria, participants must have presented in the past 6 months with the following symptoms of constipation: (a) rarely having loose stools without the use of laxatives, (b) insufficient evidence of irritable bowel syndrome, and (c) any two or more of the following cardinal symptoms:
1. Straining at defecation, at least, a quarter of the time,
2. Lumpy and/or hard stools, at least, a quarter of the time,
3. A sensation of incomplete evacuation, at least, a quarter of the time,
4. A sensation of anorectal obstruction/blockage, at least, a quarter of the time,
5. Manual maneuvers to facilitate defecation, at least, a quarter of the time, and/or,
6. Three or fewer defecations per week.
Participants with the following symptoms were excluded:
(1) mental instability over the past month as indicated by their attending psychiatrist;
(2) anatomical and physiological disorders of the gastrointestinal tract, such as mal-rotation, fistula, and colonic neuropathies;
(3) various comorbidities of mental illness such as metabolic and endocrine diseases, lead poisoning, and vitamin D intoxication;
(4) previous training in acupressure; and
(5) physical disability involving the upper limbs or pregnancy.
The attending psychiatrist assessed and confirmed whether each participant was mentally competent to participate and whether they understood the instructions for the intervention and the responses to the outcome questionnaires. Informed written consent (Additional file 2) was obtained from participants judged competent to take part in the study. These participants were asked to complete baseline measures of socio-demographic characteristics and study outcomes. Participants were then matched in pairs according to gender, a factor associated with symptom severity and quality of life in previous studies on psychiatric patients with constipation. Two sets of matched pairs of participants were listed and the paired participants in one list were then randomly assigned to either the self-administered acupressure or sham group using computer-generated random number sequences; their matched pairs were assigned to the corresponding study group. Participants in the sham group received similar training and implemented a similar acupressure procedure to the acupressure group, except that they were taught to use sham acupoints and perform abdominal massage with light pressure. Participants in this group were offered acupressure training and supervised practice after the study if the intervention was effective.
Training in self-administered acupressure for relieving constipation was performed according to a standard guideline or protocol for practice. This consisted of two simple procedures, as follows: first, the participant was taught to use the Acupen, a device used to apply constant pressure of 29.5–40.0 newton force onto five acupoints, lasting for approximately 1 min. The five acupoints were Zhongwan (RN12), which is located in the upper abdomen and on the anterior midline 4 cun (just over 10 cm) above the center of the umbilicus ; the right and left Tianshu (ST25), located in the central abdominal region and 2 cun (just over 5 cm) lateral to the umbilicus ; and the right and left Quchi (LI11), located at the lateral end of the transverse elbow crease when the forearm is flexed and at the midpoint of the line connecting Chize (LU5) to the lateral epicondyle of the humerus. Participants were informed of the specific sensations (e.g., soreness and relaxation) that should be experienced when pressure is applied accurately to the acupoints. Second, gentle rubs (with the palm) with pressure on the abdomen in clockwise circular movements around 2 cun from the umbilicus were performed for another 8 min. The positions of the acupoints and use of the Acupen were illustrated with colored photographs and pictures for the participants’ easy reference. The acupressure and abdominal massage were performed once a day for 10 days in a group setting, supervised by a trained psychiatric nurse and preferably at least 2 h after a meal. The main procedure and features of the acupressure intervention are summarized (in Additional file 3), according to the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA).
The sham group was trained to perform acupressure in a similar way to the intervention group, except that they used five sham acupoints and mild abdominal massage with slight pressure only. Participants in the sham group were not told about the sensations (e.g., soreness and relaxation) induced by acupressure on the real acupoints. The acupressure and sham group programs were reviewed and agreed upon by a panel of six Chinese medical practitioners and acupressure therapists; minor amendments were made to a few terms about acupoints and the administration of acupressure in the programs.
A training workshop was conducted by an experienced Chinese medical practitioner who had practiced acupressure for 10 years. The workshop was designed to equip five mental health nurses (one in each psychiatric ward under study) with acupressure, abdominal massage, and group supervision skills. The trained nurses were then supervised to teach a group of patients about acupressure until the practitioner was satisfied with and confirmed their competence to train their patients in acupressure with the aid of a manual for self-administered acupressure. Each of the nurses also practiced training a group of four patients in self-administered acupressure under the supervision of the practitioner prior to the start of the study interventions. The treatment fidelity among the five trained nurses was confirmed by the research team according to the items in the treatment manual, and their performance was found to be 93–98 % accurate for all items.
A socio-demographic and clinical data sheet (Additional file 4) was completed at baseline. The primary and secondary outcome measures were scores on the Chinese versions of the CAS and the PAC-QoL questionnaire, respectively. These outcome measures were administered by the researcher (who was blind to participants’ group assignment) at recruitment, immediately after the 10-day interventions, and 2 weeks after the interventions.
The 8-item CAS has been frequently used to assess constipation symptoms in the previous 7 days, such as abdominal distention or bloating, frequency of bowel movements, oozing of liquid stool, and rectal pain with bowel movements. Subjects were asked to rate each item on a 3-point Likert scale: 0 = no problem, 1 = some problems, and 2 = severe problems. Higher total scores (possible range 0–16) indicate more severe constipation symptoms.
The 28-item PAC-QoL consists of four subscales: satisfaction with constipation symptoms and treatment (five items), physical discomfort (four items), psychosocial discomfort (eight items), and worries and concerns (11 items) . Items are rated on a five-point Likert scale, ranging from 0 = none of the time or not at all to 4 = all of the time or extremely. The total and subscale scores were averaged by the total number of items, and then each average score (ranging from 0 to 4) was used for comparison. The lower the average total and subscale scores, the better the person’s perceived health-related quality of life.
Descriptive statistics (frequency and mean [standard deviation]) were used to describe the socio-demographic data and scores on the outcome variables (PAC-QoL and CAS). The homogeneity of the two study groups was assessed by comparing their baseline outcome scores and socio-demographic characteristics using the Chi-square test (for nominal variables) and the independent sample t-test or Mann–Whitney U test (for continuous variables). The mean scores of the two outcome variables were not normally distributed and there were significant differences in PAC-QoL mean scores between groups at the baseline. Therefore, the generalized estimating equation (GEE) test was used to compare differences in CAS and PAC-QoL mean scores between the treatment and sham groups across time (pretest and two post-tests), followed by contrast tests. For outcome measures showing significant results in the GEE test, subgroup analyzes were performed to examine any significant differences in mean scores between subgroups for gender, age, type of antipsychotic drug used, use of laxatives, and tendency to suppress defecation. The level of significance for all statistical tests was set at 0.05.
Ethical approval (NTW-2012-0009) and permission to conduct the study were obtained from the Human Subjects Research Ethics Committee at The Hong Kong Polytechnic University and the Clinical Research Ethics Committee of the Hospital Authority, Hong Kong. The aim and procedure of the study were explained to the participants who met the study criteria and those who agreed to participate provided written consent.
Characteristics of participants
Seventy-eight participants were recruited over 6 months and randomly allocated into either the self-administered acupressure or sham group (n = 39 in each group). Ten participants withdrew during the intervention period (attrition rate = 12.9 %) because of deterioration in their mental state; thus, 33 and 35 members of the acupressure and sham groups, respectively, completed the intervention and the two follow-up measures. Based on an examination of the participants’ diaries, the adherence rates of performing the acupressure therapy and sham program were 95.2 % (95 % CI 92.3–98.2 %) and 92.7 % (95 % CI 90.1–95.3 %), respectively, indicating non-significant differences between the groups.
The demographic and clinical characteristics of the 68 participants are summarized in Table 1. Most (n = 54, 79.4 %) had been diagnosed with schizophrenia (n = 29, 87.9 % and n = 25, 71.4 % in the acupressure and sham groups, respectively). Two-thirds (65.7 %) were aged between 41 and 60, and 33.3 % (n = 11) of the acupressure group and 37.1 % (n = 13) of the sham group were aged between 40 and 50. More than half (58.8 %; n = 19 in the acupressure and n = 21 in the sham group) of each group consumed less than 20–35 g/day of fiber (the World Health Organization recommends that 20–35 g/day as the optimal daily fiber intake ). Chi-square tests revealed no statistically significant differences between the treatment and sham groups on any of the demographic and clinical characteristics, indicating the homogeneity of the two groups at recruitment.
Table 1. Demographic and clinical characteristics of participants
Mean scores of outcome measure at baseline
At the baseline measurement, there were no statistically significant differences in CAS mean scores (Mann–Whitney U = −0.614, P = 0.539) between the acupressure and sham groups. However, the PAC-QoL mean scores were significantly different between the two groups (Mann–Whitney U = −3.495, P < 0.0005); the acupressure group [0.87 (SD = 0.09)] had a significantly lower mean score on the PAC-QoL than the sham group [1.28 (SD = 0.09)]. Therefore, the baseline PAC-QoL means scores were used as covariants for the analysis of the treatment effects.
Treatment effects of self-administered acupressure
The mean scores on the CAS and the PAC-QoL (and its subscales) at recruitment, immediately after intervention, and 2 weeks after intervention and comparisons between the two groups across time are summarized in Table 2. Over the 2-week follow-up, participants in the acupressure group showed significant improvements in CAS mean score and PAC-QoL mean score (Wald’s χ 2 = 13.11 and 39.09, respectively, both P < 0.0005) compared with the sham group. There were also significantly greater improvements in the acupressure group in all domains of the PAC-QoL (physical, psychosocial, worries and concerns, and satisfaction) compared with the sham group (Wald’s χ 2 = 17.70–39.09, all P < 0.0005). The mean scores for the CAS and PAC-QoL and its subscales for the pretest and two post-tests in the sham group were higher, indicating a worsening of both constipation symptoms and quality of life. The CAS mean score differences between the baseline and post-test 1 and between post-tests 1 and 2 were 0.18 and 0.94, respectively. The PAC-QoL mean score differences between the baseline and post-test 1 and between post-tests 1 and 2 were 0.08 and 0.28, respectively.
Table 2. Summary of outcome measures’ comparison between acupressure and sham groups before, immediate after intervention, and 2 weeks after intervention
The results of contrast tests on the variables with significant treatment effects indicated that the participants in the acupressure group experienced significantly greater improvements in symptom severity at post-test 1 (mean difference = −2.00, P < 0.0005) and post-test 2 (mean difference = −3.14, P < 0.0005) than those in the sham group. There was a significant difference in the quality of life between the groups at baseline. Changes in mean PAC-QoL scores from baseline to post-tests 1 and 2 were compared for the groups. The acupressure group reported a significantly greater reduction than the sham group in mean PAC-QoL scores at both post-test 1 (mean difference between groups = −0.36, P < 0.0005) and post-test 2 (mean difference between groups = −0.55, P < 0.0005). The CAS and PAC-QoL mean scores over the 2-week follow-up indicated that the self-help acupressure program demonstrated a significant, positive effect on constipation. In addition, the mean score differences in the acupressure group were significantly improved from the baseline measurement to post-test 1 and post-test 2 (mean difference = −1.42 and −1.81, respectively, for CAS and mean difference = −0.21 and −0.20, respectively, for PAC-QoL).
The subgroup analyzes showed that those acupressure participants who had taken laxatives (n = 14) indicated significantly greater improvements in constipation symptoms (P < 0.0005) and perceived quality of life (P = 0.002) than those who had not used such medication over the 2-week follow-up. Despite these significant differences in treatment effects between the two subgroups, those acupressure participants who had not taken laxatives during the study period (n = 19) indicated significant within-group improvements in both constipation symptoms [i.e., the mean CAS score was reduced from 3.32 (SD = 0.279) at the baseline measurement to 2.32 (SD = 0.289) immediately after the intervention, and further reduced to 2.05 (SD = 0.361) at the 2-week follow-up] and perceived quality of life [i.e., the mean PAC-QoL score was reduced from 0.97 (SD = 0.072) at the baseline measurement to 0.94 (SD = 0.074) immediately after the intervention, even though it increased slightly to 1.02 (SD = 0.081) over the follow-up period].
Air Ambulance Flight in India
AIR AMBULANCE CHINA
AIR MЕDICAL EVACUATION
Air mеdiсаl ѕеrviсеѕ could be a comprehensive tеrm соvеring thе uѕе оf air trаnѕроrtаtiоn, aeroplane оr helicopter, tо move раtiеntѕ to and from health care facilities аnd accident scenes. Pеrѕоnnеl рrоvidе соmрrеhеnѕivе рrеhоѕрitаl аnd еmеrgеnсу and сritiсаl саrе to all or any tуреѕ of раtiеntѕ however аеrоmеdiсаl еvасuаtiоn or rescue operations aboard hеliсорtеr and рrореllеr аirсrаft or jet craft.
The use of air trаnѕроrt оf раtiеntѕ dаtеѕ to Wоrld War I, however its role was еxраndеd drаmаtiсаllу throughout thе Kоrеаn аnd Vietnam соnfliсtѕ. Hеliсорtеrѕ are uѕеd tо trаnѕроrt patients bеtwееn hospitals аnd frоm trаumа ѕсеnеѕ; fixed-wing аirсrаft аrе uѕеd fоr lоng-diѕtаnсе trаnѕроrtѕ.
If you nееd to travel tо another country fоr medical саrе уоu mау be looking fоr choices to аrrivе there ѕаfеlу. Dереnding оn your medical соnditiоnѕ your trаnѕроrtаtiоn choices mау be more limitеd thаn you wоuld imаginе. It саn be terribly diffiсult to trаvеl frоm соuntrу tо country tо see thе dосtоrѕ thаt уоu nееd tо. This bесоmеѕ more true if you are suffering frоm a medical condition that rеquirеѕ соnѕtаnt саrе. This dоеѕ nоt nееd tо kеер уоu frоm gеtting tо the dосtоrѕ оr ѕресiаliѕtѕ thаt you ѕо greatly nееd to visualize. Onе means tо build ѕurе thаt you саn trаvеl tо уоur dосtоr iѕ tо uѕе a mеdiсаl еѕсоrt.
A company thаt рrоvidеѕ wоrldwidе air аmbulаnсе ѕеrviсеѕ will рrоvidе these аnd оthеr medical trаnѕроrtаtiоn services. Thеу саn create аll of the arrangements tо gеt уоu frоm уоur сurrеnt position to a different country whеrе you would like tо be. Some transport services саn give соmрlеtе bеd-tо-bеd service. Whаt thiѕ suggests that iѕ thаt they\'re going to соmрlеtеlу trаnѕроrt уоu frоm whеrе you аrе to whеrе уоu would like tо bе. Thiѕ iѕ еѕресiаllу imроrtаnt if уоur medical соnditiоn hаѕ уоu bеd ridden. Simрlу inbound in thе аrеа оf уоur dеѕtinаtiоn is nоt gооd еnоugh if уоu hаvе a ѕеriоuѕ mеdiсаl соnditiоn.
If уоu аrе ѕеаrсhing fоr a wоrldwidе аir Ambulаnсе Cоmраnу that рrоvidеѕ thеѕе med air service, уоu will want tо recognize thе right questions to аѕk. Yоu need to build ѕurе that thеу really provide a bеd tо bеd ѕеrviсе if уоu or уоur honey iѕ in thаt роѕitiоn. Mаnу medical escort соmраniеѕ could nоt рrоvidе thiѕ ѕресifiс service. By аѕking thеm ѕресifiсаllу уоu will mаkе certain thаt thеrе won\'t be any unforeseen problems оnсе you аrrivе.
A gооd company will be аblе tо hеlр уоu with аnу inѕurаnсе рареrwоrk thаt уоu mау nееd to filе.
Yоur flight mау or mау nоt bе соvеrеd bу уоur inѕurаnсе роliсу. Hаving an organization thаt knоwѕ thе ins аnd outs on hоw to filе уоur work can grеаtlу inсrеаѕе your сhаnсеѕ of уоur inѕurаnсе соvеring it. At lеаѕt, you knоw thаt the рареrwоrk are going to be filed соrrесtlу and уоur сlаim can nоt bе denied fоr a сlеriсаl еrrоr. If you аrе in would like оf an air med , these аrе juѕt some оf thе thingѕ thаt уоu ought to lооk fоr in a very соmраnу that рrоvidеѕ these services.
Thе аdvаntаgеѕ оf mеdiсаl transport bу hеliсорtеr may inсludе рrоviding a highеr lеvеl оf саrе аt the ѕсеnе оf trauma and imрrоving ассеѕѕ tо trаumа сеntеrѕ. Hеliсорtеr-bаѕеd еmеrgеnсу mеdiсаl service (EMS) аlѕо provides сritiсаl саrе сараbilitiеѕ throughout intеrfасilitу trаnѕроrt frоm соmmunitу hоѕрitаlѕ tо trаumа centers.
Heart disease and risk factors
If you often suffer from Bradycardia, a slower than normal heartbeat, then there is no need to panic as a new study has revealed that it is not a sign of developing cardiovascular disease.
Researchers from Wake Forest Baptist Medical Center have found that the heart usually beats between 60 and 100 times a minute in an adult at rest, but with bradycardia, the heart beats fewer than 50 times a minute and this condition can cause light-headedness, shortness of breath, fainting or chest pain due to the heart not pumping enough oxygen-rich blood through the body.
However, researchers said until now, there had not been any research to determine if a slow heart rate contributed to the development of cardiovascular disease.
Researchers established that a heart rate (HR) of less than 50 was not associated with an elevated risk of cardiovascular disease in participants regardless of whether they were taking HR-modifying drugs, such as beta blockers and calcium channel blockers.
Lead author Ajay Dharod opined Bradycardia may be problematic in people who are taking medications that also slow their heart rate.
He added that further research is needed to determine whether this association is causally linked to heart rate or to the use of these drugs.
The study is published in the journal JAMA Internal Medicine.
Dozens of Australian cancer patients have reportedly received less than the recommended dosage of a chemotherapy drug over a three year period in a prestigious hospital.
While the problem has been known for some time, it is only now that St. Vincent’s hospital here has begun informing the surviving patients and their families that oncologist John Grygiel had been prescribing the same dosage for head and neck cancer without adjusting to their individual test results, Xinhua quoted Australia’s national broadcaster as saying.
ABC reported that all 70 patients were administered the incorrect dosages for up to three years, and in some cases were given as little as 50 percent of the required dose.
The usual dosage for common head and neck cancers is between 200 and 300 mg of the drug, but Grygiel gave a flat 100 mg dosage.
“I think that he felt that the dose he prescribed was genuinely effective and caused less side effects for patients,” St. Vincent’s hospital director of cancer services Richard Gallagher said.
“(But) I still don’t understand where the mechanism or thought came from,” he said. “I’m not happy this has gone on. I freely admit there’s clearly a breakdown in clinical governance.”
Cancer in Australia
Air Evac in Australia
Payment guides for Air Ambulance services
What is NFC?
NFC (near field communication) is the technology that allows two devices—like your phone and a payments terminal—to talk to each other when they’re close together. NFC is the technology that enables contactless payments.
What are some examples of NFC mobile payments?
The buzziest are Apple Pay, Android Pay, and Samsung Pay.
How do I accept NFC?You’ll need to get a new NFC-enabled payments reader that can accept contactless payments. The Square contactless and chip reader accepts both NFC and EMV payments.
Are NFC point-of-sale systems expensive?
Not necessarily. Some can be hundreds of dollars, but Square’s NFC-enabled reader is just $49.
Is NFC secure?
NFC mobile payments are dynamically encrypted, making them one of the most secure ways to pay.
COMPAÑÍA DE AIRE AMBULАNСЕ
Un оrgаnizаtiоn whiсh рrоvidеѕ thiѕ раrtiсulаr ѕеrviсе iѕ соmmоnlу саllеd соmраnу аmbulаnсе aire. Thеrе es de dos tipos de оrgаnizаtiоn thаt proporcionar esta ѕеrviсе; thе firѕt оnе iѕ gоvеrnmеnt соmраnу (el оnlу gоvеrnmеnt thаt рrоvidеѕ аir аmbulаnсе ѕеrviсе es la Unitеd Kingdоm Whilе оthеrѕ аrе соllаbоrаting con соmmеrсiаl ѕеrviсе рrоvidеr.); y la ѕесоnd una empresa Privаtе iѕ.
Cоmраnу iѕ financiación рrоvidеd por fuentes vаriоuѕ, que son:
1. Dоnаtiоnѕ - Thiѕ tipo оf financiación соmеѕ de donaciones рrоvidеd bу рubliс y / оr algunos lаrgе соmраniеѕ аѕ un gеѕturе; оr аnу оthеr ѕосiаl organizaciones.
2. ѕubѕidу Gobierno - Thiѕ tipo de financiación, obviamente, соmеѕ de thе gоvеrnmеnt ѕubѕidу. Likе en thе Reino Unido, el раrliаmеnt está de acuerdo en tо fondo thеir escocesa Ambulаnсе Aire Sеrviсе dirесtlу.
3. Pago-por-servicio - hay otras empresas obtienen thаt thеir fundѕ de cobrarle a la gente fоr uѕing thеir ѕеrviсеѕ. Sоmе оf thеm аrе aviones сhаrtеr соmраniеѕ, hоѕрitаlѕ, аnd fоr beneficios privados ccsme ѕуѕtеmѕ. Casi аll thе аir аmbulаnсе соmраniеѕ en Eurоре utilizar este sistema, y Ellos hаvе thеir оwn оrgаnizаtiоn rеѕроnѕibilitу, аlthоugh fоr thаt, Ellos muѕt Tienes gоvеrnmеnt firѕt licencia.
Teniendo en cuenta thе оf unfоrѕееn nаturе emergencias médicas уоu no mау knоw cuándo se puede bе en nееd de thе оf servicios аn аir аmbulаnсе соmраnу. Si bien iѕ аlwауѕ hореd que nоbоdу se еvеr encontrarse en thiѕ ѕituаtiоn, las cifras nоt lооk buena, así que antes de уоu encuentran уоurѕеlf bесоming uno оf estos ѕtаtiѕtiсѕ que iѕ una buena idea que соnѕidеr mirando intо su acondicionador de lосаl аmbulаnсе ѕеrviсеѕ fоr ѕеvеrаl razones . Firѕtlу, ѕinсе thеѕе аrе mayoría de los servicios a cargo de las organizaciones benéficas уоu tо mау wаnt consideran оnе de thеѕе si уоu аrе buscando un сhаritу tо ѕuрроrt. Sесоndlу, thеrе son muchos iѕѕuеѕ ѕurrоunding la соѕt оf рrоviding thеѕе ѕеrviсеѕ y, antes de уоu encuentras fасing ѕоmе еxubеrаnt mеdiсаl соѕtѕ si еvеr necesita utilizar un аmbulаnсе, es рrоbаblу pena encontrar оut un littlе mоrе аbоut cómo thе wоrkѕ servicio en tо respecto соѕt, si no se le оr bе еxресtеd a рау estos соѕtѕ y hоw que саn proteger уоurѕеlf finаnсiаllу si уоu ѕhоuld еvеr rеquirе este servicio.
Yоu саn gеnеrаllу encontrar еаѕilу infоrmаtiоn аbоut аn aire аmbulаnсе empresa basada quitе Ðn thе intеrnеt. Muchos оf la bаѕеd aire ambulancia ѕеrviсеѕ wеbѕitеѕ disponibles hаvе y un quiсk intеrnеt ѕеаrсh proporcionará уоu con thеѕе. Thеir wеbѕitеѕ mау hаvе alguna información thаt que mау rеquirе оr ser capaz tо ѕuррlу que con infоrmаtiоn соntасt whеrе que саn obtener thе tо аnѕwеrѕ algunos оf уоur quеѕtiоnѕ. Thеrе es un аlѕо numbеr de оthеr оrgаnizаtiоnѕ thаt se linkеd a thеѕе thаt саn bе ѕеrviсеѕ un vаluаblе rеѕоurсе en hеlрing уоu diѕсоvеr todo уоu tо nееd knоw аbоut thе аnd аir ambulancia ѕеrviсе cómo mау аffесt уоu.
Thе fоllоwing son las normas para la nееdеd соmраniеѕ ambulancia aérea:
1. Airсrаft y сrеwѕ vuelo
La principal роint оf thе аir аmbulаnсе es el trаnѕроrtаtiоn аеriаl, thе рilоt, y thе сrеw. Comisión Ðn Aire Médico Trаnѕроrtаtiоn Sуѕtеm (CAMTS) hаѕ dado ассrеditаtiоn tо compañías aéreas, аmbulаnсе juѕt tо mаkе seguro de si tienen requisitos de ajuste thе nееdеd. Aunque CAMTS acreditación vоluntаrу iѕ, thеrе аrе thаt algunos países incluyen esta ассrеditаtiоn como fоr rеԛuirеmеnt la compañía de un médico.
2. ѕtаff Mеdiсаl
Un аir аmbulаnсе mеdiсаl соmраnу iѕ еxресtеd tener Emergencia Mеdiсаl Tесhniсiаnѕ, paramédicos, nurѕеѕ vuelo, un terapeuta respiratorio, аnd en ѕоmе саѕеѕ son un médico; pero en саѕеѕ сritiсаl se оbligаtеd a hаvе un рhуѕiсiаn аnd enfermera.
3. еquiрmеnt Mеdiсаl
El uѕеd аirсrаft para un аmbulаnсе аir es especialmente fоr dеѕignеd lifе apoyo асtivitу. Por lo tanto, thеrе аrе fеw diferencias en el interior de la аirсrаft. Thеrе'ѕ un lоt оf avanzar еquiрmеnt médica Ðn bоаrd tо thе ѕuрроrt tripulación аmbulаnсе aire fоr dоing su jоb.
El mаin ѕеrviсе iѕ trаnѕроrting раtiеnt frоm оnе lugar a otro lосаtiоn аѕ аѕ fаѕt аnd ѕаfе роѕѕiblе, pero thеrе аrе bу оthеr servicios prestados a la empresa mеdiсаl, ѕuсh como рrоviding trаnѕроrtаtiоn médico básico, transporte еxсluѕivе mеdiсаl, аnd servicios оthеr.
Si wаnt tо tаkе аir аmbulаnсе ѕеrviсе, уоu puede conseguir en contacto con su servicio сuѕtоmеr, bу саlling ellos оr viѕiting thеir wеbѕitе оnlinе. A continuación, selecciona thе servicios que nееd аnd coincidir уоur budgеt, оr si уоu no knоw tipo de whаt nееd servicios уоu, juѕt les preguntas: servicio de lo que ellos se rесоmmеnd. Aftеr eso, se le pedirá que fоr más infоrmаtiоn tales аѕ thе thе nаmе del paciente, él / ella аgе, thе оf thе actual lосаtiоn раtiеnt, y el nombre thе оf thе destino; y entonces la compañía médica se encargará de otra аrrаngеmеntѕ necesario, аlѕо Ellos se mоnitоr thе proceso de vuelo hasta thе раtiеnt se transporta ѕuссеѕѕfullу.
S®, whеn nuestra lifе оr thе оf livеѕ оur bеlоvеd оnеѕ, están amenazados, аnd rеаllу wе'rе necesitados оf un аnd seguro fаѕt trаnѕроrtаtiоn tо guardar оurѕеlvеѕ оr nuestra оnеѕ bеlоvеd, thеrе аrе mеdiсаl соmраniеѕ uѕing аir аmbulаnсе como thеir mеаn fоr ella. Después аll, еmеrgеnсу casos nееd рrоmрt аnd соnсiѕе асtiоnѕ.
Paris attack analysis
The attacks on Charlie Hebdo were conducted in January 2015 by a branch of the Al-Qaeda in Yemen. Those were conducted as an attack on Charlie Hebdo due to what was described as the blasphemous insults which were heaped against Prophet Mohammad by Charlie Hebdo.
Date of attacks: 13th November 2015.
Around 8:30 PM, an explosion is heard near the Stade de France; Francois Hollande, the President of France was inside, watching a friendly football match against Germany. Two dead bodies were recovered; one seemed to be a suicide bomber with an explosive vest; another was, possibly, a passerby. Around 21:25 Hrs Kalashnikov-wielding masked intruders barged into the Petit Cambodge restaurant in the 10th district; French Police confirm 18 dead,
21:30 Hrs Another explosion outside the stadium; another dead body, possibly another suicide bomber, also wearing an explosive vest,
21:32 Hrs Five people killed outside a bar in 11th district; attackers arrived ina black car,
21:36 Hrs Terrorists in a black car kill 19 outside restaurant,
21:40 Hrs Another suicide bomber detonates a bomb in a restaurant,
21:40 Hrs Three attackers storm a rock concert by a rock band from USA,. Many people are killed and an unspecified number taken hostage. The attackers also preferred a short speech about Iraq and Syria,
21:53 Hrs Another suicide bomber detonates a bomb; another body is recovered,
22:15 Hrs President Hollande is escorted to safety,
23:02 Hrs President Hollande places France under emergency stating that the borders of the country had been sealed. A statement from Barack Obama expressing solidarity with the people of France was also read out.
00:20 Hrs Concert hall is stormed by French police; 89 hostages are reportedly killed.
There were 129 casualties, 352 wounded and about 100 whose condition was critical. Note: The above timelines, accounts of incidents and the figures provided may lack some accuracy since there are so many sources and versions. But, these accounts are roughly precise.
Ordinary folk could not comprehend the reasons why such a horrific massacre was being enacted with such a magnitude. But, some well-known analysts have put up some very plausible arguments to explain, as far as such matters can be, which provide an insight to the approximate reasons for this senseless carnage.
Historically, France has been engaging in activities that have caused an accumulation of Muslim grouses against them. That feeling of antagonism keeps boiling over and the results are there to see.
A prominent newspaper has more or less hit the nail on the head while summarizing the reasons holding France responsible for the following hostile misdemeanors:
HI Flying was in the fore front in the patient evacuation from Paris to various destinations in Europe, Middle east and United states for their patients who were injured.
Psychologically compromised patients were also medically counseled before transportation back home.
Content is the backbone of any Air Ambulance website.
More information from our web designers at HI Flying.
How to make Content Writing Effective?
Content writing as well as content reading has been a source of great information and benefit both to the writers and the readers respectively in the world of blogs and article writing. There are not one or two but many websites that are available which provide content writing that helps give information about a business and its products or services.
The world of writing blog and social media writing is becoming fiercely competitive among the companies. There are various ways that an article writer can compose according to his or her distinct skills. But, there are formal styles that may have to be adhered to in order to make the writing effective with good content strategy.
Most website and business owners prefer to outsource content writing. These people expect professional approach and perfection when articles are written for their web pages or their blogs. An article writer has to follow a pattern that helps reach the target audiences. The writer has to begin the article with an introduction that attracts the readers. An effective method would be to begin with a question concerning the subject of the particular article.
Planning and organizing the article becomes important in terms of the format and the design of the content. An article can be written in one block but that will not have the desired effect. The writer could manage the headings in such a way that all paragraphs look distinctly organized. The important points that cover the content can be handled carefully so that the readers are able to analyze that distinction throughout the article.
The main objective of the article writer is to offer convenience to the readers by using simple and clear words so that an average reader is able to comprehend easily. The text has to convey the feeling of authenticity, as giving out wrong information could prove disastrous for the website.
If there are any products that are being considered when writing blog, the writer should not forget including information and tips on the process of buying those products. When possible, link websites could be included as means of adding further information for the readers. This will go a long way in creating a positive image of the principal website in the internet market.
A good content strategy will always insert vital headlines in the articles. It is very crucial in attracting the attention of the readers. Headlines will probably make up about ninety per cent of the reason why readers are going through the article in the first place. So, the title has to be an attractive and a relevant one so that the reader interest is pulled in from the very start. Placement of a keyword phrase in the title or the headline could also prove very effective.
When it comes to social media writing, content is all important. Internet and social media has become the express highway in the world for information seekers and that information could be about your specialty restaurant or a new brand of jeans. The content has to be a compelling one to make the writing effective and to capture a large audience.
Finding the Best Family Resort
When it comes to planning a vacation, some people plan an adventure travel, some go for a calm and relaxing vacation, and others look for a fun-filled as well as an educational travel for their kids. Family resorts all around the world have been designed to cater to the requirements of a large group of people out there, whether they are traveling alone, as a couple, or with their entire family.
Some of the best family resorts in the world also provide free accommodation, food, sports, and activities for younger kids totally free of charge. People who choose to travel with their kids also sometimes choose to stay at a serviced apartment with the facility of a maid in order to save money, which they would otherwise have to spend on expensive hotels. However, if you would like to stay at a hotel or a resort, you will be happy to know that most resorts have a facility of babysitting on board to facilitate couples who are traveling with babies or toddlers.
There are tons of activities offered at these luxury hotels for almost everyone to enjoy ranging from simple and soothing nature walks to more adventurous water sports and an evening full of pure entertainment. You can get huge discounts by staying at a family-friendly resort because these are specially designed for people with kids of up to 12 years of age and teenagers. Some resorts for family travel offer educational and craft lessons for all those creative minds out there who would like to test their skills while having a vacation in a foreign land.
Nurse Kiana from UK - Working for Hi Flying - Air Ambulance International
All Air Ambulance companies at some stage of their marketing have advertised on Google adwords.
This article is an insight to the various models of advertising on Google and the pros and cons to the two most popular way of advertising on google.
The Pros and Cons of Pay-per-click and Pay-per-view Advertising Models for Air Ambulance services
There are two advertising models provided by online search engines to website and business owners who wish to promote their business online. The first one is known as pay-per-click or PPC and the second is called by the name of pay-per-view or PPV model. Both forms of advertising require website visitors to complete a task. In a PPC model, the visitor has to click an ad and be redirected to the business website and in a PPV model, the visitor only has to view an ad in order to achieve the goal. Both models have their pros and cons and to decide which one is better suited to the requirements of a business, we need to study these pros and cons in detail.
Pros and Cons of Pay-Per-Click Advertising
Many business owners choose this method of advertising because of its prominent benefits. Here are some of the pros of this model that make it a better option when planning an online advertising campaign:
Pros and Cons of Pay-Per-View Advertising
Launching a PPV campaign is easy and straight forward and although it’s a relatively newer model in the online advertising world, many people consider using it because of its simplicity and cost effectiveness. If you are considering PPV advertising model to grow your business online, here are some of the benefits you might be interested in:
Great keywords are important for Air Ambulance advertising on the world wide web.
Online advertising has made it possible for marketers to focus on certain keywords that bring heavy amount of traffic to their website. Previously it was not possible through newspaper or television ads, in which the marketer could only convey their message but could not guarantee success. PPC and PPV models are both flexible and offer a number of opportunities to the advertisers to launch a customized and successful marketing campaign. However, before investing in either one of these models you should consider the pros and cons listed above and then decide which one is better suited to your online business.
HI FLYING Medical Team Mobilizes Help at the Emergency site
Fire started at the Make in India site of Bandra Mumbai India.
Fire Fighters were mobilized at the site.
Our Team of Medics were on the spot within an hour to take care of patient evacuation to the nearest tertiary care hospital in the region.
Prompt action limited the number of casualties at the site.
General information about Fire safety measures.
SCALD BURN SAFETY
Fire related Medical evacuation and Air Ambulance services
Kababaihang Pilipino nagtatrabaho sa Dubai ay isang pangkaraniwang paningin. Marami sa mga ito sa trabaho para sa mas mahusay kaliskis pay at ang kalayaan ito affords kanila. Ang isang babae na ay nagtatrabaho para sa isang ilang taon sa Dubai ay nahulog buntis matapos siya ay nagkaroon ng walang kambil iyutan sa kanyang kasintahan. Ang kanyang panahon ay laging regular at kapag siya ay huli na, alam niyang siya'y naglihi. Nang sabihin niya ang kanyang kasintahan, siya pinaghahanap walang kinalaman sa mga sanggol, kahit na alam niya na single buntis na kababaihan sa Dubai ay ibinilanggo at deportado. Tinanong niya ang kanyang upang makakuha ng mapupuksa ng pagbubuntis sa anumang paraan na posible.
Siya ay kaliwa na walang pagpipilian, tulad ng pagpunta bumalik sa Pilipinas, na may nito lubos na mahigpit ang mga batas sa pagpapalaglag ay din hindi pagpunta sa tulong. Nagkaroon ng isang mental labanan ng pagpunta sa sa kanyang isip bilang siya ay itinuro na ito ay mali upang iurong. Kahit na siya pinaghahanap upang panatilihin ang mga sanggol, sa kanyang kasintahan tinatanggihan upang magpakasal sa kanya, alam niya hindi siya maaaring panatilihin ang mga sanggol. Ang kanyang lamang na pagpipilian ay isang abortion. Nais niya ng isang ligtas at maingat na pagpapalaglag. Ang isang kaibigan ng ari nya iminungkahing na dapat siya lumipad sa Indya para sa pagpapalaglag bilang ito ay ang pinakamalapit na destination. Matapos na maghanap online, natagpuan niya ang Family Hospital sa Mumbai kung saan nagkaroon na pagbibigay pagpapalaglag at iba pang mga serbisyo sa mga babae sa loob ng maraming taon. Gayundin, ito ay mas madali at maginhawa upang lumipad sa Mumbai.
Nakipag-ugnay niya sa ospital sa pamamagitan ng email at sila got-usap sa kanya. Ang buong proseso ay ipinaliwanag sa kanya mula sa umpisa hanggang katapusan. Sila ay nakatulong sa kanya makakuha ng isang visa at siya ay sa kanyang paraan upang Mumbai sa loob ng ilang oras sa araw pagkatapos siya ay makipag-ugnayan sa Family Hospital. Siya ay hinihimok sa ospital mula sa airport. On admission, siya ay ipinaliwanag ang lahat ng mga iba't-ibang mga opsyon na magagamit sa kanya sa detalye. Siya ay hinihikayat na humingi ng anumang mga doubts na niya at nakuha niya kasiya-siya kasagutan sa lahat ng kaniyang mga tanong. Matapos ang pagpapatakbo ng mga pagsubok ng dugo at ultratunog, ay ipinasiya sa petsa ay natupad ang mga pamamaraan. Siya napili upang matikman ang kirurhiko pamamaraan na tinatawag na vacuum aspiration dahil hindi siya ay nais na sumailalim ang sakit na maaaring maging sanhi ng abortion pills sa panahon ng natural na kurso ng abortion.
Sa araw ng ang pamamaraan, siya ay may gulong sa sterile operating room at bibigyan ng isang mild kalmante, na kung saan ginawa ang kanyang pagtulog. Ang buong proseso ay masyadong maikli at siya ay bumalik sa kanyang kuwarto, na walang kakulangan sa ginhawa o sakit. tagumpay ay natutukoy sa pamamagitan ng isang ultratunog, na kung saan ay nagpakita na siya ay hindi na dala-dala ang sanggol.
Siya ay kumbinsido na siya ay ginawa ang karapatan desisyon sa pagtatapos ng pagbubuntis dahil hindi siya ay may been able sa gawin ang mga bata katarungan. Ang kanyang karanasan sa Family Hospital ay kasiya-siya at ang kanilang prompt at mabilis na serbisyo pinapayagan sa kanya upang sumali sa bumalik sa kanyang trabaho nang walang anumang pagkaantala.
There has been a 60 percent increase in the number of cosmetic surgeries by the youth across the country in the last one month ahead of the Valentine’s Day on February 14, doctors said.
They said the surge is mostly due to the youth’s propensity for easy ways out to look better and also the availability of cosmetic surgeries at a reasonable price.
“The sudden increase of cosmetic surgeries by the youth especially during the Valentine Day’s month is a surprise .Women in their early twenties are looking for breast implants (with permission from their parents).
“Having a good cleavage is the most common aesthetic end point today for the young women,” said Mohan Thomas, senior cosmetic surgeon at Cosmetic Surgery Institute and Breach Candy Hospital.
According to the doctors, the need for cosmetic results have arisen because of the fast results sought by the young, who otherwise are reluctant to adopt health lifestyle that can fulfil their wish naturally.
“There are requests for breast augmentation, liposuction and sometimes both. We need to cater to these requests. The trend currently is photo rejuvenation, where in just one sitting of 15-20 minutes you can find yourself glowing like never before,” said Vinod Vij, cosmetic surgeon at Clinique Asthetica and Fortis hospital.
Currently, the cosmetic surgeries relating to skin and several other minor procedures cost around Rs.8,000-9,000 only.
” The demand for cosmetic surgeries increases around the Valentine’s Day, especially due to discounts of up to 15-20 percent on offer. The trend is seen not just in women, but men too are equally feeling the need to look better,” said Aamod Rao, another cosmetic surgeon.
According to Rao, six-pack abs among men and Botox injections among women are commonly requested procedures.
“Women go for injectable treatments because of lack of time. Injectables like Botox and Juvederm have become popular among women. These fillers are just injected into the area that needs uplift or treat wrinkles, which show better and fast results,” said Rao, who is working with Get Enhanced Clinic.
More information about Medical tourism
Union Minister for Health and Family Welfare J.P. Nadda said Albendazole is a “safe and effective” drug for the treatment of parasitic worms, adding that it is approved by the World Health Organisation (WHO) and used globally.
Nadda’s statement came in the wake of media reports regarding some children complaining of nausea, gastric irritation and giddiness on being administered Albendazole tablets as part of the nationwide deworming initiative.
“Of a target of 27 crore children, 236 from Bihar, Chattisgarh, Haryana, Maharashtra and Rajasthan reported some mild adverse effect. The children were hospitalised, kept under observation and discharged without any major or serious complications. This is as per our standard protocol,” said the minister.
“There is no need to panic,” he said, “as such adverse incidences are noticed when the worm load is high among the children. However, care needs to be taken that the children are administered the drug in presence of teachers or guardians.”
National Deworming Day, a flagship initiative of the Ministry of Health and Family Welfare, was observed on February 10. It is the largest ever single-day public health campaign in the world targeting approximately 27 crore children aged 1-19 years throughout the country at risk of parasitic worm infection through the platform of schools and anganwadi centres.
The target population includes 8 crore children in the age group of 1-5 years and 19 crore children in the age group of 6-19 years across 561 districts of the country.
Over 900,000 education and health workers administered Albendazole tablet to crores of children in schools and anganwadis across India on Wednesday.
As many as 137 districts in 14 states have been excluded from the deworming initiative this year, as they have already covered during Mass Drug Administration in Lyphatic Filarsis programme of the Health Ministry.
Robust systems of monitoring have been instated and health workers trained to administer the deworming tablets
Our Thai office has reported this article.
Thailand's tourism ministry reported a 54% increase in the number of foreign tourists who died while in Thailand last year, and is looking at ways to better address tourist safety.
A report from the Bureau of Prevention and Assistance in Tourist Fraud said 83 foreign tourists lost their lives last year according to data from the ministry's 10 regional offices.
It said 34 fatalities were caused by road accidents, nine from swimming or boating accidents, six from congenital disease, four suicides and 30 from a variety of other causes.
The report highlighted several coastal areas which are deemed dangerous for swimmers and highways which have become accident black spots.
A detailed study on water accidents will take place in the resort area of Krabi while research on road safety will be conducted in Chiang Mai.
Pongpanu Svetarundra, permanent secretary at the Sports and Tourism Ministry acknowledged a need to beef up tourist safety in some areas.
"In the past, we did not deal with the root causes of the tourist safety problem. From now on, we will look at the issue and address it seriously," he said.
While the death toll rose sharply, statistics showed the number of significant injuries sustained by tourists fell 160% last year to 166.
Thailand Air Ambulance services
आग सुरक्षा उपायों के बारे में सामान्य जानकारी।
विकास और एक परिवार के भागने की योजना का अभ्यास
स्थापित करें और धूम्रपान डिटेक्टरों बनाए रखें
स्थापित करें और आग बुझाने का रखरखाव
ठीक से घर गर्म करने के उपकरण बनाए रखें
ठीक तरह से धूम्रपान सामग्री बुझाने
कभी स्टोव या पहुंच से बाहर छोड़ खुला लौ
मैचों / लाइटर बच्चों की पहुँच से बाहर रखें
एक कसकर बंद, अनुमोदित कंटेनर में स्टोर पेट्रोल
किसी भी प्रज्वलन स्रोत से दूर घर के बाहर दुकान पेट्रोल
जल हीटर <120F सितंबर जलाने की क्रिया जल को रोकने के लिए
एक कसकर बंद को मंजूरी दे दी धातु या किसी प्रज्वलन स्रोत से दूर प्लास्टिक के कंटेनर में स्टोर पेट्रोल
छोटे इंजन (उदाहरण के लिए, लॉन घास काटने की मशीन) ईधन केवल जब इंजन शांत है। कोई इग्निशन स्रोत पास है और यकीन है कि (उदाहरण के लिए, जल पत्ते, बारबेक्यू)
एक अलग इमारत में घर के बाहर दुकान पेट्रोल (गेराज या शेड)
पेट्रोल दृष्टि से बाहर रखने के लिए और बच्चों की पहुँच
कभी एक सफाई एजेंट के रूप में पेट्रोल का उपयोग
पेट्रोल के आसपास धूम्रपान न करें
सुरक्षा जलाने की क्रिया जला
अगर अपने गर्म जल तापन प्रणाली विरोधी जलाने की क्रिया है की जाँच करें, तापमान नियंत्रण उपकरणों को स्थापित किया।
एक अपार्टमेंट परिसर, नर्सिंग होम, या सहायता रहने की सुविधा में है, तो मकान मालिक acerca तापमान उपकरणों पूछने के लिए और उन्हें नियंत्रण का निरीक्षण किया।
एक मास्टर मिश्रण वाल्व (ASSE 1017 को मंजूरी दे दी), बिंदु का उपयोग तापमान नियंत्रण उपकरण (ASSE 1016 को मंजूरी दे दी) शॉवर वाल्व, और अधिकतम तापमान सीमा पर faucets और शॉवर valves.These विरोधी जलाने की क्रिया उपकरणों पर बंद हो जाता है का उपयोग पानी के 120 से अधिक गर्म रोका जा सकता है कभी तुम तक पहुँचने से एफ।
120 एफ में अपने गर्म पानी हीटर सेट
सुनिश्चित करें कि पाइपलाइन का काम है-गया या सरकारी कोड सभी आवश्यक परमिट और निरीक्षण के साथ के माध्यम से स्थानीय स्तर पर किया जाता है, एक लाइसेंस प्लम्बर द्वारा।
यकीन रखरखाव कर गर्म पानी हीटिंग सिस्टम पर किया जाता है।
एक बाथटब या स्नान में पानी खींचने अकेले हैं, जबकि कभी एक बच्चे को छोड़ दें।
टेस्ट स्नान या पहले पानी के तापमान। जानते हैं कि उचित विरोधी जलाने की क्रिया उपकरणों के बिना, पानी का तापमान तीखा तापमान को स्पाइक कर सकते हो।
प्लेस माइक्रोवेव एक सुरक्षित ऊंचाई पर, आसान पहुंच के भीतर है, इसलिए सभी उपयोगकर्ताओं को माइक्रोवेव का उपयोग हमेशा दरवाजे के सामने से अधिक होना चाहिए व्यक्ति की spills.The चेहरे से बचने के सकता। माइक्रोवेव काउंटरों स्टोव जलाने की क्रिया या ऊपर स्थापित किसी के लिए एक खतरा हो सकता है।
स्टीम, 200 डिग्री से अधिक तापमान तक पहुँचने, तेजी से ऊपर माइक्रोवेव और आसानी से गर्म में कवर कंटेनर में बनाता चेहरे, हाथ और हाथ करने के लिए जल में परिणाम कर सकते हैं। पंचर या प्लास्टिक की चादर कंटेनरों का उपयोग निकाल भाप जबकि खाना पकाने से बचने के लिए अनुमति देने के लिए। कवर हटाने से पहले कम से कम एक मिनट रुको। जब कवर को हटाने, कोने सब से अधिक दूर तुम से दूर और अपने चेहरे या हाथ से दूर उठा।
माइक्रोवेव में खाद्य पदार्थ और तरल पदार्थ तापमान बुदबुदाती की उपस्थिति के बिना उबलते से अधिक तक पहुंच सकता है। हलचल और अच्छी तरह से सेवारत या खाने से पहले परीक्षण भोजन।
सभी बर्तन रखें संभालती स्टोव किनारे से वापस कर दिया, दूर।
जब गर्म खाद्य पदार्थों से पलकों को हटाने, कि जमा हो सकता है भाप याद रखें। कवर या ढक्कन अपने चेहरे और हाथ से दूर लिफ्ट।
एक बच्चे को पकड़ गर्म पेय पीने जबकि मत करो।
सतहों पर गर्म पेय एक बच्चे की पहुँच से बाहर रखें।
मॉनिटर क्या आपके बच्चे को बिस्तर पर पहनता है। लौ प्रतिरोधी नाइटवियर में अपने बच्चे सो, इस तरह के रूप में 100% पॉलिएस्टर है।
इस तरह के सही नाइटवियर के लिए टी-शर्ट के रूप में: ढीले ढाले वस्त्र विकल्प नहीं है।
जब नाइटवियर की खरीद, लेबल ध्यान से पढ़ें। साथ लेबल / लटका टैग और आग प्रतिरोधी फाइबर (100% पॉलिएस्टर) लौ प्रतिरोधी नाइटवियर चुनें।
आप गैर-लौ प्रतिरोधी नाइटवियर चुनते हैं, तो यकीन है कि यह सुखद ढाले है बनाते हैं। हो "सुखद ढाले" यह करना होगा: लगभग तंग त्वचा करें; पर कलाई, टखनों, और कमर कसकर फिट; बच्चे को फिट होना चाहिए और अब, नहीं बाद में फिट करने के लिए एक बड़े आकार में खरीदा जा।
धोने के दौरान तरल फ़ैब्रिक सॉफ़्नर के दोहराया का उपयोग अधिक ज्वलनशील नाइटवियर बनाता है। ड्रायर चादरें सॉफ़्नर एक सुरक्षित विकल्प के रूप में सुझाव दिया गया है।
बच्चों की पहुँच से बाहर मैच, लाइटर, और मोमबत्तियों रखें। आदर्श रूप में मैच और लाइटर बंद कर दिया मंत्रिमंडल में रखा जाना चाहिए।
युवा बच्चों को पढ़ाने आग और आग वयस्कों का उपयोग करने के लिए उपकरण हैं यही कारण है कि।
ध्यान से मेल खाता है, लाइटर, और आग का उपयोग करके एक अच्छा उदाहरण स्थापित। यही कारण है कि बच्चों को मोमबत्ती, चिमनियों को याद दिलाना है, और आग के अन्य स्रोतों के लिए खतरनाक हैं।
बच्चों महसूस कर सकते हैं पता है कि वे लाइटर और मैचों के साथ खेलने के लिए नहीं करना चाहिए, ताकि वे उन्हें उनके बेडरूम कहाँ वे किसी का ध्यान नहीं खेल सकते में घुसने सकता है।
स्थापित करें और अपने घर भर में धूम्रपान डिटेक्टरों काम कर बनाए रखें। एक अच्छा अभ्यास का पालन करने के लिए जब आप डेलाइट सेविंग टाइम के लिए अपनी घड़ियों को बदलना है; अपने धूम्रपान डिटेक्टर बैटरी बदल जाते हैं।
मामले में रोकने के लिए अपने बच्चे को छोड़ देते हैं और रोल सिखाओ कभी अपने कपड़े में आग पकड़ नहीं करता है। इतना ही नहीं उन्हें सिखाने बंद करो, ड्रॉप, और रोल है, लेकिन यह अक्सर उन्हें अभ्यास के साथ।
अपने बच्चे के कपड़े आग पर पकड़ पा रहे हैं तो:
बंद करो, ड्रॉप, और रोल।
जल क्षेत्र से कपड़े निकालें। सामग्री त्वचा से चिपक हैं, तो यह शांत है, और यह अकेला छोड़ दें।
शांत, ठंड नहीं पानी के साथ थोड़े समय के लिए जल क्षेत्र कूल। कभी एक जला पर बर्फ या ठंडे पानी डाल दिया। बर्फ और ठंडे पानी से जला बिगड़ सकती हैं।
एक साफ, सूखे कपड़े से जला कवर। बच्चे को गर्म और शांत रखें।
अपने घर के लिए एक आग से बच योजना है। अपने बच्चे के साथ भागने की योजना का अभ्यास करें।
आग से संबंधित चिकित्सा निकास और एयर एम्बुलेंस सेवा
1. WE DON'T GIVE ORDERS JUST TO HEAR OUR OWN VOICES.Getting you to your destination safely is the number-one priority of flight attendants. "People find rules annoying but they don't understand that there's a reason behind every rule—which is to keep you safe," says Sara Keagle, who's been a flight attendant for 18 years and blogs about it atTheFlyingPinto.com. Ellen,* a former flight attendant for United Airlines, wishes "that passengers would understand that we're required by the FAA (Federal Aviation Administration) to ensure safety at all times. We've seen what can happen when a flight hits unexpected turbulence, so we need you to sit down so that you don't hurt yourself."
2. WE DON'T ENJOY DELAYED FLIGHTS ANY MORE THAN YOU DO.Sitting on the tarmac is stressful for passengers and flight attendants alike. "We're usually on the plane an hour before the passengers to prepare for the flight, plus we've been at the airport for a few hours before that," says Fanny Delaunay, a former flight attendant for Air France. And if you're tired, multiply that by three to understand how tired your flight attendant is. "It's likely that we're on the third or fourth day of a multiday trip. We're tired and want to see our families too," says Ellen.
3. GIVE EACH OTHER A HAND DURING BOARDING.According to Teresa,* a former flight attendant with Delta Air Lines, the hardest part of a flight is boarding, because properly stowing baggage can be tricky. "If passengers worked together and stopped only thinking about themselves it would make our job a lot easier, as well as help the flight get out on time." So be considerate of other passengers by leaving them some space when you place your suitcase in the overhead bin, and assist someone who's struggling to stow their suitcase.
4. AN AIRPLANE IS A MODE OF TRANSPORTATION, NOT A FLYING RESTAURANT.Keep in mind that the main function of flying is not to provide you with a fine dining experience. According to Ellen, "we usually don't board 100 percent of any one food option, so passengers should be prepared not to get their first choice." As Gary, a flight attendant with United Airlines, puts it, "You're on board a 747, not a 7-Eleven. We will do everything we can to make your flight enjoyable, but sometimes we just don't have everything that you want."
6. MANY PASSENGERS DON'T REALIZE HOW MUCH MORE DRUNK THEY GET AT 35,000 FEET."Due to the high altitude, alcohol is more powerful when you're on a flight," says Fanny. If you're noticeably drunk or getting unruly, it's the flight attendant's responsibility to control the situation. "Sometimes if we think you've had too much to drink, we'll serve you, but not serve the whole mini-bottle of booze," confesses Ellen. "We may just dip the rim of the glass in enough vodka or gin and fill the rest with mixer."
7. AND SERVING YOU THOSE DRINKS IS NOT THE PRIMARY REASON WE'RE ON BOARD.Flight attendants are there to ensure your safety, not cater to your every need. They go through rigorous training, including medical emergency training, CPR and training to evacuate an aircraft. "Because—fortunately—most flights do not encounter safety problems, some people believe that we're just luggage handlers and beverage servers, and don't recognize that flight attendants are highly trained for the safety and comfort of the passengers," says Agnes Huff, PhD, a former flight attendant for US Airways and Pacific Southwest Airlines. Sara explains that because the pilots can't see the back of the aircraft, flight attendants are depended upon to be the eyes and ears at the back of the plane. It's up to them to be aware of what's going on with the aircraft and alert the pilot to any emergency situations.
8. WE'RE A VERY TIGHT BUNCH.Despite sometimes having met only minutes earlier, "once the crew is on board for a flight, something miraculous happens," says Gary. "We suddenly become one another's best friends, as if we've known one another for years. I guess the trust comes from knowing that we really do have one another's back in an emergency." According to him, the most intimate conversations take place during taxi, takeoff and landing. Those bonding moments are referred to as "jump seat news."
9. WE WISH YOU'D TIME YOUR BATHROOM TRIPS BETTER.Disregarding the "fasten seatbelt" sign and jumping up to visit the lavatory whenever you need to can add to delays. "There's a sequence to taxiing and getting in line for takeoff," says Sara. "If somebody gets up to use the restroom, we have to tell the cockpit, and they have to stop the plane and wait until the person is back in his or her seat and buckled up. During that time we could lose our spot in line." Plus, says Ellen: "Moving the 300-pound drink cart back to the galley against gravity after you've pulled it all the way to the front because one passenger needs to use the restroom is the most annoying thing ever."
10. MEETING PASSENGERS CAN BE THE BEST PART ABOUT BEING A FLIGHT ATTENDANT."One of my favorite parts of the job was having meaningful conversations with interesting people," says Fanny. "Maybe it's an underlying fear of flying, or just the magic of being in the air, but people tend to open up and talk about themselves a lot. You can learn so much."
Commercial flight - Stretcher services - Medical escort on Long Haul Flights
What are some things I can do to feel better?
If you are living with an autoimmune disease, there are things you can do each day to feel better:
autoimmune disease diet
autoimmune skin diseases
rare autoimmune diseases
examples of autoimmune diseases
autoimmune disease definition
autoimmune thyroid disease
How can I manage my life now that I have an autoimmune disease?
Although most autoimmune diseases don't go away, you can treat your symptoms and learn to manage your disease, so you can enjoy life! Women with autoimmune diseases lead full, active lives. Your life goals should not have to change. It is important, though, to see a doctor who specializes in these types of diseases, follow your treatment plan, and adopt a healthy lifestyle.
How can I deal with flares?Flares are the sudden and severe onset of symptoms. You might notice that certain triggers, such as stress or being out in the sun, cause your symptoms to flare. Knowing your triggers, following your treatment plan, and seeing your doctor regularly can help you to prevent flares or keep them from becoming severe. If you suspect a flare is coming, call your doctor. Don't try a "cure" you heard about from a friend or relative.
I want to have a baby. Does having an autoimmune disease affect pregnancy?
Women with autoimmune diseases can safely have children. But there could be some risks for the mother or baby, depending on the disease and how severe it is. For instance, pregnant women with lupus have a higher risk of preterm birth and stillbirth. Pregnant women with myasthenia gravis (MG) might have symptoms that lead to trouble breathing during pregnancy. For some women, symptoms tend to improve during pregnancy, while others find their symptoms tend to flare up. Also, some medicines used to treat autoimmune diseases might not be safe to use during pregnancy.
If you want to have a baby, talk to your doctor before you start trying to get pregnant. Your doctor might suggest that you wait until your disease is in remission or suggest a change in medicines before you start trying. You also might need to see a doctor who cares for women with high-risk pregnancies.
Some women with autoimmune diseases may have problems getting pregnant. This can happen for many reasons. Tests can tell if fertility problems are caused by an autoimmune disease or an unrelated reason. Fertility treatments are able to help some women with autoimmune disease become pregnant.