First, her mother-in-law was diagnosed with late-stage colon cancer. Then, as she was coming out of a procedure in the hospital, her father-in-law suffered a massive stroke."It was a nightmare,” said Siderow, a New York-based healthcare consultant.To get more Health News, you can visit shine news official website.

Siderow helped other family members care for both husband and wife as they went through treatment starting in December 2011 and, finally, died. And for Siderow, one thing made a huge difference for both of her in-laws: palliative care."Before palliative care, no one really made sure that we understood the diagnosis. No one made sure that we understood the prognosis. No one made sure we understood what was going on,” she added.

"We had no sense that anyone was talking to each other, which is typical of the U.S. healthcare system.”Her mother-in-law died within a few months, after first trying every treatment possible. Her father-in-law lived for four years. In both cases, Siderow feels the palliative care team gave her in-laws, whom she does not wish to name, comfort and dignity in their last weeks and months of life.

Palliative care is a team approach. "Care is usually provided by an interdisciplinary team of experts, including palliative care doctors, nurses, and social workers,” the American Academy of Hospice and Palliative Medicine says.Chaplains, counselors, massage therapists, pharmacists, nutritionists, and others might also be part of the team.”

It sounds expensive and complicated. But a new study published in the Journal of the American Medical Association’s JAMA Internal Medicine shows that palliative care teams can actually cut costs.

On average, hospital costs alone were more than $3,000 lower if patients were started on palliative care within three days of admission, the team, led by Dr. Peter May of Trinity College in Dublin, Ireland reported.Palliative care — sometimes called comfort care — hit the headlines earlier this month when former first lady Barbara Bush said she was opting for comfort care just days before she died.

Dr. Sean Morrison of the Icahn School of Medicine at Mount Sinai, who worked on the study team, said people often misunderstand what palliative care is. They often fear that palliative care and hospice care mean giving up.The approach includes treating a patient’s pain and symptoms such as breathlessness so they can better understand options, communicate and withstand the stress of medical treatment.

"Every single study that has compared palliative care to usual care — there has never been a study that shows people’s lives are shortened when they receive palliative care,” Morrison said."We know that there is a very, very strong database that demonstrates when palliative care is provided at the time of other appropriate treatment, patients feel better, their quality of life improves, their families feel better and, particularly in the case of cancer, they live longer.”

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A receptive tour operator sells your product, whether it’s included in a tour itinerary or is sold alone, to tour operators and/or travel agents. They are a wholesaler and do not sell directly to the public. They produce a tariff that gives the specifics and rates for all products they carry — whether they are hotels, ranches, bed and breakfasts, sightseeing tours, horseback rides, bike tours or transportation. In our region a receptive must be an expert on the whole region, and must know so much more than just which hotels, ranches or activities are offered here.To get more travel agents, you can visit shine news official website.

The receptive markets your product for you overseas. They attend trade shows both overseas and in the U.S. where they promote your product. They do advertising for you. Overseas tour operators who carry your product print brochures or offer online brochures that contain your product. There is no cost to you for any of this advertising and promotion until the guest books and stays at your property or uses your services. The cost is in the form of a percentage discount that you give to the receptive in your rates. You pay nothing for any of this advertising and promotion unless a client books your product.

It would cost you a lot of money in print or online advertising, trips overseas, and phone calls, emails and letters, not to mention the enormous amount of time it would take, for you to contact all the individual tour operators that a receptive tour operator can contact on your behalf during its normal course of business.

The receptive makes money by adding a percentage onto the rate you give them. The receptive adds a fee to the tour operator for booking its product. That tour operator may add on a fee to the travel agent who books that product. This is why you don’t have to deal with commissions when working with a receptive. Tour operators consult receptives for assistance in setting up their own tours and itineraries, whether they are for motorcoach tours, FITs, fly/drives or tailor made itineraries. The tour operator may not know much about a region so they need the assistance of a receptive to help them with identifying hotels or services or setting up itineraries.

Receptives are especially useful in our region because our four states are not as well known to the overseas markets as other areas in the U.S. and clients often choose our region because they want a unique vacation experience. RMI’s two official receptives – America 4 You and Rocky Mountain Holiday Tours – know about lesser-known, unique or special properties or services, as well as the well-known ones, that would fit well into a particular tour operator’s offerings or that would satisfy a particular client.Large receptives may have access to a large number of hotel rooms across the U.S. but specialized regional receptives are more valuable to tour operators located in the overseas markets that RMI targets. Lena Ross, Director of Product Development at America 4 You, says "larger tour operators often simply provide what they know will be booked at high volume. Smaller operators look for the unique and different and the destinations that may not get 500 room nights but that will provide guests with an experience they will
never forget.”

Gary Schluter, owner of Rocky Mountain Holiday Tours, says his company "can work with smaller, often more specialty or boutique lodging that cannot afford to have large room blocks set aside until just prior to the booking date.” He says large receptives "tend to contract only with the ‘standard’ lodges in the region. If a specific lodge is not available, they do not have the expertise to offer an alternative.” Tour operators know they can rely on the expertise of a receptive who understands their needs and knows the region well. It is too time consuming for a tour operator to research all the lodging options; they rely on the expert – the receptive.

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Shanghai is China's most Westernized city, and the most comfortable one for expatriates without single most difficult aspect of living in Shanghai is the language: Mandarin Chinese is still, by far, the lingua franca, and without mastering the basics, an expatriate won't have access to all that the city has to offer.To get more shanghai life, you can visit shine news official website.

These days, you can buy just about everything in Shanghai, although imported goods often carry a hefty price tag. And what can't be bought can always be made.Homes for expatriates are modern and generously-proportioned, and range from city condominiums to suburban communities.

Shanghai is easy to get around, and taxis are inexpensive and easily available, and although taxi drivers don't speak English, expatriates quickly learn the names of common destinations -- or rely on `taxi cards,' cards with the names of destinations written in Chinese. The clean, modern subway system is equally easy to navigate.
The shopping in Shanghai is excellent, from street market bargains to designer duds, although larger sizes will have to stick up at home or have things tailor made -- not a bad option, considering Shanghai's tailors are considered to be Asia's finest. Shanghai's international schools offer children a good education, but the international school system here is still young. Only the Shanghai American School has a substantive high school and comprehensive facilities. Shanghai's crime rate is quite low, particularly for a metropolis of this scale and verve, and streets are generally safte day and night

-- although petty crime does occur in tourist areas like the Bund.Sports, travel and entertainment opportunities are growing:

Shanghai's basketball team produced NBA sensation Yao Ming, the Grand Theater gets musicals like Cats and Riverdance as well as prime local events, and travel to nearby destinations is comfortable and efficient.For all her capitalist form, this is still Communist China, and nowhere is that more apparent than in the media. The English language papers are under the auspices of the state and the Propaganda Bureau, and predictably, information is restricted .

This, too, is improving -- websites like the New York Times are no longer blocked, although during sensitive periods, it umay be blocked again, and certain articles will be blocked from time to time.

Shanghai is busily cleaning up her act in the pollution arena, but it is a process, and the city today fluctuates between polluted and less polluted -- not as bad as Bangkok, but not as good as Shanghai. Perhaps as a result of the challenges of trying to navigate Shanghai through both a linguistic and cultural barrier, Shanghai's expatriates are an unusually close-knit group, but one that is always willing to share their hard-won experience with newcomers. For new expatriates, the many clubs and associations make an excellent way to meet like-minded people who are all to happy to show you the ropes.

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