Massage therapy schools in Kansas offer convenient opportunities to earn certificates and associate and bachelor degrees in massage. Courses of study will include anatomy, physiology, psychology, other sciences, and a great deal of time will be spent in clinical practice under the supervision of experienced instructors. Students may also study reflexology, aromatherapy, orthopedic massage therapy, deep muscle massage, therapeutic touch, sports massage, and more.

Students in Kansas massage therapy schools will get exposure to multiple massage therapy techniques, including Western medical massage therapy styles and Eastern styles of massage therapy that renew mind, body, and spirit. Individual massage therapy schools may include courses in management, accounting, marketing, and business ethics in their curriculums to help aspiring massage therapists prepare for opening a business of their own. Some massage schools will offer studies in other natural healing techniques, such as acupuncture or chiropractic.

Massage schools in all states are responsible for seeking accreditation of their schools and programs of study from state and national organizations. Massage institutions can gain accreditation after passing evaluations made by organizations recognized by the U.S. Department of Education. Recruiters and administrators of accredited schools will happily discuss accreditation with new recruits and students alike. For a good education that prepares for certification exams, students should choose only accredited massage schools.

Kansas has no overall state requirements or regulations that affect massage therapy practices; however, individual cities and counties may apply strict regulations. Before graduation, students should seek out rules and regulations regarding massage and bodywork from local authorities in the areas in which they intend to practice their new skills. Courthouses, police stations, town halls, and perhaps your massage therapy school will help with understanding laws that apply to massage therapy practices in Kansas.

Poland’s decision to join the EU in 2004 has been a boom for the country’s medical tourism industry. Regulations in other EU states that require private health insurance to pay for certain medical procedures have meant thousands of westerners travel to this eastern European state for affordable quality treatment.

Polish medical schools have produced high quality medical practitioners who have earned excellent reputations all over the world. Many of its doctors and dentists have diplomas from medical schools in the United States, returning to set up private practice in their home country.

In general, the healthcare service is considered on a par with the rest of Europe. Many Polish hospitals and clinics are ISO 9001 certified and have accreditation with the international Quality Monitoring Centre.

Medical innovation is another feature of the Polish health landscape with many heart transplants performed in Cracow and Zabrze.Deaf patients can have their hearing restored with an implant from the International Centre of Hearing and Speech in Kajetany near Warsaw.

Poland has become a favourite for people looking for treatment in the areas of plastic surgery and dentistry with prices in these sectors currently 40 to 70% less than in many parts of Europe, as well as the United States.

A porcelain crown for example, which costs roughly €750 in the UK, is available in Poland for around €150. Not surprising then, that 3,000 medical tourists arrived in Poland from the United Kingdom in 2006 alone. Some medical tourism companies in Poland even offer total packages which include cosmetic or dental procedures plus recovery and recuperation in first- class spa resorts.

Look to online physician assistant schools to offer advanced physician assistant studies for the practicing medical professional. As a working physician’s assistant, you will qualify to enroll in an online physician assistant course to enhance your knowledge and skills without forfeiting your current employment.

As the health care profession grows, there is also a growing need for medical specialists to work alongside physicians in the fields of Family and Emergency Medicine, Forensic Medicine, Sports Medicine and Occupational Medicine. There is also a need for those who can demonstrate leadership in the medical field and those who wish to educate others in various aspects of health care. That is where online schools can offer working medical professionals an advanced education in physician assisting. With a flexible online education, the physician assistant (PA) can hone their medical skills to better prepare to meet the challenges faced in today’s world of medicine.

The professional physician assistant often assumes the duties of taking patients’ medical histories, examining and treating patients, diagnosing illnesses and injuries, giving injections, instructing and counseling patients, treating minor injuries, ordering lab tests and interpreting laboratory results, and performing medical therapies, all under the eye of a doctor or surgeon. These basic medical skills cannot be learned entirely online, so the beginner’s associate degrees or bachelor’s degrees in physician assisting are available only from traditional physician assistant schools.

If you are not yet a certified physician’s assistant, you will want to check into online schools offering entry-level online health care and medical training. This can help you get some of the basics under your belt. Or look into campus-based physician assistant schools to gain your physician assistant education. There you will learn to provide diagnostic, therapeutic, and preventive health care services under the supervision of a physician or surgeon.

However, if you already have a Bachelor of Science or Master of Science with a concentration in Health Care or Medicine, or if you are already a physician assistant, you may qualify for an online course leading to a Master of Science Degree in Advanced Physician Assistant Studies. The typical physician assistant course online will take approximately 40 credit hours to complete, and study can take place via the Internet, wherever and whenever the student desires.

Computer schools serve to provide education to people who wish to learn about computers and use them for their own specific purpose. Computer schools in Canada have many years of experience in providing focused, relevant career training. Such computer schools also offer diploma programs that include business administration, accounting, programming, networking and a wide variety of medical programs. Many people consider it wise to invest in computer education, as more and more jobs are dependent on the usage of computers.

The learning system in computer schools is based on two methods of training for adult learners. The first method allows instructors to provide lecture-based education. A competency-based training program provides applicable skill development for the chosen computer program. Computer schools in Canada are equipped with the latest software and hardware tools for students planning on joining various computer industries.

There are many computer schools in Canada that conduct evening classes. This is advantageous for those people who are working during the day or running a business. There are online computer classes as well for people who find it difficult to enroll in a computer school because of exorbitant fees or commuting difficulties.

A computer professional holds an important position in the technological world. Training at an accredited computer school enables people to take up several of the challenging tasks that the computer industry has to offer.

Employers are known to have a preference for hiring people from an accredited school. It is advisable for people to make sure that the course offered online or regular mode of study is recognized.

Computer schools in Canada have regular discussions and workshops that are organized to let students voice any doubts related to their field. Some schools in Canada also have industry experts on board that work to establish the reputation of the school. Such interactions may also open doors to job opportunities.

Midwestern students interested in a career in massage therapy will find opportunities to prepare for this profession in several massage therapy schools in Indiana. Students can opt to earn certificates or diplomas from vocational and technical schools and community colleges, or to get two-year Associate of Science (AS) degrees that are offered by some community colleges. Four-year Bachelor of Science (BS) degree programs are offered by other Indiana massage therapy schools.

A good massage school will provide students with all the classroom and hands-on training required for gaining entry-level positions in spas, medical facilities, and athletic organizations. Hands-on clinical massage experience provides many of the tools needed, while courses in anatomy, physiology, pathology, nutrition, health, and hygiene, as well as theory and practice of massage, hydrotherapy, reflexology, and more provide other necessary skills. Management, marketing, accounting, and business ethics are also offered in some Indiana massage therapy schools to provide complete business skills for operating a massage therapy business.

The best massage therapy schools are accredited by state and national organizations. Students should also seek schools that are associated with professional massage therapy and bodywork organizations. Accreditation assures students of a quality education. Some credentials that students might find attached to a good massage school may be: ACCSCT (Accrediting Commission of Career Schools and College of Technology) and ACICS (Accrediting Council for Independent Colleges and Schools). There are other qualifying credentials as well.

Massage therapy schools prepare students for providing bodywork treatments for relaxation and reducing stress and pain, and for medical massage for assisting patients in recovery after injury. Programs in massage therapy prepare graduates for positions at the entry level in spas, fitness centers, sports medicine, chiropractics, sports organizations, health gyms, or private massage therapy practices.

What issues dominated this election? I think that unquestionably it was overbuilding and traffic as a result of the overbuilding …. [Now we are] addressing the issue openly for the first time, and letting people digest what has happened. [Voters were saying] that we really need to take a step back.

Why is overbuilding a major concern at this particular point in time?

All of a sudden all of these cranes are coming. You’re beginning to visualize that NE 188th Street and Loehmann’s Plaza are going to have all of this building. The traffic that is going to be a result of that is all going to be happening at the same time, and this doesn’t give the city a chance to absorb it. It’s just sudden impact.

Most other cities would be absolutely thrilled at the growth, and I think Aventura will be thrilled at the growth. I think we would have liked more of a phased-in development so that we had a chance to absorb the impact. That’s what I’m hoping for in the future.

Plans for charter schools only go as far as eighth grade. What happens after that?

There’s been some conversation as to what will happen … at the end of middle school. Where will all these children go? And that’s an issue that the new commission is going to have to deal with …. At the present time it would be [Dr. Michael M. Krop High School], which is over crowded, so we have to deal with the school board or make some other plan.

Aventura has one of the most celebrated shopping malls in the nation, but as far as cultural offerings, it seems to be lacking. Do you have any plans to address that?

That’s really a big issue for me. I was instrumental in keeping the Miami City Ballet in Miami-Dade County. Is there a future for a small black box theater? I certainly hope so. And when I say small black box, I’m talking about a 100- to 200-seat theater like they have in other parts of the county.

How is the huge renovation of Aventura Hospital affecting the city?

The hospital is going to be a major part of our growth over the next several years …. Having Aventura Hospital as a quality medical center will be a tremendous asset to this community. There will be a marketplace over there for medical office space, to make it more convenient for the doctors to be able to go to the hospital, and that’s a great symbiotic relationship for the hospital and it’s certainly something that we need in Aventura.

How do you address the issue of overbuilding in the surrounding municipalities that are also affecting Aventura?

We are part of a greater community than just Aventura, and we need to be able to work with our neighbors to the east in Sunny Isles Beach, because their growth definitely impacts us. We need to be able to work with our government and neighbors in North Miami, because what they do on Biscayne Corridor and Biscayne Landings will definitely affect us.

THE CITY OF AVENTURA gears up for major renovations and beautifying as it prepares to welcome new visitors and mega investors into its cradle. Stay tuned for the next round of changes and additions.

Historic Collaboration Intended to Prevent Silent, Irreversible Brain Injuries to Children

WASHINGTON, D.C.-Four leading medical, nursing and public health groups, representing more than 300,000 public health professionals, today filed a challenge to the U.S. Environmental Protection Agency’s (EPA) power plant mercury rule. The plaintiffs include Physicians for Social Responsibility, the American Academy of Pediatrics, the American Nurses Association and the American Public Health Association.

The medical and health groups, represented by John Suttles and Marily Nixon of the Southern Environmental Law Center, are filing a ‘motion for intervention’ into the mercury litigation initiated by environmental organizations and 13 state attorneys general. The groups are filing the new lawsuit in response to the mercury rule’s clear threat to public health. Physicians, nurses, and other public health professionals will ask the federal courts to overturn the weak mercury rule to protect Americans’ health. (Copies of the filed legal documents and state-specific fish advisories will be posted on www.mercuryaction.org on June 14.)

Many Americans are exposed to unsafe levels of mercury from environmental sources, including power plant emissions, by eating contaminated fish. EPA investigators have estimated that over 600,000 newborns are born each year overexposed to unhealthy mercury levels in utero. According to widely accepted scientific research, mercury is a potent neurotoxicant that can cause developmental and learning disabilities, reduced IQ, and impaired motor skills in children, and altered sensation, impaired hearing and vision, and motor disturbances in adults linked directly to exposure from eating contaminated fish.

Mercury emissions from coal-fired power plants make up more than 40% of all emissions into the U.S. environment, the largest source of uncontrolled mercury pollution in the U.S. The Clean Air Act requires the EPA to make public health its first and only priority, and the law mandates that these plants reduce their mercury pollution by up to 90 percent of current emission levels by 2008.

Unfortunately, the U.S. EPA’s final mercury rule delays significant mercury reductions for 10 to 15 years longer than the federal Clean Air Act requires. The rule also substitutes an inappropriate “cap-and-trade” scheme for strong technology-based pollution control standards, also required under the Clean Air Act. This proposed trading scheme threatens individual communities with toxic mercury ‘hot spots,’ local areas of higher mercury concentrations that could result in dangerous levels of human exposure.

“Our nation’s health and safety is at stake. The EPA can help prevent future brain impairment in America’s children, by strengthening and enforcing reasonable limits on mercury emissions from power plants and educating consumers about avoiding fish high in mercury,” said Susan West Marmagas, MPH, director of Physicians for Social Responsibility’s environmental health program.

In implementing a seriously flawed mercury rule, the EPA ignored the counsel of its own Children’s Health Public Advisory Committee and ignored nearly 700,000 overwhelmingly negative public comments during the recent public comment period. The EPA also ignored the annual economic costs of methyl mercury toxicity attributable to mercury from American power plants. Researchers at the Mt. Sinai School of Medicine estimate the annual cost from lost productivity associated with IQ impairment from methylmercury to be $1.3 billion (in year 2000 dollars. Source: Environmental Health Perspectives. Public health and economic consequences of methyl mercury toxicity to the developing brain. Trasande, Landrigan and Schecter).

The loss of intelligence continues throughout the lifetimes of exposed children. If not addressed, the silent but significant public health threat associated with mercury pollution will diminish the economic competitiveness of the United States’ population. Exposed children will likely need more time and attention from their parents, thus impacting the parents’ economic productivity. Some children will likely require costly special education.

“Infants and young children are at highest risk of injury from a mercury-contaminated environment because their brains are still rapidly developing,” said Katherine Shea, MD, MPH, of the American Academy of Pediatrics. “The EPA has failed to take the most protective actions available in reducing mercury exposure to children and women.”

“Many young children exposed to mercury before birth will suffer subtle but irreversible brain damage. Preventing this tragedy, which affects not only families but entire communities, should be a national priority,” said ANA President Barbara A. Blakeney, MS, RN.

“This new EPA rule will result in excess mercury emissions and increased exposure over a longer period. We must take aggressive action to address this serious health threat,” said Georges Benjamin, MD, FACP, executive director of the American Public Health Association.

Popular crime dramas and macabre autopsy exhibitions have been blamed for a severe shortage of bodies being donated to Britain’s medical schools, hitting training courses for doctors and surgeons.

The slump is being blamed on dramas such as Waking the Dead and Silent Witness, and the controversial live autopsy and skinned- corpse exhibitions by German artist Gunther von Hagens. A touring exhibition, Bodies Revealed, has also been criticised.

Medical schools rely heavily on the public bequeathing their bodies for anatomy classes, but the number donated each year has fallen so sharply there is now an annual “shortfall” of 400 cadavers compared with a surplus a decade ago. Demand has jumped steeply because nine new medical schools have opened and the number of students has soared. Jeremy Metters, HM Inspector of Anatomy, said this meant that at least 1,000 bodies a year were now needed. This week, at its annual conference, the student wing of the British Medical Association will call for a national campaign to urge the public to donate their bodies after death.

In Nigeria, cost of drugs can account for up to sixty percent (60%) of health expenditure (Salako, 1992), in contrast to only about 10-20% in developed nations. The reason is that until recently, health was heavily subsidized and even free in some parts of the country where the party in power claimed to pursue a welfarist agenda. However, a careful scrutiny of the health budget will show that not all the drugs need to be purchased and many of those that are purchased do not necessarily give the users any substantive value for their money. Part of the problem is the intense promotional activities of marketers of pharmaceuticals, which are often more concerned with boosting sales of their drugs than promoting genuine scientific knowledge (Lexchin, 1987).

Consequently, health care professionals unwittingly rely on the information on drugs provided in the advertisement by marketing companies rather than on the scientific literature (Avorn et at, 1989; Lexchin, 1992). Advertisement– induced knowledge has been implicated in incorrect use of medicinal drugs in many developing countries (Dikshit and Dikshit, 1996) as a result of inadequate prescription guides. There is some evidence (Assad and Mirza, 1999, Okoro and Davies, 2000) that providing accurate and comprehensive drug information is not a priority for many marketing companies doing business in third world countries. Indeed, the United States Office of Technology Assessment estimated that up to two-thirds of medicines sold in developing countries by Multinational Drug Companies have probably been packaged with incomplete or misleading prescription guides (Frankel, 1993), thus precipitating irrational use of drugs as well as increasing the cost of health care.

In order to minimise this problem, the Nigerian Government organised in 1994 a workshop for senior medical educators and teachers of pharmacology in the country. At the workshop, the participants were asked to draw up a programme that would incorporate into the curriculum, the teaching of essential drug concepts with a view to inculcating the principle and practice of rational drug use as well as economic prescription model in future doctors and pharmacists.

In 1998, a pharmaceutical company also launched an educational programme, ostensibly as part of its contribution to the rational drug use programme. The educational programme was in the form of an essay competition and was designed specifically for penultimate and final year medical and pharmacy students as well as intern doctors and pharmacists. The objective of the programme, as stated by the company, was to draw attention to the peculiarities of hypertension in blacks that should be taken into consideration in the choice of anti-hypertensive drugs for Nigerians. For this reason, the company listed two essay topics for the 1999 competition for two categories of competitors, namely (1) medical interns and students and (2) intern pharmacists and pharmacy students. The essay topics were: (a) Quality of life in hypertension: Evaluation of therapeutic alternatives, for medical interns and students. (b) Pharmaco-economics and hypertension: Implications for the black hypertensives, for intern pharmacists and pharmacy students.

In the advertisement announcing the 1999 essay competition (fig. 1) the sponsors of this educational programme who were also the makers and distributors of a fixed drug combination of prazosin O.5mg and 0.25mg polythiazide per tablet indicated conspicuously and for effect, that this medication is the “antihypertensive tailored for the black patient” (fig. 1).

Background Pharmacology of Prazosin

Prazosin is an anti-hypertensive drug available as a single formulation and prazosin as a fixed combination which contains prazosin and polythiazide in doses as earlier indicated (fig. 1). Generally, prazosin is a highly selective aladrenergic antagonist that lowers blood pressure on the basis of its blockade of this receptor type at arterial smooth muscle. Its neutral effect on blood lipids and glucose metabolism reported in many studies (Alderman and Madhaven, 1981; Murphy et at, 1982) initially enhanced its popularity and preference over thiazides because of safety concerns. At that time, it was believed that the adverse effects of thiazides on electrolytes, particularly hypokalaemia, were in some way linked to the lack of reduction in cardiac mortality in hypertensive patients treated with thiazides. However, this problem has now been laid to rest because subsequent studies (Ajayi et al, 1989; Salako et al, 1998; Matterson et at, 1993; Flack and Cushman, 1996; Kapuku et al, 1998) in many parts of the world, including Nigeria, have shown that when correctly used, thiazides effectively lower blood pressure without any clinically relevant electrolyte and metabolic consequences.

Furthermore, while prazosin (single formulation) is made available in many countries by the Marketers referred to - in fig. 1, prazosin is only available and marketed as a fixed drug combination in Nigeria (Mims, 1983 - 1989; 1999; BNF, 1991). The maximum recommended daily dose for the treatment of hypertension is 16 tablets, i.e. 8 mg prazosin combined with 4 mg polythiazide (Ibid). On the other hand, polythiazide on its own is not marketed in Nigeria but is available to prescribers in the UK (BNF, 1991). The recommended daily dose for polythiazide in the treatment of hypertension is 1-4 mg, although prescribers are advised to start with as low as 0.5 mg which is often sufficient to control blood pressure in most cases (Ibid).

When John D. Abramson was practising family medicine in Hamilton, Mass., he prided himself on how conscientiously he selected the drugs that he prescribed. He closely followed pharmaceutical research. He kept track of the latest medical guidelines. And he maintained his distance when company salespeople, with promotional pitches at the ready, appeared at the practice that Abramson shared with several colleagues during the 1980s and 1990s. He typically didn’t speak to pharmaceutical sales agents, although he did let them leave behind free samples of drugs that their companies sold.

Abramson knew that the companies wanted him and his colleagues to prescribe new and often expensive drugs rather than their older, less costly alternatives. But he saw no harm in stockpiling the freebies and banding them out to patients who were without health insurance and unable to buy drugs on their own.

“I thought I was being Robin Hood,” Abramson says. Before long, however, he grew so familiar with administering the free drugs that he found himself writing prescriptions for the same substances for insured patients, whose coverage would then pay for the medications. For pharmaceutical companies, Abramson’s behavior meant new customers. “That’s what they wanted,” he says. “They were playing me like a violin.”

Abramson left medical practice nearly 4 years ago to write Overdosed America: The Broken Promise of American Medicine (2004, HarperCollins), which trains a critical eye on pharmaceutical companies’ influence on medical research and practice. He now teaches at Harvard Medical School.

At least two pharmaceutical marketing strategies converge to alter doctors’ prescribing habits. On one hand, sales representatives target physicians with visits and samples, and ads tout drugs in journals. On the other, mass media advertisements urge people to ask their doctors about specific brand-name medications. This direct-to-consumer (DTC) advertising, which is not permitted in Europe and strictly limited in Canada, has in the past decade grown into a multibillion-dollar industry in the United States.

Pharmaceutical companies and some health researchers say that promotional activities make doctors and patients better aware of available treatments. Other researchers and consumer advocates counter that the ads and giveaways goad doctors into giving patients drugs that may be unnecessarily expensive or sub-optimal in effect.

If nothing else, says internist Richard L. Kravitz of the University of Caiifornia, Davis, the consequence of drug promotions is that the medicines that are most profitable for drug companies end up being overprescribed.

ASK THE DOCTORS Eighteen actors were dispersed to physicians’ offices by Kravitz and his colleagues during 2003 and 2004. Such actors are known in the medical literature as standardized patients; they aren’t sick, but they’re trained to describe certain realistic sets of symptoms. Medical schools use standardized patients to test students’ diagnostic skills.

Kravitz had a different test in mind. He and his fellow investigators instructed the actors not only to fake specific symptoms but also, in some cases, to ask for a particular drug or a general class of drugs. The researchers wanted to know how physicians would respond to supposedly media-driven inquiries. The researchers recruited 152 family physicians and general internists practicing in San Francisco, Sacramento, Calif., or Rochester, N.Y. Each participating doctor was told that he or she would be sent two standardized patients during the next year. But the doctors weren’t told the study’s purpose or how to identify the fake patients.

The actors then scheduled appointments with the physicians. Once in a participating doctor’s office, some of the fake patients described symptoms of major depression, a long-lasting mood disorder that’s often treated with antidepressant medications. Other standardized patients complained of symptoms of a less serious psychiatric ailment, which is called adjustment disorder with depressed mood. This condition generally disappears within months without medication.

When standardized patients faking major depression didn’t specifically request an antidepressant, 31 percent received a drug prescription. However, when others claimed that a television show about depression had encouraged them to seek drug treatment, 76 percent received a prescription of some kind.

In those two groups, about 6 percent of the actors who received a prescription got one for paroxetine (Paxil), one of several drugs in a class frequently used to treat major depression.

However, when members of a third group reporting identical symptoms asked specifically for Paxil, saying that they had seen it advertised on television, more than half the resulting prescriptions were for that drug.

In standardized patients who reported symptoms of adjustment disorder and didn’t raise the subject of antidepressant drugs, just 1 in 10 got any medication. But nearly half of the actors who asked for medication got it. Most who asked for Paxil walked out with a prescription for that drug, while most who made a nonspecific request were prescribed some other antidepressant.