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Insight into the proper care of the ears
Why does the body produce earwax?
What is the recommended method of ear cleaning?
When should a doctor be consulted?
and more…
Good intentions to keep ears clean may be risking the ability to hear. The ear is a delicate and intricate area, including the skin of the ear canal and the eardrum. Therefore, special care should be given to this part of the body. Start by discontinuing the use of cotton-tipped applicators and the habit of probing the ears.
Why does the body produce earwax?
Cerumen or earwax is healthy in normal amounts and serves as a self-cleaning agent with protective, lubricating, and antibacterial properties. The absence of earwax may result in dry, itchy ears. Most of the time the ear canals are self-cleaning; that is, there is a slow and orderly migration of earwax and skin cells from the eardrum to the ear opening. Old earwax is constantly being transported, assisted by chewing and jaw motion, from the ear canal to the ear opening where it usually dries, flakes, and falls out.
Earwax is not formed in the deep part of the ear canal near the eardrum, but in the outer one-third of the ear canal. So when a patient has wax blockage against the eardrum, it is often because he has been probing the ear with such things as cotton-tipped applicators, bobby pins, or twisted napkin corners. These objects only push the wax in deeper.
When should the ears be cleaned?
Under ideal circumstances, the ear canals should never have to be cleaned. However, that isn't always the case. The ears should be cleaned when enough earwax accumulates to cause symptoms or to prevent a needed assessment of the ear by your doctor. This condition is called cerumen impaction, and may cause one or more of the following symptoms:
- Earache, fullness in the ear, or a sensation the ear is plugged
- Partial hearing loss, which may be progressive
- Tinnitus, ringing, or noises in the ear
- Itching, odor, or discharge
- Coughing
What is the recommended method of ear cleaning?
To clean the ears, wash the external ear with a cloth, but do not insert anything into the ear canal.
Most cases of ear wax blockage respond to home treatments used to soften wax. Patients can try placing a few drops of mineral oil, baby oil, glycerin, or commercial drops in the ear. Detergent drops such as hydrogen peroxide or carbamide peroxide may also aid in the removal of wax.
Irrigation or ear syringing is commonly used for cleaning and can be performed by a physician or at home using a commercially available irrigation kit. Common solutions used for syringing include water and saline, which should be warmed to body temperature to prevent dizziness. Ear syringing is most effective when water, saline, or wax dissolving drops are put in the ear canal 15 to 30 minutes before treatment. Caution is advised to avoid having your ears irrigated if you have diabetes, a perforated eardrum, tube in the eardrum, or a weakened immune system.
Manual removal of earwax is also effective. This is most often performed by an otolaryngologist using suction, special miniature instruments, and a microscope to magnify the ear canal. Manual removal is preferred if your ear canal is narrow, the eardrum has a perforation or tube, other methods have failed, or if you have diabetes or a weakened immune system.
Why shouldn't cotton swabs be used to clean earwax?
Wax blockage is one of the most common causes of hearing loss. This is often caused by attempts to clean the ear with cotton swabs. Most cleaning attempts merely push the wax deeper into the ear canal, causing a blockage.
The outer ear is the funnel-like part of the ear that can be seen on the side of the head, plus the ear canal (the hole which leads down to the eardrum). The ear canal is shaped somewhat like an hourglass-narrowing part way down. The skin of the outer part of the canal has special glands that produce earwax. This wax is supposed to trap dust and dirt particles to keep them from reaching the eardrum. Usually the wax accumulates a bit, dries out, and then comes tumbling out of the ear, carrying dirt and dust with it. Or it may slowly migrate to the outside where it can be wiped off.
Are ear candles an option for removing wax build up?
No, ear candles are not a safe option of wax removal as they may result in serious injury. Since users are instructed to insert the 10″ to 15″-long, cone-shaped, hollow candles, typically made of wax-impregnated cloth, into the ear canal and light the exposed end, some of the most common injuries are burns, obstruction of the ear canal with wax of the candle, or perforation of the membrane that separates the ear canal and the middle ear.
The U.S. Food and Drug Administration (FDA) became concerned about the safety issues with ear candles after receiving reports of patient injury caused by the ear candling procedure. There are no controlled studies or other scientific evidence that support the safety and effectiveness of these devices for any of the purported claims or intended uses as contained in the labeling.
Based on the growing concern associated with the manufacture, marketing, and use of ear candles, the FDA has undertaken several successful regulatory actions, including product seizures and injunctions, since 1996. These actions were based, in part, upon violations of the Food, Drug, and Cosmetic Act that pose an imminent danger to health.
What can I do to prevent excessive earwax?
There are no proven ways to prevent cerumen impaction, but not inserting cotton-tipped swabs or other objects in the ear canal is strongly advised. If you are prone to repeated wax impaction or use hearing aids, consider seeing your doctor every 6 to 12 months for a checkup and routine preventive cleaning.
When should a doctor be consulted?
If the home treatments discussed in this leaflet are not satisfactory or if wax has accumulated so much that it blocks the ear canal (and hearing), a physician may prescribe eardrops designed to soften wax, or he may wash or vacuum it out. Occasionally, an otolaryngologist (ear, nose, and throat specialist) may need to remove the wax using microscopic visualization.
If there is a possibility of a hole (perforation or puncture) in the eardrum, consult a physician prior to trying any over-the-counter remedies. Putting eardrops or other products in the ear with the presence of an eardrum perforation may cause pain or an infection. Certainly, washing water through such a hole could start an infection.


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The upside-down cake is a big favorite of mine. After the Bundt, of course. And no worries...I'm not going to make 30 days of upside-down cakes. Because people who do that kind of thing are just crazy.
(Well, this post isn't for my banana hater friends, Clara and Jenn)
This is from the cookbook, Cake Keeper Cakes: 100 Simple Recipes for Extraordinary Bundt Cakes, Pound Cakes, Snacking Cakes and Other Good-To-The-Last-Crumb Treats by Lauren Chattman. I made the Orange-Ricotta Pound Cake Bundt earlier this month and it was delicious. So I'm two for two with this cookbook. And the rest of it looks very very promising!
Some brown sugar and butter is heated to make caramel. A layer of bananas is placed on top. Then a chocolate cake tops the banana-caramel mixture. I thought there was a bit too much caramel, making the cake a bit too sweet. Next time, I would cut the caramel by 25%.
I want to try David Lebovitz's Banana-Chocolate Chip Upside Down Cake next!
Chocolate-Caramel-Banana Upside-Down Cake
Click here for printable recipe
Adapted from Cake Keeper Cakes by Lauren Chattman (2009), page 58. Buy it here or see if your library has it here.
1 stick butter
3/4 c light brown sugar
3 ripe bananas, cut into 1/4-inch slices
(I thought the caramel was a little too much. I would use 3/4 stick butter, 1/2 c brown sugar next time)
3/4 c plus 2 T unbleached all-purpose flour (I used King Arthur flour)
6 T (1/4 c plus 2T) unsweetened Dutch process cocoa powder
3/4 t baking soda
1/4 t salt
6 T (3/4 stick) unsalted butter, softened
1 c granulated sugar
2 large eggs (room temp)
2 t vanilla
2/3 c buttermilk
1. Preheat oven to 350 degrees. Use a 9" x 2" cake pan.
2. Topping: Heat butter over medium heat until melted and foamy. Whisk in brown sugar, turn heat to low and cook, whisking constantly, for two minutes or until the mixture is thick. Spread on the bottom of the 9" cake pan.
3. Arrange the bananas in a circle on top of the sugar mixture. Set aside.
4. Sift together flour, cocoa, soda and salt.
5. Cream together butter and sugar until fluffy (I used my KitchenAid mixer on medium for 3 minutes). Scrape down sides of bowl.
6. Add eggs one at a time, mixing well between each addition.
7. Stir in vanilla.
8. On low speed, alternate adding the flour mixture and buttermilk (3 flour and 2 milk additions).
9. Scrape down the sides and then beat batter on high for 30 seconds.
10. Pour batter over the bananas and smooth out.
11. Bake for 40-45 minutes, until a toothpick comes out clean. Let sit on wire rack for 5 minutes. Then carefully invert onto your serving tray. Let sit at least 20 minutes before diving in. The author says it keeps for 2 days in a cake keeper at room temp.

subset: commoncrawl


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SFA's live performances are presented in the concert posters, handbills, and other memorabilia available at Classic Posters. Each SFA item is described in detail; simply click the image to see the item detail page and all available information on that item, including the live concert or performance for which it was created, the artist who designed the artwork, the date and venue of the live performance, as well as item availability, size, and condition details.
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Posters and Handbills Featuring SFA
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If you only knew about America from watching TV, the last few months might lead you to think that women here wield enormous political power. First you had Game Change, the story of Sarah Palin's attempt to become vice president. Then you had Veep, in which Julia Louis-Dreyfus's character has accomplished just that. Now comes Political Animals, a new USA network series about a strong female secretary of state who I suspect even a Martian would realize is based on Hillary Clinton.
Sigourney Weaver stars as Elaine Barrish, a smart, controversial ex-First Lady. After losing her party's nomination to a charismatic upstart, Paul Garcetti — played by creepy-handsome Adrian Pasdar — Elaine surprises the world by doing two things. She accepts President Garcetti's offer to become Secretary of State, and she divorces her husband, ex-president Bud Hammond, a narcissistic southerner with zipper-troubles played by the Irish actor Ciarán Hinds with more braying Belfast ham than winning North Carolina charm.
Judging from the vigorous, if overblown pilot, Political Animals is about how Elaine juggles her tricky relationships with two different presidents — her boss, whom she finds annoyingly slippery, and her ex, whom she can't quite resist — and how she deals with her two very different sons: Douglas Hammond, played by James Wolk, is the smooth, dutiful one who fits easily into the Beltway ecosystem. In contrast, T.J., played by Sebastian Stan is gay, does drugs, and can't bear the political life. More tellingly, perhaps, Elaine also finds herself developing ties to a D.C. reporter, Susan Berg – that's Carla Gugino – who's written nastily about her in the past.
Political Animals was created by Greg Berlanti, a specialist in family melodrama who clearly cares more about the animal side of Washington — its weaseling and dogged compulsion — than about its actual politics. This is too bad. I've recently been reading The Passage of Power, the fourth volume of Robert Caro's riveting biography of Lyndon Johnson, a book that makes Berlanti's show feel not just thin but naïve. Caro knows how the political life engages the whole person. He gives us the dirty, low-minded stuff — and LBJ was certainly carnal in every sense — but also the serious daily work of, say, passing Civil Rights legislation and the moral arguments for doing so.
By comparison, Political Animals is, well, a political animal. Berlanti knows that film and TV studios don't want to risk alienating their audience by getting into the nuts and bolts of government process, much less by talking ideology. The Newsroom may wave its liberal politics like an Adlai Stevenson banner, but most political movies and shows pointedly do not. Veep, for instance, is cynical not ideological, while Game Change focused on everything about Palin except what she actually believes or why she connects to millions. Even the news coverage of this year's election has spent less time on Obama's and Romney's ideas than on the tiniest tactical details of their campaigns.
Now, it can't be denied that basing a show so clearly on Hillary and Bill betrays a certain failure of imagination. But this, too, is the American way. Our best political novels tend to be based on real people -- just think of All the King's Men — and few political pairings could be more tempting than the messy Clintons. They turned the White House into a reality show, which Berlanti has now turned into a fictionalized potboiler. Only time will tell whether that's an upgrade.
At the moment, it looks like one for Hillary Clinton, whose reputation has never been higher. She's finally escaped her husband's shadow. If he became the flawed hero of Primary Colors, she's now the center of a mash note of a TV series, one that gives her surrogate most of the good lines. At one point, Elaine is talking to President Garcetti who it's clear has been a bit of a wuss. Before she leaves the Oval Office, she says calmly but crushingly, "Someday, sir, it would be nice to be working for the man who beat me."
I don't believe Secretary of State Clinton has ever said anything remotely like that to President Obama, but it's interesting, don't you think, that in this election year, a new TV show implies that she'd be entitled to do so.
Copyright 2020 Fresh Air. To see more, visit Fresh Air.


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1-888-393-1031 | Client Hub Access
Building Experts Serving the AEC Industry in Waukesha, Wisconsin
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With DCMS, you also get access to our Scan to BIM and AutoCAD Floor Plans services. We harness the power of the latest laser scanning technologies and software to produce high-quality as-built BIM models. These models offer valuable insights and can be utilized for various applications ranging from clash detection to facility management. In addition, our high-precision AutoCAD floor plans are guaranteed to provide you with the level of detail and accuracy that your project demands.
Our commitment to your project extends to our specialized Revit As-Built Services. We offer cost-effective and highly precise solutions for documenting existing conditions of a site or structure. This invaluable data can be leveraged to aid various aspects of your project such as space planning, asset management, and facility management. At DCMS, we believe in providing smart, professional solutions tailored to your project's needs. Allow us to bring our expertise to your project and experience the DCMS difference.
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Our service of managing existing conditions involves assessing the current state of your building or structure, and identifying areas requiring attention and improvement. We provide detailed insight into your building's present conditions and suggest tailored solutions.
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Our comprehensive building surveys provide a holistic view of your property. We conduct rigorous inspections, identifying potential issues to help you make informed decisions about maintenance, renovations, or purchases.
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As-Built Drawings serve as a crucial component of our offerings. They are detailed depictions of the building as it is actually built and are essential for future renovations or expansions.
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Our Building Site Plans provide a birds-eye view of proposed projects, detailing the relationship between new structures, existing buildings, and the overall landscape.
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We use state-of-the-art 3D laser scanning technology to capture your structure in meticulous detail. This technology aids in creating highly accurate 3D models of your building, enabling precise planning for renovations or extensions.
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Our Building Information Modelling (BIM) Services provide a dynamic 3D model of your building that can be used for information management. It serves as a central resource for all information related to the building's design, construction, and management.
As-built drawings are an essential part of the construction process. They provide an accurate record of a project as it was built, which can be used for reference or modification in the future, and to verify that a project was built according to the plans and specifications.
3D scanning is a powerful tool for creating as-built documentation. By using laser scanners or other imaging technologies, we can quickly and accurately capture the geometry of existing conditions, even in difficult-to-reach places. This data can then create highly detailed 3D models and drawings.
As built surveys are a critical part of the construction process, providing an accurate record of the finished project. We can provide you with comprehensive as-built surveys, ensuring that your project meets all the requirements. We use the latest surveying equipment and techniques.
Scan to BIM
Providing fast and accurate as-built BIM models of your facilities. We use the latest laser scanning technologies and software to create as-built BIM models that can be used for a variety of applications such as clash detection, facility management, space planning, and more.
AutoCAD Floor Plans
Are you looking for accurate and precise AutoCAD floor plans? We have a proven track record of providing high-quality, accurate, and professional drawings to our clients. We use the latest software and technology to create detailed floor plans that are perfect for any project.
Revit As built
We deliver cost-effective and highly precise Revit As built Services (Measuring and documenting existing conditions of a site or structure.) that can be used for various purposes such as facility management, space planning, and asset management.
Detailed Cost Savings with DCMS Network
At DCMS Network, we pride ourselves on offering a range of services that directly result in significant cost savings for our clients. Below are five key examples:
- As-Built Services: Our accurate and detailed blueprints, delivered through As-Built Services, minimize the likelihood of expensive alterations and disruptions during the construction phase. By offering a precise representation of the final construction outcome, we help clients save on unexpected modification costs.
- Existing Conditions and Building Surveys: These services help identify potential structural or other issues at the earliest, allowing you to plan and budget effectively. By proactively addressing these issues, we help avoid sudden, costly repairs or modifications in the future.
- 3D Scanning Services: By leveraging advanced technology in our 3D Scanning Services, we significantly decrease the margin for error. This results in enhanced planning and execution, which ultimately leads to cost reductions by saving on material wastage and rework.
- Building Site Plans: Our meticulous Building Site Plans ensure efficient coordination among all stakeholders. By ensuring everyone is on the same page, we help avoid misunderstandings, miscommunications, or mistakes that could lead to cost overruns.
- World-Class Building Services: When you invest in DCMS Network, you're not just receiving services, you're partnering with a company dedicated to creating value for your investment. Whether it's through our efficient planning, expert management, or comprehensive services, we're committed to helping you maximize your ROI and minimize unnecessary expenditure.
Here is a list of the many different types of Jobs we find ourselves doing in Waukesha, Wisconsin
Cultural Facilities
- Museums and Galleries
- Performing Arts and Concert Venues
- Public Libraries
- ?Historical Laser Scanning
Government Buildings
- Federal Civilian Government
- Local Government Buildings
- State Government Buildings
- Military
- Veterans Administration Facilities
Healthcare Facilities
- Hospitals
- Medical Office Buildings, Dental Offices
- Outpatient Facilities
Entertainment Facilities
- Hotel
- Resorts
- Casinos
Residential Facilities
- Assisted Living Housing
- Multi-Family Housing and Apartments
- Student Housing
Industrial and Multifamily Buildings
- Manufacturing Plants, Warehouses
- Apartments, Condominiums
- Senior Living Facilities
- Student Housing Facilities
Office and Retail Buildings
- Buildings/Core+Shell
- Workplace/Interior Fitouts
- Entertainment Centers, Cineplexes, Theme Parks
- Malls, Big Box Stores, Strip Centers
- Restaurants
Specialized Facilities
- Science & Technology (S+T) Facilities
- Laboratories
- Schools � PK-12, Public, Private, Charter, Military
- Sports Facilities/Stadiums/Recreation Facilities
- Telecommunications Buildings
- Transit Facilities � Bus/Rail Terminals and Stations
- University / College Facilities
Other Facility Types
- Airport Terminals
- Convention Centers/Conference Centers
- Data Centers
- Parking Structures
- Public Safety/Justice Facilities
- Reconstruction Work
- Religious Structures/Places of Worship
- Design-Build Work
- Integrated Project Delivery (IPD)
- Agricultural Facilities
- Oil and Gas
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A company is only as good as the work it performs. J & H Commercial Cleaning Services, LLC is dedicated to meeting all the expectations of our clients, so that our reputation shines as much as the areas we clean.
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All schools have a duty to adapt the curriculum to the needs of individual children. This is known as differentiation. If your child learns more slowly or in a different way from other children the school can set different work or try different teaching strategies. If you are concerned about your child's progress it is important to talk to the school at an early stage.
Most children will progress well using the school's usual differentiation. However, some children will need more help or different help in order to make good enough progress at school. These children are considered to have special educational needs. They will receive SEN support.
Special educational needs can cover a wide range including physical or sensory impairments, learning disabilities, communication difficulties, emotional or social difficulties.


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Here for the making since 1919.
In 1919 our iconic Stand Mixer was born. And from that stemmed an entire kitchen of high-performance appliances-all created with the same attention to detail, quality craftsmanship, versatile technology and timeless design. As the only appliance brand that only makes things for the kitchen, we continue to keep pushing the limits with our products so you can keep doing the same with everything you create. So, here's to you, your kitchen and the delicious world that surrounds us all. |


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Zach Sayne was 25 when he died earlier this month at the place that had been his home for 15 years — a children's nursing home in Alabama.
But that was too far away, 200 miles too far, for his mother in Georgia. Nola Sayne was trying to bring him back, closer to her home. The story of why she couldn't reveals the bureaucratic traps, underfunding and lack of choices that plague state Medicaid programs.
We told the story of Nola Sayne and her son Zach in our 2010 series, Home or Nursing Home: America's Empty Promise to Give the Elderly and Disabled a Choice. One story was about the surprising number of young people — teens and those in their early 20s — living in American nursing homes.
The story explained Nola Sayne's dilemma and why parents often had no choice about placing their young sons and daughters into nursing homes.
For Nola Sayne it happened 15 years ago when Zach was just 10 and had a feeding tube inserted into his stomach. Zach had cerebral palsy and seizures. He was partly blind and couldn't talk. No other after-school program would take him.
Nola put a wanted ad in the paper. One older woman said she'd take Zach into her home day care. But it didn't last.
Sayne thought about quitting her job as a paralegal, but she was a single mother then with two kids. She needed her salary, and she needed the health insurance for Zach. The state of Georgia would pay nothing if Zach lived at home. But it offered to pay the full cost of a nursing home.
But the only nursing home that would take Zach was in another state, in Montgomery, Ala. For the last 15 years of Zach's life, his mother made that 400-mile round trip every two or three weeks. And when he got sick, she left her job and moved into the hospital with him. She counts 40 hospital stays in the last 15 years, including three hospitalizations for respiratory problems in December and January before Zach died, back at the nursing home, on January 5th.
She'd moved Zach from Georgia's Medicaid program to Alabama's because no nursing home in Georgia would take him. When she wanted to bring him home in 2010, Georgia Medicaid officials told her that Zach was no longer a Georgia resident, and no longer qualified for Georgia programs.
Sayne could regain guardianship for her son, bring him home and put him on a waiting list, several thousand people long, for services from Georgia Medicaid. In the meantime, he'd have to live in a geriatric nursing home.
She looked into doing that, but there was another Catch-22. No Georgia nursing home would take a man in his 20s.
Sayne feels her son got good care at the Alabama nursing home. But over time, he got less of it. Until he was 21, he was in a program for children in nursing homes that included physical therapy and other treatments.
Once he became an adult, that program ended. Zach spent the last years of his life mostly in bed and his health declined.
"His life benefited others more than it benefited him," says Sayne of her son. "Zach taught me so many things. I'm a better person because I was his mother. My selfishness level was pretty high when I was young and when I had him he made me grow up ... Since then I've never taken anything for granted. Everything's a blessing."
Filmmaker Narcel Reedus included the Sayne family's story in Not Home, his documentary about children in nursing homes.
Georgia and other states are under pressure from the U.S. Department of Justice to offer more alternatives to nursing home and institutional care to young and elderly people with disabilities.
A Supreme Court ruling in 1999, on a case that originated in Georgia, established a right for people, under the Americans with Disabilities Act, to get long-term care in a setting that is the "least-restrictive" of their personal freedom. But states, facing huge budget deficits and rising Medicaid costs, have struggled to make changes required by the court's Olmstead decision.
In October, Katie Chandler, who runs the Children's Freedom Initiative, told NPR's Neal Conan on Talk of the Nation, "We firmly believe that all children with disabilities can be served in a community setting."
There will be a memorial service for Zach Sayne on Jan. 19. He is the second young person featured in the original NPR story to die before leaving a nursing home.
Bylon Alexander, who was disabled by a stroke when she was 6 and toured alternative placements with Nola Sayne, had talked about wanting to find a place to live so that she could finish high school and go to college. But she died in a nursing home the next year, at age 24.
Copyright 2021 NPR. To see more, visit https://www.npr.org.


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Anxiety UK is a national registered charity formed in 1970, by Katharine and Harold Fisher, for those affected by anxiety, stress and anxiety based depression.
To read more please click here.
We will not tolerate rude, abusive, offensive, racist or sexist language. Any contact received with content deemed offensive, abusive, racist, sexist etc. will not be responded to as we operate a zero tolerance policy to abuse of any form. Legal action will be considered/taken if appropriate. For more information click here.
Download a copy of our environmental policy here.
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Anxiety UK, Nunes House, 447 Chester Road, Manchester M16 9HA
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Press/media enquiries: [email protected]
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