Diabetes Guidelines

Using needles to adjust bodily functions to optimum levels is the principle behind acupuncture. Both ancient Chinese and modern Western practitioners have used this technique to relieve many sufferers of chronic disease. Needling is a relatively safe, beneficial treatment strategy that can be used to reduce pain, improve healing, and increase general well-being. But exactly how is this procedure done and what sort of benefits can be obtained?

Procedure for Needle Puncture

There are two broad categories of acupuncture practice today, traditional Chinese medicine (TCM) and medical acupuncture. Both have their merits, so the choice is individual. The decision for most people hinges upon which philosophy appeals more to them and which technique holds the least apprehension.

In TCM, practitioners adhere to the concept of Qi, or energy flow, and the meridians in which they travel. They use longer needles and insert them deeper in order to reach the acupuncture points. Modern science has found little evidence to prove the existence of these energy channels, but this is the technique that has been used effectively for thousands of years.

In medical acupuncture, the practitioners are graduates of western medical schools. Their application of needles is not based on the traditional acupuncture points, but on anatomic data. These acupuncturists use shorter needles and the insertions are shallower. They also tend to use fewer needles and leave them inserted for shorter periods of time. Adherents to TCM feel this is a watered-down version of the real thing. Nevertheless, many patients have felt relief of symptoms through this method.

Conditions for Puncture Application

There is a broad and extensive list of ailments which can be treated with acupuncture. The conditions run the gamut from asthma to constipation, anxiety to weight loss. Most TCM practitioners believe that any health condition results from an imbalance in Qi flow, therefore amenable to needle therapy. Western acupuncturists tend to have a more limited list of indications, the most common of which is undoubtedly control of pain.

Control of pain is the most well researched of all of the indications for acupuncture. There is a definite beneficial effect for a majority of patients using this method. Migraines, premenstrual syndrome, arthritis, carpal tunnel syndrome, and neuralgias are but a few examples. The theory behind its effectiveness is also medically accepted and well researched, called the gate-control theory of pain. It states that the needles can stimulate nerves so that they block the impulses from pain triggers.

Expected Puncture Session Result

It is important to emphasize that acupuncture is used only on top of existing medical therapy. At no time should a patient discontinue medication or ignore medical instructions in favor of needle puncture. After undergoing a needle puncture regimen, the primary care physician can make an evaluation with regards to decreasing dependence on other therapies.

A course of acupuncture therapy will last anywhere from a few weeks to a few months. This depends upon the complexity of the particular medical condition. Results also vary, so it is important to have a frank discussion with the acupuncturist regarding expected results and their time frame. In general, the patient will begin to feel beneficial effects after three or four session. Certain specific conditions will actually get a little worse before improving so keeping informed is key.

In modern medicine, the use of traditional techniques with proven results has become a widely accepted practice. Acupuncture has proven its worth time and again. Modern practice guidelines make it effective, reproducible, and safe. It is a gift of healing form ancient sages that has the potential to bring relief to millions of people.

Andri Irawan
http://www.articlesbase.com/alternative-medicine-articles/a-quickstart-guide-to-acupuncture-711462.html

Evidence based case study in management of acute Exacerbations of COPD.

Introduction:

Chronic pulmonary diseases have become increasingly one of the most common chronic lung diseases and a major cause of morbidity and mortality in modern world. It is characterized by airflow limitation that is not fully reversible.

 Chronic Obstructive Disease is a leading cause of the death in the worldwide (Calverley et al, 2003). The condition can result in loss of work quality and quality of the life can be significantly effected (Barnes, 1999). In UK 27,478 men and woman die because of the chronic obstructive lung diseases and most of the death ( more than 90%) was in  the age of above 60 years old(British Thoracic Society. 2006).

Rehabilitation for patients with chronic lung diseases is well established and widely accepted as means of enhancing standard therapy in order to improve symptoms and maximise the patients function (Siafakas et al, 1995; Ries, 1990; Casaburi, 1993; Fishman, 1996). In 1974, the American College of Chest Physicians (ACCP) focused in there definition of Pulmonary rehabilitation on three important features and they suggested that Successful pulmonary rehabilitation depends on three importance features, Individuality of each case, Multidisciplinary team approach and attention to physiopathology and psychopathology of each case.

One of the main problems with COPD patient is the increase in the pulmonary secretions leading to increase in shortness of breath. These two factors affect the patient’s function and quality of life.  For exacerbation, Physiotherapy is often required to help clear secretions and reduce WOB, including non-invasive ventilation to prevent intubation (Alexandera, 2001).

There are various techniques, which can be used in physiotherapy to improve patient’s condition. The research suggests that the postural drainage is beneficial in clearing  the chest from secretions (Clarke,1989;Faling,1986), respiratory muscle relaxation manoeuvre is effective for improving the pulmonary function of pulmonary emphysema patients (Fujimoto et al, 1996), relaxation can help reduce dyspnoea and anxiety in chronic obstructive pulmonary disease (COPD) patients (Louie, 2004).

Case description case history, physical examination, and intervention)

Patient is a 67-years-old woman with acute exacerbation in Chronic Obstructive Pulmonary Disease (COPD). She complained of increased shortness of breath with loose, non-productive cough. A febrile on auscultation, bilateral rales, rhonchus, and expiratory wheezing. Patient said she is on bronchodilators and low-dose steroid. Patient said she has been suffering from this problem since 10yrs and has been on medication since. She does not do any exercises and her general practitioner who she usually sees has never mentioned about seeing any physiotherapist. Recently during this episode of acute exacerbation, she was advised by the hospital doctor to see a physiotherapist.

The strategy in this case study used was the problem-solving model, which included following six steps;

Step 1: Patient assessment,

Step 2: defining the problem,

step3: determining the goals,

step4: identifying appropriate techniques,

Step 5: applying the techniques,

step6: re-evaluation of the patients situation(Donna,1987).     

Evaluation and assessment:

Accurate assessment is the key player of physiotherapy and forms the bases of rational practice. A Problem based assessment leads to reasoning in the pulmonary rehabilitation. As result, a thoughtful evaluation will guide to both effectiveness and efficiency  because time will be saved by avoiding unnecessary treatment (Physiotherapy in Respiratory Care An evidence-based approach to respiratory and cardiac management).

Ward reports and medical notes of the patient were evaluated to know about;

·         The past and present relevant history.

·          social history , accommodation

·         Conditions required precautions in relation to certain treatments e.g. light-headedness ,bleeding disorders or swallowing disorders

·         Recent cardiopulmonary  resuscitation to examine the X-ray in case of gastric aspiration or fracture

·         Checking for possibly of bony metastases, long-standing steroid therapy that this leads to risk of osteoporosis and checking for the history of radiotherapy over the chest. These all findings contraindicate percussion or vibration over the ribs.  

·         The patient’s experience increased shortness of breath and the assessment indicate airway secretion.

A part of the patient evaluation was subjective assessment and that was by listening to patient’s problem in her own words. Following symptoms were checked:

Respiratory symptoms by looking for the how long the symptoms been troublesome.

·         Frequency, duration, and the severity.

·         Any pain, chest pain, musculoskeletal pain or cardiac pain.

·         Checking functional limitations including the daily living.

·         Observation to check the breathing rate and pattern before the patient a ware of the physiotherapist’s presence to avoid any role-play.

·         General appearance , colour, hand checked which is a good and rich source of information like cold hand indicate a poor cardiac output, oedema, jugular venous pressure, chest shape.

Objective measurement:

Exercise testing was used to monitor the progress of the patient due following few reasons:

·         Lung function tests are not a good predictor of exercise capacity (Bradley et al, 1999).

·         The laboratory tests are for physiological measurement rather than monitoring of patients progress.

·         The patients own estimate of exercise tolerance is not objective (Hough, 2001).

Exercise testing:

As long as the patient was not suffering from acute breath illness, exercise testing was used as an objective measure to monitor the progress. Oximetry on exercise testing was used which is advisable to measure the level of oxygen during the exercise (Martine et al, 1992). Because the patient was in acute exacerbation condition, only simple stair climbing testing was used and count the number of steps can be climbed up and down in 2 minute and rest allowed but included within the 2 minutes.  Each minute was passed the patient was informed about the time. The result of the test was only 10 steps per 2 minutes. Exercise testing revealed increased shortness of breath and from assessment of patient, it was clear that she had airway secretions.

Defining the problem:

Shortness of breath was probably due to increased secretions with the patient and so physiotherapy was planned after the use of bronchodilators. Percussion can trigger bronchospasm in patients with asthma and in this case would benefit to have maximum bronchodilator prior to treatment. (Donna 1987)

Determining the Goals:

Promote airway clearance; encourage relaxation and breathing exercise; encourage exercise to promote airway clearance.

Identifying Appropriate Techniques:

   Due to short shortness of breath, modified positioning was used for postural drainage as per the patients comfort, turning the patient side to side to prevent any shortness of breathiness (Hough 1991). Trendelenberg position was also used with percussion and vibration was gently applied due to consideration that the patient was on long-term steroid therapy. Emphasis was placed on both lower lobes as no specific area of pathology was described. Relaxation exercises were done for upper chest and neck to increase the ventilation, abdominal areas. Patient was also taught home postural drainage to help in early recovery.

Walking and cycling was encouraged, as it is most widely used modalities of exercise training in chronic obstructive pulmonary disease rehabilitation (Vallet et al, 1997). Patient was given endurance (aerobic) training program for 4-12 weeks (Casaburi et al, 1997; Wijkstra et al, 1996), and she attended supervised training sessions 2-5 times a week. Each session duration was 20-30 minute.   

Applying techniques:

 Techniques for vibration and postural drainage (Gumery et al 2001) were applied with consideration to the contraindications and patients condition and motivation. As the patient was on long term of cortico- steroid treatment, possibility of osteoporosis was considered which may led to fracture while doing tapping in postural drainage.

Re-evaluation:

The patient was re-evaluated after the secretions were mobilised and on observation, patients breathing was found to be more effective. The progress was slow as the patient was reconditioned. Patient was encouraged to remain active to help in early recovery. Patient and family was given education about restoration and maintenance of exercise tolerance and basic self-management. Home visits were made to check for adequate heating, and health or safety hazards. In addition, this visit was also supportive for the family.

The exercise was prescript for the patient to keep the patient fit and increase the vital capacity. The mode of the exercise was related to the patient’s life style and the patient was encouraged to use stationary bike. The bike was suggested as it supports 85% of the body weight, and large muscle groups can be exercised with less strain than walking (Bach and Haas, 1996, p.309). Furthermore, exercise programs for the muscles of ambulation were prescribed as they are a part of virtually every program of pulmonary rehabilitation (Ries, 1990; Casaburi, 1993; Carter et al, 1992; Olopado et al, 1992). Over the period of rehabilitation, the patient also said that her functional capabilities improved and this helped her to great extent in her ambulation. Exercises were also given for muscles of the shoulder girdle as these muscles can help provide support to pull on the ribcage (Criner et al, 1988). Patient was encouraged to resume her sports hobbies – bowling to combine exercise and recreation.

 Patient was scheduled for a follow up appointment after 6 weeks of rehab and treatment to monitor the patient’s progress. (Broussard 1979; Fujimoto et al. 1996; Gift, Moore, and Soeken, 1992; Louie, 2004). Patient was also provided with breathlessness rating scale to check her breathlessness after each session of exercise.

On the follow up appointment subjective and objective re assessment was done. Patient as observed to check the breathing pattern and frequencies, auscultation was done to check the chest for any signs of secretion and obstructions. The patient was sent to take x-ray to check the clarity of the chest. Stair climb test was done and there was a good progress in the patient’s condition as the result was increased significantly from 10 steps in 2 minute before 6 week to 25 step.

Improvement was also seen on the self reported and measured breathlessness rating scale where the patient scored 2 whereas she scored 4 during initial assessment and also the recovery rate post exercises reduced from 5-10mins to 2-5mins and the patient also reported that she was doing fine the day and was comfortable.

Summary:

From the above case study, it can be derived that patients suffering with similar conditions can benefit from appropriate exercise and active lifestyle. It is very important to keep encouraging the patients and educating them regarding the condition and help those to self manage.

Although suggestions for appropriate management can be made based on available evidence, the supporting literature is spotty.

References

   1.   Alexandra Hough 2001, Physiotherapy in Respiratory Care An evidence-based approach to respiratory and cardiac management, third edn, Nelson Thomas Ltd, United Kingdom.

   2.   Back, J. R. & Haas, F. pulmonary rehabilitation. Phys.Med.Clin.North Am [7], 205-406. 1996.

   3.   Barnes PJ 1999, Managing chronic obstructive pulmonary disease Science Press, London.

   4.   Bradley, J., Howard, J., & Wallace, E. 1999, “Validity of a modified shuttle test in adult cystic fibrosis”, Thorax, vol. 54, pp. 437-439.

   5.   British Thoracic Society 2006, The Burden of Lung Disease, Second edn.

   6.   Broussard, R. 1979, “Using relaxation for COPD”, Am.J.Nurs, vol. 79, no. 11, pp. 1962-1963.

   7.   Calverley PM & Walker P 2003, “Chronic obstructive pulmonary disease”, Lancet, vol. 362, pp. 1053-1061.

   8.   Carter R, Coast JR, & Idell S 1992, “Exercise training in patients with chronic obstructive pulmonary disease”, Med Sci Sports Exerc, vol. 24, pp. 281-291.

   9.   Casaburi R & Petty TL 1993, Principles and practice of pulmonary rehabilitation WB Saunders, Philadelphia.

10.   Clarke, S. W. Rationale of airway clearance. Eur.Respir.J.Suppl 7, 599-603. 1989.

11.   Criner GJ & Celli BR. Effect of unsupported arm exercise on ventilatory muscle recruitment in patients with severe chronic airflow obstruction. Am Rev Respir Dis 138, 856-861. 1988.

12.   Donna L & Frownfelter 1987, Chest Physical Therapy and Pulmonary Rehabilitation an Interdisciplinary Approach.  2 edn, Year Book Medical, INC, Chicago.

13.   Faling, L. J. 1986, “Pulmonary rehabilitation–physical modalities”, Clin.Chest Med, vol. 7, no. 4, pp. 599-618.

14.   Fujimoto, K. e. a. 1996, “Effects of muscle relaxation therapy using specially designed plates in patients with pulmonary emphysema”, Intern.Med, vol. 35, no. 10, pp. 756-763.

15.   Gift, A., Moore, T., & Soeken, K. 1992, “Relaxation to reduce dyspnea and anxiety in COPD patients”, Nurs.Res, vol. 41, no. 4, pp. 242-246.

16.   Gumery, L., Proyer, J., Prasad, S. A., & Dodd, M. clinical guidelines for Physiotherapy Management of Cystic Fibrosis.  2001. CSP.

17.   Louie, S. W. 2004, “The effects of guided imagery relaxation in people with COPD”, Occup.Ther.Int, vol. 11, no. 3, pp. 145-159.

18.   Martin D, Powers S, Cicale M, Collop N, Huang D, & Criswell D 1992, “Validity of pulse oximetry during exercise in elite endurance athletes”, J Appl Physiol, vol. 72, no. 2, pp. 455-458.

19.   Olopade CO, Beck KC, & Viggiano RW 1992, “Exercise limitation and pulmonary rehabilitation in chronic obstructive pulmonary disease”, Mayo Clin Proc, vol. 67, pp. 144-157.

20.   Ries AL 1990, “Position paper of the American Association of Cardiovascular and Pulmonary Rehabilitation: scientific basis of pulmonary rehabilitation”, J Cardiopulmonary Rehabilitation, vol. 10, pp. 418-414.

21.   Siafakas NM, Vermeire P, & Pride NB 1995, “Optimal assessment and management of chronic obstructive pulmonary disease (COPD):  the European Respiratory Society Task Force”, Eur Respir J, vol. 8, pp. 1398-1420.

22.   Vallet G, Ahmaidi S, & Serres I 1997, “Comparison of two training programmes in chronic airway limitation patients: standardized versus individualized protocols”, Eur Respir J, vol. 10, pp. 114-122.

23.   Wijkstra PJ, van der Mark TW, & Kraan J 1996, “Effects of home rehabilitation on physical performance in patients with chronic obstructive pulmonary disease (COPD)”, Eur Respir J, vol. 9, pp. 104-110.

Waleed Tawfiq

Is there any ways that really help the homeless? Does handing the panhandler a dollar do any good? Are you looking for the quick help or do you want to help solve the solution? The biggest problem is the homeless are not a group of the same person so their problems are not the same so the same solution will not work for everybody.

First off the reason for their homelessness is not the same. Yes some are due to addictions – both alcohol and drugs. Others have psychological issues. And then the fastest growing segment is those running from spousal abuse. And some simply have out spent their income and ended up on the streets with the downward spiral that leads to loss of job and loss of everything else.

So you have 2 avenues to help – the long term solution and the short term fix. The long term solution includes finding them jobs and affordable housing. The long term solution also focuses on fixing the other issues – the addictions, the psychological and emotional help, career and family counseling. So the long term solutions help with economic means to get them off the streets and the mental issues to help them cope so they don’t end up back on the street.

But since most people only want a short quick answer we will now comment on the ways to help the homeless deal with their everyday issues. Though these solutions are vital to them surviving they do nothing to help get them off the Street – they help them deal with the street.

What do you do when you see someone holding up a sign, “Will Work for Food”? Do you roll down your window and give them money? Do you pretend you didn’t see them? Nobody likes to be confronted by the homeless – their needs often seem too overwhelming – but we all want to treat them fairly and justly.

Here are some simple guidelines to equip you to truly help the homeless people you meet:

First off please do not give money to the homeless. If you want to donate money give it to the shelter that takes care of them. Too often, well intended gifts are converted to drugs or alcohol – even when the “hard luck” stories they tell are true. If the person is hungry, buy them a sandwich and a beverage. Taking time to talk to a homeless person in a friendly, respectful manner can give them a wonderful sense of civility and dignity. And besides being just neighborly, it gives the person a weapon to fight the isolation, depression and paranoia that many homeless people face.

The homeless are as diverse as the colors of a rainbow. The person you meet may be battered women, an addicted veteran; someone who is lacking job skills…the list goes on. Please do not treat them ALL as addicts – the addicted old homeless man we all pictures is only 25% of the population. So try and treat them with respect – remember they are still people too as you deal with them help them to help themselves. Take them to the appropriate homeless shelter. Most shelters offer immediate food and shelter to the homelessness through their emergency shelters. Many offer long-term rehabilitation programs that deal with the root causes of homeless. Many also offer “tickets” that can be given to homeless people which can be exchanged at the shelter for a notorious meal, safe overnight lodging, and the option of participating in a rehab program. Exposure to the elements, dirt, occasional violence, and lack of purpose all drain years from a person’s life. God can use your prayers and the brutality and the futility of life of the street to bring many of the broken to Himself.  So please pray for the homeless.

So you want to do little more. Their immediate needs are the basics – food, clothes, and shoes. So you can take food to the homeless shelters. Get with your local grocery store and ask if you can have the daily leftovers and date expired food. Take to the shelter. If you like set up a weekly trip and take them enough food every week – now you are making a big difference. Take along your kids. Another great way to help is to take your extra shoes, coats and clothes. Have a clothes drive in your neighborhood,  Do it on a monthly basis – if you like – the homeless residents next month are most likely not the homeless residents who were there this month.

The homeless in America are growing at a rapid rate and we all need to pitch in and help. Listed below are some staggering facts in regard to the homeless numbers and their conditions:

1. Family Homelessness: A New Social Problem

Except during the Great Depression, women and children have never been on our nation’s streets in

significant numbers. During the 1980′s, cutbacks in benefits coupled with rapidly increasing rents and a

dearth of low-income housing jeopardized the stability of all people with reduced or fixed incomes. At the

same time, the number of female-headed households dramatically increased. As a result, the nation’s

population of homeless families swelled from almost negligible numbers to nearly 40% of the overall

homeless population today. The United States in unique among industrialized nations in that women and

children comprise such a large percentage of our country’s homeless.

2. More Than One Million Homeless Children

Although counting the exact number of homeless children is difficult, a consensus is emerging among

researchers. According to the National Coalition for the Homeless, 1.2 million children are homeless on

any given night. Supporting this figure are estimates from the U.S. Department of Education that report

almost 400,000 homeless children were served by the nation’s public schools last year. Since more than

half of all homeless children are under the age of 6 and not yet in school, a minimum of 800,000 children

can be presumed to be homeless. On the basis of these data, the National Center on Family Homelessness

concludes that more than one million American children are homeless today.

3. Family Homelessness Will Increase

Looking beyond current numbers, The National Center on Family Homelessness (NCFH) predicts that

tight housing markets accompanied by decreasing availability of cash benefits as a result of welfare

reform will lead to an increase in family homelessness. To determine which states will have the biggest

problem, NCFH created an index of seven risk factors for family homelessness. These factors were

identified from epidemiological research conducted over the past ten years. The ranking of states is

presented in the report.

Part II

1. Homelessness Makes Children Sick

Researchers from NCFH have isolated homelessness as a direct predictor of specific childhood illnesses.

Homeless children:

• Are in fair or poor health twice as often as other children and four times as often as children

whose families earn more than $35,000 a year.

• Have higher rates of low birth weight and need special care right after birth four times as often as

other children.

• Have very high rates of acute illness, with half suffering from two or more symptoms during a

single month.

• Have twice as many ear infections, five times more diarrhea and stomach problems, and six times

as many speech and stammering problems.

• Are four times more likely to be asthmatic.

• Go hungry at more than twice the rate of other children.

2. Homelessness Wounds Young Children

Every day, homeless children are confronted with stressful, often traumatic events.

• 74% of homeless children worry they will have no place to live.

• 58% worry they will have no place to sleep.

• 87% worry that something bad will happen to their family.

Within a single year:

• 97% of homeless children move, many up to three times.

• More than 30% are evicted from their housing.

• 22% are separated from their family to be put in foster care or sent to live with a relative.

• Almost 25% have witnessed acts of violence within their family.

The constant barrage of stressful and traumatic experiences has profound effects on the cognitive and

emotional development of homeless children.

• Homeless babies show significantly slower development than other children do.

• More than one-fifth of homeless children between 3 and 6 years of age have emotional problems

serious enough to require professional care.

• Homeless children between 6 and 17 years struggle with very high rates of mental health

problems.

• Less than one-third of homeless children are receiving mental health treatment.

3. Homelessness Devastates Families

Families are the fastest growing segment of the homeless population, now accounting for almost 40% of

the nation’s homeless. More than 85% of homeless families are headed by single mothers, with the

average homeless family comprised of a young mother and her two young children, most of whom are

below the age of 6 years.

Homeless mothers have an average annual income of under $8000, living at 63% of the federal poverty

level for a family of three.

• Only 21% of homeless mothers receive money from family, partners, or friends.

• 39% have been hospitalized for medical treatment.

• 22% have asthma, compared to 5% of other women under 45 years.

• 20% have anemia, compared to 2% of other women under 45 years.

• 40% report alcohol or drug dependency at some time in their lives.

Although 70% of fathers of homeless children are in touch with their children, most do not live with the

family. The downward spiral into homelessness for a child is often accelerated if a father loses his job,

becomes injured or ill, has a bout with alcohol or drugs, or is involved with the criminal justice system.

• 50% of fathers are unemployed.

• 43% have problems with drugs or alcohol.

• 31% have physical or mental health problems.

• 32% are in jail or on probation.

Homeless children are at particularly high risk for being placed in foster care; 12% of homeless children

are placed in foster care compared to just over 1% of other children. The National Center on Family

Homelessness has identified placement in foster care as one of only two childhood risk factors that

predicts family homelessness during adulthood.

• 44% of homeless mothers lived outside of their homes at some point during their childhood; 20%

of these women were placed in foster care.

• 70% of homeless mothers placed in foster care as children have had at least one of their own

children in foster care.

The frequency of violence in the lives of homeless mothers is staggering.

• 63% have been violently abused by an intimate male partner.

• 27% have required medical treatment because of violence by an intimate male partner.

• 25% have been physically or sexually assaulted during adulthood by someone other than an

intimate partner.

• 66% were violently abused by a childhood caretaker or other adult in the household before

reaching 18.

• 43% were sexually molested as children.

When the violence from their childhood is combined with their experiences as adults, 92% of homeless

mothers have been severely physically or sexually assaulted; 88% have been violently abused by a family

member or intimate partner. These repeated acts of brutality result in unusually high rates of serious

emotional problems among homeless mothers.

• 36% have experienced Post-Traumatic Stress Disorder; three times the rate of other women.

• 45% have had a major depressive disorder, twice the rate of other women.

• 31% have attempted suicide at least once, primarily during adolescence.

• 12% have been hospitalized for treatment of mental illness.

Among homeless children:

• 8% have been physically abused, twice the rate of other children.

• 8% have been sexually abused; three times the rate of other children.

• 35% have been the subject of a child protection investigation.

• 24% have witnessed acts of violence within their family.

• 15% have seen their father hit their mother.

• 11% have seen their mother abused by a male partner.

4. Homeless Children Struggle in School

Despite state and federal efforts to provide homeless children with improved access to public school, at

least one-fifth of homeless children do not attend school.

Homelessness takes children far away from their own schools and classmates. For many homeless

children:

• There is no transportation from shelters to school.

• Improvised living arrangements are too short to make enrolling in a new school worthwhile.

• Lack of academic and medical records creates obstacles to registration.

• Daily demands of finding food and shelter push children’s educational needs aside.

Homeless children who manage to attend school face discouraging barriers to their academic success.

• Homeless children have four times the average rate of delayed development.

• Have more academic problems that other children.

• Are under served by special education.

• Are suspended twice as often as other children.

Among homeless children, there is twice the number of students with learning disabilities and three times

the number of students with emotional and behavioral problems.

Homeless children are twice as likely to repeat a grade.

• 21% of homeless children repeat a grade because of frequent absence from school, compared to

5% of other children.

• 14% repeat a grade because they have moved to a new school, compared to 5% of other children.

Within a single year:

• 40% of homeless children attend two different schools.

• 28% attend three or more different schools

So they need your help. Start with the short term help – provide food and clothes or shoes, And as you get involved start thinking of ways to help with the long term needs. With the current economic conditions its only going to get worse, And more help will be needed, And when you picture the homeless please picture the homeless child and not the drunken, pan handling bum. That  homeless child so desperately needs your help .

boake moore

Online health calculators are a tool used in calculating disease risks.

Online calculators are capable of measuring the health and fitness of a patient, especially when it comes to the weight, fitness programs, nutrition and even sports activities.

Online health calculators can help a person achieve his goals in improving overall health and fitness. It is fully customized, coming with graphical images, extensive help and printable reports. There are many health calculators available on the web which can give the best services, especially in measuring one’s health:

The BMI Calculator

BMI Calculator is a simple calculator that calculates the body mass index. BMI (body mass index) is the measurement of body fat based on one’s weight and height. It can be applied for both adult men and women.

This tool can be used by entering the weight and the height. Then, click and compute the BMI button in order to publish the result. The BMI result will feature if a person is underweight, normal, overweight and even obese.

The BMI can also help indicate total body fat in order to avoid the risk of diseases. This tool is limited to athletes and other people who have muscular build up. However, it has a tendency to overestimate calculations of body fat. On the other hand, it may also underestimate the body fat of older persons, especially those who have lost their muscle mass.

YourDiseaseRisk

YourDiseaseRisk is an online health calculator developed by the Harvard Center for cancer Prevention. It predicts and collects the latest risks of having a disease, compiling it into an easy-to-use tool.

Diseases include the following:

? Cancer
? Heart diseases
? Diabetes
? Osteoporosis
? and stroke

The cancer section can cover cancers for the following:

? Breast
? Bladder
? Colon
? Lung
? Kidney
? Cervical
? Melanoma
? Ovarian
? Prostate
? Pancreatic
? Uterine
? and stomach

Life Expectancy Calculator

Life Expectancy Calculator is a tool used for calculating the life expectancy of a person. It is a virtual interview machine that publishes the virtual age based on the family history, lifestyle, eating habits and other information from an administering doctor.

ADA DiabetesPHD

DiabetesPHD (Personal Health Decision) is a powerful health tool for risk assessment. It is powered by Archimedes care modeling software, bringing a large range of clinical research for accurate health risk predictions. Aside from this, it can be used for discovering the effects of many health care interventions such as weight loss, smoking and medicine intakes.

Diabetes PHD can ask a person to input his or her health history information. Later on, it can determine a personalized result which shows the risks for any kind of diseases. It will then input the variables in a profile, which will show how this can affect the future health of a person.

AHA Heart Attack/Coronary Heart Disease Risk Assessment

AHA risk assessment is a tool supported by the American Heart Association. It helps in assessing the risk of having a heart attack or coronary heart disease. The tool also checks if a person has a metabolic syndrome (cardiovascular disease), stroke and diabetes.

The Risk Assessment Tool is for ages 20 or older particularly for those who do not suffer from a heart disease and diabetes. The tool uses a scoring system known as the Framingham Heart Study. Hence, the national guidelines call this as “ATP III”. The results include:

? Risk assessment
? Summary report
? Metabolic syndrome
? and action plans

These can be uploaded or printed.

Smoking Risk Calculator

This tool calculates the risk of dying with lung cancer and other diseases that is acquired in smoking. The data is provided by the American Cancer Society, coming from Cancer Prevention Studies.

Dr. Sears Body Fat Calculator

Dr. Shears calculator publishes the body fat percentage, the lean body mass and the protein requirement. This is in grams and it focuses on the maintenance of the activity level. It is the so-called “zone food block guide” that lists the foods you can use in a meal structure.

MedCal3000

MedCal3000 provides a wide range of related medical formula, along with a decision tree analysis tool and clinical criteria sets. These are used by most medical educators, clinicians, nurses and health care students. A subscription must be made in order to access all the equations.

UMMS Health Calculators

UMMS calculators are being supported by the University of Maryland. It helps in assessing the risks of:

? Asthma
? Cholesterol reduction
? Depression
? HIV
? Exercise
? Alcoholism
? Suicide risk

Aside from this, it also assesses the ratio of:

? Protein
? Carbohydrate
? And Fiber intake

Health Care Insurance Cost Calculator

This calculator allows the comparison of health care options or plans at a given time. It considers monthly premiums, co-payments, deductibles and co-insurance. The variables which will be inputted will be computed for the cost results.

David H. Urmann

If you have children and even if you don’t have children, you should read this article about the importance of installing water purification equipment in your house. Having clean uncontaminated water is crucial to a child’s development.

The water supply in most U.S. cities contains dangerous chemicals. Lead, chlorine, herbicides, pesticides, pharmaceuticals drugs, and many other substances contaminate the water your children are drinking. That is why every home needs water purification equipment to protect their health.

A child’s body is smaller than ours, thus more susceptible to the harmful chemicals than we adults are. The standards for water that the EPA set are for 185-pound male. So even if your water is tested and meets the standard requirements that follow the EPA guidelines, those standards are not taking into consideration a small child’s body.

The immune system of children and teenagers are still in the developmental stage, so it is important that the toxicity levels in their bloodstream are not at high levels. We drink water to help our bodies get rid of toxins, but if our water has toxic substances in it, it can do us more harm than good – especially in small children.

A Baltimore study showed children with a high level of lead in their blood, exhibit a higher level of behavior problems than children with low levels. The exposure to chlorine and other dangerous chemicals can cause learning disorders in children and teenagers.

Wouldn’t you rather be safe, and give your child all the help he or she needs by installing water purification equipment in your house, than be exposing your children to substances in their water that may give them problems learning or even increasing their risks to diseases.

Cases of childhood asthma, leukemia, immune disorders and cancer have all increased in the last decade. Many experts believe and studies show this is partially due to exposure to more toxins. Water is one of the carriers of these toxins.

There are many dangerous chemicals in our water supply. Our water companies do not remove all of them. It is our responsibility as parents to protect our children from these dangerous substances by installing water purification equipment in our homes.

Children ingest three times more water per pound of body weight than we adults do, so they ingest a higher percentage of chemicals than we do when they drink contaminated water. Check out my web site today to learn more about dangerous substances in water. Don’t dismiss the facts you’ll find there when considering what is best for your children’s health.

Juanita Ruby
http://www.articlesbase.com/wellness-articles/water-purification-equipment-and-your-childrens-health-and-welfare-677293.html

Perfumes have been used by both sexes for over 4 000 years. Once a sign of wealth and a means to cover less fragrant whiffs, today perfumes are a must-have accessory. Perfume needs to be carefully chosen and matched to personality and occasion. Familiarity with types, ingredients and the jargon of the parfumier’s art will help you choose amongst the many hundreds of brands on the market.

Perfumes consist of aromatic compounds dissolved in ethanol (alcohol), sometimes diluted further with water. They are described according to their dilution:

°              Parfum extrait (perfume extract):           15–40%

°              Eau de parfum:                                       10-20%

°              Eau de toilette:                                         5-15%

°              Eau de cologne                                      <   5%

Like music, fragrance is described in terms of ‘notes’. Middle and base notes combine to give the principal scent of a perfume. The parfumier is an expert in creating harmonious compositions, as skilled as any artist.

°              Head notes, or top notes, are the smells you smell first in a perfume (because they evaporate first).

°              Heart notes, or middle notes, are the next to emerge.

°              Base notes may take up half an hour or longer to appear, which is why you should never spray and buy in a hurry.

For the last twenty-five years fragrances have been classified into five main families:

floral, oriental, woody, fresh and fougère. Many masculine fragrances belong in the family ‘fougère’, meaning ‘fern’ in French. Fresh fragrances include citrus and ‘green’. Gourmand fragrances are those with the ‘eat-me’ factor, with notes that may include chocolate, vanilla or other edible substances.

Plants are the main sources of organic or natural perfume essences, and include flowers, resin and even roots and bulbs. Some sources are no longer used because the species is endangered (such as sandalwood) or because of cruelty to animals (civet, musk oil, ambergris).

Synthetic compounds are commonly used in perfumes today, in some cases because they are cheaper but also because chemists have created fragrances not found in nature.

Essential oils are distilled from plants instead of being extracted by dissolving in alcohol or by other chemical processes.

Storage of perfume is important if you want it to last. Heat, light and air cause perfumes to degenerate. Ideal temperatures are less than 10 degrees Celsius. Spray bottles are best because they prevent exposure to air every time the cap comes off the bottle.

Perfumes, especially those with higher concentrations of aromatic compounds, can trigger allergies, asthma attacks and rashes. Because the ingredients of perfumes are closely kept secrets, the industry has been under-regulated but is increasingly being required to comply with regulatory guidelines. If in doubt, stop and switch.

Understanding perfume helps you match scent to scenario. A concentrated perfume with heady oriental notes is for evening, a fresh, green eau de toilette ideal for daily use. The number one rule of perfume use is that less is more. The old chestnut about spraying perfume into the air and then walking through the mist is not such a bad idea. If the whole room smells like you, you’ve overdone it and are probably quite literally getting up people’s noses. Just the right amount suggests a person of elegance, taste and sophisticated femininity.

Lawrence Carter

This is a book that talks more about asthma. It talks of the condition of the patient and control.  This book has got all the causes of asthma and how they can be avoided.  Symptoms of asthma are indicated in the book. There are various authors of these books. Some are written by asthma specialists while others are written by persons suffering from asthma.

The asthma book also speaks on the positive and negative aspect of asthma.  The cures are also indicated in the book and the various responses that have been gotten by different persons using the same treatment or even different ones.  Some books contain testimonies of patients who have been able to live with asthma normally. Since asthma is incurable, one has to learn how to live with it without interfering with their life styles.

Guidelines are given for people with asthma and those who are around them.  First aid tips are also included so as to be able to control asthma attacks.  The various forms of treatment are also stated in asthma book. It contains statistics concerning asthma and the history behind the disease.  The book has got specifications on how to handle therapy and  the various forms of therapy that are available.

Asthma book is a must have for all asthmatic people as it contains important information of their day to day life.  This book is an exposure for the patient and has a lot of enlighting issues.  Asthma book is a master hand and if used as written, in the book one can live a very normal life.  This should however not be substituted for a doctor. Doctor’s advice and regular check-ups are important for one at times may not tell how far the condition has gone.

Mercy Maranga

Asthma treatment for children can be very tedious because health professionals should always take into consideration the age and sensitivity of the children to medications. Diagnosing the kind of asthma is the first step in asthma treatment for children. It may not sound as easy because proper medications should be accompanied with it. Compared to adults, there are various complications that affect children because of their age.

The approach to asthma treatment for children is similar in some ways with the approaches to adults. However, children asthma treatment is modified accordingly to the proper recommendations of the National Expect Panel Guidelines for Asthma Treatment. Stepwise approach is commonly use for the children’s asthma treatment. It is because of the greater variability of the asthma conditions in children.

Another great asthma treatment for children is the asthma therapy, where goals are stressed by the expert panels. This therapy refers to the long-term control and maintenance of asthma using least amount of medications. It also aids in the prevention of progressing or worsening of asthma conditions to children.

The asthma treatment for children has the so-called measurement of asthma control. This measurement is done through risk and impairment reduction. The asthma measured in risk is reduced through the following:

(1) Prevention of repetitive asthma flare-ups, which then minimize the need for hospitalization or emergency care

(2) Occurrence growth of healthy lungs without the worsening of airway functions

(3) Effective medications or treatments as long as there are no any serious side effects

(4) Distinction of asthma risk from impairment, whereas the effect can be both on the quality of life and physical functions of the children

Meanwhile the asthma measured in impairment reduction is clearly recognized with:

(1) Troublesome and chronic asthma symptoms such as feeling breathless or coughing during daytime.

(2) The use of rescue inhalers for quick relief

(3) Maintenance with healthy pulmonary functions

(4) Normal activity levels that may include participation in play activities and sports

Ricky Lim

Dosage Of Albuterol Inhaler :

The dosage of your Albuterol Inhaler your health care provider recommended should be strictly followed. You may only adjust it only when you are specifically instructed to do so. It typically varies depending on the severity of your asthma or other respiratory problems, whether you are using the your inhaler to prevent or treat asthma, and implications with other medicines you are taking at the moment.

General Albuterol Inhaler Dosage :

Typically, to treat or prevent an asthma attack, the recommended dosage is 2 sprays or as needed, every 4 to 6 hours. To prevent exercise-induced asthma, it is recommended to have 2 sprays 15 to 30 minutes before exercising. However, if your Albuterol Inhaler does not adequately or effectively control your asthma attack, you should seek medical attention immediately.

Above are only some general dosage guidelines when using an Albuterol Inhaler. Different patients have different asthma conditions or breathing problems. Some patients need only 1 spray to control their asthma symptoms where others may need more sprays frequently. Some use an inhaler to prevent an attack where some use it only during an attack when they need it.

Information About An Albuterol Inhaler :

An Albuterol Inhaler is a prescription-based asthma inhaler which is typically used when there is an asthma attack. Albuterol can cause side effects and the amount of inhalations should not be administered more often than prescribed.

An Albuterol Inhaler is mainly used by patients with asthma or exercise-induced asthma, whose airways are obstructed when breathing (bronchospasm). It can also be used to treat patients with emphysema and chronic bronchitis when their symptoms are related to reversible airway obstruction.

Albuterol Inhaler Specialist

Dosage Of Albuterol Inhaler :

The dosage of your Albuterol Inhaler your health care provider recommended should be strictly followed. You may only adjust it only when you are specifically instructed to do so. It typically varies depending on the severity of your asthma or other respiratory problems, whether you are using the your inhaler to prevent or treat asthma, and implications with other medicines you are taking at the moment.

General Albuterol Inhaler Dosage :

Typically, to treat or prevent an asthma attack, the recommended dosage is 2 sprays or as needed, every 4 to 6 hours. To prevent exercise-induced asthma, it is recommended to have 2 sprays 15 to 30 minutes before exercising. However, if your Albuterol Inhaler does not adequately or effectively control your asthma attack, you should seek medical attention immediately.

Above are only some general dosage guidelines when using an Albuterol Inhaler. Different patients have different asthma conditions or breathing problems. Some patients need only 1 spray to control their asthma symptoms where others may need more sprays frequently. Some use an inhaler to prevent an attack where some use it only during an attack when they need it.

Information About An Albuterol Inhaler :

An Albuterol Inhaler is a prescription-based asthma inhaler which is typically used when there is an asthma attack. Albuterol can cause side effects and the amount of inhalations should not be administered more often than prescribed.

An Albuterol Inhaler is mainly used by patients with asthma or exercise-induced asthma, whose airways are obstructed when breathing (bronchospasm). It can also be used to treat patients with emphysema and chronic bronchitis when their symptoms are related to reversible airway obstruction.

Albuterol Inhaler Specialist