Saturday, December 14, 2019

A Fairer Way Forward For AI In Health Care Part2

A Fairer Way Forward For AI In Health Care


A Fairer Way Forward For AI In Health Care Part1

There are some efforts to plug these gaps. In 2015, the US National Institutes of Health (NIH) created the All of Us initiative with US$130 million in funding. The research programme aims to form a database of genetic and health data from one million volunteers, expanding the data sets available for guiding the development of precision medicine to provide better quality care for everyone in the United States. It specifically targets previously under-represented communities for data collection. As of July, more than 50% of the fully enrolled participants in the programme were from minority ethnic groups.

But even such diverse data sets might not translate to AI tools that can be rolled out reliably in low-income countries, where disease profiles often differ from those in high-income nations. In sub-Saharan Africa, women are diagnosed with breast cancer younger, on average, than are their peers in developed countries, and their disease is more advanced at diagnosis4. Diagnostic AI tools trained on mammograms from Europe are primed to identify disease in its early stages in older women, therefore might not travel well, says Kuben Naidu, president of the Radiological Society of South Africa in Cape Town.

The obvious way to solve this problem is to give AI developers access to data from low-income countries. But doing so raises concerns related to data protection for vulnerable populations, says Naidu. Medical data is highly sensitive — information such as HIV status could be used to discriminate against certain populations, for instance. Naidu recalls feeling troubled by the eagerness he was met with when visiting a gathering of radiologists in the United States a few years ago. AI companies among the exhibitors “were very excited to hear that I was from Africa, and asked how they could get access to our data”, he says.

Companies offer to pay for such data, he says, which might tempt cash-strapped national health systems or individual researchers to part with patient data, perhaps without thinking hard about the rights of the those whose data they are sharing. A number of developing countries are introducing data-protection laws, but in those countries where law enforcement is lax, such regulations could be circumvented.

Of course, privacy isn’t just a worry in developing countries. Even in nations with strong data-protection legislation, such as the United States, keeping personal data private might be harder than expected. The University of Chicago is currently facing a class-action lawsuit for sharing patient records with Google. The project stripped out identifiers such as social security numbers and names from the data, in accordance with the country’s privacy laws. But the plaintiffs in the lawsuit argue that the dates of patient visits, which were not excised from the data, could be combined with other information held by Google, such as smartphone locations, to match people to their health records.

A related concern is that data companies could tempt people to give up their privacy in return for medical care or financial reward. Such practices could create a privacy divide between rich and poor along the same lines as the digital divide that already separates different socio-economic groups5.

Ferryman, who sits on the institutional review board of the All of Us programme, admits that she struggles with the tension between the push — no matter how benevolent — to gather data from historically marginalized and maligned populations, and the need to protect those very populations from being exploited. “On the one hand, we want to help these people by gathering more information about them. But on the other hand, what’s to say that data will not be used in ways that discriminate against them?”

Promoting fairness through AI
One way to ensure that AI tools don’t worsen health inequalities is to incorporate equity into the design of AI tools. The University of Chicago Medicine data team did this after discovering the issues with its proposed hospital-discharge optimization algorithm. Its data science unit now partners closely with the university’s diversity, inclusion and equity department. This means addressing equity in AI is not an afterthought “but rather, a core of how we implement AI in our health system,” says John Fahrenbach, a data scientist with the university’s Center for Healthcare Delivery Science and Innovation.

Fahrenbach worries that not enough attention is being paid to equity in the design of most machine-learning models. “There are so many machine-learning models in health care being developed, deployed and pitched, and I rarely hear them even mention these concerns. This really has to change and formalized regulation is likely the best way for this to happen,” he says.

There is some way to go in this respect. The UK’s National Health Service has received criticism6 for not giving enough attention to the potential for AI to widen health gaps in its updated Code of Conduct for Data-driven Health and Care Technologies, released in February. Similarly, the US Food and Drug Administration (FDA), which regulates and approves new medical technologies, has been urged by the American Medical Association to highlight bias as a significant risk of machine-learning in its approval process for medical software. A modification to the process, proposed in April, would allow AI tools that continually improve their performance by learning from new data to do so without having to undergo another review by the FDA.

Some research funders are tackling the issue head on, by launching research programmes to study how the introduction of AI tools affects access to care and its quality. Wellcome, a London-based biomedical charity, launched such a programme in June this year. The £75-million (US$90-million), five-year programme will look at ways to make sure that innovations in the use of health data will benefit everyone — not just in the United Kingdom, but also in other parts of the world, such as East and Southern Africa and India, where Wellcome has a strong presence.

A Fairer Way Forward For AI In Health Care Par3

A Fairer Way Forward For AI In Health Care

A Fairer Way Forward For AI In Health Care

Determining whether patchy or biased data could be resulting in unequal health care will play a part in the programme, says Nicola Perrin, head of data for science and health at Wellcome, but it won’t be the primary focus. The initiative will drill down into how the unique make-up of individual hospitals — such as the availability of doctors, medicine or equipment, and the hospital’s relationship with the communities that depend on it for care — affects whether the AI tools deliver.

“That’s the bit that’s always neglected, the unglamorous, unsexy part,” she says. In developing countries, especially, it’s about making sure that tools are actually meeting demand on the ground, and building trust and buy-in from the communities they are intended to help, she says. “We need to understand people’s expectations, and where the boundaries should be.”


This point echoes that of Naidu. Rolling out health-care tools in developing countries is never easy, he says, and it requires an intimate understanding of the existing bottlenecks in the health system. For example, the AI that can identify people with tuberculosis from chest X-rays, primed for use in India, could also save time, money and lives in South Africa — especially in rural areas where there aren’t specialists to examine such images, he says. But to obtain images in the first place, communities will need X-ray machines and people to operate them. Failure to provide those resources will mean that AI tools will simply serve those already living near better-resourced clinics.

Ferryman thinks it is right to be cautious about new medical technologies. “There is no absolute guarantee that the tools will have benefits that outweigh the potential harm they can do,” she says. But she also thinks that most people working in health care in the United States want a more equitable system. Health systems are built around highly trained specialists whose primary motivation is caring for people, and many doctors are hungry for innovations that make the system fairer, she says. “That gives me hope.”

Friday, December 13, 2019

A fairer way forward for AI in health care Part1

A fairer way forward for AI in health care


A fairer way forward for AI in health care


When data scientists in Chicago, Illinois, set out to test whether a machine-learning algorithm could predict how long people would stay in hospital, they thought that they were doing everyone a favour. Keeping people in hospital is expensive, and if managers knew which patients were most likely to be eligible for discharge, they could move them to the top of doctors’ priority lists to avoid unnecessary delays. It would be a win–win situation: the hospital would save money and people could leave as soon as possible.

Starting their work at the end of 2017, the scientists trained their algorithm on patient data from the University of Chicago academic hospital system. Taking data from the previous three years, they crunched the numbers to see what combination of factors best predicted length of stay. At first they only looked at clinical data. But when they expanded their analysis to other patient information, they discovered that one of the best predictors for length of stay was the person’s postal code. This was puzzling. What did the duration of a person’s stay in hospital have to do with where they lived?


As the researchers dug deeper, they became increasingly concerned. The postal codes that correlated to longer hospital stays were in poor and predominantly African American neighbourhoods. People from these areas stayed in hospitals longer than did those from more affluent, predominantly white areas. The reason for this disparity evaded the team. Perhaps people from the poorer areas were admitted with more severe conditions. Or perhaps they were less likely to be prescribed the drugs they needed.

The finding threw up an ethical conundrum. If optimizing hospital resources was the sole aim of their programme, people’s postal codes would clearly be a powerful predictor for length of hospital stay. But using them would, in practice, divert hospital resources away from poor, black people towards wealthy white people, exacerbating existing biases in the system.

“The initial goal was efficiency, which in isolation is a worthy goal,” says Marshall Chin, who studies health-care ethics at University of Chicago Medicine and was one of the scientists who worked on the project. But fairness is also important, he says, and this was not explicitly considered in the algorithm’s design.

This story from Chicago serves as a timely warning as medical researchers turn to artificial intelligence (AI) to improve health care. AI tools could bring great benefits to people who aren’t currently served well by the medical system. For example, an AI tool for screening chest X-rays for signs of tuberculosis, developed by start-up Zebra Medical Vision in Shefayim, Israel, is being rolled out in hospitals in India to speed up diagnosis of people with the disease. Machine-learning algorithms could also help scientists to tease out which people are likely to respond best to which treatments, ushering in an era of tailor-made medicine that might improve outcomes.

A fairer way forward for AI in health care
But this revolution hinges on the data that are available for these tools to learn from, and those data mirror the unequal health system we see today. “In some health-care systems, there are very basic things that are being ignored, basic quality of care that people are not receiving,” says Kadija Ferryman, an anthropologist at the New York University Tandon School of Engineering who studies the social, cultural and ethical impacts of the use of AI in health care. These inequalities are preserved in the terabytes of health data being generated around the world. And these data have primed the health-care industry for the kind of disruption that is being driven by ride-sharing platforms in the transport sector and home-rental platforms such as Airbnb in the hotel industry, Ferryman says. “Apple, Google, Amazon — they are all making inroads into the health-care space.” But because AI algorithms learn from existing data, there is a risk, Ferryman says, that the tools that result from this gold rush could entrench or deepen inequalities — such as the fact that black people in US emergency rooms are 40% less likely to receive pain medication than are white people1.

The Chicago story is an example of bias being documented in a system before it is implemented. But not all occurrences are caught. In January, at the Conference on Fairness, Accountability and Transparency in Atlanta, Georgia, scientists from the University of California, Berkeley, and the University of Chicago presented evidence of “significant racial bias” in an algorithm that determines health-care decisions for more than 70 million people in the United States2.

The algorithm in question allocates ‘risk scores’, which are used to enrol people at high risk of future complex health needs into specially resourced care programmes. The researchers found that black people had significantly more chronic illnesses than did white people with the same risk scores. This means that white people are more likely to be enrolled in targeted programmes than are black people with the same level of health. If the algorithm scored black and white people equally, the researchers said, black people would be enrolled into the programmes at more than twice the current rate.

Rubbish in, rubbish out
Impaired access to care for certain people is just one way in which AI tools could widen the health gap globally. Another problem is making sure that AI-powered tools can be applied equally to different groups of people. Information from certain population groups tends to be missing from the data with which these tools learn, meaning that the tool might work less well for members of those communities.

White, adult men are strongly over-represented in existing medical data sets, at the expense of data from white women and children and people of all ages from other ethnic groups. This lack of diversity in the data is likely to result in biased algorithms3.

Could a new apprenticeship bridge the health and social care gap?

Could a new apprenticeship bridge the health and social care gap?

Could a new apprenticeship bridge the health and social care gap? A new integrated apprenticeship in health and social care is being developed that will equip staff with the skills to work in either sector. Trailblazer groups are seeking to create a workable model which could be in the workplace within two years.  Helen Wilcox, chair of the adult social care trailblazer group, says: “It’s early days and it’s not been nailed yet, but we are starting a scoping exercise to see if anybody can come up with a formula that can work.  “If we can’t see [health and social care] integration happening, then perhaps at least we can integrate the workforce so that the experience of people receiving care and support is one where they don’t need to feel the joins.”  Pilot projects – mostly involving hospital trusts and care providers – have already tested different integrated apprenticeship models. One obstacle that emerged was the time needed to support an apprentice in the care sector, where services are typically delivered by small- and medium-sized enterprises often lacking their own training departments. But the main obstacle proved to be differences between the sectors in pay and employment benefits. “That’s the bottom line,” says Wilcox.  A homecare provider in Gloucestershire, aVida Care, was behind a year-long pilot integrated health and social care level 2 apprenticeship that it ran with Gloucestershire Hospitals NHS foundation trust. Apprentices spent six months with aVida and another six on a medical care ward for older people.  Jacqui Adams, registered manager and director of aVida, believes a key challenge in designing an integrated apprenticeship will be governance. “There are core skills across health and social care apprentices but also key differences,” she says. “For example in domiciliary care at level 2, we allow our care workers to administer medication – but this is not permitted in hospitals, where only registered nurses can do it.”  Care Development East, formerly The Suffolk Brokerage, is a not-for-profit organisation that secures funding for social care training across the county. It also provides information, advice and guidance in health and social care training. It helped set up an integrated health and social care apprenticeship pilot in hospital, community service and residential care settings.  “One issue was the nature of the commitment required from the care sector,” says Emma White, workforce manager at Care Development East. “Some in social care feel they are the poor relation and that they would invest all this time into an integrated apprenticeship, but then lose the apprentice to health because that is where they want to work.”  Earlier this year, the first three recruits graduated from the integrated health and care apprenticeship run by North Devon healthcare NHS trust and Devon county council. They completed a level 2 clinical healthcare support award – the qualification typically required to work in an acute hospital trust – and the care certificate, the minimum needed to work in care. They also completed other qualifications in clinical competencies. All three apprentices chose to work in the NHS.  The trust and county council are now evaluating the programme before deciding whether it should become a permanent fixture. Gail Richards, the trust’s training manager and apprentice lead, says conflicting terms and conditions were an issue, but not insurmountable. “I think there are a few learning points for us, but I am sure we will continue to offer this option. It’s been absolutely great for the students – it makes them a much more rounded carer.”  An integrated apprenticeship gave Maisy Parks the chance to try three different sectors before deciding to become a healthcare assistant  Maisy Parks Maisy Parks completed her integrated health and social care apprenticeship in north Devon in March this year. She spent six months working on a surgical ward, six months working in a care home for adults with dementia and another six months working at a day centre for adults with learning disabilities.  Parks, 20, says the experience meant she could dip her toe into different sectors before deciding where she wanted to start her career. “I could have become a healthcare assistant in a hospital when I left college, but I thought if I didn’t like it I would be stuck in a job.  “What appealed to me was that the integrated apprenticeship gave me the chance to work in different settings.”  She is now employed as a healthcare assistant on a hospital surgical ward, but knows the apprenticeship has made her a “more rounded” employee. “I think it’s definitely helped me in my current job. If we get a call saying a patient with a learning disability is coming on to the ward, I feel so confident in being able to look after them.  “Before, if I had been told that the patient had autism and couldn’t communicate verbally I wouldn’t have known what to do. But because of my day centre placement I know how to communicate non-verbally – it doesn’t scare me.”  The cross-sector training has also given Parks more career options and future-proofed her working life, she says. “I’ve definitely got more employment flexibility. I’m young now and wanted to work in the hospital because of the variety, but when I’m older I might go and work in a care home because I know what it’s like and it impressed me so much.” DA



A new integrated apprenticeship in health and social care is being developed that will equip staff with the skills to work in either sector. Trailblazer groups are seeking to create a workable model which could be in the workplace within two years.
Helen Wilcox, chair of the adult social care trailblazer group, says: “It’s early days and it’s not been nailed yet, but we are starting a scoping exercise to see if anybody can come up with a formula that can work.
“If we can’t see [health and social care] integration happening, then perhaps at least we can integrate the workforce so that the experience of people receiving care and support is one where they don’t need to feel the joins.”
Pilot projects – mostly involving hospital trusts and care providers – have already tested different integrated apprenticeship models. One obstacle that emerged was the time needed to support an apprentice in the care sector, where services are typically delivered by small- and medium-sized enterprises often lacking their own training departments. But the main obstacle proved to be differences between the sectors in pay and employment benefits. “That’s the bottom line,” says Wilcox.
A homecare provider in Gloucestershire, aVida Care, was behind a year-long pilot integrated health and social care level 2 apprenticeship that it ran with Gloucestershire Hospitals NHS foundation trust. Apprentices spent six months with aVida and another six on a medical care ward for older people.
Jacqui Adams, registered manager and director of aVida, believes a key challenge in designing an integrated apprenticeship will be governance. “There are core skills across health and social care apprentices but also key differences,” she says. “For example in domiciliary care at level 2, we allow our care workers to administer medication – but this is not permitted in hospitals, where only registered nurses can do it.”
Care Development East, formerly The Suffolk Brokerage, is a not-for-profit organisation that secures funding for social care training across the county. It also provides information, advice and guidance in health and social care training. It helped set up an integrated health and social care apprenticeship pilot in hospital, community service and residential care settings.
Could a new apprenticeship bridge the health and social care gap?
“One issue was the nature of the commitment required from the care sector,” says Emma White, workforce manager at Care Development East. “Some in social care feel they are the poor relation and that they would invest all this time into an integrated apprenticeship, but then lose the apprentice to health because that is where they want to work.”
Earlier this year, the first three recruits graduated from the integrated health and care apprenticeship run by North Devon healthcare NHS trust and Devon county council. They completed a level 2 clinical healthcare support award – the qualification typically required to work in an acute hospital trust – and the care certificate, the minimum needed to work in care. They also completed other qualifications in clinical competencies. All three apprentices chose to work in the NHS.
The trust and county council are now evaluating the programme before deciding whether it should become a permanent fixture. Gail Richards, the trust’s training manager and apprentice lead, says conflicting terms and conditions were an issue, but not insurmountable. “I think there are a few learning points for us, but I am sure we will continue to offer this option. It’s been absolutely great for the students – it makes them a much more rounded carer.”
An integrated apprenticeship gave Maisy Parks the chance to try three different sectors before deciding to become a healthcare assistant
Maisy Parks
Maisy Parks completed her integrated health and social care apprenticeship in north Devon in March this year. She spent six months working on a surgical ward, six months working in a care home for adults with dementia and another six months working at a day centre for adults with learning disabilities.
Parks, 20, says the experience meant she could dip her toe into different sectors before deciding where she wanted to start her career. “I could have become a healthcare assistant in a hospital when I left college, but I thought if I didn’t like it I would be stuck in a job.
“What appealed to me was that the integrated apprenticeship gave me the chance to work in different settings.”
She is now employed as a healthcare assistant on a hospital surgical ward, but knows the apprenticeship has made her a “more rounded” employee. “I think it’s definitely helped me in my current job. If we get a call saying a patient with a learning disability is coming on to the ward, I feel so confident in being able to look after them.
“Before, if I had been told that the patient had autism and couldn’t communicate verbally I wouldn’t have known what to do. But because of my day centre placement I know how to communicate non-verbally – it doesn’t scare me.”
The cross-sector training has also given Parks more career options and future-proofed her working life, she says. “I’ve definitely got more employment flexibility. I’m young now and wanted to work in the hospital because of the variety, but when I’m older I might go and work in a care home because I know what it’s like and it impressed me so much.” DA

CHIME: Acute-Care and Ambulatory Facilities Embracing Health IT

CHIME: Acute-Care and Ambulatory Facilities Embracing Health IT


CHIME: Acute-Care and Ambulatory Facilities Embracing Health IT


Acute-care organizations and ambulatory facilities are adopting similar healthcare technologies and appear to be on similar trajectories, per CHIME’s Healthcare’s Most Wired: National Trends 2019 report, which was based on responses to CHIME’s 2019 Most Wired survey.
“This report serves as a benchmark for the industry and a roadmap for healthcare organizations that strive to be best in class,” said Bill Spooner, chair of the Most Wired Governing Board. “Overall we saw improvement in the adoption of advanced technologies compared to the previous year and identified opportunities where healthcare organizations could target their resources.”
The survey, which took data from over 16,000 healthcare organizations, described how acute-care organizations and ambulatory facilities apply core and advanced technologies into their clinical and business programs to improve health and care in their communities.
Dig Deeper
An average of 81 percent of respondents have adopted basic tools for care management, the report revealed. Also, more than 80 percent utilize their EHR for various population health activities. The 63 percent that use the EHR plus third-party tools, but no manual tools, report a stronger impact on patient, clinician, operational and financial outcomes, the report said.
Health And Care Technology Acute-care organizations and ambulatory facilities are adopting similar healthcare technologies
Just about every respondent confirmed that they offer a patient portal. Roughly half include self-management tools for chronic conditions, while the majority offer test results and visit summaries. When it comes to telehealth services, two-thirds of health organizations with telehealth capabilities said less than 10 percent of patients utilize the service.
Although just about every respondent allows for remote EHR and imaging data, less than half of respondents allow remote EHR access to alerts and notifications for patients with chronic conditions. The report noted that the majority of organizations have one or more patient-monitoring device, those that integrate at least seven reported a 10 percent higher impact.
The report also revealed more hospitals are able to obtained data from skilled nursing facilities and home health agencies also improved, with only about one-third lacking the capability to obtain the data.
The ambulatory results were very similar to the acute-care results, with some differences. Ambulatory facilities were more likely to offer telehealth services, but patients did not always utilize the services. The facilities also reported that their patient engagement tools had a high impact on the outcomes and they were more likely to have implemented both population health technologies and portal functionalities.
The survey also revealed trends in certain value-based care contracts, noting that alternative payment models are accounting for 25 percent of hospital revenue.
This is the first year CHIME has offered the ambulatory survey alongside the hospital health IT use and adoption survey. This year the organization also introduced a performance excellence certification system rating organizations on a 1-10 scale.
This deep-dive report follows up the preliminary findings CHIME released.
 “The healthcare industry is evolving at lightning speed, with many exciting innovations that can truly transform how we deliver care,” according to CHIME President and CEO Russ Branzell.
 “Most Wired gives us a way to gauge where we are, identify best practices that can elevate care everywhere and recognize those leaders whose pursuit of excellence is driving change in our in our industry,” Branzell added. “We are honored to have so many healthcare organizations from around the world participate in this year’s program and show that they, like CHIME, are committed to nothing less than excellence.”
CHIME has more than 2,900 members in 56 countries and over 150 healthcare IT business partners and professional services firms, which provides a highly interactive, trusted environment enabling senior professional and industry leaders to collaborate and improve health in their respective communities.

Effective facial massages

Effective facial massages


facial massages
facial massages


For the first time, a facial massage technique was used by French courtesans. Who, if not them, in the first place, simply vitally needed to look fresh, young and, of course, attractive. A few decades ago, this method of exposure to the skin of the face was first tested by girls of the most ancient profession. As a result, the result was obvious, it didn’t take much time, and it didn’t require any investment at all.
 Today, there are many face massage techniques that will give: 
* A visible anti-aging effect 
* improve complexion 
* reduce facial wrinkles 
* Age spots become less noticeable 
* swelling decreases. 
Cleopatra's favorite brush massage was megapopular in Egypt. It is doubtful that he helped her, because even though in a mythical story she is portrayed as a beauty, in fact, her appearance was far from ideal. Yes, stroking with brushes can only help when you are 18, and you lead the right lifestyle without drinking a liter of beer before bedtime, jamming it all with salted peanuts. Even the owner of the perfect face after such a feast in the morning wakes up with the face of an Eskimo. 
         When you are over 45, then a facial massage, no matter what it is, at least a life-long course, will not give significant and visible results. And here you have to decide whether to perceive age-related changes and reconcile, as Julia Roberts does, or become a lifelong client of cosmetology clinics, armed with a full arsenal of beauty and youth injections existing on the market. 
    For those who have not yet reached this great age, in combination with proper nutrition, well-chosen care, massage will give an excellent result, and most importantly, the effect of well-groomed, fashion, radiant skin. At the age of 25 to 40 years, the first signs of aging appear, preventive facial massage will help slow down the physiological stages, support the tone of the muscles of the face and décolleté.
Effective facial massages:
Classical facial massage  --  the basis of classic massage - these are movements such as kneading, rubbing and vibration. Using this technique, blood circulation is stimulated, as a result of which your skin is saturated with oxygen. Having completed a course of 15 sessions with an interval of 1-2 days, you will prevent the appearance of wrinkles, improve blood circulation and lymphatic drainage, significantly tighten and rejuvenate the skin. 15 -20 minutes per session, time spent by you, and your facial skin looks fresh and young.

Sculptural facial massage  -- With the help of deep exposure to various layers of the skin, a powerful effect occurs. Sculptural massage is a good alternative to anti-aging injections. The owners of the second chin rejoice, it is this type of massage that will help you get rid of the complexes. Your face contour will become more defined, facial wrinkles and “crow's feet” will be smoothed out, the condition of the skin of the neckline will improve. The main goal of sculptural massage is, of course, rejuvenation.

Jacques facial massage. Jacquet's technique is based on the patting and tingling of facial skin and décolleté. The tweaks are replaced by vibrational movements, in the end, calming movements are made in the form of strokes. Improving skin turgor, treating acne, reducing porosity, all this will be the result of a 20-30 minute massage. It will give an unsurpassed result in a course of 10 sessions if possible 3-4 times a year. Massage is done on talcum powder, which does not cause oily content and makes it possible to lead a normal lifestyle without changing your schedule, in connection with the course of massage. 

             Girls, girls, women - look after and love yourself from a young age. Any of these techniques does not require much time and even spent family funds, any of these massages can be mastered independently, the Internet will help you. Fortunately, we live in a period of information civilization, and there is no need to visit the library or ask a friend for a book to get the necessary information.

Massage & Hardware Cosmetics Will Away Gate Reflecting Roll And Volume

Massage & Hardware Cosmetics Will Away Gate Reflecting Roll And Volume


Massage & Hardware Cosmetics
Massage & Hardware Cosmetics


Very few people can frankly say that they enjoy physical activity, boiled breasts, and other manipulations that girls expose themselves to get a perfect body.
Perfectionism, an overestimated demand for ourselves and our body, makes us look for new methods of struggle for a physically attractive body. Persistent training and proper nutrition, help us achieve what we want, everything seems to be fine, we fit into smaller jeans, get new beautiful things that we had never dreamed about. But I really want to, as they say: “no bitch, no hitch,” so that on the hips and waist was perfectly smooth skin, like girls from glossy magazines. And what we see on the back of the thigh is a hated orange peel. The easiest way out is to buy shapewear and relax. But we are not like that! There are methods that can help you achieve perfectly smooth skin and even reduce your volume and improve your overall condition.
Classical massage, hardware cosmetology, which has flourished in the market over the past few years, will help you achieve what you want. An ideal body and a desire to admire yourself will make you happier, help you enjoy life. Let’s figure out which procedure will be optimal for you and help you see the desired result in a short time. Be careful, pay attention to contraindications to each of them, since their task is to improve your health, and not to worsen.
Classical massage is an effect on tissues in the form of stroking, pressure, rubbing, and vibration. With the help of massage, you will achieve not only a cosmetic effect but also a therapeutic one.

A classic massage will provide you with: 

• a pronounced anti-cellulite effect 
• normalized lymphatic circulation
• increased skin and muscle tone 
• improved metabolism.

Contraindications: gangrene, malignant tumors, thrombosis, tuberculosis, heart failure, blood diseases. Sharko shower is the impact on your body with a shock-type water-jet shower at a distance of 3-5 meters, with a temperature contrast of 20 to 40 degrees. 

With it, you: 

• strengthen immunity
• establish metabolism
• rejuvenate body cells
• heal cellulite and some forms of obesity.

Contraindications: varicose veins, skin diseases
 cardiovascular pathologies, oncology, tuberculosis.

LPG massage

                        so popular and fashionable, is in demand among many girls. This is a hardware technique that helps to achieve good results for body correction in general, reduce your size, reduce the appearance of cellulite. Specialists argue that LPG massage is an alternative to surgery, but directly liposuction. 

Effect of LPG massage: 

• reduction in volume and cellulite
• general strengthening and healing effect
• skin becomes smooth and elastic
• lymphatic drainage effect.

Contraindications: 

benign tumors, skin diseases, hernias, lymphadenitis, epilepsy, pregnancy.

SPA Capsule 

                   is a waking dream, for us a beautiful half of humanity. The effect of it, silky skin, stress relief after a hard-working day, improved metabolism, the disappearance of cellulite. The principle of operation of SPA Capsules is as follows, with the help of infrared rays and ionized steam, (in the case of a dry capsule) if (capsule is hydro use) then there is a massage shower. Infrared radiation penetrates and warms deep into the lower layers of the epidermis, and with the help of hot steam, it improves blood microcirculation. In combination, all these procedures contribute to the elimination of toxins and improve lipid metabolism. Hydromassage provides you with improved skin.

Contraindications: heart disease, dermatitis, hypertension.

Observing the whole range of necessary rules for losing weight, training, proper nutrition and massage, let's dispel the myth. Massage is the best way to lose weight. Especially for a massage therapist.

Wednesday, November 27, 2019

وزیراعظم عمران خان قوم سے خطاب کریں گے|urdu news|imrankhan|وزیراعظم عمران خان قوم سے خطاب کریں گے

وزیراعظم عمران خان قوم سے خطاب کریں گے

قومی نشریاتی ادارے کو خطاب نشر کرنے کی تیاری کرنے کی ہدایت، آرمی چیف کی مدت ملازمت میں توسیع کے حوالے سے قوم کو اعتماد میں لیا جائے گا

imran khan
Imran Khan

اسلام آباد وزیراعظم عمران خان قوم سے خطاب کریں گے، قومی نشریاتی ادارے کو خطاب نشر کرنے کی تیاری کرنے کی ہدایت، آرمی چیف کی مدت ملازمت میں توسیع کے حوالے سے قوم کو اعتماد میں لیا جائے گا۔ تفصیلات کے مطابق وزیراعظم عمران خان نے قوم سے خطاب کرنے کا فیصلہ کیا ہے۔ وزیراعظم ہاوس کے ذرائع کے مطابق وزیراعظم کی زیر صدارت اہم اجلاس جاری ہے جس میں آرمی چیف بھی شریک ہیں۔

اجلاس کے اختتام کے بعد وزیراعظم قوم سے خطاب کریں گے۔ قومی نشریاتی ادارے کو وزیراعظم کا خطاب ریکارڈ اور نشر کرنے کی تیاریاں کرنے کی ہدایت جاری کر دی گئی ہے۔ بتایا گیا ہے کہ وزیراعظم عمران خان آرمی چیف کی مدت ملازمت میں توسیع کے حوالے سے پیدا ہونے والے تنازعے سے متعلق قوم کو اعتماد میں لیں گے۔

دوسری جانب آرمی چیف وزیراعظم عمران خان سے ملاقات کیلئے وزیراعظم ہاؤس پہنچ گئے۔

وزیراعظم کی زیر صدارت اجلاس میں آرمی چیف جنرل قمر جاوید باجوہ ، اٹارنی جنرل، فروغ نسیم، سیکرٹری قانون اور کابینہ کے سینئیر اراکین شرکت کر رہے ہیں۔ ذرائع کے مطابق وزیراعظم عمران خان نے موجودہ بحران کے حوالے سے لائحہ عمل تیار کرنے کیلئے کابینہ کے سینئیر اراکین کا اجلاس طلب کیا۔ اجلاس میں لیگل ٹیم بھی شریک ہے۔ وزیراعظم آفس میں بلائے گئے اجلاس میں سپریم کورٹ کی طرف سے اٹھائے گئے اعتراضات پر مشاورت کی جا رہی ہے۔

جبکہ وزیراعظم عمران خان نے اجلاس میں بابر اعوان کو بھی خصوصی طور پر بلایا ہے۔ جبکہ واضح رہے کہ آرمی چیف کی مدت ملازمت میں توسیع سے متعلق سپریم کورٹ میں کیس کی سماعت کل تک ملتوی کر دی گئی ہے۔ سماعت کے دوران طویل بحث ہوئی جس کے بعد چیف جسٹس نے کہا کہ آرمی چیف کی مدت 28 اور 29 کی درمیانی شب ختم ہو رہی ہے۔ وقت کم ہے جلد فیصلہ کرنا ہو گا۔

میں اپنی درخواست واپس لینا چاہتا ہوں ۔ درخواست گزار کا سپریم کورٹ میں مؤقف|urdu news|imrankhan|latest news

میں اپنی درخواست واپس لینا چاہتا ہوں ۔ درخواست گزار کا سپریم کورٹ میں مؤقف|urdu news|imrankhan|latest news

میں اپنی درخواست واپس لینا چاہتا ہوں ۔ درخواست گزار کا سپریم کورٹ میں مؤقف

supreme court of pakistan
supreem court

ابھی معاملہ عدالت میں ہے ، آپ کی درخواست کا معاملہ نہیں ہے۔ چیف جسٹس کا جواب

اسلام آباد  سپریم کورٹ آف پاکستان میں آرمی چیف جنرل قمر جاوید باجوہ کی مدت ملازمت میں توسیع کے خلاف درخواست زیر سماعت ہے جس پر چیف جسٹس آصف سعید کھوسہ کی سربراہی میں جسٹس منصور علی شاہ اور جسٹس مظہر عالم پر مشتمل تین رکنی بینچ سماعت کر رہا ہے۔ سماعت میں آج کے دن دوسری مرتبہ وقفہ ہوا۔ چیف جسٹس کا کہنا تھا کہ تازہ دم ہو کر دلائل سنیں گے، اس کیس کا فیصلہ ہونا چاہئیے۔



جس کے بعد کیس کی مزید سماعت کو آدھے گھنٹے کے لیے ملتوی کر دیا گیا۔ دوران سماعت درخواستگزار ریاض حنیف راہی نے کہا کہ میری درخواست اب واپس کر دیں۔ جس پر چیف جسٹس نے کہا کہ کیس عدالت میں زیر سماعت ہے ، آپ کی درخواست کا معاملہ نہیں ہے۔ چیف جسٹس آصف سعید کھوسہ نے درخواستگزار سے کہا کہ آپ عدالت میں بیٹھنا چاہتے تو آپ کی مرضی ہے، آپ نہیں بیٹھنا چاہتے تو بھی آپ کی مرضی ہے۔


انہوں نے کہا کہ ہو سکتا ہے کہ ابھی تو ہم اٹارنی جنرل کو سُن رہے ہیں۔ اٹارنی جنرل کے دلائل کے بعد آپ کو چیف جسٹس لگا دیا جائے۔ دوران سماعت چیف جسٹس نے کہا کہ ہمیں پاک فوج کا بہت احترام ہے۔ انہوں نے استفسار کیاکہ یہ بتائیں کہ آرمی چیف کب ریٹائر ہو رہے ہیں۔ جس پر اٹارنی جنرل نے کہا کہ آرمی چیف کل ریٹائر ہو جائیں گے۔ چیف جسٹس آصف سعید کھوسہ نے کہا کہ کل آرمی چیف کی مدت مکمل ہو رہی ہے۔



پاک فوج کو معلوم تو ہو کہ ان کا سربراہ کون ہو گا۔ پھر تو اس کیس کا فیصلہ فوری ہونا چاہئیے۔ یاد رہے کہ گذشتہ روز سپریم کورٹ نے آرمی چیف جنرل قمر جاوید باجوہ کی مدت ملازمت میں توسیع کا حکومت کی جانب سے جاری کیا جانے والا نوٹی فکیشن معطل کر کے اس پر عملدرآمد روک دیا تھا جس کے بعد کیس کی سماعت آج تک ملتوی کی گئی تھی۔ آج سپریم کورٹ میں صبح سے اس کیس پر سماعت جاری ہے جس میں دو مرتبہ وقفہ ہو چکا ہے۔



Friday, November 22, 2019

پی ایس ایل 5،فخر زمان کی لاہور قلندرز سے چھٹی کا امکان|شاہد آفریدی اور شعیب ملک بھی نئی ٹیم کی جانب سے ان ایکشن ہوسکتے ہیں|URDU LATEST NEWS

پی ایس ایل 5،فخر زمان کی لاہور قلندرز سے چھٹی کا امکان

شاہد آفریدی اور شعیب ملک بھی نئی ٹیم کی جانب سے ان ایکشن ہوسکتے ہیں


لاہور پاکستان سپرلیگ (پی ایس ایل )کے پانچویں سیزن میں کئی پاکستانی سٹارز کی جانب سے ٹیمیں تبدیل کیے جانے کا امکان ہے۔ پی ایس ایل فائیو میں ٹیموں کی تشکیل کے لیے مینجمنٹ کے ارکان نے سوچ بچار شروع کر دی ہے۔ ذرائع کے مطابق قومی ٹی ٹونٹی ٹیم کے کپتان بابر اعظم اس بار کراچی کنگز کی جانب سے ۔دونوں کھلاڑی پاکستان سپر لیگ کے چوتھے ایڈیشن میں ملتان سلطانز کا حصہ تھے۔ سپاٹ فکسنگ سکینڈل میں اپنی سزا پوری کرنے کے بعد قومی ٹیم میں واپسی کے خواہاں شرجیل خان بھی کراچی کنگز کی جانب سے ایکشن میں نظر آ سکتے ہیں۔ پاکستان سپر لیگ کی ٹریڈ ونڈو اوپن ہے۔ ٹیموں کی تکمیل کے لیے ڈرافٹ دسمبر کے پہلے ہفتے میں ہو گا۔