Posts Tagged ‘empathy’

My Mother’s Recent Emergency Department Experience: Lessons for Learning

March 7, 2011

The Cleveland Clinic Improves the Patient Experience … by Improving the Hospital Gown!

October 12, 2010

The hospital gown. They have become a standard joke among comics who talk about being in hospitals.  If patients do not fasten them just right, their derrieres (or other body parts) may be on display for all to see!

The Cleveland Clinic wants to change the hospital gown and they have enlisted the help of a glamorous fashion designer! Fashion icon Diane von Furstenberg created a unisex patient-friendly, comfortable, wraparound apparel that looks good on everyone.

Jeanne Ryan, committee chair, stated, “The original goal had been to improve patients’ hospital experiences. We wanted to provide people with some dignity. They come to the hospital, it’s very stressful and then we ask them to take off their clothes. People said they feel exposed.” The gowns are expected to become available to all patients in the Cleveland Clinic’s Ohio facilities sometime in 2011.

Everything a hospital does creates either a negative or positive “patient experience.”  This initiative certainly enhances the patient experience.  From my work at enhancing the patient experience, I know that these little changes have a big impact. Bravo to the Cleveland Clinic!

MD Anderson Cancer Center Offers Innovative Patient-Professional Communications Program

October 8, 2010

I*CARE Website

One-on-one Coaching

Trainers observe healthcare professionals with patients and feedback is provided.

Research Opportunities

September 29, 2010

Patient Advocates Help Healthcare Professionals

August 31, 2010

In 2004, Trisha Torrey discovered a golf-ball sized lump on her torso.  There was no  pain associated with the lump.  Trisha contacted her doctor and ultimately several tests were performed.  The tests revealed a devastating diagnosis, a rare form of lymphoma that is nearly always fatal.  She was told to begin chemotherapy immediately.

Trisha felt something was not right.  She did all her Internet research and discovered that she had no other significant symptoms associated with this type of lymphoma.  It just did not add up.

Through a friend, she found a new doctor for a second opinion.  Then came the shocking (but happy!) news.  Trisha did not have cancer!  She would have gone through chemotherapy for nothing!  (Chemotherapeutic agents are toxic. It would have been devastating to go through this treatment and not actually need it!)

For Trisha, this was a life altering time for many reasons.  From that moment, she became a patient advocate to help others through the healthcare maze. Today, Trisha is the About.com expert on the topic of patient empowerment.  She recently posed a question to her readers, “What Should Medical Students Learn?”  These are some the responses that you will find helpful:

  •  Do not “give/write orders.” Medicine is not a military command. The patient makes the final decisions. You are there to offer expertise on diagnosis and treatment options. Take the time to make certain that patients understand clearly what options are available to them and the pros/cons/costs of all the options.
  • If you want patients who have money / insurance, you will have to accommodate some aspects of customer service in the medical care regimen. Treat patients, not disease.
  • Treat every patient with dignity and respect, imagining that each patient was your own loved one: parent, grandparent, child, brother, sister, or spouse.
  • For some patients, gender matters, especially with intimate procedures and exams. Some women would prefer female caregivers, some men would prefer male caregivers. Medical staff should not assume just because a patient doesn’t discuss their preferences, that everything is just fine.
  • Never forget that your world, the world of the hospital, is not the real world. It’s not where most of us live. Explain things. Talk. Communicate. Don’t assume too much about what patients already know, want to know, or value personally. Ask.

 Trisha’s first book, You Bet Your Life! The Ten Mistakes Every Patient Makes, was published in 2010. You can contact Trisha through her personal website:  www.EveryPatientsAdvocate.com

My Mother’s Recent Hospitalization Experiences: The Good, the Bad and the Ugly!

November 18, 2009

About a month ago, my mother was crossing the street with her friend. Just as she stepped on the sidewalk she started feeling faint and began to feel sick.  An ambulance was immediately contacted and my mother was taken to the ER.  My mother’s friend accompanied her to the hospital — she called us from the hospital and told us to come right over.

My brother and I entered the hospital’s ER to find my Mom awake and alert. An ER nurse told us that my mother’s EKG was abnormal and that she had a condition known as Atrial Fibrillation and would need to take the medication, Coumadin.

A few hours later, my mother was admitted to the hospital.  The physician on the unit determined the underlying medical issue, dehydration.  We thought my mother was drinking enough fluids — obviously not.  My mother was in the hospital for four days.  Upon proper hydration, she was feeling fine and looking forward to returning home.

These are my observations regarding my mother’s recent hospitalization.  I base the observations on my PIE Model of Patient Communication.
P  Psychosocial (providing emotional support)
I  Interviewing (getting information)
E  Educating (giving information)

Psychosocial Dimension

Everyone was very friendly and kind.  I found the healthcare professionals to be very caring and treated my mother quite well.  However, what I did not find was any direct empathic responses.  I was waiting for someone to make a statement such as, “I know this must be difficult for you.”  Every medical center and practice always mention that empathy is an important component of their work.  In reality, empathy is rarely displayed.  This is due to the fact that healthcare professionals are not educated on how to convey empathy.

Interviewing Dimension

The questioning techniques employed were sufficient to gather information from my mother and I.  There was the usual issue of asking too many closed questions in succession and not allowing the patient sufficient time to discuss their medical issues.

The biggest issue was closing the interview with this question, “Do you have any questions?”  That is a closed question.  To encourage patients to ask questions, we should rephrase the question as an open question, “What questions do you have?”

Educational Dimension

Brace yourself and fasten your seat belt!  This was by far the weakest area.  Upon discharge, the unit nurse reviewed the discharge instructions, which were disjointed at best.  There were so many issues, I almost did not know where to begin my evaluation.  These are the problem areas and suggestions for improvement:

Excessive use of medical jargon:  The discharge instructions used the terms presyncope and mixed hyperlipidemia.  I am in the healthcare field and know what the terms mean, but what if I wasn’t in the field and didn’t know what the words meant?  Use patient-friendly language.

Ultimate diagnosis not mentioned. My mother initially fainted, but was ultimately diagnosed with dehydration by the attending physician.  Dehydration was never mentioned in the discharge report. This is a perfect of example of how poor handoffs lead to medical errors. At the time of discharge, I asked about the dehydration and how much fluid my mother should consume.  The nurse said, “About 3-4 glasses a day, I guess.” (Having a solid healthcare background, I researched the topic and developed a daily fluid intake plan for my mother.)
Vague comments. The discharge form states, “Will order Influenza vaccine.” Was it ever administered to my mother?  I called the hospital and was first sent to the Medical Records Department — they had no idea.  The Medical Records Department sent me to the unit, who also had no idea.  The unit nurse did say this, “Your Mom most likely did get the flu shot.  We usually give it to people 50 or over.”  Why didn’t the report state, “Patient was given a flu shot?”

No educational materials / resources.  In spite of the fact my mother was diagnosed with dehydration, no information was provided.  A brochure, website or organization to contact would have been helpful.

Overall, the healthcare professionals who took care of my mother were kind and skilled at their jobs.  There were some issues with the interviewing questions and empathic responding, however the biggest concern was the poor patient education component.  If patients do not comprehend their medical situation, they are at risk.

I signed the form for my mother (I have Power of Attorney).  By signing the form, I indicated I understand the discharge papers.  I actually did understand them — I have been in healthcare over 20 years.  My biggest concern is that most people will sign the form stating they understand, but they really do not.

Hospitals need to do a better job at educating patients.

Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  To book one of his high-content credit-hour-approved keynote speeches or training programs, visit or call: http://www.CommunicatingWithPatients.com / 1-800-677-3256

When Patients Want Antibiotics They Don’t Need: Offer Explanations, not Prescriptions

August 31, 2009

A patient with an upper respiratory infection comes to see you.  After performing a history and physical, you determine the patient has a viral infection.  You are concerned the patient will insist on a prescription for antibiotics.  Below are the steps to handle this patient concern.
Show Empathy
Think about how sick you felt with a respiratory illness.  They can be a miserable experience.  Here is an example of a statement you can say to a patient, “I understand you are not feeling well.  I want to assure you that I want to help you.”
Explain Difference between Viruses and Bacteria
For patients, viruses and bacteria are all “bugs.”  They do not perceive a great deal of difference between these organisms.  We need to explain to them the difference and then discuss how antibiotics are effective for bacteria, but not viruses, such as the virus causing the common cold.
You can mention to patients, “Most adults, on average, get two to three colds a year; and children can have eight to twelve colds a year. Most colds last about one week. But it’s not unusual for symptoms to continue for as long as two to three weeks.”
Describe Dangers of Antibiotics
Side Effects. Mention how antibiotics can be have unpleasant side effects. Say, “I do not want to give you a drug that will not help and possibly make you feel even sicker.” Describe potential antibiotic side effects including: upset stomach, diarrhea, rashes, and (rarely) serious allergic reactions (even with antibiotics that they may have used safely in the past).
Resistance. In addition, explain how overuse use of antibiotics can result in resistance to them.  For example, you can say, “Using unnecessary antibiotics can cause some bacteria to become resistant to the antibiotic. This increases your chances of having bacterial infections later that can’t be treated by antibiotics. This is called ‘antibiotic resistance.’”
Potential Patient Issues
Concern over Green or Yellow Mucus. A patient may state they are having green or yellow mucus and fearful that means their illness is serious.  We need to combine empathy with our explanation. You can state, “I could understand your fear.  We used to think that green or yellow mucus indicated a bacterial infection. However, today, we know this is not true. A viral infection can cause green or yellow mucus.”
Previous (Unnecessary) Antibiotic Prescription. Explain to patients that if they were given antibiotics in the past for colds that antibiotics often get credit that your body’s own immune system really deserves. Review issues of antibiotic side effects and resistance.  Also, mention newer knowledge of antibiotics.
Emphasize the use of self-care measures (such as fluids) and nonprescription medications.
It is important to remember, patient satisfaction is generally linked to communicating effectively not writing prescriptions.
The CDC has an excellent brochure for patients, “Cold or Flu. Antibiotics Don’t Work for You.”  Here is the link:

Great Communication Skills = Lower Risk of Malpractice

April 1, 2009

a pediatric oncologist who was working with young cancer patient.  The
chemotherapy.  The young girl survived this medical error.  My
first thought — that girl’s parents will immediately go to an attorney.
However, that was not the case.

The oncologist spoke to the girl’s parents and explained what happened.
another oncologist.”  The
daughter — we won’t have it any other way!”  By the way, they also told
the oncologist they had no plans to take legal action.

— they liked the oncologist.  In general, people don’t sue people they

Association (JAMA)
included an enlightening article called,
“Physician-patient communication. The relationship with malpractice claims
identify specific communication behaviors associated with malpractice
history in primary care physicians and surgeons. The research compared
using audiotapes of 10 routine office visits per physician. The study
consisted of 59 primary care physicians (general internists and family
practitioners) and 65 general and orthopedic surgeons and their patients.
significant differences in communication behaviors of no-claims and claims
physicians in the primary care physicians group (no differences in
care physicians included:

Length of primary care office visit
The study demonstrates a strong
correlation between extra time spent with patients and lower frequency of
malpractice claims. Since patients dislike feeling rushed or ignored,

Engaging in a dialogue
Physicians should encourage two-way communication that includes:

talk about ways to treat the problem.”

and advice in a manner that demonstrates the
physician’s genuine caring tends to diffuse patient anger and resentment.

Physicians who have been sued for malpractice often cite “unrealistic
patient develop appropriate expectations about a medical visit, and
prompts the sharing of critical information.

Breakdowns in communication between physician and patient fuel distrust
other hand, effective communication skills tends to enhance patient

The study identifies specific and teachable communication behaviors
associated with fewer malpractice claims for primary care physicians.
Physicians can use these findings to improve communication
and decrease malpractice risk.

The Cleveland Clinic Foundation Offers Novel Approach to Dramatically Improving the Patient Experience

March 2, 2009
M. Bridget Duffy, MD, Chief Experience Officer, from the Office of Patient Experience, speaks with staff members

The Cleveland Clinic Foundation is always on the cutting edge of
breakthrough medical treatments.  However, the organization is also at the
forefront of meeting the human needs of patients.

The Cleveland Clinic Foundation created the Office of Patient Experience
(OPE), whose mission is to “create an environment that delivers superior
clinical care while valuing human-to-human interactions as a critical
component of healing.”

Through OPE, the Cleveland Clinic Foundation main campus and several
system hospitals developed councils, which focus on empowering
patients and families to take an active role in their healthcare
experience. The councils also serve as an advisory resource for employees,
staff and administration.

The Cleveland Clinic Foundation has 26 institutes that group multiple
specialties together to provide collaborative, patient-centered care.
Each institute designates a doctor and nurse to be part of the OPE
Council.  It is important that every segment of the system be represented.

Throughout the system, the councils work to impact four dimensions of the
patient experience (organizational culture dimension, clinical dimension,
emotional dimension and physical environment dimension).

There are many projects in each dimension.  Here are some examples:

Cultural/Staff and Employee Engagement Dimension
In order to deliver excellent clinical care and create meaningful patient
experiences, employees need to feel they are having a significant impact.
The councils help define, implement and communicate activities that
specifically enhance the employee experience, which in turn, positively
effects the patient
experience.  This includes work-life balance activities, such as
complimentary memberships to gyms and weight loss programs.

Clinical Dimension
Patients often feel confused and overwhelmed within the healthcare system.
The OPE is currently piloting a Health Navigator program that will assist
patients in understanding an often complex healthcare system.  The
dictionary defines “Navigation” as the process of plotting or directing
the course of a vessel.  In this case, we talking about helping patients
find direction through the healthcare system.

Emotional Dimension
Excluding wellness checks, when patients enter the healthcare system,
there is something wrong.  The condition they are experiencing can lead to
feelings of anxiety and / or depression. A program called Healing
Solutions focuses on improving the patient experience by promoting
positive activities.  An example of this program is offering massotherapy
to reduce stress.

The dimension also helps employees.  For example, if a healthcare
professional is devastated by the loss of a patient they had grown very
fond of, a “Code Lavender” can be pulled.  In this way, the employee can
be comforted by one or more people from Healing Solutions.  They also have
the option of wearing a lavender bracelet so other people would know they
are gong through a difficult time and offer their support.

Physical Environment Dimension
This area focuses on the physical environment to provide comfort and
support for patients.  This includes artwork throughout the system.
Music and dance performances also play a role in creating a therapeutic

I recently watched a TV medical drama and one doctor on the show said, “We
have a breast cancer in room 110, a heart murmur in room 118.”  Patients
are not simply “disease states.”  This type of conversation would never be
at the Cleveland Clinic Foundation who value the entire patient and this
is exemplified through the Office of Patient Experience.

For more information about the Cleveland Clinic Foundation’s Office of
Patient Experience, please contact: 216.445.5230 or

Edward Leigh, MA, is the Founder and Director of the Center for Healthcare Communication.  For more information about his high-impact communication skills programs, visit or call: http://www.CommunicatingWithPatients.com or call 1-800-677-3256

Giving Bad News: An Effective Three-Step Approach

January 28, 2009

“Breaking bad news is not as much a delivery as it is a dialogue between
two people.”
— Rabow MW, McPhee SJ. Beyond breaking bad news: how to help patients who
suffer. West J Med 1999;171:260-3.

One of the most difficult tasks for a healthcare professional is to
deliver bad news.  It is never an easy activity even for the most seasoned
of professionals.  However, there are steps we can take to be sure the
news is delivered in the most effective and caring manner.

The Definition of “Bad News”

We tend to think of bad news as telling a patient they have a terminal
disease.  However, that is a type of bad news.  There are multiple types
of bad news.  For example, telling a construction worker he can’t lift
heavy objects for six months is bad news if that is his livelihood.  Also,
telling a person they have a chronic disease, such as diabetes, is also a type of
bad news.

Bad news can be any type of news that will negatively impact a patient in
any way.

Is it Always Necessary to tell a Patient the Bad News?

Fifty years ago, it would not be unusual to withhold a terminal cancer
diagnosis from a patient.  However, recent studies have shown that
patients do want to know this information.  It is important that patients
are given all the details of their health situation; they have a right to
know.  They may want to make decisions regarding wills and other legal

Based on a case-by-case basis, there may be situations where withholding
information may be a good option, such as in the case where a patient may
have a mental breakout or harm themselves.  In some cases, the patient
themselves may ask not be told.  This should be looked at as a type of
informed consent.

Steps in Giving the Bad News

I. Before Giving the News

Think about the agenda before you meet the patient, so that you have the
significant information available. There are several items to consider
when planning what to say:  specific diagnosis, treatment plans,
prognosis, and support strategies. For a patient who has been shown to
have hypertension, this would be an appropriate manner of discussing:
specific diagnosis (describe diagnosis of high blood pressure, avoid
medical jargon like the term hypertension), treatment plans (discuss
different options to treat high blood pressure), prognosis (discuss
successful options for treating, however be careful of not guaranteeing
100% success), and support strategies (provide resources to help cope).

Prepare for the conversation with the patient.  Think about what you want
to say.  Mentally rehearse your words so you feel more comfortable sharing
the news.

Have a box of tissues in the room in case the patient begins to cry.

II. Giving the News

Physical setting: Find a quiet private place to share the news.  Be sure
you are seated at eye level with the patient.  Avoid any physical
barriers, such as a desk.  Ask the patient who else should be present; let
the patient decide who, if anyone, should be present in the meeting.
Silence all beepers and request no interruptions unless it is an absolute

Communication strategies:
* Give the patient a warning that difficult news is forthcoming, such as by
stating, “I’m afraid the results reveal the situation is more serious than
we would have hoped for …”)
* The patient is your first priority, however if the patient has other
people present (e.g., spouse), be sure to attend to those people as well.
* Speak slowly, clearly and concisely.
* Provide the information in small chucks; do not give a long lecture which
can be overwhelming to an already anxious patient.
* After discussing each segment, pause to allow the patient to take in what
you have stated.  This is known as “chunk and check.”
* Be honest about the prognosis; do not give false hope.  Be sensitive, yet
* Use empathy in the discussion (e.g., “I know this is difficult news.”)

Assess current level of knowledge.  Determine how much the patient already
knows, such as by asking, “What have you already been told about your
illness?” Pay close attention to what the patient says to evaluate their
of sophistication regarding the illness and their current emotional state.

Ask the patient how much they would like to know.  Inquire as to whether
they want all the details or just the “big picture.”  Emphasize the
fluidity of the dialogue, so they know they could always ask more
questions at a later time.

III. After Giving the News

Be very attentive to the patient’s feelings.  After you have shared all the
news, listen very carefully to the patient’s reaction while observing body
language.  Use empathy (e.g., “I know this has been very stressful to hear.”)

Emphasize your role as a partner.  Let the patient know you are working with
him or her on this medical issue (“We will be working together to help
you.”).  Confirm your role as an advocate for the patient.

Follow up plan.  This is a time for reviewing, summarizing and making next
steps.  Develop a step-by-step plan, review the plan with the patient and
then agree on follow up plans.  Provide resources, which could be a
referral to a counselor (if needed), brochures, phone numbers and

Closing Thoughts

Healthcare professionals are taught technical skills to attend to the
patients’ physical needs.  However, when giving bad news, the greatest
skill is effective communication.  Unfortunately, during a healthcare
professionals’ formal education, communication skills are often not given
the vital importance they deserve.  A growing body of evidence illustrates
how the communication skills of the healthcare professional will greatly
influence how well a patient will cope with the bad news.

Communication.  To book one of his high-content energetic keynote
speeches or training programs, visit or call:


Photo365 - 342 - Apple Market

09/12/2011 - 00:06

I'm just back from London following a night out with Samsung for their Christmas party.

They have a huge Christmas tree but I've already photographed two in this Photo365 series, so here's a shot of the Apple Market (also looking quite festive at the moment) close by.


White House seeks ban on gay and gender identity conversion therapies

Washington (CNN)Responding to a petition begun when a transgender teenager died from suicide after being subjected to therapy meant to alter her gender identity, the White House announced on Wednesday it supports banning the so-called conversion practices.

Writing an official administration reaction to the petition, which garnered more than 120,000 signatures, President Barack Obama's senior adviser Valerie Jarrett wrote the "overwhelming scientific evidence demonstrates that conversion therapy, especially when it is practiced on young people, is neither medically nor ethically appropriate and can cause substantial harm."
    A federal ban on the practice, which its proponents claim can change a person's sexual orientation or gender identity, would require congressional approval, Jarrett noted. She urged individual states to ban the therapy given studies showing its potential harm to those subjected to it.
    Some states, including California and New Jersey, have also put in place bans on conversion therapy.
    The American Psychiatric Association has found no evidence that conversion therapies are effective, and advocates against their use because of the psychological risks they pose, including depression and anxiety.
    Obama has taken numerous steps in the last year to bolster the rights of gays and lesbians, including signing an executive order barring discrimination based on sexual orientation within the federal government and at federal contractors. That order went into effect on Wednesday.
    In a symbolic step, the administration also said on Wednesday it had opened a gender-neutral bathroom within the White House complex.
    The "all-gender restroom" is in the Eisenhower Executive Office Building, next door to the West Wing, within the White House complex where many White House employees have meetings and offices.
    The White House now allows staff and guests to use restrooms consistent with their gender identity, including in the West Wing.
    "The White House allows staff and guests to use restrooms consistent with their gender identity, which is in keeping with the administration's existing legal guidance on this issue and consistent with what is required by the executive order that took effect today for federal contractors," White House spokesman Jeff Tiller told CNN. "In addition, an all-gender restroom is also available in the Eisenhower Executive Office Building, which provides guests and staff an additional option."
    While the White House is highlighting these bathroom changes now, in conjunction with the implementation of the executive order, it's unclear when the change actually occurred.
    The news of the new bathroom was first reported Wednesday afternoon by "The Advocate."


YouTrack InCloud 2017.4 Help

Export Issues as a CSV File

YouTrack lets you export a list of issues as a CSV file. You can use this option to upload issues to another application or use third-party software to compile reports.

This option is available from the rom the Reports drop-down list on the issue list.

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When you select this option, the list of issues is filtered to match the current search query and context. The CSV file contains the following details for each issue:

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Last modified: 28 February 2018


Nov 14, 2007

Gender Items

ZIPLOC BAGS - male, because they hold everything in, but you can always see right through them.

SWISS ARMY KNIFE - male, because even though it appears useful for a wide variety of work, it spends most of its time just opening bottles.

KIDNEYS - female, because they always go to the bathroom in pairs.

SHOE - male, because it is usually unpolished, with its tongue hanging out.

TIRE - male, because it goes bald and often is over inflated.

HOT AIR BALLOON - male, because to get it to go anywhere you have to light a fire under it... and, of course, there's the hot air part.

SPONGES - female, because they are soft and squeezable and retain water.

WEB PAGE - female, because it is always getting hit on.

- male, because it uses the same old lines to pick people up.

HOURGLASS - female, because over time, the weight shifts to the bottom.

HAMMER - male, because it hasn't evolved much over the last 5,000 years, but it's handy to have around.

REMOTE CONTROL - female... Ha! You thought I'd say male. But consider it gives a man pleasure, he'd be lost without it, and while he doesn't always know the right buttons to push, he keeps trying.


Artist Bio: Cora-Allan Wickliffe

Cora-Allan Wickliffe is a Multi-disciplinary artist who produces work that is heavily influenced by her Maori and Niuean cultural ancestry. In the last few years she has developed strong performance based work that explores constructed identities and translates traditional elements in performances as she shares them in a contemporary space.


Diabetes Diet and Guidelines

What is a diabetic diet? Is there only one or many? What does a diabetic diet consist of? All these questions and more will be answered in this article.

A diabetic diet is an eating plan or diet recommended for people with diabetes mellitus to assist them in controlling their blood sugar.

A diabetes diet is medically known as Medical Nutrition Therapy. It is rich in nutrients, low in fat and calories and high in vegetables, fruits and whole grains. In such a diet, individuals are encouraged to eat moderate amounts of food and stick to regular mealtimes.

The importance of eating dietary fiber is emphasized in such diets and it is even said that carbohydrates eaten with dietary fiber results in a lower glycemic status (level of sugar in the blood) than the same amount of carbohydrates otherwise consumed alone.

It has been recommended that between 40 to 65% of calories should be obtained from carbohydrates, although the American Diabetes Association in 1994 recommended 60 to 70%.

This latter recommendation has been criticized by various individuals who rather canvassed a low carbohydrate diet. Richard K Bernstein is one of such individuals. His own diet limits carbohydrate intake to just 30 grams per day along with strenuous muscle building exercise and frequent blood glucose monitoring.

Futurologist Ray Kurzweil who was previously diagnosed with diabetes likewise advocates a carbohydrate intake of one sixth of total daily caloric load.

Taking a cue from the fact that a diet high in dietary fiber has been shown to be very beneficial, studies have been made on vegan diets (diets of vegetarians). These studies show that such diet not only also help to lower hemoglobin A1C and LDL levels but also advanced glycation end products. Glycated end products are proteins or lipids which having been exposed to sugars become glycated (covalently bonded with a sugar molecule without the controlling action of an enzyme).

In the United Kingdom though, there is the Eat Well plate which is the national food guide designed to help UK citizens have a healthy balanced diet. It is based on the basic five food groups and the guide stipulates the percentage of a person’s plate that should be made up of each food group.

Thus Fruits and vegetables – 33%, Bread, rice, potatoes, pasta and other starchy foods – 33%, Milk and other dairy products – 15%, Meat, fish, egg, beans and other non-dairy sources of protein – 12% and foods and drinks high in fat or sugar – 7%.

It is noteworthy that the second group though should be whole grain-that is whole wheat bread, brown rice etc. and not refined grains like white bread and white rice. Where this is so and bearing in mind that the diet falls within the bounds of the recommended stipulation of between 40 to 65% calorie to be obtained from carbohydrates, it can be said that it is also a good diet for diabetics.

Likewise the United States Department of Agriculture (USDA) have the MyPlate nutrition guide which replaced the USDA’s pyramid guide on June 2, 2011. It is basically a plate plan requiring that 30 percent of a meal be grains, 40 percent vegetables, 10 percent fruits, and 20 percent protein. A small amount of dairy (product), such as a glass of milk or a yogurt cup is also included.

This plan was revised by the Harvard School of Public Health in their Harvard Healthy Eating Plate. Their revision features an additional percentage increase of vegetables over fruits whilst at the same time balancing healthy protein and whole grains as equal quarters of the plate.

On the other hand the American Diabetic Association recommends that you create your own plate by following these simple steps;

1. Fill the largest section with non-starchy vegetables such as:

spinach, carrots, lettuce, greens, cabbage, bok choy
green beans, broccoli, cauliflower, tomatoes,
vegetable juice, salsa, onion, cucumber, beets, okra,
mushrooms, peppers, turnips

2. Now in one of the small sections, put grains and starchy foods such as:

whole grain breads, such as whole wheat or rye
whole grain, high-fiber cereal
cooked cereal such as oatmeal, grits, hominy or cream of wheat
rice, pasta, dal, tortillas
cooked beans and peas, such as pinto beans or black-eyed peas
potatoes, green peas, corn, lima beans, sweet potatoes, winter squash
low-fat crackers, snack chips, pretzels and light popcorn

3. Then in the other small section, put your protein such as:

chicken or turkey without the skin
fish such as tuna, salmon, cod or catfish
other seafood such as shrimp, clams, oysters, crab or mussels
lean cuts of beef and pork such as sirloin or pork loin
tofu, eggs, low-fat cheese

To complete your meal, add a low-calorie drink like water, unsweetened tea or coffee”.

With regards to meal times, as a diabetic, it has been said in Sons ken, Fox and Judd that the length of time before a meal that one should inject insulin would depend on the type of insulin one is injecting. Whether it is long, medium, or quick acting insulin.

For instance where a low blood glucose reading just before bedtime of below 6 milimoles per liter (108 mg/dL) is evidenced, it is suggested that the patient should take some long acting carbohydrate before retiring to bed to prevent night time hypoglycemia (abnormally low levels of blood sugar).

Now as far as the don’ts go, as concerns alcohol, it is recommended that people with diabetes who take insulin or other medication such as sulphonylureas should not take alcohol on an empty stomach. The reason for this is that alcohol interferes with glycogenesis (the process of storing glucose in the form of the polysacharride called glycogen) in the liver and some drugs inhibit hunger pangs. This in addition to impaired memory, judgement and concentration caused by some drugs can lead to hypoglycemia.

Let us now consider some specific diets. There are several and all have at one time or another been very popular. These still enjoy varying degrees of patronage, though some more than others.

The low Carb diet

This diet advocates that the removal of carbohydrates from the standard diet may help reverse diabetes. Following this removal, the diet would consist of fatty foods such as nuts, seeds, meats, fish, oils, eggs, avocados, olives and vegetables. Fat would become the main energy source and insulin resistance related complications would greatly reduce.

The high Fiber diet

Showing better results than the American Diabetes Association recommended diet, this diet is said to control blood sugar levels with the same efficacy as oral diabetes drugs.

The Paleolithic diet

Premised on what our ancient human ancestors likely ate during the Paleolithic age and as a result of which they enjoyed diabetes (among other diseases) free good health, the Paleolithic diet consists mostly of lean meat, nuts and berries. Tests show that this diet improves glucose tolerance in humans with diabetes and in humans with ischemic heart disease and glucose intolerance.

The Pritkin diet

Is made up mostly of fruit, whole grains, vegetables and the like. It is high in dietary fiber and carbohydrates. It balances its high carbohydrate content however by including exercise as part of its stipulated regimen.

The G.I. diet

Aims at lowering the glycemic index of a persons diet with a view to assist the user in the control of his/her diabetes. Here multi-grain and sourdoughs, legumes and whole grains- foods that are converted more slowly to glucose in the blood stream serve as replacement for others like white bread and potatoes cooked a certain way.

One should not also forget the vegan diet which has an ability to improve glycemic control similar to the ADA diet.

The Newcastle Diet

Lastly it is worth mentioning the Newcastle diet. Although strictly speaking, it may not be the sort of diet one continues with once the initial objective has been met, it is worth mentioning.

The diet is geared towards people who seek to bring their blood sugar levels back to normal and so technically, “cure” their diabetes. The diet is a liquid one containing carbohydrate, protein, fat, vitamins, minerals and trace elements. It provides 600 calories a day and is supplemented by 3 portions of non-starchy vegetables, thereby bringing total calories to 800 a day.

The diabetes fighting aspect of the diet is premised on the fact that its low calorie base, results in the individual losing weight. At the abdomen, this means that the liver and pancreas are less clogged with fat and as such the pancreas is more effective in producing insulin whilst the liver is better able to react to it.

And so bearing in mind that diet forms an essential part of managing diabetes, it is important that a diabetic takes his diet seriously. Usually his doctor and or other healthcare professional will ensure this as well as advise him on a general diet to follow.

However, where he seeks a specific diet, he should endeavor to stay not only informed on the types available, the relative advantage each confers, but also seek his doctors advise so as to make an informed decision. When this is done and done aright, there is no doubt that for a diabetic, diet can serve as a veritable tool in the fight against diabetes.


How to make Women – Attract Young girls Through The Special product Power with Laughter

“Every woman is a science, ” said John Donne. Of course, if we take the time to carefully examine their needs, we’ll locate some fairly universal basics about the differences between males and females. There are always exceptions to the rule, but here are some significant things that men should be aware about women.

Women are not since competitive as we are. Only a small amount kids growing up, kids play games in significant groups with an increased exposure of winning. Competition is the identity of this male-gender game, pretty much. Little girls, on the other hand, play along in small, intimate people, with an emphasis on minimizing hostility and maximizing assistance.

The same emphasis follows both genders into adulthood. One of the many fundamental differences between people is that we still desire to prove our stage, keep score, and get the debate in connection, while women are more likely to sacrifice superiority as the price designed for keeping peace.

Females focus on the here-and-now more than we do. Someone determined the future as a place where men spend most of most of the time. You and I actually both know that’s not exactly true. But it becomes truer in comparison to the differences between men and women.

While we are scheming plans and solving problems for a better tomorrow, most women are asking, “What’s going on right now and how do I (and others) feel about it? inches One of the things that males should know about women can be that they focus on current a feeling and experiences because these kind of build emotional bonds from connection between them.

Women are not as independent as we happen to be. Let’s face it, we love the mystique with the rugged “Marlboro Man” graphic. Sure, it’s clich, although we can’t get over this kind of tough-minded, lone cowboy exactly who reports to nobody as he freely rides the product range. Women, on the other hand, couldn’t convey a can of beans regarding protecting their autonomy — one of the primary differences somewhere between men and women.

Therefore, while we men are usually more interested in the “report” from what has happened and where we are going, gals are more interested on setting up “rapport” right now (1). All sorts of things that if you want to get as small as the task of solving trouble for the future with the women in the life, you must first take the time to explore their feelings to the present.

It’s not that any particular one mode is necessarily superior to the other; they both have their strengths and weaknesses. But if we should build a healthy relationship with the women in our lives, we must honor their cooperative heart, take care not to step on the toes, and work to learn the unique differences between people.

Therefore don’t expect women to totally understand and accept your “need for space. ” One of the things that males should know about women is that they won’t romanticize ones independence. Instead, do your self and your relationships with women a favor – attack the bullet and let them know you value the relationship even though you need to ride the range.

They prize everything that Harvard’s Carol Gilligan phones “a web of connectedness. ” Just as we are threatened by a challenge to our independence, so are women threatened using a rupture in their relationships.


• tcmwell.com

Female depression prevention

Updated: Monday, Mar 17,2014, 10:09:40 PM
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Depression is a serious " psychological cold" , the high incidence , but this should be relatively high incidence is 62.9 % of patients with depression never seek medical treatment after . Because there are many people suffering from depression did not perceive themselves had depression , illness and some patients and their families will not be blamed on some important issues , that is the " spur ."

In fact, the incidence of depression when they are perceptible . If a person has depression similar performance , even in other comprehensive hospital for the relevant inspection found no unusual problems , then we must be alert to the possibility of depression , to go to professional psychological and mental health institutions for treatment . As a family or companions , identify problems and timely to remind patients to receive treatment is very important .

The etiology of depression , and now research suggests that the main factors involved in the social and psychological aspects of their quality . In females, psychosocial factors primarily with personal character or personality , social pressures and ways to cope with stress related . Studies have shown that introverted , sensitive, pessimistic, do not like contact, lack of interest in hobbies of people prone to depression ; those unpleasant experiences such as widowhood , divorce, romance, unemployment , loss of health , interpersonal tensions , economic hardship , or lifestyle the possibility of dramatic changes of people suffering from depression greater ; there are a lot of smoking, alcohol , drugs and drug -dependent people are prone to depression .

Of course , the most common cause of depression is the most important reason is the biological factors , such as neuroendocrine hormones , biochemical , and genetic and other factors , the most important neurotransmitters is happy to pass the patient information is reduced. Women are an integral part of all aspects of society , women in multiple roles , so that they have a higher risk of occurrence of depression , in addition to a lot of pressure , they have to face gender discrimination, overwork , menstruation, pregnancy, lactation and other factors. Since these women their own physical and psychological characteristics , resulting in the occurrence probability of depression than men was nearly twice as much.

Women risk of depression in adolescence is the beginning of sustained growth period until after the decline, there is a peak incidence of menopausal women , post- menopausal women to the risk of new-onset depression decreased.

In the treatment of depression , drug treatment is fundamental, psychological counseling is assisted . Because drug treatment recover faster , making more time for patients from suffering. Of course, some psychological treatment such as cognitive behavioral therapy is an effective treatment for psychological treatment for depression , but these treatments took longer than normally takes six months or even more than half of the treatment, and drug therapy generally requires 1-2 January symptoms will be controlled.

Under the guidance of doctors to help patients develop positive coping strategies are also important , such as helping patients to change cognitive bias thinking , cultivate a positive attitude ; , or to help patients through the little bed , more activities, go for a walk , listen to music , learn to relax , such as changes to the original behavior.

Most symptomatic treatment of depression after the recent treatment effect is quite significant. Of course, the main problem is likely to face recurrence. The impact of depression relapse following reasons : failure to antidepressant medication ; has negative life events after remission ; poor family and social support .

Although the cause of depression is unknown, but there are still a useful preventive measures of depression . For example, appropriate to reduce stress, relax, change negative ways to cope with stress , culture and people of good and effective interpersonal communication is effective for the prevention of depression . Playing , climbing , swimming and other sports, at the same time enhance physical fitness , but also can reduce the symptoms of depression ; in nutrition , fish, whole grains , garlic, brightly colored carrots, oranges, bananas , etc., may be helpful to resist depression .

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Stress may prove to be contagious: Study

Toronto March 10: Scientists, including one of Indian origin, have found that stress transmitted from others can change the brain in the same way as a real stress does.
The study, in mice, showed that the effects of stress on the brain are reversed in female mice following a social interaction. This was not true for male mice.
"Brain changes associated with stress underpin many mental illnesses including PTSD, anxiety disorders and depression," said Jaideep Bains from the University of Calgary in Canada.
"Recent studies indicate that stress and emotions can be contagious. Whether this has lasting consequences for the brain is not known," Bains said.
For the study, published in the journal Nature Neuroscience, the researchers studied the effects of stress in pairs of male or female mice.
They removed one mouse from each pair and exposed it to a mild stress before returning it to its partner.
They then examined the responses of a specific population of cells, specifically CRH (Corticotropin releasing hormone) neurons which control the brain's response to stress, in each mouse, which revealed that networks in the brains of both the stressed mouse and naive partner were altered in the same way.
"What was remarkable was that CRH neurons from the partners, who were not themselves exposed to an actual stress, showed changes that were identical to those we measured in the stressed mice," said Toni-Lee Sterley from the University of Calgary.
The researchers discovered that the activation of these CRH neurons causes the release of a chemical signal, an 'alarm pheromone', from the mouse that alerts the partner.
The partner who detects the signal can in turn alert additional members of the group.
This propagation of stress signals reveals a key mechanism for transmission of information that may be critical in the formation of social networks in various species.
The researchers suggested that these findings may also be present in humans.
"We readily communicate our stress to others, sometimes without even knowing it. There is even evidence that some symptoms of stress can persist in family and loved ones of individuals who suffer from PTSD," Bains said.
"On the flip side, the ability to sense another's emotional state is a key part of creating and building social bonds," he added.


aim darts shoot makelessnoise via Flickr
Interest rates today are expected to remain at a low well into 2015, which directly influences consumers' ability to earn decent returns on deposit accounts.

Despite this reality, not many Americans truly comprehend how banks set interest rates and what factors play a role in how rates change.

Bank interest rates aren't simply determined at the whim of any given bank or credit union, with no direction or benchmark.

On the contrary, there are a handful of key elements that sway interest rates today in consumers' favor — or against it.

#1. Federal Reserve Requirements

The Fed enforces a minimum reserve requirement, also called a cash reserve ratio, on banks that are members of the Federal Reserve. These institutions are required to withhold a percentage of their liabilities in either a cash vault or in a Federal Reserve Bank at all times.

Each year, the Fed assesses how much in cash reserves financial institutions must set aside; the requirements are outlined in the Federal Reserve Board's Regulation D.

Reserve percentage requirements are based on a bank's net transaction accounts (such as checking accounts), which effective December 27, 2012, are as follows:

  • $0 - $12.4 million: 0% in reserves
  • $12.4 million - $79.5 million: 3% in cash reserves
  • Over $79.5 million: 10% in reserve requirements withheld

Why does all this matter? Banks that don't have enough depositors to uphold their reserve requirement have the option to borrow funds from other banks through short-term loans to ensure the reserve requirement is met.

Banks are then charged by other banks interest on the loan, which is called the Federal Funds Rate — this cost of borrowing money is passed on to consumers via bank interest rates and adjustments on loan products like auto loans and mortgage loans.

#2. Discount Rate

The discount rate is another benchmark which determines how banks set interest rates. In addition giving banks the option to lend among one another, the Fed itself provides loans to help banks meet the reserve requirement at a "discount rate" for the loan.

This direct loan from the Federal Reserve is typically higher than the Federal Funds Rate, but has recently been lowered to supply institutions with a greater ability to provide loans to businesses and consumers. The lower the rate banks have to pay when borrowing funds from the Fed, the more affordable lending interest rates today are for consumers.

#3. Anticipated Inflation

When financial institutions determine the deposit and loan rates offered to customers, consideration is given to the potential inflation rate anticipated in the future.

Fergus Hodgson, Director of Fiscal Policy Studies for the John Locke Foundation in North Carolina, shares why this seemingly convoluted concept makes a great deal of difference on interest rates today.

"Inflation, the devaluation of a currency expressed in higher price levels, is one of two underlying drivers of retail interest rates — the other is the activity of the Federal Reserve system," explains Hodgson. "In the presence of higher inflation, which the United States is beginning to experience, lenders need to raise their rates in order to generate a return. Relatively speaking, the money they receive when paid back will be less valuable, which offsets the interest rate charged."

As lenders attempt to compensate for the rate of inflation, borrowers will likely continue seeing bank interest rates follow in suit.

"Consider a mortgage loan at an interest rate of 5 percent, alongside an inflation rate of 2 percent. The real interest rate or return to the financial intermediary is 3 percent annually. If the rate of inflation were to rise to 5 percent, the intermediary would need to offer comparable loans at a rate of 8 percent for an equal return," Hodgson illustrates.

#4. Demand For Loans

The fundamental idea of supply and demand resonates strongly with how interest rates are set as well. Since the economic recession, for example, fewer Americans have been financially capable — let alone willing — to take on large amounts of debt, such as a mortgage loan toward a home purchase. An over-saturated mortgage market (i.e. higher supply of mortgage loans) results in lower loan rates due to a lack of demand. The reverse also functions in the same way.

#5. Risk of Default

Lenders always take on a certain level of risk when lending money to borrowers. Those with a history of late payments or poor credit, for example, will likely exhibit the same dangerous financial behavior with a newly acquired loan.

For this reason, bank interest rates are increased on loans by financial institutions in an effort to hasten and secure the return of their money in the event borrowers don't make good on their promise to repay the loan within the pre-determined term.

While a lot of the factors affecting interest rates today are out of consumers' immediate control, maintaining a clean line of credit and taking the initiative to shop around for the best bank interest rates in the area opens the door to interest rates on deposit and loan products that meet customers' needs.

NOW READ: 21 ways rich people think differently >


This joint initiative between two leading South African wine producers, Du Toitskloof Wines from Rawsonville and Douglas Green Wine based in Wellington, takes the form of a brand new Mercedex Benz Axor truck fitted with a 15m trailer wherein lies a treasure trove of education material.

Some 5000 brand-new books, specially selected for school-children between Grades 1 and 5, stand between a set of ten out-of-the-box computers with full internet access from an on-board router. Included in the computer programmes is software developed by internationally renowned hand-eye co-ordination specialists Eye Gym which helps children to improve their learning skills.


Supply chain resilience - The case for understanding the ROI in resilience

Blog post   •   May 13, 2016 16:23 BST

Supply chain resilience is a topic that has been debated considerably over the last few years, which has resulted in attempts by various institutions to provide guidance on or standards for discrete elements of the topic. Ensuring greater resilience in your supply chains creates a greater value for money proposition than a supply chain that is fragile and frequently creates disruptions to your business. Understanding exactly what you are paying for in terms of resilience, and using that knowledge to create appropriate levels of investment in supply chain resilience, will give you a competitive advantage.

Procurement includes the management of risk within the category of spends or market being managed by the procurement professional. Supply chain resilience is a component part of overall organisational resilience and contains within it, elements of risk management and business continuity management. Procurement includes all of these components and more, taking into consideration such components as financial resilience, human resources, health and safety, fraud, slavery, sustainability and corporate social responsibility.

For example, what is the appropriate way to analyse the current levels of resilience within your supply chain, for those you are in contractual relationships with? How will you migrate future procurement competitive bidding processes to include resilience assessed total cost of ownership?

How can you add value by exposing the costs associated with investment in resilience within your supply chains and make a calculated informed judgement as to if you are paying the appropriate costs, too much or too little.

Undertaking a more objective calculation of the risks in your supply chain to understand the onerous costs of a supply chain disruption and the cost benefit analysis associated with reducing the chance of a disruption or recovering from one.

How to utilise good practice when analysing the market and going through prequalification to achieve shortlists?

Understanding the costs associated with service level agreements for business as usual within a contractual arrangement and expectations of service during a disruption. Calculating the costs and the cost benefit of adding specific risk and business continuity terms and conditions within a request for offers be it quotations or formal tenders, public sector or private sector and how will this affect you as a bidder?

What methodology would you undertake to utilise resilience as a distinguishing factor when undertaking bid analysis, negotiations and best and final offer due diligence?

How do risk mitigations and continuity responses feature in supplier relationship management and are they embed in contractual relationships appropriately and adequately reflected in supplier relationship management information, through self -assessment or quality audits.

Finally will your internal or external auditors in undertaking an audit of supply chain resilience give you a clean bill of health on managing risk and continuity issues appropriate to your corporate objectives and corporate risk appetite? Does your corporate attitude to risk and continuity reflect the wishes of your 'Top Management' Executives and Audit Committees

David J. Window is a CIPS Senior Consultant and Head of Supply Chain Resilience. Discover more about the return on investment of supply chain resilience during David's BCAW webinar on the 16th May. Click here to register.


Cancer Teleconference

Benefits Of Cancer Teleconference

Communication is an essential part of our life and because of this, man has always strived to make improve the modes of communication since tome immemorial. The first speech acts themselves came because of the need for humans to communicate with each other. Throughout man history the modes of communication have only improved. The invention of the telephone was a turning point in history when it became possible for people to communicate with each other using normal speech despite the distance separating them. The coming of the internet was another turning point in human communications. Nowadays, one of the most frequently used methods of communication is teleconference and this mode has its uses not only in the field of normal communications and in industry but also in the field of medical science. Teleconferences like cancer teleconference can help save lives and help those who are in need of help.

A teleconference is a mode of communication which enables the effective interaction between two or more people at the same time. The people may be located miles apart but the costs of communication need not be huge in all cases. Teleconferences help in reducing the limitations that come with physical distance.

Cancer teleconference – Medicines and treatment

The recent advances in the field of medicines and treatment has made it possible for men and women suffering from the deadly disease to get cured or live with the disease for a longer period of time. A cancer teleconference can help the medical advisor and the patient or each out to each other and erase the problems related to geographical distance. It is indeed an unfortunate situation if distance is the only factor which stops a patient from getting treatment from a specialist in the field. The importance of cancer teleconference in the field of medicine cannot be undermined.

In the field of medical science, cancer teleconference services are a boon to those who are suffering and looking of help. A cancer teleconference can help the doctor and the patient to consult each other face to face using technology which helps then to see each other. Using cancer teleconference, the doctor can correctly examine as well as diagnose the disease. After this, the specialist can keep in touch with the patient and keep providing the correct advice and help using long distance teleconferences.

Teleconference seminars

Not only as a diagnostic tool, a cancer teleconference can help in speeding up cancer research. This can be done by the use of teleconference services which could help those involved in cancer research to exchange knowledge and information, speeding up the process of cancer research. Teleconference seminars can help the doctors and researchers to exchange notes about the

Apart from this, a cancer teleconference can also help the patients to remain in contact with each other and provide emotional support to each other along with providing the chance to exchange notes on how to cope with the disease. Such support groups are seen to be really helpful in helping patients cope with the disease. Such seminars can have patients as well as doctors communicating with each other and fighting the disease together.


Chapter 8 - Akshara Brahma Yoga

Path of the Eternal God

The eighth chapter of the Bhagavad Gita is Akshara Brahma Yoga. In this chapter, Krishna reveals the importance of the last thought before death. If we can remember Krishna at the time of death, we will certainly attain him. Thus, it is very important to be in constant awareness of the Lord at all times, thinking of Him and chanting His names at all times. By perfectly absorbing their mind in Him through constant devotion, one can go beyond this material existence to Lord's Supreme abode.

Go to Verse

Verse 1

Arjuna said: O supreme person, what is that Brahman? What is that which exists in the individual plane? What is action? And what is that which is said to exist in the physical plane? What is that which is said to be existing in the divine plane?

Verse 2

O Madhusudana, how, and who, is the entity existing in the sacrifice here in this body? And at the time of death, how are You to be known by people of concentrated minds?

Verse 3

The Blessed Lord said: The Immutable is the supreme Brahman; self-hood is said to be the entity present in the individual plane. By action is meant the offerings which bring about the origin of the existence of things.

Verse 4

That which exists in the physical plane is the mutable entity, and what exists in the divine plane is the Person. O best among the embodied beings, I Myself am the entity that exists in the sacrifice in this body.

Verse 5

And at the time of death, anyone who departs by giving up the body while thinking of Me alone, he attains My state. There is no doubt about this.

Verse 6

O son of Kunti, thinking of any entity whichever it may be one gives up the body at the end, he attains that very one, having been always engrossed in its thought.


Servicio de Información Comunitario sobre Investigación y Desarrollo - CORDIS

MARINECO Informe resumido

Project ID: ICA2-CT-2000-10049
Financiado con arreglo a: FP5-INCO 2
País: Russia

Hydrogen production by seawater electrolysis and its features

Among other means of energy accumulation and reservation the particular significance is the possibility to set up of an electrolytic hydrogen and oxygen production directly from seawater, the electrical conductivity of which is due to soluble salts.

Seawater is the most widespread, cleanest and cheapest working medium, its resources are practically unlimited. In turn hydrogen is an ecologically pure fuel with the greatest specific heat of combustion. Seawater is a multicomponent natural electrolyte with sodium chloride as the main component.

Therefore the seawater electrolysis will be basically determined by the near-electrode processes, which are intrinsically for the sodium chloride solutions electrolysis. While electrochemical reaction at acceptable rates some amount of chlorine always evolves together with oxygen.

In view of chlorine being toxic, the problem of its utilization is to be solved. For example, utilization of chlorine can be achieved through absorbing of it by the aqueous solution of sodium hydroxide.

The reaction can proceed in directions resulting in hypochlorite or sodium chlorate formation. An anolyte formation of sulfuric acid is possible too.

Therefore apart from the essential electrolysis products - hydrogen and oxygen, in the course of seawater electrolysis one can produce sub-products, possessing self commercial values.

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5 tips to achieve freelance work-life balance

For freelancers and creators, achieving work-life balance can sometimes seem impossible to obtain. As entrepreneurs, you're constantly putting on a different hat for a different task, shifting priorities throughout the day. Life and work for creatives tend to blend together because we find passion and enjoyment in both. As photographers and videographers, you essentially always want to work because you never want to miss an opportunity and truly enjoy what you do for work. But that doesn’t mean you shouldn’t find balance and a time to shut off the work hat and focus a bit more on living life. Here are our five top tips to help you sort your priorities, and better balance your time.

Define your goal for success

Success means different things to different people, and it’s the first thing you should think of when trying to achieve balance. By defining what your measure of success is, you can break down your days, weeks or months into increments in order to make that goal. By doing so, you remove any pressure to reach someone else's definition of success. This measurement is completely unique to you and should be taken into consideration regarding both your work and personal life. That means defining what success in your personal life is, and using it to tackle your goals.

Make a daily list

Start your day out by writing a list every single morning of what you want to accomplish. Be realistic, and relate everything to any long-term goal you have. Separate your big tasks over your week, jotting down a few things you can accomplish to help reach that goal. Add any personal tasks you need to do, but not just the chores and housework! Include to-dos such as attending a new restaurant opening, going for a walk or yoga in the park, or anything else you can think of that has the possibility of contributing to your happiness.

Minimize Distractions

If something doesn’t help you achieve success in your personal or work life, get rid of it. For work, removing tasks that aren’t necessary to either make you money or advance your goals will free up more time to work on your personal success. In a podcast on NPR’s Hidden Brain, “Deep Thought”, they discuss how the minor distractions (checking your phone for 10 seconds, watching a quick video on YouTube unrelated to your work) actually affect your workflow more than you think. It’s the distraction itself, not the time it takes, that moves your thinking to something totally unrelated and it takes time to reassess and properly get back to work mode.

Find a Zone

As creatives, we often find ourselves doing work at home offices or on the go in a cafe or co-work space. While this is a bonus of the job, having distractions around you is a lot more prominent than if you worked in an office environment. Block off a set of time in your day to get in your zone, understanding that just because you’re technically there, doesn’t mean you're available to everyone. Blocking time to accomplish different tasks and steps towards making your success goals in an environment separate from your personal life will allow you to get into a much deeper thought process, potentially allowing you to get work done faster and more efficiently.

Take Care Of Yourself

We focus so much on work success, that we often forget about personal success and well-being in your life. Find those things that give you pure joy separate from work, whether it’s yoga and meditation, spending time with friends, volunteer work, or a good book with a glass of wine at the end of the day- spend a little time on your heart. It’s proven that people that are happier in their personal lives are more productive than people who are not. Prioritize a happy life, and the rest will fall into place.

As freelancers and creatives, balancing work and life can be hard but once mastered- it will become your most valuable resource. Being the gatekeepers of your time and only allowing things in that actively contribute to your goals will allow more free time to enjoy your life at home. Make your life full of accomplishing successes, both personal and work related, and you’ll be on your way to a fulfilled life!

Have any additional tips or things you do to stay on track of your goals? Comment them below to share with our Creatives community!

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What Can Induce Inferior Calcaneal Spur

Posterior Calcaneal Spur

Heel spur is a hook of bone that protrudes from the bottom of the foot where plantar fascia connects to the heel bone. Pain associated with heel spurs is usually pain from plantar fasciitis, not the actual bone. Heel spurs are most often diagnosed when a patient has visited a pain specialist or podiatrist for on-going foot pain related to plantar fasciitis; spurs are diagnosed via X-ray of the foot. Heel spurs are most commonly diagnosed in middle-aged men and women. As noted, most patients with this condition have other podiatry-related pain. This condition is a result of plantar fasciitis (when the fascia, a thick connective tissue that connects the heel bone and ball of the foot) becomes inflamed. Some 70% of plantar fasciitis patients have a bone spur. Bone spurs are soft calcium deposits caused from tension in the plantar fascia. When found on an X-ray, they are used as evidence that a patient is suffering from plantar fasciitis. Plantar fasciitis is typically caused from repetitive stress disorder. Walking, running, and dancing can cause this with time.

You are more likely to develop plantar fasciitis and heel spurs if you are Active. Sports that place excessive stress on the heel bone and attached tissue, especially if you have tight calf muscles or a stiff ankle from a previous ankle sprain, which limits ankle movement eg. running, ballet dancing and aerobics. Overweight. Carrying around extra weight increases the strain and stress on your plantar fascia. Pregnant. The weight gain and swelling associated with pregnancy can cause ligaments to become more relaxed, which can lead to mechanical problems and inflammation. On your feet. Having a job that requires a lot of walking or standing on hard surfaces ie factory workers, teachers and waitresses. Flat Feet or High Foot Arches. Changes in the arch of your foot changes the shock absorption ability and can stretch and strain the plantar fascia, which then has to absorb the additional force. Middle-Aged or Older. With ageing the arch of your foot may begin to sag - putting extra stress on the plantar fascia. Wearing shoes with poor support. Weak Foot Arch Muscles. Muscle fatigue allows your plantar fascia to overstress and cause injury. Arthritis. Some types of arthritis can cause inflammation in the tendons in the bottom of your foot, which may lead to plantar fasciitis. Diabetes. Although doctors don't know why, plantar fasciitis occurs more often in people with diabetes.

Heel Spur

Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).

Non Surgical Treatment

The first line of treatment for Heel Spur is to avoid the activities and positions that cause the pain. A physician can evaluate your foot with an X-ray to diagnose Heel Spur and determine a course of treatment. This condition can often be treated by non-surgical means; however in severe cases surgery may be necessary to relieve the pain. The most common surgical procedures treat the soft tissues around the Heel Spur, often a tarsal tunnel release or a plantar fascia release. Injections for heel spurs are sometimes controversial as steroids may cause heel pad atrophy or damage the plantar fascia.

Surgical Treatment

Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.


How the trucks stand today in the prefecture. Screenshot: ANNewsCH

A snowstorm shut down not only Highway 8 running through Sakai City in Osaka, but also the nearby dumpling shop Gyoza No Osho. Not wanting to let the restaurant’s food go to waste, employees banded together to cook up some 500 meals for the drivers stuck in the miles-long traffic jam cutting through the neighborhood.

The jam itself trapped more than a thousand cars, as The Japan Times reports, stretching for not quite 20 miles thanks to a bad storm that dumped nearly two feet of snow on the area. In amongst the cold, as SoraNews24 collated, were a number of joyous tweets from drivers stuck on the road exclaiming how happy they were to have a hot meal:

Japanese Defense forces handed out yet more more to drivers, per The Japan Times, hundreds of whom were desperately stuck for what’s now two nights in a row on this road. It does appear that today, finally, most cars are all but cleared, per this news report:

Heavy machinery to clear the snow is having a harder time reaching the road than hot food, sadly.

(Hat tip to Paulo!)


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New Movie Releases

Special Screenings This Week

Starring: Toshiro Mifune, Tatsuya Nakadai, Kyoko Kagawa, Tatsuya Mihashi, Isao Kimura

High and Low

In Brief: For his 1963 suspense film High and Low, Akira Kurosawa seems to have been actually trying to draw the wrath of those who find his work too “Western” by choosing the Ed McBain novel King’s Ransom for his source material. What could possibly be more Western — indeed, more downright American — than…
Starring: Erik Odom, Andie Morgenlander, Dustin Whitehead, Luke Beavers, Mondy Carter, Mary Katherine O'Donnell

Luke and Jo

The Story: A struggling screenwriter confronts his demons after meeting a young musician while promoting his script at a film festival. The Lowdown: A locally produced independent drama that makes the most of its budget — and its picturesque Asheville setting — while telling an emotionally resonant story.
Starring: Victor Mature, Hedy Lamarr, Angela Lansbury, George Sanders, Olive Deering, Russ Tamblyn, Henry Wilcoxon

Samson and Delilah

In Brief: Cecil B. DeMille's historical epics are an acquired taste in my book, but even those with accepting palates may find Samson and Delilah (1949) hard to swallow. Despite its (mostly) remarkable cast and suitably grandiose scale, it's perhaps the most forgettable of DeMille's biblical films. Sure, Hedy Lamar looks gorgeous and George Sanders gets to be sleazy,…


Category Archives: Benjamin Franklin

Benjamin Franklin (January 17, 1706 [O.S. January 6, 1705] – April 17, 1790) was one of the Founding Fathers of the United States. A noted polymath, Franklin was a leading author, printer, political theorist, politician, postmaster, scientist, musician, inventor, satirist, civic activist, statesman, and diplomat. As a scientist, he was a major figure in the American Enlightenment and the history of physics for his discoveries and theories regarding electricity. He invented the lightning rod, bifocals, the Franklin stove, a carriage odometer, and the glass ‘armonica’. He formed both the first public lending library in America and the first fire department in Pennsylvania.

“Never ruin an apology with an excuse.”