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6 Ways You're Eating McDonald's Wrong

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Want to know how to get hot fries every time?

iPhone 6 and 6 Plus

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With the iPhone 6 and 6 Plus, Apple offers two screen sizes: 4.7 and 5.5 inches. Both models feature Retina HD Displays, longer lasting batteries, a faster A8 microprocessor, and compatability with Apple Pay, the mobile payment service. CNET Senior Editor Scott Stein has a hands-on look at the sleeker, newly designed handsets

Facebook Adds Oculus Rift to its bug Bounty Program

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Facebook is offering a minimum of $500 for vulnerability reports concerning the Oculus Rift, its development software or website.

Cat Fished By The Bell

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The Ultimate Celebrity Stage Falls Compilation

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Cute Cats Working at Pizza Hut

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Energy Drinks

We all have to go through busy schedules throughout the day. We require more energy to carry out our daily activities. People sleep less and work more to earn money and satisfy their needs. Therefore, people have started using energy drinks to replenish the lost nutrients from their body. There are many popular brands of energy drinks that are consumed by people all over the world. People rely on caffeine to energize their brain and nervous system. It is an old fad that people get energy from caffeine. There are many energy drinks that contain the same caffeine as found in coffee. You should avoid taking such energy drinks as it can produce harm to your body if consumed in high quantity. You should look for the best natural energy drink. People do not have time to even search for a natural energy drink. They consume what they get easily in the market. When people get completely tired and they feel that need something to boost up energy, they start consuming caffeinated drinks to boost their energy. This is not a healthy choice. People experience low energy due to lack of sleep. When a person feels low, he/she search for an alternative to boost up energy and the best choice is an energy drink that contains caffeine. People do not want to change their sleeping habits; rather they choose an energy drink to fill up the gap which is not a good choice. If you find a natural energy drink you may get more benefits. Rebound energy drink is a natural energy drink that contains zero calories and no amount of sugar. It contains natural caffeine that helps you in a positive way to boost up your energy. You can also change your lifestyle to boost up energy instead of taking caffeinated beverages. Drink more water during the day to boost up your energy. Water helps to detoxify your body and removes the harmful substances from your body, thus making you more active and smart. It is believed that people who drink water in the morning feel active during the whole day. People have to change their thinking. They have to change their diet and eating habits to remain more active. They should choose an energy drink carefully. Energy drinks that contain only natural ingredients and no amount of sugar can provide some help. Therefore, one should look for the best natural energy drink to boost up energy naturally.

Religious Sites Of Singapore

Singapore is known for its freedom of religion. With the constitutional support, several religions and their sacred places of worship thrive in this small and wonderful country. However, when you visit Singapore on a travel package, there are few exciting shrines you must visit. The awareness and aura of these shrines heightens your spiritual experience too. Though, that is not necessarily a goal of Singapore holiday package, some places of worship in Singapore do have high spiritual and religious quotient indeed. Buddha tooth relic temple & museum: Located in the heart of Chinatown, this temple is considered sacred and holds a lot of emotional value for devotees. However, this is well loved and revered temple among tourists of all religions too. The architecture of temple, sacred tooth relic chamber on 4th floor, gold stupa, roof garden and Buddhist culture museum on 3rd floor convey heart-warming story of Lord Buddha and his teachings. This is the unique kind of experience that makes it a must-visit travel destination in Singapore holiday package. Agreeably, it is not fun like night safari, but it is an unravelling experience too. Sultan Mosque: This is the first mosque built in Singapore, by 1826 but the version you see today was completed in 1928. This national monument and local landmark has the largest prayer hall that can accommodate more than 5000 Islamic devotees. However, if you want to enter the premises as tourist, then you will need to adhere to strict dress code of the place. This is not a most common travel attraction for most Singapore holiday packages. However, it is a charming and deeply spiritual shrine indeed. Sri Thandayuthapani Temple: This temple is also known as Sri Thendayuthapani Temple or Chettiar Hindu Temple. Chettiars were wealthy lenders and early property owners in Singapore. They constructed the original temple in1860. But, it has been renovated and enhanced over period of time. This massive and grand temple in Singapore has rosewood floors, and several stunning sculptures. But the presiding deity of this temple is Lord Thendayuthapani or Lord Murugan. With the deep-felt spiritual vibe, this temple remains a well visited by locals and visitors. You can avail a tailor made Singapore holiday package and choose to visit the shrines you truly revere. Singapore has shines of Hinduism, Buddhism, Islam, Christianity, Taoism, Jainism, Sikhism, Confucianism and more. It can really accelerate your spiritual experience of Singapore indeed. So, make most of your travel package and visit the shines you want to explore rather than the ones on standard vacation itinerary.

How PMP Certification Helps Advance Your Career?

If your chosen career path is taking you down the road to management than you need to seriously consider working towards your PMP Certification (Project Management Professional). This is globally recognized and is a great enhancement to any resume. The PMP certification online course provides the resource and tools that you will need to thoroughly study for the exam and pass it with ease after putting in hours of hard work and study. It is offered through a couple of different formats such as classroom (real or virtual) and online. If you are located in the UAE region then take advantage of their face to face instructors but for others in different locations there is the ability to continue their education through long distance learning. Taking it online also allows you to continue working in your chosen career field and build your hours since this is part of the requirement to take the exam. There is nothing you have to have before going through the course but a combination of hours and a degree (or diploma) are necessary before taking the final exam. This sets this certification apart from others that order their process slightly different with allowing hours to come after the exam but before the certification. Another benefit is that you can request the amount of time you will need to complete the course without having to worry about a room full of other students that need to move at the same pace together. Review difficult concepts several times, send the qualified instructors your questions related to the material and access the site through a variety of devices so that you can study even when you are on the go. Several areas are focused on such as time management, cost management, scope and quality management and several others that are key to a company's success. You are provided with a number of professional development units (PDUs) offered at the completion of course, video-tutorials throughout the course, textbook with e-book option, practice quizzes and even a practice exam so you can measure whether you are ready to proceed or not. Once you have gained the knowledge base and proven that you have the necessary documented on-the-job experience then you can be awarded the PMP certification and start using this on your resume. This will be extremely helpful when applying for new positions or increasing the benefits in your current business. An individual with this expertise can save money and time because they are able to manage projects of any size more efficiently and help others manage their projects in a more efficient and cost effective way. Before applying to the course, check with your Human Resource or Training Department and ask about tuition assistance or employee education programs that may already be in place. The cost may be covered under one of these benefits so that you do not have pay anything out of pocket. This is a win-win situation because you increase your marketability while the business gains a valuable resource and commodity that it no longer has to find in a third party. Whether you want to get PRINCE2 training or assistance for obtaining PMP certification, a top-of-the-line organization can assist you. Don't let someone else get ahead of you when this process is simple, easy and within your reach to take a hold of and pursue. You need to have the edge over the competition and be noticed by the upper management as the self-starter and over achiever!

Benefits of Plastic Surgery

Plastic surgical procedures have one goal to help you present to the world a look that matches who you are inside. Plastic surgery makes to you very confident and improves your looking appearance. Plastic Surgery is a surgical procedure of reconstructing the face and body. Plastic Surgery has many types like skin surgery, facial surgery, Nose Job and body surgery. Due to Plastic Surgery, You could not smoke; Smoking increases your risk of developing infections, pneumonia, and death of tissues after surgery. The chemicals in cigarettes and cigars close the blood vessels, which prevents the body from braining oxygen and nutrient-rich blood to the surgical site. Closed blood vessels also prevent the blood stream from carrying away waste from the surgical site. All of this can lead to infection and slower recovery. Plastic Surgery is a very sensitive operation. So you should take care and choose the right plastic surgeon that has vast experienced in this field. Plastic Surgery is costly in USA, Canada and UK. Lebanon is a country where you can find the best hospital and surgery center for plastic surgery in Lebanon. Some People have perfect body and shape, Some have been unfortunate enough to suffer problems accidental injury. Plastic Surgery is a modern surgical method which improves your looking appearance and ability to function. Does Plastic Surgery the Right Choice? Plastic surgery helps reconstruct significant defects or problems. But what about having cosmetic surgery just to change your appearance? Is it a good idea for teens? As with everything, there are right and wrong reasons to have surgery. Cosmetic surgery is unlikely to vary your life. Most board-certified plastic surgeons pay lots of your time interviewing teens United Nations agency wish cosmetic surgery to make a decision if they're smart candidates for the surgery. Doctors wish to grasp that teen's area unit showing emotion mature enough to handle the surgery which they are doing it for the proper reasons. Many cosmetic surgery procedures area unit simply that — surgery. They involve anesthesia, wound healing, and different serious risks. Doctors United Nations agency perform these procedures wish to grasp that their patients area unit capable of understanding and handling the strain of surgery. Brazilian Esthetics Clinic is a best surgery center for plastic surgery in Lebanon. If you are looking for plastic surgeon then you need not to go anywhere. Here, Brazilian Esthetics clinic is a complete center for esthetics services. You will get the pre operation consultation. So you can check your surgeon's experience.

Hair Loss Fiber Treatment

Hairs are the most essential feature of one's personality. Whether it is a man or a woman, the hairstyle that they keep play a very important role in making them look presentable. When we are in some public place where there are lots of people, apart from the dress that we are wearing, our hairstyle is one of the key factors that people will notice and get attracted to us. Precisely, we can say that if we want that people should notice and get attracted to us, we should pay special attention to our hairs and take good care of them. However, due some hair fall and baldness problems, many a times, people have to face situations of embarrassment in such public places. This is because when a person develops bald patches on his head, usually, he becomes a subject of mockery in social get gatherings and this might wound his self-confidence as well as outer personality. To avoid all this from happening and to save people from becoming uneasy target of depression that bald patches might bring, Hair Loss Fiber Treatment has been developed with the main motive of lending a helping hand to such people. It is undeniable that everyone, at one point will experience hair loss. Whether you're a man or woman, young or old, irrespective of gender or age, falling hairs is an inevitable condition that is bound to occur. According to scientifically proven facts, a normal human being loses almost 100 strands of hairs regularly and grows the same amount of hairs simultaneously. This condition is said to be normal. However, a person needs to take things much seriously when he notices that there is more hair fall than hair growth taking place and over a time, bald patches start getting visible. In such cases, it is advisable to seek the help of a doctor. Most doctors recommend the patients who wish to get rid of those ugly bald patches on head to use Hair Fiber Products that are a part of hair fiber treatment. From many years, a lot of people have been using this treatment and most of them are satisfied after getting positive results from it. This treatment is known for providing instant, yet effective results. The people who have tried it consider it as a boon that can bring back their lost smiles and self-confidence. Though, this fiber treatment is one of the most effective keys to cure baldness, but, the degree and level of results that you wish to get after using it might vary and largely depends upon how to use the Hair Building Fiber Solution, which is the main component of this treatment. If you are looking forward to get quick and long lasting results, you need to apply that solution to your remaining hairs on regular basis. The hair building fibers present in it will provide strength to them and make them look dense and abundant, giving your head an appearance of being full of shiny hairs.

The thrill of Sports

In ancient times, what started out as a competition of hunting or running faster has evolved into a worldwide phenomenon, with the passing of each millennium! Sports have become an integral part of our lives and culture as sporting events provide great pleasure of competition and victory. Sports is enjoyed by all, fromprofessional athletes, who see it as a platform to achieve something for themselves, their team and country, to millions of fans who buy sports events tickets to witness the battle commence between theseprofessional athletes for victory and glory. The multibillion dollar worth, ever expanding sports industry is massive that includes a number of games to satisfy sports enthusiasts appetite for thrill. Football, cricket, baseball, soccer and basketball are among the most famous global sports. These games generate and revive a spirit of civil camaraderie, transcending the boundaries of nationality, race and culture, as the athletes engage in competition. The popularity of sports led to the inception of a worldwide governing body for each sport, providing a well-built structure to the games. Everything from soccer to boxing and car racing is now governed by federations on an international scale. These governing bodies are not only responsible for developing the structure of the sports but also to organize competitions between teams. In fact, there are some sports survived that survived due to these federations, as the certain amount of attention is required for each sport to prosper. These federations are also responsible for the major league governing bodies including, NHL, NFL, NBA, MLS, and NCAA events among many more. The carefully planned out leagues keep the audiences coming back for more, as this growing and prime medium is a great source of entertainment for sports fans. Arguably, The most craved event is the Super Bowl and World Cup Championships, be it Hockey, Football, or baseball among other sporting events. There are endless benefits of sports in life that's why people are involved in sports all over the world. There is something about the sports played in America that captivates audiences around the globe. Americans are known for their passion for sports, and their sports industry is regarded as a hub of entertainment for sports fans. Some of the major sports players have become a big-time celebrities, including Diego Maradona, Babe Ruth, Valetino Rossi, Michael Jordon, and Muhammad Ali among many more. Sports and celebrity now go hand-in-hand, and become another major reason for the sports industry to have grown in to multi-million dollar franchise. Although all these sporting events are also broadcasted on television, but there is nothing like experiencing the thrill of actually being in the stands and witness your favorite teams and players live in action. The adrenaline pumping moments has no match, as your favorite player or team scores. The screaming and yelling out of delight at the top of your voice alongside friends, family and thousands of fellow sports enthusiasts make the experience worth the while. Be it the competition at a football field or a fighting ring, a racetrack or a basketball court, buy sports ticketsand experience the thrill by watching it live!

Horseback Riding Benefits For the Body and the Mind

Horseback riding has amazing benefits for people of all ages. It is ideal for beating stress and increasing physical coordination. Horse riding also improves the speed of your reflexes and boosts mental concentration and agility. There are many benefits of horseback riding on the picturesque trails of Maryland. This US state is home to a vast number of equestrian camps which help professionals and novices to acquire key skills for horseback riding. There are enormous benefits of horseback riding in Maryland. Opt for horse riding lessons at the camps here if you want to improve your mental, physical and emotional health. Horse rising is therapeutic. It has immense advantages for the body as well. It improves balance and coordination of muscles. It is also useful for enhancing muscle tone and improving reflexes. You also get other benefits such as prevention of muscular cramps and improved joint mobility. It is also a great way to boost cardiovascular health and improve your blood circulation. Horseback riding has benefits for the brain as well. Riding a horse improves your visual perception of space and the integration of the sensory impulses. It also instills positive qualities such as patience, self-discipline, responsibility and self-esteem. Horseback riding is great for personality development. Riding a horse also leads to the stimulation of internal organs. Horseback riding is as effective as cardiovascular workouts when it comes to improving the health of the heart. Increasing the speed at which you ride the horse will challenge your muscles further. Riding for longer durations can also improve your physical stamina and help you to burn fat easily. Horse riding is ideal for those who have an affinity for nature. Riding horses through the trails in Maryland is the perfect way to unwind in beautiful natural surroundings. Horse riding is also a good way for children to learn a sense of responsibility. Youngsters can acquire key skills such as knowing how to groom and care for a horse if they attend these camps. Adults also engage in plenty of activity such as carrying bales of hay for the horse or cleaning the stables at the camps. These are ideal weight earing exercises for those who want to improve or maintain their bone mass. Riding a horse also improves self-confidence and helps to instill a sense of well-being. It is a great stress-buster as well. Learning to steer a horse is a challenge by itself. Learning key horseback riding skills improve cognitive clarity and mental dexterity. Horseback riding also improves emotional health. Riding a horse in an arena or a trail helps you to chase away negative emotions. A pleasant ride through the wooded trails in Maryland will help you to relax and feel good. Visit to know more about summer camps in Maryland. You can also take part in local equestrian (http://en.wikipedia.org/wiki/Equestrianism) competitions if you want to engage in a little adventure.Horseback riding is a relaxing pastime which has a very good impact on your mental health. Connecting with nature soothes the mind and drives away the worries and the tension. Horseback riding is also great for improving flexibility. Maryland horseback riding lessons are ideal for those who want an intensive work out that exercises the major muscles in their bodies. With careful instruction and guidance, riders of any age can learn how to handle a horse well.

Difference between Online Education VS Traditional Education

These days, the internet has grown into a veritable wealth of information for college seekers. Everything from applying for financial aid to taking a course can be accomplished online. Now, a student can even obtain online degrees from one of many schools offering online education as a viable alternative to a traditional classroom education. How different are these two methods of teaching, and do either prove better for the student? There's an abundance of information regarding online education, and distance education is becoming increasingly popular for students everywhere. First and foremost, there are some obvious benefits in obtaining instant degrees. For example, juggling a job, school and a home can be very difficult as far as commuting to the classroom every day. With online education, you eliminate the need to attend classes, and instead access your coursework from an internet website. This presents an obvious benefit to the overworked college student because his commute is basically slashed in half. What's more, many distance education programs allow students to complete the coursework any time during the day, while still adhering to overall deadlines. This allows for flexibility that a traditional classroom setting can ordinarily not provide. However, is an online education truly comparable to the type of education a student would receive in an actual classroom? Many professionals in the field say yes, and certainly students seeking online degrees can confirm this response. Not only does online learning provide a stimulating environment for students, but it promotes even interaction among every student because everyone has a say in classroom discussions. What's more, online education programs allow each student to learn with the methods that work best for them. Plus, many employers respect online degrees as much as a traditional college degree, so there's really no difference in the amount of education or respect a student will receive when attending an online college. While traditional colleges will never be eliminated, there's definitely been an increase in the amount of students attending online colleges in recent years. Many people choose to follow the online education route for the diversity of material they can find, or because the teachers are more approachable via the internet than they would be in a classroom setting. Students definitely need discipline and self-motivation to succeed in obtaining online degrees, but there's still the same level of help and support from teachers and students online that there would be in a classroom. What's more, internet college students are learning skills that will be beneficial to them in the workforce and beyond because of the way technology is evolving today. Life experience online degrees are becoming an increasingly popular way to obtain a college education and many students are turning to online education because of the quality of material, convenience and the level of flexibility inherent in distance education programs. Because there's no distinct differences between an online education and a traditional education, students are assured they are receiving the same kind of education that they would in a brick and mortar setting. There are definite benefits to online degree programs, and students with discipline and motivation can and will succeed greatly in online education programs.

Friendship

Friendship seems to stock a lot of fine things that cover happiness, dignity, prestige amusement and delight as well as many other feelings which are unable to express in language but heart can recognize. Friendship records sensation what may be described is a divine. To come across a true friend is an easier said than done, none but fortune can help on the issue. Friendship sheds a meaning in what friends to be obsessed with each other, they will continue to friendship in future even after death. A Person is helpless without a real friend. A friend keeps his genuine friend s friendship in deeper corner of the heart with a great passion of love. One relies on dependency on cemented friend while distress falls on one life. What is a friend, a little word but a great power to bind us very strongly? Friend is neither a blood relation nor a relative yet from school to college, university and service arena we are in a trapped in the name of friendship. Friendship bears a paramount importance on human life. Considering its significance, one can assert that witty and intelligence and taking some time should be obligatory before making a friend. In present days women in large numbers are coming into working fields. Mobile and face book user are growing day by day. For these easy social media a scoring numbers of persons hold out their friendship hands to unknown. All hands are excellent to be friendship; an astrologer cannot coincide to this opinion by his supernatural method. Taking care to select a friend what is called is an intelligence effort. Prior to selecting a friend several questions should be come up which are: at first verify mentality- same mentality helps in choosing a friend; relation between friends is mingled with respect; friends have to be respectful to each other; due to this quality friendship is sustainable for long time. An expert advises that friendship stands for mirror of soul. Friendship will have happened among those people who have same mentality and give value to others feelings. Friends in same ages are not a must while friends can be grown up around in different ages having same mindset. So mutual understanding appears to be necessary ahead of making friendship .Friends can have influence over us in various ways; many high-quality works and achievement were made successful by getting fine advice and co-operation from them. Many young person's spoil their life with the bad company of friends. Many of people are implicated them in criminal activities due to shocking friends. Younger generation is fond of friendship; at present face book is a wonderful colossal social media contributing to making friends. One confirms friend who send friend request from home and abroad in face book what is look like dreamland. What is a problem is that many individuals in face book use fake ID for real one, are remained far away from real identification. In this field advice is that one can make friends in face book in largenumber maintaining a justifiable relation but not to cross limit which call for destruction in personal life. In human life proper friends appear to be needed but those have to be gentle, cultural and believable having mentality to share sympathy with others friends distress and sorrow. In all circumstances, friends must be co-operative and faithful. What is a life but a combination of happiness, suffering and grief? Unhappiness and distress are accumulated inside a person. Those feeling can be described only to a bona fide friend. He can eliminate friend griefs by providing solace advice and accessible messages. An important question is that how a person understands a friend is either good or bad. In respond to this, one may understands if he sanctions a number of days with a friend, his appearance, nature, behaviors and performance will give signal to what extent he is awful or excellent. When a friend is wronged once, friend relation would not be broken off immediately without letting him time to understand what his mistake is. As rational time is required in building a friend, similarly friendship cannot be torn off due to trifle reason .Because afterwards a question may appear to your mind that before taking the wrong decision a modest time should have granted

Online Games

Online social games have become very popular after the tremendous growth of Facebook and other social networking websites. People spend time in playing social games and aim at developing their friendship circle. Social networking websites have now become a good place for game lovers People increase their social contacts in these social networking websites and help one another in reaching their goals. Greatest Desire is one such online social gaming network. The website enables you to make friends and play online social games. Members get to play the social game of discovering other member's desires, wishes, interests, personalities and preferences. This social game gives complete relaxation to mind and helps people to make new friends. You can share your interests and wishes with your new friends in this social network along with playing cool online games. Greatest Desire allows its members to play an online social game of predicting other member's desires and wishes. This website is all about sharing your dreams with the members of the website. The game is about finding the members with similar desires. These members soon become your friends. The social skills online games become a common platform to establish new relationships eventually. You have to complete your profile with true information and search for another member profile. After selecting a member's profile, click the "Start Game" button. You will be directed to the Desires board where you have to select one of the three desires of the user. The system processes your answer and adds the user as your friend. If you wish to join the social network of Greatest Desire, it requires an initial deposit amount of $5. You can open an account for free at Greatest Desire website. Go to your account and select deposit tab. Enter the amount you would like to deposit (a minimum of $5). You need to have a paypal account to deposit amount in the account at Greatest Desire social gaming website. The game is all about guessing the other person's greatest desire in life based on their profile information. You have to use your intuition in finding out the other member's desire. The game allows finding and making friends with similar interests, desires, preferences and wishes like yours in an exciting manner. At the end of the game, you will have friends with the same desires as yours. Kim Statham is a big time advocate of social networking as a way of life in the recent times. She recommends GreatestDesire.com as a great onlinesocial gaming networkwebsite which offers interesting avenues to get to know new people and have fun at the same time.

Stamp Collection

Collecting stamps is pretty easy. One may save stamps from packages, letters and postcards. People interesting in stamp collection can also ask their friends and family to save stamps for their mail for them. They may also swap stamps with other collectors when they have doubles. You may also collect stamped envelopes from neighborhood businesses that get a lot of mail like stores, banks and travel agencies - might save their envelopes for you, too. Or, you can start your collection by choosing one or two favorite subjects and then, collect only stamps that fit your theme, which can range from art, history and sports to transportation or science. This is called topical collecting. Most people who collect stamps do so for the sheer fun of it, without putting too much thought into making a profit. Hobbyists who collect stamps love to learn about the stories behind their stamps, as well as explore the world behind the production of stamps. Every time you collect an old stamp, you will likely be curious enough about its origins and would definitely be interested in reading up the history of that stamp. Before starting on a collection, there are certain things one must know about such as the worth of a particular stamp depends upon two aspects-its rarity and the condition it is in. You can begin to judge the condition of a stamp by examining its front. Is the stamp clean, dirty or stained? Are the colors bright or faded? Is the stamp torn? Torn stamps are not considered "collectible." Is the stamp design centered on the paper, crooked or off to one side? Are all the perforations intact? Has the stamp been canceled? A stamp with a light cancellation is in better condition than one with heavy marks across it. Now look at the back of the stamp and see whether there is a thin spot in the paper? If so, it may have been caused by careless removal from the envelope or hinge. Once you have stacked up a wide variety of stamps, you are in dire need to store them. Just a common storage space would not do, you also need to show it off to others. This is when one needs to invest in stamp collecting supplies. Pinnacle offers a range of stamp collecting supplies such as stamp collecting albums and folders that take care of their storage and keep them in Mint condition.

Control The Cancer

He National Institutes of Health surveyed that skin cancer is the most ordinary form of cancer in the United States. Squalor's and Basil cell carcinomas are the most frequently diagnosed forms of skin cancer, and while melanoma is a smaller amount, it is the most lethal. Pres-cancers come into view in the form of actinic or solar kurtosis, which, if left unprocessed, may expand into squalors cell carcinomas. Looking for skin cancer clinics in Sydney is not that difficult task, as there are number of clinics in Sydney which provide a high quality treatment with the good result. All you need to do is search out for the best. The skin cancer experts say that if they would have expertise concerning skin cancer, it generally comes from nearly 30 years of dealing with it. Although they might have lost count, they have had at least four squalors cell, basil cell and four melanomas. Medical science is still not completely convinced what actually causes skin cancer. Present theory is that it results from experience to damaging UV radiation from the Sun. But if this is the case, than why does it sometimes come into view inside the mouth, the eyes or in one case I freshly read about, on the soles of the feet. If you want to have a treatment with the 100 percent result than you definitely consult in CBD medical centre Sydney. This medical centre provides the best treatment from any other clinics in Sydney with the proper heal. The only heal for any form of skin cancer is to entirely take away it before it spreads. In the case of solar kurtosis, this type can be detached from beginning to end with the help of cryosurgery; that is, chilling it off with liquid nitrogen. This is an impermanent measure as, in my case, these skin lesions come back in a few month's time. A second handling involves a very violent skin cream that in fact devours the lesions and nearby skin. This action takes three to four weeks, and when applied on the face, the patient looks like he slanting with a mentally unbalanced cat with sharp claws. Basil cells can also be detached with cryosurgery if they are not too highly developed. But most often they have to be cut out too very soon in order to get well soon. Squamous cells and melanomas are distant surgically. Surgery for melanoma taking away involved three surgeries in order to get it all done with the perfection. Want to find clinics nearby your location than Google it and search for the best.

Window 7

The tech support or technical support belongs to the galore of services through which enterprises gives support to the customers for the technologies products such as mobile apps, mobile phones, computers, software products support and other electronic and mechanical goods. There are many people who have tech support problems with their computer and they need a help from anywhere instantly, so they thinks that if they would live tech support so that they are able to solve the problem immediately. There are many company owners who have their own technical support team which provide them tech support solution whenever they have troubleshoot problem. The windows7 is the advance version of windows xp operating system, but many of the features of it are different from previous versions. In these days all the PCs, laptops, tabs, notebook available in the market have windows7 or windows8 operating system but to deal with it is not an easy task. As we know that the world in which we live is a corporate world where a single second have its own importance. There are many people who belong to the corporate world and they do not have deep knowledge about the operating system on which their computers are running so they always need Live Tech Support to avoid troubleshoot problems. There are many people who have tech support problem while using their computer so they need an instant help which can be possible by tech support live. If you are planning to install windows7 with your old operating system it is better to uninstall the old one first then start installing windows7. The installation of windows7 is not as simple as it requires activation key while the process is going on. Many times people yammer about the slow speed of their computer or the display of the computer the double operating system exists in your computer is one of its reasons. There are many companies which provide Windows Tech Support with the help of professional IT team which has deep knowledge about each and every problem which can be possible. The tech support problem is not a big issue but if it comes between your works takes lots of time to solve it. There are many tech support companies which claims to provide better services as compare to other companies present in the market. The customer always wants a quality work instead of brand name. The tech support live are giving their services such as Kasper sky antivirus support, McAfee antivirus support, AVG antivirus support and many more services with the help of a talented and skilled team members. If the customer knows that they get the service by the expert team members they assured that their problem will be solved soon without any hassle. We offer different modes of solving tech support problem that is on call, on live chat and in very critical situation we provide remote access for your computer with your permission so that the problem can be solved instantly.

Art And Craft

Are you interested in dazzling your friends and family with new and unique arts and crafts projects? Perhaps you want to learn new ideas that will help you design something that can go in your home. No matter the reason, there are endless terrific ideas for arts and crafts projects. Keep reading to find out more. Search for fabric and other arts and crafts supplies online. A lot of the time, you can compare prices and find coupons on the Internet much more easily than going from craft store to craft store. When you shop online, you can get exactly what you want from the comfort of your own home. Browsing the internet for new ideas is a great way to expand your arts and crafts skills. You can see what other crafters are creating and gain a new perspective on what you can create with your crafting skills. So go online to find new ways to expand your creativity when you are doing your favorite craft or hobby. Keeping your arts and crafts supplies organized can lead to a more pleasant experience when working on projects. Invest in good storage boxes, organizers and cases especially for smaller items. Supplies like beads and glitter can easily be spilled or lost. When you bring home new supplies, immediately transfer them into storage or organizational boxes. Create a location in your home where you share your family's arts and crafts projects. Whether they are made at home or in school, these are things that should be cherished by everyone! So give them the proper location that allows for prime viewing. maybe a corner of your living room can be your project showcase area. Do what you can to make a craft work with what you already have at home. This isn't always possible, but you should try it. It's usually not worth running to the store to obtain the perfect paper, detail, trim, etc. You can diminish your enthusiasm for the project when you have to break to run errands. Consider opening up your own shop online, if you are particularly clever with arts and crafts. Many merchants are making considerable earnings by selling their works online, and so can you. A place like Etsy will allow you tosign up for free, and after that it's just between you and your customers; offer your most unique designs up first, and take it from there! To spend a fun afternoon filling in a paint-by-number picture, make sure you have all of the paints you need lined up, along with a bowl of water to clean out the brush between color applications. This introduces your hand to the rigors of painting without having to think up the picture as well. If you're creating arts and crafts for a sale or a give-away, map out the project you are considering first. When you need to make dozens of the same items, it's important to understand the costs of each and the time you'll need to make each one. Otherwise, you could end up with some very late nights and an empty wallet! As previously stated, there are lots of ways to create in arts and crafts. You can create a simple picture for your bathroom wall or a complex statue for your backyard. Use the tips located above to help you develop your art.

Diabetes

If you have diabetes then you know how important it is to try to keep it under control as best as you possibly can. There are many ways you can manage diabetes, and many things that you can do on your own. If you are on any kind of medication, you should be taking it every time you need to. Even if you are on a fixed income, there are many pharmaceutical companies that can supply you with medication at no cost to you, and the forms are pretty simple and straight forward. If you are planning a trip, make sure that you plan ahead, and order more medication if needed. Be sure to bring along some kind of insulin pen, that doesn't need to be refrigerated, and travels well. Make sure that you have enough test strips, and make sure that the batteries for your monitoring equipment are fully charged, but bring extras from home in case you are on an extended stay. Just because you have this disease, doesn't mean you can't eat at restaurants, but you have to be smart about your food choices. Read the ingredients closely, and try to stick with low calorie choices. You can have as many vegetables as you like, but should you choose to order a salad, make sure that you order the dressing on the side, then you can just dip the salad into it instead. Enjoy your meal slowly, and try to take home any leftovers. You can also avoid over eating by ordering half meals if possible. Make sure that you monitor you levels, thirty minutes before eating, and an hour after meals. Also be careful that you are eating when you are supposed to, because if you aren't eating properly, this could lead to further problems later on. Get regular exercise; a good cardiovascular work out can be in simple forms, such as walking or riding a bike. It is important that you get at least thirty minutes of exercise a day, whether at a gym, or at home. You need to maintain your weight and eat a healthy diet to prevent heart disease. Read the food labels when buying at grocery stores, check the calorie contents, what the portion sizes are, and stick to these to the letter. There are many other valuable resources to help you manage your diabetes. You can find many helpful tips and information on the internet, as well as from your doctor. Make sure that you talk with your doctor before you change your diet or exercise routines, and keep in touch with him about your blood sugar levels, as well as your A1c hemoglobin number. This is important in case they need to up your medication dosage, or adjust it in other areas. You don't have to let diabetes control your life, as long as you are doing what you need to do. Be informed about your diabetes, educate yourself, and those around you who may try to tempt you with things you know are bad for you. One last thing, people with this disease tend to have foot problems due to poor circulation, so you need to check your feet often, like with a mirror, after your bath or shower.

Men Ffaction

Men's fashion in the 2000s is now as indefinable as women's fashion has been for the past few years. Gone are the days when men couldn't look fashionable with those uninteresting shirts and mundane trousers. Looking good is not only a woman's privilege. Each year, trends for men's fashion are predicted, but hardly have they followed any fashion trends. Hence, they escape stylish clothing. Even if they go for shopping their last option would be on safe shirt and predictable trousers. For younger males, hip hop culture has highlighted many trends for men's fashion, while older males are increasingly aware of tailoring, and making a garment fit right for their body shape, rather than going with the fashion trend. Trends for men have always been a tricky issue. You need to make a statement, and yet not overdo it. For the men who want to get started with this voguish experiment, this year is not a year to go too bold with colors, whereas shades of blue and black are set to rule. Denims continue to rule 2014 and printed shirts and jackets will also be a hit. You can set your mood to make yourself look different from the crowd with slim, narrow trend with slush of colors. An exclusive printed jacket with layering and a good amount of texturing on the fabric with fine yet visible detailing will look great. Printed jackets can be highlighted with Kalamkari work. The trend of printed jackets and slim pants is the future of fashion and the new age man replaces cargos with slimmer pants and includes more linen jackets in their wardrobe. You can even pair up your jackets with slim fitting blue denims which are completely classic, timeless and are one of the most resourceful pieces you'll ever own. It is easy to dress oneself with the slimmer cut ensuring sharper lines and a better shape. Indigo jeans works with almost any look you can think of and will never be out of fashion, so it's worth investing good money in self finished fabrics, which is of a higher quality and is almost guaranteed to last longer. Basic knitwear will be an essential component of your layering this season, and you'll be wearing it a lot. These staple colors allow you to play around with bolder shades within the rest of your ensemble and the mid-weight ensures that they sit on the casual side of the spectrum, which is much more suitable when you're just starting out. When it comes to suits, double breasted blazers are in fashion, so for people who like slim fits, new styles have come up to give a try. Wider legged pants are replacing the slim cut trousers which were a trend last year. For those who like sweatshirts can try out ones with interesting prints or patterns, which are big and has graphic designs. Short sleeved shirts are also back in fashion. Also you can let go the traditional outfit and opt for well-fitted kurtas, bandgalas in simple designs. Sports coats, camouflage prints and army themes are very much in vogue at international fashion shows nowadays. Also, golf pants and shorts are hitting the trend. Few years back golfing attire was very simple and elegant, and aimed at comfort but trends change with time. Golfing attires have become funkier and can team up with cloth-button shirts. They look casual and less sporty.

Student Sleeping Time

High school begins across the U.S. this week and next. And it begins too early! Too early in the day, that is. Ask any groggy teenager waiting for a bus or yawning in “home room” and he or she will tell you that it’s just too darn early in the morning to learn chemistry equations or analyze a narrative by some Russian novelist. Are they just lazy? No. Scientific studies of teen sleep patterns say they’re right. So do results from numerous schools across the country that have delayed start times: The later classes begin, the more academic performance improves. Bonus points: attendance goes up, teen depression goes down, and fewer student drivers get into car crashes. Seeing the mounting evidence, the American Academy of Pediatrics yesterday released a new policy statement recommending that middle and high schools delay the start of class to 8:30 a.m. or later. Doing so will align school schedules to the biological sleep rhythms of adolescents, whose sleep-wake cycles begin to shift up to two hours later at the start of puberty, the policy statement says. The conclusions are backed by a technical report the academy also released yesterday, “Insufficient Sleep in Adolescents and Young Adults: An Update on Causes and Consequences,” which is published in the September 2014 issue of Pediatrics. The “research is clear that adolescents who get enough sleep have a reduced risk of being overweight or suffering depression, are less likely to be involved in automobile accidents, and have better grades, higher standardized test scores and an overall better quality of life,” said pediatrician Judith Owens, lead author of the policy statement, titled “School Start Times for Adolescents.” The debate over whether to start school later has run for years, but a host of new studies have basically put it to rest. For one thing, biological research shows clearly that circadian rhythms shift during the teen years. Boys and girls naturally stay up later and sleep in later. The trend begins around age 13 or 14 and peaks between 17 and 19. The teens also need more sleep in general, so forcing them to be up early for school cuts into their sleep time as well as their sleep rhythm, making them less ready to learn during those first-period classes. Practice is proving the science. Hundreds of school districts in the U.S. have experimented with later start times and the academic performance of students has improved across the board. A study released in February that tracked 9,000 high school students in three states showed that grades in science, math, English and social studies all rose when school began at 8:35 or later. Controlled experiments with different start times among the same classes of students at two North Carolina high schools and among the freshman class at the U.S. Air Force Academy also showed that academic performance improved. The later the start, the better the result, too, according to Kyla Wahlstrom, director of the Center for Applied Research and Educational Improvement at the University of Minnesota. She published the study of the 9,0000 students. Delaying the opening bell from 7:30 a.m. to 8:30 a.m., for example, paid off more than delaying only until 8:00 a.m. Research indicates that students who get at least eight hours of sleep, and preferably nine, perform better than those who do not, Wahlstrom says, so a greater delay raises the chances of achieving those numbers. School districts may balk at such a large adjustment. But Wahlstrom says any change “will create some amount of community disruption, so there’s no real reason to make only a small shift; make the bigger shift and get the maximum benefit.” Most districts find that a change entails a full year of disruption, she say, “but then they don’t want to go back,” because the benefits are so tangible. The biggest resistance is just resistance to change, she says. “We’re into homeostasis.” What’s more, communities find that the usual worries about starting school later do not pan out, according to an analysis by the National Sleep Foundation. Students still succeed in holding part-time jobs, and after-school programs such as sports and theater still run well. “I get tired of the argument that these kids have to do all these activities and community service and therefore can’t start school later,” Wahlstrom says. “The issue is not the start time. It’s that the students are overly busy. There is too much pressure to cram it all in just to have a good resume to get into college.” Students, parents and school advisors should all be more judicious with what students choose to participate in, she says, with emphasis on doing certain activities well rather than piling up a long list. Studies in other countries such as Brazil, Italy and Israel also show that later start times improve learning. Across Europe, the equivalents of high school rarely begins before 9:00 a.m. “Europeans are shocked that Americans start so early,” Wahlstrom says. According to the pediatricians’ academy, 40 percent of U.S. high schools start before 8 a.m., and only 15 percent start at 8:30 a.m. or later. If school districts and parents are still not convinced, data about car crashes may make them take notice. Controlled studies are difficult, because so many factors are involved: the age of drivers varies within a school district, school districts with different start times have different mixes of students. But a few studies stand out. In Jackson Hole, Wyoming, for example, there is only one high school within a hundred mile radius. Delaying the start time from 7:35 a.m. to 8:55 a.m. correlated with a 70 percent reduction in car crashes among drivers ages 16 to 18. Another intriguing study was done more than 10 years ago by University of Kentucky researchers. In Fayette County, which has only one school district, crash rates of teen drivers dropped 16.5 percent in the two years after start times were delayed one hour, compared with the two years before the change. The kicker: the teen crash rate for the rest of the state went up 7.8 percent in the same time period. Sure enough, the portion of Fayette County students who got at least eight hours of sleep during weeknights rose from 36 percent to 50 percent, and those who got at least nine hours rose from 6 percent to 11 percent. Nonetheless, more comprehensive results are needed before fewer accidents can be reliably linked to later school start times, Wahlstrom says. But anecdotally, the idea makes sense. “Driving is monotonous,” she notes. “So if you’re sleep-deprived, you’re more likely to lose attention, have your head nod or fall asleep at the wheel.”

March

Does it deserve the Rang De Basanti soundtrack? Totally. With little gaps of the soothing sound of “Inshallah … .Inshallah”. But soundtrack aside, what is happening? The Pakistan Tehreek-i-Insaaf (PTI) is having an Azadi party, er, march. While the Pakistan Awami Tehreek (PAT) soldiers have finally been given an opportunity to prove to their leader just how devoted and obedient they are as they chant and march behind him. Both teams want the prime minister gone. Prime Minister Nawaz Sharif looks grimmer than ever and politicians from all the other political parties are feeling severely left out, hence PPP’s Shazia Marri’s outburst at the National Assembly this morning and the emergence of MQM’s Haider Abbas Rizvi and Ejaz-ul-Haq in Islamabad. Clichéd jokes aside, the PTI has once again done what no other political party could do (without threatening or buying them out): charge the previously apolitical and get them to rally for a cause, which quite possibly could rid us of a very corrupt government. The PTI are disciplined enough to follow their leader Imran Khan’s call for peaceful protest but rowdy enough to flip a container or two without really causing harm to public property (leave aside the fact that they’ve taken over the capital city at the moment). Alongside the PTI, march the angry man PAT’s Tahir-ul-Qadri and his chanters. His followers are very different from Khan’s supporters. They will sit when he tells them to sit and stand when he wants them to rise. While Khan’s protest revolves around rigging and corruption the PML-N’s involved in, Qadri’s beef goes beyond. Two months ago, several followers of TuQ lost their lives in a scuffle with the police outside his residence in Lahore. Those killed included women and children. The tragic incident was strongly protested against and in any other country, it would have been reason enough for members of the provincial if not federal, government to step down. PML-N supporters are probably itching to have a go at the PTI and PAT crowd, except those guys are still preaching peace. Although one may add here, senior PML-N leaders have vaguely reminded the country that they too have thousands of supporters sitting in the bleachers waiting for a signal. The Sharifs and their party may not be publicly foaming at the mouth just yet, but their blockades and closures to the capital are saying enough. Oh, the representatives of democracy! TuQ’s stance remains consistent, while Khan goes up and down. Khan calls for civil disobedience and you have thousands going up in face-palms. Then he redeems himself by stating that he’s open to talks with the government if Nawaz Sharif packs up. Although that still sounds unachievable, it isn’t as unreasonable as what he first started off with. Much as we are familiar with Khan and his charisma and his ability to self-destruct, TuQ is a whole different matter. Who is he? Where did he drop in from? I mean it’s true, we do often pray for fresh faces in our political scene, but this isn’t exactly what we meant. He claims he’s been living with his extended family in a one-canal house in Lahore since 35 years except he hasn’t – he just came back from Canada where he resides. His comparisons of Pakistan with other war-torn nations are often a bit of a stretch and his warnings of the doom approaching us seem a bit exaggerated even to the strongest pessimists. But, he is a brave man. He is live on national television at the moment asking Nawaz Sharif if he would still preach democracy if it were, God forbid his children who lost their lives. Despite the session court judge’s orders, no action has yet taken place on the incident outside his residence – he asks what good is such a democracy. I wonder as well. Oh and he loves the Army. Moving on, what’s going to happen tonight? Other than PTV, which insists on showing news from South Korea and China despite everything going on here, the news channels will have another field day with experts coming in and giving their 'valuable' opinions. Both the movements in Islamabad will probably gain momentum as Khan tempts the rest of the country to join the biggest event in Pakistan’s recent history. Both the parties will also continue to vouch their love and support for the Army, which stands alert in the shadows. But will all of this make Nawaz Sharif pack up? More importantly, do you want it to be so? Those not in love with Azadi and its agents might be sitting and wondering where they stand. Nawaz Sharif packing up doesn’t just mean the end of PML-N or this government; it will deeply damage democracy, as many argue. Sure, this democracy is a sham but it is a system. A very broken and bruised system that Zardari of all people, managed to pass on to Sharif. Could supporting Khan or TuQ mean being anti-democratic? What means more right now? Not derailing democracy - or not allowing another corrupt government to take the nation for a ride. What about the precedent these rallies will set? What if someone not as good-looking and patriotic, or someone not as scholarly, approaches the capital with thousands or more, and demands for the government to resign for whatever reason? What then?

Pakistani Car Manufacturers

I always thought that this would not only help reduce the cost of cars, but will also help increase the facilities and safety of cars in Pakistan, and the boy in me was secretly hoping for these companies to eventually start a professional car racing industry in Pakistan. But after passage of more than 2 decades, I see that Pakistani cars have tripled in price, while not many new models or facilities or even safety features have been introduced in the cars in Pakistan. In fact I am shocked to find that second hand Japanese imported cars of the same company, model and year, are not only cheaper, but they have a ton of extra facilities and safety features which are missing in Pakistani cars. Strangely the price of automobiles was greatly increased (50-60%) in 2008. At that time the companies blamed the increasing dollar rate but we have all witnessed a steep fall in dollar rate and there has been no decrease in automobile rates in Pakistan. Similarly, the amount of extra facilities like back cameras, cruise control, LED displays etc and safety features like air bags, back seat belts, ABS, fog lights etc are staggering in imported second hand Japanese cars but are missing in Pakistani manufactured cars. My questions were answered when I met an ex-employee of one of the major automobile manufacturer who told me, in great details, how the cars in Pakistan are "downgraded" at the manufacturers facility. Since the Pakistan car manufacturers do not use local part makers, they instead import pre-assembled car parts, that are than assembled into a car at the Pakistani facility. While assembling the manufacturer removes all the advance facilities and safety features from the pre-assembled parts, replacing them with cheap and unsafe alternatives. The removed parts are than re-exported to Japan for further sale. Although the Pakistani car manufacturing association is very powerful. But if the CCP or any other Government organization want, they can easily impound all in-transit shipments of pre-assembled parts, and than compare the features of these parts with the parts installed in cars available at the manufacturers dealerships. I think our Prime Minister, Mr Nawaz Sharif, is a car lover and he would also want the Pakistani car manufacturing sector to be eventually exporting and researching new cars from Pakistan. Therefore he should look into this investigation personally and ensure no unfair practices are used in deceiving the public.

Health Care In Pakistan

In Pakistan history has bore witness to general lack of health facilities and medical malpractices. For one reason or the other, the situation has not been significantly improved, if at all been made better off.In technical terms medical malpractice means: “A professional negligence by act or omission of a health care provider in which care provided deviates from accepted standards of practice”. Although, usually doctors are held responsible for any medical malpractice in Pakistan’s hospitals, but here I would like to highlight some other factors as well which become the causes of ill treatment of a patient. The causes like the lack of structural infrastructure and basic health facilities, the inefficient role of the hospital administration and the profit motivated pharmaceutical companies run a great deal of risk in exacerbating and damaging a patients already vulnerable condition. However along with these factors, the institutional framework to improve health system of Pakistan has not been given proper thoughtfulness or importance which is deemed necessary. Pakistan being a third world country does not have enough resources to improve its health care system but that is not enough an excuse to keep a shamefully low amount of budget allocation for health which is just 0.7% of the GDP. Not even 1%! Yet we hear all the time that with the ongoing war on terror and disputes with neighboring countries, Pakistan cannot afford to reallocate its expenditure from defense to any other sector. With the government’s failure to provide better health facilities and increased awareness of health among people; a large gap has been created between the supply and demand of health facilities. To shorten this gap, private sector has stepped in and has been somewhat successful in improving the health facilities in Pakistan. Private sector has played a huge part in improving health facilities in Pakistan. This has been done by building new hospitals, using latest technology and increasing the doctor’s salaries. Although, efforts have been made in the past decade to improve the overall health position in Pakistan but what underlines this fact is that the number of incidents of medical malpractice has greatly increased, especially in private hospitals. The unfortunate events of medical malpractices (like the case of Immane Malik and similar) can be attributed to a number of reasons. Negligence on the part of hospital administration in handling their staff, duties and responsibility is one main reason other than the obvious doctor’s carelessness. Furthermore, when a pharmaceutical company is motivated by profits, it actually plays with the lives of the patients as recent examples of fraudulent companies and fake medicines have come ashore. The facilities here in Pakistan are not adequate to treat a patient successfully especially in public hospitals where the demand for medical health care is high. There are not even that many hospitals beds available to accommodate such number of patients. Although private hospitals have come to the rescue but most of the Pakistani population cannot afford it. The charges of private hospitals are very high so people prefer to go to public or civil hospitals where they are forced to stand in long lines and facilities are also not up to proper standards. In public hospitals there is a shortage of doctors, so the ratio of patient to doctor is very high and more often than not the doctors are unable to attend to these patients. There are not enough nurses to see such a large number of patients. Even if there are nurses they are not fully trained and often cause mixing error. Mixing error takes place when the medical staff such as nurses mixes the medication of one patient with the other. This may lead to serious problems and can even lead to death. Other than this there is no proper documentation in Pakistan’s hospitals. Documentation is essential regarding each and every detail e.g. the number of visits made to the doctor and the dates, the various reports of patients. The absence of any such documentation leads to many errors as a proper follow up is mandatory and if the hospital would not keep record of all this then effective treatment cannot take place. If the patient has been prescribed a certain course of medicine and there is no previous record of that. This can lead the patient to repeat the course which might have serious side effects. So doctors are not responsible for malpractice in Pakistan, it includes hospital administration as well which monitor the facilities provided inside the hospital such as medicine, nurses, ward boy, and finally documentation. Failure in providing any of these to proper international standard results in loss of health. Other than blaming doctors or hospital administration, pharmaceutical companies are also to be blamed for medical malpractice in Pakistan. It occurs when patient takes some medicine to improve his or health, but the medicine rather than improving the health of the patient further deteriorates and causes other medical problems. And unfortunately recent past has shoved in a number of examples of profit galloping pharmaceutical companies, hungry to make money even on the expense of precious human lives. An example could be the recent Tyno cough syrup incident which took dozens of lives. Ironically all these factors of structural incompetence or structural malfunctioning are just the tip of an iceberg in relation to the issue of health system in Pakistan. This structural incompetence or malfunctioning actually results from institutional dis-functioning where the main issue lies in planning and implementing better health strategies, and we lack both. With such mockingly low level rates of GDP being spent on health, we can barely hope for a strong stable health system in Pakistan yet we desperately seek one

Technology Means for Healthcare

What does the future hold for the transcription industry? In the third installment of the Journal’s series on transcription, take a look at the new technology aimed at boosting productivity, improving accuracy, and, in some cases, asking physicians for direct information input. The year is 2006, and there are just a few hundred medical transcriptionists (MTs) still transcribing reports, serving only those older physicians who haven’t changed with the times—and the times have definitely changed. Physicians have finally recognized the power of electronic health records (EHRs) as well as the fact that this power is realized only if they input clinical data directly into the EHR. The vast majority of physicians are using empirically refined templates, pick lists, and other methods of structured, codifiedinput through the evolved progeny of today’s Palm PCs, pocket PCs, and Tablet PCs. Input methods include touch-screen, speech recognition, handwriting recognition, and perhaps other technology not yet invented. There are no longer any delays or expenses resulting from transcription. Plus, healthcare organizations enjoy numerous benefits derived from analyzing codified clinical data. But this is only one vision. Another vision of 2006 incorporates an unavoidable reality: many physicians strongly resist directly inputting clinical data. They believe it slows them down, which outweighs the potential overall healthcare benefits. Additionally, these physicians believe that structured input of patient information limits the freedom of expression afforded by free text. And frankly, these physicians don’t put much stock in the value of clinical practice analysis. So transcription continues. In fact, it expands dramatically. Due to regulatory controls and other pressures, more providers dictate more clinical notes than ever. The need for MTs explodes. In 2006, there are half a million MTs required to convert voice dictations into text, more than double today’s number. Which is the accurate vision? Neither. In three years, it’s likely that the transcription industry will resemble a combination of these two visions. More clinical notes will be needed in computer-ready form—and not through the scanning of handwritten paper charts. Both coded input and electronic free text will have an important place in the future. But technology continues to advance, and these advances will ultimately alter both the state of clinical documentation and the face of medical transcription. In this article, we’ll take a look at the most intriguing documentation technologies of today and tomorrow. Direct Data Input Enables Analysis Most EHRs already offer physicians the opportunity to fully construct their clinical notes by selecting the appropriate data right on their computers or personal digital assistants (PDAs). They can do this with a mouse, touch-pen, or voice. Templates for common conditions facilitate the input process, but it still generally takes longer to generate a note in this manner than by dictation. Yet much of the documentation can be done during the encounter, and the payoff from this method could be awesome. One of the reasons healthcare costs continue to escalate—now consuming 15 percent of what American households spend every year, with double-digit increases from year to year—is because we are not learning from experience. The only way to turn the crisis around is to implement continuous quality improvement. We must learn from analyzing the process and outcome of every clinical encounter. Then this new knowledge will enable us to increase the quality and decrease the cost of care. But we can only do this if we have data to analyze. Direct physician input of structured/codified data would provide the data we need, particularly if the industry adopts a controlled clinical vocabulary, such as SNOMED-CT. Then we will be able to understand which findings are connected to which diagnoses, which treatments work best under what conditions, and when diagnostic tests are worth performing. We can convert this learning to point-of-care clinical guidance and decision support to improve the cost-effectiveness of healthcare. But to make this happen, physicians will have to stop dictating and, instead, enter clinical data directly into a computer. This will not be an easy change to get them to make. Physicians Input Free Text It is likely to be a while before most physicians agree to perform direct entry of structured/codified data. Even when physicians agree to enter some data this way, they will still need a free-text “option” for information that doesn’t fit into the coding structure. Free text can be entered by typing, speaking, or handwriting. Most physicians will prefer speaking. “Front-end” speech recognition enables a physician to dictate into a computer or a portable (possibly wireless) device for uploading to the computer. Recognized text appears immediately on the screen. The recognition engine will make a few errors and the dictator will correct those errors via keyboard or voice. Less than 5 percent of practicing physicians are currently using speech recognition to generate clinical reports. And even some of these early adopters confess that they could see at least two to three additional patients each day if they didn’t have to take the time to correct the errors made by the recognition engine, despite its impressive accuracy rates of 95 to 99 percent. However, those physicians claiming a time savings by having their reports transcribed by an MT instead may not be reviewing their transcribed reports for errors either. Handwriting recognition is finally coming of age. The new tablet PCs provide incredible accuracy for reasonably legible handwriting. And this technology, like speech recognition, will become more accurate over time. Although speech is considerably faster than handwriting, it is often more palatable to handwrite notes in the presence of the patient. So both will have an important place in the future of free-text clinical documentation. None of the free-text entry methods provide useful data for clinical practice research. However, natural language processing (NLP) technology can extract clinical facts from narrative reports and turn those facts into codes. NLP is currently in its infancy, but it too will advance. Clinical guidance is considerably easier to implement with structured, codified input than with free text, but changing physician behavior is not an easy challenge. Therefore, free text with NLP-aided analysis may prove to be a reasonable option in many clinical settings. Patients Can Contribute Data Patients are an untapped information resource in the healthcare delivery system. Why not let them contribute to the documentation of their own ambulatory clinical episodes? They clearly shouldn’t be documenting the physical exam, assessment, or management plan. But with the right tool, they can effectively enter the subjective data related to their symptoms and relevant medical history, which, on average, represents about half of the entire encounter’s documentation. In fact, they should be able to provide much more comprehensive and useful data than a physician could document in today’s all-too-brief clinical encounters. With a highly developed medical knowledge base driving the computer-based patient questionnaire, the quality and relevance of patient history information will be superior to the data from a physician interview. Employing a patient questionnaire would provide several benefits, including: patients know that all their symptoms will be noted encounters will be more efficient dictation and data entry time will be decreased transcription costs will be decreased service (and billing levels) will increase Patients can fill out these structured questionnaires either in the waiting room or over the Web. If over the Web, the summarized and organized output can be used for triage. For example, urgency and appropriate length of appointment can be determined. Indicated lab and radiology tests can be requisitioned, so that results are available at encounter time. And sometimes self-care can be prescribed or the patient can be immediately directed to a specialist. Patient-provided histories have the potential to significantly improve the cost effectiveness of healthcare if physicians embrace this powerful and innovative approach to streamlining healthcare encounters. The organized output from these computerized questionnaires can also be used to form a basis for “Web visits.” Many conditions do not actually require a face-to-face encounter with a healthcare provider. By using a comprehensive patient history provided over the Web, physicians can sometimes treat patients via e-mail. Patients don’t have to make the trip to the doctor and the cost of care is substantially reduced. Although patients might have to pay a modest fee out-of-pocket for this service, some insurance companies are investigating the quality and cost implications of including Web visits in their coverage. The implications this approach holds for our nation’s overall cost of healthcare are significant. Speedtyping Saves Transcription Time There’s no need for transcriptionists to type out every word in a report anymore. Speedtyping software, sometimes called “abbreviation expanders” or “word expanders,” can save a significant number of keystrokes, thereby improving transcriptionist productivity. There are two kinds of speedtyping software available. Conventional speedtyping software works like an autocorrecting function in a word processor: users create their own set of abbreviations. For example, an MT could set up “uga” as the abbreviation for “under general anesthesia.” Whenever the MT hits the spacebar or punctuation, the software checks the abbreviation list. If there’s something in the list that matches the characters that the MT just typed, it replaces the abbreviation with the associated full text. This software can save about 30 percent of an MT’s keystrokes, and is provided by multiple vendors. A more advanced approach to speedtyping, offered by a smaller number of vendors, can save about 70 percent of a transcriptionist’s keystrokes. It comes with a built-in vocabulary of the words that are used in medical reports. Users can then add words, phrases, and blocks of text to reflect any uniqueness in the kinds of reports they transcribe. This software shows the transcriptionist, character by character, which word or phrase will be inserted if the spacebar (or punctuation) is pressed. It also provides a list of other words and phrases that can be entered by striking their associated keys. The primary word and the listed words may be ordered by frequency of occurrence in medical reports. Thus, the words that occur most frequently become the easiest to type. Productivity increases with speedtyping software typically range from 20 to 80 percent, though some users actually double their productivity. Some software ensures correct spelling and hyphenation of all words. Plus, it automatically capitalizes appropriate words such as brand names. These programs have a one-time cost around $200. Consider what a 50 percent increase in transcription productivity is worth each year. There may be no better return on investment anywhere in the domain of healthcare information technology. Back-end Speech Recognition Transparent to Doctors Back-end speech recognition could also be called computer-assisted transcription. Physicians dictate as usual, while their digital voice files are run through a speech engine on a local or remote server. A draft report is then electronically shipped to a medical editor, along with the synchronized voice file. The editor listens, reads, and corrects any mistakes. The corrected text is sent back to the dictator for review and authentication. Even with the quality-degraded voice files resulting from telephone dictation, this approach is expected to eventually average enough accuracy for most dictators that editors will be far more productive than transcriptionists. To achieve this improvement, it’s important to provide the editors with software designed to streamline the correction process. With recognition accuracy in the 90 to 95 percent range (which is one mistake on every one or two lines), if physicians have to make the corrections, they will be highly distressed. However, an editor armed with the appropriate editing software should find the correction process much faster than transcribing the entire report. Most of these editors will be former MTs. Some of the implementations of this approach can, on average, double productivity. However, the technology is expensive, and users will have to pay to the providing vendor some of what is saved in labor cost. Nonetheless, back-end recognition is gaining traction in the industry and likely will play a major role in the future of clinical documentation. The most appealing aspect of these back-end systems is that they don’t require physicians to change behavior. Physician resistance to change is a reality that often has to be accepted if we want to move forward at all. As Lawrence Weed, MD, father of the Problem-Oriented Medical Record adopted in the 1970s and Problem-Knowledge Couplers, a software tool that links patient problems to a medical knowledge base, once said, “If physicians were in charge of airports, there would be no radar. Just intensive care units all around the periphery.” Weed, an entrepeneur and healthcare visionary, argues that the healthcare system’s reliance on doctors’ memories for effective care is dangerous and inefficient. Physicians and patients would be better served, he says, if doctors instead accessed medical literature at the point of care to assign diagnoses and shape treatment plans. Which Tool Meets Your Needs? We’ve taken a brief look at some existing and evolving technologies that should alter the healthcare documentation landscape in the coming years. The vision of 2006 is still a bit hazy. The solutions outlined above will find their way into more healthcare settings as the years go by. But one size does not fit all. The key will be in combining technologies to meet site-specific needs. The challenge facing HIM managers is to design and implement the documentation process most compatible with their organizational goals, available resources, and physician mindsets. This is by no means a small challenge, but it is surely an exciting one. Clinical documentation methodologies may be the most powerful tools available for improving the quality and cost effectiveness of healthcare. By 2006, the technologies will be further enhanced. Some of these tools can bring impressive efficiency and cost reduction to the transcription process. But others can actually advance the science of medicine, ultimately providing the kind of point-of-care clinical guidance that will make healthcare be all that it can be.

Advancing Technology

Is technology advancing faster than what we could handle? In today’s world, society has become accustomed to all the new technology that has been made for us. Our world today isn’t the same as it was fifty years ago. This is because technology has advanced tremendously in such a short time. Technological advances have helped us in many ways, such as improving our lifestyles and helping our society in quite a few ways. However a few people are afraid that technology will advance even more, yet slow our society down. In just a decade, technology has advanced tremendously. We went from dinosaur phones, to small touch screen phones. And from elephant-like televisions, to sixty inch wide televisions that could be hung up on the wall. Our world is capable of doing so many things that couldn’t be done fifty years ago. Technology has brought us new equipment that is capable of helping us advance in a fast, yet safe way. People who use technology the proper way and don’t abuse it, can actually say that technology has improved our lifestyles and has made many tasks easier. As a student who wants to major in Architecture, I have noticed that technology will play a huge role in this specific career. This is why I consider the technology as a good thing, unlike others who see it as a negative thing. The reason some people disagree on tech advancing so fast, is because they are afraid that it could slow our society down, by causing people to become a bit lazy. However this only applies to those who abuse it and don’t use it the proper way as how it is supposed to be used. Technology seems to be opening more opportunities for people, and helping us connect to the rest of the world. I could now easily see my family from Mexico within a few minutes, other than having to drive seven hours south. Technology is a wonderful thing, and is capable of providing our world with a better future. It excites me to know how fast tech is advancing, and to think about how it will be in another ten years, excites me even more! Our world will change for the best, and technology will be the reason why it will.