{"id":"urn:lj:livejournal.com:atom1:ducesorb","title":"ducesorb","subtitle":"ducesorb","author":{"name":"ducesorb"},"link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom"}},{"@attributes":{"rel":"service.feed","type":"application\/x.atom+xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom","title":"ducesorb"}}],"updated":"2011-11-01T09:40:57Z","entry":[{"id":"urn:lj:livejournal.com:atom1:ducesorb:2239","link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/2239.html"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom\/?itemid=2239"}}],"title":"Florida's Women's Health","published":"2011-11-01T09:40:57Z","updated":"2011-11-01T09:40:57Z","content":"See also: <a href=\"http:\/\/medicsmed.com\/buy-viagra-usa.html\" target=\"_blank\" rel=\"nofollow\">viagra online pharmacy<\/a>&nbsp;|&nbsp;<a href=\"http:\/\/medicsmed.com\/buy-viagra-usa.html\" target=\"_blank\" rel=\"nofollow\">cialis online pharmacy<\/a>&nbsp;|&nbsp;<br><br \/><br \/><a href=\"#\" target=\"_blank\"><img style=\"margin: 0pt 0pt 10px 10px; float: right; cursor: pointer; width: 178px; height: 129px;\" src=\"https:\/\/imgprx.livejournal.net\/c9c9c8b1661a504102663a11346f90cfdb5de5d3e294a7b1221e6ae6521b35a9\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h0iwCAV_xRg9_U4AjbgY-mB0dpP0RIB0BYohRvqSfvLDBSC20LjD0o1HAmxFbuGcigzHtxhThUZTbPCtKtuesWgk558QEhMztW50ex821WE8B1CTtaNC-Lt1873wFLQaZjkg:J2h9qgoeMS1e2mFrNYPS_w\" alt=\"\" border=\"0\" fetchpriority=\"high\" \/><\/a><br \/><ol><li class=\"\"><div class=\"\">The <em>Women's Health<\/em> Program has adopted a new overarching  theme of <em>health<\/em> literacy, which is defined as &#8220;the ability to  understand and act appropriately on  <b>...<\/b><br \/><cite><\/cite><span class=\"\"><\/span><\/div> <\/li><li class=\"\"> <h3 class=\"\"><span class=\"\"><em>Women's  Health<\/em> Newsletter - Yale Medical Group <em>Health<\/em> Information<\/span>  <\/h3> <div class=\"\">Here, you will find the latest healthcare news and information as  it relates to <em>women's health<\/em>, from before puberty to after menopause.  <b>...<\/b><br \/><cite><\/cite><span class=\"\"><\/span><\/div> <\/li><li class=\"\"> <h3 class=\"\"><span class=\"\"><em>Women's Health<\/em> News -  Topix<\/span>  <\/h3> <div class=\"\">News on <em>Women's Health<\/em> continually updated from thousands  of sources around the  net.<br \/><cite><\/cite><span class=\"\"><\/span><\/div> <\/li><li class=\"\"> <h3 class=\"\"><span class=\"\"><em>Women's Health<\/em> -  AOL <em>Health<\/em><\/span>  <\/h3> <div class=\"\">Learn more about <em>women's health<\/em> issues - osteoporosis,  heart disease, sleep disorders, hormone replacement, vitamins and more.<\/div><\/li><li class=\"\"> <h3 class=\"\"><span class=\"\">NIH - <em>Women's  Health<\/em><\/span>  <\/h3> <div class=\"\">Official website of the National Institutes of <em>Health<\/em>  (NIH). NIH is one of the world's foremost medical research centers. An agency of  the US Department of <b>...<\/b><br \/><cite><span class=\"\">health.<\/span><\/cite><span class=\"\"><\/span><\/div> <\/li><li class=\"\"> <h3 class=\"\"><span class=\"\">The National Council on <em>Women's  Health<\/em><\/span>  <\/h3> <div class=\"\">The National Council on <em>Women's Health<\/em>, Inc. (NCWH) is a  non-profit, volunteer partnership of professionals dedicated to educating girls  and <em>women<\/em> about <b>...<\/b><br \/><cite><\/cite><span class=\"\"><\/span><\/div> <\/li><li class=\"\"> <h3 class=\"\"><span class=\"\"><em>Womens  Health<\/em> at St. Luke's - St. Luke's Episcopal <em>Health<\/em> System<\/span>  <\/h3> <div class=\"\">To help you learn more about <em>women's health<\/em>, St. Luke's  has provided links to other web sites that may have other useful information.  <b>...<\/b><ol><li class=\"\"> <h3 class=\"\"><span class=\"\">CRRWH Home<\/span>  <\/h3> <div class=\"\">The Center for Research on Reproduction and <em>Women's Health<\/em>  of the University of Pennsylvania Medical Center is a biomedical research  enterprise composed of <b>...<\/b><br \/><cite><\/cite><span class=\"\"><\/span><\/div> <\/li><li class=\"\"> <h3 class=\"\"><span class=\"\">The <em>Women's Health<\/em>  Team<\/span>  <\/h3> <div class=\"\">The <em>Women's Health<\/em> Team is dedicated to <em>health<\/em>  and balance for all generations of <em>women<\/em>.<\/div><\/li><\/ol><\/div><\/li><\/ol>"},{"id":"urn:lj:livejournal.com:atom1:ducesorb:1848","link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/1848.html"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom\/?itemid=1848"}}],"title":"Canadian pharmacy discount code viagra  No Prescription, Discount","published":"2011-10-29T08:38:05Z","updated":"2011-10-29T08:38:05Z","content":"<div>   Erectile Dysfunction<\/div> <div> &nbsp;<\/div>  <div>  <\/div> <div>   <span class=\"\"><a href=\"#\" target=\"_blank\">   <img alt=\"Viagra\" src=\"https:\/\/imgprx.livejournal.net\/4410bbdfb7008ee9da0df467e6816892c92a00b571d916e1ffdcb1d8402ac8ef\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4TxUpiU9QmHPUcwQHAA:UFs4NVSzBMIAx4FbP3g84w\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Viagra<\/div>     <div class=\"\">       Our price: <span class=\"\">$1.15<\/span><\/div>     <div class=\"\">       <a href=\"http:\/\/alpharxonline.com\/\" target=\"_blank\" rel=\"nofollow\">online pharmacy viagra<\/a> is an oral medicine used for treating male impotence (e.g.,        erectile dysfunction). 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src=\"https:\/\/imgprx.livejournal.net\/f920bbbca81f531cae4cbac7cc29a462126a8149e7836c35dd89ec3a5ba89d5a\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SB8p5n1YmTmQaRNCX08:kwRRft1rX6CZhTlMmB-Alg\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Apcalis SX<\/div>     <div class=\"\">       Our price: <span class=\"\">$5.49<\/span><\/div>     <div class=\"\">       Apcalis SX (Ajanta Pharma) is a jelly solution for the treatment of male        erectile dysfunction.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"ProSolution\" src=\"https:\/\/imgprx.livejournal.net\/44ae6f342014e193724b13bc2930f8810fce2a309dbecca33b347b39f936a43d\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SxQh4n1YmTmQaRNCX08:4qzXF8XcOcHKQHW_u2SYAg\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       ProSolution<\/div>     <div class=\"\">       Our price: <span class=\"\">$58.59<\/span><\/div>     <div class=\"\">       ProSolution is a supplement that addresses men's sexual concerns about        male enhancement.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"ViagRX\" src=\"https:\/\/imgprx.livejournal.net\/bfc9e5fa7cff1774edaf498f10c7251f03e7cf4cf6269ab73eed6d12b171edb0\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SxQm5n1YmTmQaRNCX08:ZQ8rvokVtm05EhFennawjQ\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       ViagRX<\/div>     <div class=\"\">       Our price: <span class=\"\">$0.58<\/span><\/div>     <div class=\"\">       ViagRX is the first anti-impotence OTC sublingual tablet that has been        clinically proven for its instant effectiveness and complete lack of side        effects while treating Erectile Dysfunctionality.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"Sublingual Cialis\" src=\"https:\/\/imgprx.livejournal.net\/67967746ed3297b5e7ff25bb56414c60b96b04649f247ca78dca8aae146bb9db\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SxUo5n1YmTmQaRNCX08:Pe3tC32tdv26apT70HEQzw\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Sublingual Cialis<\/div>     <div class=\"\">       Our price: <span class=\"\">$2.29<\/span><\/div>     <div class=\"\">       Sublingual Cialis is used for treating erectile men's erectile dysfunction        (e.g., impotence). Sublingual Cialis starts working in 30 minutes and        lasts for about 36 hours, while Viagra effect lasts up to 5 hours. Besides,        you can take Sublingual Ciali...<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"Yagara\" src=\"https:\/\/imgprx.livejournal.net\/a9b031da21325afe038258c4b4870250fdd6987b2b8ee46505d68034fb42a0aa\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4Sxso5n1YmTmQaRNCX08:3fmVzEjsf2MYYcVnrq3-Qg\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Yagara<\/div>     <div class=\"\">       Our price: <span class=\"\">$18.62<\/span><\/div>     <div class=\"\">       Yagara is made from the world's most erotic herbs to enhance stamina,        pleasure, confidence & strength of man.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"Mojo Maxx\" src=\"https:\/\/imgprx.livejournal.net\/339f11010ce208eeeaac0fcc0c626d70e4a302a1249728176b557929c6128971\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SxQh5X1YmTmQaRNCX08:VMLnbTbySrfnQnwA3xQsOA\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Mojo Maxx<\/div>     <div class=\"\">       Our price: <span class=\"\">$39.14<\/span><\/div>     <div class=\"\">       Mojo Maxx increases your sperm count.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"Sublingual Viagra\" src=\"https:\/\/imgprx.livejournal.net\/abea6e18a56439260cf90bc0ba29d55a6e3fc9df3873996745a7ef141fe7deae\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SxUm731YmTmQaRNCX08:zGWp_K_qom5TzoVr4J4Qbg\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Sublingual Viagra<\/div>     <div class=\"\">       Our price: <span class=\"\">$2.10<\/span><\/div>     <div class=\"\">       Viagra is an oral medicine used for treating male impotence (e.g.,        erectile dysfunction). Viagra's advantages are a great safety track record        and proven side effects. The effect of Viagra starts in 30 minutes to 1        hour and lasts for about 4 hours.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"Viagra Soft Flavoured\" src=\"https:\/\/imgprx.livejournal.net\/e1cde2dfe791031342a339efe4274773469db04b760e8bd61244093fb51e0514\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SB0j431YmTmQaRNCX08:09nI5y0Mz39r5vzU4jxXlQ\" border=\"0\" width=\"67\" height=\"67\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Viagra Soft Flavoured<\/div>     <div class=\"\">       Our price: <span class=\"\">$2.74<\/span><\/div>     <div class=\"\">       Viagra Soft Flavoured is the time-proved and effective medicine, which is        prescribed to treat erectile dysfunction (ED).<br>       Viagra Soft Flavored is famed for its splendid taste characteristics!<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"Revatio\" src=\"https:\/\/imgprx.livejournal.net\/fefaba76967fba74864d5f12afa99ed456e68fc9d4a410d9853830651b784131\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4Sxsm4n1YmTmQaRNCX08:x_13IaCKEUK6wK9_2f5kVA\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Revatio<\/div>     <div class=\"\">       Our price: <span class=\"\">$0.83<\/span><\/div>     <div class=\"\">       Revatio (sildenafil) is used to treat pulmonary hypertension (high blood        pressure in the blood vessels between the heart and lungs) when people        have not responded to conventional treatment.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div> <div>  <\/div> <div>   <span class=\"\">   <a href=\"#\" target=\"_blank\">   <img alt=\"Viamax Maximizer\" src=\"https:\/\/imgprx.livejournal.net\/32e4298f5ad63aa944b5afbf23e203a24d8dfe2713493bda14fa2a516a705c3a\/P2WlxyVijxKgh2tu88ZSUEMdsf-ah7h00kGGQr5VhsrJvRvbmI6xAF8rAlQ4SxQg4X1YmTmQaRNCX08:dxXJKtSS6B5CXMfHwOsTvA\" border=\"0\" width=\"100\" height=\"100\"><\/a><\/span>   <div class=\"\">     <div class=\"\">       Viamax Maximizer<\/div>     <div class=\"\">       Our price: <span class=\"\">$59.85<\/span><\/div>     <div class=\"\">       Viamax Maximizer is an effective and all natural supplement specially        developed to maximize blood flow and sexual performance.<\/div>     <div class=\"\">       <div class=\"\">         <a href=\"#\" target=\"_blank\">More info<\/a><\/div>       <div class=\"\">         <a href=\"#\" target=\"_blank\">      <\/div>   <\/div> <\/div><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/a><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>"},{"id":"urn:lj:livejournal.com:atom1:ducesorb:1752","link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/1752.html"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom\/?itemid=1752"}}],"title":"Acer Iconia Tab A100, Tablets Android Honeycomb with NVidia Tegra CPU 2","published":"2011-10-29T07:42:59Z","updated":"2011-10-29T07:42:59Z","content":"<div style=\"float:right;padding:10px 0 0 5px\"><br \/><\/div><br \/>&lt;\/div&gt;<br \/><div class=\"\" style=\"clear:both;text-align:center\"><a href=\"#\" target=\"_blank\"><img border=\"0\" height=\"274\" src=\"https:\/\/lh5.googleusercontent.com\/-G2MFY21WQyM\/TXJA61rjnCI\/AAAAAAAAAQ8\/G3JWfYJFb2g\/s400\/acer_iconia_tab_A100_onlinesmallnote2.jpg\" width=\"400\" fetchpriority=\"high\" \/><\/a><\/div><br \/><br \/><span lang=\"EN\" style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\">Battle on the tablet PC market increasingly heated. Many vendors follow-so players, including the manufacturer of computer \/ notebook ACER, this time trying to offer Android <a href=\"http:\/\/alpharxonline.com\/\" target=\"_blank\" rel=\"nofollow\">online pharmacy<\/a> labeled <b>Acer Iconia Tab A100<\/b>.<br \/><br \/><span><br \/><br \/>In addition to the Android operating system comes with Honeycomb (v3.0), claim Acer tablet is also packed with dual-core processor <i>Nvidia Tegra 2<\/i>, plus a <i>Nvidia GeForce graphics chip<\/i>. This means for browsing, watching videos or playing games <b>Iconia Tab A100<\/b> is very well established, fast and convenient. Now, to access the connection is supported by the device with Wi-Fi, and Bluetooth 2.1 3G\/HSDPA technology.<br \/><br \/><br \/><br \/>Slightly different from the tablets i<\/span><span style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\">P<\/span><span lang=\"EN\" style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\">ad, A100 carrying more fully in the web browsing facility, play flash videos and animations. And, its size is smaller, which sailed 7 inches up to more comfortable in the hand.<br \/><br \/><br \/><br \/>Screen Resolution 1024 x 600 pixels, with a ratio of 16:9 which will display video clips with clear and bright. Various colors can be displayed properly. Fun again, <b>Acer Iconia Tab A100<\/b> is also equipped with Dolby Mobile technology, which allows games to music, show video until the game sound effects sounded steady and booming.<\/span><br \/><br \/><div class=\"\" style=\"line-height:normal;margin-bottom:0.0001pt\"><br \/><br \/><\/div><div class=\"\" style=\"clear:both;text-align:center\"><a href=\"#\" target=\"_blank\"><img border=\"0\" height=\"320\" src=\"https:\/\/lh3.googleusercontent.com\/-CrClPwAWTlE\/TXJBskK2RJI\/AAAAAAAAARE\/lXr3E1yszOI\/s320\/Acer-Iconia-.jpg\" width=\"241\" loading=\"lazy\" \/><\/a><\/div><div class=\"\" style=\"clear:both;text-align:center\"><\/div><div class=\"\" style=\"line-height:normal;margin-bottom:0.0001pt\"><br \/><br \/><\/div><div class=\"\" style=\"line-height:normal;margin-bottom:0.0001pt\"><b><span lang=\"EN\" style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\">Acer Iconia Tab A100<\/span><\/b><span lang=\"EN\" style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\"> accompanied with an HDMI port, to connect the device to a high definition television. Also, the available output HD video, mini-USB port. Not to forget, this tablet also equipped with two cameras. Rear side of the 5 MP resolution, with autofocus. While the front side 2 MP, which enabled to access the video chat.<\/span><span style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\"><\/span><\/div><div class=\"\" style=\"line-height:normal;margin-bottom:0.0001pt\"><span lang=\"EN\" style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\"><br \/><br \/><span class=\"\">In the sector of<\/span> <span class=\"\">the interface<\/span>, <span class=\"\">A100<\/span> <span class=\"\">have added<\/span> <span class=\"\">the shortcut<\/span>, <span class=\"\">which<\/span> <span class=\"\">consists<\/span> <span class=\"\">of the<\/span> <span class=\"\">Game<\/span>, <span class=\"\">ebook<\/span>, <span class=\"\">MP3<\/span> <span class=\"\">Player<\/span> <span class=\"\">and social networking sites<\/span>. <span class=\"\">Tablet<\/span> <span class=\"\">PC<\/span> <span class=\"\">is<\/span> <span class=\"\">also<\/span> <span class=\"\">equipped<\/span> <span class=\"\">Clear.fi<\/span> <span class=\"\">applications<\/span>, <span class=\"\">ie<\/span> <span class=\"\">applications<\/span> <span class=\"\">for<\/span> <span class=\"\">sharing<\/span> <span class=\"\">photos<\/span>, <span class=\"\">videos<\/span> <span class=\"\">and<\/span> <span class=\"\">music<\/span> <span class=\"\">to<\/span> <span class=\"\">all the<\/span> <span class=\"\">friends<\/span> <span class=\"\">users<\/span>.<br \/><br \/><br \/><br \/><span class=\"\">Based on the<\/span> <span class=\"\">information<\/span> <span class=\"\">obtained<\/span>, <span class=\"\">the Acer<\/span> <span class=\"\">tablet<\/span> <span class=\"\">wrapped in<\/span> <span class=\"\">a black<\/span> <span class=\"\">glossy<\/span> <span class=\"\">plastic<\/span> <span class=\"\">material<\/span> <span class=\"\">plus a<\/span> <span class=\"\">metal<\/span> <span class=\"\">frame<\/span> <span class=\"\">this<\/span> <span class=\"\">would be<\/span> <span class=\"\">available<\/span> <span class=\"\">in<\/span> <span class=\"\">the market<\/span> <span class=\"\">at the<\/span> <span class=\"\">end of April<\/span> <span class=\"\">2011,<\/span> <span class=\"\">with<\/span> <span class=\"\">the early stages of<\/span> <span class=\"\">marketing<\/span> <span class=\"\">in<\/span> <span class=\"\">the UK<\/span><\/span><span class=\"\"><span style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\"> (United Kingdom)<\/span><\/span><span lang=\"EN\" style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\">.<\/span><span style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\"><\/span><\/div><div class=\"\" style=\"line-height:normal;margin-bottom:0.0001pt\"><br \/><br \/><\/div><div class=\"\" style=\"line-height:normal;margin-bottom:0.0001pt\"><a href=\"#\" target=\"_blank\"><span style=\"font-family: &quot;Aldine401 BT&quot;,&quot;serif&quot;; font-size: 12pt;\">source<\/span><\/a><\/div><br \/><div class=\"\"><br \/><ul class=\"\"><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><li class=\"\"><a href=\"#\" target=\"_blank\"><\/a><\/li><br \/><\/ul><br \/><span class=\"\"><\/span><\/div><\/span>"},{"id":"urn:lj:livejournal.com:atom1:ducesorb:1408","link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/1408.html"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom\/?itemid=1408"}}],"title":"What Does it Take to be a Medical Astrologer, Part 3","published":"2011-05-24T06:40:00Z","updated":"2011-05-24T06:40:00Z","content":"What Does it Take to be a Medical Astrologer, Part 3<br \/><br \/>Medical Astrology Blog 3.8.09 by Eileen Nauman, DHM, medical astrologer<br \/><br \/><br \/><br \/><br \/>I believe that every practicing astrologer should know some thing about medical astrology--even if to say:  &#8220;Hey, this is beyond me, go check with your <a href=\"http:\/\/sigmarxonline.com\/\" target=\"_blank\" rel=\"nofollow\">viagra<\/a>.&#8221; <br \/><br \/>The information I&#8217;m sharing here isn&#8217;t an edict or the only way to go about becoming a medical astrologer.  Indeed, many paths to Rome, as they say.   For myself,   I found myself getting into the physiology and anatomy of medical astrology first because I didn&#8217;t know the body and I wanted to understand how it worked.  And after that, I began to create planet and zodiac sign assignments to it over a course of a decade of experimentation, failure and success.  The assignments in my book have gone through a lot of testing to get to where they are today.<br \/><br \/>I had an interest in herbs because my mother was an untrained herbalist (info down the family line) and I was mostly raised on them in lieu of a medical <a href=\"http:\/\/consultantmediconline.com\" target=\"_blank\" rel=\"nofollow\">cheap cialis<\/a> because we couldn&#8217;t afford one.  My love of herbs goes on to this day and morphed in 1970 into homeopathy.  This is a 260 year old alternative medicine that began in Germany with Dr. Samuel Hahnemann.  Later, I received my Doctor of Homeopathic Medicine (DHM) from the British Institute of Homeopathy, England.   By law, I can practice homeopathy anywhere beneath the United Kingdom umbrella.  I&#8217;ve written five books on the topic over the years and lectured worldwide on it.<br \/><br \/>Every student of mine who wanted to learn to become a medical astrologer had a passion for something, be it vitamins and minerals, herbs, energy medicine (Reiki, polarity therapy, hand&#8217;s on-healing, ect.), Chinese medicine, acupuncture, homeopathy, flower and gem essences and the list of complementary and alternative medicine grows every year. <br \/><br \/>Another area that will come up through clients seeking medical help is referrals.  You will have traditional and nontraditional medical doctors and health practitioners, psychotherapist and other nontraditional healing modalities as well.  The one thing I have learned is that there are no people who are alike.  In looking at their dis-ease, where they are at within it, and if they really want to get well, all play into what you might suggest for them.<br \/><br \/>Also your client may have a strong sense of what they want to use to get well.  Usually, I draw people to me who distrust the traditional medical establishment, got burned by it or really don&#8217;t want ANY (or as few as possible) drugs in their body.  You&#8217;ll find out who you draw.  My predicament with the client who refused to go to an M.D. was scary sometimes.  Because that is exactly what the client needed.  Back in the 1970&#8217;s and 1980&#8217;s, there weren&#8217;t many M.D&#8217;s around who were willing to give alternative medicine a chance.  Trying to find an M.D. who was open-minded about it was very tough.  I always kept a list of local people but usually, my cliental was global, so my little list wasn&#8217;t of much help to them.<br \/><br \/>Keeping a list of health practitioners and suggestions is key.  When the client comes to you, they may be in a panic and not thinking clearly.  It becomes your responsibility to go through the possible avenues of help for the is client.<br \/><br \/>You will find you have &#8216;pet&#8217; therapies.  Everyone does because it worked for them or you saw it work wonderfully for a close friend or family member.  Or, you may have training in a modality.   For example, homeopathy is ruled by Neptune (my assignment).   People with a strong (Definition:  the planet is conjunct the MC, ASC or conjunct another planet in their natal chart) Neptune responds remarkably well to homeopathy.  I have run into cases where the client is turned off by it.  And I don&#8217;t try to sell them on the efficacy of it, however.  One of the many truisms of being a medical astrologer is you never take a client&#8217;s hope away from them.  By trying to argue them out of the modality they believe will make them well to try the one you think best, IS taking their hope away from them.    I&#8217;ve learned to work within the client&#8217;s reality---not mine.  I can suggest approaches but ultimately, the client&#8217;s health is in her or his hands--not mine.<br \/><br \/>One of the best alternative medicine specialties I find useful are Naturopathic doctors.  They have an expert knowledge of herbs, a half year course in homeopathy, as well as vitamins and minerals.  If you do not feel qualified to talk about these, ask your client if they would consider seeing a Naturopath.  Or, if your client loves herbs and believes in them with all their heart, then a Naturopath or an Oriental Medicine Doctor (OMD) would be possibilities that you &#8216;d want to acquaint them with as avenues of healing.<br \/><br \/>A real murky area that needs an herbal expert is this:  what if your client is on one or more traditional medical drugs?  Are you aware that many of the &#8216;medical herbals&#8217; may have a chemical &#8216;fight&#8217; with a traditional drug?  And it can cause immediate, painful or possibly, even life-threatening situation for the client if he or she does not know this.  That is why when I have a client submit to me their medical history, I always want to know if they are on traditional drugs AND herbal remedies.  Herbs and drugs don&#8217;t always get along.  There have been many times when this situation has come up.   When it does, I send the client to a Naturopath to sort it all out because they are the experts on herbs and how they do or don&#8217;t get along with traditional medical drugs.<br \/><br \/>NEXT WEEK:  The Med-Scan Technique or How Eileen&#8217;s Mind See&#8217;s Medical Interpretation of a Person&#8217;s Natal Chart!<br \/><br \/><br \/><br \/>Copyright Eileen Nauman 2009.  (NOTE: RSS feed websites can use a few paragraphs of my blog with my permission on their website)<br \/> Contact: docbones224@earthlink.net.  Visit her website at: www.medicinegarden.com.   MEDICAL ASTROLOGY is available for sale at her website.  For those interested in HOMEOPATHY, Eileen has written several and they too are on her website."},{"id":"urn:lj:livejournal.com:atom1:ducesorb:1116","link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/1116.html"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom\/?itemid=1116"}}],"title":"How to Create a Lingam Shrine","published":"2011-05-17T11:24:27Z","updated":"2011-05-17T11:24:27Z","content":"See also: <a href=\"http:\/\/softdj.net\/\" target=\"_blank\" rel=\"nofollow\">cheap cialis<\/a>&nbsp;|&nbsp;<br><br \/><br \/><p><em>\"He who desires perfection of the soul must worship the lingam.\"<\/em> - Linga Purana<br \/><br \/>Evidence of phallic worship goes back 28,000 years (give or take a few  years). In classical Hindu tradition, the lingam (penis) is a phallic  symbol representing the god Shiva, who embodies the male principle. The  lingam is not just the organ of generation, but a sign of the   progenitor and the essence of cosmic manhood manifested in the   microcosm. By worshiping it, we are not merely deifying a physical   organ, but recognizing a form that is both eternal and universal.<br \/><br \/>Your man's lingam is what makes him a  man. It makes him strong and  courageous, a valiant protector, a fierce defender, a world conqueror,  and an explorer of brave new worlds. It also makes him gentle when he  wants to be. It makes him loving and tender towards the woman who  inspires love in him and the children they create together because of  it.<br \/><br \/>It shouldn't be that hard to worship your man's lingam. When fully  erect, it resembles the fertility phallus, which  has been a sign of  godliness since the dawn of time. It is smooth and  hard all at once, and it feels wonderful wrapped  within the fingers  of your hand, between your lips, or sunk deeply  between the folds of  your yoni.<br \/><br \/>How do you practice phallus worship? One way is to make a lingam shrine.<br \/><p><\/p>  <p>The centerpiece of the shrine should be a representation of your man's erect lingam. This can be a photo, a drawing, a painting , or even a life-sized sculpture. If you use a photo, be sure to crop it so that  the length of his lingam fills the photo from bottom to top. Also, put the photo (or drawing or painting) in a nice frame.<br \/><\/p> <p>Here are some other items you might consider including is part of the shrine:<\/p> <ul><li>Incense<\/li><li>Candles<\/li><li>Small rocks<br \/><\/li><li>A single fresh rose or other flower or a small plant<br \/><\/li><li>A recirculating water sculpture<\/li><li>A short note or poem to his lingam<\/li><\/ul> You can arrange your shrine on a table or a dresser, or, if you think you may need to move your shrine out of sight of visitors  to your home, arrange all the items in a wooden tray.  Occasionally, light a stick of incense, or  otherwise show that you &#8220;visit&#8221; the shrine so that he will know that you  actively use it. Replace the poem or note in the shrine from time to time and tell him to read the new one when he has a chance.<br \/><br \/>Whether you're trying to rekindle your sex life with a long-time lover  or just starting out in a relationship, I guarantee you great success if  you worship your man's lingam. A lingam shrine is a visible reminder of your devotion that will make his heart swell with pride.<br \/><br \/>When personal Tantra instruction is either inconvenient or too  expensive, <span style=\"font-weight: bold;\"><\/span><strong><\/strong>Al  Link and Pala Copeland's <a href=\"#\" target=\"_blank\">Sexual  Mastery Course<\/a> and Kerry and Diane Riley's <a href=\"#\" target=\"_blank\">Ultimate Home  Tantra Course<\/a> are two excellent self-teaching courses. I highly  recommend either of these courses for those who can't find a local  Tantra teacher, attend a Tantra workshop, or just want to explore Tantra  in the privacy of their own home.<a href=\"#\" target=\"_blank\"><br \/><\/a><\/p>"},{"id":"urn:lj:livejournal.com:atom1:ducesorb:880","link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/880.html"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom\/?itemid=880"}}],"title":"Pilot program at hospital, health center deemed success","published":"2011-05-03T15:21:17Z","updated":"2011-05-03T15:21:17Z","content":"Pilot program at <a href=\"http:\/\/nbwhp.org\/\" target=\"_blank\" rel=\"nofollow\">order cialis<\/a>, health center deemed success<br \/>Grant aims to shift patients from ER to health center<br \/>BY KENNY WALTER Staff Writer<br \/>Midway through a two-year study, two local health care facilities are seeing positive results from a pilot program aimed at reducing costs and shifting primarycare patients from <a href=\"http:\/\/bestpharmshop.net\/\" target=\"_blank\" rel=\"nofollow\">cheap cialis<\/a> emergency rooms to community health centers.<br \/><br \/>The Emergency Department at Monmouth Medical Center in Long Branch is participating in a two-year study aimed at educating patients to use a health center for primary care rather than the ER. ERIC SUCAR staff The Emergency Department at Monmouth Medical Center in Long Branch is participating in a two-year study aimed at educating patients to use a health center for primary care rather than the ER. ERIC SUCAR staff Monmouth Medical Center, part of the St. Barnabas Health Care System, and its affiliate, Monmouth Family Health Center, both in Long Branch, are participating in the pilot program that is designed to encourage and support the transition of Medicaid and uninsured patients from the hospital Emergency Department to the health center for primary care.<br \/><br \/>According to Bill Vasquez, project director, the two Long Branch health care facilities were selected to be part of a $2 million grant program.<br \/><br \/>Above: The emergency room at Monmouth Medical Center in Long Branch. Left: Monmouth Family Health Center, an affiliate of the hospital, is located on Broadway. Above: The emergency room at Monmouth Medical Center in Long Branch. Left: Monmouth Family Health Center, an affiliate of the hospital, is located on Broadway. &#8220;The program was funded by CMS [Centers for Medicare and Medicaid Services],&#8221; Vasquez said. &#8220;New Jersey looked at high-volume counties that had more than the average of Medicaid visits in their emergency departments.&#8221;<br \/><br \/>The pilot program is designed to run for two years and began in December 2008.<br \/><br \/>The grant, which is administered through the New Jersey Hospital Association, was awarded to Monmouth Medical Center, SecondAvenue, and Monmouth Family Health Center, which is located at 370 Broadway and on-site at the hospital.<br \/><br \/>According to the St. Barnabas website, the health center &#8220;provides economically disadvantaged individuals in Long Branch and surrounding communities with highquality, comprehensive, affordable, culturally sensitive and linguistically appropriate primary and preventive health care.&#8221;<br \/><br \/>The center&#8217;s staff provides a wide range of services to more than 10,000 people each year, with more than 40,000 visits annually, the website states.<br \/><br \/>Most insurance plans are accepted, and deeply discounted services are provided to uninsured pediatric and adult patients. The center is staffed with personnel who speak fluent English, Spanish and Portuguese.<br \/><br \/>Health Center Executive Director Marta Silverberg explained the statistics and demographics for the health center.<br \/><br \/>&#8220;The population is 30 percent Hispanic, and 50 percent of our patients are below the poverty guidelines.<br \/><br \/>&#8220;Sixty percent are on Medicaid and 25 percent are uninsured,&#8221; she added. &#8220;We have 13,000 patients in our system and maybe 5,000 pediatric.&#8221;<br \/><br \/>Monmouth&#8217;s Emergency Department, which handles about 42,000 annual visits, provides comprehensive care to the acutely ill. The department also operates Express Care, a unit that is available for adults and children with minor emergencies.<br \/><br \/>Vasquez explained that the grant money provides for dedicated staffing in the Emergency Department and in the health center. The staffing includes advanced-practice nurses in the hospital, patient care assistants, a full-time physician, nursing staff, case management staff, a data analyst and outreach staff. He explained how the program works for the patient who currently comes to the emergency room for primary care.<br \/><br \/>&#8220;[When] a patient comes into the ED, they are seen in triage,&#8221; he said, &#8220;the same course any patient would take.<br \/><br \/>&#8220;It is then determined that the patient has a primary-care diagnosis, something that could otherwise be treated by a primary care physician. The advanced-practice nurse is called to see that patient and does the assessment, treatment, and medicates the patient accordingly.<br \/><br \/>&#8220;Then she educates the patient,&#8221; he continued. &#8220;She gets on the computer and pulls up the record of this patient, and accesses the appointment system and makes an appointment in real time.&#8221;<br \/><br \/>Dr. Catherine Hanlon, chairwoman of emergency medicine at Monmouth Medical Center, explained that the extra support provided to patients has helped them transition to the health center.<br \/><br \/>&#8220;We always referred patients to the health center, but what we did was typically give them a phone number and had them call to make their own appointment,&#8221; she said. &#8220;If you really want to beef up compliance, you need to walk them through the system a little better.<br \/><br \/>&#8220;We have a health center computer in our emergency department that we actually use to make patients&#8217; appointments. It is not left open-ended for them to do.&#8221;<br \/><br \/>Vasquez confirmed that thus far the program has been successful in that patients are keeping appointments at the health center.<br \/><br \/>&#8220;What we found [is] that of the patients that were seen in the ED and appointments were made for them, that 70 percent show up and are seen in the health center as a result of the program,&#8221; he added. &#8220;The other 30 percent are individuals that say &#8216;I have my own doctor, I don&#8217;t need to go to your health center.&#8217; &#8221;<br \/><br \/>The program is succeeding in cutting down on the number of patients returning to the emergency department for primary care, he said.<br \/><br \/>&#8220;Of the 1,000 or so patients that have been referred [to the health center],&#8221; he said, &#8220;about one in nine have returned to the ED.&#8221;<br \/><br \/>Vasquez said those results are higher than anticipated.<br \/><br \/>&#8220;What we consider so successful is so many people are taking advantage of it,&#8221; he said. &#8220;I don&#8217;t know if we would have predicted a 70 percent success rate. We would have been real happy with 50 [percent].&#8221;<br \/><br \/>One of the most important aspects of the program is educating the patient, he noted.<br \/><br \/>&#8220;This is where we begin educating the patient,&#8221; Vasquez said. &#8220;It is not just moving people, it&#8217;s actually educating.<br \/><br \/>&#8220;Because this advanced-practice nurse is additional staff, she has more time to spend with these patients. She can really help educate them [on] why it is important, signs and symptoms to look for, why a follow-up visit is important,&#8221; he continued.<br \/><br \/>Vasquez explained that the true goal of the program is to use the facilities more cost-effectively.<br \/><br \/>&#8220;The goal of this demonstration was to more efficiently use the resources,&#8221; he said. &#8220;A primary-care visit costs that ER close to $400 a visit. The cost for that visit in the health center is about $125.<br \/><br \/>&#8220;To stretch those Medicaid dollars,&#8221; he explained, &#8220;they&#8217;d much rather have patients be seen in the appropriate setting.&#8221;<br \/><br \/>Vasquez explained the differences in the type of care the two facilities are designed to deliver.<br \/><br \/>&#8220;The ER is really episodic,&#8221; he said. &#8220;They go in there and take care of this, and this alone.<br \/><br \/>&#8220;[At the health center] they look at the well-being of the individual, their family history. We want the health center to become their medical home.&#8221;<br \/><br \/>Vasquez said that the inappropriate use of the emergency room by the community is what the pilot program aims to change.<br \/><br \/>&#8220;It is a model that people are looking to because it takes care of a portion of the population that uses resources poorly,&#8221; he said. &#8220;[In] the hospital, they want to take care of you if you&#8217;re really sick. When you&#8217;re a little sick, you should go to some place where that care is more appropriate.&#8221;<br \/><br \/>The idea is to educate people to use the health center for primary medical care.<br \/><br \/>&#8220;The ED doesn&#8217;t want to waste their time with the &#8216;walking well,&#8217; and the HC wants to see that &#8216;walking well,&#8217; &#8221; Vasquez said. &#8220;It&#8217;s just people not being familiar with the resources.&#8221;<br \/><br \/>Vasquez explained that there is no guarantee for future funding once the grant program concludes.<br \/><br \/>&#8220;We don&#8217;t know whether there will be additional funding to continue it,&#8221; he said. &#8220;Given the kind of results we are seeing, we are hopeful that&#8217;s the case.&#8221;<br \/><br \/>There is also no guarantee that the program will work, because any patient who shows up at the ED must be seen.<br \/><br \/>&#8220;This is not an alternative to receiving care in the emergency room,&#8221; he said. &#8220;The federal requirement is that anyone who appears in an ER to request care must be seen.&#8221;<br \/><br \/>Vasquez explained the role of the health center.<br \/><br \/>&#8220;What the family health center cares for are individuals who would not otherwise have access to a primary care physician,&#8221; he said.<br \/><br \/>Vasquez explained that one misconception is that the ED is free health care.<br \/><br \/>&#8220;You&#8217;re always charged. You may not be able to pay it, but there is no such thing as free care,&#8221; he said. &#8220;The health center has a sliding scale; it is important [that] everybody contribute something.<br \/><br \/>&#8220;If they did lots and lots of free care, they&#8217;d go out of business,&#8221; he added. &#8220;We&#8217;ve seen a whole rash of hospitals close.&#8221;<br \/><br \/>When the grant was first being talked about, Vasquez explained, there was some initial trepidation in both organizations.<br \/><br \/>&#8220;There was certainly reticence, and there was some trust issues that needed to be breached,&#8221; he said. &#8220;The [family health center] and hospital work closely and collaboratively; they are two separate organizations.<br \/><br \/>&#8220;Fortunately, we worked things through in a positive manner,&#8221; he added. &#8220;Also, since the money was shared equally &#8230; there was no competition.<br \/><br \/>&#8220;The grant was developed between them, and both had to sign off on it before the grant was submitted,&#8221; he continued. &#8220;It took a little work, but everyone saw it as a plus for each side.&#8221;<br \/><br \/>Silverberg agreed that the existing relationship between the two facilities helped with the introduction of the program.<br \/><br \/>&#8220;We had a lot of the structure set up for it,&#8221; she said. &#8220;We are already connected electronically; we didn&#8217;t have to start from scratch,&#8221; she said. &#8220;It was easy to implement, because we had a very strong relationship.&#8221;<br \/><br \/>According to Hanlon, as of October there were about 800 referrals to the health center, but there also seem to be more and more patients using the emergency room.<br \/><br \/>&#8220;Of the patients that have been referred, there definitely was a decrease in the number of patients that have gone to the clinic and come back,&#8221; she said, adding, &#8220;We are still seeing an increase in the volume of emergency patients going up, and that is a national trend, not just a New Jersey trend,&#8221; she said.<br \/><br \/>&#8220;This is why we are running this grant, to try to get some of these people into more appropriate and cost-effective places to be seen.&#8221;<br \/><br \/>Hanlon said she is encouraged by the preliminary data that there will be cost savings realized.<br \/><br \/>&#8220;It will decrease but not eliminate the emergency room visits,&#8221; she said. &#8220;For the population that we are seeing, I think we definitely will see a decrease in visits.<br \/><br \/>&#8220;That&#8217;s what we are shooting for,&#8221; she added. &#8220;Our preliminary data are very encouraging.&#8221;<br \/><br \/> <br \/>Click here to enlarge<br \/>  <br \/><br \/><br \/>No Flash Detected<br \/>Please download the latest version by clicking below:<br \/><br \/>Get<br \/><br \/>Advertisement for Brock Farms"},{"id":"urn:lj:livejournal.com:atom1:ducesorb:723","link":[{"@attributes":{"rel":"alternate","type":"text\/html","href":"https:\/\/ducesorb.livejournal.com\/723.html"}},{"@attributes":{"rel":"self","type":"text\/xml","href":"https:\/\/ducesorb.livejournal.com\/data\/atom\/?itemid=723"}}],"title":"Pilot program at hospital, health center deemed success","published":"2011-05-03T12:51:57Z","updated":"2011-05-03T12:51:57Z","content":"Pilot program at <a href=\"http:\/\/nbwhp.org\/\" target=\"_blank\" rel=\"nofollow\">cheap cialis<\/a>, health center deemed success<br \/>Grant aims to shift patients from ER to health center<br \/>BY KENNY WALTER Staff Writer<br \/>Midway through a two-year study, two local health care facilities are seeing positive results from a pilot program aimed at reducing costs and shifting primarycare patients from <a href=\"http:\/\/bestpharmshop.net\/\" target=\"_blank\" rel=\"nofollow\">cheap cialis<\/a> emergency rooms to community health centers.<br \/><br \/>The Emergency Department at Monmouth Medical Center in Long Branch is participating in a two-year study aimed at educating patients to use a health center for primary care rather than the ER. ERIC SUCAR staff The Emergency Department at Monmouth Medical Center in Long Branch is participating in a two-year study aimed at educating patients to use a health center for primary care rather than the ER. ERIC SUCAR staff Monmouth Medical Center, part of the St. Barnabas Health Care System, and its affiliate, Monmouth Family Health Center, both in Long Branch, are participating in the pilot program that is designed to encourage and support the transition of Medicaid and uninsured patients from the hospital Emergency Department to the health center for primary care.<br \/><br \/>According to Bill Vasquez, project director, the two Long Branch health care facilities were selected to be part of a $2 million grant program.<br \/><br \/>Above: The emergency room at Monmouth Medical Center in Long Branch. Left: Monmouth Family Health Center, an affiliate of the hospital, is located on Broadway. Above: The emergency room at Monmouth Medical Center in Long Branch. Left: Monmouth Family Health Center, an affiliate of the hospital, is located on Broadway. &#8220;The program was funded by CMS [Centers for Medicare and Medicaid Services],&#8221; Vasquez said. &#8220;New Jersey looked at high-volume counties that had more than the average of Medicaid visits in their emergency departments.&#8221;<br \/><br \/>The pilot program is designed to run for two years and began in December 2008.<br \/><br \/>The grant, which is administered through the New Jersey Hospital Association, was awarded to Monmouth Medical Center, SecondAvenue, and Monmouth Family Health Center, which is located at 370 Broadway and on-site at the hospital.<br \/><br \/>According to the St. Barnabas website, the health center &#8220;provides economically disadvantaged individuals in Long Branch and surrounding communities with highquality, comprehensive, affordable, culturally sensitive and linguistically appropriate primary and preventive health care.&#8221;<br \/><br \/>The center&#8217;s staff provides a wide range of services to more than 10,000 people each year, with more than 40,000 visits annually, the website states.<br \/><br \/>Most insurance plans are accepted, and deeply discounted services are provided to uninsured pediatric and adult patients. The center is staffed with personnel who speak fluent English, Spanish and Portuguese.<br \/><br \/>Health Center Executive Director Marta Silverberg explained the statistics and demographics for the health center.<br \/><br \/>&#8220;The population is 30 percent Hispanic, and 50 percent of our patients are below the poverty guidelines.<br \/><br \/>&#8220;Sixty percent are on Medicaid and 25 percent are uninsured,&#8221; she added. &#8220;We have 13,000 patients in our system and maybe 5,000 pediatric.&#8221;<br \/><br \/>Monmouth&#8217;s Emergency Department, which handles about 42,000 annual visits, provides comprehensive care to the acutely ill. The department also operates Express Care, a unit that is available for adults and children with minor emergencies.<br \/><br \/>Vasquez explained that the grant money provides for dedicated staffing in the Emergency Department and in the health center. The staffing includes advanced-practice nurses in the hospital, patient care assistants, a full-time physician, nursing staff, case management staff, a data analyst and outreach staff. He explained how the program works for the patient who currently comes to the emergency room for primary care.<br \/><br \/>&#8220;[When] a patient comes into the ED, they are seen in triage,&#8221; he said, &#8220;the same course any patient would take.<br \/><br \/>&#8220;It is then determined that the patient has a primary-care diagnosis, something that could otherwise be treated by a primary care physician. The advanced-practice nurse is called to see that patient and does the assessment, treatment, and medicates the patient accordingly.<br \/><br \/>&#8220;Then she educates the patient,&#8221; he continued. &#8220;She gets on the computer and pulls up the record of this patient, and accesses the appointment system and makes an appointment in real time.&#8221;<br \/><br \/>Dr. Catherine Hanlon, chairwoman of emergency medicine at Monmouth Medical Center, explained that the extra support provided to patients has helped them transition to the health center.<br \/><br \/>&#8220;We always referred patients to the health center, but what we did was typically give them a phone number and had them call to make their own appointment,&#8221; she said. &#8220;If you really want to beef up compliance, you need to walk them through the system a little better.<br \/><br \/>&#8220;We have a health center computer in our emergency department that we actually use to make patients&#8217; appointments. It is not left open-ended for them to do.&#8221;<br \/><br \/>Vasquez confirmed that thus far the program has been successful in that patients are keeping appointments at the health center.<br \/><br \/>&#8220;What we found [is] that of the patients that were seen in the ED and appointments were made for them, that 70 percent show up and are seen in the health center as a result of the program,&#8221; he added. &#8220;The other 30 percent are individuals that say &#8216;I have my own doctor, I don&#8217;t need to go to your health center.&#8217; &#8221;<br \/><br \/>The program is succeeding in cutting down on the number of patients returning to the emergency department for primary care, he said.<br \/><br \/>&#8220;Of the 1,000 or so patients that have been referred [to the health center],&#8221; he said, &#8220;about one in nine have returned to the ED.&#8221;<br \/><br \/>Vasquez said those results are higher than anticipated.<br \/><br \/>&#8220;What we consider so successful is so many people are taking advantage of it,&#8221; he said. &#8220;I don&#8217;t know if we would have predicted a 70 percent success rate. We would have been real happy with 50 [percent].&#8221;<br \/><br \/>One of the most important aspects of the program is educating the patient, he noted.<br \/><br \/>&#8220;This is where we begin educating the patient,&#8221; Vasquez said. &#8220;It is not just moving people, it&#8217;s actually educating.<br \/><br \/>&#8220;Because this advanced-practice nurse is additional staff, she has more time to spend with these patients. She can really help educate them [on] why it is important, signs and symptoms to look for, why a follow-up visit is important,&#8221; he continued.<br \/><br \/>Vasquez explained that the true goal of the program is to use the facilities more cost-effectively.<br \/><br \/>&#8220;The goal of this demonstration was to more efficiently use the resources,&#8221; he said. &#8220;A primary-care visit costs that ER close to $400 a visit. The cost for that visit in the health center is about $125.<br \/><br \/>&#8220;To stretch those Medicaid dollars,&#8221; he explained, &#8220;they&#8217;d much rather have patients be seen in the appropriate setting.&#8221;<br \/><br \/>Vasquez explained the differences in the type of care the two facilities are designed to deliver.<br \/><br \/>&#8220;The ER is really episodic,&#8221; he said. &#8220;They go in there and take care of this, and this alone.<br \/><br \/>&#8220;[At the health center] they look at the well-being of the individual, their family history. We want the health center to become their medical home.&#8221;<br \/><br \/>Vasquez said that the inappropriate use of the emergency room by the community is what the pilot program aims to change.<br \/><br \/>&#8220;It is a model that people are looking to because it takes care of a portion of the population that uses resources poorly,&#8221; he said. &#8220;[In] the hospital, they want to take care of you if you&#8217;re really sick. When you&#8217;re a little sick, you should go to some place where that care is more appropriate.&#8221;<br \/><br \/>The idea is to educate people to use the health center for primary medical care.<br \/><br \/>&#8220;The ED doesn&#8217;t want to waste their time with the &#8216;walking well,&#8217; and the HC wants to see that &#8216;walking well,&#8217; &#8221; Vasquez said. &#8220;It&#8217;s just people not being familiar with the resources.&#8221;<br \/><br \/>Vasquez explained that there is no guarantee for future funding once the grant program concludes.<br \/><br \/>&#8220;We don&#8217;t know whether there will be additional funding to continue it,&#8221; he said. &#8220;Given the kind of results we are seeing, we are hopeful that&#8217;s the case.&#8221;<br \/><br \/>There is also no guarantee that the program will work, because any patient who shows up at the ED must be seen.<br \/><br \/>&#8220;This is not an alternative to receiving care in the emergency room,&#8221; he said. &#8220;The federal requirement is that anyone who appears in an ER to request care must be seen.&#8221;<br \/><br \/>Vasquez explained the role of the health center.<br \/><br \/>&#8220;What the family health center cares for are individuals who would not otherwise have access to a primary care physician,&#8221; he said.<br \/><br \/>Vasquez explained that one misconception is that the ED is free health care.<br \/><br \/>&#8220;You&#8217;re always charged. You may not be able to pay it, but there is no such thing as free care,&#8221; he said. &#8220;The health center has a sliding scale; it is important [that] everybody contribute something.<br \/><br \/>&#8220;If they did lots and lots of free care, they&#8217;d go out of business,&#8221; he added. &#8220;We&#8217;ve seen a whole rash of hospitals close.&#8221;<br \/><br \/>When the grant was first being talked about, Vasquez explained, there was some initial trepidation in both organizations.<br \/><br \/>&#8220;There was certainly reticence, and there was some trust issues that needed to be breached,&#8221; he said. &#8220;The [family health center] and hospital work closely and collaboratively; they are two separate organizations.<br \/><br \/>&#8220;Fortunately, we worked things through in a positive manner,&#8221; he added. &#8220;Also, since the money was shared equally &#8230; there was no competition.<br \/><br \/>&#8220;The grant was developed between them, and both had to sign off on it before the grant was submitted,&#8221; he continued. &#8220;It took a little work, but everyone saw it as a plus for each side.&#8221;<br \/><br \/>Silverberg agreed that the existing relationship between the two facilities helped with the introduction of the program.<br \/><br \/>&#8220;We had a lot of the structure set up for it,&#8221; she said. &#8220;We are already connected electronically; we didn&#8217;t have to start from scratch,&#8221; she said. &#8220;It was easy to implement, because we had a very strong relationship.&#8221;<br \/><br \/>According to Hanlon, as of October there were about 800 referrals to the health center, but there also seem to be more and more patients using the emergency room.<br \/><br \/>&#8220;Of the patients that have been referred, there definitely was a decrease in the number of patients that have gone to the clinic and come back,&#8221; she said, adding, &#8220;We are still seeing an increase in the volume of emergency patients going up, and that is a national trend, not just a New Jersey trend,&#8221; she said.<br \/><br \/>&#8220;This is why we are running this grant, to try to get some of these people into more appropriate and cost-effective places to be seen.&#8221;<br \/><br \/>Hanlon said she is encouraged by the preliminary data that there will be cost savings realized.<br \/><br \/>&#8220;It will decrease but not eliminate the emergency room visits,&#8221; she said. &#8220;For the population that we are seeing, I think we definitely will see a decrease in visits.<br \/><br \/>&#8220;That&#8217;s what we are shooting for,&#8221; she added. &#8220;Our preliminary data are very encouraging.&#8221;<br \/><br \/> <br \/>Click here to enlarge<br \/>  <br \/><br \/><br \/>No Flash Detected<br \/>Please download the latest version by clicking below:<br \/><br \/>Get<br \/><br \/>Advertisement for Brock Farms"}]}