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Last October, after one of the presidential election debates that had addressed healthcare and reform, I asked you whether you thought healthcare in America should be a right or a responsibility. Overwhelmingly -- almost 2 to 1 -- you felt healthcare should be a right that all Americans should enjoy. Along comes an interesting article by Tom Head, the About.com Guide to Civil Liberties, who asks the question, Is Universal Health Care a Human Right? Beyond just whether it should be a right for Americans, he's looking at human rights and government declarations. According to his article, healthcare IS a right, based on "widely accepted international human rights treaties" which have been both drafted and signed by American representatives. That's right. Evidently we've made it known throughout the world that we think healthcare is a right. But in the United States, healthcare clearly is not a right. If it were, we would not have 47 million Americans who can't get the medical attention they need. So I have to ask -- is this a question of "do as we say but not as we do?" Or do we believe healthcare should be a right for the rest of the world, but not for us? Tom's article points out a major disconnect -- lip service vs reality. We can only hope that our congressional representatives take a look at what we're telling the rest of the world so they can make it jive with the reality of American healthcare, too. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation.

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Last October, after one of the presidential election debates that had addressed healthcare and reform, I asked you whether you thought healthcare in America should be a right or a responsibility. Overwhelmingly -- almost 2 to 1 -- you felt healthcare should be a right that all Americans should enjoy. Along comes an interesting article by Tom Head, the About.com Guide to Civil Liberties, who asks the question, Is Universal Health Care a Human Right? Beyond just whether it should be a right for Americans, he's looking at human rights and government declarations. According to his article, healthcare IS a right, based on "widely accepted international human rights treaties" which have been both drafted and signed by American representatives. That's right. Evidently we've made it known throughout the world that we think healthcare is a right. But in the United States, healthcare clearly is not a right. If it were, we would not have 47 million Americans who can't get the medical attention they need. So I have to ask -- is this a question of "do as we say but not as we do?" Or do we believe healthcare should be a right for the rest of the world, but not for us? Tom's article points out a major disconnect -- lip service vs reality. We can only hope that our congressional representatives take a look at what we're telling the rest of the world so they can make it jive with the reality of American healthcare, too. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation.

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If you looked in the dictionary to define an empowered patient, you would find "Colin." Of course, Colin is not his real name. I met him this week in Toronto where I attended a symposium called "One Patient/One Record." The program was focused on the many benefits of electronic medical records, and Colin's story really brought home their importance. Colin has Crohn's disease, and has for 40 years. As a teenager, he spent several years with no diagnosis. Since he was finally diagnosed, he has had numerous surgeries, and his symptoms have expanded into problems that affect not just his gatrointestinal system, but his bones, teeth and skin, too. The problems result not just from his Crohn's, but from side effects from his meds, too. They can't be helped. Colin's care requires 19 different doctors in any given year, so you can imagine how empowered he must be to coordinate all that care! Why must he be the one to coordinate it all? Most of us expect that would be something our doctors would coordinate for us. It's actually a question I hear frequently. "Why can't I find a doctor to coordinate my care?" It turns out that it's just as difficult to find a doctor to coordinate care in Canada as it is in the US. I talked to many Canadians who assumed that for those of us Americans who have insurance, we are therefore getting some sort of private, unrestricted care. But of course, we don't. Not even close. If Colin lived in the US, he would have the same problem getting the care he needs. So let's return to the original reason for the symposium. Electronic medical records. You can understand now why electronic records would be so important to Colin. One, coordinated, all-encompassing record, easily accessible by Colin and all his doctors could make a world of difference in his care. We're not there yet. But the buzz is getting louder, no matter which side of the border or, as it turns out, the ocean you're on.

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January 29, 2009
Okay, five days and counting: Todays topic medication safety and other rants
Tomorrow is pre-op testing, I was called by the hospital and told to arrive early and be sure to bring a medication list with dosage information.
MEDICATIONS ARE IMPORTANT AND NO-ONE EXCEPT THE PATIENT HAS AN ACCURATE LIST AND EVEN THAT IS DOUBTFUL
I asked the representative if the hospital had a web registration and personal health record in which I could upload data. I was told we are not quite that state of the art yet. Oh-well, I suppose my paws can scribble a few hundred more lines of redundant information that exists in at least ten electronic medical record and registration systems across Raleigh NC. I have been experimenting with Microsofts Health Vault but find that, where it is an excellent technology, the market is not ready with interfaces to the myriad of systems that exist in a single system of care. This could be addressed with a Federal or State based system which serves as a public utility for personal health information. Unfortunately the market drivers are not in place and various privacy regulations get in the way. Funny how HIPAA, which was designed to standardize information transfer, increase transparency of data for patient safety and enforce security has now created such costly social barriers. We can thank our litigious society, advertisers of legal services seen every three minutes on nightly television and the use of personal information to screen for pre-existing illnesses for the barrier. Too bad, our species has such a history of poor integrity. HAVE YOU BEEN EXPOSED TO ASBESTOS, TAKEN ARTHRITIS MEDICATION, BURNED YOURSELF WITH HOT COFFEE? CALL THE OFFICES OF JOHN SUESTHEMALL FOR A FREE CONSULTATION YOU POOR VICTIM OF AMERICAN BUSINESS CULTURE!
So here are some issues with personal health information that are threatening our safety. I will use myself as an example. Go ahead deny me medical coverage or employment. Ill just call Attorney Suesthemall.
I have diabetes, chronic hepatitis c (what do you expect I grew up in the 60s and 70s) and post traumatic stress disorder. No big deal, with the advent of modern medicine and personal investment in my health I have done remarkably well! That said, I am on eight maintenance medications which influence a wide variety of biochemical systems. I can guarantee that without constant vigilance on my part, my five physicians would have no reconciliation of my medication data: For a primer on patient safety check out The Institute for Healthcare Improvement. This organization is on the forefront of protecting US PATIENTS and improving our healthcare system.
So, tomorrow I will re-write my medications onto a paper form for the fifth time since I started down this treatment path. Each time I have hand-written my meds, someone has transcribed my data into a medical record and verified (to varying levels of reproducibility) with the patient (ME). When I have provided typed lists, my providers have still required that I complete their paperwork (I imagine the legal system has something to do with this).
By the way, SureScripts-RxHub RxHub has a great solution for medication transparency; I just hope it is affordable to the institutions and providers who need the data at the point of care. They have records on over one hundred million of us that could save our lives. The last time I looked they charged $1.00 per medication history report to an admitting hospital, not sure if it is still the same price.
To keep my records straight I have a few choices as a patient:
Have an incredible memory like all baby-boomers
Make sure one of my relatives has an incredible memory (doubtful)
Keep a reliable notebook and remember where I put it: Best suggestion for folks with chronic disease who prefer pencil and parchment.
Keep a record on my computer with reliable back-ups and pointers to back-up files on my hard-drives, CDs and Flash Media.
Choose one of four personal health records that have been provided by my constantly changing healthcare business environment. For example: I have a record with two payers, one pharmacy benefits group and one beta software that I have been testing for a friend.
GIVE UP AND TRUST THE SYSTEM AFTER TOSSING TWENTY FIVE POUNDS OF PAPER FROM MY FILES AT THEM ON ADMISSION DAY
On to creating my advanced directive in-case I forget not to take the drug prescribed by my PCP that is suspended in an aspirin compound.
I am going to be fine folks, but this is freaking hysterical since I can point to systems in other nations that are more effective at reducing variance in medical outcomes.

On with the crapshoot with carefully loaded dice in the morning.

Peace,
Halbstein




January 28, 2998
As they used to say on Hill Street Blues "Be careful out there".

This year, I find myself disabled with degenerative spinal disease and am awaiting surgery on Tuesday February 3rd. Since I have little else to do, I thought I would archive my experiences on this blog and also post some videos of the adventure.

As I write this stuff, keep in mind that I have spent numerous years working for my cause: universal coverage for all Americans and the deployment of a universal personal health record to prevent errors in clinical judgment and facilitate a smooth transition for all patients between systems of care.

The industry and our politicians are working on this dream, but the issues are complex and numerous so I pray we see it in time for our childrens generation. Many -who have something to gain e.g. politically or financially will tell you that what we need is only a few years away. Where this might be technically feasible; I challenge such enthusiasm with the very real social issues of: alignment of financial incentives between providers and payers and patients and employers, the revision of laws which prohibit access to critical health information e.g. mental health diagnosis. The reluctance of people to adopt new workflows. The current population of burned out primary healthcare providers and their lack of collaborative relationship with insurance companies.

We have a long way to go folks so lets get started with my 'case' and try to find some humor in the message!

Within the last few weeks I became disabled from neck pain, had and MRI done and found out that I have severe degenerative disease with compression of my spinal cord. I am scheduled for surgery (three level cervical fusion) on Tuesday AM at Rex.

To say I am not frightened would be an outright lie; I know way to much about medical misadventures. That said, I am having a humorous time chronicling my experience and attempts to make sure that 1) no-one kills me due to misinformation and 2) no-one overcharges me due to misinformation. Do you see a theme emerging?

Lets see

I am in excruciating pain so
I go to an orthopedist who schedules me for PT and MRI

I go to a see a clinician friend who suggests three neurosurgeons

I struggle to determine if one of the neurosurgeons suggested is in my new health plan.

After research I settle on a doc by searching Pub-Med for clinical outcome info and looking around the country for published quality indicators.

I AM SURPRISED BY the variance in success rates between physicians and facilities

The neurosurgeon I select is one of the best in the area (1500 cases, 97% success, .001% infection)

The neurosurgeon will be working on the part of my anatomy that connects brain to the rest of body (seems like a big deal to me)

The neurosurgeon soothes me with his ego and data (He clearly states that he is one of the best)

The neurosurgeon seems to only consider my neck anatomy when establishing his patients identity (guess this is neck centered vs. patient centered)

The neurosurgeon asked me to make sure I received clearance for cardiovascular risks and my insulin pump (diabetes). I thought they did this but I guess this is a reflection of the new consumer directed and patient centered healthcare system.
I wonder what folks do that dont understand the definition of cardiovascular risk?

The surgeons office called for a $1000 deposit even though I have no deductible, co-pay or co-insurance.

I was called by the endocrinologists office who I need to clear me for surgery and they gave me 24 hours to come up with insurance info or they were canceling my appointment because they had a long waiting list

I called endocrinologist office manager and give her insurance info. While I am at it I ask if they do means testing and adjust fees for self-pay. She states that patients receive a flat 20% discount. I ask if they see Medicaid patients (huge diabetes prevalence rate) and am politely told . I find myself wondering how people of lesser means get their diabetes care and what happens if they need an endocrinology clearance for surgery? Then I realize that my surgeon probably wont treat people of lesser means since he already asked me for a down-payment on a procedure for which he is contracted 100% to payer.

My primary care doctor is worried about someone following me closely in the hospital as I have diabetes and other chronic conditions so she writes a stern letter to the surgical team inspiring confidence in this patient.

I ask my primary care doctor to prescribe an aspirin free narcotic since I cant take aspirin due to potential bleeding complications (I read this is a handout given to me by neurosurgeon and wonder what folks do if they can't read).

I go to CVS to get some codeine and the pharmacist blankly stares and tells me we dont have that. I ask where to get it and she continues to stare at me with a flat affect. I am concerned that she might be having a seizure but take care of myself by suggesting she call another pharmacy which she politely does.

I drive across town to get the codeine, an extremely inexpensive light-duty narcotic that seems to be quite rare since the invention of stronger, more-costly agents that have created a population of new patients for the rehab and detox centers (oxycontin etc).

Tonight I am assembling a living will
I have also arranged for a friend (RN) to monitor me during the hospital stay.

And on it goes.

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I am sure you have seen one before. In your backyard, crossing the street, maybe in your trashcan or on the school campus... they tend to pop up in many places, and this is to be expected as they can roam miles in a night.

There are many misconceptions people have about them because they are a wild animal. But I wanted to take the time here to address the topic because there is a large population of them existing in Fullerton.

Our condo complex was home to many and it is where I gained the knowledge I now have of them; hubby and I raised 10 of them (yes, we had 10) after we found one and took her in temporarily to help her out (she was far too skinny) and then she had 8 babies, and then we found an orphan.

They are not the prettiest creature I will give you that. But when they are little they are quite adorable. The picture you see above is one of two we have now. We are rehabilitating them after they fell off of their mom.

So here goes:

They do not carry rabies, or any other disease for that matter. Their body temp is too low to get rabies. They can get fleas, that's the only thing they can pass on to you.

They do not bite. They will try to nibble your finger if you smell like food but they will not actively attempt to bite you no matter how much they hiss or bare their teeth at you when you scare one.

They do not like loud noise, bright light or quick movement, which is why they look so mean when you surprise them by banging the trash can lid, glaring a flashlight in their face and yelling angrily at them.

In the wild only one usually survives out of a litter (which can be up to 13 babies) and on average only have a lifespan of a couple years.

They are not dangerous to your pet. They do like cat food but it is not good a good diet for them. They eat trash because that is what they can get in the city. However, their diet is fairly complicated (a mix of cat food, canned salmon, yogurt, mixed veggies and hard boiled eggs). They also need fruit. Eating a bad diet can give them metabolic bone disease, causing the similar symptoms of crippling arthritis.

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The mainstream medias (MSM) reporting on GMs has evolved. Initially, the press told its audience that The Generals terminal glide path was all part of the wider economic meltdown. As the company augers in for its June 1 federally mandated Chapter 11, the reality of the situation is filtering down the info-food chain. The story has moved from financial reports to the general news to the sharp end: car reviews. For example: todays Washington Post carries a review of the Pontiac G8 GXP that lauds the Australian V8 four door as part old-fashioned American muscle car, part sophisticated European performance ride. And then . . . s good news. But heres hoping it doesnt come too late in the news cycle for GM. Right: stupid news cycle. I blame the news cycle for GMs upcoming bankruptcy.

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It appears that Naive Americans have become very accustomed to deceive each other.  Deception is at all levels high and on all subjects.  At the top of the list we find career politicians, followed shortly by preachers, business people, etc, etc, etc.  Deception continues all the way down to our homes with kids and spouse (assuming you are married and have children).
From http://encarta.msn.com the definition of:
Deceive:  Transitive verb; intentionally trick or mislead somebody: to mislead or deliberately hide the truth from somebody.
The reader should note that the definition has nothing to do with legal terms used in a court of law (note that Naive Americans use the term court of law as opposed to court of justice).  The definition is simple and direct.
From the same source on a closely related word:
Lie:  Deliberately say something untrue: to say something that is not true in a conscious effort to deceive somebody.
Lie:  Be deceptive: to give a false impression.
As one can easily rationalize, unless you are an attorney, that deceiving is the same action as lying.  Well perhaps you do not have to be an attorney to arrive to this simple conclusion.  It appears that our entire society has embarked in a deception voyage, which does not appear to have an end in site.  If you disagree, then as mandated by this site, lets review some examples, which might help one, arrive to the proper conclusion.

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In the June 2008 issue of In Style Magazine, featuring Cameron Diaz on the cover, a brief Beauty Q A addresses the sun protection in many common skin products, such as foundation powders and crèmes.  Foundation powders, even if they are listed to have an SPF of 10 or more, do not offer sufficient sun protection with the kind of coverage that most people use.  One would have to apply much more to their skin than would be reasonable in daily makeup.  The article suggests using a broad-spectrum sunscreen before applying the makeup to ensure that your skin is protected from the sun.
What AMA has to say:
The key is in ‘broad spectrum’ sunscreens – products that protect against both UVA and UVB rays, the two harmful wavelengths in sunlight.  Most products on the market do not protect against both!  So, while you may be faithfully applying your sunscreen every morning before you go out regardless of the weather, you may not actually be as protected as you think you are.
American Medical Aesthetics carries a wide range of high quality, medical grade skin products that include broad-spectrum sun protection.  Whether you’re looking for a light, tinted moisturizer for daily wear or a heavy-duty, waterproof high-SPF for a long, bright day at the beach we have you ‘covered’!
Sun protection is essential, particularly during the summer months when you want to be out as much as possible enjoying the warm air and great weather.  Make sure that you don’t come away from your recreational activities with sunburns and long-lasting damage to your skin.
If your skin has already paid a price to the sun, resulting in spots, wrinkles, and uneven texture, then get on the path to healing today.  Your sun damage can be reversed through AMA’s revolutionary, holistic process of Physiological Transformation.  Our unique protocols and highly trained specialists can actually renew your skin from the inside out, making it healthier, stronger, and younger on the inside so that it is years younger, healthier, and more beautiful on the outside, naturally.

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Accurate In The Noninvasive Monitoring Of Fluid Status During Surgery Experts Weigh In On Controversial Issue Of Determining Value Of Cancer Care At NCCN Conference New Survey Reveals The Lipstick Effect With Non-Invasive Facial Plastic Surgery Procedures Study Finds That Dying Patients And Families Suffer From Lack Of Continuity Of Physician Care Early Detection Remains Key In Updated NCCN Guidelines For Ovarian Cancer Caltech Students Honored For Innovative Work National Quality Board Grows In Strength, UK Heart Attack Recovery Improves If You Keep Exercising GOC Offers CET Surgery At Optrafair 2009, UK Women Urged To Conceive At A Younger Age: Why? NJIT Receives $20,000 Grant From Horizon Foundation To Promote Teen Health Old People- NMC Facts And Figures, UK Caribbean Coalition On Women, Girls Pledges To Address HIV, Gender-Based Violence U.N. Member States Agree To Drug Control Policy District Of Columbia HIV/AIDS Prevalence At 3%, Report Says Young Patients To Benefit From IT Advance, UK Editorial, Opinion Piece Address Recent Supreme Court Decision On Pre-Emption Utah Gov. Huntsman Signs Four Health Care Bills Congressional Committee Chairs To Lead Health Care Reform Effort New Route For existing Specialists To Gain Entry Onto The Specialist Register Opens, UK Obama Nominates Former New York City Health Chief Hamburg As FDA Commissioner, Baltimore Health Commissioner Sharfstein As Deputy Obama Advisers Suggest President Might Not Oppose Taxing Some Employer-Sponsored Health Benefits Accelerate Improvements In Commissioning Services For People With A Learning Disability, Urges Watchdogs Los Angeles Times Examines Conservative Opposition To Embryonic Stem Cell Research Obamas Actions On Issues Such As Abortion, Stem Cells Evoke Mixed Reactions From Evangelicals Obama Nominates Former NYC Health Chief Hamburg For FDA Head, Baltimore Health Chief As Deputy Thermo Fisher Scientific Announce Certification For The Varioskan Flash Multimode Reader Use In Invitrogen Lanthascreen Assays Experts Analyse Likely Impact Of London 2012 Olympics On Physical Activity Studying The Viscosity Of Cancer Cells During Cell Death Preventing Pseudomonas Aeruginosa Biofilms Cheap Alcohol Is Killing Us And Our Quality Of Life, Says Chief Medical Officer, UK Painful Nerve Condition May Be Improved By Blocking Protein New Technology Opens Gateway To Studying HIV-specific Neutralizing Antibodies Key Enzyme In Fat Absorption May Also Be Key To Losing Weight Aid Achievements In Solomon Islands: The Key To Good Foreign Aid Cryogenic GLACIER Stocked With Research Samples Deemed A Success Campaign Launched To Tackle Alarming Ignorance About Rheumatoid Arthritis Revealed In New Poll Projects To Purify Drinking Water In Guatemala, South Africa Aim To Improve Health Of Residents Religious Leaders Must Play Role In HIV Prevention Efforts, Opinion Piece Says Efforts Needed To Increase HIV/AIDS Education, Prevention, Experts, Advocates Say At California Conference American Indian Youth Group To Perform In Minneapolis To Mark Native HIV/AIDS Awareness Day CQs Armstrong Discusses Obamas Stem Cell Order, Congressional Health Reform Efforts, Follow-On Biologics, FDA Leadership Oklahoma House Passes Mandate-Free Bill For Low-Cost Health Insurance New York Times Examines Challenges Facing Massachusetts Health Insurance Law Economic Recession Forcing Local Health Departments To Reduce Services To Undocumented Immigrants Editorials, Opinion Pieces Respond To Obamas Executive Order Lifting Restrictions On Embryonic Stem Cell Research Reducing Cost Of Birth Control For College Women Victory For Common Sense, NYT Editorial Says States Move Forward With Bills Limiting Embryonic Stem Cell Research Cinryze Infusion Reverses Plasma Activation In Hereditary Angioedema New, Published GELNIQUE Data Show Efficacy, Convenience And Excellent Tolerability Overactive Bladder New Treatment For Generalized Anxiety Disorder Approved By Health Canada Surprising Role In Cystic Fibrosis Lung Damage Played By Immune Cells, Stanford/Packard Study Shows Cause For Severe Pediatric Epilepsy Disorder Identified Clinical Trial To Improve Outcomes In Patients With Breast Cancer Now Open News From The American Chemical Society: March 11, 2009 Study Helps Unravel Mysteries Of Brains Endocannabinoid System NIDA Research Could Lead To Better Treatment For Pain And Marijuana Addiction News From The Journal Of Clinical Investigation: March 16, 2009 Chronic Care: A Call To Action For Health Reform AARP To Release Comprehensive Survey And Report At March 23 Solutions Forum Biotec Pharmacon ASA Completes Patient Inclusion In The First Phase III Diabetic Ulcer Study New Human Genetic Link To High Levels Of Cholesterol Canberra Parents Lack Allergy Awareness: Study In HIV-Infected Individuals Combination Therapy Restores T Cell Numbers Long-Term Damage From Traumatic Brain Injury Prevented By Alzheimers Disease Therapeutic In Pre-Clinical Studies American Association For Cancer Research Congratulates Margaret Hamburg, M.D., On Her Nomination As Commissioner Of The FDA Aged Care Residents Need More Nurses, Medical Care, Australia Research Suggests Scientists Should Follow The Bodys Lead To Prevent HIV From Taking Root Potential Targeted Treatment For Rare Form Of Anemia Increase Risk Of Blood Disorders Due To Genetic Abnormality Oncogenic Kras Initiates Leukemia In Hematopoietic Stem Cells Where Does Consciousness Come From? Two Cases Of Rabies In Viet Nam After Butchering And Eating A Dog Or A Cat Older People With Comorbidities May Not Benefit From Defibrillators Diabetes Risk In Aboriginal Canadians: Metabolic Syndrome Can Help With Identification Warning: Stun Guns May Cause Seizures UV Lights Decrease Infectious TB In Hospital Room Air Antibiotic-Resistant Organisms: Hospital Infection Control Strategies Fish Consumption Guidelines Not Environmentally Sustainable News From Annals Of Internal Medicine Clavis Pharma Announces Positive Elacytarabine Phase II Results Late Stage Acute Myeloid Leukaemia Orexo: Orexos Edluar (Sublinox) Receives FDA Approval For The Treatment Of Insomnia Roche Acquires Innovatis AG To Complement Its Product Portfolio In The Rapidly Growing Area Of Cellular Analytics Neovacs Announces The Publication Of A PNAS Article On Anti-IFNα Kinoid Active Immunization In Lupus Allium Offers Urethral Bulbar Stent: Minimally Invasive Treatment For Recurrent Urethral Strictures Alzheimers Disease Neuroimaging Initiative Announces Completion Of Genome-Wide Analysis Laptop Ultrasound Used In Paediatric Emergencies At Royal London Hospital ACUSON P50 Provides Portability And Reliability In Critical Situations Health Protection Agency Issues Doctors With Advice On Diagnosing Carbon Monoxide Poisoning, UK Search For Blood Pressure Secrets Reveals A Surprising New Syndrome Linked To Seizures, A Lack Of Coordination, Developmental Delay And Hearing Loss Stem Cells Crucial To Diabetes Cure In Mice What is Obesity? What is BMI (Body Mass Index)? How Proteins Find The Right DNA Sequences Demonstrated By Important New Model Stress May Cause The Brain To Become Disconnected Immune Cells Play Surprising Role In Cystic Fibrosis Lung Damage, Stanford/Packard Study Shows Cytheris Announces Publication Of IL-7 HIV Data In The Journal Of Clinical Investigation Immune Tolerance Ensured By Dendritic Cells DNA For Canine Form Of Muscular Dystrophy Lays The Foundation For Human Testing Task Force Recommends Using Aspirin To Prevent Cardiovascular Disease When The Benefits Outweigh The Harms Steroid Nasal Wash Appears To Improve Health Status Of Patients With Chronic Rhinosinusitis Without Affecting Adrenal Gland Function Less Of A Stink In Diabetes Patients? Tracking Down And Attacking Cancer Cells Using Nanoscopic Probes Acitretin Therapy May Help Reduce Nail Psoriasis Wet Combing More Accurate Than Visual Inspection For Identifying Active Head Lice Infestation New Type Of Botulinum Toxin Appears To Be Well Tolerated And May Help Reduce Forehead Wrinkles Risk Score Helps Identify Candidates For Combined Heart And Kidney Transplants Obesity Associated With Worse Outcomes After Pancreatic Cancer Surgery Biomarker Signatures Predict Conversion From Mild Cognitive Impairment To Alzheimers Disease NRL Researchers Report A Forceful New Method To Sensitively Detect Proteins Black Male Children Face Highest Risk for Food Allergies (HealthDay) Migraine in pregnancy tied to stroke, heart attack (Reuters) Preventium Is Where The Prevention Of Breast And Prostate Cancer Begins Danger In The Home: An Overlooked Safety Threat From Glass Tables Brain Waves Of Guitarists In Sync Hormone Offers Promise As Fertility Treatment On Africa trip, pope says condoms wont solve AIDS (AP) What Is Leukemia? What Causes Leukemia? Denmark compensates night workers after breast cancer link (AFP) Family Physicians Urge State Leaders: t Ask Poor, Frail, Elderly, Or Children To Solve Budget Crisis Clinical Trials Update: March 17, 2009 (HealthDay) Lymphedema Raises Cost of Breast Cancer Care (HealthDay) U.N. advises governments how to stop Internet drug peddling (Reuters) Cochlear implant surgery safe for seniors (Reuters) Safety Concerns Raised Over Wakefulness Drug Modafinil (Time.com) Narcolepsy Drug Being Used To Improve Cognitive Performance Affects Brain Dopamine Activity, Suggesting Potential For Abuse And Dependence Use Of Religious Faith To Cope With Advanced Cancer Associated With Receiving Intensive Medical Care Near Death Medication Does Not Appear To Reduce Progression Of Atherosclerosis Admissions for Prescription Painkiller Abuse on Rise (HealthDay) Narcolepsy Drug Might Be Addictive (HealthDay) Study: Smart drug Provigil may be habit-forming (AP) U.S.

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It's easier to criticize what's wrong than to figure out how to solve just about any problem -- let alone one as massive and messy as our healthcare system. So, it seemed a pretty good idea when President Obama's Health Policy Transition Team asked for input on how to heal our sick system -- urging everyone with ideas or interest in the topic to host grassroots sessions in their own communities. Thousands of people in all 50 states volunteered. James Gordon, MD, former chairman, White House Commission on Complementary and Alternative Medicine Policy, and founder and director of The Center for Mind-Body Medicine in Washington, DC, was among those who accepted the challenge."

Prevention must become the new primary care. Dr. Gordon said this means that the "true primary care" should be a focus on wellness through the use of nutrition, exercise, stress management and mind-body approaches before resorting to symptom-suppressing tactics like drugs and surgery. As one participant, a mother of three, put it, "breathing, moving, learning how to shop [for healthy products]" should be mandated as primary care. With better wellness strategies, the cost of illness management naturally declines.

Retraining... for everyone. The group recommended lots of role-shifting and retraining in integrative approaches to healthcare in order to change the paradigm from disease-focused to wellness and prevention. They also recommended adopting a view of healthcare that combines treatment modalities for better outcomes. "Nothing will change if people remain stuck in the old model that no longer works," Dr. Gordon told me. "Surgeons ought to understand the role of self-care and group support -- people will always need surgery, but we also need to emphasize how to prepare for surgery... and how to recover in a more healthful way."

Mitigate the influence of profiteers, most notably pharmaceutical companies. The group supports banning direct-to-consumer drug advertising.


Free education, strings attached. A plan for transforming the system for the selection and education of health professionals should emphasize ideals, not economics, a "primary devotion to science in the service of people, to patients, not profits," said Dr. Gordon. The group proposes free education for healthcare professionals -- and in return, requiring compulsory public service from all physicians, nurses and other health professionals.

Change starts with children. The Department of Education should become a central agency in health promotion and disease prevention, teaching kids how to be healthy. Dr. Gordon pointed out that at present, health education to children is "largely negative -- don't smoke, don't drink, don't have sex -- and largely ineffective." Parents' responsibility to act as good role models should be reinforced.

Stop the malpractice insanity. We need a new "sane alternative to the current overpriced, counterproductive, indeed destructive system of malpractice insurance." The group proposed a national fund to fairly compensate patients in a way similar to workmen's compensation. "The practice of defensive medicine has been destructive to the delivery of quality healthcare," Dr. Gordon said.

Write a new research agenda. Expenditures for medical research should be reallocated to serve different priorities -- the budget should set an agenda for true health, rather than one that advances profit potential. Specifically, the group recommended that the $30 billion-plus budget of the National Institutes of Health be reconfigured, dedicating approximately 20% to studying the effectiveness of prevention, self-care and wellness... 20% shifted away from the single-intervention studies that now predominate and toward the study of comprehensive, integrative and individualized programs of care (e.g., mind-body therapies, nutrition and exercise interventions for arthritis and heart disease) for the chronic illnesses that beset our population (and consume healthcare dollars)... and 10% allocated to single-intervention studies for research on non-patentable approaches, such as herbal remedies and musculoskeletal manipulation. The remaining 50% would be spent, as it is now, on basic science research and the study of single interventions.

Aim higher. Healthcare should be envisioned as promoting personal, emotional, social and spiritual fulfillment -- programs should be designed to manifest this perspective.

Hire a boss. Dr. Gordon told me he believes this last recommendation is particularly urgent, and will facilitate all the others and help ensure their sustainability. A small, but powerful agency, a White House Office of Health and Wellness, should be established to ensure the government continues to respond to the ongoing and changing health needs of Americans. The mandate would be to enforce accountability of governmental bureaucracies to a vision of real healthcare for all Americans.

WHAT CAN YOU DO?

As the discussion moves into legislation, with debates already underway on what specifically needs to change about our current system, it presents an opportunity to get things right. You may agree with these ideas or not... you may have heard other plans you think are better... or you may have ideas of your own you believe strongly in. Now is the time to speak up. If you like these ideas, Dr. Gordon asked me to ask you -- readers of Daily Health News -- to pass them along to President Obama (1600 Pennsylvania Avenue, NW, Washington, DC 20500 or at www.whitehouse.gov/contact or by fax at 202-456-2461) and to Ezekiel Emanuel, MD, PhD, special advisor for health policy to the director of the Office of Management and Budget at eemanuel@omb.eop.gov or at www.fedspending.org/contact.php or fax at 202-395-1005. You can also contact Senator Tom Harkin at harkin.senate.gov/c/ and Senator Barbara A. Mikulski at mikulski.senate.gov/Contact/contact.cfm. He also asked that you forward him a copy of your communications at jgordon@cmbm.org.

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Struggling with an acne problem to some adult is very embarrassing. Dont worry you are not alone. Almost fifty percent of adult women and twenty five percent of adult men are in the same boat as yours. Acne is a painful problem both physically and psychologically.
How come the adults suffer from acne problems too?
As an adult the constant changing of hormone in your body could result to acne problems. Among women the other reason could be your skin reaction to cosmetics or skin care solutions that you use. Other than that our daily stressful life could be a factor too.
For adults, the first basic acne treatment start with a good skin care routine. Choose the right skin care solution for your skin. Skin care products that is not suitable for your skin, could result to skin irritation and acne problems. A gentle cleaning solution is your safe choice since it is suitable for all skin type.
If you keep changing to different kinds of skin care products, this will have an impact on your skin as well. You should find one products that is suitable for your skin and stick to that one.
Skin care products that are non-acnegenic and non-comedogenic is suitable for people whose skin are prone to acne problems. Also remember that your fingernails are your worst enemy to your acne. Do not pop or squeeze your pimple or blackheads.
What is the best acne treatment for adults?
There are many acne treatment products on the market that claims to be the best. Finding the right one that will suit your skin type is a challenge.
If you have a mild to moderate acne problems, products that contain benzoyl peroxide and salicylic acid are known to be effective in acne treatment. Normally you will find these ingredients in many skin care products such as foundations and moisturizers.
Some of the acne treatment products that are prescribed by the dermatologist might be retinoid based. Just be careful with retinoid based products because to some people, they could have a skin irritation. If your skin is always expose to sunlight, using retinoid based product could intensify the sunburn effect.
What about oral medication or surgical procedures for acne treatment?
If external application of skin care solution to treat acne problem fails, then what is the alternative? Some people choose to go for oral medication or surgical procedures for acne treatment.
How does the oral medication works? A prescribed medication such as Tetracycline is given to you. The antibiotic is suppose to get rid of the bacteria from under the skin.
An oral form of retinoids which is called isotretinoin is also available for acne treatment for severe cases. Oral medication are also used to treat acne problems that are caused by hormone imbalances.
Surgical treatment is becoming more popular for an acne treatment today. With the advancement of technology laser surgery is quickly replacing the conventional surgical tools.
As your physical appearance is affected by your acne problem so is your self confidence and your self esteem. Fortunately there are many choices you can make for acne treatment. Your wise choice of acne treatment not only solve your acne problem but also will boost your self confidence.

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My mind is spinning with so many things this evening. New years has always been a time for me to reflect on life. Now let me tell you that I am an emotional one and I reflect often. But new years is different--it's a time to reflect on what you want to do differently in your life and make goals for the future. While I really want to lose weight, and really should, it sounds so cliche--"oh my new years resolution? That's easy, exercise and lose weight!" Uh--not. And then you start it but by the second week of January, you have already forgotten about it.

So while I am actively trying to eat better and learn when to eat and when not to eat, because this medication I am on for mastocytosis makes me feel hungry all the time--and am waiting til this dreadful cold has passed me so I can begin going to the gym to be on the stationary bike 3 times a week so that maybe the arthritis in my legs will feel better and perhaps it will help me lose some of this extra weight I am carrying around right now--breath--that was a really long sentence--it isn't what my resolutions will focus on this year.

This year I am thinking of other things that are perhaps more meaningful. I have two right now. The first is that my husband and I decided that our son will go to preschool twice a week this September. Now at first glance, you say uh--big deal, every child goes to preschool! We hadn't planned to send him and his pediatrician at last converstion wasnt too keen on the idea....but I am hoping she has changed her mind by the time I talk to her about it again.

However, Gavin is not the typical kid--but if you have been reading my blog for some time, you likely already know that. I will say that I have noticed that I dont write much about our medical issues--that is, as much as I used to when we had a caring bridge site (http://www.caringbridge.org.goreckikids/). But I think it is because Gavin having a reaction feels so normal to us now. It almost feels no different than him going potty, brushing his teeth or eating three meals a day. He has reactions, he feels sick a lot, and he takes a boatload of medications everyday to attempt to counteract it. What's to talk about? I mean really, how many times can I write that he had another reaction. It would get pretty boring. Besides that, mastocytosis is not on the forefront of my mind anymore. My life actually stopped revolving around it. But way back when we had already decided that we were not sending him to school.

Our reasons were plenty. Besides the fact that I am a credentialed teacher (did you know that about me?!), I homeschool Chelsea three days a week. I figured big deal, so I continue doing that with her and homeschool Gavin 5 days a week.

He hates leaving me and Tim--he doesn't even go to the childcare at church for an hour--ever. If we try to, he starts crying hysterically--which always starts a reaction--that in the past--always led us to using an epinephrine shot to calm his mast cells down. He hates going to the childcare so much, that he is willing to sit quietly for an hour and a half each week so he wont have to go. When we sat for two services in a row when Chelsea did her muscial, he sat quietly the whole time. Not one peep! I saw that no other 3 or under year old kid did that. Chelsea didnt even do that on Christmas Eve!!

He doesn't have any desire to have playdates with anyone, even with me--and he doesnt even want to go to the park unless Chelsea is with us. He isnt afraid of people in a developmentally delayed or a sensory impaired way, he just is really introverted. My husband is the same way. He is not interested in making lots of friends, and would never do this whole blog thing(!). He knows a few people who he would do anything for, and the rest he smiles, says hi, and moves on his way. While I recognize it is a personality thing, Gavin needs to be in these social environments so he can make a friend of his own! While Tim is introverted, he enjoyed school and he had lots of friends. I don't want Gavin's only friend of choice to be his sister's best friend.

He needs to learn to trust other grown-ups and learn that he can have fun without us. That would be big for him. To be excited to have fun with someone other than me, Tim, and Chelsea.

If these issues were not enough, he is such a medical liability! He needs to have rescue medications with him, and they would need to be administered by the teacher when needed--which would of course depend on the teacher noticing it and treating it before he is really sick. He also has many brain based reaction--where he starts screaming, and gets really irrational and violent--and it is totally reversed with benadryl--so we know it is only a mastocytosis issue and nothing more. It is him acting out in fear of how he is feeling, and also just the effects of histamine release in his brain. But take note, that this can start in response to him being upset that we are leaving him at preschool!

At this point, you may or may not be surprised to know that most teachers would prefer not deal with his medical issues. Knowing that he reacts to pretty much anything at any time and that you dont know when it will be a quick road to shock or a slow one, pretty much scares all of them out of their wits--especially when he does have a reaction and needs intervention, it will disrupt the entire class and it wont be a quick fix. It is scary for me, imagine it being scary for a young woman who doesn't know what she is doing when she is trying to take care of him.

Once they know all of this information, the looks in their faces say it all! It really doesnt make us feel comfortable leaving him, so we don't--and he knows it. Throw fuel on the fire!

So saying that we want to register him at the homeschool coop for a two day a week preschool is saying a lot. Lofty goal. Big dream. And it's one we would really love to get him to want and enjoy. But it's one thing to have a sick kid that wants to go to preschool--it's another to have a sick kid that doesn't want to go to preschool. Let me clarify though--this is a pre-K. He will be 4 this spring. Chelsea started in the class that we want to enroll him in, and she loved it. She did great and she wanted to be there. She loved every minute of it. I am so hoping this for him, I am hoping to change his mind!

So now that I unloaded all of that from my mind--I have my second one, but I think I will leave it for tomorrow night. It is more of a personal one--one that describes what the Lord is putting on my heart to do, but I am terrified of doing it. So we will call this new years part one and tomorrow, I will post new years part 2.

Soooo, til tomorrow.

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10. You Hired Your Nephew

So you heard that he has created a site or two, besides he knows how to use your audio system. Thinking of the money you could save, you decide to give him a chance. If you have fallen into this trap you've with little doubt found out what the popular adage means to "get what you paid for". Not only do you now have a website that is no benefit for you, but you have lost out on the benefits of well designed and marketed website could have done for you.

9. You Outsourced Your Work to a Near-Third-World-Country

Hiring outside of the country is often difficult and disappointing. If you caved into the idea of hiring a professional for less outside of the country you've probably found like many of my colleagues and myself included that the hassle and work you received isn't even worth it being done for free. Save yourself the stress, and hire a competent firm close to home.

8. You Purchased a Template and Did it Yourself.

By every right you are the leading expert of your business. You figure, "why spend money when I am the best qualified to present the business to my clients?" So you find a neat looking template and try to build the site yourself. In all honesty, there is truth behind the premise, but your execution was your failure. A good designer will know how to leverage you as the expert of your business in creating an effective design. Websites just seem so simple, but there are entire degrees in college, volumes of books and other reading materials, plus years of application that are needed to make something so simple to be so effective. Look at the ingenuity of Apple Computers, there is a reason why so few people have been able to match their prowess of simple design.

7. Your Website is Outdated

If your website looks junky, how do you think your visitors think about your products, services or business. Invest in your business image, or you'll see that you'll fail fast.

6. You Have an Intro Page

It is starting to become rare to see these pages, for good reason. Visitors appall them, have better respect for you visitors and you'll see more of them stick around.

5. You Can Count the Number of Pages on Your Site with One Finger.

Limiting the time your visitors spend on your site is one problem, but giving them no reason to come back is your other problem. The Internet is about Content, and if your website lacks in this regard, don't expect your website to amount to very much.

4. Your Site is Boring

Keep things fun, keep things light and above all keep things interesting. It is interest that brought your visitor to your site in the first place and it will be interest that will keep your visitor from leaving. If everything about your website is boring, you'll never convince them to stay long enough to take a chance on you.

3. You Only Hired a Web Designer/Developer.

If you forgot to appropriate sufficient funds to get visitors to your website, your website does no good for you. Not only do you need a website to succeed, but you need visitors as well, and just by building a website will not bring anyone to it. Without traffic, you will fail.

2. Your Website is Too Broad

You can have traffic to your website, and your design might be appealing to your visitors but if you show no uniqueness or advantage over your competitors your losing more business than you should. Although Branding is often misunderstood, it is a crucial part of defining a unique business image and which should be portrayed through your site. Show a competitive advantage through your website design, style and content and you'll retain more customers and take a few from your competitors as well.

1. Your Website Doesn't Influence Your Visitors to a Profitable Action.

If you didn't plan out the primary and secondary objectives of your website, then your website is probably spinning your visitors in circles. Give your website an objective, and every aspect of it should be in accomplishing it. If your trying to sell a product make it appealing and easy for them to do so, if you want them to call you on the phone do the same. Too often a website is about a company and loses its potential influence it can have to make your company more money. If you aren't getting what you need from your visitors, your website has failed.

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Eagle Scout Bruce Scott (Jackie Cooper), leader of Martinsville Troop Number One, and his pack set off in search of lost treasure using a map provided by Tenderfoot scout, Skeets Scanlon (Bill Cody, Jr.). Scoutmaster Hale (Jack Mulhall) leaves the expedition to rush home to an ailing wife, but Bruce and the scouts push on, and the map leads them to Ghost Town. The treasure turns out to be a large cache of counterfeit $20 bills and the plates used to print them. The troop also discovers a lost branch of Inca Indians living in the mountains still undetected in 1939. The tribe gives ferocious efforts to keep the scouts from discovering their Temple cave as it contains a huge radium deposit known to them only for its ability to heal wounds. Bonus Features: Bios| Trailers|Scene Selection Specs: DVD9; Dolby Digital; 235 minutes; B/W; 1.33:1- Aspect Ratio; MPAA - R; Year - 1939; SRP - $19.99.
Free download of Scouts to the Rescu Online Right Now!
Scouts to the Rescu was affable! You have to clear up this movie! A gilt-edged performance by Jackie Cooper David Durand make Scouts to the Rescu a want to respond movie!
The wonderful cast includes Jackie Cooper, David Durand, Bill Cody Jr., Vondell Darr, William Ruhl. This cast just make Scouts to the Rescu the more staggering.

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Adapted by screenwriter Sooni Taraporevala from the novel by Jhumpa Lahiri, director Mira Nairs The Nameksake is populated by well-drawn characters and filled with memorable shots and engaging scenes. But in the larger sense, the film is a provocative look at the two sides of immigration: the adjustments faced by a couple who move here from a distant land, and the struggles of their offspring to reconcile their parents traditional culture with their own distinctly American outlook. The tale begins in the late 70s, when aspiring engineer Ashoke Ganguli (Irfan Khan) and his new wife Ashima (the radiant Tabu) move to New York from Calcutta. Life in America is strange, in ways both good (the gas in their apartment stays on 24 hours a day! You can drink water straight from the tap!) and not-so-hot (New Yorks winters). But for their children, first son Gogol (a standout performance by Kal Penn, heretofore best known for the stoner comedy Harold Kumar Go to White Castle), nicknamed for his fathers favorite author, the Russian novelist Nikolai Gogol, and then daughter Sonia (Sahira Nair), the American way is at odds with their folks more conservative mores. Gogol (who later adopts his more formal first name, Nikhil) smokes dope, calls his parents you guys, goes to Yale, and hooks up with a preppie white girl (Jacinda Barrett); for her part, Sonia complains that she wants to go home when the family returns to India for a visit. Only when tragedy strikes suddenly does the young man realize how totally alienated from his family he has become, prompting some major changes. Theres nothing especially original about any of this, and even those who havent read the book may sense that some of Lahiris material has been lost on the way to the screen (the treatment of Gogols marriage to a beautiful Bengali-American girl, played by Zuleikha Robinson, seems oddly truncated). But even while dealing with lifes Big Issus (birth and death, marriage and separation, joy and misery), Nair has created a winning, intimate film that reminds us of the strength of family ties and effortlessly persuades us to care. Sam Graham
Kal Penn Blogs About The Namesake
Welcome to The Namesake DVD. After touring the festival circuit last year, our film opened globally (including North America) in March of this year, and Im proud to bring you the DVD!
This is a project that has been close to me from the beginning. I was a big fan of the book ever since John Cho recommended it to me during the first Harold Kumar shoot. John and I tried to get rights to turn the book into the film, but Mira [Nair, director of Monsoon Wedding and Salaam Bombay] had already acquired them. That began a really aggressive campaign on my part to try to get seen for the role. Id call Miras office, have my manager call - but we had no luck in getting in the door. Luckily, unbeknownst to me, Miras son Zohran and her agents son Sam were lobbying on my behalf (turns out they are huge Harold and Kumar fans, so they were trying to get their parents to bring me in to read for the part of Gogol). Mira finally agreed, and I got a call saying that Id be able to audition. I flew out to New York, and luckily things worked out.
There are some similarities between my life and Gogols. We are both Americans of Indian descent, both born and raised on the East Coast, both bilingual, and both passionate about our careers. But Gogol is much more subdud than I am; he carries a certain silence (which he gets from his father). His place in the world is one of constant shift a byproduct of being single in New York, being passionate about his job, close with his family, and so on.
This film is my favorite to -date. Mira has been a role model of mine since I was very young, Jhumpa [Lahiri, author of The Namesake] is one of my favorite authors, Sooni [Taraporevala, screenwriter for Salaam Bombay] one of my most admired screenwriters, so its an honor to have the chance to be part of the screen adaptation of this story.
To me, its a very American film. Its about family, about hope - about how we all got here, through the lens of this particular family. With so much negativity every time I turn on the television, Im proud to be part of something that hopefully leaves the audience with a tremendous amount of hope, and a connection to the people we love. Kal Penn
See The Namesake Online Right Now!
The Namesake was pleasant! You have to look on this movie! A miraculous performance by Irfan Khan Kal Penn make The Namesake a must recognize movie!
The startling cast includes Irfan Khan, Kal Penn, Jagannath Guha, Ruma Guha Thakurta, Tabu. This cast just make The Namesake the more amazing.

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By Shannon Fiecke, Correspondent
Library hours may be cut, the visitors’ center at Cleary Lake Regional Park will likely close for the winter and additional squad car cameras won’t be purchased because of nearly $1.7 million in budget reductions agreed to last week by Scott County commissioners.
In the quest to fill an anticipated $3 million budget hole,
commissioners slashed funding for roads, parks, libraries, capital
improvements and a retirement benefit fund, as well as reduced support for outside agencies.

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By Shannon Fiecke, Correspondent
Library hours may be cut, the visitors’ center at Cleary Lake Regional Park will likely close for the winter and additional squad car cameras won’t be purchased because of nearly $1.7 million in budget reductions agreed to last week by Scott County commissioners.
In the quest to fill an anticipated $3 million budget hole,
commissioners slashed funding for roads, parks, libraries, capital
improvements and a retirement benefit fund, as well as reduced support for outside agencies.

Similar posts: american arthritis foundation

Like most Americans, I like to journey a lot and I think, you too like to go on vacations. But safety is not always guaranteed while you are going on vacations. When we plan a vacation break, we are too pre-occupied with what we are escaping from, like a job and all the accompanying stress, but there is always danger looming wherever we go. Let me offer you these safety tips that you can take into consideration so that you will be guaranteed of a safe journey.
Certainly, you would be carrying any case when you go traveling so make sure that you, by no means, would put your address on the case. There ought to be a case tag and just put your name and telephone number on it. This will assure you that your case will be given back if you happen to misplace it for that person who wants to return it will know how to find you.
The reason why putting your full postal address on the tag is quite risky, is because the robber will somehow find his way to your home thinking that there are better things in there once he was able to get a hold of valuable things found in your luggage. Its a rather safe bet to just settle on leaving your first and last name.
Let me tell you something about any important document to be carried. In fact your luggage should contain only things, which even if lost, does not matter, like clothes. Your valuables such as credit cards, passports, and other significant papers should never be kept in your case. As I mentioned it earlier, if somebody can access these items, he has all your personal details.
Be less boastful about your money: Usually, those who love to show off to the people that they have all the luxuries are those travelers who have the most debts. For instance, if you sport high-priced jewelry, a goon may decide to pursue you to a point where you find yourself lost. Travel gear should not include flamboyant clothes etc, as it hardly matters to anyone how you look or how much you are worth. Would you rather care and be concerned enough about the style of other people?
Clean out the wallet: Before you go on your next journey, try and clean out your billfold. According to [travel] gurus, it is better to journey light and not carry multiple charge cards and documents which are best left at home in a secure place. In any case, one charge card is just more than enough. Make a note of the number that you need to contact in case the credit card you carry gets stolen so that you can call immediately to cancel out any transaction.
There are a lot of points that can be provided for you as much as you want but it still depends upon your verdict of what you want to follow and take heed. The most critical point to remember is not to flaunt or carry things, which are worthwhile when traveling. Take things with you, which, if lost would not hurt you very much, and if you follow this small advice, you can have a safe journey.

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