Skin care products wouldn’t be complete without face masks and scrubs. Masks primarily function to sooth and replenish while scrubs are best as exfoliants. Facials can play a vital role in helping keep skin healthy and glowing. Body scrubs are a spa experience you can create at home. Making your own body scrub is very easy to do. You should only make enough for one use or at most four uses. Clay face mask draws up the natural skin care component in clay to cleanse and purify the skin. It is actually a drying mask that draws out impurities from under the surface of the skin. The goal of this type of mask is to tighten, revitalize and activate skin circulation, giving the skin a youthful and vibrant glow.You can make your own body scrub from the ingredients you probably already have on hand.

Exfoliate ingredients include sea salt, epsom salt, white sugar, brown sugar, cornmeal and oatmeal. The wet ingredient is either an oil or vegetable butter or liquid soap. A cream face mask is a moisturizing mask that revitalizes and hydrates the skin. It may contain organic skin care exfoliation agents to help cleanse skin pores, remove waste and toxins and fight free radicals leaving the skin more velvety and luminous. Organic facial masks may contain generous amounts of botanical freshener like rose floral water and calming sea algae to double act as toner. Scrubs work by removing deeply ingrained dirt and grime to leave skin soft and clear. The good ones are made up with the grinded core of the peach fruit or almonds. The natural granules remove dead skin cell and blackheads.

Scrubs are a great, inexpensive and effective way of thoroughly cleansing your entire body while providing it with an overall skin care treatment. Some body scrubs use small beads, which work to gently remove dead skin without causing harm or irritation. If your skin is oily this is the ideal homemade scrub. Take 4 table­spoons of chickpea powder. Add to this, half tablespoons of turmeric power, a few drops of rose water and milk to make a thick paste. Rub it all over the body. Apply baking soda on wet face using circular motions. Make a mixture of 1 tsp walnut powder,1/2 tsp honey, 1 tsp lemon juice and scrub your face with it. Other scrubs mash a piece of papaya, then add 1/2 tsp brown sugar and rub your face with it. Leave it on for 20 minutes and rinse well.

Just take a minute and imagine how much time and money you could save if you were able to download all your favorite TV shows without paying over $50 for a whole season? What if you could actually download the whole season of Scrubs for less than a penny a day? Why pay when you can download Scrubs episodes for free and enjoy them at the comfort of your own home? So is it actually possible, or am I a dreamer? Let’s find out!

For the past few months I was looking for a way to download Scrubs episodes for free, as I figured that it is pretty expensive to download them on iTunes, or buy them at sites like Direct2Drive. So I have spent a few day looking for a a web site, or service that would allow me to download high quality TV show episodes for free, or at least for cheaper prices.

Unfortunately, I didn’t have much success, all the sites I tried were complete waste of time and money as they either didn’t have any TV shows that I like to watch, or simply they had such a low quality of service. Until recently, I stumbled upon a web sites, which claimed that I could download Scrubs episodes, Lost, Heroes, The Office and many other TV shows without paying per every download.

Well, I knew it was way too good to be true, however, I decided to try it out and find out what was all the fuss about. So I joined it and… Well, I was actually blown away, I couldn’t believe my eyes, because this was probably the best investment I have ever made!

The web sites had thousands of different TV shows which I could download for free and also legally. I could download Scrubs episodes without spending so much money, they only thing I had to pay is a one time membership which was around $30, but I that’s pennies compared to what other services like Direct2Drive and iTunes charge!

I highly recommend you try out a web site like this and if you are looking for more information about it, feel free to visit TV Show Paradise.

In the past, washing your face simply meant taking a wash cloth and scrubbing your face with soap and water and rinsing it off.

These days, washing your face means applying a cleanser, massaging it in, tissuing it off or rinsing it off with water. Then you soak a cotton ball with a toner to remove all traces of the cleanser and tone your skin. At least once a week, a facial scrub might be applied before the toner, in which a grainy cream or wash is massaged onto skin to get rid of dirt and slough off dead skin cells to keep skin clear.

Is all that necessary?

Do you really need facial scrubs?

Actually, the old fashioned way of using a wash cloth to scrub your skin is akin to what the facial scrubs do. If you simply cleanse and rinse your skin without sloughing off the dead skin cells, chances are, the skin might get flaky leading to dry looking skin that is dehydrated beneath.

Another possibilitiy is that the debris left behind might clog the pores, giving bacteria the perfect breeding ground which can well lead to acne.

Hence regular scrubs are necessary.

So why buy a scrub when a wash cloth will do?

Personally, I’d rather not use a wash cloth. The thought of bacteria or mould breeding on that wash cloth is enough for me to turn to the first off-the-shelf facial scrub I can find. Sure, use a wash cloth if you intend to send it to the laundry every day and use a fresh wash cloth each day.

Imagine scrubbing your face with the wash cloth. The bacteria and dirt from the skin gets left behind on the cloth. Rinsing it with water wouldn’t get rid of all the bacteria and soap. As you leave the washcloth in the bathroom, which I assume, doubles up as the toilet, the bacteria from doing business floats in the air. Bacteria from the air happily breeds on the moist washcloth which you then use to scrub your face at night.

Okay, I sound like a germ phobe and if your skin is fine with that, a wash cloth should do.

Alternatively, you could make your own scrub. I tried that. A tiny jar of powdered almonds makes a good scrub. Dip your fingers into it, add water, mix and you have got a scrub. The problem is the almond powder left in the damp bathroom, mould and bacteria thrive. If you do not take care, the moisture in the scrub introduced by wet fingers encourage mould and bacteria to thrive which can lead to disastrous results if you use it on your skin, since that home made scrub does not contain anything that would kill the mould or bacteria.

You will find plus-size nursing scrubs in various designs and colors. Some have a design that ties on the side and contains a front pocket. You can get this particular design in sizes up to XXLarge. Those having a flower and leaf design on a royal blue background are attractive and comfortable as well.

A V-neck tunic is another style of plus-size scrubs highly popular among nurses. It contains three pockets, making it comfortable and also highly usable. You will also come across matching unisex scrub pants that are available with a drawstring waist. You can get some of these pants are in sizes up to 5XL.

Some plus-size scrubs are available in a keyhole neck top. You can get them in several print designs, such as guardian angels, banana boats, hearts, and others. If you are looking for more, you can find a three-quarter-length sleeve high V-neck with a rose pattern made from pure cotton. All of them are easy to look after and, more importantly, retain their colors after repeated washing.

There are many other plus-size designs that are extremely attractive, highlighting the positives.

For instance, A-line designs minimize wide hips or thighs. There is also one that minimizes the tummy and broad shoulders. Waist-scoop-neck designs minimize the chest, while drop-waist designs lengthen short torsos. For flatter, full figures, V-neck and scoop neck designs are best suitable.

Unisex cargo pocket scrub pants of XXL and XXXL sizes have extra-long inseams, elasticized waist bands, deep double pockets on the right leg and a spacious single pocket on the left. Unisex cargo pocket scrub pants have long length (33 in inseams), XXL have long (33″”) inseams, fabric of blended cotton and polyester, an elasticized waistband, deep double pockets on the right leg and a large single pocket on left.

Do you have hard, cracked heels and dry feet? You can have soft, pretty feet in as little as 10 minutes with a sugar scrub treatment that relaxes and relieves stress while you massage your feet. Sugar scrubs are natural spa therapy products with powerful and effective exfoliation properties. Sugar contains natural alpha hydroxy acids that dissolve dry skin while sugar granules polish, for feet that feel luxuriously soft and smooth. The added bonus of this foot spa treatment is the relaxation and stress relief you will experience as you massage your feet. Massaging the feet helps to relieve stress, allowing you to feel relaxed and refreshed.

With an investment of about 10 minutes, this foot spa treatment will allow you to “put your best foot forward”, with feet that feel great and you are proud to display. And, men benefit from this foot treatment just as much as women. Ridding the feet of hardened dry skin makes feet feel surprisingly relaxed and comfortable.

You will need:

- Natural Sugar Scrub - Select a natural sugar scrub containing granulated sugar or cane sugar and soap or foaming cleanser to be most effective in softening and polishing feet. The scrub must contain pure sugar to allow you to experience the alpha hydroxy acid effect that dissolves dry, hardened, and flaky skin.

- Moisturizer - Rich body butters and creams work best. Look for body butters and creams that contain natural oils including shea butter, olive, soybean and sunflower oils. These natural oils absorb into skin to moisturize and condition feet to prevent dryness.

Sugar Scrub Spa Treatment - For Dry Feet and Heels

#1. Exfoliate. Apply about a quarter size amount of sugar scrub and massage into feet with a little water to work into creamy lather. Massage feet for about 2 minutes. Rinse.

#2. Dry. Dry feet thoroughly with towel.

#3. Moisturize. Apply body butter or body cream, and massage into feet. It is very important to moisturize feet after exfoliation, and after bath or shower, to condition skin and protect against dryness.

Depending on the amount of dry skin on the feet, exfoliation with a good quality natural sugar scrub, followed by the application of a rich, creamy, moisturizing butter may solve the problem of cracked heels and dry feet with the first treatment. If not, continue to exfoliate with this sugar scrub treatment following with moisturizer once or twice per week, until feet are smooth and soft.

Emily, I’ve been diagnosed with rosacea and have been taking antibiotics for quite some time now to counteract the symptoms. I don’t want to have to take antibiotics the rest of my life and wonder if there are more holistic, healthier solutions out there?

–Brent, Atlanta, GA

Brent, you are not alone. The National Rosacea Society (NRS) estimates that nearly 14 million people suffer from this chronic skin disorder, typically characterized by persistent redness and flushing of the facial skin. Other symptoms can include feelings of dryness and tightness, burning sensations and even eye irritation. Common medical treatment for rosacea is different for each patient, but tends to be a combination of oral antibiotics, topical medications and even treatment with lasers. The NRS states that dermatologists often prescribe long-term use of topical therapy to maintain remission.

Are there more holistic, drug-free ways to avoid flare-ups? The first reaction many have is to simply avoid anything that causes the skin to flush: sun exposure, wind, alcohol, caffeine consumption, and stress. Yeah, right. No problem.

Steve Coward, N.D., of Asheville Natural Health and Homeopathy, believes there is a better way to approach rosacea. “The only real conventional treatment that works consistently is oral antibiotics. But no definitive bacterial cause for the disease has been established. The problem is generally the result of an imbalance in the body.” He goes on to compare treating rosacea with antibiotics to keeping a sick person in a plastic bubble. The person may never get worse, but has he really been helped? Dr. Coward believes that homeopathic remedies, changes in diet, and occasional supplementation can help to correct imbalances in the body, but he stresses that each treatment must be tailored to the individual. The National Rosacea Society refused to comment on the efficacy of any holistic treatments, and only stated that based on surveys conducted by their organization, the non-medical treatment favored by the majority of rosacea sufferers was avoiding triggers. I do believe this makes a difference. However, I know that anyone who lives in the real world encounters all of the triggers mentioned, so seeking the help of a qualified naturopathic doctor, holistic esthetician, or homeopath, will probably be the most helpful solution.

What can you do right now? Start by cleansing your face the right way. In the heat, it may be tempting to jump in the shower and let ice cold water beat down on you. Don’t do it! Same goes for extremely hot water. Extremes in temperature can cause rosacea to become more apparent. Use tepid water for washing and rinsing. Look for words like “fragrance-free,” “noncomedogenic,” and “mild” on your skincare products. Whole milk can be a very gentle cleanser; just be sure to rule out dairy as a trigger before using it. Tempting ms it may be to scrub away the dry patches of skin that often accompany rosacea, you should avoid scrubs, clay masks, and dry brushing. Using a moisturizer that does double-duty as sun protection is a good idea. Also, try using this olive oil treatment at night: Olive Oil Skin Conditioner

A really simple mix that works to help rosacea and other skin ailments. I recommend using this treatment at night because it can make you look a tad shiny.

1. Mix 1 tablespoon Olive Oil with 1 drop of Chamomile Essential Oil.

2. Gently massage onto face, neck and ears (all areas where rosacea can be found).

Another thing to keep in mind, is the debilitating effect a chronic skin problem can have on your self-esteem. Having struggled with acne from the minute I hit puberty until my late teens, I can attest to the increase in self-consciousness (and at times, anger, sadness and depression) that comes with red, blotchy skin. As an adult, these feelings can be even worse. I encourage you to stay aware of your mental health and make sure not to overlook your great physique, hair, personality, and so on. Discuss any concerns you may have with your healthcare provider.

One more suggestion, Brent, and bear in mind that many women, including myself, don’t consider men wearing this a major no-no. Makeup. So long as you stay away from the sparkly hot pink eyeshadow (as all my readers should do), a little carefully applied and properly blended foundation may help you to hide the redness associated with this condition, thereby alleviating some of that self-consciousness. Dr. Zoe Draelos, clinical associate professor of dermatology at Wake Forest University, states that “camouflaging with green- and yellow-tinted skin-tone foundations usually works best, while most should avoid those covering products with pink or orange hues.” If you’re so inclined, try a liquid foundation. And look for a hypo-allergenic product.

It seems commonplace these days for a father to be in the delivery room with the mother of his child. But 50 years ago that practice was unheard of … unless you were a patient of Dr. E. Catherine Cline.

It’s believed that around 1950-she’s not sure of the exact date-Cline (better known as Kitty to her friends at Bethlehem Lutheran Church, Sturbridge, Mass.) was the first doctor to invite fathers to be fully involved in the birthing process. While the significance of her influential act can be understood years later, Cline at the time didn’t think of herself as a trailblazer.

A 1947 graduate of the McGill University Medical School in Montreal, which she attended because so few top U.S. medical schools at the time admitted women, Cline began her practice at the New York Infirmary in Manhattan. “I worked 22-hour days, but I loved it,” she said.

After a couple of years at the infirmary, Cline came to the conclusion that fathers “needed to know what was what.” So she began by inviting them to sit in with their wives during appointments. Then she encouraged them to put on surgical scrubs and join her in the delivery room, where, just after the babies were born, she would let the fathers hold them.

“At first about three-quarters of the fathers would come into the delivery room,” she recalled. “I don’t know why other doctors didn’t follow the practice. In fact, it took about 10 more years before other hospitals started doing it.”

Now 82, Cline retired 15 years ago. But she still is breaking new ground. She is a founding member of Bethlehem. And the congregation, which didn’t have a permanent home for more than a decade, now sits on land that Cline bought in 1985. Bethlehem’s parish hall is named in her honor, and it includes a plaque that reads: “Leadership, desire, fortitude and persistence. All characteristics of a woman who has the vision to see a church at this location and to challenge other people of Bethlehem to build it.”

Acne is a skin condition in which pimples (comedones) appear on the skin, usually on the face, chest, or back. Adolescents and young adults are most often afflicted. Acne tends to be more severe in males; however, with females, acne may persist into adulthood.

The skin has hair follicles that each contains a hair shaft and an oil gland. The oil glands continuously produce and secrete oil to lubricate and protect the skin. However, when dead skin cells and oil (sebum) build up inside the follicle and close off the follicle's pore, pimples appear, in the form of either blackheads or whiteheads. If the plugging material protrudes from the opening at the surface of the skin, this plug of oil and dead cells darkens, forming blackheads; if the plugging material does not protrude, whiteheads form. This type of acne is referred to as comedonal. When the accumulated material of a closed-off pimple causes the follicular wall to rupture, an internal inflammatory reaction occurs, causing oil, dead cells, and bacteria to spill onto the skin. The skin around the pore becomes red and inflamed, and the result is inflammatory acne. When white blood cells infiltrate the area to repair the inflammation, papules, nodules, and cysts may develop. Papules form near the surface of the skin, whereas nodules and cysts are caused by inflammation deeper in the skin.

In the past many persons attributed abnormally high oil secretion and the development of acne to the afflicted individual's diet and hygiene. However, current research suggests that oil secretion is under genetic control, primarily related to the ability of androgenic hormones to stimulate oil secretion. The bacterial species Propionibacterium acnes is believed to play a role in converting acne into an inflammatory condition. Stress and the use of certain cosmetics may also be contributing factors.

Treatment of Acne

There are many ways to treat acne. Gentle washing of the face is important because it helps to remove accumulated oil, bacteria, and dead cells on the skin's surface. Other treatments help to unclog pores, kill bacteria, or minimize oil. Products that help to open up pores include mild cleansers, scrubs, exfoliants, and masques. All of these are available without a prescription. Exfoliants remove the outer layer of skin, thus opening pores. These agents, as well as astringents and toners, help to wipe away excess oil. Antibacterial agents are used to kill bacteria. The most common mild antibacterial agent is benzoyl peroxide. It is available in the form of creams or lotions that are applied to affected areas, and may even be found in some cleansers. Other antibacterial agents available by prescription include topical antibiotics such as erythromycin , clindamycin, and sulfacetamide, and oral antibiotics such as tetracycline, doxycycline, minocycline, and sulfa drugs.

A female with untreated acne on her face. Several prescription and nonprescription drugs are used to effectively treat acne.

Benzoyl peroxide. Benzoyl peroxide encourages peeling of the outermost layer of the skin and, as mentioned previously, is a mild bactericidal agent. It kills bacteria by virtue of its oxidizing properties. It is often included in prescription acne medications, and in nonprescription acne products such as gels, lotions, and cleansers. It may be used alone or with other treatments. At even low concentrations (2.5–10%), benzoyl peroxide diminishes the population of Propionibacterium acnes. The most common adverse effects are dry skin and bleaching of the skin.

Retinoids. The term "retinoid" refers to retinol or other closely related derivatives, either natural or synthetic. Retinoids may or may not have retinol-like ( vitamin A–like) activity. Retinoids affect epithelial cells by binding to receptors inside these cells, inducing alterations in the transcription of genes. Retinoids enhance the synthesis of some proteins, such as proteins that serve as receptors for certain hormones and growth factors, and reduce the synthesis of others. Some of the most commonly prescribed treatments for acne—tretinoin, isotretinoin, and adapalene—are retinoids. (See Table 1.)

Tretinoin became available as a topical treatment for acne in the United States in 1971. Tretinoin is also known by its chemical name, all- trans -retinoic acid. It increases the turnover of skin cells at the surface of the hair follicle. This leads to the extrusion of comedones. Side effects include local skin irritation and increased sun sensitivity. Newer preparations of tretinoin, designed to achieve slow absorption of the drug into epithelial cells, cause less skin irritation than forms available initially. Improvement in acne may not be noticeable until two to three weeks after treatment begins.

In 1982 the Food and Drug Administration (FDA) approved the oral use of isotretinoin (Accutane) for the treatment of severe nodulocystic acne that has not responded to antibiotics. This drug is not active topically. As the name suggests, isotretinoin is an isomer of tretinoin. The only structural difference between the two molecules lies in the spatial arrangement of the atoms around one carbon-carbon double bond. Isotretinoin has the chemical name 13- cis -retinoic acid. Through mechanisms not well understood, it decreases the size of the sebaceous glands and inhibits closure of the pore. These actions may diminish the ultimate formation of cysts.

QUESTION: We use standing orders for several common procedures, such as arthroscopy, tonsillectomy, and cataract extractions. A new RN at our facility says that this is against Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards. She also says that we should not accept medication orders that give a range for the dosage. We have been doing this for a long time and have undergone several ICAHO reviews but never have been questioned about this practice. Using standing orders has worked well for us and has not caused any problems, but we want to comply with JCAHO standards. Can we use standing orders and medication range orders?

ANSWER: Standing orders are acceptable if the health care facility has a written policy that specifies the required elements of the order. The 2004 JCAHO standards require that medication orders be written clearly and transcribed accurately. The health care facility should take steps to reduce the potential for medication errors. Preprinted order forms, commonly referred to as standing orders, must be reviewed and updated “as needed.” (1) The Joint Commission does not specify the frequency for review of standing orders and does not further define what is meant by “as needed.” The facility must determine how and when the review should take place and include this in the written policy.

When used and managed appropriately, preprinted orders may help reduce the opportunity for transcription errors and can be a valuable tool for providing safe and efficient patient care. AORN suggests that standing orders or preprinted order sheets be reviewed by the ordering physician on a routine, defined schedule. Most facilities require an annual or semiannual review. An original copy of the current preprinted order sheet with the surgeon’s signature and date should be kept on file in the OR. To ensure that outdated forms are not used by mistake, a process should be in place for removing outdated order sheets from circulation and making new ones available for use. A verbal or written order to use the standing orders should be documented on each individual patient record and signed by the ordering physician. A copy of the preprinted order form should be placed on the patients’ chart and signed by the ordering physician.

Medication orders that give a dosage range (ie, the dose or dose interval varies within a prescribed range, depending on the patient’s status), titrating orders (ie, the dose is either progressively increased or decreased in response to the patient’s status), tapering orders (ie, the dose is decreased by a particular amount with each dosing interval), as occasion requires orders (ie, PRN), and orders for medications at discharge also are acceptable if the health care facility’s written policy specifies the required elements of the order. Blanket orders to reinstate previous medication orders are not acceptable2

Whether a health care facility is accredited by JCAHO or another agency, communicating medication and other orders in a safe manner is of utmost importance. Every facility should develop physician ordering policies and procedures that reduce the potential for misinterpretation and error.

QUESTION: At our facility, we use an automated endoscope reprocessor to process flexible endoscopes with a high-level disinfectant. The reprocessor is a closed system that automatically recycles the disinfectant, and it is very difficult to check the solution concentration daily. Given that it is a closed system, are we still required to perform a daffy test strip?

ANSWER: The concentration of chemicals used for high-level disinfection should be monitored at least daily or according to the disinfectant manufacturer’s directions. Liquid chemical disinfectants can be diluted by water remaining on surfaces and in lumens of endoscopes and other items, even when an automated reprocessor is used. A test strip or other testing device cleared by the US Food and Drug Administration should be used to test the concentration of the disinfectant. The test must be specific for the liquid chemical disinfectant. (2) If the solution has been diluted as demonstrated by the concentration monitor, the solution should be discarded, even if it has not reached the manufacturer’s recommended reuse time, number of reuses, or expiration date. (3)

The difficulty in performing concentration testing will vary with the design of the reprocessor. Automated reprocessors that operate with reusable liquid chemical disinfectants contain reservoirs that supply the disinfection basin of the unit with the disinfectant during a disinfection cycle and store the disinfectant between cycles. Some automated reprocessors are designed with disinfectant reservoirs that are easy to access for concentration testing. Other reprocessors’ disinfectant reservoirs may be more difficult to access or may be inaccessible. If an automated reprocessor has a design that renders concentration testing in the disinfectant reservoir difficult, users may need to run an abbreviated disinfection cycle that will transfer liquid disinfectant to the disinfection basin so that it can come into contact with a concentration test strip. Under these circumstances, users should contact the manufacturer of their automated reprocessor for recommendations regarding accessing the disinfectant for concentration testing.

The start of a second series for the playful US comedy (above, the cast) about the bizarre experiences of a medical intern as he pursues his career in a surreal hospital. Zach Braff stars as JD, who is apparently no wiser since he started at the hospital - and still in the lower reaches of the hospital pecking order. Tonight, he attempts to patch up his relationship with Elliott (Sarah Chalke) after Jordan tells the staff about her one- night stand with him.

Fascinating little documentary tracing the use of dolphins and sea lions by the US Navy. In the 1950s, the US studied the sleek shape and sonar capabilities of dolphins, hoping to use the results to build better ships and submarines. Then they realised the animals’ potential for carrying out tasks in place of human