Car Rental Coupons

Rental cars have become quite popular during the current economic slowdown. People who plan to buy a used car or even a brand new car is getting attracted to different car rental agencies because of the tough competition, cheap prices and unbelievable options car rental companies offer. Several car rental agencies offer car rentals coupons throughout the year for various reasons. Some of the agencies want to promote their business during off season while some other agencies offer car rentals coupons so that their service will be cheaper than that of their competitor who offers similar services.

Once you finalize a rental company suiting well to your needs, you can check on their official website for ongoing discounts and rental coupons. These coupons come with different offers. Some of the coupons offer a discount on rate from 10-50% while some others add 1-5 extra days to your booking period without extra cost. It is up to you to choose the right type of discount. If you plan to rent for long term, a discount on the rental price will be the right choice for you. If you plan a trip for 7 days and find a coupon offering ‘book for 5 days and get 3 extra days free’ will be the right choice for you.

There are several websites that compare different car rental services and their rates. These websites also highlight the ongoing discounts and coupons available. Such comparison websites are a good choice to know what is going on in the neighborhood but always watch out for scam. Try to rent your car from a reputed car rental agency but also check for any hidden costs. Then check for car rental coupons offered by such reputed agencies.

Some coupons also provide free insurance coverage for a selected number of days and some additional accessories like GPS or child seat for free of cost. Such promotional offers may or may not be useful for you. For example, if you are planning to travel somewhere you are not very familiar, a coupon offering free GPS navigation system can be a great choice for you because you hardly will ‘get lost’ somewhere. Similarly a free child seat is good for you only if you are travelling with a child. Car rental companies design their coupons targeting different customers and their various tastes.

If you are planning to rent a car for your vacation trip or for your everyday requirements, check with different agencies for their specialized coupons. Don’t assume that you will not get a discount coupon because its holiday season. There are several service providers and several offers throughout the year and you will not find the best for yourself without constantly checking for them. Websites such as carrentalmomma.com and rentalcarscode.com have coupons throughout the year with a wide array of offers. Even Google is a great place to find information on best deals available.

What New Drivers Need to Know About Car Insurance

If you are a new driver, there are several things that you will need to know about car insurance. The most basic rule though, is that if you are going to drive a car, you must carry some form of coverage. This is just one fact you need to know pertaining to auto insurance. Listed below are several more things you will need to know as well.

Locating a Provider

First of all, in the past, you would have to sort through page upon page of ads in your local yellow pages to locate insurance providers in your area. Then, you had to phone them one by one to get quotes. However, this is no longer the case. The Internet has made locating insurance companies extremely easy.

You simply need to choose one of the many car insurance comparison websites available and type in some basic information pertaining to you and your car. The site will then match you with several providers in your area. At this point, you can choose to have these companies phone you, email you or both.

Comparing Coverage and Rates

The next thing you must know about auto insurance is how important it is to compare the coverage and rates of several providers before you choose one. Different companies offer varying rates, coverage and even discounts. With that said, you should always contact the providers in your area and find out more about them before you choose to purchase a policy.

When it comes to discounts, if you search long enough, you are sure to find some valuable ones that will help reduce your insurance premiums. Many insurance providers offer attractive discounts in an effort to gain clients. Some of the discounts that are commonly offered include new drivers, senior citizens, excellent students, safe-driving courses, air bags, safety equipment and good driving histories.

Raising Your Deductible

In addition to discounts, there are many other ways you can reduce your insurance premiums. One way is to opt for a higher deductible. This is a matter of choice, and you should think this through carefully before making a decision. While a high deductible will lower your monthly premiums, you may have to pay more should you become involved in an accident.

Liability or Full Coverage?

Another thing you need to know about car insurance is the difference between liability and full coverage. Liability is the minimum coverage that you can purchase, and it will provide compensation to other drivers in the case of accidents if you are at fault. However, it will not pay for any damage to your car or injuries to you or your passengers.

Full coverage is much more expensive than liability but there are many benefits to this type of coverage. The best thing about full coverage though, is that it not only will pay for the other driver’s damages and injuries, but it will pay for yours as well. In many cases, it will also cover such things as theft and damage to your car due to weather conditions or falling objects.

These are just a few things that new drivers need to know about car insurance. If you are a new driver, the above information can help steer you in the right direction when choosing a policy to suit your needs. However, always remember that you should compare the rates and coverage of several providers before choosing one.

Perfect Beaches for Holiday Rentals in Murcia

Murcia, located along Spain’s Costa Calida, is known for its year-round warm, sunny climate which attracts holidaymakers to the region. With an abundance of villas for rent on resorts such as Polaris World’s Mar Menor Golf Resort, La Torre Golf Resort and El Valle Golf Resort tourists can rent luxury Murcia villas with private pools or affordable apartments and take full advantage of resort facilities such as communal pools, playgrounds, tennis courts and nearby restaurants.

If you’re planning on looking for holiday rentals in Murcia this summer make sure you explore the local area and visit the many beautiful beaches on offer. Murcia, also known as the Costa Calida in Spain offers over a hundred beaches for everyone to enjoy, whether you want to travel by boat to a picturesque deserted cove, or relax on a stretch of sandy beach to soak up the sun.

Simply travel a short distance from Murcia city to the coast to explore popular areas. Beach towns to visit include Mar Menor, San Javier, Cartagena, Mazarron, Aguilas, San Piedro del Pinatar and Lo Pagan. The Mar Menor in particular ( a large salt water lake effectively) is a really popular area to visit, with its warm Mediterranean waters and vast, golden beaches, shallow waters and small waves; Murciabeaches really cater for everyone.

Mar Menor beaches

Villa Nanitos

Located on the Costa Calida above Lo Pagan, the Villa Nanitos beach offers water skiing, volleyball, windsurfing and sea kayaking. Nearby are the mud baths of San Pedro del Pinatar; well worth a visit.

La Llana

Located on San Pedro de Pinatar, Mar Menor, this is a blue flag beach and can get busy during peak season. It is a long, sandy beach and foot showers are available during the peak season. The waters here are mild and so perfect to take a dip.

El Espejo

Another blue flag beach, El Esperjo can also be found on the Mar Menor coastline. This sandy beach is perfect if you fancy a spot of surfing, volley ball and kayaking. The waters here are calm.

Los Nietos

This is another popular Mar Menor beach. It offers 4km of long grey, sandy beach with shower facilities, as well as lots of restaurants and calm waters.

San Javier beaches

Euromanga

Euromanga beach is located in San Javier, Murcia. It’s typical of the La Manga stretch, which means its golden sands and pleasant waters attract many tourists and locals.

Castillicos

This San Javier sandy beach offers a picnic area, snack bar, accommodation, showers, beach cleaning and houses a Red Cross station. Lifeguards also patrol the area, and it’s also one of the safest beaches as it’s patrolled by local police.

Cartagena beaches

Cala Cortina

Close to Cartagena, this Murcia cove is located just a couple of minutes drive away. The locals will cycle and walk to Cala Cortina to enjoy a day of relaxation; spend a peaceful afternoon here with friends or family.

Calblanque

Calblanqueis a protected nature reserve, home to sandy beaches and coves. This beach is one of the few you are allowed to take dogs down to, so it’s advisable to keep away from the lower end of the beach if you wish to avoid the family pets. As it’s a protected area, there are no facilities like restaurants or bars, but there is a car park.

Cala Medina, Las Melvas and Levante

This group of three beaches are small beaches, with slightly less calm water. They range from sand to gravel to rock. There are restaurant services nearby, and it’s the perfect location if you fancy a spot of snorkelling.

El Portus

This is a very quiet beach in Cartagena. It’s sandy, and does offer showering facilities, but has limited disabled access as it’s difficult to reach.

El Belonte Grande and Salitrona

These two beaches in Cartagena are short and sandy, and are only accessible by boat or on foot, so they’re perfect if you’re looking for a quiet spot. These coves are very beautiful, surrounded by mountains with wild vegetation.

La Calera and San Gins

La Calera and San Gins are gravel and sand beaches, with calm water making them suitable for families. They offer reasonable facilities such as showers, as well as a few restaurants and shops nearby.

Mazarron beaches

Bolnuevo beach

Bolnueva beach is located at Mazarron, Murcia. This lovely golden sandy beach is great for families, and offers a picnic area, snack bar, showers and toilets. It’s also got a Red Cross Station and lifeguards on duty, in addition to offering water sport equipment for rent. It can get very busy during peak seasons, but generally isn’t quite as busy as other blue flag beaches along the Costa Calida.

Nares

Also located at Mazarron, Murcia, this golden sandy beach is great for children with its calm waters and shower facilities.

El Castallar

Facilities available: This beach is located near the town and harbour of Mazarron. El Castallar is a sandy beach, with lovely clean, calm waters. Although popular with families, this beach does not get quite as crowded as some other Blue Flag beaches in this region. Facilities include snack bars, restaurant, showers, telephones, beach cleaning, and a Red Cross point.

El Rihuete and Puerto de Mazarrn

These sandy beaches are perfect for families exploring the Mazarron area, with plenty of local shops and restaurants.

Aguilas beaches

Las Delicias

The sand and pebble beach of Las Delicias can be found in Aguilas, Murcia. It offers many facilities such as a snack bar, restaurant, showers and it also has a Red Cross station, is manned by life guards and patrolled by the local police, so it is an extremely safe beach to visit.

Poniente

This urban-setting beach offers a snack bar, restaurant, toilets, showers and parking. It’s a very popular beach in the summer months.

Calabardina

This beach is also located at Aguilas, Murcia. Its waters tend not to be as calm as other beaches in the region, making it more exciting for water sport enthusiasts. It offers a Red Cross point, parking and beach cleaning, and again, Calabardina can get quite busy.

Levante

Sizes at just over 440 metres, Levante beach offers a snack bar, restaurant, showers, a Red Cross station, lifeguards. Ideal for children, this popular beach is sandy, with calm waters.

Abejerro and Las Pulgas

If you’re after quiet sand and gravel beaches, head to Abejerro or Las Pulas in Augilas. These are both quiet, unspoilt beaches, unfortunately there are no facilities at either location.

Punta del Fraile

This beach is only accessible by foot and offers great, clear water for snorkelling.

Lo Pagan beaches

Villanitos

Villanitos can be found in San Piedro del Pinatar, Lo Pagan, Murcia. It has plenty of facilities available for use, such as snack bars and restaurants, toilets, showers, parking and if you want to take part in water sports, there is equipment available for rental. Calm waters and it’s large, mostly sandy beach make it very popular.

La Puntica

This is a sandy beach, with calm waters. Like many beaches in Murcia, La Puntica offers a restaurant, snack bar, showers, toilets, beach cleaning and a Red Cross station, and is patrolled by lifeguards and local police.

Lorca beaches

Bao de las Mujeres and El Ciscar

These beaches are located further south of the coast, at Lorca. They are both short beaches
, offering fantastic fishing opportunities as well as being perfect locations for swimming and snorkeling.

AED – Automatic External Defibrillator

How many chances do you have in your life to save another?

Purchasing an AED (automatic external defibrillator) may seem as simple as purchasing a copier machine, but the choices you make today, may be instrumental in more than just reducing your insurance policy-it may actually save a life.

Just a few short years ago, the very concept of a average person using a defibrillator on a person in cardiac arrest may have resembled a comedy movie. Fortunately today, the advancement of technology has transformed science fiction into everyday convenience. The modern Automatic External Defibrillator is safe to use, simple to operate and portable enough to go anywhere.

With rapid advancement of technology comes explosive opportunities for the marketplace. Entire companies now focus on the manufacturing and sales of this important, life-saving device. With a wide variety of choices, colors, models and prices the uninitiated buyer will most definitely be confused.

Here are the 7 key things you should insist upon when purchasing an Automatic External Defib.

Company

Variety of models. A “one size fits all” isn’t a good strategy. You may only have a single need, but a distributor with a variety of options will be able to custom fit the right device with your organizational needs.

Other medical equipment. On the surface it seems that a company that specializes in AED units would be the logical choice. However, by working with a company that has other medical equipment available, you’ll be working with a supplier for all your needs. Customization with one-stop shopping!

24/7 Support. While shopping may be a daytime activity, your lifestyle may not. Be sure to work with a company that has 24/7 support either by phone or online where you can get your order fulfilled, product tracked and questions answered.

Product

Charging of the unit. What is the shelf life of the unit? How long can it last without be charged? What is the expiration date of the unit?

Accessories. Does the product come with pads compatible for children? Is it wall mounted on in a kiosk? Does the unit come with signage for the unit? Is a storage container included?

Training. Is the unit easy to use. Does it come with English only instructions or can a non-English speaking user easily operate the device? Does it come with a DVD or manual for the owner? Are appropriate compliance documents included?

The value you seek in purchasing a life-saving device must be clearly defined. Getting a good price doesn’t mean the lowest price. There will be more than one good choice of an AED for your organization, but selecting the best one will require you to eliminate those options which don’t fit your needs and working with a company that thinks and acts like you. By purchasing your AED from a supplier with a variety of models, options and prices, you’ll now only be confident you’ve made the right choice for you, but you’ll know that the value you received is 2nd to none. Be wary of discounts in parachutes, insurance and defibrillator’s. The life you save, could be your own.

Want a Sweet Deal? Favorite Websites For Fashion Bargains

A lot of people ask me where I get the clothes I’m wearing and they’re always surprised when I say where I got them and how much the item cost. Typical reactions include disbelief and jealousy, especially when I’ve spent less than $20 on a pair of shoes identical to an $80 pair someone else owns.

when I say where I got them and how much the item cost. Typical reactions include disbelief and jealousy, especially when I’ve spent less than $20 on a pair of shoes identical to an $80 pair someone else owns.

How do you find your own sweet deals and which online shopping destinations will give you the most bang for your buck?

Here are a few of my favorite sites:

Forever 21 has incredible selection and style and the prices are outrageous, especially if you do a bit of digging. I’ve unearthed fabulous dresses for less than $20 and great costume jewelry pieces for around $5. The shipping from the site is painless and quick and they have easy return policies should something not fit.

Here are my tips for shopping online at Forever 21:

Visit the store before you shop the website so you know what fits you and what you’re looking for. Often, the actual clothing looks different in person than it does on their website, especially in the dress length area. Some “dresses” Forever 21 sells are more tunic-lengthed, meaning you’d have to wear them as shirts or with leggings in order to make them street-appropriate.

Don’t expect pristine quality. Forever 21 keeps their prices low by mass-producing huge quantities of clothing that aren’t meticulously made. Don’t expect your clothing to hold up for years-or sometimes weeks-on end.

Beware of dresses or shirts you need to zip. Forever 21 has fairly cheap zippers that often break.

If in doubt, go up a size. Their clothing runs tiny-truly tiny. If you have a wide rib-cage, like I do, you may need to go up two sizes if something is really fitted around that area.

Urban Outfitters is a true fashionista’s paradise. Chock full of interesting bohemian pieces, you can find some great clothing for less than $50. Often Urban also carries more expensive lines (upwards of $200), so make sure you don’t fall in love with something before checking the price.

Some things to buy from Urban:

Accessories are always a great bet. They have tons of belts, handbags, scarves, etc. Their shoe selection is also enviable. Check out their flats and sandals, especially now. They have lots of cute new things.

When cold weather is once again upon us, Urban carries a wide-range of outerwear which is all pretty affordable and cute, without being cutesy.

Urban always carries Converse All-Star sneakers in hard-to-find colors and patterns. Check the men’s shoe section for more.

Cutesygirl.com has shoes for unbelievable prices. Truly unbelievable. I tell people I got boots or heels for $12 and they don’t believe me until I show them the webpage.

The thing about Cutesygirl.com is that they mix some really awful, ugly shoes in with adorable and stylish ones. You’re going to have to be willing to put in some search time.

The quality is fairly good, about what you’d expect from Target or Payless shoes. Not great, but they’ll do. Some of the brands (like Steve Madden) that Cutesygirl.com has are obviously better quality than others. Just be choosy and you’ll be okay.

Watch for these styles from Cutesygirl.com:

Flats or pumps are always a good pick. Search by “Price- Low to High” to find the best deals. If you see something you like and they have your size, snatch it up quick. The cheaper shoes go fast, and they often run out of the most popular sizes quickly, leaving only 6’s to be had.

There are some great boot offerings from Cutesygirl.com, but once again, search carefully. Avoid stiletto, pointy-toed boots at all cost. You can get those almost anywhere now, but they really aren’t tremendously popular anyway. Don’t fall into the trap of buying something just because it’s cheap: there are lots of inexpensive shoes on Cutesygirl, but don’t sacrifice style just because something is $10.

Age Appropriate and Attractive Ideas For Aging Gracefully

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

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

The Importance of Being Current 

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

What Were We Thinking?

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

A woman in Act Two need never wear:

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

What’s Age Appropriate Now?

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

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

Online Shopping for Clothes: Tips and Facts

Nowadays online shopping for fashionable clothes has become very popular all over the world. It seems that online shopping for apparel is much more convenient. Consumers have this great opportunity to browse an international clothing market at the simple click of a button.

Undoubtedly, online stores for clothes have become the new hit. Today you can buy everything from an e-store – from the socks and the underwear, through women and men tops to the sportswear and the coats, including fashion accessories such as hats, bags, you name it. You can shop while drinking your coffee at home, during your break at the office, at any time, at any place. You had a busy day at work and it’s already late in the day, and you have a party approaching – the perfect solution is to lounge on your couch and start browsing for online shop offering clothes that match your style. Also, many e-shops make big season sales and discounts for holidays.

Yet with all the advantages of the online shopping for clothes, there are some flaws. You are not able to try out your clothes to see if they fit you, you can’t feel the fabric either. I am offering you some easy-to-follow tips for a successful online shopping inspired by the many online shopping woes of customers around the world.

  1. Look at the return policy
  2. Before you buy your clothes online, read the return policy. Loyal clothing e-shops offer returns. Mistakes happen and it is always good idea to have a backup plan. Make sure that if it turns out that you need a different size, or you have changed your opinion and you want to buy something else, you can return your purchase to change it.

  3. Chart sizes
  4. Take into consideration that different countries have different sizes. Many customers underestimate this fact. When you are choosing your size, make sure you choose the right one. Most online shops for clothes offer chart size legend where you can see in detail what measures stand for each size number.

  5. Fabric content
  6. Since you cannot feel the materials of the clothes, read the fabric content. All good online clothing shops note the fabric content of each item in detail. Do not rely on an image to buy your clothing online. You are more likely to be unfortunate surprised with your choice.

  7. Research your online clothing store before buying from it
  8. There are clothing e-retailers that are quite disloyal. Often you pay for something that turns out to be different from what you have expected. Sometimes purchases take a lot longer time to arrive etc. You can find a lot of fashion forums, blogs about apparel and social networks where you can search for a loyal clothing e-store like SpiralFashion.com that offers trendy apparel.

Online shopping for clothes saves time and money, but do it the right way. Shop reasonably.

Planning and Design of Behavioral Healthcare Facilities

Behavioral Healthcare Facilities: The Current State of Design

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

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

Changing the Way We Design Behavioral Healthcare Facilities

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

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

What has changed?

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

1. Introduction of modern psychotropic drugs that greatly speed recovery

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

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

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

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

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

Understanding the Complexity of Behavioral Healthcare Design

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

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

1. Right Sizing

2. Humanizing Materials and Color

3. Staff-Focused Amneties and Happiness

4. Security and Safety

5. Therapeutic Design Tenants

Right-sizing

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

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

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

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

Humanizing Materials & Color

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

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

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

Staff-Focused Amenities & Happiness

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

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

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

Security & Safety

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

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

Therapeutic Design Tenants

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

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

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

1. Provide clinical excellence in the treatment of the body

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

3. Produce measurable positive patient outcomes and staff effectiveness

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

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

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

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

1. Access to Nature

2. Provide Positive Distractions

3. Provide Social Support Spaces

4. Give a Sense of Control

5. Reduce or eliminate environmental stress

Access to Nature

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

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

Positive Distractions

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

Social Support Spaces

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

Sense of Control

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

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

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

Reduce or Eliminate Environmental Stress

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

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

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

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

Conclusion and Additional Information

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

Dentist for Children With Special Needs

Special-needs children need a dentist who specializes in their care. This is because there are certain conditions that point to them needing this extra kind of care. Another reason is mainly due to the specialized techniques and methods that need to be applied when caring for children like them. Dental professionals who prefer to work with kids who have special needs are trained and educated in the best possible ways that can make their methods more effective. Usually, pediatric dental professionals are the ones who train to tackle these cases, but there are also some cases of others who belong to another dental field but can specialize in it.

There are a lot of things that parents of special children need to understand when they consult a dentist of this field. One primary thing that needs to be understood is the fact that their kids need to be handled by people who have a lot of patience, understanding, and knowledge regarding their conditions. These things need to be in abundance, especially when it comes to the mouth.

Another thing that parents need to know about when it comes to the oral health of their special-needs child is that there are certain conditions that really need the attention of specialists. Specific medications that may be prescribed to the child might affect the state of the mouth, which in turn needs to be handled with care. Specialists know how to circumvent any repercussions of the medications through treatment and correction of whatever result may come from ingesting the medicines.

A pediatric dentist is educated for two more years compared to general dentists in regards to the needs of those with special needs. These specialists are also well aware of what they need in their clinics to be able to handle their patients. Many of the pediatric dental professionals who offer their services to children with conditions that need extra care often equip their clinics with equipment, supplies and other things that will come in handy when it comes to comforting and treating them.

Even access to the different areas and aspects of clinic will need to be planned with the needs of the patients in mind. The dental professionals will also explain to the parents or guardians of the kids that there may be instances or sessions in which the use of sedation or restraint may be necessary in order to implement the necessary corrections or treatment to the child. The dentist will need to outline the instances when the restraint or sedation may be used, and he or she needs to make the parents understand that these will only happen when there is an urgent need to do so.

It is good to bear in mind that children with special needs will benefit greatly from the techniques and methods that this particular dentist might use. Parents should also keep an open mind with regards to the techniques and methods.

Effective Bird Control For Healthcare Centers & Hospitals

It’s no secret that people who are already sick are more vulnerable to contracting diseases.And one potentially unhealthful source of disease is bird waste. As a hospital administrator, you are no doubt aware of the problems pest birds can cause. Many species of birds, including pigeons, starlings and sparrows, often gather to roost on a hospital’s roof, under parking structures, in receiving bays and loading docks, and around exterior employee lunch and snack areas. Without bird control, you soon have a noisy, smelly and potentially dangerous problem on your hands.

Keep in mind that a single pigeon can excrete up to 25 pounds of droppings per year. The bacteria, fungal agents and ectoparasites in bird droppings and nesting materials have been known to carry any of 60 diseases–including histoplasmosis, encephalitis, salmonella, meningitis, and toxoplasmosis, even the West Nile virus.

No less harmful is bird fecal dust carried into hospitals through rooftop heating, ventilation and air-conditioning ducts. Birds often build nests around air handling equipment, ducts, compressors and other vented pathways. Dried by wind and sun, this disease-infested dust gets sucked into HVAC systems. The fine particles can quickly spread diseases throughout a hospital or medical center.

Hospital administrators should also be aware of the negative visual impact bird droppings, nests and other debris can have on a hospital’s image. Finally, bird droppings can cause dangerous slip-and-fall hazards–a huge legal liability for any institution.

Today’s Bird Control Measures

Hospitals and healthcare centers are somewhat restricted in their use of pest bird control measures. They certainly can’t use firearms, noise cannons or fireworks. And poisons present too much of a liability. Besides, federal, state and local wildlife protection ordinances forbid the use of lethal or harmful bird control measures. Fortunately, there are several highly effective bird proofing solutions currently available that are safe, sane and humane.

Bird Spikes

The good thing about Bird Spikes is that they prevent many species of large birds from landing in the first place. Suddenly, rooftops, ledges, signs, light fixtures and other elevated areas are off-limits to birds. Bird Spikes come in rows of spiked strips. And you can get them in either rigid U.V.-resistant unbreakable polycarbonate or high strength, durable stainless steel. The stainless steel spikes come in 3-, 5- and 8-inch widths; the plastic spikes (which cost slightly less) come in 3-, 5- and 7-inch widths. Plastic spikes are ideal for use near antenna arrays since they won’t interfere with radiated RF energy. You can get bird spikes in a non-reflective metal finish or a variety of colors–like white, tan, gray, black, brown, brick red and crystal clear. There’s also a no-gap spike that’s easy to affix to curved surfaces.

If your hospital or healthcare center is being invaded by large birds like gulls, try the Mega Spike. Its 7-inch spikes made of marine grade stainless steel will make sure these birds get the point and leave. There’s also the Gutter Spike, ideal for keeping large pest birds out of gutters or drains. Look for gutter spikes that have adjustable clamps at the base; these allow the spikes to be easily attached to the lip of a gutter.

Lastly, Birds Spikes look dangerous, but they are harmless to birds or people. They have even been approved by a number of humane groups worldwide–including the U.S. Humane Society and PICAS (Pigeon Control Advisory Service).

Sonic Bird Deterrents

Ideal for use in certain areas of a hospital or healthcare center, Typically, Sonic Bird Deterrents emit predator and distress calls that frighten pest birds but are basically just Uncategorized sounds that are not unpleasant to humans. Some highly versatile sonic systems emit distress and predator calls for as many as 22 types of birds. The sounds are cycled every few minutes to convince pest birds that they best leave or risk being attacked. Sonic Bird Deterrents are an ideal bird control solution for deterring pigeons, crows, starlings, swallows, gulls, woodpeckers, sparrows, grackles, cormorants and many other birds.

Bird Netting

To keep pest birds out of certain specific areas–like eaves, overhangs, patios, and parking structure recesses–there’s Bird Netting. This barrier bird control measure is available in various cuts and mesh sizes. For large birds like pigeons or seagulls, use a 1-1/8-inch to 2-inch mesh size. Sparrows or starlings, on the other hand are best excluded using a 3/4-inch mesh net. The best bird repellent netting will meet ISO 1806 protocols, is U.V. stabilized, flame resistant and rot- and water-proof. In areas where electrical conductivity or radio frequency interference is a problem, non-conductive netting is often used. Also note that netting now comes in various colors– including white, stone and black–to match a structure’s color scheme.

Electric-Tracks
A great spot deterrent for ledges, rooflines, eaves, signs and most flat or curved surfaces, Electric Tracks impart a mild electrical shock when birds land on their surface. This is an ideal bird control device for use against a wide variety of pest birds–including pigeons, sparrows, gulls, starlings and crows. The best electric tracks feature a low-profile design that makes them almost invisible. The strips of electrified track are usually powered by an AC charger or solar charger. One manufacturer uses copper knitted wire mesh in a continuous tube-in-tube stocking design. This gives the track greater conductivity, strength and reliability. The copper mesh is resists corrosion and will stand up to alkali and acidic environments.
Bird Slope
These angled, slippery PVC panels known simply as Bird Slope, won’t allow pest birds enough of a grip to land. After a few unsuccessful attempts, they just slide off like water off a goose. Bird slopes are easily installed, tucking unnoticeably into ledges, eaves, beams and other 90-degree areas pest birds often nest. The best panels are U.V. protected and sun and weather resistant. They deter a wide range of birds, including swallows, starlings, pigeons and seagulls. Some panels have a “snap-on” extender, which allows them to adapt more easily to wider ledges and coverage areas.
Bird Scare Deterrents

These inexpensive bird control devices make pest birds too nervous to nest. There’s Flash tape, an iridescent material that shimmers and crackles in the sunlight and breeze to scare pest birds. And Bird Scare Balloons, which, emblazoned with lifelike reflective predator eyes, bob and weave menacingly in the breeze to make birds really uncomfortable.