Valley Fever In the Central Valley

Valley fever is considered, by most people in the health industry, a silent epidemic because the spread of the disease is not clearly detected. Most people who might have the disease show no symptoms or display symptoms that are identical to other diseases like the flu, pneumonia, and sometimes even as cancer. Valley fever has become an increasing problem in the US, but namely in the Central Valley. The main behaviors contributing to the rising valley fever problem in the Central Valley include not enough groups raising awareness in the community about the disease and misdiagnosis from health care professionals.So what is valley fever? Valley fever is a fungal disease caused by the soil-dwelling fungus called Coccidioides immitis. The fungus prefers to reside within hot, dry, and dusty regions and is therefore prominent in the Central Valley. It is saprobic in soil, meaning that it will eat dead matter, and it becomes parasitic once it enters the body. The fungus tends to be located in rodent burrows. It is not known why exactly but it is theorized that this is because desert rodents are resistant carriers of the pathogen and are able to spread the spores of the fungus throughout the burrows and the fungus is able to live off the rodents’ excrements. When the rodents die, the fungus can then colonize in their body, use it as food, and also utilize the body as a source for the spreading of spores. Normally, these fungal spores can be inhaled through dust when soil is disturbed and will settle within the lungs where they then transform into larger, multicellular structures called spherules. Spherules leech off the nutrients in the lungs and grow until they burst, releasing more spores. These spores repeat the process, causing the fungus to vastly multiply within the lungs. This multiplication may lead to spreading of the spores outside of the lungs and throughout the skin, bones and the membranes surrounding the brain, causing meningitis. When the fungus spreads outside of the lungs, it is known as disseminated valley fever.There are certain groups of people in the Central Valley who are more severely afflicted by valley fever. This includes individuals 23 to 55 years of age, people who work outside in the fields or at construction sites and definitely field workers who speak little English. Hispanic farm workers are greatly affected due to lack of awareness and resources. This is a grand problem because the Central Valley has a vast population of field workers who are Hispanic with limited English capability. This dilemma causes structural violence because the poor immigrant field workers lack awareness of the disease and their employers do not provide them with the proper protective gear and information, putting the field workers in high risk conditions. Employers themselves may not know or are simply trying to save money. However, the groups of people most likely to develop disseminated valley fever are African Americans and Asian/Pacific Islanders. Studies on lab mice has shown that overexpression of the cytokine IL-10, a cytokine responsible in suppressing hyperactive immune responses in the body, led to mice who got injected the disease to acquire disseminated valley fever. Humans also express IL-10 so it is speculated that African Americans and Asian/Pacific Islanders may produce a lot of IL-10, allowing the fungus to proliferate in their bodies while remaining undetected by the immune system.

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Research evidence shows 111,717 reported cases in the US between 1998 – 2011. The Centers for Disease Control and Prevention (CDC) estimates about 150,000 cases of valley fever go unreported each year due to lack of awareness. California Department of Public Health reported 4,094 valley fever cases in California in 2012. Over 75% of valley fever cases from California come from the people who live in the Central Valley. Just recently, 3,000 prisoners in San Joaquin Valley had to be transferred due to risk of valley fever after some other inmates contracted the disease, indicating the possibility of the fungus harboring close to the jail.There are certain current behaviors in the Central Valley that have led to the valley fever becoming such a big problem. At the individual level, workers find it easy and a convenience to not use proper masks when working outside in areas with coccidioidomycosis (scientific name of valley fever) spores. At the organizational level, organizations like the United Farm Workers have not been able to fight hard enough to come to agreement with farmers to provide proper protection for their workers. The San Joaquin Valley Air Pollution Control District also does not have enough restrictions established on how much farmers are allowed to disrupt soil, which does not set a limit to the amount of coccidioidomycosis spores released. Regulating this would help prevent and lower cases of Valley Fever. A major behavioral problem is that healthcare providers are not knowledgeable about the disease thus leading to many misdiagnoses.Consequences that can be used to ensure that workers use protection when working outside is to have a system put in place where they can be fired or punished by their employer if they are caught not wearing a mask. In order to get organizations like United Farm Workers to petition for more change on protection against coccidioidomycosis spores is to have all the workers in the union stop funding them if they do not represent their worries of valley fever. The consequence that could be given to The San Joaquin Valley Air Pollution Control District would be to cut their funding by a certain percentage if they do not reduce valley fever in the Central Valley. Healthcare providers will be given a positive consequence like a bonus for correct diagnosis or a subtraction from their pay if they misdiagnose.A solution to dealing with valley fever would be to modify clinician behavior to make mandatory blood tests for patients who display one or more valley fever symptoms. Diagnosis of valley fever is difficult based on symptoms alone due to vague characteristics. Symptoms of valley fever include fever, cough, chest pain, chills, night sweats, headache, fatigue, joint aches, and red-spotty rashes. This often leads to valley fever being mistaken for the flu due to the flu-like symptoms associated with it. In light of this dilemma, valley fever should be diagnosed through mandatory blood tests to check if the patients has valley ever by looking for antibodies present in their blood that fight against the fungus. The goal of this solution is to perform a proper and timely diagnosis that will get rid of the faulty behavior of valley fever misdiagnosis. This will allow for collaboration between patients, health care providers, and insurance companies. The consequence will result in an annual bonus incentive program for clinics where compliance will be reported through attestation from the patient. This will include a 10% bonus to health care providers for proper procedures and a 1% penalty for improper procedures. The funding source will be provided by insurance companies.

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This solution will be effective and observable because doctors will get the incentive to properly diagnose valley fever every year. No other incentive program for valley fever has been tried before. The incentive program would be rather inexpensive because the money for the incentive will be reciprocated from the money saved by insurance company. It will also be decentralized since the program can definitely be applied to smaller scales communities such as those in Central Valley where insurance companies usually pay for all the medical bills. The program is flexible because incentives can be adjusted according to area it is being implemented in. The solution will remain sustainable because the funding comes from the money saved from all the misdiagnosis on a yearly basis. The solution is simple to implement since insurance companies already have all the records of all the procedures done on the patients and it is definitely compatible with the value of the target users because doctors value their reputation in giving the correct diagnosis and the incentive programs will give them the push they need.Other possible solutions are to have people in endemic areas to wear powered air-purifying respirators (PAPRs) with high-efficiency particulate air (HEPA) filters. These masks reduce the average spore concentration to 1/1000 of the ambient air concentration, reducing risk of valley fever infection to around 0.17% due to a battery-powered blower that pulls air in through filters to clean it before delivering it to the wearer’s breathing zone. People living in the central valley can also limit outdoor activity in dusty areas and water down construction sites before disrupting the soil in order to avoid the spreading of spore-containing dust. Dusty clothing should also be removed prior to entering home environment. Research has shown that the drug nikkomycin Z inhibits the enzyme responsible for the formation of chitin, the building block of the fungal cell wall. So far this drug has tested successful in mice inoculated with valley fever in which the disease was halted and mice survived. These results have made nikkomycin Z a favorable candidate for battling the valley fever epidemic in the Central Valley.

Be Independent This Independence Day – Guide for Every Solo Traveler

Going with an organization without a doubt is an incredible approach to appreciate the excursion; be that as it may, doing only it will make the explorer more sure and sufficiently solid to take choices rapidly. Investigating a spot in the own way and discovering the capacities, unquestionably, adjusts the nature of a person. It is very realized that voyaging alone is less demanding than meandering around in organization. Nobody needs to get caught in a feline battle about petite issues, which is very basic in sidekick voyaging. The best a portion of voyaging alone is that one can tend to make his or her own particular calendar and not stay reliant on the other for deciding. This makes a man more engaged about schedule and empowers them to wander around in a superior way.

Getting up in the morning early and sitting tight for the sidekick to be conscious is just aggravating now and again. In any case, there is not at all like this in solo voyaging. Grateful to the god; the explorer gets up at his own time and plan out the day without waiting for any other person. It is astounding that the performance explorer can visit wherever he or she needs. There is no such thing that two individuals are differing on seeing one thing together. Indeed, solo setting out ends up being to a great degree tranquil. As the day begins, one can cover whatever number destinations as would be prudent; contingent upon the pace of investigating them. As known, everybody has their own velocity of strolling and solo explorer is not required to sit tight for another person to be with him or her.

Indeed, another fortunate thing about voyaging alone is that the costs have a tendency to be in the point of confinement. For the most part, what happens is that two or more individuals have a tendency to spend much on devouring according to each other’s decision. Be that as it may, the alone explorer will know where to stay and what to eat inside the assigned spending plan. It is truly obligatory that the financial backing ought to dependably be in control as the cash can spent on whatever other vital thing. Along these lines, there won’t be any sort of pointless costs. What’s more, with regards to voyaging alone; definite information of the spot to be gone by ought to be swallowed. This tends to shield the explorers from getting into upsetting circumstances.

Be that as it may, voyaging alone brings valuable impact on the individual since it permits him or her to meet new individuals. Be that as it may, it is encouraged to do as such in a cautious way as this won’t not end up being hazardous circumstance. By meeting new individuals and making companions, the informal community happens to widen up. That is the reason; the travel connections change into successful business connections or everlasting companionship. Also, the voyager doesn’t know in the matter of what sort of contact may turn out to be valuable at which time of life. Unquestionably, voyaging alone makes a man more grounded than he really is. This is the reason that doing as such every so often is unquestionably suggested.

The significance about voyaging alone lies in the reality of investigating the shrouded abilities resting inside. Surely, there are different needs or needs that are disintegrating inside the heart and the individual is not aggregating the bravery to manage it. Thus, when the individual is voyaging alone, he or she finds the opportunity to take a stab at understanding their needs into facts. In this way, they tend to influence their inward fears and get to be more grounded than some time recently. Alongside this great part of voyaging solo, the voyager ought to take mind that he or she conveys all the fundamental assets; else, they may wind up meandering here and there for the crucial stuff. Be that as it may, voyaging alone is about enlarging the canvas of chances and painting the photo oneself.

As the visitor tends to visit the spots all alone, they will get mindful of the streets and in addition venture focuses in a superior way by asking questions from the new individuals on the square and discovering their own specific manner to the locales. This will acquire a high measure of trust in the visitor and feel elated than they would have ventured with some accomplice. Clearly, voyaging alone will improve the traveler a man in veracity by understanding their capacities. What’s more, what else, the vacationer will have the capacity to end up more educated in voyaging alone than giving his partner a chance to do the needful of asking the routes from others and sitting like a stupid.

There are specific regions present around that opens up for vacationers to travel alone, which can end up being captivating minute and a demonstration of brave. It is a sort of excursion where the voyager can understand better places, its conventional qualities and people. Certainly, it is undeniable that wandering alongside the accomplice, companions or even family can permit the vacationers to have a ton of fun and be set up to face difficulties to manage circumstances. There are sure quantities of voyagers, who are sufficiently intense to deal with the circumstances all alone and emerge as victor and additionally more confident.

California Dreaming – Central Coast Bound

When it comes to heading out on a relaxing, scenic adventure, there’s no question that the eye candy California’s Central Coast offers is the stuff that California dreaming is made of. But even the most stunning of scenery can take on a whole new look when it’s amplified by an extraordinary ride.So you can imagine how excited I was to get out of Fresno and the Central Valley for a few days, put the top down, crank up the XM on my Bose audio system, and test out my new Chevrolet Corvette along the sunny, mountainous shores of Santa Barbara. Sure, I’ve been to this charming seaside area dozens of times, but not in a convertible like this.As I tested out my six-speed manual transmission and glided up the traffic-laden highway in my Atomic Orange Corvette – out of Fresno and toward my destination – I was sure that the charm of this Mission-era town and the coastal communities just outside would take on a whole new charm.A VERY quick 250 or so miles – and I arrived at my destination. It felt like I was worlds away from Fresno. The Spanish architecture of Santa Barbara, with its tell-tale adobe buildings, gives this beachside community a beautiful and historic charm. The Red Tile Walking Tour is one I definitely recommend – it covers 12 blocks and shows off the Court House, Mission Santa Barbara and the gorgeous Stearns Wharf, which extends out into the bay for prime beach views. But for me, it was all about the drive. So after a quick check-in at my hotel, I was once again behind the wheel of my Corvette, heading toward Los Padres National Forest.

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The vivid beauty of this 24-mile scenic drive through the mountains, along the coastline and the Channel Islands was definitely a whole new experience in a high-performance convertible. My Corvette not only hugged the twists and turns of Highway 33 like a champ, its good looks even had other drivers doing a double-take. On the edge of Los Padres National Forest is the town of Ojai (an Indian name that means “nest”) so I decided to stop and grab a bite to eat. This quaint community is chock full of art galleries, adorable shops and caf├ęs.Next stop before heading back to Santa Barbara for the night – Cachuma Lake Recreation Area. Located along Highway 54, about 25 miles north of Santa Barbara, this place is great for camping, boating, fishing, hiking – you name it. But I was bound and determined to find a little place called Cold Springs Tavern, a secluded restaurant and pub off Old Stagecoach road. I’ve heard from my friends in Fresno that it’s impossible to find, and I’ve tried several times – but thanks to the OnStar navigation in my Corvette, I bypassed part of the highway at Kinevan, and ran right into Cold Springs Tavern. The food and atmosphere at this old stagecoach stop-turned-bar-restaurant was every bit as good as they say. (Try the Game Chili and Onion Rings!)After heading back to the hotel for a good night’s rest, I was ready for another adventure in my Corvette. On to Solvang I would go, just 35 miles north on the 101. Each time I pull up to this Danish village, I’m always taken aback by its charm. More than half of the town people claim Danish descent and it’s more than apparent in the architecture: thatched roofs, wooden storks, windmills and cobblestone sidewalks. I spent the morning walking around, visiting shops and – of course – sampling the goodies at the bakeries! But it’s not all about Dutch flavor. This is very much Cowboy Country, so you’ll find a lot of great horse ranches nearby. Alisal Guest Ranch, just three miles from downtown, is a great place to stay. No TVs in these guest rooms – just outdoor cooking, campfires and horseback riding.

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After lunch, it was on to the Old Mission Santa Ines, established in 1804. This Franciscan mission is absolutely beautiful – and it’s just a short drive from downtown Solvang. I continued on to Nojoqui Falls County Park to check out the 164-foot waterfall. Luckily, I still had plenty of hiking gear and a change of clothes packed in the back of the Corvette, so I decided to spend the rest of the day exploring the park. It was well worth it.Before ending my two-day excursion and heading back to the Central Valley, I continued along through the rolling hills in my Chevy Corvette to the “Valley of Flowers” near the city of Lompoc. I can tell you, the nearly 20-mile-long flower field made for an absolutely stunning drive.While there were many places yet to explore: Pismo Beach, Morro Bay, Mission San Luis Obispo de Tolosa, and Hearst Castle, it was time to head back to Fresno. Perhaps next weekend, I’ll be back in my Corvette, heading out for another coastal journey!

Don’t Get Taken Advantage Of While Traveling

Your sacks are pressed and you’re prepared to go? Excursions can be a considerable measure of fun yet you can likewise begin off kilter by falling prey to these travel tricks. Ideally, this will never transpire. In any case, it’s ideal to be arranged so you’re not found napping.

Main 10 Travel Scams

1. Finding an inn. You leave the air terminal just to be welcomed by a few people all encouraging extraordinary arrangements on the off chance that you stay at their inn. You pick one of them and find when you arrive the guaranteed rate is no more accessible. Presently you’ll need to pay significantly more to sit tight. At the point when attempting to discover an inn room, chat with visitor data or book the inn yourself.

2. Getting to your inn. You just arrived and are leaving the airplane terminal. Take a gander at the taxi lineup. This could take thirty minutes or more. A driver approaches you and lets you know he can get you to your lodging without the hold up. You choose to take the driver up on the offer. The driver puts your baggage in the vehicle and abandons you remaining on the control. Ensure you’re riding in an official taxi. Additionally, arrange with the driver the expense of the trek before making a beeline for your lodging. You need to ensure they go up against you an immediate course and don’t cheat you for the taxi charge.

3. Hungry for supper? You’re in luckiness, somebody has slid takeout menus under your entryway! You call the telephone number and submit a request. The sustenance never arrives and they have your charge card data. In the event that you need to arrange, within proper limits with the lodging for suggestions before calling a number from a flyer that was slid under your entryway.

4. The reminder. You’ve been voyaging throughout the day and you simply need to get some rest before you begin touring in the morning. The telephone rings. You answer it to discover the work area assistant on the flip side requesting that check your charge card data. You tell the work area assistant they have the wrong number and you give them the right data. Issue? You just gave somebody acting like the work area assistant your charge card data. You do a reversal to rest just to discover in the morning that you’re Mastercard has been utilized by another person. On the off chance that this transpires, either get back to the front work area or even better, go down in individual. To keep away from these sorts of travel tricks, never give out your Visa data on a call that wasn’t started by you.

5. Try not to give them a chance to get the drop on you. You snatch something for lunch from a merchant. Somebody standing close-by gets their sustenance or beverage spilled on you. They offer to help just to discover they’ve bailed you out of your wallet. Be watchful of somebody attempting to dismiss nourishment of your garments.

6. Take my photo! What number of time have you requested that somebody take your photo? Watch out for your camera. They could without much of a stretch vanish once they have your camera close by. Additionally, you could have an issue in the event that they request that you take their photo. They give you their camera, you let them know it’s not working, and they wind up making a scene shouting that “you broke their camera”. They will continue attempting to stand out enough to be noticed in the trusts that you will give them some cash to alter their camera. These travel tricks work in light of the fact that a great many people will pay to prevent them from attracting thoughtfulness regarding you.

7. Watch your gear. Do you ever hurl your gear in the overhead on trains? Be cautious while experiencing dull passages. Criminals will sit tight for these regions and essentially snatch your sack and continue strolling to the following auto while the auto you’re riding on is dull. You’ll be unaware and not understand your pack has been stolen until you’re prepared to get your sack. Attempt to connect the sack to the baggage rack when riding on a train so it’s not effectively taken.

8. Stop for a moment and watch the road entertainers. It’s a considerable measure of fun. There’s a vast group. Here and there these exhibitions request that the group of onlookers move out and shape a greater circle. At that point they’ll request that everybody move in. By then, individuals are catching each other. This is an incredible time for the pickpockets to get your wallet. Be cautious where vast gatherings structure to watch an execution.

9. Fascination is shut for the morning. I really had this transpire in Bangkok. We were headed to the Palace and an aide drew nearer me letting me know the Palace was shut for the morning for a private gathering. They would go up against me a private visit and bring me back later when it was open once more. As I looked over, there was such a large number of individuals in there, children, grown-ups, I didn’t trust him. We strolled over to discover it was open. Check for yourself if a fascination is really shut. It’s presumably open.

10. Tallying your change. When you pay for something, ensure you know the amount you ought to get back. On the off chance that you have all the earmarks of being in a rush, merchants may number your change gradually and take a long respite part path through the tallying. Their trust is that you think the exchange is finished, take your cash and go, not understanding they’ve just checked out some portion of your change.