Thứ Tư, 30 tháng 1, 2019

Waching daily Jan 30 2019

hey guys it's Jennasea and welcome back or to my channel so today I'm going to

be how do you explain this I'm going to be showing you how to become the

physical manifestation of boo boo boo boo boo so like really weird but yeah

we're gonna become boo boo today and I know you're excited try to

contain your excitement and I need to look bald for like sorry a little bit

too long I think but okay I just look like I am not my

age I look a lot younger start by wetting my Beauty Blender

should this be like a tutorial yeah I'm gonna treat this like a real tutorial

what your beauty sponge i'm using the morphe one it's really dirty and very

old I should probably get a new one now I'm using the androgynous skin clearing

complexion Perfector also okay if you're wondering what who is boo will is like

okay it's the it's really the little face that it makes it makes like a face

you know like that kind of face that the user the eyes and the W is the mouth boo

and it's kind of something that like anime people do they do that kind of

like literally I love you boo oh I'm so cute oh and if you're on Tik Tok you

know that like it's become a meme it's kind of becoming meme just everywhere

not just on Tik Tok but especially on Tik Tok because the different sounds I

have been made featuring it and stuff so this look I'm showing you is

basically just how to become the people that say boo but you know we're just

gonna say that I'm becoming guru because it's more interesting than saying

turning until I got kawaii person oh okay is it just me but like when hailey

Morales started getting really popular that was just an awesome period in my

life because I mean I also was getting really

popular but like I don't know like I just associate her getting popular with

like a good time in my life and now to be honest I don't really care for her I

know half people that watch my videos probably watched her and your holy

feeling really upset that I just said that right now and I probably only cut

this out of the video but probably not because I'm irrelevant so no one really

cares what I think but she's just become way too much of a

drama channel rather than just sticking to makeup and spreading positivity like

like she says that she does but she doesn't really spread positivity she

just kind of rants about being depressed and having anxiety and how her parents

her parents forced her to get air pods like she put that on her story like my

parents are forcing me to get air pods with like like upset emojis and I

thought it was like a joke at first but she was like being genuine about it just

a thought now I'm setting this powder or setting my foundation with physician's

formula powder but like just around here because we need this nice and fresh from

blush blush is a huge part of the OE look you can like set your forehead and

anything else that you need a set no I'm gonna use bronzer like don't use a lot

don't contour sorry Oh God don't like really contour it just bronze

to warm your face up I hate these cat ears like they're cute and all for being

cat ears but it just makes it seem like I'm really into like the whole like

thing I don't know anyway speaking of Haley Morales I just talked kind of

trash about her I hate that I just basically just oh my channel to her like

I don't know I started my channel because Annika österlen inspired me to

but then Haley Marella shouted me out and that's the reason I'm even here

talking to you guys still probably I probably would have given up unless like

something else of mine went viral but I doubt that would have happened because

nothing I posted since then did and today is the one-year anniversary of the

day that she did shout me out so I probably shouldn't have

talk garbage about her for a second sorry now we're gonna let this

Beautyblender in what you're gonna want to do this is actually a chapstick I got

from TJ Maxx my bare minerals and it's pop of passion why is it tracking the

cat ears and not my face okay so now this is kind of risky I just used this

like thing as a blush and it's so frickin pigmented this is a eyeshadow

from colour-pop which I used in the video at my school bathroom in the shade

centerfold but I like to use it's a blush seems like I'm gonna be using

everything but blush as blush today and it's really important to make sure that

this blush is like all across here and really pigmented so now taking the elf

highlighter but we're gonna take the pink shaded one which I used like twice

and then I like to use my finger for nose for eyebrows I don't like having

them super dark because I think dark is more like menacing like a goth

girlfriend goth gf maybe that could be my next video who is more like light and

cute so I'm just gonna fill in anyway um scrimmage normal frazzled

now I'm gonna curl my eyelashes now I'm gonna do mascara the good thing about

this look is there's not really any eyeshadow involved at least from my

version of it I don't do eyeshadow because the kind of like clean look is

also really popular I don't know the title this video like who will makeup or

like how to become Who I am Who I am who are you that was not funny well it was

probably one of those funny things I've ever said okay no I have to do winged

eyeliner but I obviously can't do that like easily so I'm gonna turn off the

camera and do it in this mirror and then I'll be back oh I'm back I'm back with

winged eyeliner and also little hearts

I love this camera so much because this is crucial

trust me the hearts are crucial you can do dots even new stars

you can do anything but these specimens right there under your eyes crucial and

I also added some sparkly pink in the inner corners because I've seen some

people do that and I just thought it'd be coming you you know I just had to

delete some stuff because Zee card was to fool I also realized I could

definitely zoom the camera in and look better so that's what I'm doing also

okay we add flex okay okay so ignoring that I just did that we're gonna do

adding fake eyelashes now it's important that you get absolutely insane ones I

got these from the dollar store color meets maybe I don't know something

really really offer into though these are no lily blush Miami's okay and I've

got really good at being patient with this - I've decided as a good New Year's

resolution or something I'll actually wait for them to get sticky and tacky I

hate I hate few fellowships with a burning passion I love the way they look

but I hate wearing them so much because they never look good they never look

good I'm like born to not do these right I swear I just can't

also these make me look like an alien I would really look like an alien

oh my camera is about to die that's so nice okay you're gonna want a pinkish

liquid lipstick or just anything that's kind of pinkish not to think you don't

want it to really look like you're wearing lip color you just want to put

on enough so your lips are colored you know now if you have bangs you can put

them out now I don't really have bangs I just have these weird little pieces but

if you have bangs they will complete the look

however I just have these I just look like I don't know like Haley

Morales on crack this is like the third time I mentioned her in my video I'm

sorry this just she has things and she's popular grabbing papers yeah thank you

guys so much for watching this video maybe I'll take off my glasses thank you

guys so much for watching this video I really hope you liked it it was so fun

to make I love doing this comment what kind of like face or thing I should do

next if really anything maybe I'll do bar XD or something comment what you

want me to do next if anything yeah um thank you guys so much for watching this

video it really honestly means the world to me it has been an amazing year with

you guys absolutely my channel progress to numbers I never thought it could I

never imagined never imagined I'd have anywhere near what I have now and I have

a 957 because I lost before tonight but we don't even talk about that it's been

an amazing freaking journey and it's not over never over I'm gonna keep doing

makeup keep doing what I love keep expressing myself keep being quirky keep

making tea talks just being myself and you should do the same along with that

you should like this video and if you like me subscribe to me cuz that's the

equipment of liking to me wait and so if you like this video like it and if you

like me then subscribe that's the equivalent of liking me and come to

anything because I answer absolutely everything and even if you don't even

ask a question I just rolled or plywood but yeah oh my god there's a hair in my

eye this is painful I love you guys so much

okay okay so much bye

For more infomation >> how to be uwu - Duration: 10:18.

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When Your Vlog Is Stopped... - Duration: 0:20.

For more infomation >> When Your Vlog Is Stopped... - Duration: 0:20.

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Gorgeous Beautiful 2000 Dutch Park 2 BEDROOM/ LOFT Park Model from RV Trader - Duration: 5:40.

Gorgeous Beautiful 2000 Dutch Park 2 BEDROOM/ LOFT Park Model from RV Trader

For more infomation >> Gorgeous Beautiful 2000 Dutch Park 2 BEDROOM/ LOFT Park Model from RV Trader - Duration: 5:40.

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MY BIGGEST SECRET TO SUCCESS // MY FIRST YOUTUBE VIDEO - Duration: 9:56.

if you take anything at all from this video I want you to know ONE thing and

ONE thing only... What's up guys good morning, good afternoon

and maybe even good evening BUT wherever you're at in the world welcome to my

very first ever YouTube video. Let's get one very potent question out of the way:

what is my name? Well my name is Marissa and I'm here because I have a story to

tell you guys and I'm hoping that my story will touch your guys's heart in

the way that it has touched other people's hearts that I've met throughout my life

and touched my heart as well. Let's see, when I first got into school I was 5

years old like everyone else and I had no idea what I wanted to do with my life

I went to wanting to be an astronaut, wanting to be the president wanting to be

a dancer, an actor, a singer everything you could possibly name that a little

kid would want to be that was me right there and there was this piece of me

that thought that when I got into college that eventually I would figure

it out and I would know what I wanted to do with my life and to be completely

honest with you I don't know what I want to do with my life and that's terrifying

and I'm sure a lot of you feel the same way about that but I'm here to tell you

that that's okay and here's the truth of why that's okay. I watch every single day

as people give up on their dreams. I can see it in that person that's sitting

behind the counter working at McDonald's and their eyes are lifeless but they're

sitting there drawing and you can see that that's actually their passion or

when you go out and you just like look at somebody that's working a job and you

can tell that they absolutely hate their life and it breaks my heart to see

people give up on their dreams and I do not want you guys to give up on your

dreams and that's why we're here. I want you to know that that passion that you

feel when you're out there in the world and you completely lose track of time

and you absolutely love what you're doing you're just consumed by it is the

reason that you're here so don't ever let anybody tell you that you can't do

something because it's NOT true. You were put on this earth to follow

your passion and it would be a disgrace to your destiny not to go pursue it and

tell everyone to suck a fat one because you are going to do what you love and I

can promise you that if you put your mind to it. And what absolutely breaks my

heart is there's people out there that accept jobs that they absolutely hate

without even thinking about it they stay with people who don't treat them right

because they're afraid to go on to anything else and they

accept societal standards without really taking the moment to sit there and ask

themselves: does this really REALLY make me happy? Make me happy in the way that

it catches my soul on fire and makes me dance in my room and sing with my deodorant

because that's the kind of happy that I want people to be in their life and when

I see somebody settling for anything less than they deserve it absolutely

breaks my heart and that's why we're here today. But it's important for you to

know that as you're chasing your dreams it's not going to be easy nothing is

easy even if you aren't chasing your dreams

that's not going to be easy either

nothing in this life worth having is an easy way to get there and that's okay

because the growth that you experience along the way is going to shape you into

the person that you were destined to become. I have gone through some pretty

heart-wrenching things in my life and I wouldn't mind going into detail into

those later on in different videos but in the moment it sucked it sucked so bad

but once I actually got through that and saw the light and the other side I saw

this person that I grew into and I was so proud of who I'd become and all those

struggles that I went through to chase my dreams really just gave me so much

more compassion not only for the world but appreciation for what I had and what

I was working towards as well. If you take anything at all from this video I

want you to know one thing and one thing only you are enough let that sink in for

a minute you are enough and don't let anyone ever tell you anything different

because it's not true and then if you keep listening the second thing I want

you to know is to never give up on your dreams because people say that it's

unrealistic because that's also not sure either and I am living proof of that and

I would love to go into further detail with you guys in future videos but just

know that you can do anything that you set your mind to and anything that you

open up your heart to if you are willing to put in the work and if you show up

every single day I can promise you that whatever your little heart desires that

you ARE capable of it you just have to know it first. A year ago I needed a

stranger to help me and I needed strangers to inspire me and they did and

I feel like I owe it to not only you guys and to the world but to the universe to

show people that they can do anything they set

their mind - and does this mean that I'm completely content with where I'm at in

my life? Absolutely not. I don't believe in be content, I think that everyone always

needs to grow and as you grow you become the person that you're supposed to be

If this topic is something that gets your heart pumping and sets your soul on fire

I encourage you to give this video a thumbs up and subscribe for some more

weekly videos. Before we go I am gonna give you guys a little sneak peek of what this

channel is gonna be all about sooo question number one: What is the most

valuable important asset that I have that has rendered success in my life? And

I'll tell you what it is choosing kindness. I know it sounds so

simple but it's true. When I was in a very, very dark place I was horrible to

myself. I told myself that I was nothing, that it didn't matter and that I wasn't

good enough and all this crap that everyone gets to at some point in their

life. And eventually when I got into a different mindset I chose to be kind to

not only myself which has helped me tremendously but also to others. So I

changed the vibe that I had in my head and the vibe that I put out in the world

and that has helped me immensely, in ways that I'm not sure you'll ever ever be

able to understand so I encourage you to implement that into your life. And the

word, "choosing kindness" is such a strange phrase/word because what does that

even mean? That can mean so many different things to so many different

people. But in my mind I think that "choosing kindness" is factored around a

couple things the first thing is kindness to yourself, kindness to your

soul, kindness to your body and kindness to other. And choosing kindness is so

much more than just being nice to somebody or to yourself too. Choosing

kindness is choosing to be optimistic instead of pessimist. And choosing

kindness is choosing to believe that you're worth more when you question

whether you are not. And most importantly choosing kindness is just being

determined and not defeated because when you're in the right mindset and when you

believe that you can do anything that you set your mind to I can promise you

that you will be unstoppable. And that is the most powerful asset that

you can have. Guess what guys?! Newsflash: and I'm sure you already know this but

you cannot give out healthy love if you do not have

healthy love in your heart which is why it's so important for you to learn how

to not only love yourself and choose to be kind to yourself but take that energy

that you have and put it out into the world because when you know how to love

yourself and you know how to love others guess what that means? It's a whole

freakin' domino effect of a life that you deserve to live and a life that you will

live as soon as you open up your mind to it. Anyways I'm sure you're probably

wondering what my passions are. Well, I'm a very indecisive person and I can't

just pick one but the things that I really just absolutely love is I love

fitness. I went on a fitness journey this past year I'd love to make a video about

that and share with you guys I lost a ton of weight I got super toned and it

was really fun and my dad calls me the "crazy workout lady" and I totally love

that because I worked hard for that name so he can call me the "crazy workout lady"

all that he wants because I am living for it. But anyways, I want you to know

that my passion may be fitness and I'm gonna encourage you guys to chase your

dreams through my fitness passion and my other passions that I have but just know

that just because your passion isn't the same as mine doesn't mean that you*

aren't going to take something from the advice that I have to pursue and chase

your dreams as well. And being healthy for me isn't just about fitness it's

about taking care of your mind and your body and your soul and really just

giving the best positive vibe that you can out there and that's one thing that

I really want to strive with this channel is to encourage you guys to give

out good vibes because I'm a firm believer that the vibes that you put out

attract your tribe and I think that if you put it out good vibes that's gonna

take you one step closer to your dream. Other passions that I really enjoy is

interior design. I love real estate I'm actually currently studying real estate

right now I just graduated with my degree but that's what I'm currently pursuing

in terms of like a real estate license. And I also love being outdoors that's

another one of my passions. But in terms of this channel I'm gonna focus a lot on

being healthy with your mind and your body such as fitness but I also would

love to get into further depth about umm like fashion and interior design and

home decor and all that stuff I am excited about. If you're interested in being

a part of the community that strives to be the best version of themselves

every single day I encourage you to subscribe like I said before because I

can promise you that we ARE going to create one heck of a community and I'm

super excited to help you guys and show you guys how to lay the foundation of a

successful happy thriving life and I'm so excited to see where I can take this

channel to. But in the meantime before you go, one thing that I really wanted to

do that I thought would be really fun and interesting is to 1. put an

inspirational quote at the end of every single video just to help you guys feel

good and get those good vibes out there and 2. I wanted you guys to comment

below if you don't mind a good deed that you've done today this week big or small

it does not matter I just want to hear the efforts that you guys are making to

make this world a better place. So don't forget to leave a comment below of a

deed that you've done and I hope you enjoyed this video and I'm excited to

make new videos for you guys so don't forget to subscribe and I hope you have

an* awesome rest of your day Thanks, bye!

For more infomation >> MY BIGGEST SECRET TO SUCCESS // MY FIRST YOUTUBE VIDEO - Duration: 9:56.

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What Do You Have to Consider Regarding Stroke Prevention? - Duration: 4:39.

There are three limbs to treatment for people with afib:

rate control, rhythm control, and prevention of stroke.

I'd like you to forget the first two for a moment because if you get the third one wrong,

I don't really care what you do with the first two.

Without a doubt, the most important thing is

to get the third one right, preventing a stroke.

And, this is the one patients struggle with the most

because their initial reaction is, "A blood thinner?

You know Doc, when I, when I just breeze by a door, I cut my...

Look at this. I get, I get bruises all over the place."

So, here's the thing, the obvious downsides of anticoagulants are there.

You see them all the time. I hit my hand; I got a bruise.

I nicked myself; I had a cut, it bled a little longer.

But, the protective effects of a stroke aren't looked at unless you have a stroke

and you didn't get the protection, right?

So, you always see the downside of blood thinners, and that's absolutely the way it is.

You've got to look past that and look at the upside, which is you didn't get a stroke.

So, you never know that though, right?

Because a patient can say to you, "Well, how do you know it was the drug, Doc?

Maybe I just was lucky, and I didn't have to take blood thinners,

and I wouldn't have had a stroke anyway?"

You're right. You don't know it's protecting you until it's not protecting you. Okay?

And, do you want a stroke?

So, here's what happens.

This is the longest part of my discussion in the office with a patient.

I sometimes take 10 or 15 minutes just on this.

But, I cheat a little bit because I was a part of a team a long time ago that put together

afib videos that are available to anybody.

And, one of the most important videos I put in there shows

what can happen if you make a mistake. It shows a clot in the heart.

And, I show it to patients on my iPad that I use in the office,

and I say, "Just watch this." And, I don't say anything.

And, what you see is a clot; you see the clot dislodge; you see the clot go out of the aorta,

right up to the brain, and boom, a stroke takes place.

And, I say to them, "I'm not here to scare you.

I'm telling you why we worry about this issue." And, it's powerful.

I'm just going to tell you, very few people turn down blood thinners after that.

But, I don't show that video until I've had a full discussion of blood thinners,

and if they meet criteria.

So, it's not up to you to push anybody into a blood thinner.

I think that's the wrong thing to do.

I think it's up to you, as the doctor, to be as open as you can in your discussion

about risks and benefits of blood thinners.

What is the actual risk to this patient? What is your CHA2DS2-VASc score?

What is your actual risk of bleeding?

But, I think it's important, at that point, to also show them why we're concerned.

And, that's why I show the video.

It's not to scare them.

It's to say, this is not some abstract theory.

Here's what we're actually worried about.

These are data that had been proved; this is not made up stuff.

And, then I let the patient decide, with me, which way to go.

The hardest decisions are people who are in that mid zone, we call it CHA2DS2-VASc of one.

There, the patient could have almost the same, you know, stroke risk as a bleeding risk,

and it's hard to figure that out.

So, honestly, I just tell them the following, after we've had a thorough discussion,

they're often not sure.

They always say to me, "What would you do, Dr. Prystowsky?"

And, you know, I'm happy to tell them that,

but you know, I'd rather them come to a decision on their own.

And, I just say, "Well, let me explain this to you a little differently.

If the risks are about the same, would you rather have a bleed,

or would you rather have a stroke?

I know you don't want either, but what would be more important to you

because the risks are about the same."

And, looked at that way, most people say, "Whoa, I never thought of it that way."

I say, "Well, that's how you have to look at it this way because I can't tell you

you're going to have a better outcome versus not in that category of risk."

And, usually, they'll side with a blood thinner.

Strokes scare all of us, and certainly patients.

And, once you have a stroke, game's over, or it's usually over.

So, honestly, I do everything I can to avoid strokes in my patients.

It's the first thing I talk about, and it's the last thing I do before they leave.

For more infomation >> What Do You Have to Consider Regarding Stroke Prevention? - Duration: 4:39.

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How Do You Stop or Change Warfarin or DOACs? - Duration: 2:21.

Two issues occur that require alteration of anticoagulant therapy.

The most common is the patient is going to undergo a procedure, often a colonoscopy,

and the gastroenterologist will not do it without stopping the drugs,

whether it be warfarin or a DOAC.

We have a standard reply to that.

We tell them that there is a risk of stroke; it's very small, but there is a risk,

and you have to accept that.

They won't do the procedure, in my experience, unless we stop it;

or, they're undergoing surgery.

So, those situations are black and white.

Either you stop it and get the procedure, or you just keep going on

and the procedure's not going to be done.

And, that's a decision you just have to make.

My guidance to both the patient and the doctor is, there is a small risk — it's very small,

but there's a small risk — and to please minimize time off the anticoagulant.

A different issue is when you have to switch from one anticoagulant to another,

and there are guidances on this.

If it's a DOAC to a DOAC, let's say, apixaban to rivaroxaban, okay?

One is twice a day, one is once a day, but the guidance is, when your next dose is due,

you just switch over. And, usually, this is a smooth transition.

I've done that many times with patients.

You do have to make sure there's no drug-drug interactions with the new drug.

Sometimes, there are.

Not all drugs work through the same elimination pathways in the body.

So, you have to check that.

The biggest one, that I actually don't keep in my head, I look up,

is the warfarin to a DOAC, or a DOAC to warfarin.

Sometimes, for whatever reason, patient decides I'm off of this, I want to be on that.

Those are different depending on the drug.

And, what you have to do, and it's in a lot of programs

that doctors can get on their phones, they'll give you instructions.

They'll say, "Stop this, check this, start this when this is this,"

and I just follow the rules.

I mean, they're not all the same, so it's not something I personally commit to memory.

I just look it up when a person has to switch, and I give them the rules.

For more infomation >> How Do You Stop or Change Warfarin or DOACs? - Duration: 2:21.

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What Do You Do When Patients Forget Medications? - Duration: 1:28.

One of the issues that comes up occasionally in the office is a patient who is more elderly

and is starting to forget things, and I always try to, and they're on warfarin, let's say,

but they could be on a DOAC, too.

And, I'll have a serious chat with the family members because, not infrequently,

they're living at home still; I mean, they're living in their own home.

If they're in a controlled environment, like a nursing home or assisted living,

where there's somebody who can check their medicines, it's a little different.

But, not infrequently, they're still on their own.

And, one of the concerns I have, and the family members have, is are they taking their medicines?

Because this an area you can't mess with.

If you're in persistent afib, and you're more elderly, and you have a bunch of risk factors for stroke,

either you take too much, and you have a major bleed, or not enough, and you have a stroke.

These are tough questions to ask.

And, I've actually made some recommendations at times to family that either they have

an aide come in daily, and make sure they get their meds, or they consider moving them to

a different facility because this is a dangerous situation and you must take these medicines.

They're protective of your brain, and you can't mess this one up.

For more infomation >> What Do You Do When Patients Forget Medications? - Duration: 1:28.

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When Do You Consider a Stroke Prevention Device? - Duration: 1:45.

A lot of patients read about these new devices we have;

they can go plug up the left atrial appendage and minimize the stroke risks.

And, you know, they're on websites and afib sites, or they know someone who had it.

And, I'm glad they're up on the data, and up on the concept that they exist.

But, what they don't know is they have very limited clinical use right now.

First of all, they don't work in everybody; I mean, just like blood thinners.

I mean, not every stroke comes from the left atrial appendage.

So, they need to know there's still some residual risk.

And, they're not for everybody.

So, if you can take a blood thinner, and you've been doing well on a blood thinner,

usually you're not a candidate for it.

I reserve them — I don't put them in, but I've sent them to be put in by one of my partners —

I've reserved it for people who absolutely worry me as far as the stroke risk,

but are either contraindicated, or relatively contraindicated, to a blood thinner.

I have a patient, not long ago, who had three gastrointestinal bleeds on one of the DOACs.

That's enough. I mean, it required six units of blood.

That person cannot be on a blood thinner long-term, and I've referred

that person for consideration of one of these devices.

But, at the moment, they're not for everybody. They have to be used selectively,

but they are valuable, and they should be part of your armamentarium.

For more infomation >> When Do You Consider a Stroke Prevention Device? - Duration: 1:45.

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David Luiz 'KNOCKED OUT': Did you see the moment Chelsea star was rocked by ball to face? - Duration: 2:25.

 The Brazilian was standing up to the Cherries' attack when he received a ball flush in the face

 Josh King was running at the Chelsea defence when he unleashed a deadly shot which hit Luiz and knocked him to the floor

 And the former Paris Saint-Germain man seemed to be out for the count. He did eventually get up and carry on

 And it was the man who hit him in the face, King, who gave the hosts the lead in the second half

 Fans took to Twitter to react to Luiz's misfortune. One fan said: "David Luiz has just got smacked in the mooey and I heard the slap from here tbf

#CFCLive" Another added: "Ouch. Shot straight to the head of David Luiz." A third added: "Poor old David Luiz getting a bullet in the mush seems very popular with a lot of your following

Terrible. (Must admit did a thumbs up myself)." "If anyone questions David Luiz's commitment again

show them pictures of that block," another said. Antonio Rudiger believes Eden Hazard can help bring the best out of Gonzalo Higuain

 "Everyone who understands football and knows Eden, you can make a profit out of him playing with him," he told the Evening Standard

 "It [playing without Hazard] is the same as Barcelona playing without [Lionel] Messi

For us it's Hazard. He can make always the difference, as he showed against Tottenham last week

 "We have to be patient with Higuain. He's new. Everything's new. But he will be important for us and he will show his strength

 "First of all, if you see his record, you know he's a goalscorer. He will do the same here

I'm confident about him."

For more infomation >> David Luiz 'KNOCKED OUT': Did you see the moment Chelsea star was rocked by ball to face? - Duration: 2:25.

-------------------------------------------

学习世界上最常用的3种语言 - Duration: 15:59.

Learn Spanish World Presents

Learn Spanish World Presents

Today we're going to learn about the 3 Most spoken languages in the world

For more infomation >> 学习世界上最常用的3种语言 - Duration: 15:59.

-------------------------------------------

How Do You Choose Between Warfarin and DOACs? - Duration: 2:42.

During the discussion of anticoagulation, it's important to talk about two different roads.

One is the classic warfarin that requires, usually, monthly INR checks.

And, the other are these new drugs, so-called Direct Oral Anticoagulants, or DOACs.

They should both be brought up in the discussion, with risks and benefits,

and advantages and disadvantages, mostly, of discussion.

So, I usually tell a patient, "If you want to take warfarin, we'll be able to track your actual blood thinning.

We'll know, from a lot of experience, if you're in the range or not.

And, we can adjust accordingly.

You do have to have monthly blood checks.

There are foods and other things that interact, but it's fine.

I mean, there's nothing wrong with being on warfarin.

If you take one of these DOACs, you need to know they're dose-related.

And, no, there's not a blood test I can do to say how protected you are.

You just have to accept the fact that you're protected because all the studies showed,

at this dose, you had at least as good of an effect against warfarin,

and sometimes better."

So, what's the downside of them?

It's usually cost, quite frankly; and, if you get into a Medicare age group,

they can be cost prohibitive.

So, you just have to discuss both.

Some patients actually like the idea of knowing that they're protected.

They know an INR number. I'm okay with that.

That's fine with me. We teach them how to do warfarin.

Some people have bad kidney function, and then they have to be on warfarin. Okay?

Or, some people have artificial valves, and they have to be on warfarin.

But, if you can take both, my own bias is I like to give you one of the newer drugs.

Compliance, in my experience, is better.

They're easier to take. They're more user-friendly.

If your wallet doesn't get diuresed — you know, and you can't afford them —

then I would prefer some of the newer drugs.

I don't see any downside to them regarding that.

But, if you're in a group that can't afford them,

I would suggest warfarin, and not say it's terrible.

I mean, you will get patients come in and go,

"That's rat poison, Prystowsky. I'm not taking it."

Actually, it is rat poison, you know? So be it; I mean, but it works.

So, I think the discussion has to be made, benefits and risks of both;

cost has to be taken into account; and then, let the patient make a decision.

For more infomation >> How Do You Choose Between Warfarin and DOACs? - Duration: 2:42.

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How Do You Weigh Fall Risk Versus Stroke Risk? - Duration: 1:47.

One of the toughest decisions patients and doctors have to make is

the issue of a person falling and hitting their head

and getting an intracranial bleed, for example, versus preventing a stroke.

And, as people age, and they get more frail,

and their abilities to not fall down are not as good, this issue rises up.

My approach is pretty hardcore.

I do everything I can, if someone's at high risk for stroke,

to find out exactly what their fall risk is.

Often, when you dig into it, you'll realize they never fell and hit their head.

They've been unsteady of gait a couple of times; once or twice, they tripped.

And, that's not enough to take someone off a blood thinner.

And, I know that very much from a patient of mine

who I've been taking care of for almost 25 years.

I tried my darndest to tell the doctor not to take — she was a high stroke risk —

and he stopped it because he thought she was "falling."

She had a major stroke.

She's been in a wheelchair for over a decade. I see her twice a year.

Every time I see her, I'm reminded what a mistake that was to stop her warfarin.

So, if you truly are at risk, and if you're truly falling, and you've documented that

you've fallen and you've hit your head, okay, let's try something else.

Maybe they need some left atrial appendage occlusive device or something.

But, just because someone is "unsteady" is not a reason to stop blood thinners.

For more infomation >> How Do You Weigh Fall Risk Versus Stroke Risk? - Duration: 1:47.

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You and Mr. Rat (US Dept of Health, Education, and Welfare and WRC-TV, 1972) - Duration: 28:23.

[Narrator:] The following program is brought to you in living color by NBC.

[Music]

[Baby tosses and turns while crying in his crib.]

[Mother:] Okay, Okay!

Here's your bottle.

[Rat scampers around on the floor while baby is being fed.]

[Baby crying.]

[Woman runs out of the house screaming.]

[Narrator:] Not a pretty sight is it?

No, rat bites never are.

But treating rat bites, or all the diseases rats cause is one thing,

preventing them is another.

That's where I come in.

I'm Jeff Gannon.

My job, Director of Rat Control for the city health department.

At least that's my official title.

Mostly, people simply call me the rat man.

That's Joe Barnes just leaving.

He's new on the job, but turning into a good rat man himself.

And so is George Wilson there.

Sometimes George and I work together, most times we don't, but either way he's tops.

Been at it twenty years.

[George:] Another rat bite, Jeff?

[Jeff:] A baby again.

Mercy Hospital.

Multiple bites on the face and hands.

It shouldn't bother me after five or six years...but, it should never happen.

[George:] Don't let it get you down.

Think of all the cases that don't happen because you're in their pitching.

[Narrator:] Well, as usual our work was waiting.

All cases of one kind or another that we have to investigate before we can send a crew out.

Where?

Most everywhere.

We get the word from hospitals or the police, from homeowners, store owners, or tenants,

anybody who calls in for just one reason.

He's got rats.

[Young lady:] No sir, my mother wasn't home when the baby got bit.

She works and I keep the baby.

[Jeff:] But if you were with the baby, how come?

[Young lady:] I mean, I just gave her a bottle.

There's nothing wrong with that, is there?

I can't watch her every minute.

[Neighbor:] You know mister, the kids around here don't care.

They don't care one bit.

Did you hear about all those rats?

Well, we sure got 'em around here.

[Jeff:] I can see that, and apparently the kids aren't the only ones who don't care.

[Narrator:] And that suits the rats just fine.

Listen to the rat man, all they want is a place to live.

A messy place, where they can gnaw their way through doors or loose screens

or jump right in through broken windows, holes around pipes or in the walls.

Just enough room for a runway between their food and their shelter.

A place to bore into the ground and come up inside a building.

Enough rubbish to build their nests and have another litter in less than a month.

And what they want most of all is enough to eat.

There's an old saying in my business "If you're feeding 'em, they're your rats."

They'll eat most anything too.

Even spoiled food that would make people sick.

For them, garbage is a well-balanced diet.

And the closer that food is, the better.

Rats don't like to travel far.

Or in the open.

Or in the daytime.

Too dangerous.

Just grab it quickly and then hide.

That's the way they want it.

Rats are smart.

[Jeff:] Okay ma'am I'll notify the owners, and then get a crew out here to set up poison

bait

and try doing some ratproofing.

Meanwhile, you folks in the neighborhood better start cleaning up.

Or else these rats will be hanging around on the streets.

[Woman:] Well I don't know, it sure ain't going to be easy but we'll try.

You know, they've always lived here and probably always will.

[Narrator:] Sure, they've always lived here, and why not?

Almost like ringing the dinner bell for every rat in town.

Exactly what they need and want to set up housekeeping.

Rats go through the drums for you.

Too big for the city to handle, no lids.

Shouldn't be used for garbage in the first place.

[Resident:] Something the matter, rat man?

[Jeff:] Yes.

That's a real mess you've got there.

Why don't you get good cans, with lids.

[Resident:] Not my problem, I just live here.

[Jeff:] Sure you just live here, you and the rats.

[Manager:] Rats?

Heck yeah, we got rats.

Man it's like I told you, I'm not the owner. I'm just the manager.

Besides, ain't nothing I can do.

[Jeff:] Mister, I've given you two warning notices, now you get a penalty ticket.

Once the owner pays the fine in court, you can bet he'll tell you to start acting like

a real manager.

[Restaurant Owner:] Look, I don't want rats in my restaurant.

You think I'm crazy?

If the city would do its job I wouldn't have 'em.

[Jeff:] The city does what it can, but the citizen is in this thing, too.

We can't keep house for you.

[Resident 2:] This used to be a good place to live.

Look at it now.

Before these ole rats started coming around.

[Jeff:] Don't blame the rats lady, don't blame anybody.

Just keep in mind that it takes a bit of effort on everyone's part to keep a neighborhood

clean and neat so you won't have rats.

[Narrator:] Oh yes, there are thousands of rat bite cases every year.

Most of them infants with food on their faces after eating.

Or, older persons.

If we get them promptly to treatment, most wounds usually heal satisfactorily.

Unfortunately, many victims also suffer from the agony and pain of rat-bite fever.

[Jeff:] Biological warfare, rats versus people.

You betting on the people, George?

[George:] Sure, just the same as you are.

Just like you say, war is everybody's business.

It has to be.

That's why more of 'em have got to join up.

[Jeff:] Right, and if cats were the rat- catchers people think they are,

we wouldn't be mixing tons of poison bait, ratproofing buildings, or forever holding clinics.

[George:] Cats, dogs.

what's the difference?

They're not much better than traps really.

Like the butcher shop case.

Ahh, that was before your time, Jeff.

[George narrating:] It was over on the west side.

And the butcher used traps, and he caught a rat now and then...

so he figured he had the problem licked.

Most people do.

But man, the ones he didn't catch must have had a picnic every night.

Why, with all those scraps, it's a wonder he ever caught a rat in a trap.

This was all in the backroom, of course,

so the customers had no reason to suspect a thing.

Not then anyway.

Most people expect places that handle food to be clean as a whistle.

But they sure knew something was wrong when that food poisoning hit 'em.

And I mean them!

Men, women, kids.

Why that food was so contaminated from rat droppings left on his table,

that butcher could've poisoned a small army.

On top of losing his customers, he got a good case of lepto all on his own.

Probably from infected rat urine, and the mop water got right into his system.

Anyhow, he sure got the message.

[Jeff:] Leptospirosis huh?

Complete with chills, vomiting, muscular aches, that's pretty serious.

[George:] You better believe it.

[Dr. Lee:] I am Dr. C. Bruce Lee of the research and development office

of the Environmental Control Administration of the US Public Health Service.

We have with us today Mr. Harry B. Pratt, Chief of the Rodent Control Branch

of the Environmental Control Administration.

How are you, Mr. Pratt?

[Mr. Pratt:] Dr. Lee, it's a pleasure to be here today.

Uh, we plan to use this motion picture in many places throughout the country

where there is a rat problem.

But particularly in the twenty cities which are funded under the Partnership for Health program.

[Dr. Lee:] Could you tell us something, where these cities are located?

[Mr. Pratt:] Well as you can see on the map, these twenty cities are scattered from coast to coast.

Uh, including such very large cities as Chicago, Cleveland, New York, and Washington.

[Dr. Lee:] How much money is the federal government allocating

for this rat control program?

[Mr. Pratt:] Well, in the first year of operations, the federal government has spent about fifteen million dollars.

particularly in places like Chicago, New York, and Baltimore

where there are existing programs,

and in certain places like Atlanta and Nashville are where the money is used to start new programs.

[Dr. Lee:] Can you uh, tell us some information? Does the program cover an entire city?

[Mr. Pratt:] No.

Usually there's not enough money to cover an entire city,

so the work is concentrated for effective rat control in the low-income areas.

Quite often in the Model Cities or in the Model Neighborhood area.

[Dr. Lee:] Now that's interesting.

In these areas, who does the actual work on the program?

[Mr. Pratt:] Well, each program is planned and directed by trained engineers, biologists,

and sanitarians with broad experience in insect and rodent control work

and uh very frequently, years of work with the health department.

However, the majority of the workers are recruited from the inner city where the control work

is being carried out.

[Dr. Lee:] You mean to say that we have people working on the program

who have grammar school educations and who have been to high school?

Are they working on these activities?

[Mr. Pratt:] Yes, as you can see here, uh, some of these men are dropouts

or people who could not go further in school because of lack of money.

However, they can be trained to do very fine work in a number of types of jobs,

such as collecting rubbish.

Or they can be used to observe rat signs, as you see on the corner of this door here.

Uh, rats' teeth grow four or five inches a year and they can gnaw through many building materials,

even lead pipe with their sharp teeth.

Notice along the edge of this building, a rat runway.

Rats feel comfortable when they're using the same path day after day between their homes

and the source of food.

[Dr. Lee:] These signs are very interesting, of rats being about, but what else do the men

who are engaged in the program look for when they make an inspection?

[Mr. Pratt:] Well, of course the most important thing, we feel, is the checking

to see about refuse storage and garbage,

because garbage and refuse furnish the food and nesting material for the rat.

It's amazing how many garbage cans have no bottoms or tops.

There's no place for the bottomless or topless fad in refuse storage.

[Dr. Lee:] Well, since we have no place for the bottomless or topless fad in refuse storage,

what do the control workers do when they find garbage cans which are unsatisfactory?

[Mr. Pratt:] Well, of course the first thing they do is to come up and meet the householder

and try to get him to buy new garbage cans.

Uh they try to get rid of old appliances, old automobiles, places where rats

would hide in the backyard.

This is probably the most important thing that each householder can do,

is to have good refuse storage on his own property.

[Dr. Lee:] Well this is important to note, we must have good storage places

for refuse, on property.

Now, are rats confined to particular areas of the city?

[Mr. Pratt:] We can start in the sewers.

So these sewers, then, serve as a place where the rats can hide and they can travel.

And of course they can come up into some of our very best houses right through the floor

drains.

They can even crawl and swim through a toilet, into our basements.

[Dr. Lee:] Now that's most amazing and it's sort of chilling to think that even in my

own home...

[Mr. Pratt:] Right...

[Dr. Lee:] I could have a rat coming in by this means.

Uh of course I am interested in knowing what are the methods used for killing rats?

How do you go about killing them?

[Mr. Pratt:] Well of course, on the big city program we use three types of rodenticides,

that is, rat-killing chemicals.

We use uh, the anticoagulants, we use red squill, and we use zinc phosphide.

Now the anticoagulants are a chemical, which is mixed usually with yellow cornmeal.

This sort of thing here.

Now the rats must eat this for four or five days consecutively before their blood

begins to lose the ability to clot, or coagulate,

hence the name anticoagulant.

After this period of time, four or five days to a week or more, they become weak

and actually die painlessly from loss of blood.

Now there's a built-in safety factor.

If your child, for instance uh, should happen to eat this once, or your pet should eat this

once,

there's actually no danger from one feeding.

No sickness, no death.

It must be eaten four or five days in a row.

[Dr. Lee:] Well, it's good to know this, that there is this built-in safety factor

and I'm pleased because I do have children.

Now I'm concerned, what would I do if I found I had rats or mice about my house?

[Mr. Pratt:] Well, of course if you had rats, the best thing to use are these anticoagulants,

because of this built-in safety factor.

Now they can be bought and used in a yellow cornmeal mix, it's soft like this,

but it tends to blow, so a number of manufacturers have made it in a pellet form

which does not blow around nearly as much.

This comes probably in fifty or more different types of commercial formulations.

[Dr. Lee:] This is fascinating to see the uh, packaging in which these poisons come.

I remember as a child that they often said that a trap was best baited with a piece of

cheese

to tickle so a rat's nose, it almost makes them sneeze.

Now, is cheese the best bait to use for traps?

[Mr. Pratt:] Well of course most housewives feel that cheese is the best material to use

in baiting a mousetrap.

So it'll be done like this and of course you put the trap on hair-trigger.

But actually, we have found that you can get just as many mice or more with apples or peanut butter.

a nutmeat, or many other types of things that are in our houses, like bacon.

[Dr. Lee:] Well then, what do you do about rats in buildings, for instance?

[Mr. Pratt:] Well of course rats are much bigger, so we use essentially the same type

of snap-trap uh,

which we would set like this.

And uh you put your bait here and it would go like that.

On the other hand, if this is the wall now, like this, we can sometimes trap the rats

by having an expanded trigger of cardboard or metal as you see here.

And uh you've got to be very careful Dr. Lee,

because this is uh, something that could catch your finger very easily.

Now if this is the wall, we don't set the trap this way so that the rat comes in and

is thrown away.

We try to get it so that as the rat travels along the wall that way, why, it is caught

you see,

as it goes along the treadle.

Now, there's still another type of trap that we use that essentially is unbaited.

This is called a steel trap.

Now this one again, you can catch your finger in and have a real good little wound.

But if you use real caution and set it like this, and then you come under

and set it at hair-trigger,

remembering that one jaw of the trap is free, why then you can do it.

Now if this is, again, we don't set it this way so that if the rat runs along

it's thrown out, we set it this way.

Then as the rat comes along it's caught in the trap as you see there.

These, then, are some of the things that we do as we uh, try to get rid of rats and mice

in our houses.

[Dr. Lee:] I'm glad to have you the person who's demonstrating these traps on the, on

the program.

But what does all this mean to the average householder?

[Mr. Pratt:] Well of course to the average householder uh, this means that

rats are something that they should try to get rid of as quickly as possible.

Now let us look again at our motion picture and see a little bit more about the urban

rat problem.

[Footsteps]

[Mr. Barnes:] So the rat is a stealthy, clever enemy.

He can climb up wires and pipes,

squeeze through half-inch holes,

jump up and out three feet,

jump down and out eight feet.

Even drop fifty feet and still survive.

He starts fires,

destroys food and valuables,

contaminates even more,

and when you multiply the damage of a single rat by the rat population of the US,

about one rat for every two persons, the yearly loss skyrockets to more than a billion dollars.

So how do you change the picture?

By eliminating a rat here and there, not a chance.

You have to control the entire rat population and the first step is to eliminate the one

thing

that supports any population.

Food.

A single open garbage can for example, will support just so many rats, no more.

But add a few more messy cans,

then the mess of a city block,

plus that of an entire neighborhood,

and suddenly you're supporting a king- sized rat population.

[Jeff voiceover:] Amen, Mr. Barnes.

A lot of food, a lot of rats.

Less food, less rats.

No food, no rats.

Way I see it, most people are so close to their rat problem, they overlook the most

obvious solution.

Especially when they're blaming somebody else.

As always, it boils down to communication,

to telling him point-blank, "Look, if you want to get rid of your rats, quit feeding them.

Quit giving them hiding places.

Rats won't stay in an area where they can't get food and shelter.

So when you take it away, you take away the rats."

Here's the idea.

You see that?

It's a jumbo-sized, always-closed container

to handle a jumbo-sized garbage and rubbish problem.

And it does just that.

What's more, the city thinks it's great.

To me, most excuses are cover-ups for doing nothing.

But if anybody, a manager, owner, or tenant ever had reason to cover up,

it's right inside his garbage can or outside of it.

With just a bit of conscience, a bit of pride, and a bit of effort on everybody's part,

people can get rid of their rats, and they will,

if everyone keeps working at it.

[Jeff:] I mean that.

Every word of it.

There's no doubt that the rat problem is serious in every city, large or small.

We can't ignore it and we can't wish it away.

But we can do something about it.

Each one of us.

I'm betting on the people in this war on rats.

How about you?

[Truck engine revs]

[Dr. Lee:] Harry, your film says that the rat problem is serious in this country.

Just how serious is the urban rat problem.

[Mr. Pratt:] Well, every big city has a rat problem.

This varies of course with the age of the housing, with the condition of the housing,

and with the amount of food and harborage for rats.

Now, in the map that we showed you before, in the twenty cities where we examined,

we found about two thousand yards, out of twelve thousand carefully checked,

had signs of rats outside the home.

This is roughly one-sixth, or sixteen percent.

But even more important uh, sixty-one percent of the blocks in these cities had at least

one yard

with signs of exterior, rat signs outside the home.

[Dr. Lee:] Well these uh, statistics, the few that you've given us are most revealing,

and I was wondering does this, are these indications that give us any uh,

way of knowing what steps you're making in controlling uh rat, the rat problem?

[Mr. Pratt:] Well, we're making a rather sizable amount of advance success

in cutting down the number of rat bites and in cutting down the actual prevalence of rats

in these cities.

Uh for instance in New York City, the number of rats used to be reported so that there

were

six hundred cases of rat bites a year.

Then in a five-year period, from '63 to '67, uh it dropped down

to about five hundred and fifty.

In '68, there were only three hundred and ninety rat bites reported in greater New York.

And this year we only know about two hundred thus far.

[Dr. Lee:] Well, this does indicate that there is progress.

I can remember when I was a teacher many years ago, my children, when we were discussing rats,

showed me fingers, and noses, and ears that had been bitten by rats when they were babies.

This brought home to me the importance of control measures.

Now I realize that most of the film that we have seen today has demonstrated

the areas of town that you might say are poor, which are, where people who live, who don't

have opportunities;

however, rats are found everywhere,

as you said.

And one of the methods of control I assume is that we must get everybody to cooperate,

meaning the tenants, the residents, and the people who own the property.

It's got to be a...it seems to me, a broad attack involving everybody

who has anything to do with the environment in which rats are found.

Would you agree to this?

[Mr. Pratt:] I would think that this is very definitely true and that this very definitely

has a bearing on another significant part of the rat problem,

mainly about mental health and well-being.

You take children that are brought up in the inner-city uh, very frequently they grow up

wihtout being able to sleep at night because the rats are up in the ceiling

or they're gnawing in the walls.

There's a fear of rats and of these ugly, disfiguring scars.

And in some work that we've done it seems to us that uh, the rats uh, are probably

the number four cause of unrest and turmoil in the inner-city.

Uh, following such things as human relations, and poverty, and unemployment.

[Dr. Lee:] It's interesting to feel that an animal, a small animal which has traveled

with man from Asia

to our country, could be a definitive cause in unrest within our urban centers.

My first experience was reading Hans Zinsser's book, "Rats, Lice, and History."

This is a rather old book, but it is still pertinent.

It gives the history of man's reactions, his relationships to this pest, this neighbor

of man

who has followed without his asking man about the face of the earth from its origin in Asia.

And I am more than pleased to realize that the Environmental Control Administration

and Public Health Service has within it a program which is concerned with this rat control.

Are there, is there any information the viewers can secure concerning the uh,

control measures uh, the activities that are being undertaken in rat control.

[Mr. Pratt:] Of course we feel that this is a people problem

and that we must have the people behind us.

Now New York has done this, they have made this sign.

Seven things that every New Yorker should know about their neighbor.

And this brings home to them very clearly uh, that these are definitely in their homes.

We do a great deal of training with health departments all over the country

and we have recently produced this book:

Control of Domestic Rats and Mice,

which is available through the Government Printing Office.

Many health departments and other agencies are using this with pictures of rats

and uh trapping, of uh rodenticides and the refuse storage, all these things.

So go to your health department if you have a rat problem

and get advice from your health department.

[Dr. Lee:] Thank you so much for coming aboard to talk to us today, Harry.

It's a pleasure.

[Mr. Pratt:] My pleasure.

[Music]

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