How to choose may 14

A Collection of Expert Advice to Help Consumers Choose the Best in Professional Services

HOW tO CHOOSE May 2014

Š2014 The Punxsutawney Spirit & Jefferson County Neighbors

A Special Publication of The Punxsutawney Spirit and Jefferson County Neighbors

How to choose the right rehabilitation center for your needs your choice of a rehabilitation facility.

• A rehabilitation center should be part of a major medical center/Level I trauma center capable of handling the medical complications of catastrophically-injured

patients.

• Programs offered by a rehabilitation center should be individually accredited by the Rehabilitation Accreditation Commission (CARF).

This accreditation signifies that the center has met or ex-

How to find the right real estate lawyer Buying or selling real estate is rarely free of complications. Unforeseen issues often arise during real estate transactions, and in such instances a real estate attorney can prove invaluable. While buyers, sellers or veteran real estate investors might be able to handle minor or routine issues on their own or with the help of their realtor, more complex matters are best left in the hands of a real estate attorney.

O n e o f t h e b e n e fi t s t o hiring a real estate attorney when negotiating a complex or potentially complex real estate transaction is the expertise that lawyers can bring to the table. Realtors may have vast experience buying and selling homes, and many are adept at negotiating as well. But realtors are not licensed to practice law, and even the savviest r e a l t o r wo u l d a d m i t t h a t offering legal advice is not his or her forte. Men and women involved in complex or potentially complex real estate transactions would be wise to hire a real estate attorney, and the following are a few things to consider before hiring someone to represent you.

Experience One of the reasons to hire a real estate attorney is to make use of their experience.

Hurdles have a tendency to spring up during complicated real estate transactions. Men

and women involving themselves in development deals or buying rental properties likely won’t see potential red flags as clearly as a veteran real estate attorney will. When interviewing a real estate attorney, ask how long he has been working as a real estate lawyer and how long he has been practicing in your particular state and city. Zoning laws and other restrictions vary from state to state and city to city, so look for a lawyer who has considerable experience in your state and city or the state and city where the transaction is taking place.

Plan of action When interviewing pros p e c t ive a t t o r n ey s , d o n ’t assume each one knows the best way to approach your particular case. Provide the details of your transaction and then ask each attorney to explain how they would approach the case. A veteran real estate attorney should be able to provide a detailed account of how he plans to represent you, including what needs to be done to get the transaction off the ground, any potential hurdles that might need to be cleared and how to clear those should they arise. Avoid attorneys who give general or ambiguous answers, as such answers may be poor attempts by the lawyer to mask his or her inexperience with transactions such as yours. Some

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attorneys may request time to develop a plan of action, and you should not immediately remove them from consideration, especially if they ultimately answer the question in thoughtful detail.

Billing Attorneys are expensive, so it’s best to discuss the billing process before hiring someone to represent you. Attorneys tend to bill by the hour, but their rates may be negotiable depending on the service they’re providing. Those who will be overseeing your real estate transaction and continuously representing you will likely bill by the hour, but if you’re hiring a real estate attorney to examine a potential agreement or draft a contract then you can probably negotiate a flat fee for those services.

But be sure to discuss billing before hiring an attorney.

Real estate transactions are rarely inexpensive, so you don’t want to be blindsided down the road when your legal bills come due.

Representation When interviewing an attorney, many people assume the attorney they initially interviewed will be the person who represents them throughout the transaction.

H ow eve r, t h e d a y - t o - d a y work on your case may be assigned to a junior associate or even someone who isn’t licensed to practice law, such as a paralegal or a current law school student who is interning with the firm. These people might be perfectly capable of handling your transaction, but you should meet them before hiring the firm to represent you. A good rapport with the person who will be working on your case can ease the stress associated with complex real estate transactions.

Real estate attorneys can help men and women navigate the sometimes turbulent waters of real estate transactions, and it helps to consider a host of factors before hiring a firm to represent you.

ceeded very high standards of treatment, staff performance and technical capabilities. It symbolizes the kind of quality care that every patient should receive.

• The medical staff should include physiatrists (physicians who are specially trained in rehabilitation).

• Nurses and therapists should have specialty training and experience in the treatment of patients with spinal cord injuries, stroke, brain injuries, and other injuries and diseases that require rehabilitation.

• The rehabilitation center should use state-of-the-art technology to maximize the patient’s recovery. Examples of this technology include computerized neuromuscular retraining (NMR), an on-site therapeutic pool and computerized balance systems.

• The rehabilitation center should have a patient-andfamily education program.

Support groups should also be available for the individual and his or her family after the patient’s discharge.

• There should be an active therapeutic recreation program that includes community field trips.

• The treatment unit for patients with brain injury should include treatment areas that limit the patient’s distraction and should also include structural modifications for those at increased safety risk.

Psychologic and neuropsychologic services should be available.

• The program for patients with spinal cord injury should include psychologic and peer counseling services. Independent living experiences and home evaluations by trained professionals should be completed long before the patient’s discharge.

• A wide range of outpatient services should be available to patients who have undergone acute rehabilitation.

• The Driver’s Assessment and Training Program • The Computerized Functional Electrical Stimulation Program (CFES Bike) • Post acute brain injury services

The Short Term Rehab Therapy Unit at Christ The King believes in a ‘hands on’ approach to making the transition from hospital to home as easy and comfortable as possible.

Our therapy department features highly trained physical therapists, occupational and speech therapists.

Other amenities include: Private Rooms with Mini-Kitchens and Private Bathrooms Country Kitchen • Separate Dining Facilities • Spa For more information and a tour of our Rehab Therapy facilities call 814-371-3180.

2 - How to Choose Guide, The Punxsutawney Spirit & Jefferson County Neighbors, May 2014

Most rehabilitation facilities provide traditional programs. Although basic therapy is extremely important to the patient’s success in a rehabilitation program, additional therapy is often required. Use these guidelines to clarify

Tips for choosing a hospital (BP) – Americans are faced with many purchasing choices every day.

Informed consumers often take the opportunity to research their options before making a decision to buy. So why don’t Americans apply the same rigor when choosing a hospital?

Oftentimes, people don’t realize that they can choose among the hospitals in their community in a

for your condition, how well the hospital monitors and improves its quality of care, and if it participates non-emergency situation. When in Medicare. you can plan ahead, whether it’s a Make a checklist of your needs knee replacement or elective heart Medicare’s Guide to Choosing surgery, you should look for the a Hospital provides information hospital that’s right for you. on what steps to take to research Here are tips for choosing the and compare hospitals, including hospital: an easy-to-follow checklist that Talk to your doctor walks you through the process and Find out what hospitals your highlights important questions to provider works with, which ones ask along the way. they think will give the best care Compare quality of care Whether you are on Medicare or not, Hospital Compare is a great resource that allows you to find and compare hospitals that are close to you or across the nation. Using Hospital Compare, you can determine how often a hospital gives the number and length of walks the right treatments for certain and exercise sessions,” Olszewski advises. “Exercise should occur more frequently than is necessary for bladder relief.”

Kellogg suggests defining ‘exercise.’ “Do they put him in a run by himself, or is there a person there with hands-on interaction? Some dogs prefer to go running alone.

Other animals would become highly stressed without human playtime,” he says. He also recommends against group play.

Individual needs and preferences Even though the Humane Society of the United States names boarding kennels as a known cause of stress in pets, you can take steps Dr. Alzuhaili to help calm your furry friend.

“Providing a familiar blanket or sleeping pad can help to reduce anxiety associated with being in different surroundings,” Olszewski says. “This stress coupled with a sudden change in diet can lead to gastro-intestinal upset. I recommend providing the kennel food your pet regularly eats.

If your dog is on medication, ask about the administration procedure.

Most facilities will give medications, but some will not. Ask ahead of time to be sure.

Safety issues Safety is the most important thing you want for your pet. Here are some important issues to address.

• Vaccination policy: Look for a strict vaccination policy, verified through a veterinarian; unvaccinated animals could threaten the health of vaccinated ones.

• Aggressive animal screening: You will no doubt feel better if aggressive animals are not permitted.

• On-site supervision overnight: Is someone on the premises 24 hours a day?

Boarding your four-legged friends

How to Choose Guide, The Punxsutawney Spirit & Jefferson County Neighbors, May 2014 - 3

(BPT) – Whether traveling for business or fun, it’s not always practical to take along a four-legged family member. Arranging care of a beloved pet for an extended absence can be daunting. Knowing what to look for in a kennel, and what to look out for, can help you choose wisely.

Ask around “Family and friends can be a good source of recommendations,” says Christi Olszewski, registered veterinary technologist (RVT) and instructor at Brown Mackie College – Albuquerque. “Your veterinarian is also a good reference point.”

Scout out facilities Be sure to tour a facility before boarding your pet. ”Ask to see everything, not just a single room or two,” says Dr. Barry Kellogg, senior veterinary advisor for the Humane Society Veterinary Medical Association.

Here are some factors to consider during your tour: • Cleanliness: Floors, runs and kennels should be clean and free of debris.

• Light and ventilation: The interior should be bright, with odors whisked away.

• Cage size: Each animal needs space for a bed, plus room to move.

For cats, the space also should accommodate a litter box, and offer a place to hide.

• Exercise runs: Runs are usually located both inside and out; those with a double-gated entry provide extra security.

• Separation of dogs and cats: Ideally, cats and dogs are kept in separate rooms, not just separate enclosures; it can be highly stressful for cats to reside near unfamiliar canines.

Who are the caretakers?

“Most kennels won’t have a veterinarian on staff; however, the staff should be trained and experienced, and include at least one RVT with technical knowledge of health concerns and elderly pets,” says Olszewski. Kellogg reminds pet owners to “watch staff interaction with your pet. You want to see if they can sense the personality, and understand animal communication and behavior.” The experts also advise to ask about the ratio of staff to pets. The fewer animals each staffer is responsible for, the more individual attention your pet is likely to receive.

Daily activity ”Ask about the daily routine,

conditions – like heart attacks, heart failure and pneumonia; the number of patients who got a knee replacement or other procedure; infection rates and more.

Compare the experiences of patients Hospital Compare also provides information on patients’ experiences during recent hospital stays.

You can find patients’ answers to more than two dozen questions, including: • How often did nurses explain things in a way you could understand?

• Did you get information in writing about what symptoms or health problems to watch out for once you leave the hospital?

• Would you recommend this hospital to your friends or family?

Consider coverage, pricing and logistics Check with your Medicare, Medicare Advantage or private health insurance plan to find out if you need permission from your health plan before you’re admitted for non-emergency hospital care, or if you have to use certain hospitals or see certain surgeons or specialists. This could have a big impact on your choices and costs.

Consider how close the hospital is to your home, family and friends; flexibility in visiting hours; and whether a family member can stay with the patient.

All the resources mentioned in the article can be found at hospitalcompare.hhs.gov or by calling 800-MEDICARE (TTY 877-4862048).

Surgery

“Taking time to hear your concerns and answer your questions is very important.”

Dr. Alzuhaili and his office staff are known for the warm, personal style they bring to individualized, precise and effective care and surgery.

Dr. Alzuhaili provides expertise in the full range of general surgical procedures.

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Low vision problems vary Millions of people have significant visual impairments that can make daily life challenging.

Although many vision problems are readily treated with corrective lenses, treating low vision may not be so simple.

“Low vision” is a term used to describe the inability to see clearly. Even after correcting for vision with glasses or contact lenses, many people still cannot see well and test at lower than 20/40 vision. The American Academy of Ophthalmology defines low vision as what happens if ordinary eyeglasses, contact lenses or intraocular lens implants do not provide a person with clear vision.

Anyone with reduced vision that is not corrected by some method of lenses or surgery is considered to have low vision or be visually impaired. Low vision may cause slight vision loss or even blindness.

Causes of low vision There are many factors that contribute to the onset of low vision, including disease, aging, injury, and heredity. The following are some of the more common causes of low vision.

• Age-related macular degeneration (AMD): This is a common eye condition among people age 50 and older. In fact, it is the leading cause of vision loss in older adults, says the

National Eye Institute. When a person has AMD, the macula, which is the most sensitive part of the retina responsible for fine-tuning images received by the eye, deteriorates and does not work properly. Though there might be some vision, images won’t be clear. The most common form of age-related macular degeneration is known as nonexudative, or “dry” form.

This generally causes vision loss that develops gradually.

More rapid and severe vision loss comes from exudative, or the “wet” form, of macular degeneration. This occurs when abnormal blood vessels develop under the macula and leak fluid and blood.

• Cataracts: Cataracts are a clouding of the lens of the eye that usually develops with aging. It may be present at birth or be the result of an injury to the eye. Depending on the severity of the cloudiness of the lens, vision can be impacted greatly.

Cataracts may form as a result of long-term exposure to ultraviolet light, exposure to ionizing radiation, secondary effects of diseases such as diabetes, hypertension and advanced age, or trauma.

• Glaucoma: When a person has glaucoma, eye damage occurs to his or her eye when there is a buildup of fluid pres-

sure within the eye, also known as intraocular pressure. This pressure can damage the optic nerve and cause visual field loss, which over time might escalate to blindness.

Treatment for low vision Treatment cannot begin until your vision is assessed by a professional. An optometrist may conduct various vision acuity tests to determine what might be the cause of vision loss.

Each type of low vision problem requires a different approach to treatment, so it’s important to correctly diagnose the problem before beginning treatment.

Some treatment options for low vision may include specialized optical systems, video magnification, therapeutic filters, or special prescription glasses. There also may be the need to perform eye exercises that help maximize existing visual function. Individuals may have to use a combination of devices to find the ones that help the best.

Only a doctor can determine the culprit behind vision loss. Routine visual exams are recommended at least every year and may need to be more frequent if a person is suffering from deteriorating vision. If caught early, many eye conditions can be managed to help prevent further loss of vision.

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When choosing a college, students often look for the best academic institutions. While it’s hard to argue with that approach, high school students facing the decision of where to spend the next four years of their lives should know that the right university is not necessarily the one with the best academic reputation.

A host of factors come into play when finding the right match between student and university.

Academics should always carry the most weight, but students should consider a host of other factors before ultimately deciding where to continue their academic careers.

Cost In a perfect world students would not have to worry about financing their college educations.

But that’s not a world in which today’s students live, so the cost of a college education is something nearly every college-bound student must consider before making his or her decision. According to the College Board, the average overall cost to attend in-state public college for the 2012-13 academic year for students who did not receive financial aid was $22,261, a nearly 4 percent increase from the previous school year. That sticker price includes the cost of living in a dorm, food, books, and the additional expenses

college students typically have.

And the College Board notes that, despite the cost increase, financial aid budgets stayed the same as the year before, meaning even those students who received financial aid paid more money.

While cost should not dictate where high school students ultimately go to college, students should know that eventually student loans will have to be repaid with interest, so those who do not want to bury themselves in student loan debt after graduation would be wise to choose a university that’s more affordable or one that’s offering a more attractive scholarship and grant package. Unlike student loans, scholarships and grants do not have to be repaid.

Distance from home While many high school students may think a school far away from their folks is ideal, the reality of being far away from home is a struggle for many college students who attend college outside of their home states. Homesickness is a very real thing for college students who are away from home and on their own for the first time.

In addition to homesickness, college-bound students should consider the cost of travel before enrolling in a college or university that’s far from home. Mom and

Dad might not be able to afford to fly their college students home several times per year for the holidays and other breaks in the school year, and the burden of financing that travel can fall on students. If you are not planning to work during the school year, then financing trips home may prove very difficult.

Environment Both the academic and social environments at a college or university merit consideration when students are deciding where to continue their educations. Some students thrive in a competitive academic environment, while others tend to fare better in a more casual setting. Students should assess which environment is best for them and choose a university that best suits them as a student.

A college or university’s social environment is another factor for students to consider. Larger schools tend to rely heavily on Greek life, while smaller schools may be more intimate and less exclusive. Students who hope to join a sorority or fraternity might benefit from a school with a thriving Greek life, while those who want a more intimate social environment might prefer a smaller school where all of the students seem to know one another.

4 - How to Choose Guide, The Punxsutawney Spirit & Jefferson County Neighbors, May 2014

Things to consider when choosing a college

Four steps to planning a funeral service in advance (BP) – Planning a funeral is not what most of us want to think about, but it is something we will have to deal with at some time in our life. Planning ahead and understanding your options is important so you can reduce stress and feel confident your loved

ones’ wishes are being fulfilled.

“The death of a loved one is always stressful. Fortunately, preplanning is something you can do now to help your family,” says funeral director Mark McGilley with the Dignity Memorial network of funeral, cem-

Benefits of hiring a landscaping service

How to Choose Guide, The Punxsutawney Spirit & Jefferson County Neighbors, May 2014 - 5

The desire to have a pristine, well-manicured landscape leads many homeowners to toil outdoors for hours every weekend. Hiring a professional landscaper can free up homeowners’ time and help them ensure their yards are cared for properly.

One of the benefits of hiring a landscaper is the time savings.

Landscapers typically have commercial-grade equipment that can dramatically reduce the time it takes to mow and perform other maintenance tasks around your property. Furthermore, some services have multiple employees working concurrently, enabling them to tackle several projects at the same time and complete them in a fraction of the time it would take a homeowner working on his or her own.

Landscapers familiar with botany and landscape design understand how to properly care for plants and trees on your property, while novice green thumbers may be unaware about when to prune trees and shrubs, at what height to cut the lawn and which plants will thrive in particular locations. Such do-it-yourself maintenance may even cost more money than leaving it to a professional.

Hiring a professional landscaper is, in many instances, more economical. For a certain weekly or monthly fee, homeowners receive the benefit of professional knowledge and execution. Also, homeowners will not have the expense of purchasing the various tools and equipment necessary for lawn and garden maintenance, tools and equipment that include lawnmowers, string weeders, edgers, fertilizer, grass seed, leaf blowers, and shovels.

Another benefit is the lawn will continue to be mowed whether a homeowner is home or not. During the spring and summer vacation season, it’s easy for homeowners to overlook their lawn and garden in favor of recreation and leisure activities. Without proper watering and maintenance, lawns and gardens can brown or overgrowth can occur. But hiring a landscaping service allows homeowners to rest assured that their yards will be maintained whether they’re home or not.

Hiring a local landscaping service will not only benefit homeowners, but also it will benefit the local economy. Residents can feel comfortable knowing their lawn service will be available for calls when needed and will be familiar with the community. Also, local contractors may go the extra mile to earn your business recommendation.

Hiring a landscaping service can be advantageous to homeowners who want to free up time and still enjoy a well-maintained landscape.

etery and cremation providers.

“Often, family members and friends are unsure of the answers and worry about making poor choices. Preplanning can help your family make better choices and significantly reduces the number of difficult decisions that traditionally confront loved ones at a time of loss.”

Preplanning helps to answer questions like: • Did she want a traditional funeral with burial?

• Didn’t he say he wanted to be cremated?

• Should we have the service at the funeral home or our church?

• What music should be played?

Step 1. Decide on the Service Deciding on the type of service you want is a great step towards feeling confident that your wishes will be fulfilled. Traditional services generally have a visitation at a funeral home and a funeral service. These services are most common, but options are changing. Funeral homes are responding to the demand for customized, complete services.

Spend some time deciding what type service you want, if it should it have religious elements, if it should be intimate or large, and if there are any unique requests that can be accommodated.

Another important element to discuss is body disposition.

Will you have a burial or cremation? A cemetery plot should be purchased if you are having an in-ground burial; a mausoleum crypt for above ground. If cremation is the choice, plan the disposition of the ashes. Will the ashes remain with someone, be stored or buried, or scattered somewhere?

Step 2. Shop Around Don’t think that your local funeral home is your only option. Investigating different funeral homes is an important part of planning a funeral. After you

have decided what type of ceremony you want, you should be able to work with a funeral director and ask all the questions you need.

It is appropriate to ask for a price listing. Many funeral homes offer package funerals that may cost less than purchasing individual items or services.

Remember, it’s your funeral, have it done the way you want.

The sky is the limit, so the funeral homes of today should be able to accommodate your requests.

Step 3. Choose a Funeral Home Choose a home that fits your budget and is willing to work with you on your requests. It is important that you are comfortable with your decision, so choose the home that you trust most. Never feel uncomfortable asking questions, a good funeral director understands this process is not something people do every day and should be able to assist you and make you feel comfortable.

Many funeral homes are able to offer specialized services that help during this difficult time. Because funerals are an investment of time and money, ask about the transferability of your funeral plans. For example, the Dignity

Memorial National Transferability allows prearranged funerals to be fully transferable across their North American Network. So if life takes you to a different location, your plans will transfer.

Step 4. Understand Your Funding Options Know that you do not need to prepay in order to preplan your funeral. Simply sharing a written record of your final wishes with family and friends relieves them of the burden of making difficult decisions regarding your final arrangements. If you do choose to prefund your prearrangement, you can lock in today’s prices for products and services that likely will be more expensive in the future. Work with a funeral professional to understand your state’s particular laws and regulations that protect preneed funds, and select a funeral provider that provides its own guarantee of your funds’ protection.

Regardless of whether or not you fund your prearrangement, preplanning your funeral ensures that your services will be as you would have wanted and relieves your loved ones of additional stress at a trying time. For more information about funeral planning, visit www.DignityMemorial.com.

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Finding the right pre-school Smart shopping tips for

budget-savvy baby boomers (BPT) – While the economy is moving again, many Americans – baby boomers included – continue to realize the importance of good money management skills. Boomers are focused on making the most of their money by boosting earnings, investing more and shopping smarter.

“Smart shopping isn’t about spending less on something, but about making sure you get the best value for the money you spend,” says America’s top lifestyle expert and author Mar Jennings. “Fortunately, with some savvy shopping tactics, it’s possible to stretch your dollars without skimping on your lifestyle.”

Jennings offers some sMARt shopping tips for boomers: • Plan shopping trips before you leave the house. Make lists, map out your route and consolidate errands into one trip.

You’ll not only save time and gas, you’ll cut down on impulse buys that will affect how much you spend overall.

• Keep quality in mind when you’re tempted to buy less expensive brands of everyday

Prepping for kindergarten makes an easier transition Kindergarten used to be a time when kids grabbed a nap in between fingerpainting and playing outside, but today’s coursework is much more rigorous and kindergarteners are now introduced to concepts that were once taught in later years of elementary school. Preparing children who have never attended school for their first day could take a little time prior to the start of school.

Getting prepared Some children are anxious to be “big kids” and begin school.

Others may be nervous about what’s in store. The best way to prepare children is to think about

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enrolling them in some sort of social program. Preschool is the avenue many parents choose, but simply spending time together with other kids in a structured social setting is enough for many kids to get acclimated.

Talking about what to expect at school can also ease jitters.

Parents can establish a schoollike structure at home to illustrate their points. Have set times for meals and snacks, require small chores be done on time and set additional rules and limits. Bed time and wake times should be the same each day as well.

Children who are unaccustomed to having structure may find the rigors of the classroom scary.

Parents should inquire about touring the school to help calm kids’ nerves. This way children will see exactly what environment they will be working in each day.

Honing skills Children will partake in a variety of activities during kindergarten. They’ll begin learning to write and perform other activities that require fine motor skills. Parents can introduce their children to pencils, crayons, markers, and safety scissors so they can learn the proper grip and how to maneuver these tools.

It’s also never too early to read

with children. Studies indicate that children who frequently read with their parents or others tend to have greater success in school. The National Education Association says that children who were read to frequently are more likely to: • count to 20, or higher than those who were not • write their own names • read or pretend to read The Educational Testing Services reports that students who do more reading at home are better readers and have higher math scores.

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necessities. For people with bladder control issues, Depend Underwear with new Fit-Flex protection is a smart buy because it offers a discreet fit that helps give you the freedom and confidence you need every day.

• Try samples before investing in a full-sized product.

Many manufacturers offer free samples of everyday items – like laundry detergent or personal care products – through their websites. For example, you can request a free sample of Depend Underwear with new Fit-Flex protection at www.Depend.com.

Sampling products can help ensure you spend money only on things that you know you’ll use and work well for you.

• If you have the storage space, don’t be afraid to stock up when something you use often is on sale. Buying something you know you will use when the price is right ensures you won’t end up paying more when you run out of it.

• Coupon, coupon, coupon!

Digital coupons have made it easier than ever to save. Con-

sumers have embraced high-tech mobile coupons as a “green” and convenient alternative to traditional paper coupons. Look for a free app, like Retail Me Not, that allows you to select your favorite stores and use online or in-store coupons. You can even opt in to receive emails with additional discount offers.

• When you’re buying a bigticket item, ask for a discount, even if none is advertised. More retailers these days are open to negotiation, and often the difference between paying full price and getting a discount is simply asking for one.

• Pay cash whenever possible and minimize credit card purchases. It’s human nature – and a tried-and-true tactic – that seeing actual dollar bills go out of your wallet underscores the fact that you’re spending real money.

Paying with a credit or debit card often doesn’t have the same psychological effect. Spending cash can make you think twice about impulse purchases.

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6 - How to Choose Guide, The Punxsutawney Spirit & Jefferson County Neighbors, May 2014

Parents know that choosing a preschool for their children is a decision not to be taken lightly. Preschools are often a child’s first extensive experience away from home, and the right school can help kids make that transition more smoothly. When looking for a preschool for their kids, parents may want to employ the following tips.

• Make preschool a priority. Procrastinating with regard to finding a preschool carries considerable risk. Many of the best preschools have only a limited number of spots available, and there may even be a waiting list for those spots. So it behooves parents to begin their search for a preschool as early as possible.

Doing so affords parents the time to visit various facilities, speak with staff members and maybe even observe a typical day at the school. Leaving things until the last minute takes away that flexibility, and parents may be forced to choose a facility with which they are largely unfamiliar.

• Ask around. Fellow parents make for great resources as parents look for a preschool for their children. Ask parents of current preschool children or even older kids who attended preschool to share their impressions of a given facility and share their insights as to a facility’s operations and its pros and cons.

• Take kids along on visits. Though parents typically have a checklist of things they want to find in a preschool facility, it pays to remember that the kids will ultimately be the ones spending time at the school. So take youngsters along when visiting facilities, paying particular attention to how kids react to each facility and how well staff members engage your youngster in the day’s activities. Many kids take time to adjust to preschool, but you can still learn a lot about a facility by observing how your child interacts with staff and how well the facility meshes with your child’s personality.

• Don’t mistake cost with quality. The cost of preschool can range from affordable to exorbitant. But the costliest school is not necessarily the best facility, nor the best fit for your child.

While an expensive preschool may be well worth the investment, parents should still consider all of their options before making any commitments.

Tire maintenance an important safety precaution Tires are the link between a vehicle and the roadway, and tire quality has a direct impact on the performance and safety of an automobile.

But tire maintenance is easy to overlook. However, ignoring tire maintenance can threaten driver and passenger safety and make a vehicle operate inefficiently.

Steering, breaking ability and traction are all governed by good tires. Worn tread can result in longer stopping times and make it difficult to brake immediately in an emergency situation. Although driving tends to be the primary culprit behind worn down tires, sometimes bald or unevenly worn out tread is indicative of a larger problem, such as a misaligned wheelbase, improperly aligned tires or tires that are underinflated. The following are some common problems associated with tires and how to address these issues should they arise.

Blowouts Worn tire treads increase the risk of punctures, which can lead to blowouts. Bald tires also may blowout as a result of friction on roadways that is met with minimal rubber. Get-

ting caught on the side of the road with a tire blowout can be a hassle, so routinely check tire treads and replace tires accordingly.

Tread depth Average new tires on cars usually start with 10/32 inch to 11/32 inch of original tread depth. When tread reaches a depth of 2/32 inch, they are considered worn out. There are different ways to gauge tread depth. Insert a penny into the tread groove with Lincoln’s head upside down and facing you. If you can see all of Lincoln’s head, it is time to replace the tires. Another coin test is to insert a quarter into the groove. If the tread touches Washington’s head, you have at least 4/32 inch of tread left. Don’t have any currency on hand? Then look at the treadwear indicator bar molded into the tires. When these bars become flush with the adjacent ribs of the tire, the tires should be replaced.

Alignment According to the Rubber Manufacturers Association, improper alignment causes rapid or uneven treadwear.

Tires should be aligned and balanced periodically to avoid

irregular wear and having to replace tires prematurely.

Tread pattern Tires feature different tread patterns depending on the brand of tire. They may be directional, asymmetrical, nondirectional, and directional/ asymmetrical. When purchasing replacement tires, it is adviseable to match the tread pattern to the existing tires.

This helps enhance the performance of the car. In fact, some newer cars require tread to match. Mismatched treads may cause problems with transmission shifting or impact control and steadiness.

Tire pressure Underinflation of tires can cause failure, stress and irregular wear. Underinflated tires also may contribute to loss of control that leads to accidents.

Always maintain the manufacturer’s recommendations for the correct pressure, which should be adjusted based on the temperature.

Tires should undergo the same inspection and maintenance as other parts of the vehicle. Tires are a vital component to safe driving, and routine maintenance can prevent accidents and other problems.

Prescription drugs can be quite expensive, and even those who have health insurance often pay more than they need to. According to a recent Consumer Reports “Best Drugs” poll on prescription drugs, Americans routinely take an average of four medications per day, spending nearly $800 on drug costs each year. Those who do not have health insurance may have to pay much more out of pocket.

As expensive as prescription medications can be, there are still ways to save money on prescription drug costs.

Comparison shop Believe it or not, drug prices vary depending on the time of the year and even the pharmacy.

A person can shop around for the most affordable medication just like they would when buying another product. Prescription drug apps enable you to search for discounts in your neighborhood.

Read your bill Medical coding and billing is not always accurate. Employees entering codes may put in the wrong information, inadvertently charging a person for the wrong medication. Treat your medical bills as you would any other bill and verify that

the charges are correct. If you have any doubts, check the drug name with your doctor and then consult with the pharmacy to see if an error was made.

Opt for generic medications Generic versions of hundreds of brand name prescription drugs are available and typically cost a lot less money. With a generic medicine you are not paying for marketing and advertising costs. These drugs are routinely tested for efficacy and safety. There is really no reason to select a name-brand medicine over the generic alternative, even when it comes to over-the-counter drugs. Ask your doctor on your script to check the box for the generic option.

Use a preferred pharmacy mail-order service Certain insurance companies have negotiated discounts with mail-order pharmacies and pass on the savings to their members. Medicare and other government-sponsored plans may offer the same type of deal, and consumers can save a substantial amount of money by opting for mail-order service.

Consider big wholesalers for prescriptions You may think of Costco or Sam’s Club as your go-to place

to buy 30-packs of toilet tissue, but these retailers also offer discounts on prescription drugs.

Even nonmembers are allowed to use these warehouses for their prescription drug needs.

Big wholesalers could give you the best deal on your pills.

Skip the insurance sometimes Consumer Reports says hundreds of commonly used generic medications can be purchased for around $10 for a three-month supply at various major chains. Program details vary, but consumers might be able to save a lot of money by using these programs and leaving their insurance cards in their wallets.

Opt for OTC In many cases, an over-thecounter medication may be just as effective as a prescription drug. Talk to your doctor about trying an OTC remedy before a prescription is written.

Ibuprofen may relieve arthritis pain, and diphenhydramine could alleviate insomnia, all at a much lower cost than prescription drugs.

Prescription drug costs can add up. But there are a number of strategies consumers can employ to reduce the out-of-pocket expenditures on medications.

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What you can expect at your annual physical Routine health screenings are an integral part of maintaining personal health. Although some individuals make frequent visits to their physicians, many others limit their doctor visits to their annual physicals.

Those who have never had a physical examination may be unsure of what to expect of such a procedure. That uncertainty can induce anxiety. However, a physical examination is a simple procedure for many people. Depending on a patient’s age, doctors may consider a more extensive examination, but the following procedures are what constitute a physical for younger patients without preexisting medical conditions.

Vital signs During a physical, doctors will check patients’ vital signs. Patients can expect to have their blood pressure taken and pulse rates measured. Respira-

tion rates may be taken to determine if there is a lung or heart problem.

Doctors also will examine a patient’s ears, nose and sinuses. The neck and possibly under the arms also will be examined to check the feeling of the lymph nodes and the carotid arteries. Some doctors hook patients up to a machine that measures heart rhythm through sensors on various areas of the body.

Medical history Doctors also discuss patients’ medical histories, updating their charts with any new information when necessary. Inquiries about particular health issues that run in the family will be discussed, as well as any illnesses or hospitalizations patients may have had in the past. Doctors will ask patients if they are taking any medications or supplements, and also will ask if patients have been dealing with any nagging medical issues.

Physical examination During the physical examination, doctors will look at and feel patients’ abdomens to detect the size of their livers and to determine if there is any abdominal fluid present.

The stethoscope may be placed on the abdomen to listen for bowl sounds. The physician also may examine other areas of the body, including the back and spine to ensure there are no abnormalities. A weight and height check will be given to measure for body mass index, or the percentage of body fat patients have, which will then be measured against the norm for patients of similar age, weight and height.

Female who do not see a separate gynecologist also may receive a pelvic examination and breast exam during their physical examinations. Doctors will check that the uterus and reproductive organs are in good health, and feel

for lumps or other issues within the breast tissue. A sample may be taken from the cervix so a Pap smear can be conducted to determine if cervical cancer is present. An external exam will look for sores or other indications of disease.

Men can expect a visual examination of the penis and testicles. The physician will check the external structure to look for abnormalities like tumors or hernia. To check for hernia, the physician may examine visually or feel the scrotum and ask patients to cough as part of the exam.

Dermatological exam Some doctors will examine the skin for the appearance of unusual moles or growths that could be indicative of skin cancer or refer patients to a dermatologist for such an examination.

Additional tests Nerves and neurological responses, including strength and balance tests,

may be tested during a physical. Doctor also may look for sensory changes in the extremities of the body. Doctors may order urine and blood analyses to verify that the levels are within range. A blood test usually will include a cholesterol test, and may include an examination of blood-sugar levels to rule out diabetes.

Men and women over the age of 40 may be referred to specialists who can conduct a mammography, colonoscopy or prostate examinations. These tests will rule out the presence of cancer or other diseases.

Doctors also may suggest patients have their vision and hearing checked.

Annual physicals can reassure men and women that they are in good health.

Such examinations also can serve as early detection systems that can catch potential health problems before they become more serious.

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