#although it is important harm reduction information as well

[trans-axolotl]

eating disorders can cause seizures???? I’ve never heard that before

content warning: continued in depth discussion of disorderly eating, restrictive eating behaviors, refeeding syndrome, and specific physical effects. no specific numbers are listed. scientific sources are linked.

it happens pretty rarely. what i was talking about in the tags of another post was referring to something that happened to a friend because of refeeding syndrome. refeeding syndrome can happen when someone has been restricting food intake pretty severally and then reestablishes nutrition again. this can happen to people at any weight and size, and it's actually a huge issue in eating disorder treatment because fatphobic doctors sometimes don't take into account the risks of refeeding syndrome when they're only using fatphobic metrics like BMI instead of actually looking at the patterns of behavior and nutrient levels. because of the electrolyte + fluid shifts that happen when you're going from extreme restriction to regular intake again, refeeding syndrome can cause things like seizures, cardiac complications, and can be fatal. here's an scientific study that talks more about it (TW for continued eating disorder talk, specific calories, numbers, etc)

so it's really important that when people are reengaging with food and nutrition after long periods of restriction and malnutrition, that they have access to vitamin + electrolyte supplementation, and that they have the support to understand how to taper back up to slowly increasing nutrition intake to prevent refeeding syndrome. that applies to anyone, regardless of weight or bmi. it also applies to anyone who is re-accessing nutrition after a long period of malnutrition caused by things other than eating disorders, such as chronic illnesses or famine.

i went through refeeding syndrome and luckily my doctors caught it in time to supplement my potassium and electrolyte levels enough that i didn't have very severe effects beyond cardiac effects. it was really scary and felt really horrible, and has left me with some complications even months later.

so yeah, it can be a really serious and fatal complication with eating disorders and i honestly think that it's one of the most important things to know in harm reduction for eating disorders so that people can understand how to prevent some risks related to accessing to nutrition while also in active restriction. people need to understand the specific risks so that people can make more informed decisions about what steps they can take to prevent refeeding syndrome, how to support their body even if they aren't ready for full recovery or to stop using behaviors.

[grison-in-space]

Reading Men Who Hate Women (Laura Bates, 2020) at the moment. She's talking about the manosphere: the massive online communities of men who congregate to talk misogyny, ranging from PUAs to MRAs, incels and MGTOW. These aren't new topics to me—I've been following this off and on since watching Gamergate kick off—but Bates handles them well and I think this book could serve as an introduction if this is a movement with which you're not familar. By the way, it's been a decade since Gamergate this year. Isn't that a kicker?

(Incidentally, I first ran into the concept of incels way before I think many people did: when I was still on AVEN, c. 2006-2007ish, I remember a few occasions where users ran into incel communities and brought them to our forums to ask: is this like what we're doing? Is this like us? Consensus quickly solidified on the direction of "no," each time, not least because asexuality dialog at the time was extremely clear about divorcing desire from action, and it was very clear that the desires centered in that community were very different than the ones people in asexuality spaces were untangling.)

Bates handles the topic with grace, compassion, and a deep understanding that I really wish more writing on radicalization or terroristic networks used: people in real pain, who are struggling in pitiable circumstances to do their best and clearly need more support, can also in their pain be truly dangerous to others. Hurt people hurt people. Compassion for pain suffered is important—you can't understand recruitment without understanding that—but you also have to understand that pain, fermented in darkness, can create deadly poisons. Pain isn't essentially holy or cleansing or cauterizing. It doesn't accomplish anything good by existing. If we can relieve it, we should—but we should follow harm reduction principles as we do so, lest pain be allowed to multiply and fester.

What gets me is that in 2017, in the wake of the Google bro "manifesto," I spent a feverish week writing what wound up being a 20,000 word rebuttal studded with what eventually totaled 100+ peer reviewed citations. It got quite a bit of reach and covered ground ranging from effects of testosterone on behavior, the concept of effect size in sex differences, basic statistics, the ways that humans treat people differently based on their perception of gender, intersex trauma, and whether feminists care about men's problems (yeah, actually, and they should).

I released that piece, changed up my name and fannish presence—my long time pseud was tangled all over the piece's genesis—and hunkered down for the reprisals. I expected harassment and vitriol. It never really came: I ignored the comments on the post, after a bit, and I held boundaries on what I was willing to pay attention to. But by and large, I had no direct consequences from the Manosphere.

Perhaps the piece was too long (although I got many comments from people who read it and found it useful, and I included an index). Perhaps it was simply that I included a headshot of myself, with uncharacteristic red lipstick and characteristically buzzed hair, and cheerfully discussed throughout that I was butch and queer: sometimes I confuse people who are very focused on bioessentialist sex differences, because I don't fit their paradigms in the slightest.

About six months later, James Damore attempted to frame his incredibly poor decisions in light of his Asperger's, and I did get a couple dudes on social media presenting me with this information apparently in the hope that it would shock or embarrass me. I immediately pointed out, acerbically, that I'm equally autistic and that he was making us look bad, and they melted away again into the background. It wasn't really the well of terrifying anger and obliterative fury I was expecting.

I find myself reading these stories in Bates' book and thinking about the internet I grew up on: AVEN by 2005, WrongPlanet the same year, listening to people on the margins talk about their fears and hopes and dreams and theories about themselves. I find myself thinking about narratives and meaning, the stories we tell ourselves about who we are and why.

I'm certainly not the first person to worry about radicalization of young autistic people, especially autistic men. Not even close. Paradoxically, it's a group of people for whom an understanding of intersectionality is crucial: young disabled men often alienated deliberately from conceptualizing themselves as disabled, without the tools to understand why life is hard and painful and never seems to reflect their experiences, trying to construct understanding beyond one's singular, isolated defective wrongness—which is what's left, if you take community off the table.

(Have I mentioned how grateful I am that so many autistics are trans spectrum? Imagine if we weren't, and if I didn't have so many transfeminine sisters funneled along those same currents and drifting closely enough alongside to understand. My sisters, so many of whom are out there living and modeling better ways to understand and participate in gender as a social activity: by figuring out what is most comfortable for you, understanding that comfort for one might be agony for another, and taking steps to shape your own life into a fashion that wells forth the most peace and joy. It's a message we all need to hear, but that is a group of people I hear singing so loudly from my place in a different wing of the choir, and I love them for it.)

I don't have answers. As is, so often, the case these days, I have only grief and love, and the determination to build better structures where my own hands reach. I had intended to direct my career, once, to undermining the entire concept of "good genes" models of evolution and explaining how their convoluted connections to natural phenomena are better explained by other, more direct motives. Since 2020, I've been moving in a new direction—but what precisely it is, I'm not sure.

Sex differences is certainly a piece of it, though. Even if I find myself often enough writing that it's not enough to know a sex difference in one species to assume that another will reflect a similar relationship: we should study sex differences in animals, but we really shouldn't assume that humans will have the same ones or work the same way. I suspect this won't be the first time I tangle with that community. I suppose it depends how much authority I can accrue as protection first.

[possum-dyke]

I'd love to share with you all my undergrad honors thesis! Warning, it's a long read but well worth it, especially if you're into harm reduction

Why do Chronic Pain Patients Use Opioids Outside of the Realm of Prescription?

December 21, 2022

Nadiya 

With the guidance of mentors David Frank, PhD and Noa Krawczyk, PhD

Macaulay Honors College Public Health Honors Project

AbstractThis exploratory review aims to summarize the reasons why chronic pain patients have been using opioids not as prescribed. Review and analysis of Reddit posts revealed people’s reasons for not using drugs as prescribed, and yielded meaningful anecdotes about their stories. Results showed four overall themes, with one theme being patients not getting enough supply, either through underprescription, no prescription, or getting cut off prescriptions; one theme being issues with withdrawal, often linked to lack of information or various reasons for patients to DIY the process; one theme being blocked communication between doctors and patients, specifically focusing on stigma in the medical community against drug users; and the last theme focusing on the negative effect of national, state, and practice-based prescription guidelines. These can be summarized by one overarching theme of disconnect between patients and doctors. Recommendations can be made to improve guidelines and to train doctors better.

Background/Introduction/LiteratureThe use of opium as an analgesic can be traced back to the times of ancient Sumer, with references to it written on a clay tablet of medical preparations (Norn et al., 2005). Since then, opium and increasingly stronger opioids, including synthetic opioids, have been used in a widespread manner, primarily for pain management and for recreational use, as opioid euphoric properties hold similar levels of power as analgesic properties (Norn et al., 2005). Although there had been previous opioid “epidemics” such as the high level of Opioid Use Disorder following the Civil War, the most currently thought of opioid “epidemic” is the one that occurred in the late 1990s and early 2000s, whose dangerous aftereffects we are seeing today with the advent of fentanyl (Jones et al., 2018). A perfect storm of the medical institution starting to briefly acknowledge the importance of pain and the invention and widespread marketing of preparations like OxyContin, as well as the willingness of many physicians to prescribe of opioids, caused an increase in the rates of opioid use, unfortunately leading to dependence and overdose in some cases (Jones et al., 2018). These negative consequences caused a shift in the pendulum in the complete other direction, with more crackdown on prescribing doctors, crackdown on users, and low rates of prescription of opioids (Marchetti et al., 2020). By now, the CDC has put out federal guidelines about opioid prescription for doctors (2016 guidelines dealt with how much opioids can be prescribed and what risk factors can be considered in prescription) (Bohnert et al., 2018). Furthermore, states have set up their own guidelines to try to curb causing dependence (Soelberg et al., 2017). Also, private healthcare companies often have blanket rules or limits that either they won’t prescribe opioids or no more than a limited dose of opioids (Webster & Grabois, 2015). In theory this was to cut down on pill mills, where anyone could claim any injury for a prescription they could get multiple refills of (Kennedy-Hendricks et al., 2016).When reading this paper, it is important to note the different kinds of opioids mentioned.OxyContin, Norco, Lortab, and tramadol are all available by prescription but also on the street; in the US, heroin is only available on the street. Methadone and suboxone are forms of medication-assisted treatment (MAT); suboxone, which was mentioned more often in this research, is a partial opioid agonist which also often includes naloxone, an antagonist, in its preparation to block users from getting high on other opioids (Velander, 2018). Although mostly obtained via prescription, suboxone can be acquired on the street (Hswen et al., 2020). Kratom is a plant with opioid characteristics that while still often used for pain or euphoria, is most frequently associated with assisting with withdrawal symptoms or tapering off stronger opioids (Eastlack et al., 2020). It is not legal in all states or countries, but where it is legal, it is typically sold in headshops or online; it is never prescribed (Prozialeck et al., 2020).Another important concept that received several mentions in patient posts was withdrawal, which requires explanation. After some level of dependence, an opioid user will start developing withdrawal symptoms when they stop using (Kosten & Baxter, 2019). These will worsen over the duration of use (Kosten & Baxter, 2019). Symptoms include an agitated/anxious mental state, insomnia, sweats, chills, flu-like symptoms, cramps, diarrhea, nausea, and vomiting (Kosten & Baxter, 2019).

MethodologyIn this exploratory review and analysis, Reddit posts were analyzed to answer the question of why current chronic pain patients use opioids in an illicit and/or non-prescribed way to manage pain. The social media forum Reddit, through its subreddit r/opiates, was used to sort through posts that might be of relevance. The search term used was “chronic pain.” Inclusion criteria used when considering posts for analysis incorporated posts consisting of at least 5 words in the body, and if there was repeat posting, only first posting in order of the algorithm was counted. Non-prescribed use had to be present or heavily implied in the content of the post. The project defined non-prescribed use as use beyond the scope of a prescription, encompassing everything from using drugs bought on the black market to doubling the dose of a prescription or using non-prescribed supplements. At this point, 50 posts that matched criteria were collected.The posts were coded on Google Sheets using the following list of categories, which were picked after thematic analysis of the topic.Can’t obtain a prescriptionAlready dependent from previous prescriptions or non-prescribed useWant more after prescription but can't getPrescription too lowRan out of prescription earlyRaised toleranceOff label use of prescriptionAre using for recreational reasonsDon’t want to go to a doctorCan't afford a doctor/doctor doesn't take insuranceReceived shared pills from othersWere already using pre-pain,Want the high from a stronger drugAvoidance of dopesickness/withdrawal symptomsUse vs suicideNo illicit use mentioned (still not using as prescribed)On medication-assisted treatmentUse of kratom,Different route of administrationRelief from dopesickness/withdrawal symptomsFear/avoidance of painUsing from non-prescribed supply on top of prescriptionUse of non-opiate drugs mentioned,Doctor lowered/took off scriptNew or worsening chronic pain after withdrawal/abstinence (post-acute withdrawal syndrome)Use of heroin.Each category was given a code and these codes were marked next to posts that pertained to them. Then important quotes were gathered and several themes were identified, some stemming from criteria, and some from analysis.Limitations include the fact that posters could use other terms than “chronic pain” to describe their pain, and the fact that posts were shown in the order of Reddit’s proprietary algorithm. Another limitation is the lack of inclusion of “should I” posts, or posters who haven't yet made the jump but are asking about using their prescriptions in a different way or trying new substances. Another limitation involves the fact that this study does not take into account the people who would not be using Reddit to talk about their experiences, including, notably, many elderly individuals who may be a part of the target demographic.

Results

Quantitative AnalysisOut of 50 data points, here’s how many were counted positive for each category:Category Count

Can’t obtain a prescription  13

Prescription too low  11

Use of heroin  10

Are using for recreational reasons  9

No illicit use mentioned (still not using as prescribed)  9

Using from non-prescribed supply on top of prescription  8

Different route of administration  7

Want more after prescription but can't get  7

Off label use of prescription  6

Use of kratom  6

Use of non-opiate drugs mentioned  5

Raised tolerance  5

On medication-assisted treatment  5

Relief from dopesickness/withdrawal symptoms  5

Ran out of prescription early  4

Fear/avoidance of pain  4

New or worsening chronic pain after withdrawal/abstinence (post-acute withdrawal syndrome)  4

Use vs suicide  3

Doctor lowered/took off script  3

Don’t want to go to a doctor  2

Received shared pills from others  2

Were already using pre-pain  2

Avoidance of dopesickness/withdrawal symptoms  2

Can't afford a doctor/doctor doesn't take insurance  1

Want the high from a stronger drug  1

Already dependent from previous prescriptions or nonprescribed use  0

Qualitative AnalysisAnalysis of the Reddit posts revealed four umbrella themes:1. Patients aren’t getting enough medication to manage pain.2. Patients are dealing with issues related to opioid withdrawal/dependence/tolerance.3. Patients are not consulting with their doctors about their opioid use.4. Guidelines for prescription of opioids are not serving patients well.

Umbrella Theme 1: Patients aren’t getting enough medication to manage pain.Multiple Reddit users found that although they were getting prescriptions, the prescriptions were insufficient to their levels of pain. Some patients feel their doctors aren’t understanding their pain, and are acting out of a fear of overprescription.One poster described their frustration at not being prescribed opioids.“and what got me so pissed off, was when I talked to one of the docs he was saying “we really don’t want to use any narcotics as they’re dangerous and we want to keep you safe, if you have excruciating pain, you can have a small dose of norco once a day.” ”Self-management of pain medication is a strategy many use to allow for their low prescriptions. Here, one patient described using dietary changes to make their dose have a higher effect, in this case using grapefruit juice to potentiate the effects of opioids. (Nieminen et al, 2020)“It's gotten so bad that I've begun to starve myself most of the day and drinking mostly grapefruit juice to have my limited dose hit as hard as possible.” Others, like the next two posters, stretch their limited prescription, finding themselves in a conflict to take multiple doses to alleviate pain versus risking having nothing left to deal with a potential flare-up.“Try to keep it in the 15 - 30mg range per day so I don't max out my script in one week.”“I hate that so far today, I've taken 75mgs of oxy [Oxycontin], yet my back is still screaming at me. I hate that I only have one 15mg pill left, and I'm trying so hard not to take it just yet.”Many users found themselves unable to take prescriptions at all: “cant get doctors to help me for shit have to self medicate.”In some of these cases it is clear that the patients have already sought extensive care but still can’t get a prescription.“There's so much scaremongering about doctors overperscribing (sic) opiates, but I'm out here with a super fucked up back (dont want to get into specifics but its gnarly) and the xrays and MRIS to prove it and i still can't find a doctor to prescribe me anything stronger than naproxen.”“I've had a torn miniscus (sic) tendon for the past 7-8 years and none of the doctors I've been to will do anything about it. Doctors refuse to send me to pain management, their excuse is that I don't need it. I've taken it upon myself to medicate with the only pills that seem to work for it. (Oxy, Lortab)” For at least one patient, only mild or highly improbable solutions have been given.“every single doctor I've been to just gives me shitty NSAIDs and tells me to exercise”In some cases, doctors are cutting patients off their medications. One patient has been told that there is no cure and is therefore scared of being cut off their meds.“I’ve been told this “is it” for me, as after 6 years of treatment/surgeries there’s nothing left to do but treat symptoms, and I’m terrified I’ll be cut off my meds this year, it’s terrifying…..”This patient’s story shows a direct link between being cut off and buying on the black market.“I was prescribed quite a bit of opioids but I was cut off because it was just a general doctor and I had to go to the streets which eventually led me to suboxone [an opioid partial agonist used for withdrawal]” 

Umbrella Theme 2: Patients have issues with withdrawal/dependence/tolerance and the way interactions with doctors about these topics have gone.One patient was worried that trying to taper off legally with suboxone would affect other prescriptions, and was crowdsourcing information instead of telling the doctor their fears.“I’ve bought subutex [same as suboxone] before and managed to get myself off it but I can’t get it this time. Would a doctor allow you to be prescribed subs  while your already on other opioids prescribed?”Another patient is trying to crowdsource answers to their problem; they started off using legal kratom, but it wasn’t enough for the pain.“Now i tried to just come off morphine and jump on to kratom but my habit is too big and the kratom wasn't holding me plus it wasn't really putting a dent in my pain. I'm so fkn lost, i really don't know what to do at this point this seems insurmountable and i've just been crying all day.”One person feels they made a mistake telling their doctor. There are steep costs associated with suboxone for them, and they consider heroin to be more pleasant and cheaper.“Doctors refuse to help me. Even with my medical history , I made a horrible mistake of going for help in my most desperate moments of withdrawal, tried to get on subs [suboxone, an opioid partial agonist used for withdrawal], But said fuck it when I realized they wanted $16 every single day to dispense me a sub [suboxone] strip 6 days a week with only 1 take home for sundays. My dope [heroin] habit I could maintain on for only a little more money and it felt way better so why the fck would I get on maintenance?”Two patients likely weren’t given enough information about withdrawal. Withdrawal is seen as a “junkie” thing, so doctors don’t want to give their patients the impression they’ll get it (or don’t know much about it themselves), and patients don’t think it will happen to them so they don’t research it. (Rieder, 2017)“Only today it dawned on me what an odd coincidence it is I feel sick when I don't take it but I'm fine when I do. I've been using it continuously for the past couple days and today I woke up feeling like complete shit.”“Now my tolerance is so high I haven’t been taking as directed and taking the max dose. I ran out almost 3 days ago now. I am so tired, my legs and my arms hurt if I don’t move them, have the shits [diarrhea], headache, and all over feeling terrible [typical opioid withdrawal symptoms]. I’m assuming this is withdrawal but I feel so fucking awful.”

Umbrella Theme 3: Patients are not consulting with doctors about pain and opioid use.Patients were often found to be deliberately withholding information from their doctors for various reasons:“Like I said I hid it from my doctors, so I never really got to find out exactly what that pain was”At least one patient was scared that doctors would think they were lying for a prescription.“I tried to hide it from everyone. I was scared that doctors would think I was phishing [committing fraud/lying] for pain pills, and/or that my family would doubt my sobriety because of my behavior.”Rehab facilities often don’t let patients take any psychoactive drugs, and this person was rightfully worried that if she entered rehab, her meds could be taken from her.“She says she can't go to treatment because they'll take her meds for her illness (she collects SSI for her disability) and they could fuck with that as well.”There are often lengthy processes associated with trying to get specialists that put people off.“I've been thinking of trying to get a referral by my regular doctor to the nearest chronic pain center, to see a specialist and psychiatrist for specific pain-related treatment. In this country the doc has to write up my medical history, explain the current condition in a referral letter, mail it to the pain specialist, and if he deems it legit he'll mail me a form to fill to evaluate my pain levels. Which I have to mail back to expect a call back about a first appointment. You can understand that this is so convoluted it doesn't even make me wanna do it.” Doctors are often wary if a patient asks for a specific opiate, thinking they are trying to commit fraud.“As of now I have been to two docs who pushed me aside giving me 800mg Tylenol, it didn't do shit but I remember I had gotten a script of trammadol (sic) for a root canal and it made everything painless and easy but as soon as I said that to the doctor he immediately wrote another 800mg Tylenol script without hesitation and sent me on my way.”Many patients were scared of being marked as addicts due to withdrawal symptoms, other prescriptions, or being honest about recreational drug use. “Doctors see the addict mark on my history and treat me like a piece of garbage.”One patient regrets honesty with their doctor, who won’t prescribe to a heavy drinker. Although alcohol and opioids are synergistic, this patient is still in a lot of pain. (Cushman, 1987)“I went to the doc my sister goes too (sic) and told him about my drinking habits and the pain, he told me he won't prescribe any opiates for "fear of additional addictions" occurring.”Here, the patient knows they are labeled dependent, so they are scared that the “addict mark” will not let them request extra of their prescription.“And when I go in for my next appointment, if I mention that the 10mg dose is preferable do you think I'll run into any trouble for suggesting that now that I have been labelled as dependent?”The patient feels they can’t be honest about illicit use without fear of being cut off from their meds.“If I go to my doctor and come clean that I’m using oxy’s {Oxycontin] and heroin will the (sic) blacklist me from the prescription I’m on?”This poster is worried that coming clean about their opioid usage will cause their psychiatrist to stop giving them benzodiazepines.“I have no intentions of telling my psychiatrist because knowing her, she'd most likely just take away my benzo [benzodiazepine] prescription away and think the problem is solved. I'm almost 100% if I tried telling anyone else I wouldn't get taken seriously either, just like with all my other both physical and mental health issues, and it's not that dangerous of a drug anyway. I don't want to make the situation even worse for myself, like it's always happened before when I mistakenly trusted people, despite it being their job to help me”This poster is worried that if suboxone is on their record, they will be blacklisted from future pain medication prescription and is wanting to try to self-medicate withdrawal with kratom instead.“I’m thinking about using kratom as a substitute for suboxone. I don’t want to take subs [suboxone] because 1. i don’t want my family to know 2. i don’t want that on my health record as i struggle with chronic pain and it would hinder some medical treatment for sure”In this case, a doctor’s beliefs about marijuana use are getting in the way of evidence-based care; the patient has essentially been cut off after admitting to marijuana use and exhibiting vague symptoms.“Now when it comes to my doctor. I feel like the stigma behind my marijuana use has greatly affected my care. He thinks I’m addicted to marijuana which is absolutely ridiculous. I’ve had panic attacks before in the hospital (I’ve dealt with anxiety far longer than I’ve been using marijuana) and he attributes them to “marijuana withdrawals” like wtf. And more recently he’s completely cut out any opiate use in my care. I’ve had multiple times where I have bad chest pain episodes and I need to go to the ER but the only thing they will give is toradol and Tylenol which does jack shit. This has forced me to start going to my local hospital ER whenever I have bad pain cause I know it can be treated there properly then I could be transferred to my normal hospital.”

Umbrella Theme 4: Guidelines for prescribing opioids aren’t serving patients.In this case, the patient is unsure but thinks state or healthcare company regulations are applying a rule that results in insufficient care.“Idk if doctors in California specifically at kaiser [Kaiser Permanente, a healthcare company] can even still prescribe monthly pain meds I don’t care about being high anymore I want this pain to end.”Here, a GP is prescribing an insufficient dose because of fear of crossing guidelines, which could impact their licensure.“My doctor (not pain management doc, normal GP) won't go over 50 MME [morphine milligram equivalents] a day because they're scared of the 2016 CDC Opioid guidelines bullshit.”Many practices have pain contracts, which require opioid-receiving patients to give their word to do certain things to keep getting their prescription (Payne et al., 2010). Here, a patient is scared that because they will have six less than needed if they didn’t use extra, at their next count they or their doctor will get penalized.“My doctor does pill counts now, the amount I’m supposed to be coming in with is 12 and if I’ll only be left with 6, am I gonna be fucked [low counts might look like abuse or dealing]? I’m not abusing them in any way, and I’m scared that I’ll look like I am and fuck up my prescription or get my doctors narcotic license taken away or something. I’ve only failed one drug screening when I wasn’t taking my medication because (TMI sorry) I hadn’t shit in a week.”

Discussion In analysis of these posts, the most common overarching theme was patients feeling disconnected from doctors, from not being able to convey their level of pain and having it met, to being prescribed medications they don’t understand, to not sharing issues with their doctors for fear of judgment or non-prescription.. All four themes — insufficient prescription, withdrawal issues, patients not consulting with doctors, and prescription guidelines — often come down to issues with the medical institution or individual doctors. However, this is such a widespread problem among individual doctors that change must be made on the systemic level, for instance, during education.Insufficient prescription stories in the data can be narrowed down to three categories: patients with prescriptions who experience more pain than their prescription can help, patients who cannot obtain a prescription for opioids, and patients who are cut off from their prescriptions. In all of these sub-categories, there is a common theme of frustration with doctors not meeting patient needs. There is also a theme in the already-prescribed sub-category of using other strategies to make a prescription have more power, some of which are risky. Using other substances to potentiate the drugs, especially benzodiazepines and alcohol, can lead to overdose, and doubling up on doses to then run out can lead to a cycle of withdrawal (Knopf, 2020). In the never-prescribed subcategory, it is becoming clear that many patients who are seeking extensive medical attention are not getting the medications they need. In the cut-off category, getting cut off or tapered down without permission can precipitate withdrawal. In all, this umbrella category shows a pattern of denial of a patient’s agency in their own pain management process, and doctors should find better ways to monitor people’s pain and not assume the least effective methods will do the trick.Multiple issues come up with withdrawal precipitated by running out of opioids and self-precipitated withdrawal due to the desire to taper off. For instance, it is hard to obtain suboxone and when people do, it can be quite expensive (Hswen, 2020). Kratom can also run quite expensive, and oftentimes does not treat withdrawal symptoms effectively (Eastlack et al., 2020). In a lot of cases, patients aren’t able to utilize detox programs because they would have to be free from opiates, but either doctors aren’t providing helpful ways to get patients off opioids, or patients don’t feel comfortable approaching the subject with their doctors (Timko et al., 2016). Additionally, many patients are not adequately educated on withdrawal; it can take a while for them to catch on to the fact that they don’t have a nasty flu, they are instead in withdrawal from the prescribed opiates they take (Kearney et al., 2018). This would imply  that in long-term opiate prescriptions, doctors need to do a better job of describing the near-inevitability of withdrawal, the signs and symptoms, and when to seek help.Patients are also often scared to seek help from their doctors, often preferring to seek answers from nonprofessionals on sites such as Reddit instead. There is fear that doctors would think they are lying. This is especially true when patients want to ask for a specific opiate, as this often makes doctors wary (Lagisetty et al., 2019). Instead, self-research about medications should be encouraged and not seen by doctors as grounds for a scam. Additionally, strict rehab policies and lengthy processes to get specialists are turning patients off (Mehrotra et al., 2011). The specialist issue is not unique to pain management, but should still be improved (Mehrotra et al., 2011). Rehabs or other drug treatment centers should also have less all-or-nothing, more harm-reduction centered approaches, especially ones that match the reasons why a person might be taking a specific drug.There is also a heavy stigma against drug users of all kinds in the medical profession (Ahern et al., 2007). Although it can be understood that a provider would be wary to prescribe an opioid to a self-disclosed drinker or benzodiazepine user, as these can cause dangerous combinations, there has to be some way to balance this. Otherwise, we have a system where patients lie to their doctors about their drug and alcohol use and therefore are not properly counseled and can succumb to these consequences. Doctors should take extra care if there is a Substance Use Disorder (SUD), but still prescribe, maybe with mandatory counseling, as more than anyone, people with SUDs can find these drugs on their own. In this system, posters are reporting lying so they won’t be cut off any prescriptions and even withdrawing by themselves so they are not marked as an addict by records.In the wake of the 2000s “opiate epidemic,” doctors were given more stringent prescription guidelines. In many cases, patients aren’t aware whether they are being affected, unless their doctors told them directly, but patients are aware that some great changes have been made, either from their past medical experiences or that of the people they know. Private practices have also instituted blanket rules against prescription, mandatory pain contracts, drug urinalysis, and pill counts, which can lead for one “slip-up” or double dose in a patient’s pain regimen to get them in trouble (Tobin et al., 2016). These policies should be reexamined as they are mostly working just to deter and punish chronic pain patients (Tobin et al., 2016). State and federal guidelines also need to be loosened, as doctors should have more freedom over their prescription choices, making patients’ lives better.

Hope you like this and feel free to share!

[healthyheartsgurgaon]

How Nuts Can Keep Your Heart Happy and Healthy   

Nuts may be good for the heart when consumed in a healthy diet. They contain nutritional and unsaturated fatty acids. They're also great snacks. They're easy to pack and store and inexpensive on the go.

It is crucial to remember that some snacks contain high calories. Hence, it's vital to control your portions. Opting for nuts over less healthy snacks can help you stick to a heart-healthy diet. If you need guidance on heart health, consulting a heart specialist in Gurgaon  could provide valuable insights and personalized advice tailored to your needs.

Are nuts good for your heart?

Several studies have shown that nuts and seeds lower inflammation levels associated with diabetes and heart disease.

Nutritional benefits include:

Maintain healthy arteries.

Improve heart health by reducing inflammation.

Prevent heart attacks and strokes by reducing blood clot risk.

Blood pressure can be lowered.

Cardiovascular disease is a leading cause of early death.

Lower unhealthy cholesterol levels, specifically triglycerides and low-density lipoproteins, or "bad" cholesterol.

Are nuts heart-healthy?

They are the best protein sources. Furthermore, it comes with these heart-healthy nutrients:

Contains unsaturated fats. Some believe that nuts' monounsaturated fats and polyunsaturated fats lower harmful cholesterol levels for reasons that are not fully understood.

Fats rich in omega-3. It is the omega-3 fatty acids found in these nuts that make them a healthy snack. Healthful fatty acids include omega-3s. There may be a reduction in the risk of heart attack and stroke caused by these nutrients.

Contains fiber. Almost all of them contain fibre, a substance that lowers cholesterol. By consuming fibre, you feel complete for extended periods and eat fewer calories.

Sterols from plants. A substance found in some nuts can help reduce cholesterol, called plant sterols. It is common for plant sterols to be added to products such as margarine and orange juice for their health benefits; however naturally contain plant sterols.

The L-arginine. The amino acid L-arginine can also be found. There is some evidence that L-arginine lowers blood pressure, reduces cholesterol, and improves the health of blood vessels in general.

Nut servings: what is a healthy amount?

It is important to note that nuts contain fat. Even though most of them come from healthy fats, the calories can still add up. The key to keeping nuts healthy is to keep them in moderation.

Ensuring an adequate intake of unsalted nuts in your diet typically means aiming for about 4 to 6 servings per week for adults. Serving recommendations may differ for children depending on their age. If you're worried about your child's nut consumption, it's wise to consult their paediatrician to determine the appropriate serving size. Additionally, for personalized advice on maintaining heart health, consider contacting a heart doctor in Gurgaon who can offer tailored recommendations and support.

Instead of cooking nuts in oil, choose raw or dry-roasted nuts. You can enjoy two tablespoons of nut butter with each serving of whole nuts or a handful of whole nuts (1.5 ounces).

Are nuts of different kinds better than others?

There is no evidence that nuts are harmful in general. However, some may contain more heart-healthy nutrients than others. Walnuts, for instance, contain Omega-3 fatty acids.

The heart-healthy properties of almonds, macadamia nuts, hazelnuts and pecans are well-established. The same applies to peanuts, although they are technically legumes, not nuts.

It would help if you chose unsalted or unsweetened nuts. Salt or sugar can diminish heart-healthy benefits.

The following is information on the nutrition of some of the most common types of nuts. A serving of unsalted nuts contains 28.4 grams of calories and fat.

Are nut oils a good idea? How healthy are they as well?

Nut oils provide nutrients but do not contain the fibre found in whole nuts. Walnut oil has more omega-3s than any other oil.

Contemplate incorporating nut oils into your recipes when preparing salad dressings or cooking. Nut oils possess distinct properties compared to vegetable oils, particularly in their reaction to heat. It's essential to avoid overheating nuts, as it can lead to a bitter taste. Furthermore, owing to their high fat and calorie content, it's advisable to use nut oils sparingly. For individuals seeking specialized care and treatment for heart conditions, the Best Heart Hospital in Gurgaon can provide comprehensive services and expert guidance tailored to individual needs.

   To book an appointment with our cardiologist: Dr. Monik Mehta (MBBS, MD, DM, FACC)  Interventional Cardiologist, Cardiologist, Cardiac Electrophysiologist  24*7 Helpline No.: +91–9873214382 

Email: heartcare@healthyheartsgurgaon.com 

[apex-pest-control]

Managing Grey Squirrel Populations

What methods work best in order to get rid of grey squirrels?

Many people are unhappy about the grey squirrels that have taken up residence on their farms and homes. The effects of these pests include harm to gardens and farms, destruction of structures, and competition for food with other animals. The good news is that grey squirrel populations can be successfully decreased, mitigating some of these detrimental effects.

Looking at methods to keep grey squirrels at bay is a good first step when dealing with an issue on your property. Two examples of such tactics are habitat modification and exclusion; the objective of both is to decrease the availability of food and possible nesting places. Trapping, hunting, and other violent control measures, as well as deadly alternatives like fumigants and poisons, will also be covered.

With any luck, this post may shed some light on how to implement an integrated pest control strategy to permanently reduce the amount of grey squirrels on your property.

One thing you can do right away to deal with grey squirrels on your property is to educate yourself on all the possibilities for dealing with them and how to combine them into a comprehensive approach.

 

When dealing with grey squirrels, what approaches are considered the most humane?

Grey squirrel populations can be humanely controlled in a number of ways, including expert individual despatch and live catch traps. One of the most common and humane ways to catch grey squirrels is with live traps. If you don't want to capture any non-target animals by accident, you need to check these traps every day. The best way to deal with grey squirrels is to contact a professional exterminator who can assess the situation and offer suggestions.

Another option for the humane removal of troublesome animals from a particular region is cage trapping. Animals trapped in traps won't have to suffer needlessly if someone keeps an eye on them and baits them with nuts or seeds.

In conclusion, there are a number of non-lethal ways to reduce the grey squirrel population. To ensure the right actions are taken in every case, it is essential to regularly seek expert guidance.

In what ways might grey squirrels be made less problematic?

Harm caused by invading grey squirrels cannot be decreased without proper management strategies. An integrated approach to managing grey squirrel populations must include reducing populations, improving habitat, and employing physical exclusion tactics. Keep reading for additional information.

Building an exclusion fence is the best way to physically keep grey squirrels out of your yard. You may need to erect fences or other obstacles to physically prevent them from entering. The easy-to-use and widely-available wild animal traps can be a big help in the humane removal of grey squirrels from particular areas.

Extra deterrents, like odour-repellents or motion-activated sprinklers, may be useful in some situations.

Reducing the number of invading grey squirrels is another prospective solution. In certain areas, hunting and trapping are legal ways to control populations, although one must use caution when doing so because of legal restrictions.

Effective management of damage mitigation and grey squirrel control frequently requires a combination of these strategies. An end to the suffering caused by invading grey squirrels is possible through the application of population reduction strategies and physical exclusion procedures.

How can we ensure the safety of our customers when dealing with grey squirrels?

When dealing with grey squirrels, it's important to be cautious. This type of squirrel is common in many areas and can cause a lot of trouble for local wildlife and people. As a result, control methods should be used with caution.

It is imperative to use protective gear, such as goggles, gloves, and a mask, when operating a trap. Ensure that the region is devoid of both humans and pets before attempting to manage the population.

The possible consequences for the ecosystem must be carefully considered when choosing between ruthless and merciless control tactics. By way of example, poisons can wipe out any local fauna. Finally, squirrels are vulnerable to injury or death when caught in traps.

It is essential to investigate local regulations while dealing with grey squirrel control. Given that many jurisdictions have varying restrictions and regulations on wildlife management, it is crucial to familiarise oneself with local laws before attempting any form of control.

It is essential to employ a combination of humane and wildlife-friendly techniques while attempting to control grey squirrels. A practical method of population control is spring trapping. But while using this tactic, keep safety in mind at all times.

Another strategy for managing their numbers is to routinely cut back the branches around buildings, making it harder for them to get inside.

How Challenging Is It to Manage Grey Squirrels?

The rapid proliferation of grey squirrel populations makes them a very difficult pest to manage. Grey squirrels are notorious tree and garden destroyers, and it's not just because they hibernate. Buildings can sustain costly damage from their destructive gnawing on wires and insulation. Furthermore, due to competition for food and shelter, grey squirrel populations pose a threat to red squirrel populations.

Experts in pest control can't devise a foolproof plan without first determining if the squirrels in question are grey or red. For instance, squirrels of the red variety can be captured in tunnel traps.

However, these wouldn't work well for grey squirrels because they're bigger than red ones. It is possible to supplement trapping methods with others, such as fly control, fox control, or shooting, depending on the circumstances and regulations in the area.

Therefore, reducing grey squirrel populations requires knowledge of species identification, experience with different methods, and adherence to animal care regulations. This is crucial for controlling invasive species like the grey squirrel (Sciurus carolinensis) that pest management professionals face.

What Is the Potential Impact on the Environment from Grey Squirrel Control?

“The U.K. Forestry Commission estimates the grey squirrels cause £6-10 million damage to British forestry each year. The E.S.I. are concerned unless prevention gets done, there will be no oak, sweet chestnut, or mature beech trees for the future generation.”

Controlling grey squirrels may have unintended consequences for the ecosystem, such as upsetting natural food chains. The widespread dependence of numerous predators on grey squirrels as prey means that any attempt to reduce their population could have far-reaching effects on the food chain. This might cause predator numbers to drop or perhaps lead to the extinction of certain species in certain areas.

The extinction of other species that rely on the same ecosystem as grey squirrels is another potential ecological consequence. Squirrels of the grey variety may root out other creatures that rely on trees for shelter, as they construct massive nests in trees and subsist on tree sap.

Strategies for controlling grey squirrels may have both positive and negative effects on the environment. Applying control mechanisms in an ethical and sustainable manner is crucial for reducing potential repercussions.

How Much Money Is Necessary to Remove Grey Squirrels?

The cost of controlling grey squirrels depends on several factors, including the area, the method, and the density of the animals. Certain treatments may come with an additional price tag, while others may require multiple treatments before they yield any noticeable results.

Capturing grey squirrels is an affordable method of controlling them. Setting up traps in ideal spots, like close to trees or bird feeders, allows you to catch squirrels when they're active throughout the day. Not only may squirrels be caught and managed with traps, but ants and bed bugs can also be removed efficiently in a single attempt. There is an inexpensive and efficient way to keep squirrels away from your area or to stop them from returning after you've trapped them: use a repellant.

Some wildlife management strategies may be more effective than trapping when it comes to controlling grey squirrel populations. To limit food supplies, one may, for instance, bring in native predators like pine martens or eliminate bird eggs. Despite their occasional efficacy, these procedures can be somewhat pricey.

Choosing the optimal technique for managing grey squirrels is entirely subjective, as every circumstance and budget is different.

Use Grey Squirrel Control to Keep Squirrels Off Your Property

If you care about protecting your property and the environment, you must take measures to keep grey squirrels under control. When attempting to eradicate grey squirrels, it is crucial to keep in mind the animals and their environment.

Changing their habitat, capturing them, or introducing natural predators are some approaches to controlling grey squirrel populations. The severity of the grey squirrel infestation will determine the budget required for these repairs.

To effectively and humanely control grey squirrels, it is vital to follow best practises. It is feasible to manage grey squirrel populations in an ecologically responsible and efficient way with the correct approaches.

[naturalweightlosscenter]

Myths vs. Facts in the World of Weight Loss

Finding the right advice to follow when starting a weight loss journey can be challenging, as there are many different sources of information. We'll clarify common myths about weight loss and provide fact-based information that will help you choose a more lasting and healthy way to lose those extra pounds.

Myth 1: Crash Diets Guarantee Rapid and Lasting Weight Loss

Fact: Crash diets might promise swift results, but they often lead to short-term weight loss due to water loss and muscle breakdown. These types of diets can damage your metabolism and are not long-term solutions. Adopting a sustainable and well-balanced technique involves regular exercise, a healthy diet, and small changes to your lifestyle, which are essential for long-term weight loss.

Myth 2: Carbohydrates Are the Enemy

Fact: The body uses carbohydrates as a major source of energy. The key is to choose complex carbohydrates, such as whole grains, fruits, and vegetables, over refined ones. Whole, unprocessed carbs provide essential nutrients, fiber, and sustained energy, supporting overall health and weight management.

Myth 3: Loss of Weight Occurs When Meals Are Skipped

Fact: Meal skipping can have adverse effects because it lowers metabolism and increases overeating later in the day. To maintain an active metabolism and avoid eating too much food, aim for well-balanced, portion-controlled meals and snacks throughout the day instead of missing meals.

Myth 4: Spot Reduction Exercises Target Fat Loss in Specific Areas

Fact: Performing endless crunches won't magically melt away belly fat. Spot reduction is a myth; fat loss occurs uniformly across the body with a combination of cardio exercises, strength training, and a healthy diet. Targeting specific areas with exercises can tone and strengthen muscles, but it doesn't eliminate fat exclusively from those regions.

Myth 5: All Calories Are Created Equal

Fact: Although the concept of "calories in, calories out" is essential for weight loss, the amount of calories is important as well. Foods high in nutrients and rich in vitamins and minerals are good for your overall health. Natural weight loss centersuggests that rather than concentrating just on calorie counting, choose a balanced diet that consists of a variety of foods.

Myth 6: Weight Loss Supplements Are a Magic Solution

Fact: Although a lot of weight loss products make great assurances, there is sometimes no proof to back up their claims. Some supplements may even have harmful effects on health. Instead of depending on pills, focus on a well-rounded diet, regular exercise, and consulting with the natural weight loss center Florida for personalized advice.

Myth 7:The Only Workout That Works for Weight Loss Is Cardio

Fact: Although cardio activity is important for increasing heart health and burning calories, strength training is also an essential part of a complete fitness schedule. Building lean muscle mass boosts metabolism and helps with long-term weight management. A combination of cardio and strength training gives the best results.

Myth 8: Genetics Determine Your Weight, and Nothing Can Change That

Fact: While genetics play a role in body weight, lifestyle choices significantly influence weight management. Healthy habits, including a balanced diet and regular exercise, can positively impact your weight and overall well-being, regardless of your genetic characteristics.

In conclusion, understanding the difference between weight loss myths and evidence-based facts is important for making informed decisions on your fitness journey. Remember, there are no shortcuts to health, and a balanced, evidence-based approach is the key to achieving and maintaining a healthy weight over time.

[catfoodblog]

Can Cats Eat Almonds? 8 Facts You May Want To Know

 Almonds' nutritional value for cats

Because of their high fat content, almonds are not recommended for cats because they can cause digestive issues and pancreatitis. Furthermore, almonds contain cyanogenic glycosides, which can cause cats to vomit cyanide if consumed. It is best to avoid feeding almonds or other nuts to cats because they can be harmful.

Are almonds safe to feed to cats?

No, cats should not consume almonds. They can be difficult to digest in cats and can cause gastrointestinal upset, such as vomiting or diarrhea. Furthermore, almonds can be a choking hazard and can cause an intestinal blockage in cats. It is best to avoid giving your feline companion almonds or other nuts.

Can cats consume almonds?

Almonds are not digestible by cats. Almonds contain substances that are difficult for cats to digest, which can result in stomach upset, vomiting, and potential digestive blockages. It is best not to feed almonds or other nuts to cats.

Almond poisoning symptoms in cats

gastrointestinal upset, such as vomiting and diarrhea, can be symptoms of almond poisoning in cats. Lethargy, weakness, difficulty breathing, tremors, and seizures are all possible symptoms. It's important to note that while some cats may have mild reactions to almonds, others may have severe reactions. If you suspect your cat has eaten almonds or is exhibiting any concerning symptoms, seek immediate veterinary attention.

Keeping cats from accidentally eating almonds

Because almonds can be toxic to cats, preventing accidental almond consumption is critical. Almonds contain substances that cats cannot digest, resulting in gastrointestinal issues such as vomiting, diarrhea, and abdominal pain. Almonds can also cause pancreatitis in cats in some cases.

To avoid accidental almond consumption by cats, take the following precautions:

Keep almonds out of reach of your cat by storing them in airtight containers or sealable bags. Avoid leaving almonds on countertops or in open bowls where cats can easily get to them.

Trash disposal: Place almond-related waste, such as shells and packaging, in sealed garbage cans to keep cats from rummaging through and potentially ingesting them.

Inform others: If you have visitors or live with others, make sure everyone is aware of the dangers of almond consumption in cats. Encourage them to take precautions as well, such as not leaving almonds within reach of feline companions.

Be cautious when snacking on almonds in the presence of your cat. Ingestion can occur as a result of accidentally dropping or sharing almonds. During snack times, keep a close eye on your cat's surroundings.

Alternative treats: Instead of almonds, provide safe and appropriate cat treats. There are many commercially available cat treats that are specifically designed for feline consumption, ensuring that their nutritional needs are met without risk.

Remember, if you suspect your cat has eaten almonds or is exhibiting any unusual symptoms, seek immediate medical attention from a veterinarian.

Almond health benefits for humans vs. cats

Although almonds have numerous health benefits for humans, they can be harmful to cats.

In the case of humans:

Almonds are high in nutrients such as healthy fats, protein, fiber, vitamins (such as vitamin E and B vitamins), and minerals (such as magnesium, calcium, and potassium).

Heart health: Almonds may aid in the reduction of bad cholesterol, the prevention of heart disease, and the overall improvement of cardiovascular health.

Weight management: Almonds' combination of healthy fats, protein, and fiber can promote feelings of fullness, potentially assisting with weight loss or maintenance.

Almonds have a low glycemic index, which means they have little effect on blood sugar levels. They may aid in blood sugar regulation and insulin sensitivity.

Almonds contain vitamin E and other antioxidants that can protect against oxidative stress and cell damage caused by free radicals.

For felines:

Due to their high fat content, almonds can be difficult for cats to digest, resulting in gastrointestinal upset, pancreatitis, and even intestinal blockage.

Cyanide toxicity: Almonds contain cyanogenic glycosides that, when chewed or ingested by cats, have the potential to release cyanide. This can be toxic, if not fatal, to them.

Whole almonds pose a choking hazard for cats due to their shape and size, especially if they are swallowed without proper chewing.

It is important to note that, while almonds have health benefits for humans, they should not be fed to cats on a regular basis. If you suspect your cat has consumed almonds or any other potentially harmful substance, you should seek immediate medical attention.

Almond substitutes for cat treats

Alternatives to almonds for cat treats include pumpkin seeds, sunflower seeds, and cashews. However, it is important to note that treats should only be given in moderation and as part of a veterinarian-approved balanced diet.

Finally, can cats eat almonds?

Cats should not consume almonds. Almonds can be difficult for cats to digest and may cause digestive problems. Furthermore, almonds contain fats and oils that, in large quantities, can be harmful to cats. To ensure the safety and well-being of cats, it is best to avoid feeding them almonds.

Can Cats Eat Almonds?

Cats should not consume almonds. Almonds can be difficult for kittens to digest and can cause digestive problems. It's best to stick to a balanced diet designed specifically for kittens.

Can Cats Consume Almond Butter?

Almond butter should not be consumed by cats. Almonds are difficult to digest in cats and can cause stomach upset or even pancreatitis. It's best to avoid feeding almond butter to cats and instead stick to foods designed specifically for their dietary needs.

Can Cats Consume Almond Yogurt?

Cats should not consume almonds or yogurt. Almonds can be difficult for cats to digest, causing stomach upset and possibly leading to pancreatitis. Yogurt frequently contains lactose, which many cats are sensitive to, resulting in digestive issues such as diarrhea. Stick to cat-specific food and treats that are safe and appropriate for their dietary requirements.

Can Cats Consume Almond Extract?

Cats should not consume almond extract. When cyanogenic glycosides in almonds are metabolized, they can release cyanide. Toxic to cats, cyanide can cause serious health problems such as difficulty breathing, seizures, and even death. To ensure the safety of cats, keep almond extract and any almond-containing products away from them.

Can Cats Consume Almond Oil?

Cats should not be given almond oil. It can cause digestive upset and even pancreatitis or other health problems. Stick to cat-specific food and avoid giving them human oils or foods that are not suitable for feline consumption.

Can Cats Consume Almond Flour?

Cats should not consume almond flour. Cats should avoid almonds and almond products, including almond flour. They are difficult for cats to digest and may cause stomach upset, diarrhea, or vomiting. Furthermore, almonds contain fats and oils that may cause pancreatitis in cats. It is best to avoid giving your cat almond flour or other almond products.

Can Cats Drink Almond Milk?

Cats should not drink almond milk. Almonds and almond milk are not suitable for cats because they can cause stomach upset, diarrhea, or vomiting. Furthermore, almond milk may contain additives such as sugar, flavorings, or thickeners that are toxic to cats. To ensure that your cat's nutritional needs are met, stick to a balanced diet designed specifically for cats.

[cleaning-service-providers]

Why Should You Hire The Best Pest Control services?

The fact of the issue is, however, that there are various Best pest control services or bug control firms out there to choose from. Although they could also demand significant fees, the money you spend on their professional services might very well be well spent. A corporation’s experienced and qualified representatives will do more for you than just thrust pricey strategies in your face. In addition, they help determine the specific nature of the insect problem. This information is of the utmost significance in assisting in the formulation of a practical treatment approach.

A pest control firm will come up with a solution after it is determined that there is an issue. This strategy addresses identifying the steps to Deep Cleaning services near me, the period of facilitation, and approaches to limit any subsequent infestations. In addition, legitimate and trustworthy firms will give you guarantees if a treatment does not work as advertised or if your property is damaged while exterminating household pests.

Reasons why you should Hire Pest Control Services?

1. Trained and Qualified Pest Control Technicians

Because of this, we are now in a much better position to eliminate the sort of undesirable insects that you have quickly, efficiently, and effectively. Furthermore, we are aware of simple approaches to plugging all the openings. As a result, we will assist you in mitigating the present risk and preventing such infestations in the future.

2. Tailored Programs for the Control and Treatment of Pests

The Best pest control services will begin by analysing the situation at hand and will then provide you with solutions that are tailored specifically to the requirements that you have. Because the treatment plan will be tailored specifically to the kind of pest, the property’s dimensions, and the infestation’s severity, you can be sure that the eradication process will provide satisfying and appropriate results for your requirements.

3. Assistance in minimising the impact of potential dangers and threats

This is of the utmost importance when considering that specific pest control management solutions may be toxic to you and your family and the environment. A growing number of businesses are turning to natural and organic Best pest control services, which are risk-free to use in and around your home and do not present any possible hazards. We know which anti-infestation products work the best and are most efficient in combating your problem. You no longer have to be concerned about potentially harmful chemicals being ingested or exposed to by youngsters or household animals.

4. The Leverage You Will Have With Your Time

Because the specialists use risk-free goods and solutions that are tailored to your specific needs, you should begin to experience improvements in a concise amount of time. We will also get started on your project whenever you require our services and quickly complete an evaluation and project proposal so that you may begin seeing significant changes as soon as possible. In addition, the vast majority of the procedures and products do not even need you to leave your home, and as a result, you are free to have the treatment carried out whenever it is most convenient for you.

5. Helpful contributions to the reduction of expenses

This considers that some undesirable pests, such as termites, may do a lot of damage, leading to the need for pricey repairs and replacements inside your home. However, when you engage the efficient Deep Cleaning services near me, you can be sure that the pest infestations will be stopped before they pose any dangers to your home or health.

You will also be rescued from circumstances where you spend money on Pest control in Dubai that doesn’t function as effectively as it should. This is because the industry specialists know what works on what kind of pest, which removes the burden of expensive trial and error off of your shoulders.

6. Precautions to Take in Case of Insect Problems

Certain bothersome insects pose health risks and need Deep Cleaning services near me to be eliminated. As an instance, the eradication of killer bees by methods that are not suitable may be fraught with enormous danger. However, because of our training, the exterminators are well-versed in the most efficient and risk-free strategies for dealing with troublesome insects and eliminating their nests.

7. Employing a Qualified and Experienced Pest Control Company

Infestations caused by unwanted organisms may be irritating, risky, and detrimental to one’s health. Rodents, termites, and spiders are a few of the creatures that fall under this category. In most cases, your location may determine precisely what Pest control in Dubai you are much more prone to. Still, the vital thing to emphasise is that you will need to find the most straightforward technique to get rid of them before they begin causing problems and having harmful effects.

Even though the undesirable bugs give the impression of being simple to control, it may be highly challenging for you to get rid of them efficiently and entirely. You may want to employ professional pest control services from a reputable pest control business like Insect Control if you keep having recurring infestations since it can be disheartening to deal with pest problems.

Conclusion

If you have decided to engage professional pest control services, then you can do so at Al Ameen Pest Control at prices that are very close to the industry standard. You can find a wide variety of Pest control in Dubai for hiring in this location. In addition, you can choose the most appropriate option in light of the nature of the insect infestation. Read full blog.

[wwwquickpakinccom]

What is compostable packaging?

Compostable Packaging: Reducing impact on the environment is high on the agenda of millions of businesses – large and small. And well designed, sustainable packaging is a great way to lower your carbon footprint. When it comes to eco-friendly packaging materials, one of the most common requests that we hear is for compostable packaging.

On the surface, compostable packaging sounds great – but it’s important to understand what compostable packaging is, how it differs from other sustainable packing materials and acknowledge that not all compostable packaging is made equal.  

What is compostable packaging?  Compostable packaging is a type of packaging material that can be disposed of in a responsible way and adheres to the principle of circular economy.  Compostable packaging products are made from materials that decompose fully into compost without producing toxic residue as they break down.

The difference between compostable and biodegradable packaging.  There is a common misconception that compostable and biodegradable packaging are interchangeable. In fact, they are not the same.

If something is biodegradable, it simply means it will decompose with the help of bacteria or other living organisms over time. Theoretically, all things will decompose eventually, but some may take thousands of years to do so!  Biodegradable products also require specific conditions to break down properly and may produce harmful greenhouse gas emissions if left to decompose in landfill. Therefore, although the decomposition process occurs naturally, it can still be harmful to the environment.  In contrast, compostable products disintegrate without harming the environment, turning into soil enriching compost instead.

So, how can packaging reduce your businesses’ impact on the environment? Here we look at several factors – it’s role in the circular economy if it can be recycled and the benefits and challenges associated with using this type of packaging.

Compostable packaging and contributing to the circular economy.  For many, compostable packaging is a step in the right direction in terms of packaging and the environment. However, it is worth noting that compostable packaging is still single use.

When used appropriately, it is another weapon in the packaging industry’s arsenal to prevent waste and regenerate nature but long-term, infrastructure to support organic material collection and repurposing will be key to make compostable packaging a success.  Therefore, businesses must ask themselves if compostable packaging is right for their packaging strategy and make an informed decision whether they should first look at material reduction or reuse.

Is compostable packaging recyclable?  This all depends on the type of compostable packaging you are using.  For example, some compostable and biodegradable materials, such as cardboard, can be recycled. Compostable plastics, however, are not designed to be placed into the mixed recycling bin, due to the differences in decomposing processes.

Most recycling plants are not equipped to deal with compostable plastics and placing them into mixed recycling could simply lead to potential contamination. They will have to be placed into your general waste bins instead.

 Benefits of using compostable packaging.  Switching to compostable packaging can help reduce your environmental impact and carbon footprint.  Compostable packaging takes less time to break down in landfills and does not produce harmful substances in the process. It can enhance soil quality and, as it’s made from organic materials, requires fewer sources to be produced.  Compostable packaging can also help improve your brand image and show that your company cares for the environment – but it must be used appropriately and labelled properly.

Challenges of using compostable packaging.  While there are benefits of using compostable packaging, there are potential challenges too. Packaging labelled as “compostable” is not always suitable for home-composting. It is important to check the labels to make sure the packaging is disposed of correctly to avoid cross-contamination. This is something that businesses need to factor in.

Compostable plastics cannot be placed into the recycling bin as they require the correct decomposing conditions to fully disintegrate. Compostable packaging can also be more expensive, however, as demand for it grows, there is a potential for it to become less pricey. If designed correctly and used in an appropriate application, it can also save you costs in the long run, but businesses should balance the swap against if reducing material use or returnable packaging options could have better environmental impact for their operation.  

When considering plant-based bioplastics, case should be taken to understand how that plastic is being created and the environmental consequences around land use, agriculture and transport relative to the alternative.  There are some exciting innovations in the compostable packaging area, and it is the one to watch, as it’s likely to continue to evolve! One example is the seaweed packaging that won the Earth Shot prize with packaging that is completely natural and harvested in an environmentally friendly way from seaweed.

This has good applications currently for primary packaging but is not yet on the scale to offer viable secondary packaging solutions.

[drrohitbatra007]

Do Brazilian Laser Hair Removal Affect Women’s Fertility?

Lasers are the quickest, safest, least intrusive, and most convenient option to remove unwanted body hair. Laser hair removal methods produce heat to destroy hair follicles, preventing hair from regrowing. It is usually painless, but people doubt whether this treatment is safe for sensitive areas like bikinis since lasers are involved. 

Another question that commonly pops up is, Can Brazilian laser hair removal affect fertility? This blog includes information related to the  same, including insights shared by the laser experts of DermaWorld Skin & Hair Clinics. The clinic is renowned for providing the best laser hair removal in Delhi. Continue reading to learn more.

No, it does not affect fertility. This method's laser light technology will only influence the skin's surface up to the base of the hair follicles, which means it will not penetrate further to harm any of the internal organs.

How Brazilian Laser Hair Removal Is Considered Safe for Fertility?

Brazilian laser hair removal treatments use laser light technology to target pigmentation and eliminate individual hair follicles right from the root. 

This weakens the framework for consistent hair regeneration in the area, resulting in a semi-permanent outcome.

This laser wavelength technology targets only the hair follicle and does not harm the surrounding skin cells or the pores. 

As a result, if it just affects the superficial skin, particularly the hair follicle, it will have no radiating impact on the organs and skin tissue underneath the treated region. 

Despite this, there are still concerns about the treatment's safety during pregnancy.

Brazilian hair removal procedure does not influence the organs or fertility in general. There are no such reports that this hair removal procedure might be causing the ovarian problem. If one still doubts the same with their ovaries or fertility after just one Brazilian laser hair treatment, they should discuss it with their laser expert.

How Safe is Brazilian Laser Hair Removal?

Like all other hair removal and skin procedures, Brazilian laser hair removal has certain risks, although none involve infertility or ovarian diseases. Brazilian hair removal treatments, for example, may work better for those with a lighter complexion and dark hair. However, people believe that as laser hair removal strikes dark pigmentation, the treatment may become more painful for darker-skinned clients than those with lighter skin. However, advanced lasers like Alma Soprano Ice Platinum are helpful in delivering pain-free and best results. This technique is used at DermaWorld Skin & Hair Clinics by the laser experts. 

Brazilian laser hair removal treatments are generally painless and low risk. However, people with sensitive skin may experience a minor pinching sensation. Thus, the following are the most prevalent negative effects of this type of hair removal:

Minor Swelling.

Scarring and crusting of the skin.

Hair growth stimulation.

Redness or mild redness, as well as a slight discomfort.

Skin structure or pigmentation changes. 

Furthermore, limited research confirms the safety of Brazilian laser hair removal therapy during pregnancy, but this does not mean that this approach is completely risk-free. However, Brazilian hair removal is generally not recommended during pregnancy.

Tips to Get the Most Out of a Brazilian Laser Hair Removal Treatment

Brazilian laser hair removal results in smoother skin over waxing and other long-term hair reduction treatments. However, in order to achieve the best results from the procedure, one needs to get it done from certified laser hair removal professionals. Given below are some tips to help individuals to get the best results: 

Choose the Right Laser Expert

Brazilian laser hair removal in Delhi is typically safe. However, it should only be conducted by someone licensed or qualified. It is important to trust the laser technician. The sessions are often scheduled and are not conducted only once. So, in order to build a laser hair removal treatment plan which works right for the patient, the provider must have appropriate expertise.

Those with darker skin tones and lighter hair colors may have a different experience with hair removal, but visiting the right laser clinic and being treated by a competent laser technician or aesthetic specialist, like one available at DermaWorld Skin & Laser Clinics, will help them get the best results. These trained professionals utilize advanced technologies and can modify the laser heat to optimize the experience and alleviate pain.

Follow Pre-Treatment Instructions 

Always research before having a Brazilian laser hair removal procedure to stay prepared. When preparing for the treatment, keep the following things in mind:

Shave the day before the treatment so that laser light may reach them directly without exposing the skin to excessive heat.

Before the laser hair removal appointment, refrain from waxing, exfoliating, or tweezing the treatment region.

Take a shower before the treatment for hygiene purposes.

Bring additional loose-fitting clothing to wear after the therapy session.

Thoroughly Follow the Aftercare Guidelines 

The skin expert may suggest post-treatment care instructions such as:

To relieve burning feelings, use ice.

Use the topical antibiotic prescription as prescribed.

Other hair removal methods (topical hair removal medication or waxing) should not be used in the treatment region.

Apply no pressure or friction to the treatment area.

Exfoliate carefully, as directed by your laser expert.

Avoid heat for at least two months to avoid skin irritation and redness.

If looking for Brazilian Laser Hair Removal in Delhi, one can visit DermaWorld Skin & Hair Clinics, the best laser hair removal clinic in the city.

[jackjoneuk]

How Do Disposable Vapes Help Switchers Quit Smoking?

Are you thinking of quitting smoking? If the answer is yes, you are at the right place. This blog will give you concise and brief information about disposable vapes' significance in quitting smoking habits. As disposables, like Aroma king jewel, provide many conveniences to individuals, these vaping devices are common among switchers. 

Disposable Kits Facilitate Quitters:

Although the harm caused by smoking is well known, quitting it might be a complicated process. Many smokers find quitting hard due to their addiction to a fixed amount of nicotine and psychological dependence on smoking. 

Regardless, disposable vapes, like Aroma King 8000, are crucial devices for vapers trying to quit their smoking habit. This blog contains detailed information about the importance of disposable devices in the evacuation of smoking and facilitates many ex-smokers:

Gradual Reduction Of Nicotine Intake:

Disposable devices can help switchers to cut down their nicotine consumption gradually, which ultimately helps them to quit smoking. Most disposable vapes have different nicotine strengths, at most 20mg; you can pick one depending on your craving level. 

While using vape kits like Aspire R1, switchers can start vaping with a high nic salt strength and gradually reduce the strength over time, which helps them to overcome their nicotine addiction and break the smoking routine. However, salt nicotine is an upgraded form that absorbs rapidly into the bloodstream and makes you comfortable in less time. 

Similar Appearance To Tobacco:

One of the main reasons smokers find it hard to quit is that they miss the physical texture of cigarettes and the habit of carrying them in their hands. For this concern, disposable vaping devices like Crystal Pro Max 4000 Puffs are convenient and easy to carry vaping devices, as they are designed to mimic the physical appearance of traditional tobacco. 

Additionally, disposable vapes also come in various flavours, which can help switchers find a flavour that they enjoy and make the transition from smoking to vaping more enjoyable.

Fewer Harmful Chemicals:

Disposable kits are better than cigarettes as they contain fewer harmful chemicals. Cigarettes contain thousands of harmful chemicals, including tar, carbon monoxide, and formaldehyde. 

Disposables, like Aroma King 8000, on the other hand, contain vape liquid, a blend of PG, VG, nicotine, and flavours. This makes them a 95% less harmful alternative to cigarettes and can help switchers to reduce their exposure to harmful chemicals.

Cost-effective:

Disposable kits can be a cost-effective alternative to smoking. While the initial cost of a disposable vape may be higher than a pack of cigarettes, over time, the cost of vaping can be significantly lower than the cost of smoking. For example, the Crystal bar vape 4000 Puffs is a disposable device that is available at a reasonable price.

No Secondhand Smoke:

Disposable vaping kits do not produce passive smoking effects, which can be harmful to others. This makes them a more considerate choice for ex-smokers trying to quit smoking. Due to this reason, the use of disposables, such as Aspire R1, is often permitted in places where smoking is banned, making it a more convenient alternative to smoking.

Easy To Use:

Disposable vapes are easy to use, which can make them a more accessible alternative to smoking. These devices, like Aroma King 8000, have various integrated components; switchers begin vaping by placing their mouths on mouthpieces without complicated customisations. This ease of use can help quitters to make the transition from smoking to vaping more seamless.

Wrap-up Statement:

To cap the discussion, it is concluded that disposable devices can be a helpful tool for switchers who are trying to quit smoking. They provide a similar experience to smoking, with lower levels of harmful chemicals, and can help switchers gradually reduce their nicotine intake. Disposable vapes, like Aroma King 8000 Puffs, can be cost-effective and easy to use.

[stressmanagementnearme]

Anxiety Physical Symptoms Can Be Brutally Uncomfortable And Make Life Challenging

Anxiety Physical Symptoms Can Be Brutally Uncomfortable And Make Life Challenging. However, Anxiety Is A Medical Issue, Not A Personality Trait. It's Not Your Fault, And There Are Therapies To Help Manage Worry And The Physical Effects It Can Have. For Instance, Anxiety Can Cause Headaches, Dizziness, And Heart Palpitations. These Anxiety Physical Symptoms May Worsen If Anxiety Is Not Appropriately Handled Or Addressed. For Further Information Or Treatment Options If You Experience Any Of These Anxiety Physical Symptoms Along With Your Depression, Speak With Your Doctor. Keep A Record Of Your Anxiety Physical Symptoms In The Meanwhile, And See If Any Of The Treatments Indicated Below Can Assist.

  Stress Is A Widespread Problem That Can Harm Our Health And Well-Being. To Properly Manage Stress, You Must Choose A Stress Reduction Technique Such As Stress Management, Mindfulness And Meditation That Suits Your Personality And Way Of Life.

 Look Up Stress Management Near Me Or Mindfulness Near Me. These Interactive Sessions Help You How To Recognize Stressors And Lower Your General Life Stress Levels. Participants Learn Efficient Stress Management Techniques And Learn How The Mind Works In Mindfulness Classes In Addition To Relaxation Techniques Such As Meditation.

 The Benefits Of Registering For Stress Management Near Me Or Mindfulness Classes Near Me

If It Is An In-Person Class, You Will Be Able To Visit And Check Out The Place Where The Training Will Be Held. You Can Give The Facilitator A Call In Advance And Speak To Them To Know More About The Course.

 Benefits Of Attending The Course

 Although Stress Is A Constant Companion, It Does Not Have To Be. While Stress Is An Inevitable Part Of Life, There Are Advantages To Attending Our Stress Management Workshops. We Educate You How To Spot The Symptoms Of Stress And You Learn How To Manage Your Stressors And Triggers. We Provide Instruction On How To Calm Down, Sharpen Your Focus, And Feel Better. Additionally, Our Courses Are Offered Both In-Person And Online, Making It Simple To Search For And Sign Up. In Addition To These Benefits, Workshops Can Increase Focus And Productivity. If you’re searching for a Simple Solution to Reduce Your Stress, A Workshop Is A Terrific Choice!

 Mindfulness And Meditation

 There Is No Denying The Rising Popularity Of Mindfulness And Meditation. And For Good Cause; There Are Countless Advantages. It offers Several Benefits, Including Lowering Stress, Anxiety, And Depression As Well As Enhancing Focus, Productivity, And Attention. In Addition, It Has Health Advantages; For Instance, Mindfulness And Meditation Can Enhance Your Overall Wellness And Help You Lead A Happier And Healthier Life By Lowering Your Stress Levels.

 It Takes Time To Develop A Sustained Practice Of Mindfulness Or Meditation. The Methods Must Be Mastered Over Time And Through Practice. If You Want To Achieve Lasting Results, The Most Important Thing You Can Do Is Find A Practice That You Are Comfortable With. This Indicates That You Must Seek Out A Mentor Or Teacher Who Can Point You In The Proper Route. Additionally, It Is Important To Be Patient As Mindfulness And Meditation Take Time To Develop Mastery Over Its Techniques.

[leftbirdstrawberry]

6 Books About motorcycle accident lawyer fresno You Should Read

The 20-Second Trick For 15 Best Fresno Motorcycle Accident Lawyers

Table of ContentsNot known Factual Statements About Motorcycle Accident Lawyer Fresno, Ca - Law Motorcycle Accident Lawyer In Fresno Can Be Fun For EveryoneThings about Fresno Attorney - California Motorcycle Accident Injury LawsuitMotorcycle Accident Lawyer In Fresno, Ca Can Be Fun For Anyone

Accumulate titles of chauffeurs, connect with information, insurance coverage details, and certificate varieties. You ought to also gather relevant information regarding the cars involved, such as shade, create, design, as well as permit layer amount. You need to additionally gather witness details if any sort of (best motorcycle accident lawyer fresno). You ought to compile witness titles and also contact information for potential referral. Observe testaments are actually necessary to the excellence of motorbike incident claims.

If you possess a mobile phone tool with photographic functionalities, you should photograph your accidents as well as the performance of the incident. Make sure that all your personal injuries are actually very clear in the photographs - accidents in fresno today. When photographing the scene of the collision, make sure that you photo the vital components, such as the damages to the cars entailed as well as the damage to your motorbike (best motorcycle accident lawyer fresno).

Even when there are actually no apparent accidents, a physical examination might show internal traumas. After you acquire therapy as well as have actually collected every little thing above, you need to talk to the Fresno motorcycle attorneys at Normandie Law practice (motorcycle accident lawyer fresno). Our lawyers are going to obtain your motorcycle accident case began and also begin operating in the direction of recouping the remuneration you ought to have.

What are the different kinds of compensation you could be entitled to get? Several bike accident preys that submit claims are actually eligible to get the settlement listed here: Medical expenditures, Dropped wages, Discomfort and suffering, Reduction of consortium, Property damages, Damages Although you could be entitled to get various forms of settlement, it is actually significant to note that not all preys are eligible to acquire all the types of payment - fresno motorcycle accident.

The type as well as quantity of settlement you are entitled to obtain relies on the circumstances of your mishap; consequently, you need to quickly call a Fresno regulation company to talk to California motorbike accident legal representatives who can easily give you extensive information regarding the settlement you could be eligible to get. Just how much opportunity perform you need to file your suit? If you experienced a motorcycle crash, you need to start your lawful process as quickly as possiblewithin the law of limitations. motorcycle accident fresno.

The 3-Minute Rule for 15 Best Fresno Motorcycle Accident Lawyers

If you perform certainly not file your insurance claim within the statute of limits, you could drop your right to file a claim against. You have pair of years from the day of the crash to submit your claim along with a Fresno legal professional - motorcycle accident lawyer fresno. Although the statute of limits is actually a strict deadline, some exemptions may put on prolong the opportunity you must sue.

If you were harmed in a bike collision, you have to quickly look for lawful assistance. A bike accident may leave you along with life-altering personal injuries that can leave you with hills of medical expenses. You have rights as a motorcyclist; our attorneys can easily help you submit a motorbike crash lawsuit to recoup the compensation you ought to have (motorcycle accident lawyer fresno).

Our legislation company is based on the idea that every victim must have access to legal services. A lot of preys of motorbike accidents are actually unfamiliar of their legal rights and carry out not get the important lawful relevant information since they perform not seek legal assistance with an attorney. Victims carry out certainly not seek legal support given that they worry the legal expenses linked with talking with attorneys and also acquiring legal counsel. accidents fresno.

Normandie Legislation Agency gives free of cost assessments and totally free second opinions. motorcycle accident fresno. These free of cost lawful services enable our clients to call our company without ever needing to quit to bother with being not able to afford our services. Throughout our totally free consultations, you will possess access to a Fresno lawyer with knowledge in motorcycle collisions.

If you currently have a legal representative along with one more law office, you could be fascinated in a free of charge 2nd opinion from one of our skilled legal representatives - fresno motorcycle accident. If your previous legal representative fell short to address your concerns, lead you to the details you require for a prosperous claim, or even provide you and your insurance claim the moment you are entitled to, you need to contact our lawyers quickly.

The Best Strategy To Use For Motorcycle Accident Lawyers In Fresno, Ca

If you were Additional resources injured or hurt in a motorcycle mishap, you may contact our team without concern of any sort of costs. Our legislation organization is strictly based upon backup; for that reason, you will certainly not possess to spend any lawful fees till you succeed your case and also bounce back the compensation you deserveif you carry out certainly not gain, you are going to not be called for to pay for.

fresno motorcycle crashes law office catastrophe, fender-bender, smash, hazard, accident, Using a motorbike supplies independence, as well as the locations in and around Fresno may be suitable for vacations on a bike. A motorcycle excursion can swiftly become a nightmare as a result of to a sloppy driver, nevertheless, and you or even an adored one might have recently understood the injury that can easily stem from a motorcycle mishap (best motorcycle accident lawyer fresno).

Because suit, that gathering might owe you remuneration for the losses that you have endured. A Fresno bike accident lawyer are going to assist you seek any kind of awards that you are entitled to (motorcycle accident lawyer fresno). The group at Ben Crump Legislation, PLLC is going to perform what it requires to seek economic judicature for you or an adored one.

The National Freeway Traffic Protection Administration (NHTSA) states that greater than 2,100 motorcyclists perish every year in visitor traffic collisions. best motorcycle accident lawyer fresno. Moreover, the rate of fatality coming from traffic mishaps is 16 opportunities more significant than those of travelers as well as electric motor vehicle motorists (accidents in fresno today). It is actually certainly not complicated to observe why this is the scenario.

A bike carries out not possess: An exterior metallic structure Conventional seats with spines Seatbelts Airbags Restraints Typical windscreens Defenses that automobile may normally consist of Motorcyclists are certainly not unconcerned to the fact that their picked mode of transport is actually different coming from an auto or truck, as well as in many techniques, this might be why the liberty of a motorcycle entice them - best motorcycle accident lawyer fresno.

The Fresno Motorcycle Accident Attorney Statements

Motorcyclists might likewise make sharper turns, street modifications where there is a lot less space offered, and various other steps that chauffeurs of various other vehicles can not or even will not attempt. Therefore, automobile chauffeurs might typically take action in a much more mindful, protective manner when bikes reside in their distance. Some specific steps that a driver might need to stay clear of a motorcycle incident are actually: Checking blind places completely before transforming streets Delivering motorcyclists enough span when approaching from behind Checking out crossways completely prior to bring in a left-hand spin Knowing that, depending on to the The Golden State Highway Patrol (CHP), motorcyclists may divide lanes under certain scenarios which you must permit all of them the area to perform so Ensuring that your fronts lights work, your mirrors are clean and also functional which your home windows are tidy as well as devoid of cracks or acnes Performing basic safe driving A driver who performed not practice these and various other secure driving methods may have induced you or even a really loved one to be actually injured or hurt.

One or even more of these gatherings might attempt to breach your rights or even get you to approve compensation that is actually lower than what you definitely should have, and also a legal representative is going to be actually the barrier between you and also any such tries - motorcycle accident lawyer fresno. If your legal professional prospers in their objective of securing settlement for you, then you may receive honors dealing with lost earnings, medical expenses, discomfort as well as suffering, and every other danger that has originated from your motorcyclist incident - motorcycle accident lawyer fresno.

Fresno Motorbike Accident Legal Professional Near Me ( 800) 924-3113 The group at Ben Crump Rule, PLLC would like to ensure that you or your loved one are actually certainly not injured further by accidents gone through in a motorcycle incident - motorcycle accident fresno. Carry out certainly not wait to contact our company, as the quicker you get in touch with, the earlier our experts might have the capacity to start helping you.

[decriminalizedrugsoregon]

The DPA podcast with guest Portland City Commissioner Jo Ann Hardesty offers illuminating insight into the importance of the passing of Measure 110. Although recorded and published over a year ago, in March of 2021, it still offers an important glimpse into the benefits of the measure. Hardesty references the billions of dollars used in our criminal justice system, and the lack of support for those who are processed within it in terms of recovery and rehabilitation- especially impacting our BIPOC communities. The podcast focused largely on the disproportionate impact of drug influenced incarceration and the war on drugs as a whole within the BIPOC communities, as well as the correlation between the Black Lives Matter movement and the efforts of decriminalization. They touched lightly on the importance of harm reduction towards the end of the podcast, however due to the time when the podcast was recorded and published there was little information given on how the city would move forward with this portion of the measure. We now know that they have opened one harm reduction clinic, and continue to sponsor and provide grants for others. One of the most important points made in the episode is how low level drug crimes are a part of a larger group of petty crimes- loitering, and public intoxication for example- are made to punish poverty, which disproportionately impacts BIPOC communities, and those who feel the worst impact of drug criminalization are those who are experiencing poverty or part of these marginalized communities. 

[dexrlybel0ved]

for parents with mentally ill children, written by a mentally ill girl :

these r some things (not everything; pls ask ur own child for anything else if they r comfortable and/or do ur own research) that i think r important for parents to kno :

although u may not understand ur child’s symptoms, pls try to make an effort to. it’s something that i appreciate quite a lot. this also goes for symptoms that u may find do not make sense to u, or u find irritating. remember: this is not abt u, n if u want ur child to possibly learn to manage their symptoms, u have to get over urself n b understanding.

if ur child opens up to u abt smth, pls, pls, pls try to not get defensive or invalidate them. i cannot emphasize the importance of this one enough. even if what they r saying seems odd to u, or scary, implies that u have done smth wrong (which u very well may have), or u for some reason don't believe them (this is another thing that is super shitty of a parent to do), pls listen and ask encouraging and thoughtful questions. pls refrain from getting angry, being dismissive, playing the victim, or overall just being u supportive. even if u have done smth wrong, pls try to b open minded and a good listener. chances r if ur child has decided to come to u, they r rly struggling, n opening up abt mental health is super, super difficult. pls respect n consider that as u formulate some kind of response.

it may b extremely appreciated by ur child if u do research in terms of mental health as well as symptoms of whatever disorder they may have so u may understand them better. it may also help to do so even if they have not opened up to u so u may spot warning signs of an issue going on. this way, u could have the opportunity to ask ur child if they r okay n if they need anything.

don't expect ur child to tell u everything. some stuff can b super hard to tell ppl abt, especially if it is smth that they fear will make ppl-including u-look at them differently. many may also fear that smth bad will happen or become true if they speak whatever it is aloud. in addition, if they r in some kind of therapy, do not demand information from either ur child or their therapist. it's hard enough to tell a therapist smth, nevermind ppl a child is quite close to, n thus ppl whose opinion matters to them immensely (most of the time). if u r curious (which is not a crime, btw!), u can gently ask for anything they'd like to share, all the while ensuring they r aware that they r by no means obligated to tell u things they may not want to share.

if u r worried that ur child is at risk of causing any harm to themselves, whether it b some kind of self harm, remember:

this is most likely outside the realm of things u can adequately n properly deal with. since u will b alarmed n afraid, u may react in an unhelpful way, i.e. becoming angry, yelling, etc. not only this, however; u will b quite biased as this is ur own child. pls consider reaching out to professionals so that ur child will get the proper care they need. even tho this will b hard for both parties, it is most likely the best course of action.

in cases of self harm, if u feel that this is smth u can deal w at home/by urselves, pls reconsider doing the thing that most parents do: removing all items used to harm oneself. it may b helpful to think of sh as being akin to a drug addiction (which it is); quitting cold turkey does not often do the trick, n often leads to a relapse or use of unsafe materials. therefore, harm reduction is much more important: ensuring the materials ur child uses r safe/clean, providing bandages n disinfectants, encouraging ur child to talk to u abt this, n providing them the opportunity to come to u for a ride to the hospital for further treatment should it b necessary.

be mindful of the way u speak abt mental health issues, n just the things u say in general. if u r speaking abt someone else's mental health in a way that stigmatizes it further, or portray mental illness as shameful/demonize it, doing so may b the difference between ur child asking for help or spiraling further on their own. in addition, if u r aware of ur child's triggers, pls remember to attempt to avoid triggering them. even tho we all make mistakes, n we r bound to mess up at times, if u do so too much, not only r u not acting as a parent should, u r also indirectly communicating to ur child that u do not care, or do not feel they r valid.

n last but certainly not least: love them. b there for them. n make sure they kno just how much u care. once again, this is most definitely not everything, but these r just some things that i personally feel r a good way to make us children feel safe around parents <3

[timefortrees]

Review of the schools of thought related to measuring tree vitality in urban trees through tree growth, physiological measurements and chlorophyll fluorescence testing

Understanding the health of our urban trees is an important part of any arboriculturist role, but how exactly is it that we can measure this? There are different schools of thought related to the measuring of tree vitality which revolve around tree growth, physiological measurements and the testing of leaf chlorophyll fluorescence. However, measured, the subsequent information from measuring a trees vitality can be essential in some tree management situations. Being able to know the vitality of a apparently declining tree can make all the difference in the decision to fell or retain, if it shows good vitality then there is an argument for retaining as the tree may be through whatever stress or strain has caused the initial decline and may now be in the process of recovering, however if a tree is in decline and shows poor vitality it is likely it will continue along the downward spiral of decline and removal may be a justified option.

Tree Growth

Tree growth as a method for measuring tree vitality is based upon the principle that a tree will grow less if it is stressed or unhealthy (poor vitality) and as such will be smaller than it would otherwise be if the tree was healthy and without significant stresses. There are several different measurements of tree growth that can be used to measure tree vitality.

A measurement of tree height and diameter at breast height have been used for many years in regard to tree vitality. These measurements have been used in many experiments into the effects of various commonly occurring tree stresses such as planting depths and the effects of drought. These measurements are simple and quick to attain and can be carried out by anyone with a basic understanding of how to measure heights and diameters. The methodology is based around the principle that a stressed or tree with low vitality will have a thinner diameter stem and be shorter in height, whilst I cannot dispute the logic or the accuracy of this there are a few issues with the use of this method on mature urban trees.

The measurement of tree height and diameter at breast height has significant benefits on assessing young , newly planted trees in experiments and the urban environment, however when it is used on older and larger trees they are some questions over its effectiveness. Over the course of a trees life it is likely to experience a wide range of external stresses and strains which may vary from natural environmental stresses to those caused by the activities of humans. The intensity and frequency of these external factors may vary from tree to tree within the same street and even more so over the expanse of a city, county or country. As such the tree height and diameter at breast height is likely to be so variable on older trees that it cannot be definitively used as an accurate measure of a trees vitality and this doesn’t include the natural genetic variance between specimens that may have a significant effect on the potential growth rate of any one tree. Of course, extremes will be present and reliable such as an avenue of lime trees all planted at the same time, if one of them is significantly shorter and has a smaller trunk diameter at breast height it is likely that its vitality is lower than its surrounding larger neighbors, however, this could be genetic.

It is important to remember that trees have stored resources and their growth rates partly depend on the previous years stored carbohydrates. As such all tree growth measurements will suffer from time lag, meaning that there is potential for either the reductions in growth rates to be measurable too late after the external factor occurred and subsequently caused significant harm to the tree or the event has occurred and has been ”dealt with” by the tree making the measurement “out of date” and fairly irrelevant as a one off measurement.

It is important to remember that trees growth varies from year to year due to an immeasurable amount of external factors, unless the measurements are fairly extreme one way or another I feel that the usefulness of one years measurements have the potential to be fairly irrelevant within the lifetime of many tree species.

However, what about the leaves? On deciduous trees these are replaced each year.

There are methods for measuring the leaf area of trees and using this as a measure of tree vitality. Leaf area index is the ratio of leaf area to ground area and is a widely used method for analysing the growth of crops or forest areas. It is not really practical or effective when used for individual urban trees. For individual specimens we are able to measure direct leaf areas and combine this with leaf weights to create a ration call the specific leaf area (SLA). SLA is defined as the ratio between projected leaf area and leaf dry mass. The SLA reacts sensitively to many factors that affect trees such as the availability of resources (light, nutrition) and hydraulic limitations and lower water potentials in greater branch heights. Because of this it is essential that leaves are harvested from similar positions within the trees (aspect, height, distance along branch) to ensure accurate comparison with surrounding and other measured trees. SLA is effectively a measure of density and subsequently health of individual leaves. Because leaves are regularly replaced (albeit at different rates for different species) this allows for a more “up to date” measurement of tree vitality. A lower SLA will tend to indicate a lower tree vitality, in studies by Pierce et al. 1994; Cornelissen et al. 2003; White and Scott 2006; Poorter et al. 2009, it was found that trees that are well supplied with nutrients tended to have a higher SLA than the same species of tree positioned in nutrient poor environments.

The SLA of a leaf is highly sensitive to a wide range of factors, many of which may vary throughout a growing season, light, nutrient availability, and as such the results should be compared against many other trees of the same species and in similar growing positions to allow for an accurate result. The impracticality of this method is a significant downside to it, the removal of leaves from different parts of the tree, whilst also being the same positions on other tested trees, will require aerial access (climbing, MEWP) which requires time and money. Unless the tree is particularly valuable or a study is being conducted it seems unreasonable to expect a tree owner to be funding such a investigation when there are many other methods available.

Tree canopy architecture can be used as a measure of tree vitality. It is commonly used by tree inspectors, to be honest it is commonly used by everyone who looks at a tree and states they think it looks “unhealthy” or “that tree doesn’t look right, I think we should get someone to look at it” , although many people are using the basis of this method unknowingly. In 2017 at the arboricultural association annual conference Dr Andreas Roloff presented a methodology of using above ground symptoms as a measure of tree vitality, within which he proposed that the crown transparency and branching patterns of trees are the most practicable methods for assessing tree vitality.

Crown transparency is an easy to learn, fast to carry out and above all a practicable method for tree vitality assessment, it relies upon the differences in the amount of light penetrating a tree canopy and is graded on a scale of 0-3.

Although it has important benefits there are significant disadvantages with this method.

· There are natural variations in crown transparency. E.g Betula pendula allows high amounts of light through its canopy whereas at the other end of the scale Cupressus × leylandii allows very little.

· In deciduous species this methodology is only really reliable for 4 months of the year

· Fructification and weather can influence the results

· Damage to the tree such as branch loss will result in increased light penetration and can lead to result misinterpretation.

· In some trees it is not possible to have 10% crown transparency due to their growth characteristics, which will mean they are at best ranked as 1 or 2 on the scale despite not having any vitality issues.

· Tree age can affect the results

Because of the above issues Roloff proposed that the use of branch architecture is a more accurate measure of tree vitality. He proposed that using branch and canopy architecture we can assess a trees vitality at all time of the year. Below is an image showing the vitality stages 0-3 in relation to branch and canopy architecture.

0 At stage 0 we can see the canopy is dense, there is good crown extension, and the branch architecture is very spear like.

1 At stage 1 the outline is spikey, the outer crown has started thinning, and the canopy has some bottle-brush type shapes at its periphery. There is little or no spear like architecture.

2 By stage 2 the canopy is getting sparser, it only contains short shoots and appears more bushy in nature rather than as a singular canopy.

3 Stage 3 shows the canopy retrenching. The leader has died back and the crown is reducing in size and density.

(the image to the left is originally from A.Roloff presentation at the 2017 AA conference)

This methodology is easy to understand and put into practice, in fact many people utilize its principles everyday without necessarily knowing. Most importantly it is effective for 12 months of the year.

The main downside or at least potential for misuse/ misdiagnosis is that the rough age of the tree should be known and whether the condition of that tree is normal for that age. For example, Quercus robur is a long-lived tree, but is known for its natural retrenchment until it becomes short and squat. If a mature Quercus robur is at stage 2 and is considered to be approximately 500 years old we could consider that to be fairly normal and that unless there is obvious indication otherwise, it is likely entering its natural retrenchment stage. However, if the same tree was only around 150 years old, being in stage 2 would indicate that something is wrong and causing the tree to enter early retrenchment or mortality spiral.

While this is an extremely useful and effective method of measuring tree vitality, I do feel it is also only formalising what many people do when assessing trees already.

Physiological measurements

Electrical admittance/impedance

Shigo and Shortle developed the principle of using electrical admittance/impedance for measuring the vitality of trees. The principle states that trees with a higher vitality have higher moisture content, therefore a higher concentration of mobile cation in their vascular tissues and lower concentration of mobile ions. Shigo developed his “Shigometer” as a tool for measuring electrical admittance/ impedance. It uses two needle probes that are pushed through the bark, cambium, and slightly into the wood. The pulsed electrical current from the meter passes through one needle, through the tree tissues and back through the other needle to the ohmmeter in the “Shigometer” where resistance in kilohms is measured. Because the cambial zone is so moist and contains high amount of cations most of the current flows through this zone. The higher the electrical resistance, the less vital the tree. It is important to have a baseline for which to compare the readings against, to do this at least 20 healthy trees of the same species need to be measured prior to testing.

Harris, Clark, & Matheny, developed the plant impedance ratio meter in 2004, it used two needle probes like the “Shigometer” but instead measured the impedance of an alternating current over 2 frequencies to measure the cambial electrical resistance (CER).

There have been many studies into the effectiveness of measuring cambial electrical resistance (CER) and using it has a measure of tree vitality which have produced mixed results. Effectively there are some issues with the methodology. The reliability of the results fluctuates between different tree species, cause of tree stress and time of year, there is certainly a difference in the amount of moisture within the tree at differencing times of year. Research cited in “The measurement of plant vitality in landscape trees” by Denise Johnstone, Gregory Moore, Michael Tausz and Marc Nicolas, stated that Clark, Kjelgran, Hushagen, and Fiore (1992) found that CER was not able to detect changes in tree vitality when compared against the diameter growth on Liquidamber styraciflua but conversely Martinez-Trinidad et al. (2010) could detect the tree vitality in mature Quercus virginiana when compared to a visual assessment of the trees when their symptoms were acute. A number of other studies produced similar variance in the effectiveness of CER.

In 2006 Gibert, Le Mouel, Lambs, Nicollin, and Perrier found evidence of a direct relationship between sap flow and electrical potential in the trunk of a Populus nigra in the spring, but not so in the summer. This indicates that the time of the year is likely to have a significant effect on the results of any electrical resistance or admittance-based testing.

Gaseous exchange

Carbon dioxide intake and water release take place through tree stomata. The measurement of gaseous exchange can provide an indication of tree vitality. These measurements allow for the estimation of CO2 assimilation, stomatal conductance and transpiration. Research by Epron, Dreyer and Breda in 1992 found that a Quercus petraea suffering from drought stress showed declines in leaf CO2 assimilation, similar results were found on Quercus ilex by Peria-Rojas et al in 2005. If very little gaseous exchange is occurring then it is likely that low vitality is present, whereas high amounts of gaseous exchange would indicate a good vitality and healthy tree. There really needs to be a baseline to compare the readings against in many cases and tests on multiple trees of the same species in the same area would be needed to form any reliable conclusion on a singular urban tree in the absence of some extreme results, e.g. no gaseous exchange. The measurements taken in measuring gaseous exchange are carried out by an infrared gas analyser (IRGA), this is a complex tool to use and is also expensive to purchase, because of this it is primarily only used for research purposes. Gaseous exchange can only be carried out while the tree is in leaf and presumably while the tree is not subjected to some external factors such as drought. While droughted a tree will close its stomata so there is likely to be a notable reduction or cessation in gaseous exchange and water release through transpiration as such testing at this time would not provide an accurate measurement of tree vitality and it would be predictable that the tree would not be in full health, although after the drought event the use of this method could indicate which trees, for example, along a street suffered worse because of the drought event and subsequently may need different management.

Chlorophyll fluorescence testing

Normally a healthy tree will use about 78-85% of the sunlight it receives at the leaf surface for life processes such as photosynthesis. The remaining sunlight is dispersed or reflected. A tree leaf will do this through non-photochemical processes: re-emitting in the form of infra-red radiation (heat) or as far-red radiation (chlorophyll fluorescence). This all changes when a tree is not in optimum health, lowered vitality. For example, after a period of drought the rate of photosynthesis is likely to be reduced, and as such more energy from the sun will be dissipated as infra-red radiation (heat) or as far-red radiation (chlorophyll fluorescence).

Chlorophyll fluorescence is a non-invasive measurement of photosystem II (PSII) activity, it has developed from a fairly novel technique to a widely used technique in plant physiology. Photosystem II is extremely sensitive to the influence of abiotic and biotic factors and as such the measurement of this allows us to understand otherwise invisible physiological changes a plant has/is experiencing and provides us with an accurate measure of how environmental change can affect a plant. The tools and equipment to carry out chlorophyll fluorescence testing have vastly improved over the last decade or so, it is now an affordable piece of equipment that can fit in a pocket or small pouch which connects to a portable computer device such as a tablet which provides detailed and easy to understand data about the test subjects physiological health. Some tests are now so sensitive that they may pick up physiological stress weeks before it manifests as a visible symptom.

Although the use of many modern devices is very simple, the science behind it remains complex. Below is a diagram that shows a simplified depiction of events in photosystem II that allow for identification of the key parameters used in chlorophyll fluorescence testing. It is originally from Chlorophyll fluorescence analysis: a guide to good practice and understanding some new applications written by E.H. Murchie and T. Lawson.

A-     A schematic figure which shows the electron transport within the photosystem II reaction centre complex. Energy that is absorbed by chlorophyll within this light harvesting complex is either dissipated vie photochemistry, by heat or as fluorescence. These processes are always in competition which allow for the efficacy of photosystem II to be measured.

B-     Shows a typical fluorescence trace made on a dark-adapted leaf material which shows how and are formed. The measuring beam of the chosen testing tool excites the chlorophyll but is not enough to be able to cause electron transport through photosystem II. This gives , the minimum amount of fluorescence, reaction centres are open at this point. Once the measuring tool creates a pulse of light the maximum possible yield of fluorescence () can be found. During the pulse of light, the reaction centres are closed.

C-      Shows a schematic figure which explains how the transfer of energy and electrons within photosystem II results in open and closed centres as well as the creation of and . The excited state and the subsequent transfer of an electron to the primary acceptor causes a closed centre. cannot accvept another electron until it has passed its electron onto the next electron acceptor (). It should be noted in the context of chlorophyll fluorescence that and are bound quinones and is a type of chlorophyll.

The most commonly used measurement of chlorophyll fluorescence is / where F is the difference between the maximum () and minimum () fluorescence. / is widely considered to be the theoretical measure of the quantum efficiency of photosystem II if all of the reaction centres are open during photosynthesis. The values of / are generally between 0.78 and 0.85 on healthy and non-stressed specimens with the optimal value for most leaves being 0.83.

Chlorophyll fluorescence testing has a vast array of uses within arboriculture from monitoring the health of nursery stock during growth and before planting to inspecting trees suspected to have been adversely affected by changes in surrounding land use or development. The modern devices and tools for carrying out measurements have made this form of vitality testing widely available and affordable and I expect to see an increase in its use in the future. The largest drawback of this testing is that it requires leaves, limiting the time of year when testing can be carried out quite significantly.

The use of unmanned aerial vehicles

The development of unmanned aerial vehicles (UAV) over the last decade or so has created a potential arboriculturally related platform for their use. As UAV’s become more affordable, accessible and are developed so as to be able to carry more complex equipment it was almost inevitable that someone was going to attempt to use them in the field of arboriculture at some point. A UAV with a camera allows the user to quickly view large areas of land, for example some woodland, or view the upper parts of a tree in greater detail than if that person was stood on the ground using binoculars. The images/video is also recorded and stored for future analysis.

It is now possible for UAV’s mounted with thermal and/or narrow band multispectral imaging equipment to be used in the assessment of tree vitality. The ability of a UAV to fly and view a large area in a short time makes it a very versatile tool indeed. Areas of woodland or forest can be assessed in a fraction of the time compared to on foot and individually inspecting each desired tree and a tree or group of trees vitality can be easily compared against the wider tree population. This is an important feature as it allows the surveyors to assess whether it is individual trees that are stressed, groups of trees or even an entire tree population, being able to highlight pockets of stressed trees amongst a forest or urban forest is useful for assessing how species are coping in certain areas.

Aerial imagery using thermal and narrow band multispectral detects the sun induced fluorescence (SIF) or dissipated heat produced by trees during photosynthesis. Any alteration in the efficiency of one of the components will affect the other. Light that is re-emitted by the tree as sun-induced fluorescence is a small emission but is a strong proxy for tree photosynthesis. Tree responses to environmental stress, such as, light, nutrients, water availability and, extreme temperatures, affect the photosynthetic rate and therefore fluorescence emission.

Tree temperature is related to stomatal conductance and transpiration associated evaporative cooling. When stoma close, under water stress conditions, vegetation temperature increases and the transpiration rate decreases accordingly. Consequently, the temperature of the tree can be used to learn information about transpiration and the health of the tree.

Trees have various mechanisms to overcome the excessive reduction of the light energy transferred when photosynthesis is reduced. This includes downregulating the rate of electron transport in cells and dissipation of excess energy controlling the pool of xanthophyll pigments. The dissipation of excess energy by non-photochemical quenching through the xanthophyll cycle is one of these mechanisms. Non-photochemical quenching is linked to tree stress, caused by limited resources and to the tree photosynthetic activity through the associated changes in the reflectance of the blue and green regions of the spectrum. When excess excitation energy accumulates in the leaf, the chloroplast thykaloid pH gradient increases, and the xanthophyll cycle is activated. These chemical changes affect the spectrally selective absorption of light, the relative absorption by each pigment and hence the leaf spectral reflectance and transmittance factors.

The use of UAV’s allows the aforementioned tree changes to be monitored on a wide scale in relatively small amounts of time. The results can easily be compared over multiple surveys and years. The main downside to this technique is that like, chlorophyll fluorescence testing, it relies on the trees being in leaf which limits the months each year this is usable, however, the large number of trees able to be tested at a time reduces the hindrance of this as a forester could easily survey their entire stock within the limited time window each year. There are restrictions to UAV usage in and around urban environments and airports, however with the evolution of licenses and professional competencies this has become less of an issue over recent years, there are now many professional UAV survey companies available who are licensed to operate in urban areas.

Conclusion and discussion

There are a number of different methodologies and techniques for measuring tree vitality, some are more complex than others, whilst some are used in their basic form by many people without them even knowing (crown/branch architecture).

Methods such as electrical impedance/admittance testing were promising and useful in their time, however advances in technology and scientific understanding of trees has, in my opinion, made this an outdated method with only niche uses in current times. Their unreliable results that were affected by the time of year and the subsequent changes in moisture within the cambial layer of the subject tree made the reliability of the results unpredictable.

The use of tree measurements, height and trunk diameter at breast height, is limited. Although these are basic bits of information regularly recorded during tree inspections/ surveys they are effectively useless on their own. To give insight into the health of the tree there needs to be baseline measurements for that species or a number of previous years measurements of the inspected tree to compare against. Where such information exists these basic measurements can be useful, similarly when a group of the same tree species, that was planted at the same time is compared such measurements will highlight specimens that are not growing as well as the rest of the group. However, there are endless factors that may impact on tree growth over a period of years or even a single year so this methodology should be used in conjunction with other visual findings.

The use of branch architecture is a great system for assessing tree vitality, it can be used 12 months of the year and take little skill or time to learn. I do think that it is not a new discovery or methodology, rather, a formalization of what many people did already, some without realizing. It is however extremely important to take into account the point in its life cycle that the tree is already in, concluding that a veteran tree does not have a positive future outlook due to some thinning of the canopy is not only a gross misunderstanding of the tree and methodology but potentially damaging to the development of future veteran and ancient tree habitats.

Chlorophyll fluorescence testing, this is a highly complex method for assessing tree vitality, behind the tools. But using the modern advancements in testing tools is simple, quick and accurate. The development of some of the most up to date tools that produce graphs and easy to understand data on a tablet is a significant step in not only being able to assess tree vitality, but in communicating it to the client whilst also justifying any management decisions with hard data.

The advancements in UAV technology over recent years has allowed for the development of their use for surveying trees. The usage is still relatively low, compared to the other methods, however it has the potential to be a game changer. For a tree manager to be able to survey the vitality of their entire tree stock in a fraction of the time it would normally take is a significant advancement in tree health care. It will allow the tree manager to pin point trees that are showing early signs of ill health that are invisible to the naked eye, allowing for early treatment.

The important part of any tree vitality assessment is choosing the most appropriate method for the situation. Visual checks and measurements are arguably the most commonly used and, in my opinion, always will be due to their everyday occurrence, sometimes sub consciously but every day for tree managers nonetheless and even with advancements of other techniques, such as UAV’s tree managers and surveyors will still visually inspect a tree that has been highlighted by other techniques when they are sent to investigate further. The advancements of chlorophyll fluorescence testing may narrow the gap in future years due to the affordability and production of tree vitality data that can be used in reports, however, I believe that UAV technology is going to be a significant part of the future of tree management. The ability to survey large areas of tree populations in a short period of time, whilst detecting changes in tree physiology that are invisible to the naked eye is a game changer. I foresee this technology being widely used in the coming years and decades as the basic and initial survey technique, with traditional physical inspections being used once trees have been highlighted as stressed or showing lower vitality than normal.

Ultimately, as with most inspection techniques and tools, a combination of multiple techniques will, in my opinion, provide the most accurate and reliable results whilst allowing the tree managers tool kit to remain versatile and able to accommodate the wide range of situations and environments that the future will bring.

(The above text is based on information originally found in “  Specific leaf area of European Larch (Larix decidua MILL.)” written by Helga Fellner, Gerald F. Dirnberger and Hubert Sterba, Pierce LL, Running SW, Walker J (1994) “Regional-scale relationships of leaf area index to specific leaf area and leaf nitrogen content. Ecol Appl 4:313–321”, Cornelissen JHCA, Lavorel SB, Garnier EB et al (2003) “A handbook of protocols for standardised and easy measurement of plant functional traits worldwide. Austria J Bot 51:335–380”, White JD, Scott NA (2006) “Specific leaf area and nitrogen distribution in New Zealand forests: species independently respond to intercepted light. For Ecol Manage 226:319–329”, Poorter H, Pepin S, Rijkers T et al (2006) “Construction costs, chemical composition and payback time of high- and low-irradiance leaves. J Exp Bot 57:355–371”, “ The Measurement of plant vitality in landscape trees” written by Denise Johnstone, Gregory Moore, Michael Tausz and Marc Nocolas, “Visual assessment of tree vitality via branch architecture” by Professor Dr. Andreas Roloff – PDF presentation and audio of initial presentation viewed from https://www.trees.org.uk/Amenity-Conference-2020/Conference-Presentations/Conference-Presentations-2017#wednesday , “Modern Arboriculture” written by Alex L. Shigo, Kate Maxwell, Giles N. Johnson, “Chlorophyll fluorescence—a practical guide, Journal of Experimental Botany, Volume 51, Issue 345, April 2000, Pages 659–668”, “Chlorophyll fluorescence analysis: a guide to good practice and understanding some new applications” written by E.H. Murchie and T. Lawson, “Early Diagnosis of Vegetation Health From High-Resolution Hyperspectral and Thermal Imagery: Lessons Learned From Empirical Relationships and Radiative Transfer Modelling” written by R. Hernandez-Clemente, A. Hornero, M. Mottus, J. Penuelas, V. Gonzalez-Dugo, J. C. Jimenez, L. Suarez, L. Alonso and P. J. Zarco-Tejada, “Estimating chlorophyll with thermal and broadband multispectral high resolution imagery from an unmanned aerial system suing relevance vector machines for precision agriculture” written by Manal Elarab, Andrres M Ticlavilca, Alfonso F. Torres-Rua, Inga Maslova, Mac McKee)