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10G Shrimp King Tank Complete LED
MSRP: $149.99 (Log in for Wholesale Pricing)
Model No. DE-T2
PGS Item #10-800-00051
JBJ Lighting is the proud distributor of the new Shrimp King Tank Kit from Dennerle! This panoramic aquarium has an enhanced depth effect that is lower and deeper than standard aquariums. The seamless front corners offer improved viewing. The tank includes a cover panel with a finger hole and heat insulating safety underlay.
Dennerle Nano Power-LED 5.0:
• 12 first-rate power LEDs
• Perfect grow light for aquarium plants
• Superior aluminum casing
• Stainless steel mounting rods
• Horizontally (max. 3.94 in.) and vertically (max. 7.09 in) adjustable
• 6.500 K, 500 Lumen, 21 V, 5.5 W
Dennerle Nano Bio-Filter:
• Shrimp and crayfish safe
• Adaptable water flow
• Filter outlet rotates up to 90°
• Easy to use and maintain

subset: commoncrawl


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Deutsche Bank has released its first-quarter net profits of €120 mln ($146 mln), down 79 percent from last year, CNBC reported today, April 26. The net profits make the Frankfurt-based,148-year old institution less profitable than the world' top crypto exchange, Binance.
Less than a year old, and currently the world's largest cryptocurrency exchange by trade volume Binance has to date posted quarterly profits higher than that of Deutsche Bank. On March 3, Binance's CEO Changpeng Zhao, better know as CZ in the crypto industry, reported $200 mln in profits in the first ever second-quarter in the life of the exchange:
"In the first 3 months from inception, profits amounted to $7,500,000 USD. In the 2nd quarter, profits amounted to $200,000,000. ….Binance is aggressively recruiting, and is projected to recruit over 2000 employees this year alone, and even more next year."
Binance's official update this month reported third quarterly net profits of $150 mln, marginally higher than Deutsche Bank's first quarter figures.
According to Reuters, Deutsche Bank fired 300 U.S.-based investment bankers yesterday, and plans to significantly reduce its workforce – by the end of this week, another 100 employees will have lost their jobs, as the Financial Times further reported.
Zhao had previously declined requests from Bloomberg News to grant access to Binance's financial statements, or to provide proof of his personal wealth, which he claims is as much as $2 bln.
Deutsche Bank's woes are not shared by all traditional financial sector players: JPMorgan Chase's first-quarter 2018 net earnings this year were reported at $8.7 bln and Goldman Sachs's at $2.83 bln. JPMorgan is currently testing a Blockchain platform for issuing financial instruments, but remains wary of cryptocurrencies, allegedly regarding them as innovative, yet also as a disruptive source of "competition" and "risk" to its business. Just this week, Goldman Sachs hired a crypto trader as vice president of digital asset markets in their securities division.


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Archive for the 'Site Updates' Category
Episode 3 November Update
It's been a while since we released the Episode 3 podcast and our users have resorted to threats of ransom for updates!
As you can imagine, a lot of progress has been made towards finishing Episode 3. I am looking at my Episode 3 flowchart right now and far more is crossed off than isn't, and every day I cross off some more. Right now the majority of the development is in my hands, as all the conversations/items/forums have been built for some time.
A couple of weeks ago during our meeting, I told Jalapeno and BingeBot 2015 that if I worked my ass off, I could have a beta out quickly. But we all decided it was in everyone's best interests to take our time with it and not rush it out. We want Episode 3 to be as awesome as possible, and if that means launching a little later so be it.
I'm still not sure how long Episode 3 will take to play through (we'll need beta testing for that), but content wise it's pretty enormous. I think in most metrics, Episode 3 is bigger. I found out this morning that there are more sTalk conversations in Episode 3 than in Episodes 1 and 2 combined!
So please be patient with us. The worst of the wait is over, and it's just a matter of time before we're ready to open our beta testing and announce a release date.
-ET and the crew
itembuildr: The Episode 3 Hijack
When Episode 3 of Forumwarz launches, there will be hundreds of new items available for players to obtain, trade and use to their advantage. Since we've covered the basics of Episodes 1 and 2 with itembuildr already, we're going to hijack itembuildr for a while to create Episode 3 content.
The content you guys create will exist when Episode 3 launches in addition to the hundreds of items we've created internally, so there will be plenty of new shopping opportunities.
This is how it'll work:
- The stats of items will be hidden. We will assign them later.
- All winners will get a special Episode 3 item contributor E-Peen(tm)
- The winners will also get an IOU for the item once Episode 3 launches. These IOUs can be traded via Kyoubai in the meantime, so it's a great way to earn extra Flezz.
You can start building Episode 3 items right now! Have fun!
Gameplay Update: Launching Sep 10th
I'm delighted to announce that after months of development, we're going to launch the new gameplay enhancements on September 10th.
Addtionally, the new gameplay features will also herald a new Domination season!. We due for a new season, and since things are changing so much we figured it would be better to not mess with the existing medals and winners too much.
Important Launch Notes
The migrations for the new gameplay changes are HUGE. The database has to change in about 20 different ways, some of which could take hours to process. So rather than do our typical "The site should be down for a few hours" thing, we've scheduled a full 24 hours of downtime. This will happen directly following the ending of the current domination round, at 9:30PM EST on September 9th. So we can expect the site will be up by 9:30PM on September 10th.
The road to Episode 3
We haven't talked about it much, but Episode 3 has been under heavy development for months. I'm really happy with the progress the writers have made. Following the gameplay update, the integration of Episode 3 will be my primary development focus, so you'll be hearing more about the cool things ahead.
Until then, I'm hoping these new gameplay enhancements will keep everyone busy, and keep the game feeling fresh.
Thanks again to all the testers, apprentices and regular users who provided feedback to help get this release out the door!
Episode 3 Stuff
It has been about 6 months since we launched Forumwarz Episode 2!
The initial plot for Forumwarz was written quite some time ago. Based on a few meetings where the team discussed what we'd like to have in the story, Jalapeno Bootyhole wrote up an outline. (At the time we were planning on releasing the entire game in one go, where half way through you'd be forced to pay to finish the storyline.)
As we got into the development and writing we figured out that it would be a lot more work than we thought to finish the whole story before we ran out of money. We decided to split the game into Episodes. Three made the most sense, so we found logical end points and adapted the story accordingly. Reviewing the document now reminds me how far we've come:
First mission:
You get a popup message, that refers to whatever search term you came up with.
Bottom corner: Dr. Mysterion/Johnny Anonymous/HornySanta24/AnonImus/Shallow Esophagus has added you to his IM list!
Some presence (Sentrilion? Googhole?) adds itself to your IM list. I know you were searching for pictures of monkey snatch, but: Can I talk to you for a minute? Yes/No, doesn't matter. Singles you out for never having done anything in your life. Says you can change the world forever, just have to listen to instructions. "Why me?" etc. Not important. Asks you to destroy this forum. He'll make it worth your while, and if not, you can block him.
Hah, part of me wishes we went with Dr. Mysterion now!
Throughout the design stage, I referred to the overall storyline as the mythology. In other words, the story that glues together the entire universe. We also introduced a lot of side missions, which are basically interesting characters with a gripe that want you to help them out for money.
Episode 3
Episode 3 is the last piece of the mythology, as far as we've written it. People keep asking me what we have planned for the game after that. Well, just because this particular storyline ends doesn't mean we can't create others. We aren't about to abandon the franchise just because what we initially wrote runs out!
We are committed to working on Forumwarz as long as it is viable to do so. I'm not sure what form that will take, because we'll likely want to take some time to imagine our options, but it might be a new storyline split up into episodes, or single one-off episodes that have shorter but self-contained storylines.
In a little while, Jalapeno Bootyhole will enter the heavy lifting aspect of the writing process. We'll work together to create a detailed outline of the events in the game, the actor dialogue, the forums, the gameplay, etc. It will take some time, but once the ball is rolling you'll hear a lot more about it and what's contained.
But first, the combat revamp!
While Jalapeno is fleshing out the writing, I plan to spend some time beefing up the existing gameplay. In Episode 1, you spend so much time learning about the different aspects of the game that time flies quick and before you know it you're finished. In episode 2, the storyline is much longer, so the limitations with the existing combat engine are more evident. It ends up playing too much like World of Warcraft, where you hit the same combination of keys on the keyboard over and over.
I have some good ideas on how to improve combat and make it more intelligent, and I want to spend some time implementing them into the existing game. I'll need a bunch of volunteers from every class to help test the new mechanics, and there will likely be some speedbumps along the way, but in the end I think it will be worth it.
Look for more on that in the coming weeks.
The three most common question:
These are what I get asked most frequently about Episode 3.
When is it coming out?
We aren't giving a release date because we'd rather launch it when it's stable than push it out too soon. Based on our previous history, a release towards the end of 2009 is likely. Episodes 1 and 2 were both released in October.
How much will it cost?
We're not sure yet. It'll depend how long it is and how epic it feels. We are certainly not out to gouge people so it'll stay affordable like Episode 2 was. Last time the pre-order was successful, so we'll probably offer that again when we have a release date in sight.
Can I beta test it?
Last time the beta tester feedback proved to be invaluable. However, we made some mistakes about letting everyone into the beta at once. Once most people had finished it, they had little reason to start again and test it fresh. This time I plan to have multiple beta sessions, staggered from each other.
We'll probably be hand picking most testers based on their feedback of the game (we even like harsh criticism) and based on their ability and willingness to spend time playing an unfinished game. However, we might end up doing a random selection of people. If we create a sign up list for random selection, you'll hear about it on this blog!
Affiliate Ads
As part of the continuous effort to introduce more players to Forumwarz, we have coded up a Beta system for running affiliate ads. We're looking for people who have sites and are trying to monetize them.
Basically here's how it works: We give you ads to run on your site. We then give you a percentage of the revenue earned from any users you refer to us. We also give you a special tracking page to see how many people clicked on the ads, signed up for Forumwarz accounts, etc.
Right now we're only interested in sites that get a reasonable amount of traffic. If you are the curator of one, contact me and we'll talk about getting you set up. In the future, we might allow anyone to run the ads regardless of the level of traffic their site gets, but for now it's very much beta and we want to figure out all the kinks.
itembuildr Updates
We've listened to your feedback on itembuildr and pushed out a few updates:
- The item-generating code is a lot better. There should be fewer random repeats of the same item class. You should never get the same item class twice in a row. Secondly, there are fixes to prevent pricing from going way out of whack (like with the Dragon Ball items.). Thirdly, we can create special items for all classes now (like Hackers!). Unfortunately, I had to make adjustments to a few of the existing items to keep their prices in line with our economy.
- There are two new E-Peen(tm) for itembuildr — one is for having your idea chosen. The second is for having your image chosen.
- A bunch of items built with itembuildr have been moved into the regular stores. Each item will display credits for its creation. They have subsequently been removed from the ItemBuildr consumer's co-op.
I'm hoping these fixes will go a long way to making itembuildr a lot more useful and fun for everyone. As always feedback is appreciated.
IDC ignoring command
One of our most requested features for IDC is the ability to ignore other players. Lately I made some changes to how IDC works on the back end that allowed me to implement the feature. Here's how it works:
On the IDC console, if you type:
/ignore name
Will start ignoring the player in IDC with the name supplied. If you want to unignore them, simply run the ignore command again (it toggles.)
If you want to list all the people you've ignored, type in:
Without a name. It will tell you everyone you're hiding from!


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How can you become a successful DevOps Engineer ?
These days in software industry one word is high in trend and that is "DevOps". Industry experts define DevOps either as a "culture" or "methodology". But when organizations and companies looking for DevOps expert for their projects or organizations they post job ad like this "Hiring or Looking" for "DevOps Engineer" or "DevOps Architect". So… Read More »


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The Most Filling Snacks Under 150 Calories
Filling Fruits & VeggiesWhen it comes to produce that doesn't leave you hungry an hour later, you need fiber, and these fruits 'n veggies have it! Pro tip: Dip those low-calorie veggies in salsa, hummus, or calorie-slashed guacamole!
Packaged Snacks that Pack SatisfactionDon't stick to chips and crackers... Unconventional snacks like soup, oatmeal, and tuna are where it's at!
Krave Jerky
1 oz.: 60 - 100 calories
Bada Bean Bada Boom Crunchy Broad Beans
1 oz.: 100 calories
StarKist Tuna Creations
2.6-oz. pouch: 70 - 110 calories
Pacific Foods Organic Chicken Noodle Soup Made with Chicken Bone Broth
1 cup: 100 calories
Better Oats 100 Calories Instant Oatmeal with Flax Seeds
1 pouch: 100 calories
Snack-Friendly RecipesReady to take things to the next level? Make your own snacks! Prep a few batches on the weekend, and you'll be set for days...
Roasted Root Veggie Power Hour
128 calories
Beet & Parsnip Chips
100 calories
Grin 'n Carrot Fries
116 calories
Bake-tastic Butternut Squash Fries
125 calories
Totally Turnip Fries
96 calories
Slow-Cooker Veggie-Noodle Soup
56 calories
Instant Pot Chicken Zoodle Soup
103 calories
Mmmmm Marinated Cucumber Salad
33 calories
Zucchini-Noodle "Pasta" Salad
73 calories
Cranberry Tuna Slaw
118 calories
Spiralized Sunomono Salad 'n Shrimp
109 calories
ABC Egg-White Salad
119 calories
Turkey & Veggie Meatloaf Minis
142 calories
Buffalo Chicken Stuffed Zucchini Boats
120 calories
Hip-Hip-Hooray Chicken Satay
115 calories
Bacon-Avocado Egg Bites
128 calories
Chew on this:
October is National Apple Month, and we could really go for a bowl of Scoopable Slow-Cooker Apple Pie right about now!
Quick, before your pals grab the wrong snacks! Click "Send to a Friend" now.
We may have received free samples of food, which in no way influences whether these products are reviewed favorably, unfavorably, mentioned with indifference, or mentioned at all. Click for more about our editorial and advertising policies.
SmartPoints® value* not what you expected? We follow the same method as WW (formerly known as Weight Watchers) when calculating the value of a recipe: We add up the SmartPoints® values* of the individual ingredients using the Recipe Builder, not the calculator. (Many foods have a value of zero and remain zero in recipes.)
*The SmartPoints® values for these products and/or recipes were calculated by Hungry Girl and are not an endorsement or approval of the product, recipe or its manufacturer or developer by WW International, Inc., the owner of the SmartPoints® trademark.


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Design an EMS in Distributed Power Station for a microgrid using MATLAB simulink
Budget $12-30 SGD
To design an Energy Management Distributed Power System (EMS) in Distributed Power Station (DPS) for a microgrid with design and modeling of the generators for a microgrid.
The proposed EMS should implement the following functions: (a) Different strategies and control techniques developed; (b) Several optimization techniques applied in order to lessen the overall cost of micro grid; (c) Calculation of power loss by simulating the results on MATLAB or ETAP.
Also, if time permits, the project will be further carried on with the in-depth study and modeling of Gasoline Generators and Diesel Generators for the Micro Grid of Woodleigh Singapore Power.
Awarded to:
hi how are you i can handle this task so can you please leave a text to me so that i talk with you i hope you will like my work quality i will deliver good and on time work


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Go To Section
BARKER, Scorie (c.1652-1713), of Grove House, Chiswick, Mdx.
Available from Boydell and Brewer
Family and Education
b. c.1652, 1st s. of Henry Barker of Grove House, Chiswick by Anne, da. of Chaloner Chute† of Sutton Court, Chiswick. educ. M. Temple 1662, called 1675; Oriel, Oxf. matric. 17 May 1667, aged 15. m. lic. 19 May 1679, Anne, da. of Sir John Robinson, 1st Bt.†, of Milk Street, London and Nuneham Courtnay, Oxon., 8s. 5da. suc. fa. 1695.1
Offices Held
Freeman, Wallingford 1679; bencher, M. Temple 1691, reader 1693, treas. 1702–3.2
Of Berkshire origin, the Barkers had first established themselves in Chiswick in the mid-16th century, and by the time of the Restoration were one of the leading families in the parish. According to the evidence of his matriculation, Scorie was born in about 1652, but his marriage licence suggests that his birth came two years later. He derived his unusual Christian name from his maternal grandmother, Anne Skory, who had married the eminent lawyer and Speaker, Chaloner Chute. The family's respectability owed much to their long-standing association with the legal profession, and Scorie duly entered the Middle Temple, thereby following the example of three successive generations of Barkers. Moreover, enduring family influence in Berkshire, most notably their ownership of the manor of Clapcot, facilitated his return for Wallingford in 1679–81. Although his father held a clerkship of the crown in Chancery, Barker was prepared to oppose the Court, voting for Exclusion. However, despite his success at Wallingford, he did not seek to regain a place in the House until December 1701, when he stood for Middlesex 'singly upon his own interest', and finished a lowly fifth. There were reports that he put up only to transfer his votes to another candidate, which may partially account for his undistinguished performance at the poll.3
Barker did not contest the county election of July 1702, but subsequently demonstrated support for the war effort by advancing £3,000 to the crown. In 1705 he emerged as one of the Whig candidates for Middlesex, and finished top of the poll. Lord Sunderland (Charles, Lord Spencer*) regarded his return as a Whig gain, while another parliamentary analyst classed him as 'Low Church'. He also voted for the Court candidate as Speaker, and on 18 Feb. 1706 supported the Court during proceedings on the 'place' clause in the regency bill. Unfortunately, the presence in the House of fellow Whig Samuel Barker, Member for Cricklade, makes it difficult to delineate his Commons activity. However, in the first session he can be plausibly identified as the main sponsor of a bill to settle the estate of Thomas Gower of Edmonton, Middlesex. The politics of the Middlesex Member were far from obscure, since in 1708 two parliamentary lists classed him as a Whig.4
Barker enjoyed an unopposed return at the county election of May 1708, and proved an active Member, there being no possible confusion concerning entries for 'Mr Barker' in the Journals for that Parliament. Although selected for drafting committees for bills to give powers to the London commission for sewers, and to regulate the payment of seamen's wages, he was more prominently involved with the management of a bill to relieve creditors of the Royal African Company, and, not surprisingly, with a land registry bill for Middlesex. During this first session he was classed as one of the supporters of the poor Palatines, and in the next voted for the impeachment of Dr Sacheverell. Further proof of his party loyalties came in February 1710, when he played an important role in drafting the bill to regulate select vestries within the bills of mortality, a Whig measure aimed at limiting High Church influence within the capital. Soon afterwards he signed an address from the Westminster commission of the peace condemning recent disturbances by Church supporters, and supported a similar volley from the Middlesex sessions.5
Having emerged as an opponent of the High Tories, Barker paid the price at the county contest of October 1710, when both he and his running-mate John Austen* were well beaten. He did not get another chance to regain his seat, since he died shortly before the next general election, and was buried on 22 Aug. 1713 at Chiswick. His will revealed a surprising distaste for dynastic honours, directing that his funeral should not be accompanied by 'escutcheons, achievement, or anything else belonging to the useless science of heraldry'. His estate, which included gardens at Chiswick reputed to be 'the finest in England', passed to his eldest son Henry, who subsequently used the family interest to mount four unsuccessful campaigns for a county seat between 1715 and 1740.6
Ref Volumes: 1690-1715
Author: Perry Gauci
- 1. PCC 201 Leeds.
- 2. Berks. RO, Wallingford statute bk. 1648–1766, f. 108.
- 3. Vis. Berks. (Harl. Soc. lvii), 64; VCH Mdx. vii. 76–77; W. P. W. Phillimore and W. H. Whitear, Chiswick, 251; London Mar. Lic. ed. Foster, 77; VCH Bucks. iii. 230, 549; Post Boy, 18–20 Nov. 1701.
- 4. Cal. Treas. Bks. xix. 338.
- 5. Add. ch. 76111, 76123.
- 6. Mdx. and Herts. N. and Q. iii. 159; PCC 201 Leeds; Phillimore and Whitear, 13.


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As you can see, it sits on the table of the longarm frame. I follow the grooves in the template with a stylist. I work from the back of the quilt when I do this. This particular board goes the length of my frame (almost). It accommodates a king-sized quilt if necessary. Note: I am not using this template for the quilt loaded on the frame. Here's some photos of quilts I have done using the Circle Lord Swirlz template set.
Soooo versatile!!!


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We are so excited about this season of Theatre Under the Stars. We have guest contributors this week attending opening nights to share their experiences. First up, Mamma Mia….
Guest Contributor: Mahima Lamba
Chai drinker, educator, beachcomber
Opening night of Mamma Mia!
A must see for this summer, rain or shine.
Here we go again, another season of one of Vancouver's most magical summer experiences, Theatre Under the Stars (TUTS). Opening night this year had a forecast of rain throughout the evening. Too excited for the ABBA hits and no rain insurance attached to our tickets, my mom and I came prepared and were "Super Troupers" in the rain. While TUTS does offer a $5 rain insurance to change your tickets to another night, there is truly no need to cancel your plans in the event of a sprinkle.
A generous mist of bug spray and donning rubber boots, yoga pants tucked into socks, warm fleece sweaters and rain jackets we walked into Malkin Bowl with our blankets and thermoses of hot tea. In true Vancouver fashion, we looked more prepared for camping than a night at the theatre. Don't be fooled, while the audience and environment are decidedly casual, the production and cast were nothing short of professional.
The TUTS staff and volunteers were ready to welcome guests and distributed rain ponchos to eager theatre goers with a "show must go on!" gusto. The effect was beautiful. Audience members looked ethereal draped in white plastic gowns gently flowing in the breeze, reminiscent of angel costumes of Christmas pageants bygone. With everyone as snug as a bug in a rug, the show started amidst the rain. The cast and music were full of sunshine. An enthusiastic and talented all-ages cast transported us to a warm Greek island where a young Sophie (Keira Jang) has invited three men to her wedding, each possibly her father!
Mamma Mia is the quintessential mother daughter show. The relationships amongst the female characters take center stage as Sophie learns about life, love and family. Sophie and Donna (Caitriona Murphy) have a playful rapport with each other as they move around the beautiful set (designed by Francesca Albertazzi). Not long into the first act when Donna takes the stage in her iconic denim overalls for the namesake number "Mamma Mia" nearly everyone is singing along. Infectious dance numbers (Music Director Wendy Bross Stuart) and fun costumes (designer Christina Sinosich) made this a show to remember. Make sure to stay until the very end of the show in order to make good use of the pre-show dance instruction!
Check in tomorrow where we discuss Newsies at Theatre Under the Stars.
Get your tickets at https://tuts.ca/ to catch the shows this summer!


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So I realize it's Thursday… so this giveaway is a day late, but I promise I have a legit reason. I'll explain why in a post soon! But lots of things are stirring up! Change on the horizon… and as a result, the past couple months I've spent ample time in airports/living out of a suitcases. My sleep schedule and eating habits have been totally out of wack. I can't wait to get back into a normal rhythm come August… But for now, I'm living the, "keep calm and drink tea" motto.
This week I'm giving away a bag of FitTea, a 28 day all natural detox. I've just started using this stuff and I already feel more energized, especially since getting back into running. It's so simple to add to breakfast in the morning, or before a workout. It tastes like an orange field and a Moscow Mule mixed together! Over ice with some honey, lemon, and raspberries, it's the perfect late summer drink:)
Enter the giveaway on my Instagram @audreyroloff
Winner will be announced in the caption on Sunday!
This week's challenge:
Tell someone that one thing you've been wanting to do for a while, but you've doubted yourself. Give someone else the authority to hold you accountable. Don't secretly dream it, tell someone and then do it! Chances are it will end up encouraging both of you!


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George Springer's wedding brings two opponents back together
One of their guests staying at Dodgers manager's home
HOUSTON – World Series MVP George Springer will officially be off the market in a few days. He will exchange vows with his longtime love, Charlise Castro, on Saturday. While the couple takes care of all those pre-wedding preparations, one of their guests is spending some time with his World Series counterpart.
Astros manager A.J. Hinch is reportedly staying at Dodgers manager Dave Roberts' home while he's in the San Diego area for Springer's wedding.
Hinch and Roberts, of course, were opponents for seven games in the World Series. But they were friends long before that. The pair spent several seasons together when they both worked for the Padres organization. Their friendship continued for many years and apparently even survived one of them losing the World Series to the other.
Reporter Andy McCullough with the L.A. Times interviewed Roberts recently and tweeted this afterward: "AJ Hinch will be crashing at Dave Roberts' house this month ... so he can attend George Springer's wedding. Life is strange."
AJ Hinch will be crashing at Dave Roberts' house this month . . . so he can attend George Springer's wedding. Life is strange. https://t.co/k6BPsS0Jsw— Andy McCullough (@ByMcCullough) January 12, 2018
According to the L.A. Times article, Roberts didn't know at first whose wedding Hinch would be attending when he invited him to crash at his place. "When Hinch mentioned he was attending a wedding near San Diego, Roberts invited him to stay over. He did not even balk when he learned who the man of honor was," McCullough wrote.
But giving Springer's coach a place to stay is apparently as far as Roberts will go, meaning no gift for the World Series MVP. "He should be sending me a present," Roberts joked during the interview with McCullough. "A.J. better bring a really good bottle of wine."
Copyright 2018 by KPRC Click2Houston - All rights reserved.


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A cataract is a clouding of the eye's interior lens that occurs as the human body ages. A cataract can lead to loss of vision, and it can't be remedied through contact lenses, eyeglasses or LASIK surgery. While it sounds like a serious malady, cataract surgery can do more than merely restore vision. It can even decrease an individual's dependency on glasses.
Relevant Statistics
More than 2 million people in the United States have cataracts surgery every year. Approximately 90% of the operations are successful in restoring meaningful vision. Complications do occur but at an incredibly low rate. People over the age of 50 constitute the demographic that is most likely to suffer from cataracts.
Studies have shown that more than 20 million Americans over the age of 40 have at least one cataract. More than 6 million people in this group have already had cataract surgery. Contemporary cataract surgery is incredibly safe and effective. Only those with pre-existing eye conditions like macular degeneration or diabetic retinopathy should have concerns about the surgery.
Cataract Surgery
Cataract surgeries are typically performed by ophthalmologists, also commonly referred to as eye surgeons. The surgery takes place in an ambulatory environment, typically in a hospital or surgical center. The ophthalmologist almost always applies a local anesthesia in either a topical, retrobulbar, or peribulbar form.
During the cataract surgery, the lens inside of the eye that has become cloudy due to a cataract is removed and an artificial lens is substituted in its place. These are typically referred to as intraocular lenses. When the lens is implemented, vision is restored.
To eliminate the cloudy lens, ophthalmologists usually rely on a high frequency ultrasound probe to dismantle it into pieces that are then suctioned out of the eye. Patients can choose from a variety of replacement lens options. The lenses that are traditionally used are called monofocal intraocular lenses. These offer vision at one of three distances: near, intermediate, or far.
The newer lenses are called multi-focal intraocular lenses. These are considered to be premium level lenses because they enable a person to see at multiple distances. Those who choose this lens won't have to wear glasses or contact lenses to see at all distances. Premium lenses are always applied when astigmatism or presbyopia exists.
Costs And Health Coverage
Cataracts are incredibly common and have the potential to cause significant losses in vision. Therefore, the majority of health insurers cover the surgery cost to remove them and implement a new monofocal lens. The cost of the surgery per eye usually ranges from $500 to $600. The vast majority of insurance companies will pay for conventional intraocular lenses, yet patients will oftentimes have to pay the difference in price when they choose premium lenses.
Cataract surgery is one of the more common operations that is covered through Medicare's part B. It is worth noting that patients who opt for the multifocal and astigmatism-correcting lens may not be fully covered under their insurance plan. Patients who have a flexible spending account through their employer can utilize those funds for the more costly lens.


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2007: This Blogging Year
Hold up! Before you read on, please read this...
This post was published more than 12 years ago
I keep old posts on the site because I often enjoy reading old content on other people's sites. It can be interesting to see how views have changed over time: for example, how my strident teenage views have, to put it mildly, mellowed.
I'm not a believer in brushing the past under the carpet. I've written some offensive rubbish on here in the past: deleting it and pretending it never happened doesn't change that. I hope that stumbling across something that's 12 years old won't offend anyone anew, because I hope that people can understand that what I thought and felt and wrote about then is probably very different to what I think and feel and write about now. It's a relic of an (albeit recent) bygone era.
So, given the age of this post, please bear in mind:
- My views may well have changed in the last 12 years. I have written some very silly things over the years, many of which I find utterly cringeworthy today.
- This post might use words or language in ways which I would now consider highly inappropriate, offensive, embarrassing, or all three.
- Factual information might be outdated.
- Links might be broken, and embedded material might not appear properly.
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2007 was an interesting year, perhaps primarily because it was the year when a lot of things didn't happen. That might seem an odd statement, because clearly most years lots of things don't happen. But this year has been one of many unfulfilled expectations.
I didn't discover what religion actually is, despite fairly extensive efforts. My readers and I did manage to have a pretty good debate on the issue – just never came to any real conclusion.
Rather than things improving as promised, the situation regarding junior doctor's jobs reached new lows this year. I certainly expected that once such a low had been reached, the Government would be forced to get its house in order – how wrong I was.
Despite confident predictions, no-one actually faced charges in the Cash for Honours row, which was frustrating for many.
On top of that, the majority of teenagers didn't pass their A-Levels this year, M&S didn't move in a completely new direction (though did gain £3.5m), and mobile phones didn't advance quite as far as we'd hoped. And the Queen didn't storm out of a photo shoot.
As well as seemingly predictable things not happening, many unexpected did happen. Completely unexpectedly, even to me, I actually said something nice about Tony Blair, and he himself appeared on a hard news programme outside of an election campaign.
Floods devastated swathes of the UK, and the Church blamed the gays – like some many other people.
Celebrity Big Brother managed to spark an international race row, Sky and Virgin Media had a puerile fight which still hasn't been sorted, and the world of premium rate phone-ins caved in on itself.
I did manage to have a bit of a guilty laugh at this poor chap's expense, the Vatican published Commandments for Driving, and we mourned the death of Rose Tombe – well, a bit.
A terror attack on Glasgow airport shocked everyone, though didn't lead me to the conclusion that terrorists are evil. The disappearances of Alan Johnston and Madeleine McCann generated acres of media coverage – to date, only one has been found. And I was shocked last week to hear of the tragic death of Benazir Bhutto.
Oh, and then there was the small incident of half the country's bank details getting lost in the post.
And then, I guess, there were the predictable things.
Blair left office, Brown and Co came in, didn't call an election (despite dithering), and the scandals and muddled thinking continued apace.
In terms of sjhoward.co.uk, you helped to generate over seven million hits this year alone – well over double the number achieved last year, and the first book of the site was published. I started writing for Trinity Mirror regularly, which was nice. And the site put on a little weight.
And that was, essentially, 2007.
All that remains is for me to thank you for sticking with the site throughout the year, and invite you to continue reading in the new year – I do hope you will.
This 1,242nd post was filed under: Blogging.


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Anthropology is a subject which is currently proving to be remunerative for the UPSC aspirants. Besides being scoring and less time intensive it is an extension of GS preparation for around 30-40% of its syllabus. Before selecting this optional for UPSC please go through the syllabus (Paper-I, Paper-II ) in a comprehensive manner.
Criteria for selection of anthropology as an optional–
- Familiarity with topics related to biology
- Ease with slight mugging
- Preparedness for giving Dedicated 2 months for it.
Anyone with interest in Anthropology without any past background can opt this optional if he/she satisfy anyone of the above three criteria.
Anthropology was/is field study based subject. It was born out of colonial need to know the origin and evolution of native culture. Hence to make it scoring , following points need to be kept in mind while writing answers.
- To quote anthropologist in answers
- To give case studies while writing answers
- To give examples
( use newspaper for collection of useful case-studies, example etc)
- To draw diagrams wherever required
- Attempt physical anthropology and theory based questions as much as possible as socio-cultural based questions fetch lesser marks comparatively.
- For non-physical anthropology part – give some pictorial representation/ flow chart.
- To use anthropological language in answer writing.
- For general understanding of Anthropology – Ember and Ember
- General Anthropology- Nadeem Hasnain
- Socio-cultural Anthropology- Nadeem Hasnain
- Archeology- Bhattacharya
- Physical Anthropology- P.Nath
- Physical Anthropology- Shukla and Rastogi
- Theories and Indian anthropologist- Pandey and Upadhyay
- Indian Anthropology- Nadeem Hasnain
- Archeology- Bhattacharya
- History of Anthropological Thought – Pandey and Upadhyay
- Demographic Anthropology- Census 2011
- Tribal Anthropology- Nadeem Hasnain
- National commission on ST – A handbook
- MoTA- Annual report
Advantages of anthropology
- Scoring subject
- Interesting subject
- Easy to grasp especially For science students
- Less time consuming
- Helps in GS paper
- Short syllabus
Remarks- We will try to cover complete Anthropology here, no need to refer to any book or notes.


text:
Learn more about how you can help
your loved ones with in home care.
Guide to In-Home Care for Seniors
Table of Contents
- 1. What is In-Home Care?
- 2. What Is Non-Medical Home Care?
- 3. What is the Difference Between Skilled Home Health Care and Non-Medical Home Care?
- 4. What are Activities of Daily Living (ADLs)
- 5. When is Home Care Needed?
- 6. Does Someone in my Family Need Home Care?
- 7. Pros & Cons of In-Home Care
- 8. How do I Find a Professional Caregiver or Home Care Agency?
- 9. Benefits of Using a Licensed Home Care Agency
- 10. Care Needs Checklist
- 11. Who comes to my home to provide the care?
- 12. Paying for Home Care
- 13. In-Home Care Costs vs Continuing Care in a Facility
- 14. Alzheimer's Disease & Dementia Home Care
- 15. Where Can I Find Senior Home Care Near Me?
What is In-Home Care?
In-home care services can provide companionship, supervision and assistance with personal care in the comfort and convenience of a person's own home–making it possible for older adults to live at home rather than move into a senior living community. As baby boomers advance in years, come to retirement age and start collecting social security, before they know it their adult children find themselves caring for elderly parents. When routine phone calls or even alert systems are not enough, but the elderly don't want to spend their retirement living outside the home they are familiar and comfortable with, their loved ones can still assure their health and well-being.
Care in the home may include some combination of skilled health care services and non-medical or assisted living services, but there is a distinction to be made: the term "home health care" is understood to mean licensed nursing care, while "in-home care" or "home care" refers to non-medical care, personal care, custodial care or domiciliary care. These differences are important because they help determine the appropriate level of care provided, which in turn will determine the actual cost of care and also the funding sources available to pay for care.
In-home care from a professional agency is appropriate whenever an individual prefers to stay at home, but needs ongoing care that cannot easily or effectively be provided solely by family and friends. As their physical and cognitive abilities diminish, a growing number of elderly are electing to keep living independent, non-institutionalized lives by receiving care at home. Most senior citizens want to age independently while not burdening their families. Professional in-home care makes that possible. Families, meanwhile, are provided with peace of mind and assurance that their loved ones are well-cared for and comfortable in their own home.
What Is Non-Medical Home Care?
In-home, non-medical care services include supervision and help with personal care (see Activities of Daily Living, or ADLs, below), as well as help in the home with tasks such as meal preparation, medication reminders, laundry, light housekeeping, errands, shopping, transportation, and companionship. While there are differences in the terms describing aspects of in-home care or home health care, in reality, most older adults needing one type of care, will eventually need both as they continue to age.
What is the Difference Between Skilled Home Health Care and Non-Medical Home Care?
Skilled Home Health Agency vs Non-Medical Home Care
The most familiar provider of medical home care services is the skilled home health agency. The main purpose of this type of agency is to provide skilled, professional care for medical treatment or rehabilitation services to homebound patients. Home health care professionals must strictly adhere to a physician-approved plan of care.
Services provided generally include:
- Medical and/or Psychological services
- Wound care
- Pain and medication management
- Disease management
- Nursing care services
- Oxygen services
- Medical supplies and equipment
- Physical therapy
- Speech therapy
- Occupational therapy
- Other basic home health aide care
The same agency may deliver different kinds of home care services through registered nurses, therapists, social workers, home care aides, medical equipment and supply dealers, and volunteers. Some agencies limit their services to nursing and one or two other specialties. If care is needed from more than one specialist, the home health agency will set up a team to provide care that covers the patient's needs. Because home health agencies hire and supervise their personnel, they assume liability for their services.
Skilled home healthcare services generally are available 24 hours a day, 7 days a week. The home health agency is state-licensed and usually Medicare and Medicaid (Med-Cal in California) certified and may also accept other third party health insurances. Medicare certification means that the agency has met specific federal guidelines and criteria.
Many are also accredited by independent third-party review organizations such as JCAHCO, CHAPS or HHC. Services are generally paid for by Medicare, Medicaid, and private health insurance and patients must meet strict criteria for participation and payment authorization. However, some medical agencies also offer their medical home care services on a private duty or private pay basis. There are approximately 14,500 licensed home health agencies operating nationwide.
While the main focus of these agencies is medical care, some also offer a dedicated non-medical, in-home care service. Individuals often have ongoing personal care needs even though skilled home health care services are no longer required. With this home care component, the same agency can continue to provide personal and custodial care to their patients, but it will usually be on a private pay basis.
What are the Main Types of Senior Care?
Companion Care
Just as the name states, companion care offers seniors the comfort of companionship. The primary focus of this type of care is to provide emotional support and companionship for seniors who are healthy, generally speaking, but would prefer to to remain independent at home. It can include a wide range of non-medical services, aimed to help make a senior's life more manageable. To give you an idea, here are some of the most common companion care services: Medication reminders, assistance with Activities of Daily Living (ADLs), light housekeeping, cooking and meal prep, transportation, and help with planning, scheduling and keeping appointments. In addition, companion care often includes encouraging exercise and planning social activities.
Personal Care
Personal care services essentially provide seniors with assistance in completing everyday tasks, such as eating, bathing, dressing, grooming and oral hygiene. Furthermore, this type of senior care generally entails performing home safety evaluations to prevent avoidable accidents.
Transitional Care
Transitional care refers to the care provided following hospitalization, or a stay in a rehabilitation facility. This type of care plays a key role in optimizing the health and well-being of the senior, all while significantly reducing the risk of hospital readmission. Once released from the hospital, a caregiver will tend to the recovering senior, relieving them of many day-to-day responsibilities. The senior can rest and recuperate, while having peace-of-mind knowing household chores, medication management and fresh meals are being taken care of.
Skilled-Nursing Care
As the aging process continues, health-related issues often become more prevalent. Skilled-nursing care helps reduce the stress that both seniors and their family members experience when a loved one is sick, or diagnosed with disease. The clinical care these nurses provide, make the lives of their senior clients easier, and in-turn increase a seniors quality of life. Skilled Nursing Care services include: high-tech nursing, assistance with medical machinery (including ventilators), administration and maintenance of catheters, PICC line dressing changes, drawing blood, performing injections and more!
What are Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) and Why are they Important?
Activities of Daily Living (ADLs) refer to six specific tasks of basic self-care:
- Personal hygiene including bathing, grooming, nail care, and oral care.
- Dressing: choosing appropriate clothing and being able to physically dress and undress oneself.
- Transferring i.e. being able to move from one body position or location to another.
- Toileting: the ability to get on and off the toilet and cleaning oneself
- Eating, meaning the ability to feed oneself.
- Ambulating: walking or otherwise being able to get around independently (for example with a wheelchair).
Instrumental Activities of Daily Living (IADLs) are more advanced activities related to independent living:
- Managing personal finances
- Transportation, either by driving or by organizing other means of transport.
- Shopping for food, clothing, and other necessities.
- Meal preparation including cooking and safely using kitchen equipment and utensils.
- Housework and home maintenance required to keep a tidy and hygienic place of residence.
- Managing communication, such as the telephone and mail.
- Taking medications in accurate doses and at appropriate times.
The number and severity of a person's ADL and IADL needs are used to determine the level of assistance required, as well as to determine eligibility for long-term care insurance benefits. Insurance companies require justification and documentation that the insured individual needs help with at least two (sometimes three) ADLs in order for the benefit to be effective. The new Medicare benefit for non-medical care available only through Medicare Advantage Plans beginning in 2019 will most likely also require the same.
When is Home Care Needed?
Home care is especially useful in the following scenarios:
Support for daily activities
When an individual needs assistance with ADLs and IADLs. Also when general supervision is needed for persons with alzheimer's disease, dementia or other cognitive deficiencies.
Respite care
When regular in-home care is provided by family and close friends, respite care through a professional agency is a convenient and safe option for giving them a break from the emotional and physical demands of daily caregiving.
After a serious medical episode
Some medical episodes–falls resulting in a broken hip or femur, joint replacements, strokes, etc.–can result in prolonged recoveries, especially among the elderly. Hospital discharge planners and social service personnel are required to ensure that patients have adequate care at home before they can be discharged. Because hospitals are financially penalized if patients are readmitted within 30 days of discharge, they have a strong incentive to ensure that their patients are properly cared for at home. In the past, hospitals focused primarily on the clinical, medical care the patient needed in the home. Today, hospitals and insurers are increasingly focusing on the non-medical services that caregivers can provide. They want to ensure that their patients follow doctors' orders, take their prescriptions, comply with diet restrictions, follow specific therapy regimens, and avoid falls or other accidents at home.
Short term disability or illness
Including situations such as a difficult pregnancy, or after a complicated childbirth.
For chronic conditions or illnesses such as:
Most elderly, especially the frail elderly, will have co-morbidity diagnoses, meaning they will be diagnosed with two or more serious health conditions. It would be quite common, for example, for an 85 year-old woman who suffered a stroke to also have diabetes, osteoporosis and dementia. She would most likely have multiple prescription medications and have been given important dietary restrictions–often ordered by different doctors. After her 3-5 day stay in the hospital for her stroke, she would go to a short-term rehab facility for 10 days before being discharged home. Without constant, capable care and assistance at home, there is a high degree of probability that she could sustain a serious fall, sending her back to the hospital for a broken hip or femur–where she could in turn catch pneumonia or another infection, worsening her chances of full recovery. Hospital discharge planners, case managers, and professional geriatric social workers face the reality of this scenario constantly. The need for in-home caregivers, especially those experienced in condition specific co-morbidity care for the frail elderly, has never been higher.
Pros & Cons of In-Home Care
According to extensive research conducted by the American Association of Retired Persons (AARP): More than 90% of seniors want to stay in their own homes as they age.
"Aging in place" is, by far, one of the fastest growing trends in senior living. As enticing as growing old in the comfort of your own home may sound, seniors often find themselves struggling to perform some of the basic Activities of Daily Living (ADLs) on their own. Others may find that, as time goes on, it becomes increasingly difficult to remember when medication needs to be taken, or what time their scheduled doctor's appointment is. In-home care for seniors can help solve these issues, and many more common problems that may arise as we get older.
The chart below summarizes both the pros & cons of in-home care for seniors. We know that each and every situation is unique, as every person has their own set of needs. That said, this chart provides a basic overview of the advantages and disadvantages associated with senior home care.
Chart of Advantages & Disadvantages of Home Care
Does Someone in my Family Need Home Care?
Fearful of losing their independence, aging individuals will often mask or cover-up the signs and symptoms indicating they might need assistance. Younger adults and children with disabilities or who are recuperating from acute illness may also benefit from in-home care.
Knowing the ADLs and IADLs and looking for patterns of behavior and neglect within those areas can help pinpoint whether a loved one needs in-home care. The IADLs are usually the earliest to suffer, so look for difficulties with those first:
- Unpaid bills, irresponsible spending, susceptibility to scams.
- Inability to drive safely or to access other means of transportation.
- Low supplies of fresh food and other necessities; spoiled food in the fridge; evidence that only canned food is being consumed.
- Messes left untidied, laundry piled up, home care and maintenance neglected.
- Telephone calls unanswered, mail unopened.
- Unfilled prescriptions; medications not being taken as directed.
Next look for evidence of trouble with ADLs:
- Infrequent bathing, unusually sloppy appearance, bad body or mouth odor.
- Inappropriate clothing choices or not being able to physically dress and undress oneself.
- Difficulty standing up, sitting down, or getting in and out of bed.
- Incontinence or difficulty cleaning oneself after using the toilet.
- Weight loss, appetite changes, difficulty swallowing, dehydration.
- Inability to walk or otherwise be able to get around independently.
In addition, look for the following warning signs:
- Burns or bruises.
- Hearing loss.
- Spilling or dropping things.
- Fatigue; sleeping too much or too little.
- Isolation; lack of interest in friendships, hobbies, or activities; curtains drawn day and night.
- Change in attitude; sadness or feelings of depression and despair; abuse of alcohol or drugs; paranoia; refusal to communicate or unusual argumentativeness; verbal abuse.
- Diminished cognitive abilities; forgetfulness about where things are, getting lost walking or driving, confusion, loss of reasoning skills, difficulty answering questions, inability to find the right word or complete a sentence, repetitive words or phrases, wandering, loss of sense of time or season, forgetting how to use ordinary things, consistently forgetting to turn off the stove, close windows, or lock doors.
With the advent of professional in-home care agencies, families can easily help their elderly or disabled loved ones to stay in the comfort and security of their own homes, while still receiving the care and assistance they need to be safe.
How do I Find a Professional Caregiver or Home Care Agency?
Traditionally, much of the care in the home was provided by families and friends or by independent or freelance caregivers, even though there are significant labor and liability risks associated with directly hiring a caregiver. That course is changing due to the emergence of widely available, capable and affordable in-home care agencies.
Many people looking to hire professional care for a loved one will ask a relative or trusted friend, advisor or clergy if they know of any caregiving services and options. Some families would rather hire a caregiver privately. There may be some potential cost savings in going this route, but if you are considering this, you must be aware of the additional responsibilities and liabilities involved.
If You Decide to Hire a Caregiver Directly:
Hiring a caregiver independently means:
- You must do a substantial background check to ensure that the employee has no record of criminal activity or abusive behavior and that they, in fact, have the experience and training necessary to meet your care needs.
- You, as the employer of record, are responsible for all the employment paperwork–payroll taxes, proper withholdings and filings, worker's compensation insurance, etc.–necessary to comply with all federal, state and local labor, tax and insurance laws.
- You will need to arrange for a suitable substitute or relief caregiver if your caregiver is ill, needs time off or simply abandons you.
Using a Referral Agency:
Home care referral agencies, also called home care registries, can help match you to an independent caregiver. These agencies do not employ caregivers; they simply collect a referral fee if you hire someone from their registry. Referral agencies vary widely in the quality of the screening they do, and they do not generally offer professional liability or workers' compensation insurance. When you hire a caregiver, you will become the employer of record and be responsible, as above, for complying with all federal, state and local labor, tax and insurance laws.
Using a Licensed Home Care Agency:
Full service, licensed home care agencies (also called home care organizations) specialize in recruiting, hiring and supervising their caregivers. They are responsible for performing background checks, handling all payroll taxes, withholdings and filings, worker's compensation insurance, and arranging replacement and back-up staff for time-off, sick-time and emergencies. Indeed, they lighten the burden of hiring a caregiver and provide peace of mind to the patient's family.
Benefits of Using a Licensed Home Care Agency:
1. Convenience
InHomeCare.com makes it simple and easy to find a reputable in-home care company serving your area. You'll work out a schedule and the list of duties your caregiver will perform when you meet with your selected company. The company will choose the best caregiver for you to ensure that the care you receive is personalized to meet your exact needs.
2. Comfort
You or your loved one is able to continue living as independently as possible, in familiar surroundings and in the comfort of home.
3. Companionship
In-home care services can also provide something that we all need, companionship. Most in-home care companies will match a caregiver to your personal care needs and to your personal interests.
4. Cost-Effectiveness
You'll receive the one-on-one care and attention from your caregiver that you can't get in a facility. That means greater value for every dollar spent on care. Plus, your caregiver may perform tasks previously handled by an errand service, a housekeeper, a transportation service, etc.–saving you more money and time, too.
5. Security
Having a professional caregiver in your home can provide an additional level of security. However, when contacting an in-home care company, be sure to ask how the agency screens caregivers and manages their staff. Make sure your selected agency is properly licensed and insured, and that its caregivers are fidelity bonded.
6. Assurance
In-home care assures you and your family peace of mind. Many adult children of aging parents can't regularly pop-in to check on their loved ones or tend to their every need. With a caregiver in the home, families are regularly updated as to the well-being of their parents. Having a personal, caring, professional caregiver in the home provides everyone peace of mind.
Care Needs Checklist:
Non-medical home care agencies provide some personal care that skilled home healthcare agencies do not; conversely there are needs that can only be provided by skilled healthcare personnel. Although these tasks vary by state because of license regulations, the following are some general guidelines:
|Non-medical Care
|Skilled Healthcare
|Household Tasks
|Light Housekeeping: clean and keep tidy all living areas
|Laundry: wash and change bed linens and launder clothing, etc.
|Meals: cook, grocery shop, prepare food ahead for later meals
|Organization: schedule daily tasks and appointments, sort mail, etc.
|Transportation, Companionship, General Safety
|Drive and escort on errands, shopping and doctor appointments
|Encourage social participation, escort on outings and to recreational events, everyday stimulating conversation, phone call assistance
|Supervise in home to avoid falls, household accidents and ensure easy access to emergency contacts
|Personal Care
|Eating: assist feeding, provide nutritious meals and adequate fluids
|Bathing: assist bathing, transferring in/out of tub/shower, bed-baths as needed
|Dressing & Grooming: assist dressing, glasses, hearing aids, special orthotics (i.e. braces), hair care, shaving, oral hygiene
|Ambulation: assist walking, safe use of assistive devices, range of motion and strengthening exercises
|Toileting: assist to bathroom, bedside commode, urinal, bedpan usage
|Incontinence: assist changing diapers, undergarments, pads, related skin care
|Therapy: assess, plan, implement and evaluate therapy to regain speech, breathing and swallowing function
|Teaching: instruct speech therapy regime, evaluate technique and compliance
|Assistance: help to perform prescribed exercises, report progress to supervisor
|Referrals: identify and arrange local resources for home care services, adult daycare, respite, financial assistance and support groups
|Intervention: identify and arrange local resources for family and individual counseling and crisis intervention
|Wounds and Bedsores
|Assess wound, incision or bedsore; evaluate signs and symptoms of infection and monitor response to treatment
|Teach Care: instruct wound or bedsore regime, evaluate technique, compliance
|Treatment: perform wound/bedsore care per prescribed regime; report signs & symptoms of infection
|Alzheimer's and Dementia
|Home Safety: closely supervise for safe environment, secure area with use of monitoring alarm devices to avoid wandering
|Emotional Support: provide structured activity at appropriate cognitive level to minimize confusion
|New Diabetic: teach specialized skin care, insulin injection technique, blood glucose monitoring, hypo/hyperglycemia symptoms and related emergency protocol
|Glucose Monitoring: remind to check blood glucose per orders, report results to supervisor
|Insulin: remind to inject insulin per prescribed regime, follow-up and report compliance to supervisor
|Diet: prepare special prescribed diets, encourage compliance with restrictions
|Ostomies: Colostomy, Urostomy
|New Ostomy: teach ostomy care, preventive skin care, troubleshooting
|Care: assist with ostomy changes, monitor peristomal skin blood work and report results to physician
|Feeding Tubes: G-Tube, NG Tube
|New Tube: teach proactive skin care, dressing changes and troubleshooting problems with blockage, tube placement, skin infections
|Tube Changes: insert new tube per authorized plan of care and as needed
|Feeding: teach tube feeding regime, evaluate competency and compliance
|Care: perform daily and as needed dressing changes and skin care to tube site
|Catheters: Foley Indwelling and External
|New Catheter: teach drainage bag changes and cleaning, securing tubing, troubleshooting dislodged catheters, placement, blockages, drainage amounts
|Catheter Changes: insert catheter per authorized plan of care and as needed
|Care: perform daily and as needed catheter care including emptying drainage bag, monitoring intake and output, cleaning and securing tubing and bags
|Basic Health Monitoring
|Skin: monitor for signs of breakdown, apply pressure reduction measures
|Nutrition: monitor weight, nutritional intake, adhere to dietary restrictions
|Intake/Output: encourage adequate fluids, monitor fluid intake and urine output
|Vital Signs: take blood pressure, temperatures, pulses and report changes
|Lab Monitoring: perform prescribed blood work and report results to physician
|Medication Management
|Remind to take medications and follow-up
|Administer oral medications
|Teaching: instruct new medications or monitor changes in regime per plan of care, assess response, side effects, and adverse reactions
|Injections: administer prescribed injections per authorized plan of care, report side effects, adverse reactions
|Supplies: manage supply of prescriptions to have all meds on-hand
|Home Assessment: evaluate home safety needs, arrange for adaptive equipment
|Therapy: assess, plan, perform and evaluate physical therapy to regain strength and maximal activities of daily living plan
|Teaching: instruct prescribe exercise regime and safe ambulation with/without assistive devices
|Assistance: help perform prescribed exercises, report progress to supervisor
Who comes to my home to provide the care?
Certified nursing assistants (CNAs), home health aides (HHAs) and personal care attendants (PCAs) perform similar but distinct roles in the home care community. Because they are able to offer much of the personalized care needed without being registered nurses, these care professionals play an important role in reducing healthcare costs, especially among senior citizens. CNAs, HHAs and PCAs have the ability to help reduce patient falls and readmissions, and improve outcomes by helping patients adhere to doctors' orders and to comply with prescriptions, diets and exercises.
CNAs, HHAs and PCAs can all provide companionship and basic personal care to patients, but they have different levels of education, training, and certification. They also differ in the level of medical care they are allowed to provide without supervision from a doctor or nurse.
Certified Nursing Assistant (CNA)
CNAs are state-licensed nursing assistants who have received classroom and hands-on training, as well as passed an exam. Requirements vary by state, but generally certification must be renewed every few years and requires additional hours of training. The basic health care training that CNAs receive qualifies them to work in a hospital, Skilled Nursing Facility (SNF), Assisted Living Facility (ALF) or with a home health or in-home care agency.
In addition to assisting with personal care needs, CNAs help monitor their patients' medical conditions. They can monitor and record vital signs and symptoms to share with the supervising nurse or doctor, and in some states they are allowed to
administer medication. They may also assist with basic medical care such as changing dressings, etc.
Home Health Aide (HHA)
HHAs are also state-licensed and must meet the same kinds of requirements as CNAs, however their health care training is very limited. Home Health Aides will usually work in an Assisted Living Facility (ALF) or with a home health or in-home care agency.
HHAs rarely provide any kind of medical care, although this can vary by state. They assist with all personal care, prepare meals, perform light housekeeping duties, and provide transportation.
Personal Care Attendant (PCA)
Also referred to as personal care assistants/aides, or homemakers, PCAs make up the majority of individuals providing care to senior citizens or the disabled in their home. There are no formal education requirements necessary to become a PCA, but many states now require all professional in-home caregivers to obtain a certain number of supervised training hours.
Many of these caregivers started their careers by taking care of a relative; nearly all obtain their caregiving skills and knowledge through hands-on, on-the-job experience. Some have supplemented their experience with additional training. Training usually includes basic personal care principles, common diseases and health conditions, sanitation practices and safety precautions, communication and cultural sensitivity, privacy and ethics, and transfer assistance.
As with HHAs, PCAs primarily provide companionship and assistance with basic personal care, homekeeping and transportation.
Paying for home care
How Much Does Home Care Cost?
The cost of care varies widely. Factors include the type and number of hours of care needed and the geographic location. On average, the cost of light companionship care is between $17-$21 per hour. The cost for total care can range from $28-$40 per hour. Someone needing a moderate amount of in-home care services could expect to pay around $22-$28 per hour.
The rates, terms and types of programs offered by agencies vary when it comes to paying for home care. Rates may be priced on an hourly, per day, or per shift (including a "live-in") basis. Some determine their charges based on the level of care needed, while others charge a flat rate per hour or day regardless of the care needed. Paying an upfront deposit is common in the industry. Agencies usually bill twice each month or on a monthly cycle. Payment by check is still the most common form of payment although many agencies are set up for automatic debit payment. More and more accept major credit cards as an additional form of payment.
How Will I Pay for Home Care?
Private Pay
Where does the money to pay for care come from? There are several sources of funding for non-medical, in-home care services. However, the vast majority of care is paid from the savings, retirement accounts and resources of the individual receiving care or from their family. This type of payment is commonly referred to as private pay or as out-of pocket payment.
Medicare does not presently cover non-medical care except when certain custodial services are part of a doctor authorized plan of care. In this case the licensed home care agency must be approved and, of course, the patient must be Medicare eligible and must meet Medicare's definition of "homebound."
In 2019, the federal Medicare program will include a benefit for non-medical, in-home care under certain conditions, only if the Medicare beneficiary is enrolled in a Medicare Advantage Plan. The specific details of the new Medicare in-home care benefit will soon be unveiled and should include the conditions and limitations that will apply.
Long-Term Care Insurance
Long-Term Care Insurance (LTC) carriers currently pay for about 20% of the in-home care in the U.S. LTC companies generally pay a fixed benefit per day and have a maximum benefit they will pay for in-home care. Most home care agencies will assist you in complying with the requirements of your LTC carrier. They will usually verify policy benefits, perform a pre-evaluation, obtain a doctor's order, and complete daily care notes and itemize bills for services rendered. It is generally your responsibility to pay the care agency and then to submit the claims to your LTC insurance carrier for payment on your policy. Some agencies do accept assignment of benefits, meaning they do all the paperwork and get paid directly by your LTC carrier.
Other Options
There may be other options to consider which might assist in paying for care including:
- Paid Family Leave
- Medicaid & State Assistance Programs
- Veterans Administration
- Grants
In-Home Care Costs vs Continuing Care in a Facility
The cost of care in a facility, as with most medical expenses, depends on many factors including the type of facility (Short-term Skilled Rehab vs Chronic Long-term Care Facility, or Skilled Nursing vs Assisted Living), the health and care needs of the patient, private room vs semi-private, the quality and location of the facility, etc. Cost varies widely: anywhere from $350 to $1,200 per day.
Because a patient does not receive one-on-one care in a facility, a patient or resident in a facility may also elect to hire, at additional cost, an outside care agency or caregiver to supplement the care provided by the facility. In these cases, the agency and caregiver must comply with all rules and regulations of the facility.
Alzheimer's Disease & Dementia Home Care
Did you know: Alzheimer's Disease is a type of Dementia, and is the most commonly diagnosed form.
What are the symptoms of Alzheimer's Disease?
The most common symptom of Alzheimer's is progressive memory loss. Here are the symptoms associated with memory loss:
- Forgetting appointments and/or prior-set engagements
- Losing, or misplacing, objects – And primarily storing them in illogical places
- Experiencing feelings of confusion, or loss, even if you are in familiar areas
- Forgetting the correct name of basic objects and/or household items
- Forgetting the names of familiar people – such as family members
What are the signs of Dementia?
- Apathy
- Withdrawal in social situations
- Inhibition loss
- Suffering from a sleeping disorder(s)
- Delusions, such as believing a theft has taken place – when it hasn't
- Losing trust in those close to you
How is Dementia Diagnosed?
When you go to meet with your doctor regarding signs of Dementia, they will likely ask for your family's medical history. In addition, lab work, cognitive testing and brain scans may be performed. For more information on the stages of Alzheimer's Disease, click here.
Can In-Home Care Help Seniors with Dementia?
In-home care services include both medical, and non-medical, assistance with a variety of daily activities. From safe and reliable transportation to medication management and bathing. If you, or a loved one, is suffering from the effects of memory loss, it may be time to look into home care. Many seniors who have had to live alone with Dementia, say their quality of life has increased significantly – ever since hiring a home caregiver to help them with day-to-day affairs.
What is Respite Care?
Respite care provides short-term relief for a primary caregiver. In other words, this type of care allows primary caregivers the chance to take time off for vacation, if they are sick, or any other reason. A different caregiver will step in and take care of the primary caregiver's clientele. Respite care can be arranged for an afternoon, or for several days – to weeks at a time. The care can be provided in the home of the client, in a healthcare facility, or at an adult day care center.
Respite Care Costs
Respite care services are charged on an hourly or weekly basis, depending on what senior services are provided. It is important to mention – the majority of insurance plans do not cover respite care costs. You are responsible for all costs not covered by insurance, or other funding sources. That said, Medicare will cover most of the cost of care for up to 5 days in a row – as long as the respite care is received in a hospital or skilled nursing facility. In some cases, Medicaid may also offer assistance.


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Ask anybody to name the most common cause of lung cancer, and they'll probably know the answer: smoking. But you're more likely to get a blank stare if you ask them about the second most common cause.
The answer, if you didn't know, is radon. It's an invisible, odorless, radioactive gas that can build up in homes. Experts say that nearly 1 out of 15 houses in the U.S. has elevated levels of radon.
That sounds pretty alarming, but there are steps you can take to protect yourself from radon and lung cancer. You just need to test your home for radon, and then -- if you have high levels -- make some changes to get them lower.
What Is Radon?
If you don't know much about radon, you're not alone. For such a serious health issue, it seems to have a low profile. Many only find out about it when they're buying or selling a house, since testing for radon sometimes happens along with home inspections.
So what is it? It's a gas that comes from the ground naturally. When uranium deep in the earth breaks down, it creates radon. Most of this gas finds its way up through the ground and into the air. Outside air always has some radon in it, but the level is usually low enough that it doesn't cause trouble.
How Radon Gets Into Homes
Radon can become a problem when it seeps up from the ground into your house, through cracks in your foundation, gaps around pipes or wires, or other openings. When radon gets trapped inside, like in a basement, the levels can build up and become dangerous. Since you can't smell or see it, you won't know it's there.
While most radon comes from the ground, there are a few other sources. Sometimes it can get into well water. Small amounts of it can also come from building materials, like concrete, brick, and granite, but experts say that the levels are usually low enough they don't cause problems on their own.
How Radon Causes Lung Cancer
When you breathe in radon, tiny radioactive particles get trapped in your lungs and cause damage there. If you're in contact with these levels of radon day after day for years, that damage can lead to lung cancer.
Experts most often measure radon by the amount that's in the air. The higher the level, and the longer you're in contact with it, the greater your risk of lung cancer.
To put the risks of radon in perspective, about 21,000 people die each year from lung cancer related to radon. It's a serious home hazard, since it kills more people than falls in the home, drownings, and house fires. And keep in mind that smoking and radon are a bad combination. If you smoke and live in a home with high radon levels, your risk of getting lung cancer is especially high.
Find Out if Radon Is in Your Home
While radon can be a problem in any building, including schools and workplaces, the biggest danger for most people is at home, where they spend so much time. So find out about the radon levels where you live.
These levels vary across the country, but even states with relatively low radon levels can still have areas with high radon. Sometimes, houses next door to each other can have different levels. The type of home doesn't matter either. Old homes and new homes can both have radon.
That's why experts say that everyone needs to test their home. There's no way to know otherwise. Radon tests are easy to get online or in hardware stores.
Usually, you just set up the testing kit in the lowest level of your home that you use regularly, such as your basement or first floor. It should not be placed in a kitchen or bathroom. Then after a few days, you send it off to a lab for results. If you have well water, you may want to test your water for radon, too.
When you get the results, you may see some numbers in front of units called "pCi/L." That's how the amount of radon is measured. According to the Environmental Protection Agency:
- 1.3 pCi/L is an average indoor level of radon.
- 2.0 to 3.9 pCi/L is higher than average, and you should think about fixing your radon problem.
- 4.0 pCi/L is high enough that you need to take action.
What to Do if You Have High Radon Levels
If you find out that radon is high in your home, you don't need to panic or flee your house. Remember, lung cancer from radon is a long-term risk. It takes years of contact with it, not days.
But you do need to deal with the problem. Get in touch with a contractor who's an expert in solving radon issues. Fixes can include things like sealing up cracks in your basement or installing a pipe under your home to suck out the radon and blow it outside.
If you've never tested your home for radon, or think you might have but can't remember, now is the time to do it. Testing is so easy to do, and the benefits, for you and your family, could be huge.


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Those of you who balk at doing a foreign MBA should meet Rishub Jhunjhunwala. This HKUST grad from the batch of 2012 is now Associate Director at Standard Chartered Bank, Mumbai. A dizzyingly fast rise, if you consider that he had just completed the BMS program from Jai Hind college in 2006. He is a great example of what a foreign MBA can do for you. It can open doors that remain locked for local MBA graduates. Of course, it is expensive, and it is not easy to get in, you need top notch credentials, and Rishub's CFA qualification and would have gone a long way in helping him stand out among the pool of applicants. Not everyone can complete their CFA before even applying to B school, but the broader lesson here is that if you have a career plan and execute accordingly, and if you are willing to spend a little bit extra, the rewards to a foreign MBA from a top B school can be fantastic.
In our third article featuring HKUST, (read the introduction to HKUST here and interview with executive director of the MBA program) we bring to you an interview with Rishub Jhunjhunwala.
- What were the main reasons for choosing HKUST for your MBA?
The key reasons for me to pursue an MBA at HKUST are as follows (not in order of importance):
- Student Body: I think that the HKUST student body is one of the most eclectic across all business schools in Asia. Having had limited international exposure prior to my MBA, I thought it was important for me to expand my myopic vision of the world and expose myself to people from different backgrounds. Hence, I wanted to go to a school that offered me the opportunity to interact with people from all walks of life. HKUST offered me just that, my classmates came from countries all over the world (including Azerbaijan) and from different professional backgrounds (including a former Scotland Yard Detective and a Professional Musician) and we all had a great time together.
- Location & Asian Focus: HKUST's locational advantage and strong Asian focus fit very well with my intention of building a career in Finance in Asia. Being one of the largest financial hubs in Asia, Hong Kong offers immense opportunities to learn and network especially in the field of finance. Also, Hong Kong is a great place to live, it has so much to offer; there is never a dull moment in Hong Kong. HKUST's curriculum is tailored to the Asian context and offers students specialised courses and case studies that are relevant and useful if you want to build a career in Asia.
- Economics: The cost of doing an MBA at HKUST and the potential benefits made a lot of sense to me. The HKUST MBA cost me half of what an MBA in the US or UK would cost me. Additionally, HKUST offered me an MBA from a reputed school that has been consistently ranked very highly and enjoys a growing franchise value across the world. HKUST's reputation is not only a function of its ranking, but is also a function of other attributes such as its impressive list of faculty, it's beautiful campus, its students & alumni body and the opportunities that it offers.
2. In your perspective, what all the necessary and sufficient conditions to get a final call from HKUST?
I don't there is a specific set of criteria with regards to GMAT score, number of years of work experience, professional background etc. I believe that applicants should be honest in their applications and demonstrate the following:
- Have a clear idea of their goals and a roadmap to achieve the same
- Understand what HKUST can offer and how it can help them achieve their goals
- Leadership and international experience
- How their participation will contribute to the learning of classmates
- Excellence in their current profession
- Unique traits of their personality
- Strong communication & social skills
3. What was the best part of your MBA experience?
I think the best part of the MBA experience for me was interacting with my classmates, professors, alumni and all the people I met as a result of living in Hong Kong. I met people from all around the world and learnt a lot about their cultures, their professions/industries, their aspirations and all sorts of random things. My learning was not just limited to the classroom or formal academic settings but stretched to the most unlikely of places & situations such as an evening drinks session with professors and classmates at the Unibar (on-campus bar), a visit to an oyster sauce factory in Hong Kong, meetings with glass suppliers for a business plan, an equity pitch to a hedge fund manager in Singapore and many such other unique experiences.
4. How did you find Hong Kong as a place to live and work?
I think I can answer this most efficiently in just one word – AMAZING.
5. You did your internship with a private equity fund focussed on investments in Mongolia. How was the experience?
Mongolia is a fascinating country and my experience there was simply great. I interned with a local securities firm in Ulan Bator (the capital city) and spent most of my time helping them with the preliminary study for setting up a Mongolia focussed PE fund. I am grateful to the school's career services for organizing this unique internship for me that gave me the opportunity to do something out of the ordinary for ~3 months in Ulan Bator. There is a lot of investor interest in the frontier market of Mongolia given the rapid economic expansion it has witnessed as a result of the mining boom. Since the business community in Ulan Bator is still really small, I got the opportunity to interact with a lot of high ranking government officials, lawyers, businessmen, regulators and foreign dignitaries including the president of India (who was on a business trip in Ulan Bator at the time) during my internship. I learnt a lot about the economy of the country, its industries and its culture. Outside of work, I had a memorable time in Mongolia as I had six other classmates from HKUST interning with me. We camped in the country side, hitch hiked our way around the city (no cabs usually available, you just stick your hand out and hope for some random car to stop and take you where you want for a negotiated price) and enjoyed the surprisingly good nightlife the city had to offer.
6. Most Indian students (even the ones with 3 or so years of work experience) balk at doing foreign MBAs because of the following reasons
- Costs of the MBA program
- Complexity of admission process – essays need to be written at the beginning itself – in comparison, the CAT, although tough to crack , offers a relatively straightforward route to MBA. What would your advice be to such candidates?
Indian B-schools are undoubtedly excellent and economically feasible; however, most of them lack international exposure that makes an MBA degree really worth it. So yes, you do pay more for an MBA abroad but I believe you get more out of it as well if you choose wisely. Also, many schools have financial aid programs that help students with tuition and other expenses if need be. You just need to do some work and find out all the options available. In terms of the admission process, while I agree that it can be demanding, I believe you need to be motivated enough to go through the process wholeheartedly it if you really want to do an MBA from your school of choice.
7. How do placements work at HKUST?
Unlike Indian B-Schools, where most of the recruiting happens on campus, at HKUST, like other international B Schools, the responsibility for placements is primarily with the students themselves. There are a few companies that come to campus for hiring MBAs but it is not as much as it is in India. Having said that, the career services does help by organizing company & speaker events and connecting students with the industry, but at the end of the day you have to follow up on your own and generate leads for yourself. One needs to be diligent and creative because anything may work right from shooting out a hundred cold emails to getting job interviews after a tennis match with your prospective boss.
8. How far do you think the CFA has helped you in your career? How has BMS and MCom helped?
I think the CFA has helped me a lot. The CFA curriculum is exhaustive and covers a variety of financial concepts with considerable depth. The CFA helped me grasp concepts taught in class quickly and allowed me to gain exemption from quite a few basic classes in the MBA curriculum which I could replace with more advanced electives. Career wise, the CFA has helped me build credibility with potential employers and contributed meaningfully to business discussions. The BMS (undergraduate) degree helped me build basic business concepts and polished my public presentation skills. The MCom degree honestly was not really helpful, I pursued it primarily to complete sixteen years of education which used to be a pre-requisite for some B schools earlier.
9. And finally, any specific reasons for choosing to work in Mumbai over other options? Was it the profile, the location or a combination of both?
I was born and raised in Mumbai and have spent all my life with my family here, so coming back to Mumbai was always on the cards. I wouldn't have minded spending a year or so in Hong Kong or Singapore before moving back to Mumbai, but then I got an opportunity with Standard Chartered in Mumbai much before I completed the programme and I had to make a quick decision whether to accept or not. Although I was interviewing for positions in Hong Kong and Singapore and had a few options in the pipeline, I decided to take up the offer in Mumbai since it fit well with my larger life plan and career aspirations.
We thank Rishub Jhunjhunwala for the above interview.
(Correction: The earlier version of this interview stated that Rishub had completed his BMS studies from Sydenham college.)
You may also want to read -
Click here to read career perspectives from top B school grads