Planning and Design of Behavioral Healthcare Facilities

Behavioral Healthcare Facilities: The Current State of Design

In keeping with most districts of healthcare, the marketplace has seen a boom in the construction of Behavioral Healthcare facilities. Contributing to this increase is the paradigm shift in the way society views mental illness. Society is placing a heavier value on the need to treat people with serious addictions such as alcohol, prescription and elicit drugs. A large percentage of people suffering from behavioral disorders are afflicted with both mental and addictive behaviors, and most will re-enter communities and either become contributors or violators.

These very specialized facilities do not typically yield the attention from today’s top healthcare designers and their quantity accounts for a small fraction of healthcare construction. However, Behavioral Healthcare projects are increasing in number and are being designed by some very prominent architectural firms such as Cannon Design and Architecture Plus. Many are creating state-of-the-art, award-winning contemporary facilities that defy what most of us believe Behavioral Healthcare design to be.

Changing the Way We Design Behavioral Healthcare Facilities

As with all good planners and designers, A+D (along with facility experts) are reviewing the direct needs of patient and staff while reflecting on how new medicine and modern design can foster patient healing rates, reduce environmental stress, and increase safety. This is changing the face of treatment and outcome by giving the practitioner more time to treat because they require less time and resources to “manage” disruptive patient populations.

The face of Behavioral Healthcare is quickly changing. No longer are these facilities designed to warehouse patients indefinitely. And society’s expectations have changed. Patients are often treated with the belief that they can return to their community and be a contributor to society. According to the National Association of Psychiatric Health Systems (NAPHS), depending on the severity of illness, the average length of stay in a Behavioral Healthcare facility is only 9.6 days.

What has changed?

Jaques Laurence Black, AIA, president and principal of New York City-based daSILVA Architects, states that there are two primary reasons for the shortened admission period:

1. Introduction of modern psychotropic drugs that greatly speed recovery

2. Pressures from insurance companies to get patients out of expensive modes of care

To meet these challenges, healthcare professionals are finding it very difficult to effectively treat patients within the walls of antiquated, rapidly deteriorating mental facilities. A great percentage of these facilities were built between 1908 and 1928 and were designed for psychiatric needs that were principled in the belief to “store” not to “rehabilitate.”

Also impacting the need for Behavioral Healthcare construction is the reluctance of acute-care facilities to provide mental health level services for psychiatric or addiction patients. They recognize that patient groups suffering from behavioral disorders have unique health needs, all of which need to be handled and treated only by very experienced healthcare professionals. This patient population also requires a heightened level of security. Self-harm and injuring staff and other patients are major concerns.

The Report of the Surgeon General: “Epidemiology of Mental Illness” also reports that within a given year about 20% of Americans suffer from a diagnosable mental disorder and 5.4% suffer from a serious mental illness (SMI ) – defined as bipolar, panic, obsessive-compulsive, personality, and depression disorders and schizophrenia. It is also believed 6% of Americans suffer from addiction disorders, a statistic that is separate from individuals who suffer from both mental and addiction disorders. Within a given year it is believed that over one-quarter of America’s population warrants levels of mental clinical care. Even if these statistics were cut in half, it cannot be denied as a serious societal issue.

With a growing population, effectively designing in accordance with such measures is at the heart of public health.

Understanding the Complexity of Behavioral Healthcare Design

Therefore, like Corrections, leading planners and designers specializing in Behavioral Healthcare are delving deeper to better understand the complexity of issues and to be the activist to design facilities that promote treatment and healing – and a safer community.

The following is a list of key design variables that are being studied and implemented:

1. Right Sizing

2. Humanizing Materials and Color

3. Staff-Focused Amneties and Happiness

4. Security and Safety

5. Therapeutic Design Tenants

Right-sizing

Today’s Behavioral Healthcare facilities are often one-story single buildings within a campus size. Often debated by Clients due to costs, this design preference is driven by the demand for Uncategorized light, window views to nature for all patient areas, and outdoor open-air gardens “wrapped” within. All of this provides soothing qualities to the patient, reduces their anxieties, counteracts disruptive conduct and helps to reduce staff stress.

“When you look at the program mix in these buildings, there’s a high demand for perimeter because there are a lot of rooms that need Uncategorized light. Offices, classrooms, dining areas, community rooms, and patient rooms all demand Uncategorized light, so you end up with a tremendous amount of exterior wall, and it forces the building to have a very large footprint.” – James Kent Muirhead, AIA, associate principal at Cannon Design in Baltimore

These design principles are also believed to improve staff work conditions. Unlike a multi-story complex, at any moment staff can walk outdoors and access nature, free from visual barriers, and within a building that more accurately reflects building types that both patients and staff would encounter in their communities.

In addition to right-sizing for the overall building footprint, is right-sizing for internal patient and staff support area. Similar to the move we have seen in Corrections to de-centralize support spaces, Behavioral Healthcare is moving to decentralized nursing/patient units called “neighborhoods.” With mental health facilities there is a large concern with distances and space adjacencies in relation to the patient room and patient support areas such as treatment and social spaces. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, Troy, NY, advocates neighborhoods that average 24-30 beds arranged in sub-clusters, called “houses”, of 8-10 beds. Thus, each neighborhood consists of three houses. Often these layouts will include a common area where patients congregate and socialize, with a separate quiet room so patients can elect to avoid active, crowded areas. In addition Pitts states, “There’s a move away from central dining facilities. So, while facilities will still have a central kitchen, it’s a whole lot easier moving food than it is patients.” However, it is important for the facility to mimic normal outside daily life routines, so patients are encouraged to frequently leave their neighborhoods to attend treatment sessions, and outdoor courtyards.

Humanizing Materials & Color

In all facilities that play a role in rehabilitation, design strives to create spaces that humanize, calm, and relax. Behavioral Healthcare patients need to feel that they are in familiar surroundings; therefore, the architectural vocabulary should feel comfortable and normal. Since these facilities are about rehabilitation (when possible) and encouraging patients to merge back into society, the facility should feel like an extension of the community. Their spaces should reflect the nature and architecture of the surrounding region and thus so, no two facilities should look too much alike.

“Our a
pproach to designing these facilities is to view the facility as an extension of the community where patients will end up when they’re released. Interior finishes also depend on geography because you want to replicate the environment patients are used to. You want to de-stigmatize the facility as much as possible.” – Tim Rommel, AIA, ACHA, OAA, principal with Cannon Design in Buffalo, NY.

Therefore, materials and colors within these spaces want to feel familiar to one’s region and everyday life. To soothe the psyche and rehabilitate, they want to feel soft and comfortable, yet visually stimulating. An interior that is overly neutral or hard in appearance is not appropriate. Materials should reduce noise, and colors should lift the spirit. This can help to create an environment in which the patient can learn, socialize, and be productive while easing anxieties, delivering dignity, and modifying behavior. As stated previously, behavioral studies advise the use of softer interior materials-like carpeting, wood doors and tile. Doing so translates directly to both patient and staff well-being, particularly staff safety, and makes for a nicer place to work. In addition, staff have more resources to “treat” instead of manage heated situations. When staff experiences are eased and satisfied, morale is boosted and life-saving rules and policies are more likely to be enforced.

Staff-Focused Amenities & Happiness

While reducing staff stress and fatigue through a healing supportive environment seems like an obvious goal, there are relatively few studies that have dealt with this issue in any detail. More attention has been given to patient outcomes. However, many leading hospitals that have adopted therapeutic tenants into their newly built environments have seen vast improvement through their “business matrixes” and financial reporting.

In one example, the Mayo Clinic, a national leader in implementing healing design in its facilities, has reported a reduction of nursing turnover from a national annual average of 20% to an annual 3%-4%. In another example, when Bronson Methodist Hospital incorporated evidence-based design into its new 343-bed hospital, they cited their 19%-20% nurse turnover rate dramatically dropped to 5%.

Now, both the Mayo Clinic and Bronson Methodist Hospital have had to initiate a waiting list for nursing staff seeking positions. This converts to better-trained and qualified staff, and a reduced error rate. Therefore, more health facilities are investing in staff support areas such as lounges, changing rooms, and temporary sleep rooms. Within these staff spaces and in the hospital throughout, facilities are also recognizing the need for upgrade materials, better day lighting, and an interesting use of color: One soon realizes that the need of patients and staff are interwoven, each impacting positively or negatively the other.

Security & Safety

Without debate, self harm and harm to staff is one of the biggest concerns mental health facilities manage. Often the biggest safety and security concern is the damage patients can do to themselves. “There are three rules I had drummed in me,” says Mark Hanchar; Director of Preconstruction Services for Gilbane Building Company, Providence, R.I. “First, there can’t be any way for people to hang themselves. Second, there can be no way for them to create weapons. Third, you must eliminate things that can be thrown.” Hanchar says that the typical facility is, “a hospital with medium-security prison construction.” This means shatter proof glass, solid surface countertops (laminate can be peeled apart), stainless steel toilets and sinks (porcelain can shatter), push pull door latches and furniture that cannot be pulled apart and used as a weapon. These are just to name a few.

Additionally, removing barriers between patients and nursing staff is a safety consideration. Frank Pitts, AIA, FACHA, OAA president of Architecture Plus, says what may be counter-intuitive for safety precautions, “Glass walls around nursing stations just aggravate the patients.” Removing glass or lowering it at nursing stations so patients can feel a more human connection to nurses often calms patients. There is also discussion of removing nursing stations altogether; decentralizing and placing these care needs directly into the clinical neighborhoods and community spaces. Pitt says, “The view is that [nursing staff] need to be out there treating their patients.”

Therapeutic Design Tenants

As medicine is increasingly moving towards “evidence-based” medicine, where clinical choices are informed by research, healthcare design is increasingly guided by research linking the physical environment directly to patient and staff outcomes. Research teams from Texas A&M and Georgia Tech sifted through thousands of scientific articles and identified more than 600 – most from top peer-reviewed journals – to quantify how hospital design can play a direct role in clinical outcomes.

The research teams uncovered a large body of evidence that demonstrates design features such as increased day-lighting, access to nature, reduced noise and increased patient control helped reduce stress, improve sleep, and increase staff effectiveness – all of which promote healing rates and save facilities cost. Therefore, improving physical settings can be a critical tool in making hospitals more safe, more healing, and better places to work.

Today’s therapeutic spaces have been defined to excel in 3 categories:

1. Provide clinical excellence in the treatment of the body

2. Meet the psycho-social needs of patients, families, and staff

3. Produce measurable positive patient outcomes and staff effectiveness

Considering the cost of treating mental illness, which is exceedingly high, and wanting facilities to have effective outcomes, a further practice of incorporating therapeutic design is increasing. The National Institute of Mental Health (NIM H) approximated in 2008 that serious mental illnesses (SMI ), costs the nation $193 billion annually in lost wages. The indirect costs are impossible to estimate.

The estimated direct cost to clinically treat is approximately $70 billion annually and another $12 billion spent towards substance abuse disorders. In addition to the increased need of care and the boom in Behavioral Healthcare construction, it becomes an obligation to make certain that we as facility managers, architects, designers and manufacturers therapeutically plan and design these facilities.

Notably, in 2004, “The Role of the Physical Environment in the Hospital for the 21st Century: A Once-in-a-Lifetime Opportunity,” published by Roger Ulrich P.H.D., of Texas A&M University, was released. In a culmination of evidence-based research, research teams found five design principles that contributed significantly to achieving therapeutic design goals.

The report indicates five key factors that are essential for the psychological well-being of patients, families and staff, including:

1. Access to Nature

2. Provide Positive Distractions

3. Provide Social Support Spaces

4. Give a Sense of Control

5. Reduce or eliminate environmental stress

Access to Nature

Studies indicate that nature might have the most powerful impact to help patient outcomes and staff effectiveness. Nature can be literal or figurative – Uncategorized light, water walls, views to nature, large prints of botanicals and geography, materials that indicate nature and most importantly, stimulating color that evokes nature. Several studies strongly support that access to nature such as day-lighting and appropriate colorations can improve health outcomes such as depression, agitation, sleep, circadian rest-activity rhythms, as well as length of stay in demented patients and persons with seasonal affective disorders (SAD).

These and related studies continue to affirm the powerful impact of Uncategorized elements on patient recovery and stress reduction. Thus, it is clea
r that interior designs which integrate Uncategorized elements can create a more relaxing, therapeutic environment that benefits both patients and staff.

Positive Distractions

These are a small set of environmental features that provide the patient and family a positive diversion from “the difficult” and, in doing so, also negate an institutional feel. These can be views to nature, water walls, artwork, super imposed graphics, sculpture, music – and ideally all of these want to be focused on nature and, when applicable, an interesting use of color. Therapeutic environments that provide such patient-centered features can empower patients and families, but also increase their confidence in the facility and staff. This helps with open lines of communication between patient and caregiver.

Social Support Spaces

These are spaces designed partially for the patient but mainly for the comfort and socialization of family members and friends of the patient; therefore, family lounges, resource libraries, chapels, sleep rooms and consult rooms all play a role. When family and friends play a key role in a patient’s healing, these spaces encourage families to play an active role in the rehabilitation process.

Sense of Control

In times when patients and family feel out of control, it is very healing for the facility design and staff to provide it back when appropriate. Although, this cannot always be done suitably in mental healthcare facilities. However, when applicable, these design features include optional lighting choices, architectural way-finding, resource libraries, enhanced food menus, private patient rooms and

optional areas to reside in. A few well-appointed studies in psychiatric wards and nursing homes have found that optional choices of moveable seating in dining areas enhanced social interaction and improved eating disorders. When patients feel partially in control of their healing program and that the building features are focused to them, an increased confidence of the quality of care enters and tensions lower.

As with all therapeutic design, this allows the caregiver to use their resources healing in lieu of “managing” patient populations.

Reduce or Eliminate Environmental Stress

Noise level measurements show that hospital wards can be excessively noisy places resulting in negative effects on patient outcomes. The continuous background noise produced by medical equipment and staff voices often exceeds the level of a busy restaurant. Peak noise periods (shift changes, equipment alarms, paging systems, telephones, bedrails, trolleys, and certain medical equipment like portable xray machines are comparable to walking next to a busy highway when a motorcycle or large truck passes.

Several studies have focused on infants in NIC Us, finding that higher noise levels, for example, decrease oxygen saturation (increasing need for oxygen support therapy), elevate blood pressure, increase heart and respiration rate, and worsen sleep. Research on adults and children show that noise is a major cause of awakening and sleep loss.

In addition to worsening sleep, there is strong evidence that noise increases stress in adult patients, for example, heightening blood pressure and heart rate. Environmental surfaces in hospitals are usually hard and sound-reflecting, not sound-absorbing causing noise to travel down corridors and into patient rooms. Sounds tend to echo, overlap and linger longer.

Interventions that reduce noise have been found to improve sleep and reduce patient stress. Of these, the environmental or design interventions such as changing to sound-absorbing ceiling tiles, are more successful than organizational interventions like establishing “quiet hours.”

Conclusion and Additional Information

The information contained in this excerpted report is intended as a guide for architects, specifiers, designers, facility planners, medical directors, procurers, psychologists and social workers which have a stake in providing improved facilities for behavioral healthcare patients. It is a portion of a report entitled “The Contributions of Color” authored by Tara Hill, of Little Fish Think Tank. Ms. Hill was commissioned by Norix Group Inc., in 2010 to research the role color plays in the safe operation of correctional facilities and behavioral health centers. More in-depth information specifically about the psychological influence of color and behavioral healthcare facility design can be found by reading the full report.

You May Be Statistically At Risk For A Payday Loan

Recently, there has been a lot of talk about percentiles. With the presidential election on the horizon, Americans are being flooded with percentages and many are drowning in confusion. Payday loan lenders have been inundated with borrowers who are trying to stay on top of their bills. A deluge of mass media has emerged to cover the politic elections, surfacing statistical claims about economic differences among the American population and submerging any consistent sense of where one fits into the fiscal scheme of things.

These statistics raise questions that come with a lot of political baggage: Am I one of Occupation Wall Street’s 99 %? Am I one of Mitt Romney’s 47% who rely on federal benefits? And, if so, is this a bad thing?

These ‘factual’ numbers, which are meant to act as clear, logical backing for political campaigns, are leaving many Americans mystified, obscuring political agendas behind a silk-screen of percentages.

Let’s face it; politicians employ these statistics, which may or may not be whole truths, to inspire voters to stand up for a cause–their cause. Among the aforementioned percentages, there is one common denominator: they all target or discuss an audience of low income families. In some cases, these statistics are used to draw attention to discrepancies between high and low income families, while others demonize those in the low income demographic as moochers and/or freeloaders.

Yet, another statistic that has not been addressed in the campaigns but that directly relates to low income families is the number of households in this demographic that utilize payday loan services. A PEW survey recently exposed that 72 % of payday loan borrowers have a combined family income of less than $40,000 per year. Clearly, those in lower income demographics are more inclined to borrow these high interest loans, which they are required to pay off at their own expense.

It is easy to comprehend the reasons that those in low income families are more inclined to borrow–utility bills need to be paid, children need to be fed and clothed, cars need to be in working order and fueled up. This becomes even clearer when considering that most payday loans are taken out to accommodate recurrent, necessary life expenses. Evidently, many low income American families are treading water, relying on temporary safety rafts, like payday loan lenders, to stay afloat, and getting closer and closer to a tidal wave of unavoidable debt.

This raises the questions: do the aforementioned political percentages and statistics accurately represent low income families who are relying on payday loans?

To answer the question, statistics rarely speak for themselves. Yes, over 40 % of Americans rely on federal benefits, but it is important to note that this percentage is largely made up of impoverished families, mothers with young children, and senior citizens. Without such services, more people from these demographics would be pushed to rely on payday loans and cash advances, furthering their debt and making them more susceptible to extreme financial circumstances, such as bankruptcy, which ultimately costs tax payers a great deal of money. It is important to note, additionally, that a person must be employed to take out a payday loan, challenging the idea that the low income families and individuals who rely on such services are freeloaders.

In short, not only is the onslaught of political statistics confusing, it is often unreliable, as it only presents a partial picture of the current circumstances of low income American families–a demographic which makes up a significant portion of the American population.

Are There Alternatives to Pay Day or Cash Advance Loans?

Negative government reports, consumer advocate studies, and investigative journalists for newspapers and television, have all taken pay day and cash advance lenders to task for their so-called loan shark activities. These protectors of the common good do have their points, but they offer few alternatives. When folks are in desperate need of cash, when they need the money quickly, there are no viable alternatives. Credit card companies, banks, and other traditional financial institutions are not too interested in loaning $500 to $1,000 to folks in dire need and often with less than stellar credit ratings.

Banning Pay Day or Cash Advance Loans

A market exists for lending money to people who need cash fast, and a legal market is the best answer. What would happen if pay day or cash advance lenders were banned? Law enforcement authorities would soon discover that back alley lenders, organized crime lenders, and other loan sharks will have stepped in to fill the void, exposing otherwise law-abiding citizens to the world of crime. And the enforcement wings of these loan sharks do not just break legs when a borrower cannot repay them on time. Whole families could be practically held hostage for a $500 loan.

Loans Are Interest Rate Heavy

Indeed, pay day and cash advance loans to carry substantial interest rates, far higher than those from traditional lenders with credit scores and collateral to underwrite the loans. But many of these folks do not have valuable property or acceptable credit histories. The fact is, the alternative to not being able to come up with cast in an expedient manner, could cause the borrower a lot more than just footing a high interest loan for a short period of time.

Interest Rates Vs. Financial Relief and Peace of Mind

Lack of cash can mean utility services being interrupted, going without medications or medical treatments, inability to purchase equipment for a business, job, or home necessity,and late payments along with further blemishes on credit reports. The interest rates, while high, are probably a small price to pay for financial relief and peace of mind. Because of the great risks a lender assumes offering these loans, the interest rates may be somewhat justified.

Improvements Needed

Perhaps the biggest problem, next to the high interest rates, is the short term requirements regarding repayment. Often, the very next pay check the borrower receives is eaten up by the repayment. One pay period is often not enough for a borrower to regain their financial bearings. They may have to keep extending the loan and that is where the real interest rates start to go into the loan shark realm. Often, a borrower can get so overwhelmed that they soon are making payments only on the interest.

Last Word on Pay Day or Cash Advance Loans

Many companies, in the onslaught of borrowers needing pay day or cash advance loans, are starting to change the terms of their loans so that they allow up to three months for repayment. They are responsibly addressing the needs of folks in these recessionary times. Three months is often long enough for people to get back on track financially. Unless someone can come up with a better legal alternative, a market exists for pay day and cash advance loans. That market, of course, should be carefully monitored.

A Resource Buying Guide For Internet Marketers

The “make money online” crowd is probably the most actively targeted niche market on the internet. Which is quite ironic when you think about it; “The hunters become the hunted.” And it’s not surprising we are so serviced with offers continually, the truth is we are, on the whole, information junkies. We are suckers for a good ebook, report, or video.

The problem is that an over supply of internet marketing tools (even good ones) can leave you feeling overwhelmed, unproductive (too busy reading about internet marketing to actually DO any), and flat broke!

So how do we filter the offers we are bombarded with, so that we invest sanely in our education and resources?  Let me offer this simple “buying guide” to help.

When you boil it all down there are basically 4 different kinds of products on the market, and you have to be able to recognize them so you don’t waste your time and money:

1) Basic training guides & tools. Everyone needs some of these, but you don’t need to be buying 10 versions of the exact same information.

2) Advanced techniques. These are the “Shazaam!” products.  The ones with truly unique and creative ideas. If I can identify which ones these are, I’ll buy them all day long. If I can get ONE really good, repeatable idea, it is money in the bank.  The caveat, though, is you’ve got to actually implement them – otherwise you’re just wasting your money, and spinning your wheels.

3) Tools that make life easier.  These are OK if you’ve got disposable money to spend on them, but if you’ve got a limited budget (like most marketers that are still getting going) you’re probably better off spending it where it can be best leveraged for the most effectiveness.

Case in point: At the time that I’m writing this article I’ve been getting emails all week — I’ve had at least 15 just today – promoting a particular hot product.  The free teaser report is great — it includes a couple of really exciting ideas (see point 2).  However, when I looked at what is actually being offered in the main package – 8 software programs that collate information in various forms from around the internet — they’re all really cool tools, but they are nothing that you can’t already do yourself for free. Cool, but not necessary. Convenient, but not essential.

4) Snake oil. These are the products that are thrown together to make sales to newbies, but they do not work. They are bad advice. You’ll discover that usually the author hasn’t had any success with the method he’s teaching at all, but he can make a few bucks wasting other people’s time with it.

So, when you’re considering buying resources to help you build your online business, read the sales copy discerningly.  Honestly evaluate the product and classify it in one of the above 4 categories.  Then it’s a simple decision to make the appropriate response:

Category 1:  Buy it if you don’t already have a product covering the same topic, or if you are reasonably convinced that your understanding is going to be increased sufficiently to justify the investment.

Category 2:  Buy it, and DO something with it! Don’t procrastinate — take action.  Winners are taking imperfection actions while others are still formulating their “perfect” plans.

Category 3:  Buy it only if you have surplus cash, and don’t mind blowing some on a luxury — because that’s what it is.  Ask yourself, “Could I leverage the money I’m about to spend on this to better effect in my business?”

Category 4:  Click that little “x” button at the top of the browser window, and be proud of yourself that you’ve developed the wisdom and experience to stop wasting time with that kind of rubbish.  If you already bought it before you figured out that its “snake oil”, ask for a refund and chalk it up to experience.

Buying is far more an emotional decision for us than we “savvy entrepreneurs” would care to admit. Anything we can do to take pause and inject some thought into the process will save us time and money. This buying guide offers a place to start.

Aarkstore Enterprise– Medical Equipment Industry

The report provides an overview of the Chinese market for medical equipment and devices, with focus on four key emerging markets beyond already established cities such as Shanghai, Beijing, and Guangzhou.

Table of Contents :

Introduction
Executive Summary
Industry Overview
Market Overview: Tianjin
Market Overview: Shenzhen
Market Overview: Nanjing
Market Overview: Chongqing
Trade Event
Key Contacts
Methodology
About the Author
Aarkstore Enterprise is a leading provider of business and financial information and solutions worldwide. We specialize in providing online market business information on market research reports, books, magazines, conference at competitive prices, and strive to provide excellent and innovative service to our customers. Our customers include more than 700 leading financial institutions, professional service firms, consulting, law and accounting firms and other corporations throughout the world.

Market Research, Market Research Reports, Industry Analysis, Business Research, Business Market Research, Apparel, accessories, Babies Corner, Books, Food, Household Needs, Jewellery, Web Designing, Development, Search Engine Optimisation, Search Engine Marketing, Automotive, Accounting, Banking, Finance, Biotechnology, Consumer Goods Construction, Energy Resources, Food Drink, Health Safety Insurance, Law & Regulation Management, Pharmaceuticals Telecommunications, Accounting Biography, Finance Health, Safety, Law, Regulation Educational, Management Engineering, market size information, market access strategies, market share, export and import information, market analysis, market trends, competition, domestic production, best sales prospects, statistical data, tariffs, regulations, distribution and business practices, end-user analysis, trade shows, contact points, conference, events, seminars, magazines.

Aarkstore Enterprise specialize in providing online market business information on market research reports, books, magazines, conference booking at competitive prices, and strive to provide excellent and innovative service to our customers.

Types of Drug Detox

There are 4 primary types of drug detox available for addicts and alcoholics to achieve the initial stages of sobriety. This includes the cold turkey method, specialized detox centers, medical detox facilities and rapid detox centers. Each type of drug detox has its own benefits and pitfalls that people seeking to recover from addiction should understand before they decide which treatment option is right for them.

Cold Turkey Drug Detox

This type of detox is also called “Uncategorized detox” and essentially consists of an addict or alcohol undergoing the stages of acute withdrawal in a private setting with little or no assistance or care. Unfortunately, the chances of successfully breaking the initial stages of acute withdrawal syndrome are small with this method, and most addicts will return to their drug of choice before they have reached a critical mass in their recovery efforts.

Despite its propensity for failure, quitting cold turkey isn’t dangerous if the substance in question is fairly benign such as marijuana or mild opiate addiction. However, some substance addictions can lead to life-threatening symptoms of AWS in the event of sudden cessation. The three most dangerous of these substances are alcohol, barbiturates and benzodiazepines; all of which can lead to seizures, respiratory and/or cardiac arrest, coma and in rare cases, death.

Regardless of the substance of abuse, most experts do not recommend Uncategorized detox as the chances for success are significantly impaired.

Specialized Drug Detox Centers

Specialized detox centers provide inpatient style treatment for up to 2 weeks. Patients receive an initial evaluation which will be used to develop an individualized treatment plan for the duration of their stay. Because of the individual nature of these plans, some detox patients will undergo treatment in just a few days, while others will require a week or two. In many cases these types of detox facilities work in conjunction with longer-term treatment centers that patients can automatically transfer to once they are past the acute stages of withdrawal.

Specialized detox centers work because of the therapies employed – such as individual and group counseling – and because they effectively isolate the addict or alcohol from people, places and things that could be triggers for them to relapse.

Medical Detox

Medical detox is similar to a specialized detox center but with a distinctly medical component. This can consist of an on-site nurse or doctor, 24 hour monitoring and other types of medically-oriented benefits. A medical detox center can also help addicts to step-down their drug usage in an effort to maintain medical safety and reduce or eliminate symptoms of acute withdrawal.

Medical detox is often required by addicts that have relapsed repeatedly, as subsequent attempts to get clean result in more severe withdrawal symptoms that last for a longer period of time. This is referred to as the Kindling Effect and is a very real phenomenon that can make it extremely difficult for people to get clean and stay clean. A medical detox center can address these issues expertly in a safe, relaxed and non-judgmental environment.

Rapid Detox

Rapid detox refers to a type of medical-detox procedure whereby the patient undergoes most of the symptoms of withdrawal while unconscious. This is accomplished by placing the patient into a medically-induced coma, then administering a series of drugs that facilitates and hastens the process of acute withdrawal. This spares most patients the worst of the symptoms and allows them to begin their treatment without the pain and discomfort of a long period of withdrawal.

Unfortunately, rapid detox is a relatively new practice and it’s not well understood yet how successful it is from a long-term treatment standpoint. Addicts considering this method should consult with their primary physician prior to speaking with a detox specialist.

Going through detox in a specialized or medical facility is the best option for most addicts and alcoholics; not only from a safety standpoint, but also because sequestering an addict away from potential exposure to drugs or drug- abuse triggers provides the best chance for lasting recovery.

Find out for yourself by reaching out for help now if you or someone you love is fighting the disease of addiction.

Uses of Car Detailing

Owning a car has now become a norm for middle class families in India. With the country showing good economic growth, the average middle class consumer has enough money to splurge on a car. With a wide range of models to choose from, the Indian consumer is pampered for choice. From going out on picnics to having a fun drive, a car has become a part and parcel of an Indian family’s growth, happiness and transportation needs.

Buying an automobile is always a daunting task. First one has to decide if one needs a new care or a used car based on one’s budget and needs. But whatever be the case, a car once bought needs good care and maintenance for peak performance and all round reliability. Given that a car is a utility, due care must be taken to ensure that there are no breakdowns at any time so as not to be caught unawares. Besides periodic maintenance of the engine, chassis, turbocharger and other technical aspects, the aesthetic aspect of things must also be considered. A car is a work of art and over time, it is subject to a lot of wear and tear. The initial lustre may be lost, scratches and dents may occur. Further, when the owner decides to sell a car, he must ensure that he can attract potential buyers and convince them that their potential investment is good value for money. A first impression is always the best impression at any point in the lifetime of a car and here is where car detailing comes in.

Auto detailing is a technical process where an automobile is thoroughly cleaned, waxed and polished both on the inside and the outside to produce show quality level of detail. Besides improving appearance, it helps to raise the resale value of a car. It is subdivided into three aspects- exterior detailing, interior detailing and engine detailing.

Interior detailing involves cleaning the passenger compartment, trunk, dash board areas, panels, windows and carpet. Vacuuming is the first step and this may be followed by steam cleaning, use of liquid cleaners and brushing to remove stains. Exterior detailing involves cleaning and bringing to shine all the parts of the visible exterior like wheels, paint, chrome trim, windows, wheels and other components. Cleaning, polishing and protection are the three steps in exterior detailing. Cleaning deals with the removal of all foreign matter from the exterior surface. Polishing involves the use of machines to remove scratches and other imperfections from the surface. This is done by removing a micrometre of paint from the surface by special pads. Waxing or protection involves the application of wax on the surface to prevent foreign matter from adhering to the surface. The third aspect of detailing is where steam, high pressure water, degreasers and all purpose cleaners are used to clean under the hood of a car. A lot of car dealers in India offer restoration services in addition to car detailing. The best way to shortlist a company will be based on reputation, service quality and cost effectiveness.

The Benefits of Advertising – Business Internet Marketing

Marketing online has become a very profitable way of marketing products and services of the company. Online advertising is one method of advertising that uses the Internet to deliver the marketing message that can attract customers. World Wide Web is the main medium that can be used as part of online advertising to attract customers and spread the name of the company. There are also several examples of online advertising such as email marketing, banner ads or contextual ads on various search engines.

The benefits of advertising business internet marketing are:

1. Ad beneficial for sellers and buyers. This is mutually beneficial. Sellers use advertising to promote products on the internet by providing an explanation of the details of products both in price, usability, and benefits of these products. Buyers who come to the site, they know about the various products from these ads and can choose according to their wishes.
2. Before the Internet, advertising is limited to newspapers, television and so on. Along with the development of the Internet, we can use a variety of ways to advertise our businesses either through email or posting through various websites. Through advertising on the internet allows you to expand the business globally, not limited to time and place.
3. Internet is becoming increasingly popular in line with the number of people who use these systems and tools. Almost all people use online facilities to perform the work as they use email to send and receive the official letter to the company or using social media such as twitter, Facebook, and others. By using advertising on the internet the more people will see and some of them will make a purchase.
4. Advertise your business with the internet; you will be able to reach very specific target audience through this online facility. This is often referred to as SEO Optimize system where you use specific keywords for specific markets. There is also the term PPC or pay per click where you need to pay for keywords that you are advertising on the internet.
5. Online ads can reach every person in the whole world in a small time period. Some tools or software is provided either free or paid; where you can choose which best suit your business. On average a good website can be optimized in a few months and with time running it will be increasing visitors and buyers so that we get a return on investment.
6. Cheap online advertising as a source of advertising would cost so much while placing an ad in the newspaper or television will be more expensive than online advertising. You can also get a clear picture of how much money he would spend and how much profit from your investment.

If you have not done in the advertising business internet marketing, it is good you start to learn the details and start running. This not only shortens your time in business, but you can increase your profits away from what you get. Of course, learning from the right sources and correct.

Age Appropriate and Attractive Ideas For Aging Gracefully

Maturity is a badge of honor to be respected with good taste. There simply comes a time when all the extra bling and fabulousness of fashion, hair and makeup is best toned down. When you were a younger Alluring, Innovative or Dramatic woman, those items of “look at me, I’m au currant” stood for something. Status, hipness, a woman in the moment who’s up on the trend. But wisdom carries with it a confidence and sophistication that allows you to do less and achieve more. A maturing face and figure carries a patina of wisdom. A statement in and of itself, it doesn’t require bright lips, over the top earrings or a crazy hip belt to bring it forward. It stands there, gently making its own beautiful statement. Less is simply more as we age. To accentuate your second act best:

o    Avoid drawing attention to your mouth with bright or dark lips.
o    Avoid drawing attention to aging eyelids with frosted shadow.
o    Avoid drawing attention to aging hands with bright nail polish and/or a multitude of attention-grabbing rings.
o    Draw the eye to your face with neckline interest and earrings.
o    When in doubt leave it out.

The Importance of Being Current 

Keeping current is undoubtedly a constant and not inexpensive challenge. With all the technology with which we are bombarded, however, we still have the old standby; the monthly magazine. Magazine subscriptions are one of the most effective ways of getting information you can absorb on your downtime. The whole experience of sitting down with and perusing a magazine that inspires is a ritual that endures. Magazines are the great equalizer. No matter where you live in the country you have the same access to fashion, fitness and beauty that the most upscale, in-the-know New York socialite has, because she gets her “W” magazine the same time you do. When “O” comes out, you’re right there with all of Oprah’s associates on the hottest, latest and most suitable fashion, food, fun and inspiration you need that month. You just go to your mailbox, Oprah is waiting for you, and it’s your turn to dream. 

What Were We Thinking?

We’ve all done it. Looked back at those embarrassing fashion photos and wondered, “What was I thinking?” I look back at my pinstriped jeans, permed hair and parachute pants and think “Hmmmm.” The more extreme trend, the more risk of later embarrassment. We may forgive the young. But it’s not so easy to forgive a second actor in a leather mini.

A woman in Act Two need never wear:

1.     A micro mini
2.     Combat boots with formal wear
3.     White hose
4.     Frosted eye shadow
5.     Chunky platforms
6.     Dark brown lipstick
7.     Butterfly barrettes
8.     Extreme low-rise jeans
9.     Visible underwear
10.   A spiral perm

What’s Age Appropriate Now?

In our Second Act it becomes difficult to find the balance between matronly and modern. Looking current and youthful should not translate into “mutton dressed as lamb.” I met a woman recently whose long, blonde, permed hair was pulled up on one side and suspended with a comb. For height she created gravity defying bangs with a curling iron and “Spritz Forte.” She wore a fitted navy knit tank, tight tapered pale denim jeans and a crocheted sparkly baby blue shawl tied around her hips. She was 48. 

I liked her and enjoyed hearing her tales of woe in raising teenagers. But as I listened I was continually distracted by her image. It just wasn’t working in her favor. The reason it didn’t work was because it was expressing only a part of this woman. I obviously knew who she had been, but as she talked, the more interesting experienced and attractive parts were hidden behind a façade of fear of aging. Yes, she was attractive and sexy but she was also a 48-year-old single mother of teenagers who had quite a bit of sun damage, an advancing derriere, tan lines across her back and thinning hair. The look did not make her look younger; it made her look vulnerable and insecure. Our image must reflect who we’ve become, not who we were. That is age appropriate. 

The Flavorful Delights of Israeli Cuisine

It figures I’m about to start a culinary journey on Israeli cuisine while being exceptionally hungry. In my mind’s eye (and a grumbling stomach) I can see the comfort foods of my youth; foods that might make some people in the world ask, what on earth is that?

There’s no easy way to pigeon hole Israeli cuisine, a blend of cultures from Eastern Europe to the shores of Northern Africa and the far reaches of Asia. Each distinct region has brought Israel to the forefront the very best of their tasty dishes, making the act of eating in Israel a vacation all its own.

Many of you might have already heard of some traditional Israeli dishes. Ashkenazi cuisine comes from the folks from Eastern Europe. These are the same folks that give us some wonderfully sweet pastries, yet gave us borsht and gefilte fish. Go figure.

Sephardic foods come from countries like Spain and Morocco, food like the savory pastry known as bourekas, made with puff pastry filled with cheese and spinach, just to name a few.

I’m getting ahead of myself–I should’ve talked about breakfast first. It is the most important meal of the day, right? Most hotels in Israel are quite proud of their Israeli breakfast, which many promote in order to get you to stay there.

Oh no, my American friends, this isn’t your bacon-laden, side of home-fries meal. Look around, you’ll find bowls of fresh fruit, salads made with finely chopped tomatoes, fish, eggs, bread, and yogurt.

Now that I think about it, almost all of Israel’s dishes center on fresh produce. This even includes the ever popular falafel; fried ground chickpeas stuffed in a pita served with Israeli salad (tomato, cucumber, onion) and tahina.

Oh tahina, a sesame sauce that makes everything taste better. Not that the world’s best street food like falafel can’t stand on its own, mind you.

I think the only thing more popular than falafel is hummus. Made with ground chickpeas, often served with pine nuts or a smatter of olive oil, it is generally eaten with just pita. Hummus is so popular in Israeli cuisine it seems to be a culinary staple, no matter what meal it is.

Food in Israel might be fresh and tasty, but it means nothing if not shared with family and loved ones. That is, unless, you’ve gotten a Moroccan and Tunisian fighting it out over who makes better couscous, a dish made from semolina flour with lamb or chicken simmered with veggies on top.

One of the best ways to enjoy Israeli food with the family is a hafla. This is a traditional Bedouin meal of salads and kebabs with Bedouin pita (known as fatir) served as you lounge on soft pillows drinking mint infused beverages (like tea or lemonade).

Food is so ingrained in Israeli culture so that if you’ve been invited into someone’s home, they will try to feed you. And it’s an insult to refuse–so eat up.

Food even has its superstitions. One lady friend who was going to have a baby mentioned in passing that she was “craving” falafel, only to be handed an entire container of them by her Israeli neighbor soon afterwards, simply because it was “wrong” to refuse a pregnant lady any food she wished for.

You could go on forever talking about food in Israel, and spend another lifetime talking about beverages in Israel. Great, now I’m even hungrier than when I started.–someone pass the falafel, please?