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No vaccinations are required to enter this country.
Your trip is a good occasion for a reminder to keep your routine immunizations updated; more than 80% of adults in industrialized countries have not maintained their immunization status. The following vaccinations are recommended for your protection and to prevent the spread of infectious diseases.
Tetanus, Diphtheria, Pertussis, Measles, Mumps, Rubella, Polio should be reviewed and updated if necessary. Note: Many of these vaccine preventable illnesses are making a resurgence due to non-vaccination, incomplete vaccination, and waning immunity. It is important to keep your routine immunizations up-to-date.
Seasonal influenza vaccination is recommended for all travellers over 6 months of age, especially for children, pregnant women, persons over 65, and those with chronic health conditions such as asthma, diabetes, lung disease, heart disease, immune-suppressive disorders, and organ transplant recipients. Note: In the northern hemisphere the flu season typically runs from November to April and from April to October in the southern hemisphere. If the flu vaccine is not available at the time of departure, contact your doctor or travel health clinic regarding influenza anti-viral protection.
Pneumococcal vaccine is recommended for persons over the age of 65 and persons of any age suffering from cardiovascular disease, diabetes, renal disorders, liver diseases, sickle cell disease, asplenia, or immuno-suppressive disorders.
The Hepatitis A virus (HAV) is primarily transmitted from person to person via the fecal-oral route and through contaminated water and food - such as shellfish, and uncooked vegetables or fruit prepared by infected food handlers.
Risk: The virus is present worldwide, but the level of prevalence depends on local sanitary conditions. HAV circulates widely in populations living in areas with poor hygiene infrastructure. In these areas, persons usually acquire the virus during childhood when the illness is asymptomatic (but still infective to others) or mild, and end up developing full immunity. Large outbreaks in these countries are rare. In contrast, a large number of non-immune persons are found in highly industrialized countries where community wide outbreaks can occur when proper food handling or good sanitation practices are not maintained including in daycare centres, prisons, or mass gatherings.
Symptoms: In many cases, the infection is asymptomatic (persons do not exhibit symptoms). Those with symptoms will usually get ill between 15 to 50 days after becoming infected. Symptoms include malaise, sudden onset of fever, nausea, abdominal pain, and jaundice after a few days. The illness can range from mild to severe lasting from one to two weeks or for several months. Severe cases can be fatal especially in older persons. Most infections are asymptomatic in children under six years of age, but infants and children can continue to shed the virus for up to six months after being infected, spreading the infection to others. Many countries are now including vaccination against Hepatitis A in their childhood vaccination schedules.
Prevention: Practice good personal hygiene, including washing your hands frequently and thoroughly, drink boiled or bottled water, eat well cooked foods, and peel your own fruits.
Vaccination: Recommended for all travellers over 1 year of age.
There are two inactivated vaccines available in Canada and the USA, including a combined Hepatitis A and Hepatitis B vaccine. A combined Hepatitis A and Typhoid Fever vaccine is also available in Canada and Europe. Hepatitis A vaccines confer long term protection and can be given in accelerated schedules. Discuss your options with your healthcare provider if you cannot finish the series prior to your departure. Immune Globulin may be recommended for some last-minute travellers.
The Hepatitis B virus (HBV) can cause acute and chronic liver infections. It is transmitted through infected blood products, unprotected sex, infected items such as needles, razor blades, dental or medical equipment, unscreened blood transfusions, or from mother to child at birth. The virus is present worldwide, but some populations in sub-Saharan Africa, Southeast Asia, Eastern Europe, and the Middle East, as well as indigenous communities are chronic Hepatitis B carriers.
Risk: Travellers getting tattoos or piercing abroad, using drugs intravenously, sharing needles and razor blades, undergoing dental or medical procedures, or having unprotected sex are at risk.
Symptoms: In many cases, the infection is asymptomatic (persons do not exhibit symptoms). Those with symptoms will usually get ill between 30 days and 6 months after becoming infected. Symptoms include fatigue, malaise, nausea, abdominal pain, dark urine, and jaundice. The illness can last several weeks and some adults can become chronic carriers after being infected. Hepatitis B can cause chronic liver infections, cirrhosis of the liver, or liver cancer. Most infections are asymptomatic in children under five years of age but they can become chronic carriers. Many countries are now including vaccination against Hepatitis B in their childhood vaccination schedules. Treatment includes supportive care of symptoms. Some cases of chronic Hepatitis B can be treated with antiretroviral drugs.
Prevention: Avoid getting new piercings or tattoos on your trip and do not share needles or razor blades. If you need medical or dental care abroad, ensure that it is done by a reputable provider. Always practice safe sex.
Vaccination: Hepatitis B vaccination is a routine immunization. If you haven't been vaccinated, it is recommended for travellers on working assignments in the health care field such as physicians, nurses, laboratory technicians, dentists, or for those working in close contact with the local population such as teachers, aid workers, and missionaries.
There are two inactivated vaccines available in the Canada and the USA, including a combined Hepatitis A and Hepatitis B vaccine. Both types of vaccines confer long term protection and can be given in accelerated schedules. Discuss your options with your healthcare provider if you cannot finish the series prior to your departure.
Rabies is a viral infection caused by viruses belonging to the Lyssavirus genus. It is a zoonosis (an animal disease that can spread to humans) transmitted through the saliva of infected mammals bites. The infection primarily circulates among domestic and wild animals such as dogs, cats, monkeys, foxes, bats, raccoons, and skunks, although all mammals are at risk. The virus attacks the Central Nervous System targeting the brain and the spinal cord, and if untreated is fatal.
Risk: Rabies is present on all continents except Antarctica. The majority of human infections occur in Asia and Africa. Travellers coming into close contact with domestic animals or wildlife on ecotourism trips, or those undertaking outdoor activities like cave exploring, camping, trekking, and visiting farms or rural areas are at higher risk. Rabies is also an occupational hazard for veterinarians and wildlife researchers. Children are especially vulnerable since they may not report scratches or bites. They should be cautioned not to pet dogs, cats, monkeys, or other mammals. Any animal bite or scratch must be washed repeatedly with copious amounts of soap and water. Seek medical attention immediately.
Symptoms: Usually appear 1 to 3 months or later, although they can appear as early as a few days after being infected. The illness is characterized by fever and pain or a tingling sensation at the wound site. As a result of inflammation to the brain and spinal cord, some patients present with anxiety, hyperactivity, convulsions, delirium, and have a fear of swallowing or drinking liquids, as well as a fear of moving air or drafts. In other patients, muscles become paralysed followed by a coma. Once symptoms are present, most patients die within 1 or 2 weeks.
Prevention: Avoid contact with feral animals or wildlife. Try to anticipate an animal's actions and always be careful not to make sudden moves or surprise them. If you've been bitten by a mammal, wash the wound repeatedly and thoroughly with soap and water. Seek medical attention immediately.
Vaccination: A series of 3 pre-exposure rabies vaccination shots is advised for persons planning an extended stay or on working assignments in remote and rural areas, particularly in Africa, Asia, Central and South America. The pre-exposure series simplifies medical care if you have been bitten by a rabid animal and gives you enough time to travel back from a remote area to seek medical attention. Although this provides adequate initial protection, you will require 2 additional post-exposure doses if you are exposed to rabies. The preferred vaccines for rabies pre-exposure vaccination and post-exposure therapy are HDCV (Human Diploid Cell Rabies vaccine) and PCEC (Purified Chick Embryo Cell vaccine). These two vaccines are interchangeable.
Travellers who have not received the pre-exposure shots need 4 injections (those with compromised immune systems need 5 injections) and the Human Rabies Immune Globulin (HRIG) which is calculated as 20 IU (International Units) per kilo of body weight. HRIG must be injected around the bite site and intramuscularly. In some countries purified Equine Rabies Immune Globulin (ERIG) is used for post-exposure therapy when HRIG is not available. HRIG is in short supply worldwide and is often not available in rural and remote areas.
Note: If you are in a remote area and offered daily rabies injections lasting 14 to 21 days, it may be one of the older animal brain-derived vaccines. We recommend that you do not take them due to serious side effects.
Tick-borne Encephalitis is a viral infection caused by one of three tick-borne encephalitis virus (TBEV) subtypes belonging to the Flaviviridae family: Central European, Siberian, and Far Eastern (formerly known as Russian Spring-Summer Encephalitis). It is transmitted to humans through the bite of infected Ixodes ticks found in parts of Europe, Central Asia, and East Asia. Transmission season is usually from March to November.
Risk: Travellers involved in outdoor activities in forested areas are at risk, including campers, hikers, and hunters. Brushing against vegetation or walking in city parks known to have infected ticks can also put a person at risk.
Symptoms: Usually appear 7 to 14 days after being bitten by an infected tick. Symptoms can last up to 8 days and include fever, headache, fatigue, muscle pain, nausea, and loss of appetite. Approximately one-third of patients develop severe symptoms after the first phase of the illness where the virus causes meningitis (attacks the thin lining that surrounds the brain and the spinal cord) and / or encephalitis (swelling of the brain). Second phase symptoms include stiff neck, fever, headache, nausea, aversion to light, confusion, disorientation, drowsiness, behavioural changes, seizures, and paralysis. Some patients may experience long term complications such as memory loss, speech and language problems, mood disorders, epilepsy, fatigue, and motor skill difficulties. Treatment of the acute infection includes supportive care of symptoms.
Prevention: Travellers who engage in hiking, camping, or similar outdoor activities in wooded regions of endemic areas should take measures to prevent tick bites, including applying a DEET-containing repellent to exposed skin and permethrin spray (or solution) to clothing and gear. When hiking in wooded areas, stay in the middle of the trail and avoid tall grasses and shrubs. Wear light coloured clothing, and long shirts and pants tucked into socks. Carefully examine your clothing, gear, and pets for ticks before entering a dwelling.
Regularly check your body for ticks and promptly remove using tweezers by grasping the tick's head and mouth parts as much as possible and by pulling perpendicular from the skin. Thoroughly disinfect the bite site with soap and water or alcohol. If travelling in an endemic area, you may want to save the tick in a zip-lock bag or empty container to have it analyzed through your healthcare practitioner.
Vaccination: Recommended if you're involved in recreational activities in forested areas such as camping and hiking or working in forestry occupations, as well as long term travellers to endemic areas.
A whole-cell inactivated vaccine for adults is available in Canada, and in pediatric and adult formulations in countries where Tick-borne Encephalitis is endemic. Re-vaccination is recommended every 3-5 years depending on your age if you continue to be at risk. This vaccine is not available in the USA. Discuss prevention options with your health care provider or if you cannot complete the series before departure.
Risk is present in forested areas in the western part of the country.
The recommendations for vaccinations outlined above are intended as guidelines only. Your immunization needs depend on your health status, previous immunizations received, and your travel itinerary. Seek further advice from your doctor or travel health clinic.
Outdoor air pollution (a mix of chemicals, particulate matter, and biological materials that react with each other) contributes to breathing problems, chronic diseases, increased hospitalization, and premature mortality.
Risk: No matter where you travel, you will not be able to escape air pollution since cities and rural areas worldwide are affected by air pollution. Exposure and concentration of pollutants can adversely affect your health. When planning your trip, consider your health status, age, destination, length of trip and season to help you mitigate the effects of air pollution.
Symptoms: Short term symptoms resulting from exposure to air pollution include itchy eyes, nose and throat, wheezing, coughing, shortness of breath, chest pain, headaches, nausea, and upper respiratory infections (bronchitis and pneumonia). It also exacerbates asthma and emphysema. Long term effects include lung cancer, cardiovascular disease, chronic respiratory illness, and developing allergies. Air pollution is also associated with heart attacks and strokes.
Prevention: Comply with air pollution advisories (ask around and observe what locals are doing) and avoid strenuous activity. If you have asthma or chronic obstructive pulmonary disease (COPD), carry an inhaler, antibiotic, and oral steroid (consult your doctor to see what is best for you). It is recommended that older travellers get a physical exam that includes a stress and lung capacity test prior to departure. Newborns and young children should minimize exposure as much as possible or consider not travelling to areas with poor air quality. Ask your medical practitioner if a face mask is advisable for you.
>> For city and country air pollution levels, see the World Health Organization.
Sexually transmitted infections (STIs), also known as Sexually Transmitted Diseases (STDs), are caused by bacteria, viruses or parasites and are transmitted via unprotected sex (oral, anal, or oral) and skin to skin genital contact.
Bacterial infections include Bacterial Vaginosis, Chlamydia, Gonorrhea, Lyphogranuloma venerum (LGV) and Syphilis. Viruses cause Genital Herpes, Hepatitis B, Human Papillomavirus (HPV) and Human Immunodeficiency Virus (HIV). Parasites are responsible for Trichomoniasis and pubic lice.
STIs occur worldwide, but some infections like chancroid, lymphogranuloma vernerum (LGV), and Granuloma Inguinale are more common in less industrialized countries.
Risk: Travellers are at high risk of acquiring STIs if they have unprotected sex outside a monogamous relationship, engage in casual sex, or use the services of sex workers. During travel, some people may be less inclined to follow social mores dictating their behaviour back home and look for adventurous opportunities involving sex. Long term travellers may also be at increased risk due to feelings of loneliness or being homesick.
Travellers should also be aware of sexual tourismand how it spreads STIs. Sexual tourism is travel for the procurement of sex abroad. Travellers participating in this type of exploitive tourism use the services of sex workers or children that are forced to engage in the trade as a result of deceptive practices or are part of human trafficking networks. It's illegal in many countries and you can be prosecuted in your home country for engaging in sexual exploitation of minors abroad. Sexual violence such as rape or assault can also increase risk of STI.
Symptoms: In many cases you can spread a sexually transmitted infection unknowingly because you are asymptomatic (do not exhibit symptoms). Depending on the infection, symptoms can appear within days or weeks (Chlamydia, Gonorrhea, Genital Herpes), weeks or months (Hepatitis B, Syphilis, HIV) after the initial infection. Common symptoms, which may appear alone or in combination include abnormal genital discharge, burning sensation when urinating, bleeding after intercourse or between periods, rashes and sores in the genital or anal areas, swollen lymph glands in the groin, and sudden fever or appearance of flu-like symptoms.
Note that the sudden or eventual disappearance of symptoms does not mean you are cured from the infection since it can return or manifest itself in different symptoms. Many sexually transmitted infections can be treated with antibiotics (although there is mounting evidence that Gonorrhea is becoming increasingly resistant to antibiotics) or antivirals. If left untreated, infections can lead to infertility, pelvic inflammatory disease, cancer, chronic liver conditions, pregnancy complications, and birth defects.
Prevention: Always practice safe sex. Pack your own male and / or female condoms. Note that condoms obtained abroad may have higher breakage rates, may be expired, or may have been stored in hot or humid places compromising their effectiveness. Use your condom correctly and do not use oil based lubes. If you engage in oral sex use a male condom or dental dam. Keep in mind that birth control methods such as oral contraceptives, injections, IUDs, or diaphragms do not prevent STI transmission, and that condoms aren't fully effective from infections acquired via skin-to-skin contact like genital herpes.
Avoid behaviour that increases your chances of contracting an STI such as casual sex with a stranger or a sex worker. Drinking heavily or taking mind-altering drugs will impair your judgement and inhibitions during a sexual encounter, putting you at risk of making unsafe choices like not using a condom. If you already practice safe sex, avoid getting tattoos, body piercings, or acupuncture treatments. Also don't share razors, toothbrushes, or needles. If you have engaged in risky sexual activities or suspect that you may have an STI, visit a healthcare provider immediately. If the results confirm that you have an STI, inform all your sex partners and encourage them to seek medical attention.
Hepatitis B and Human Papillomavirus (HPV) can also be prevented through vaccination.
Note: Some countries continue to have entry restrictions for travellers with HIV / AIDS. Consult your destination country's embassy or consulate to get the latest information. See also HIVTravel for details.
The health risks listed below are of interest to travellers who undertake special activities like adventure travel or ecotourism, long term travellers, visiting friends and family, or those on work assignments abroad. We update our travel health information daily with any new confirmed outbreaks so check back here before your trip for updates. Please note that some infectious diseases are not reported or under reported, preventing us from giving you the full picture of the health risk.
Lyme Disease is caused by bacteria belonging to the genus Borrelia transmitted through the bite of infected ticks belonging to the Ixodes genus. Borrelia burgdorferi is the predominant cause of the illness in North America, and Borrelia afzelii and Borrelia garinii in Europe and Asia. Ticks get infected when they feed on deer, birds, and rodents who are reservoirs for the bacteria and spread it to humans typically by nymphs (immature ticks).
Risk: Lyme Disease is present in North America, Europe, and Asia. Travellers involved in outdoor activities in forested areas are at risk, including campers, hikers, and hunters. Brushing against vegetation or walking in city parks known to have infected ticks can also put a person at risk.
Symptoms: Lyme Disease usually progresses in three stages. One of the first symptoms (for approximately 70% to 80% of persons) is a small bump and skin rash at the site of the bite which usually goes away after 1 or 2 days. Anywhere from 3 to 30 days, the rash expands to an encircled red patch (known as Erythema migrans or Bull's Eye rash) which is warm to the touch but not painful or itchy. The rash may produce lesions. Other symptoms include fever, headache, muscle and joint pain, chills, fatigue, and swollen lymph nodes. Contact your healthcare practitioner immediately if you develop symptoms.
If untreated, the illness progresses to the second stage within days or weeks of getting infected. Symptoms include severe headaches, meningitis, swollen joints, skin lesions, heart palpitations, dizziness, persistent fatigue, sleep disturbance, as well as loss of muscle tone in the face (Bell's palsy). Some of these symptoms usually disappear within weeks or months. However, if untreated, the illness will progress to a third stage which includes arthritis and chronic pain, numbness, tingling of hands and feet, and short-term memory loss.
If treated promptly, Lyme Disease usually takes 2 to 4 weeks to cure and includes antibiotics such as doxycycline, amocicillin, or ceftriaxone.
Prevention: Travellers who engage in hiking, camping, or similar outdoor activities in wooded regions of endemic areas should take measures to prevent tick bites, including applying a DEET-containing repellent to exposed skin and permethrin spray (or solution) to clothing and gear. When hiking in wooded areas, stay in the middle of the trail and avoid tall grasses and shrubs. Wear light coloured clothing, and long shirts and pants tucked into socks. Carefully examine your clothing, gear, and pets for ticks before entering a dwelling.
Regularly check your body for ticks and promptly remove using tweezers by grasping the tick's head and mouth parts as much as possible and by pulling perpendicular from the skin. Thoroughly disinfect the bite site with soap and water or alcohol. If travelling in an endemic area, you may want to save the tick in a zip-lock bag or empty container to have it analyzed through your healthcare practitioner. There is no preventive vaccine or medication against Lyme Disease.
>> For Lyme Disease images, life cycle, and distribution maps, see Infection Landscapes.
Lyme Disease is a risk in wooded and brush areas.
Tuberculosis (TB) is an airbone bacterial infection caused by Mycobacterium tuberculosis. TB can be acquired by breathing contaminated air droplets coughed or sneezed by a person nearby who has active Tuberculosis. Humans can also get ill with TB by ingesting unpasteurized milk products contaminated with Mycobacterium bovis, also known as Bovine Tuberculosis. The most common form of the infection is pulmonary TB which affects the lungs. In some cases, the bacteria can also attack the lymphatic system, central nervous system, urogenital area, joints, and bones.
Risk: Tuberculosis occurs worldwide and commonly spreads in cramped, overcrowded conditions. There is no evidence that pulmonary TB is more easily transmitted in airplanes or other forms of public transportation. Travellers with a compromised immune system, long-term travellers, and those visiting friends and relatives (VFR travellers) in areas where Tuberculosis is endemic are at greater risk. Humanitarian and healthcare personnel working in communities with active TB are also at increased risk. Persons with active TB should not travel.
Symptoms: Persons with active TB have symptoms which include excessive coughing (sometimes with blood), chest pain, general weakness, lack of appetite, weight loss, swollen lymph glands, fever, chills, and night sweats. It can be misdiagnosed for bronchitis or pneumonia. If untreated, active TB can lead to fatalities.
The majority of persons with the illness (90% to 95%) have latent TB infection (LTBI) and do not exhibit any symptoms. The bacteria can remain inactive for many years and the chance of developing active TB diminishes over time.
Tuberculosis treatment involves taking antibiotics for a minimum of 6 months. Drug-resistant TB is a major concern as an increasing number of people are no longer able to be treated with previously effective drugs. Due to misuse of antibiotic therapies, patients can develop multi-drug resistant Tuberculosis (MDR TB). When a second line of antibiotics fail to cure the multi-drug resistant infection, it is known as extensively drug-resistant Tuberculosis (XDR TB).
Prevention: Avoid exposure to people known to who have active Tuberculosis and only consume pasteurized milk products. Travellers at higher risk should have a pre-departure tuberculin skin test (TST) and be re-tested upon their return home. Those at increased risk should also consult their healthcare provider to determine if the Bacillus Calmette-Guérin (BCG) vaccine is recommended.
Tuberculosis is highly endemic and a major public health problem in Romania.
The West Nile Virus (WNV) belongs to the Flaviviridae family. It is transmitted to humans and animals through the bite of infected Culex mosquitoes which are active from dusk to dawn. The mosquitoes acquire the virus from feeding on infected birds. Human to human transmission does not occur.
Risk: West Nile Virus is commonly found in North America, Europe, Africa, the Middle East, and west Asia. There is greater risk for long term travellers visiting endemic areas. Older persons and those with a compromised immune system or pre-existing health conditions are also at increased risk of getting ill. Peak transmission occurs during summer months.
Symptoms: The majority of cases are asymptomatic (persons do not exhibit symptoms). Approximately 1 in 5 people have symptoms which include a fever, headaches, nausea, vomiting, muscle aches, including a rash (typically on the torso) and swollen glands. Symptoms usually last a few days to several weeks. More severe symptoms of the illness include high fever, disorientation, tremors, convulsions, paralysis, and coma that can cause neurological damage. Fatalities can occur. The focus for hospitalized patients is supportive treatment of symptoms and prevention of secondary infections.
Prevention: Travellers should take measures to prevent mosquito bites both indoors and outdoors, especially during the daytime. Insect-bite prevention measures include applying a DEET-containing repellent to exposed skin, applying permethrin spray (or solution) to clothing and gear, wearing long sleeves and pants, getting rid of water containers around dwellings and ensuring that door and window screens work properly. There is no preventive medication or vaccine against West Nile Virus for humans.
>> For West Nile Virus images, life cycle, and distribution maps, see Infection Landscapes.
Cases of human West Nile virus have been reported in Romania. For the latest information on West Nile virus outbreaks please go to: <ECDC>. Accessed on October 17, 2014.
Drinking water is chlorinated and has no ill effect on the local population. However, some strains of E. coli (naturally occurring bacteria found in your gastro-intestinal system) may be present in very small concentrations in the local water supply. Some local strains are different than those that you may be used to, and may cause diarrhea in travellers since immunity is not developed as a result of short-term exposure. Using bottled water for the first few weeks will help you adjust and decrease the chance of traveller's diarrhea.
Milk is pasteurized and safe to drink. Butter, cheese, yoghurt, and ice cream are safe.
Local meat, poultry, seafood, vegetables, and fruits are safe to eat.
Globalized food production and shipping are making it harder for consumers to know if their food and water is safe. Travellers should be aware that food and water contamination not only occurs through improper food handling or poor hygiene practices. Air, soil, and water pollution resulting from heavy metals, dioxins, pesticides, agro-chemicals, and drugs given to food-production animals, occurs worldwide. IAMAT recommends eating locally sourced foods from reputable growers as much as possible. We will post any new information on outbreaks resulting from environmental contamination on this page. Don't forget to consult our website before your trip!
Being prepared is important to preventing allergic reactions or anaphylactic shock during your trip.
The term Traveller's Diarrhea is used to describe gastro-intestinal infections affecting travellers caused by ingesting bacteria, viruses, and protozoa. These micro-organisms are found worldwide and are typically transmitted from person to person via the fecal-oral route – an infected person who does not practice proper hand or body hygiene passes on the infection to another person when handling food and water. Traveller's Diarrhea is the most common illness among travellers.
Risk: Traveller's Diarrhea can happen when:
Prevention: The golden rule to prevent gastro-intestinal infections is: Boil it, Cook it, Peel it, or Forget it! However, it's not just about what you eat, it's also important to consider where you eat. It's not always easy to know if a restaurant or food vendor follows proper food handling and hygienic practices (properly cleaning cutting boards, utensils, sink to wash hands, refrigeration). Be cautious of food that has been stored uncovered, has been improperly refrigerated, or has been standing out for a long time, such as buffets.
More information on Food and Water Safety:
>> How To Prevent Traveller's Diarrhea [PDF]
>> How To Prevent Food and Water Illnesses [PDF]
>> How To Prevent Illness by Washing Your Hands [PDF]
>> 24 World Food and Climate Charts
>> Guide to Healthy Travel
Approximately 85% of Traveller's Diarrhea is caused by bacteria. Symptoms involving bacterial infections generally appear within hours of eating contaminated food or water and can last 3 to 7 days. Typical symptoms include diarrhea, abdominal pain, nausea, general weakness, headache, low fever, and possible vomiting. Severe cases can cause dehydration.
The following are common bacteria causing food and water illnesses in travellers:
Enterotoxigenic Escherichia coli (ETEC) – Commonly known as 'E. coli' and responsible for the majority of Traveller's Diarrhea cases. The illness is associated with contaminated food and water. Symptoms appear 1 to 3 days after infection. Treatment includes supportive care of symptoms and in severe cases antibiotics are prescribed.
Campylobacter jejuni– Associated with contaminated water, undercooked poultry, unpasteurized milk. Symptoms appear 1 to 7 days after being infected and can last 2 to 3 weeks without treatment. Some patients also have bloody diarrhea. Post-infection complications can lead to Guillain-Barré Syndrome, where the immune system attacks the nerves and causes paralysis, or irritable bowel syndrome. Treatment includes antibiotics.
Salmonella enteritidis – Associated with eggs, poultry, meat, raw fruits and vegetables. Symptoms usually appear 1 to 3 days after infection and can last up to 7 to 14 days. Infected persons can become asymptomatic carriers and shed the bacteria for weeks or months, becoming the source of infection for others through poor hygiene practices. Treatment includes supportive care of symptoms. Salmonella typhi is the cause of Typhoid Fever.
Shigellosis – Associated with contaminated food and water and caused by one of four Shigella species that spreads as a result of unsanitary conditions, contaminated food and water, and overcrowded living conditions. Symptoms usually last 4 to 7 days. The illness may progress to bloody diarrhea with mucous and the constant urge to pass stools. Shigella bacteria can be shed from your gastro-intestinal system for up to 3 months after symptoms disappear. Treatment includes antibiotics.
Vibrio cholera, Vibrio parahaemolyliticus, Vibrio vulnificus – Associated with contaminated water, raw or undercooked fish and shellfish and causes Cholera, an acute gastro-intestinal infection. Risk to travellers is low and vaccination is advised only for medical and rescue personnel working in endemic areas. The infection can lead to severe dehydration and death in undernourished persons or those with compromised immune systems or kidneys. Vibrio vulnificus has caused septicemia (blood poisoning) in persons with liver disorders.
Approximately 5% of Traveller's Diarrhea is caused by viruses. A person can become ill when touching contaminated surfaces with the virus (railings, door knobs), shaking hands, or coming into close contact with an infected person and then touching your mouth and eyes.
The most common viruses causing food and water illnesses in travellers are:
Norovirus – Associated with outbreaks at large gatherings or on cruise ships. The illness is also caused by contaminated water and foods like salads, clams, and oysters. Symptoms can appear 10 hours to 2 days after infection and include nausea, vomiting, abdominal pain, diarrhea, and sometimes fever and dehydration. The illness usually last 1 to 4 days and treatment includes supportive care of symptoms.
Rotavirus – Particularly affects children less than 5 years old and is also associated with contaminated food and water. Symptoms appear 1 to 3 days after being infected and include vomiting, diarrhea, fever, abdominal pain, and headache. Dehydration and body limpness are characteristics of this illness which typically lasts 4 to 8 days. Vaccination is recommended for children. Treatment includes supportive care of symptoms for both children and adults.
Approximately 10% of Traveller's Diarrhea is caused by protozoa. In addition to contaminated food and water, these one-celled microscopic organisms are also transmitted to humans by swallowing contaminated water from lakes, rivers, fountains, ponds, and other bodies of water or accidentally swallowing soil or sand containing protozoa eggs. Typical symptoms include abdominal pain and cramps, diarrhea, bloating, nausea, lack of appetite, fatigue, headache, and light fever. Prolonged infection causes dehydration and weight loss.
The most common protozoa causing food and water illnesses in travellers are:
Amoebiasis – Caused by Entamoeba histolytica protozoa. The majority of cases are asymptomatic (persons do not exhibit symptoms). Those who do exhibit symptoms usually develop them 2 to 4 weeks after being infected. Amoebic Dysentery is the more severe form of the illness where patients develop fever and blood in their stools. In rare cases, the protozoa can cause lesions in the liver. Treatment includes taking medication belonging to the nitroimidazole family of drugs.
Cryptosporidiosis –The infection, commonly referred to as 'Crypto', is primarily caused by Cryptosporidium hominis protozoa. The illness is associated with contaminated food or water, including swimming pools and other water bodies. Some people are asymptomatic (do not exhibit symptoms). Those who do exhibit symptoms usually develop them 2 to 10 days after being infected. Some patients may also have a cough, recurring headache, dizziness, eye pain, and joint pain. The illness can trigger irritable bowel syndrome and inflammatory bowel diseases. Symptoms usually disappear after 1 to 2 weeks as the protozoa are shed through feces. Treatment includes anti-protozoal medication or antibiotics.
Cyclosporiasis – Caused by the Cyclospora cayetanensis protozoa and associated with fresh produce like berries and lettuce. Symptoms usually appear 2 to 7 days after infection. Some patients may develop fever after a few days. The diarrhea may come and go throughout the duration of the illness which can last from 2 to 12 weeks if untreated. The infection tends to be seasonal for reasons yet unknown and disinfecting agents like chlorine do not seem to kill the protozoa. Treatment includes taking antibiotics.
Giardiasis–Caused by Giardia intestinalis protozoa and associated with contaminated food and water. Symptoms usually appear 1-2 weeks after infection. The symptoms usually disappear 2-4 weeks later as the protozoa are shed through feces. Treatment includes taking medication belonging to the nitroimidazole family of drugs. Treatment includes taking medication belonging to the nitroimidazole family of drugs.
Another source of gastro-intestinal illness are foodborne toxins produced by bacterial spores that germinate on food – particularly meat, poultry, salads, baked goods, and dairy products – that is improperly stored or refrigerated, usually standing at room temperature for a prolonged period of time.Symptoms can appear within hours of ingesting contaminated food and include abdominal pain, diarrhea, nausea, and vomiting. The infection usually lasts 1 or 2 days and treatment includes supportive care of symptoms. Antibiotics are not recommended.
Common foodborne toxins affecting travellers include:
Clostridium perfringens – Associated with meat and poultry and is the most important agent causing food poisoning in industrialized countries. Symptoms appear within 6 to 24 hours after ingestion.
Staphylococcus aureus – Associated with creamy desserts, custards, meats, and baked goods. Enterotoxins are transmitted via unsanitary practices by infected persons. Symptoms appear within 30 minutes to 8 hours after ingestion.
Clostridium botulinum – Associated with improperly canned food, lightly preserved vegetables, salted fish, and meats. Symptoms usually appear within 12 to 48 hours and include nausea, vomiting, blurred and double vision, paralysis of respiratory and motor muscles that may progress rapidly.
Seafood and shellfish poisoning occurs as a result of eating marine food products contaminated with naturally occurring toxins in sea water. Travellers are at risk in any country as a result of the availability of these products (fresh or frozen) around the world.
The most common seafood and shellfish related illnesses in travellers are:
Ciguatera Fish Poisoning – Occurs when toxins created by dinoflagellate micro-organisms are passed up the marine food chain and bio-accumulate in large fish like barracuda, grouper, red snapper, moray eel, amberjack, parrotfish, hogfish, sturgeonfish, kingfish, coral trout, and sea bass. The toxins are not destroyed through cooking, smoking, or freezing, they are odorless and tasteless, and do not alter the appearance of the fish. For information on symptoms and prevention, see Ciguatera Fish Poisoning.
Scombroid Poisoning – Results from improper handling and refrigeration of fish containing high levels of natural occurring histidine (amino acid in protein). Contamination with bacteria will convert histidine to histamine causing symptoms similar to allergic reactions, which occur very rapidly and include headache, abdominal cramps, diarrhea, itching, flushed face, dry mouth, heart palpitations, difficulty breathing. Symptoms rarely last over 8 to 12 hours. Scombroid poisoning affects fish from the Scombridae family: Tuna, mackerel, skipjack, and bonito. It can also affect other species such as herring, bluefish, sardine, anchovy, amberjack, and mahi-mahi. Treatment includes taking anti-histamines and supportive care of symptoms. Treatment in severe cases may include anti-inflammatory steroids and epinephrine related medication.
Shellfish Poisoning – Associated with the algal blooms (red tides) occurring in temperate and tropical areas. Oysters, clams, cockles, mussels, scallops, crabs, and lobsters filter or ingest toxins produced by dinoflagellates micro-organisms. There are four different illnesses associated with shellfish poisoning:
Puffer (Fugu) Fish Poisoning – Caused by a tetrodotoxin accumulating mainly in the liver, intestines and ovaries of puffer fish, ocean sunfish, globe fish, and porcupine fish. Symptoms appear between 6 and 20 hours and include nausea, abdominal pain, diarrhea, vomiting, profuse sweating, salivation, headache, hypothermia, heart palpitation. Neurological symptoms include numbness, loss of coordination, tremors, and paralysis. The illness can also cause respiratory failure and approximately 60% of patients die. Treatment involves supportive care of symptoms and may include cholinesterase inhibitors (anti-poisoning agents).
Travel is enjoyable, but there is no doubt that it can be stressful. Even if you don't have a prior history of mental illness, travel stress, mood changes, anxiety and other mental health concerns can unexpectedly affect you and potentially disrupt your trip. Studies show that psychiatric emergencies are the leading cause for air evacuations along with injuries and cardiovascular disease.
Your mental and physical health prior to, and during, a trip determines how well you will cope with travel stress. Consider the following:
Mental illness is an under recognized public health concern and travellers often have difficulty accessing adequate emergency psychiatric care abroad. While some countries are leading the way in mental healthcare and treatment, 30% of countries do not have a budget dedicated to mental health and 64% do not have any mental health legislation or it's outdated.
Accessibility to a psychiatrist varies from more than 10 per 100,000 to fewer than 1 per 300,000 people. Almost 70% of psychiatric beds are in mental hospitals rather than general hospitals or in integrated community care facilities.*
Persons with mental health concerns have the additional burden of dealing with stigma ? negative attitudes and behaviour towards their illness. Prejudice and discrimination towards mental illness may determine the type of medical care you will receive abroad.
* World Health Organization: Mental Health, Human Rights and Legislation Framework.
Please select your travel destination.
Select your travel destinations, and get an instant, personalized guide to our medical services and comprehensive travel health information for the countries your are visiting. Print a copy or save securely for future online access.
October 29, 2014
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GTA IV // The Best Stunt Ever (x)
GTA IV // The Best Stunt Ever (x)
Posted 1 year ago
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Achievement Hunter, gta iv, Geoff Ramsey, Ryan Haywood, Jack Pattillo, Michael Jones, Ray Narvaez Jr, Gavin Free, let's play,
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Definición de fungo en inglés:
fungoSaltos de línea: fungo
Pronunciación: /ˈfʌŋɡəʊ /
sustantivo (plural fungoes or fungos)
1 (also fungo fly) Baseball A fly ball hit for practice.
Más ejemplos en oraciones
- If that is working on your hitting, than Pedroia taking fungoes before the game is working on your fielding.
- What if instead of the traditional coach hitting fungos to the outfield a new device is created that helps a fielder increase the area they cover in the field?
- A writer in Scientific American in 1915 advised players not to hit fungo flies during pregame practice because it would lead to hitting flies during the game.
1.1 (also fungo bat or stick) A long lightweight bat for hitting practice balls to fielders.
Más ejemplos en oraciones
- Our infield and outfield fungoes are turned from solid, high quality, northern white ash.
- Available in four colors, our fungo bat is specifically designed to hit a tossed ball for practice and pre-game drills.
- All fungo bats are available in any color and style.
mid 19th century: of unknown origin.
Definición de fungo en:
- el diccionario Inglés de EE.UU.
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Palabra del día deictic
Pronunciación: ˈdeɪktɪk
denoting a word whose meaning depends on context...


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Sports - Articles
Any time you see or hear the word "guaranteed" in a gambling context, your default position should be one of skepticism. Actually, I'd just apply that line of thought to the word "guaranteed" in any circumstance. No other word in the English language
Sports betting is a high variance endeavor. You're going to have streaks that work in your favor and streaks that work against you. The only way to ride through the inevitable downswing is to place bets that are small in comparison to the size of your bankroll.
Although Bovada itself is only a few years old, the people who run the book have been involved in online sports betting for decades. Bovada has a sports betting bonus that all new players should know about. After you sign up for an account at Bovada, you'll get a 50% bonus added to your first deposit.
Chris Weidman and Lyoto Machida are scheduled to fight on July 5th at UFC 175. This is going to be a huge fight as the champ defends his belt against a motivated Lyoto Machida. As is always the case in big-name matchups, opinions on this fight are running wild.


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Toll-Free Phone: 1-888-851-9088
FREE SHIPPING on orders over $85! Most in-stock orders ship in 24 hours (weekdays).
A Simpler Time prides itself on not having the most nautical gifts, but rather having the highest quality, best priced vintage nautical-themed items available. From solid brass porthole mirrors to working ship bells and telescopes, our retro sailing collection is heirloom quality...at very competitive prices. Plus, we ship many items FREE, with a money back guarantee if not satisfied.
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Mizunio Wave Propechy 2 Review – Away from Politics to my Hobby
I have now owned Mizunio Wave Propechy 2 for over 2 years and wanted to share a review on these great running shoes that I think are one of the best quality running shoes I have ever tried in over 20 years of running, so if you are looking for running shoes for women – these will do just fine!
I am very happy with the quality construction and materials that were used. They are light and very flexible with no heel counter that is going to abuse my heel or ankle, the toe box does not squeeze my feet and my toes splay naturally as I run. They might not be wide enough for some people, but they are wide enough for me.


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Airbus Military says it hopes to resume, in November, the remaining 140 hours of function and reliability flight-testing that is required before its A400M airlifter can be granted a full type certificate. The flights with MSN6, the first production-representative aircraft, were suspended in July because of the repeated detection of metallic chips in the oil system of one of the TP400 engines.
Aero Propulsion Alliance
Europrop International (EPI) performed the first TP400-D6 engine control and monitoring system (CMS) test in Villaroche late in May, the consortium announced just before the show. The TP400 is the turboprop engine designed for the Airbus A400M military transport aircraft.


text: Judicial Vacancies By: admin November 3, 1997 Following are judicial positions that are currently vacant, according to the Judicial Nominating Council. Pending Vacancies For Which The JNC Has Submitted Candidates, And That The Governor Has Not Yet Acted Upon Milford District Court Clerk-Magistrate Wrentham District Court Clerk-Magistrate Springfield Juvenile Court Clerk-Magistrate Ware District Court Worcester District Court Brockton District Court Bristol Probate & Family Court Fall River District Court Vacancies That ... Subscribe Login Email Address: Password: Already a paid subscriber but not registered for online access yet? For instructions on how to get premium web access, click here.Forgot your password? Share this:EmailPrintFacebookLinkedInTwitterGoogle +1 1:00 am Mon, November 3, 1997 Massachusetts Lawyers Weekly admin


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I just don't know how you bounce back from this, Pau. #griffining
.@TheNYRangers had an ugly sweater party which featured @bdubi17 as Santa and skinny jeans one could only acquire in Brooklyn. #blueshirts #skinnyjeans
The Best Tony Romo Tweets of the Past 24 Hours
There's really nothing better than reading through Twitter conversations immediately after a public figure makes an epic fail. I first realized this earlier this summer when the Heat choked in the NBA finals. That said, you can imagine my delight when Tony Romo lost the game for the Cowboys last night [see animated GIF below] and was completely destroyed on Twitter for the entire day that followed.
Some of my favorite tweets, in no particular order:
LouBrutus Lou Brutus - If Tony Romo was a Cowboy 125 years ago we'd all be speaking Apache today. #quarterbacksbetterthanromo
*Point of reference: Geronimo
CRM_Stephen Stephen Douglas - If Tony Romo and Mark Sanchez played darts it would take weeks and thousands of people would die.
MhiZz_Co0kieDo3 Narii - #quarterbacksBetterThanRomo Beyonce's unborn child
CaptainBLUNTman Mylo (MTG) - #quarterbacksBetterThanRomo Air Bud
*Point of reference: Air Bud 2 trailer
JayEyeTheKing J.I. - Gucci Mane's ice cream cone tattoo'd on his face > TonyRomo
*Point of reference: Gucci Mane
harvilla rob harvilla - tony romo with the 'entourage' finale of QB performances
Aqua174 Alvin aqua Blanco - Soulja Boy ringtones > Tony Romo
*Point of reference: Soulja Boy "Turn My Swag On"
donniethurmanjr donniethurman - #quarterbacksBetterThanRomo my nephew Jabari….he's 5
TravisGarland Travis Garland - Shake Weight Commercials > Tony Romo.
*Point of reference: Shake Weight Commercial
TravisGarland Travis Garland - Whoopi Goldberg > Tony Romo.
*Point of reference: Sister Act trailer
MrKleanKickz The Shuru aka Rob - Tony The Tiger > Tony Romo
sexysportschef April Thompson - #quarterbacksbetterthanromo Harold from hey Arnold
*Point of reference: Harold (editor's note - ZOMG remember him?!)
FakeJasonBay Fake JasonBay - #QuarterbacksBetterThanRomo Cindy Brady
BlakeHightower Nightmare - #quarterbacksbetterthanromo the chick from "Soul Surfer"
*Point of reference: The chick from Soul Surfer
TRUTH_DOT_COM Benjamin M. - #quarterbacksbetterthanRomo Jon Moxon from Varsity Blues
*Point of reference: Varsity Blues trailer
The Best Chris Bosh Tweets of the Past 24 Hours
Chris bosh looks like little foot - @djtrizzy
Y Chris Bosh gotta collapse and cry on the floor like he was at a funeral tho? - @broncos_nrl
Chris Bosh would kill it in the WNBA - @thelegster
Chris bosh right now probably eating yogurt & watch R Kelly's trapped in the closet on repeat - @hennfreshdaily
Chris Bosh probably at the club right now dancing to Rudeboy. - @nigelnixon1
I bet Chris Bosh is in the locker room throwing air punches and crying like Tré did in Boyz n the Hood. - @doza_said
Chris bosh fell on da floor crying like he got BAD RESULTS ON THE MAURY SHOW - @cloud9oohlahlah
Chris Bosh after they stole his eggs in Jurassic Park 3 http://twitpic.com/5awigi - @scottywashere
Great case study on effective clothes-lining via Ron Artest
Somebody hits me, I'm going to hit him back. Even if it does look like he hasn't eaten in a couple weeks."
— Charles Barkley


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31 Flavors and Then Some
There are nearly 1,900 recorded edible insect species on Earth, and counting.
This Forest Is Bugged
Rainforest Connection is a tiny nonprofit launched two years ago in San Francisco by Topher White.
Watchmen of the Global Forest
In February, the World Resources Institute launched the first interactive, regularly updated map of the world's forests.
Dietary Restrictions
"The Chinese do eat probably the world's greatest diversity of beasts," wrote Craig Simons in his Fall 2013 feature story "Chinese Takeout.
Solar Is Big—and Cheap—in Texas
Over the past several years, an unexpected flood of cheap natural gas has taken a bite out of U.S. carbon dioxide emissions. But natural gas is still a fossil fuel.
Conservation and Poverty Reduction
Ever since conservationists started to marry protected area management with social programs, the relationship has been rocky and ill-defined.
Does Wood Construction Benefit the Climate?
In the "Think Again" section of Conservation's Summer 2012 issue, Sarah DeWeerdt laid out the carbon-storing virtues of using wood in skyscraper construction ("Tall Wood").
Free the Seed
In "Closed Source Crops" (Conservation, Summer 2011), Paul Salopek explored how a handful of large corporations are laying the groundwork to control the genetic data of our major food cr
The European Green Belt
From Death Strip to Lifeline
The Iron Curtain divided the European continent for over 40 years.
Making Guitars in Tune with Nature
Taylor Guitars was honored on January 29, 2014, with a U.S. Secretary of State's Award for Corporate Excellence.
- About
- Climate
- Energy
- Nature
- Technology
- Culture
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- About
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- Energy
- Nature
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It looks like nothing was found at this location. Maybe try one of the links below or a search?
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Try looking in the monthly archives.
beachfront radio bob marley brent burns buffett info Buffett News dani hoy destin fl featured artist frankendread Gulf Coast Cowboy howard livingston hugo duarte Island Travel Jerry Diaz jimmy buffett jimmy parrish John Friday john frinzi John Patti john reno Kelly McGuire kenny chesney Key West loren davidson margaritaville MOTM new orleans no shoes nation tour on island time in paradise Parrothead Parrotheads reggae Reggae News Rum Sunny Jim swim skinny tall paul trop rock Trop Rock Artist Trop Rock Band Trop Rock Bands trop rock junkies Trop Rock Music trop rock news william fair roberts


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Should you wish to question that premise that change only comes about due to an excessive amount of yicky-ness, can we first agree that no one, not one person, wakes up, conducts a self-inventory, and exclaims, "Wow! Things are perfect! Let me see how I can muck them up"?
The unfortunate counter-reality is we decide to modify our lives only when two conditions are met:
1) Life is not performing anywhere optimal level ã and
2) We can no longer fool ourselves into believing, should we follow the present course, it will change anytime soon
Only once we are defeated, will we begin the process. It¼s sad, but it¼s true.
In my case, as with many others, the symptoms were aplenty. My marriage was failing; we were barely paying our bills; my relationship with my two young children was spotty; my chest and back were in a constant spasm ' and I tipped the scales at 250 pound with a 44-inch belly.
Oh sure, I could belt out the "If Only Blues" with self-righteousness.
[Insert guitar lick in 4/4 beat]:
"I complained to my wifeä [da-da-da-dunt]
I yelled at my kidsä [da-da-da-dunt]
If only they¼d changeä [da-da-da-dunt]
It would end all my strife. [da-da-da-dunt]
But since they won't budge - I'm eating this fudge.
One night, alone and desperate, I examined the difficulties that were smothering me, looking for a common denominator. The answer, horrifyingly, was, "Me." Continuing the metaphor, the only note in the score over which I had control was my own actions.
So I began therapy. It's odd; you'd think if you were paying $100 an hour to someone to "fix you," you'd take his advice. You'd think that, wouldn't you?
Nope, not I. If Jerry, my therapist, wanted to earn his keep, he'd have to work for it. This didn't seem to bother him at all; said he, "This is your hour. If you don¼t want to do the work, it¼s fine with me. You pay for it either way."
The catalyst manifested itself when he cut to the chase; "We've been going around about this for months. So, let's nail it down. Tell me; when are you actually get to work and really lose the weight you keep saying you're going to do?"
Trapped, flatfooted, I responded with the brilliantly eloquent, "Uh, I don't know."
Jerry had a habit of scratching his forehead when he was going to twist the knife. I knew it was coming and braced myself. "So," he said, "Why don¼t you put me in touch with the guy who runs your life. We¼ll figure it out and get back to you."
I referred to my therapy sessions as emotional muggings.
Not every therapist has Jerry¼s style, and not everyone will respond well to it if they did. For me, it was what I needed; I needed an unflinching mirror held up to my life.
Twenty years hence, there's still more I have to do; and I (usually) accept that. Being mentally healthy means you know you'll never "get there." However, when I get resistant (as I'm prone to do), I am also well aware it takes a lot of work to live a healthy life. So I remind myself, "This is your life. If you don't want to do the work, that's fine. You¼re going to pay for it either way."
Scott "Q" Marcus is a nationally known weight loss expert for baby boomers and the CRP (Chief Recovering Perfectionist) of www.ThisTimeIMeanIt.com Get his free ebook of motivational quotations and one year of his highly-popular Monday Motivational Memos at no charge by visiting his website. He is also available for coaching and speaking.


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News, advice & tips for Harrisburg, Dauphin, Cumberland & more
Browse by month:
- View pet photos
- Patriot-News photos
- Reader photos
- Central Pennsylvania Pet Businesses
Pets available for adoption: Pet Tales for May 19, 2014
By Susan Simmers
May 19, 2014, 10:00AM
Chip, Rosie and other pets are looking for good homes. Full story »
Monkey on the loose in Adams County after exotic animal rescue facility burns down
By The Associated Press
May 17, 2014, 4:42PM
A monkey was still on the loose after firefighters rescued birds, snakes, lizards and cats from a southern Pennsylvania exotic animal rescue facility that burned down. Full story »
Biting dog fended off by Tara the hero cat to be euthanized for attacking boy
By John Luciew | firstname.lastname@example.com
May 16, 2014, 7:15AM
A Bakersfield Police spokesman says the dog shooed away by Tara the cat will be quarantined for 10 days, then euthanized. Full story »
Tara the cat saves boy from biting dog, becomes feline sensation on CNN, Today Show (video)
By John Luciew | email@example.com
May 15, 2014, 7:40AM
Tara, the family cat, leaps into action when his owner's little boy is being bitten by a dog. The smaller but quicker cat tackles the dog with perfect form. Full story »
Pa. pups donate blood to help other ailing dogs
By The Associated Press
May 14, 2014, 10:49AM
The four canines recently donated precious pints of blood to their fellow pooches. And they did it without having to travel far from home: They visited an animal bloodmobile. Full story »
Caring cop rescues tiny dog from busy highway (with video)
By John Luciew | email@example.com
May 12, 2014, 10:48AM
Dog lovers have taken to Twitter to bark their approval of the CHP's saving the small dog. Others are still wondering how the puny pooch got on that perch of the concrete median in the middle of that busy Interstate. Full story »
Golf tournament to benefit Cumberland Valley Animal Shelter: Pet Calendar
By Susan Simmers
May 12, 2014, 10:00AM
Events include a golf benefit and volunteer opportunities. Full story »
Pets available for adoption: Pet Tales for May 5, 2014
By Susan Simmers
May 05, 2014, 10:00AM
Lucy Lou, Utopia and other pets are looking for good homes. Full story »
Vaccine clinics scheduled for cats and dogs: Pet Calendar
By Susan Simmers
May 05, 2014, 10:00AM
Events include vaccine clinics for cats and dogs. Full story »
Dog shot, killed by state police during search for wanted woman at Lower Windsor Township home
By Jeremy Arias | email@example.com
May 02, 2014, 8:03PM
State police say the dog, a rottweiler, growled, then charged a state trooper attempting to secure the perimeter at the scene. The trooper put the dog down. Full story »
Family thought sickly dog Sid was put down, but vet allegedly kept pet alive for blood transfusions: Humane?
By John Luciew | email@example.com
May 01, 2014, 8:00AM
It's the hardest decision any dog lover must make: When to put down his or her beloved best friend. But what if the vet kept the pet alive? Full story »
Video of hungry hamster stuffing cheeks with tiny burrito goes viral: Watch here
By John Luciew | email@example.com
April 30, 2014, 10:28AM
A bite-sized burrito is served up, and the hungry hamster proceeds to stuff his face with it. Literally. Full story »
Reward offered for 'kitty serial killer' after dead cats found hanging in trees
By John Luciew | firstname.lastname@example.com
April 30, 2014, 7:54AM
Public works crews doing an annual cleanup discovered the bodies of more than 25 cats tied in plastic bags hanging from trees in Yonkers. Full story »
East Shore man pleads guilty to slitting unwanted dog's throat
By Matt Miller | email@example.com
April 29, 2014, 2:05PM
A Dauphin County judge imposed a time-served prison sentence after Jeffrey S. Fletcher Jr. pleaded guilty to animal cruelty charges. Full story »
Dozens of dead, bludgeoned cats found hanging from trees in garbage bags: Disturbing video
By John Luciew | email@example.com
April 28, 2014, 10:56AM
At least two-dozen dead cats, most of them bludgeoned to death, were found hanging in bags from trees in Yonkers, NY. Full story »
Browse archives »
Find area pet shelters and rescue organizations.
Dauphin Co.Cumberland Co.York Co.Lancaster CountyLebanon Co.
- • Keystone GreyhoundsAdams County


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|Table of Contents
|Vol. 62, No. 2, 2009
Issue release date: July 2009
Large Vessel Cerebral Atherosclerosis Is Not in Direct Association with Neuropathological Lesions of Alzheimer's DiseaseLuoto T.M. · Haikonen S. · Haapasalo H. · Goebeler S. · Huhtala H. · Erkinjuntti T. · Karhunen P.J.
aDepartment of Forensic Medicine, University of Tampere, bDepartment of Pathology, Tampere University Hospital, cSchool of Public Health, University of Tampere, Tampere, and dDepartment of Neurology, Helsinki University Central Hospital, Helsinki, Finland
Introduction: Cerebral hypoperfusion caused by large vessel atherosclerosis has been suggested to be associated with the pathogenesis of sporadic Alzheimer's disease (AD). Atherosclerosis and AD share risk factors such as age, diabetes, hypercholesterolemia, hypertension and apolipoprotein E ε4 (APOE ε4) allele. We studied the association between atherosclerosis of the circle of Willis (CW) and AD neuropathology in a large autopsy sample. Methods: The present study comprised a consecutive autopsy series (n = 466) representing noninstitutionalized general population aged 50 years and over (mean 70.8, SD 11.5 years). The atherosclerosis of CW was scored semiquantitatively and the amyloid plaque (AP) load in the frontal cortex and the number of neurofibrillary tangles (NFT) in the hippocampus were measured. Results: In a linear regression model, AP percentage area was associated with age (p < 0.0001) and APOE ε4 allele (p < 0.0001), but not with CW score (p = 0.70) or gender (p = 0.11). Similarly, the NFT count was predicted only by age (p > 0.0001), and not by CW score (p = 0.36), gender (p = 0.41) or APOE ε4 allele (p = 0.072). Conclusion: Our results suggest that cerebral large vessel atherosclerosis is not in direct association with APs or NFTs – hallmarks of AD neuropathology.
|Direct payment
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you profit from a special rate for this and other single items.
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Not to get Brent Musburger here, but she [Beyoncé] is delightful.
Gosh. If I had some gift, I'd be Beyoncé. I'd be some great singer.
In an interview with People that hits newsstands Friday, the first lady was asked, "If you could be someone else, who would you be?"
I would never compare anyone to my friend's wife…Come on now, that doesn't even sound like me. If I don't say something in a rap or on Twitter, it's not true.
some fun facts, 450,000 people joined a facebook group called "i hate reading", while 45,000 joined one called "i love reading" - and beyonce's pregnancy announcement got more tweets than the death of bin laden. wait, those arent fun at all, they pretty much suck


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Teenager Lucy has started writing a blog about her experiences of Demelza.Click here to read her thoughts and see why your support makes such a difference to young people like Lucy.
We will once again be marking Christmas with three carol concerts in aid of Demelza this December.To find out more about our events at Eastbourne College, the Old Naval College in Greenwich and Canterbury Cathedral click here
your donated items and it will add an extra
to the value of your goods when they are sold in our shops.
This costs you nothing and really helps Demelza to support the children and families that we care for.
Click here for more details
We have a wonderful range of Christmas cards available to buy online or via post - including Reindeer, designed by Zac.
Trip for two on a Pullman Orient Express Train London SE12A £500 Bluewater Shopping Voucher South LondonA £500 holiday voucher BeckenhamNight away for two AshfordA MASSIVE thank you to everyone who purchased tickets.
Art Therapy is an essential part of the support Demelza provides for the children and their families. to find out more
Medical, clinical, social, educational and spiritual information will be gathered from all professionals involved, to assist us to best meet the needs of the child or young person.
It may not be possible to accept all children or young people referred to our service, but this will be discussed with those with parental responsibility and signposting to other services will be offered.
Each child or young person referred to our service will be annually reviewed to ensure that they still meet the criteria. Sometimes a child or young person's condition may improve and we will liaise with the family towards a discharge from our service. We will also work with any young person and their family who is likely to continue to need hospice or other services into adulthood.
Many children or young people referred to our service have complex medical and other needs, therefore there is no definitive list of conditions or illnesses which may or may not meet the criteria.
If you would like any more information specifically about any part of our referral process then please contact the relevant Head of Care.
Demelza KentDebbie McSwiney, Acting Head of Care Direct Line: 01795 845 206 Email: email@example.com Central Care Line: 01795 845 201
Demelza South East LondonSarah Carter, Head of Care Direct Line: 020 8859 9802 Email: email@example.com Central Care Line: 020 8859 9801
Demelza Community Jane Streeter, Head of Community Care, East Sussex Direct Line: 01323 446 470 Email: email@example.com Central Care Line: 01323 446461
All forms need to be returned to the Care Services Administrator, as detailed on the form.
If you would like to see a copy of our Admissions Policy, please contact us.We are currently looking for nurses. If you would be interested in joining Team Demelza


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tag:blogger.com,1999:blog-37309174.post6836232780566815869..comments2014-10-22T21:24:26.748-07:00Comments on Crazy Days and Nights: Blind Items Revealedent lawyerhttp://email@example.com:blogger.com,1999:blog-37309174.post-49955319316592732032014-06-03T20:44:42.120-07:002014-06-03T20:44:42.120-07:00Don't think it's Dockery since I don't...Don't think it's Dockery since I don't think she would have seen The Heiress or had dinner with him (remember there was a photo around that time) afterwards if that was the case. But since that cast is so big it could have been any of them.gossiphttp://email@example.com:blogger.com,1999:blog-37309174.post-79152478399333811752014-06-02T11:17:43.809-07:002014-06-02T11:17:43.809-07:00Downton Abbey has NOT jumped the shark, and while ...Downton Abbey has NOT jumped the shark, and while most of us uber-fans were devastated when they killed off Matthew/Dan Stevens, the next season showed that it just added more spice and interest to the plot overall.

But who's the actress who didn't like him? Michele Dockery?figgyhttp://email@example.com:blogger.com,1999:blog-37309174.post-48939769473436492702014-06-02T09:09:43.421-07:002014-06-02T09:09:43.421-07:00Let's face it, DA has completely jumped the sh...Let's face it, DA has completely jumped the shark and Dan was smart to be the first to realize it. His character was being played for a Ross/Rachel..are they together/whoops, no they're not. If you watch the show now, its a sad ghost of what it used to be.

As for the encounter, I can only hope that it was Maggie Smith .dav725http://email@example.com:blogger.com,1999:blog-37309174.post-58024980873192586532014-06-02T08:27:29.140-07:002014-06-02T08:27:29.140-07:00I also saw him in that Broadway play, "The He...I also saw him in that Broadway play, "The Heiress". It was really good. Afterwards both Dan & Jessica spent a lot of time with fans, signing autographs and chatting. I'll just add that I was stunned by how good looking Dan is in person. The camera doesn't do him justice. Jessica is very pretty, quite petite & slim. Just as you would imagine. Remembering Dan's behavior there, I'm sad & disappointed that he would be the subject of this blind item. Oh well!EastCoasterhttp://email@example.com:blogger.com,1999:blog-37309174.post-6455573047091915192014-06-02T07:52:23.464-07:002014-06-02T07:52:23.464-07:00I love love British TV and watch it in the majorit...I love love British TV and watch it in the majority. One of the reasons, is the actors look like real humans, not some glossy plastic doll with overly white capped teeth. It's always a disappointment when they jump the UK ship for the US. Very few make it, and they end up never being a viable UK actor again.BlondeBhttp://email@example.com:blogger.com,1999:blog-37309174.post-39640345201181251482014-06-01T21:04:19.344-07:002014-06-01T21:04:19.344-07:00Oh the guy from Downton. He's become a caution...Oh the guy from Downton. He's become a cautionary tale.Aoifehttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-46056464087944668462014-06-01T21:01:27.235-07:002014-06-01T21:01:27.235-07:00Who?Who?Aoifehttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-16441407803700249592014-06-01T20:23:59.410-07:002014-06-01T20:23:59.410-07:00Josh Charles has a 25-year-long career to fall bac...Josh Charles has a 25-year-long career to fall back on, and left GW to take time off from acting, not to pursue other projects. Aeolhttp://email@example.com:blogger.com,1999:blog-37309174.post-88862757978410538502014-06-01T17:21:19.485-07:002014-06-01T17:21:19.485-07:00@QueenAnne & @Clark Woot! Other Hawks fans hey...@QueenAnne & @Clark
Woot! Other Hawks fans heyyyy. I am cheering for the Rangers for the Cup this year though (well specifically Dom Moore). But Kaner is my fav. Rivenhttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-59799405551825208922014-06-01T17:07:18.649-07:002014-06-01T17:07:18.649-07:00Enty, you are fickle my friend but I've come t...Enty, you are fickle my friend but I've come to love that about you.

I totally prefer Branson to Matthew any day. So married Dan Stevens took advantage of a fellow cast member? Got too big for his britches? Never bite the hand that fed you. However I heard the Broadway play he was in with Jessica Chastain was great. My cousin met him & said he was nothing but gracious to her.lalaland923http://email@example.com:blogger.com,1999:blog-37309174.post-45798188727844417032014-06-01T17:01:08.280-07:002014-06-01T17:01:08.280-07:00I wanna see Charlie and Guido try to high five one...I wanna see Charlie and Guido try to high five one another...LowKeyhttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-68475202001874904022014-06-01T16:55:52.636-07:002014-06-01T16:55:52.636-07:00I don't have cable, so I'll have to listen...I don't have cable, so I'll have to listen to the wretched radio broadcast here in Chicago on whatever station carries it.
The last game I listened to on the radio a week ago, they missed the first 20 or so seconds coming out of every timeout or commercial.
I'm just afraid the Hawks are worn out from last year's playoffs, the Olympics & so many playoff games to win tonight, even though they have a great home & seventh game record.Clark St.http://email@example.com:blogger.com,1999:blog-37309174.post-68262026530349796252014-06-01T16:27:32.131-07:002014-06-01T16:27:32.131-07:00Clooney honoured his full contract and even came b...Clooney honoured his full contract and even came back for rare appearances which helped the Doug & Carol storyline work. He's a pro. Sprinkhttp://email@example.com:blogger.com,1999:blog-37309174.post-22582901545741051972014-06-01T16:26:10.738-07:002014-06-01T16:26:10.738-07:00Wonder what will happen with Josh Charles' car...Wonder what will happen with Josh Charles' career, although everyone really liked him on setWhatsNewPussycathttp://email@example.com:blogger.com,1999:blog-37309174.post-57549329390194941062014-06-01T16:15:38.035-07:002014-06-01T16:15:38.035-07:00I agree that it was foolish of Dan Stevens to leav...I agree that it was foolish of Dan Stevens to leave DA, but he made the decision during season 2 because he thought the plot for his character had gotten a bit ridiculous. And he was right, for a few episodes. Season 3 was getting much better and he should have changed his mind and stayed but by then he had committed to the Broadway play.

He is NYC based, not Hollywood, and he didn't lose all that weight and dye his hair to become "Hollywood" he lost it for a specific role where he plays a junkie. He's gained a little bit of it back, but I still think he looks a little bit thin lately.

I wish Enty would give a few more details about the 'incident' even if he doesn't want to name the actress. If Dan is a douche, then give us the full story (and yes, as much as I like him, I can believe that he is an arrogant, pretentious snob). FShttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-89087598819255972712014-06-01T14:18:18.433-07:002014-06-01T14:18:18.433-07:00Katherine Heigl was still on the GA for quite awhi...Katherine Heigl was still on the GA for quite awhile before she left though. Wasn't it 5 or so seasons?

How could this guy go from mostly TV to mostly movies if he can't get a movie career started?

Rosehttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-76555950156499448052014-06-01T14:12:00.169-07:002014-06-01T14:12:00.169-07:00This comment has been removed by the author.Essiehttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-27037185874828238522014-06-01T14:11:52.418-07:002014-06-01T14:11:52.418-07:00Just because he has lots of movies coming up doesn...Just because he has lots of movies coming up doesn't mean there are people who want to pay to see him. Downtown Abbey isn't something everyone knows about.Essiehttp://email@example.com:blogger.com,1999:blog-37309174.post-74511731153619421982014-06-01T14:01:57.191-07:002014-06-01T14:01:57.191-07:00Oh, I forgot - Anthony Edwards. It helps to be hu...Oh, I forgot - Anthony Edwards. It helps to be humble, rather than self-important.MadLybhttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-82122107869716497732014-06-01T14:00:10.973-07:002014-06-01T14:00:10.973-07:00Dan Stevens could have had it so good if he'd ...Dan Stevens could have had it so good if he'd stayed with "Downton Abbey" to the end. What makes minor actors think they are the shit enough to burn bridges like this? Even Farrah Fawcett failed miserably after leaving "Charlie's Angels", and she was THE hottest thing from the 1970's. The list is long: Suzanne Sommers, David Caruso, McLean Stevenson, etc, etc, etc. George Clooney was the exception, but he wasn't an ass about it.MadLybhttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-11771693397120763952014-06-01T13:26:39.155-07:002014-06-01T13:26:39.155-07:00Katherine Heigl got a lot of work too when she qui...Katherine Heigl got a lot of work too when she quit Grey's. Now...not so much. He may someday regret giving up a steady job on a popular show.evie2345http://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-85396857900430278152014-06-01T13:19:12.018-07:002014-06-01T13:19:12.018-07:00The way they killed Matthew off on DA was so idiot...The way they killed Matthew off on DA was so idiotic and irritating. He was driving to the house for no reason that made sense, other than to kill him off on the way there. I'm still pissed about that. Mangohttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-87578924743496290352014-06-01T12:07:41.233-07:002014-06-01T12:07:41.233-07:00+1, Violet. And no mention of "foreign-born?&...+1, Violet. And no mention of "foreign-born?" Hmmm...Jenniferhttp://email@example.com:blogger.com,1999:blog-37309174.post-17673132037157726772014-06-01T12:05:43.271-07:002014-06-01T12:05:43.271-07:00Lol, true,trueLol, true,trueJenniferhttp://firstname.lastname@example.com:blogger.com,1999:blog-37309174.post-55899209152902340262014-06-01T11:39:00.111-07:002014-06-01T11:39:00.111-07:00Well, I imdb'd him and dude has 6 projects in ...Well, I imdb'd him and dude has 6 projects in the works. Not too shabby. Many in that cast could be so lucky (except for the Dowager of course!).shopgirlhttp://firstname.lastname@example.com


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Overall rating 4 out of 54 (2 ratings)
Last updated 02 December 2012, created 04 December 2011, viewed 3,834
This was a lesson we did to give students some knowledge of the conditions in the trenches. The events of WW1 are not on the GCSE specification, but it coincided with Remembrance Day and thought it would improve their understanding before learning about the Versaiiles Treaty.
Please provide a rating.
useful resources for WW1 recent topic, thank you.
A good lesson which sets the scene for the Treaty of Versailles, the lesson has some good thinking points and discussion topics.
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Lance Stephenson was announced the starting point guard of the Indiana Pacers. Nobody saw it coming. The fans just assumed that he would just be some back-up shooting guard. But Stephenson lighted up and earned his spot with the team as the starting point guard.
But guess what? Paul George did the same thing. He lighted it up for all the Summer League games. Doesn't he deserve a starting spot anywhere with the team? The 6'8″ athletic specimen can play both shooting guard and small forward. It's kind of like Tracy McGrady. I know it's early, but it can happen.
But at least start George at shooting guard or something. If Stephenson can, so can George. But I guess Indy will have to leave Brandon Rush and Dahntay Jones rotating at shooting guard. As for George, I guess he'll be playing less minutes a game than Stephenson.
I see Stephenson playing 20-24 minutes a game. As for George, it might be 16-20 minutes a game for him. But at least he gets to rotate more than a lot of the others guys in the line-up and there's not too much to worry about. Why? Well, if Troy Murphy is traded by the deadline, the line-up could look much more different.
But I think George can start very soon. He's going to be a very important factor to the squad in the next coming years.
Note: Sorry for the short column today. Time is not fully on my side today.
Tags: Indiana Pacers NBA Paul George


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DHEA is rapidly becoming known as the anti-aging miracle of the 20th Century, writes Beth M. Ley in her book, DHEA: Unlocking the Secrets to the Fountain of Youth
It reaches its highest concentration during puberty and declines as the body ages. It is necessary for at least 18 different steroidal hormones associated with youth, including estrogen, progesterone, cortisone, and testosterone. Levels of all these hormones decline with age.
Studies have demonstrated that dehydroepiandrosterone converts or stimulates production of cortisone, testosterone, progesterone and estrogens, along with other steroid hormones, as the body requires them.
In an article entitled, "DHEA: Youth in a Bottle?" in the October, 1996 issue of "Let's Live", author Ray Sahelian, M.D., writes that "the theory behind supplementing with DHEA is that after about age 30, our bodies naturally produce less of this hormone. The expectation is that by supplementing the body's low level of this hormone, we will be able to slow down symptoms of aging and prevent degenerative disease. Anecdotal evidence suggests other benefits, including more energy and an increased sex drive.
And, according to "Nutrition News", Vol. XX, No. 2, 1996 author Siri Khalsa points out that scientific research has demonstrated that DHEA supplementation can bring relief for an array of disease states including multiple sclerosis, thyroid problems, lupus, arthritis, inflammatory bowel disease, herpes infections, allergies, stress, depression, menopause and premenstrual syndrome. It has also been used for building lean muscle tissue, and has exerted beneficial effects on collagen and skin integrity.
DHEA is the most abundant hormone produced by the adrenal glands, Sahelian states in his book "DHEA: A Practical Guide". The adrenal glands, which are located just above the kidneys, produce more than 150 substances. Each gland has a medulla, which is the inner core, and the cortex, which is an outer sheath.
"After DHEA is made, it goes into the bloodstream, and from then on it travels all over the body and goes into our cells, where it is converted into male hormones, known as androgens, or female hormones, known as estrogens.
According to Sahelian, there are several proposed mechanisms whereby DHEA exerts its storied anti-aging effects. It "turns on the 'youth' genes in our DNA that may be shut off by low levels of DHEA in old age; decreases the incidence of osteoporosis; decreases the rate of heart disease by lowering cholesterol and acting as a blood thinner; and balances DHEA/cortisol ratios.
He cautions that studies of the effects of DHEA supplementation on aging have been performed only on rodents; therefore, similar effects on humans are unknown.
The DHEA supplements available to you are produced by dietary supplement manufacturers. Typically, notes Sahelian, the manufactures will extract a sterol substance known as diosgenin from wild yams. "After a few side chains have been cleaved from diosgenin in the laboratory, DHEA is produced."
As far as dosages are concerned, Ley points out that the best DHEA dosages vary from individual to individual. She says it's important to take into account such factors as age and other biological influences. Dosages can range anywhere from 5 to 500 mg. Many people who have studied DHEA think it is advisable to take a blood test to determine your DHEA level before you begin supplementation, and to have the levels checked periodically, as advised by your health-care practitioner.
"Anti-aging doses would be quite low," Ley writes, "taking only enough to raise the levels to [that of] a normal 20-year-old, which would be approximately 31 mg in men, 19 mg in women." For long-term preventative measures, DHEA supplementation is typically between 5 and 50 mg daily. Therapeutic doses, however, are more sizable, commencing at about 200 mg daily.
For some people, Ley says, possible side effects that indicate that DHEA dosages are too high include acne flare-ups, unwanted hair growth, irritability and rapid heart beat.
There is a lot to be aware of before you begin taking DHEA. Ask your health product retailer for further literature written on Dehydroepiandrosterone before you purchase some.
DHEA: Unlocking the Secrets to the Fountain of Youth by Beth M. Ley
DHEA: A Practical Guide by Ray Sahelian, M.D.
The Super-Hormone Promise by William Regelson, M.D. and Carol Coman
Let's Live, October, 1996
Nutrition News, Vol. XX, No. 2, 1996


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Application for New Members 2014-2015
CVHS Students,
If you are interested in joining Model United Nations next year, please submit a completed application by email to firstname.lastname@example.com or in person to Mr. Dollar in Room H-11 by May 19th.
Model United Nations is a 7th period elective class, and we meet every Monday evening from 4:00-6:30 p.m. For more information, please see the attached MUN Information Page.
The application is attached. If you have any questions, feel free to contact Mr. Dollar at email@example.com or stop by his room H-11. You can also contact our Secretary General (President) Shayna Vayser by email at email@example.com.
New Website!
Please see our new and improved website at
for up to date information!
CVHS MUN Conference 2014
For more information on the upcoming
8h Annual CVHS Model United Nations Conference
Please see the conference website.
The link is located on the left sidebar.
What in the world is MUN?
MUN is Model United Nations. No we do not model. In MUN, we become model delegates of the United Nations and emulate the activities of the real United Nations in order to get a better understanding of international events and to develop our speech and debate skills to a higher level.
CVHS MUN is a one-of-a-kind, fully student-operated club / elective class that meets every Monday @ 4:00 PM to 6:30 PM.
2014-2015 CVHS MUN Executive Board
Secretary General: Shayna Vayser
Director General: Iman Eslami
Director General of Conference Management: Akhil Patel


text:
Welcome ActiLean Visitor to Health Education on the Internet
Swimmer's Ear (Outer Ear Infection)
What is swimmer's ear?
What is the cause?
What are the symptoms?
How is it diagnosed?
How is it treated?
How can I take care of myself?
How can I help prevent swimmer's ear?
Ear Medicine, How to Put in Ear: Illustration
Click here to view a full size picture.
Ear: Illustration
Click here to view a full size picture.
What is swimmer's ear?
Swimmer's ear is an infection of the ear canal. It is also called otitis externa.
What is the cause?
Bacteria and sometimes fungi may cause the infection. It can result from an injury, as might occur if you use a Q-tip or something sharp to clean your ear canal. It can also be caused by dirty water in your ears (for example, from a lake or ocean). Frequent showering or swimming can increase the risk of getting an infection. Outer ear infections often happen in the summer from swimming in polluted water. The chemicals in hair spray or hair dye may also irritate the ear canal and increase the risk of infection.
Some people get outer ear infections repeatedly, especially if they clean their ears too vigorously. People who have skin allergies also seem prone to these ear infections.
What are the symptoms?
Symptoms include:
- Itching (often the first symptom)
- Pain and swelling in ear canal
- Discharge from the ear, which may smell bad
- Crusting around the ear canal opening
Sometimes swelling or pus may decrease your hearing.
How is it diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine your ears. Your provider may take a sample of pus and culture it to identify the bacteria or fungus.
How is it treated?
Your healthcare provider will carefully clean and dry your ear. If your ear is very swollen, your provider may insert a wick soaked with an antibiotic into the ear to get the medicine into the infected area. You may need to put drops in your ear several times a day to keep the wick moist.
Your provider may prescribe an antibiotic if you have a severe infection.
Your provider may suggest a cream or ointment medicine for some types of infection.
The pain and swelling will go away gradually as the antibiotics or other medicines take effect. Most outer ear infections clear up completely in 5 to 7 days.
How can I take care of myself?
Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:
- How and when you will hear your test results
- How long it will take to recover
- What activities you should avoid and when you can return to your normal activities
- How to take care of yourself at home, including how to take care of your ear and how to remove the wick
- What symptoms or problems you should watch for and what to do if you have them
Keep water out of your ears until the infection is completely gone. Take baths instead of showers. Ask your provider how you should protect your ears when you wash your hair.
Make sure you know when you should come back for a checkup.
How can I help prevent swimmer's ear?
- Don't put anything into your ear canal that should not be put there. This includes Q-tips. Q-tips are for cleaning the outer ear, not the ear canal.
- After your ear is healed, ask your healthcare provider if it might help to wear earplugs or use something such as lamb's wool to keep your ears dry when you swim and shower.
- Dry your ears carefully if you get water in them. You can use a hair dryer (on the "warm" setting) at least 6 inches from your ear to help dry the water in the ear canal.
- Avoid any substance that may cause an allergic reaction of the ear canal skin. Read product labels carefully and ask your healthcare provider before you use chemicals or medications in the area around your ear.
Reference Sources:
Centers for Disease Control and Prevention. Swimmer's Ear (Otitis Externa). US Dept of Health and Human Services, Centers for Disease Control and Prevention. 8/31/2011. Accessed 8/31/2011 from http://www.cdc.gov/healthywater/swimming/rwi/illnesses/swimmers-ear.html.
Patient.co.uk. Otitis Externa. 1/2012. Accessed 8/2013 from http://www.patient.co.uk/health/Otitis-Externa.htm.
Sander, R. Otitis Externa: A Practical Guide to Treatment and Prevention. American Family Physician v.63.5 (2001). Accessed Aug. 31, 2009 from http://www.aafp.org/afp/20010301/927.html.
Last Modified: 2013-11-06
Last Reviewed: 2013-09-03
Website Updated: March 2014
Developed by RelayHealth.
Published by RelayHealth. © 2014 RelayHealth and/or one of its affiliates. All Rights Reserved.
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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Dr. Jennifer A. Brown, MD
Hematology/Oncology, California Cancer Care
- 218 De Anza Blvd
San Mateo, CA 94402
- 1 Office Location
- Email a Friend
- (650) 341-9131
Dr. Jennifer A. Brown has been practicing medicine for 15 years. Dr. Brown graduated from the Rush Medical College in 1999. She practices medicine in San Mateo, CA and specializes in Hematology/Oncology and Medical Oncology. Dr. Brown is affiliated with Sequoia Hospital, Mills Peninsula Health Center and Mills Peninsula Health Services. She speaks English and Spanish.
Gender: Female
Years in Practice: 15 Years
Languages Spoken: English, Spanish
Medical School: Rush Medical College
Graduation Date: 1999
Hospital Affiliations: Sequoia Hospital, Mills Peninsula Health Center, Mills Peninsula Health Services
Specialties: Hematology/Oncology, Medical Oncology
©2005-2014 WebMD, LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment. See additional information.


text:
4 sources have come to Sports Illustrated and have said that Alex Rodriquez tested positive for 2 anabolic steroids in 2003, the year he won the AL MVP and the AL Home-run title as a Texas Ranger. When a reporter tried to speak to A-Rod on Thursday in Miami he responded with, "I'm not saying anything."
This can be a huge blow for A-Rod and the MLB. We've seen how the Hall of Fame feels about voting in players who have tested positive for steroids, just ask Mark McGwire or Rafael Palmeiro. A-Rod is only 33 years old, and is just over 200 homers away from the all time home-run record, held by someone also linked to steroids, Barry Bonds.
This hasn't been formally announced by the MLB, MLBPA, or anyone in the A-Rod camp, however I trust SI's reports more than most. How will fans respond to this news as another baseball great from the 2000's is a victim of the steroid-era.
SI: A-Rod tested positive for steroids in 2003
2/7/09 in MLB | Terry | 25 respect


text:
Create a Finder window update key | 29 comments | Create New Account
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Create a Finder window update key
In my experience this problem arises regularly with list view, especially with remote servers. Most — but certainly not all — the time, quickly switching to icon view and back to list view will update the modification dates/times of the files in question. (Interestingly, switching to column view and back has no effect.)
But since I am usually using the mouse to manipulate files and folders in the Finder, I would find it even more useful to somehow attach this AppleScript to an icon in the Finder toolbar. I haven't tried it yet, but I'm guessing one could just drag the AppleScript icon to the toolbar. Anyone know if that's possible — and how one might set a custom icon in the toolbar? TIA.
Create a Finder window update key
When I need to update the window, I normally click on the desktop then back to the Finder window that needs updated. This normally works, but I don't the networked folders that much either.
Create a Finder window update key
Even though I do use Butler I am not a 'hotkey' fan typically so I did exactly as you are asking. I simply saved as a run-only app and dragged it to the finder window menubar. I also have a 'resize' script to set to column view and a set window dimension. I don't use the icon view so mine has a label for 'Refresh'
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On tour with a Stone Gossard
As Photographed by Lance Mercer 1992-1995
Ok I'm seeing Pearl Fucking Jam next friday and I can't believe it!! I'm so happy!!
An evening with Pearl Jam, Trieste, Nereo Rocco Stadium, June 22nd, 2014.
Dovrebbero annoverarvi tra le droghe più potenti e dagli effetti più meravigliosamente devastanti di questa terra.
Grazie di tutto. A presto!
You guys should be mentioned among the most powerful and wonderfully heavy drugs on earth.
Thanks for everything. See you soon!
Songwriting and Surfing 101 with Eddie Vedder
You brighten my life like a polystyrene hat
But it melts in the sun like a life without love
And I've waited for you so I'll keep holding on
Without You […]
THIS man here…just…how are you even real??
Funny mouth…
Brody Dalle - The Distillers