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    Patients Need to Know the True Cost of ‘Free’ Screenings – AAFP News - December 5, 2019 by Mr HomeBuilder

    I was in college the first time I observed World AIDS Day.(www.worldaidsday.org) I spent the night with others from our Gay-Straight Student Alliance, tying red ribbons and placards to the palm trees that lined the main campus lawn. Our focus was raising awareness of the impact of HIV/AIDS in different communities and fighting the stigma associated with the disease.

    Since then, the focus (for the alliance and other advocates) of subsequent World AIDS Days, which is observed each year on Dec. 1, has shifted from simple awareness of HIV/AIDS to supporting free proactive HIV screening tests and education about pre-exposure prophylaxis.

    The results of these collective efforts (along with making HIV medications accessible to people living with HIV) are as you would expect. Progress is slow, but the rate of new HIV infections is at the lowest level ever.(www.hiv.gov) However, we are still missing critical populations. Black men who have sex with men, for example, account for a high proportion of new HIV diagnoses.

    There's an obvious lesson here: When it comes to health awareness and screening, it's all about getting the right methods into the right communities. This is consistent with what we already know about screening asymptomatic patients for disease, a practice that is based on longstanding, clear principles(apps.who.int) (availability of an accurate test, identification of an appropriate population and ability to act on results obtained).

    But we are shifting into a world of direct-to-consumer screening tests, and the result is that patients think that acquiring information -- in any form -- is better for their health. There is a drive to constantly track and improve our health.

    That's why it's even more interesting to reflect on why HIV screening tests are (somewhat) a success story in the world of patient-driven screenings compared with other offerings.

    Take, for example, the carotid artery ultrasound. Most people don't need this test to screen for carotid artery stenosis. So imagine my surprise when, early in my career, a healthy patient in her 40s told me she needed a referral to a cardiologist after she had somehow gotten this test at a mobile health fair offering "heart screening."

    I've since learned that hospitals and third-party vendors offer things such as stroke screening packages. For my patient, it was the carotid artery ultrasound. For others, the free or low-cost screenings may involve EKGs or ultrasounds of the abdominal aorta.

    The subsequent harms from these tests can be tremendous. They may yield false-positive results or incidental findings that lead to riskier procedures and increased costs to our health care system -- all while failing to make people healthier.

    In the medical community, the idea that screening tests might cause more harm than good is far from novel. Robust studies have shown no to low reduction in mortality from certain screening tests.(www.ncbi.nlm.nih.gov) Every physician understands the sensitivity and specificity of screening tests. We know the pitfalls of false negatives. We know the fallacy of the idea that early detection prolongs life and we know the definition of lead time bias.

    Yet despite the evidence and our education, we've collectively failed to deliver cohesive messaging to patients about screening tests, especially information regarding which patients to screen.

    For the HIV screening test, most patients are able to appropriately self-select while avoiding overscreening. In fact, many patients who should get tested still don't. Contrast that with EKGs or carotid artery ultrasounds, which many patients think they would benefit from although most patients don't need them.

    Mass media is partly responsible for this critical missing piece of the narrative. Patients who are the exception to the rule generally get airtime, telling stories that are often steeped in fearmongering: the missed pancreatic cancer diagnosis, the rare young patient with a stroke or the atypical presentation of a heart attack.

    "Disease of the month" awareness campaigns often are well-intentioned but may also lead to unnecessary overscreening. Breast cancer screening is probably the most misunderstood example of screening complexities. Only 10 of 10,000 women in their 50s will have their lives extended by annual screening mammography, but 940 patients will undergo an unnecessary biopsy. And 62 of those 10,000 women will still die from breast cancer.(jamanetwork.com)

    But patients still believe the blanket "early detection is key" mantra and insist that mammograms will save their life.

    Given all these nuances, patients shouldn't be expected to navigate the confusing health care landscape on their own. Literally, the reason the U.S. Preventive Services Task Force exists is to guide clinicians, and earlier this year, the USPSTF published its first recommendation on preexposure prophylaxis. The task force recommends that clinicians offer PrEP to patients who are at high risk of acquiring HIV infection. That recommendation, supported by the AAFP, carries an "A" rating, which means the treatment should (eventually) be covered by payers.(www.healthaffairs.org)

    Family physicians are the first line of defense when it comes to patient education. It's our role to show patients that screenings are not primary preventive care. No screening test can actually prevent cancer; rather, they exist to detect cancer.

    When it comes to reducing risk of disease, primary prevention is best. Eating your vegetables, quitting smoking, taking PrEP. Giving PrEP to just 10 young black men who have sex with men will prevent one new HIV infection.(www.ncbi.nlm.nih.gov) No screening test can beat those numbers.

    On World AIDS Day this past weekend, I reflected on the work being done to fight AIDS -- the research, the increased access to medications, the times I've appropriately screened a patient for HIV infection, the times I've diagnosed it and initiated treatment. I'm proud of all that work. But I'm even prouder of the times I've taught my patients about PrEP and reduced their risk of being infected in the first place.

    Natasha Bhuyan, M.D., is a board-certified family physician in Phoenix. You can follow her on Twitter @NatashaBhuyan.(twitter.com)

    Read other Fresh Perspectives posts by this blogger.

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    Patients Need to Know the True Cost of 'Free' Screenings - AAFP News

    How do you want to enjoy the Mississippi? St. Cloud’s Riverwalk plans to be finalized soon – SC Times - December 5, 2019 by Mr HomeBuilder

    Planned repairs to the roof of St. Cloud's drinking water treatment facility will require the grass to be torn up and allow for development of the riverwalk.(Photo: City of St. Cloud)

    ST. CLOUD A new way to embrace the Mississippi River just north of downtown St. Cloud could be open to the public within the next two years.

    The city of St. Cloud is wrapping its vision for a Riverwalk into scheduled improvements at the city's drinking water treatment plant along Fifth Avenue North.

    The public is invited to attend an open house from 5-7 p.m. Wednesday at Whitney Senior Center to give opinionson possible Riverwalk features.

    The proposed Riverwalk site has changed since it was first proposed in 2015. Preliminary drawings showed an interactive river channel and swimming area, amphitheater space, a canoe launchand event buildings on the site ofCathedral High School's Rau Field.

    The updated plans instead feature amenities near Hester Park including the transformation of the green space on top of the water treatment plant, which is tucked under the turf.

    Residents at the open house will be asked about their preferences for the space. That could include music or performance space, benches, flexible lawn space, an athletic field, space for family and community events, and space for picnics, among other things. Landscaping could include a shelter or pergola, a wildlife habitat, a sculpturegarden or other gardens.

    Matt Glaesman, community development director, said he expects the council to approve final plans and bids for the project in the coming months.

    The roof of St. Cloud's drinking water treatment facility is tucked under green space that the city plans to redevelop as part of a riverwalk.(Photo: City of St. Cloud)

    The overall plan also includes the relocation of two lift stations along Fifth Avenue North near Cathedral High School. That project is estimated to cost $1.4 million and is funded by sewer utility revenues.

    The water treatment facility improvements are expected to cost $25 million, funded by a state revolving fund. Planned improvements include advanced treatment and disinfection systems.

    Tracy Hodel, public services director, said the improvements are primarily related to water quality compliance. Construction is anticipated to begin in the summer and be completed by 2022.

    The Riverwalk, which will connect the downtown Beaver Island Trail extension to Hester Park, is estimated to cost$5 million. It will be funded by $2 million in local-option sales tax revenues, $1 million from a grant and $2 million in private donations.

    The Riverwalk project is a partnership between Mississippi Partners, Rotary Club of St. Cloud and the city of St. Cloud, among others.

    "These are the three things coming together that are creating the corridor improvements," Glaesman said of the projects.

    The Riverwalk project also provides an opportunity to restore the eroding shoreline of the Mississippi River and fits with Mayor Dave Kleis' priority to spotlight the mighty river that runs straight through the heart of the city.

    Those efforts spurred the Beaver Island Trail bridge, a sloping bridge snuggled up against the downtown riverbank that connects the trail from River's Edge Convention Center to Fifth Avenue North. The bridge, which cost about $8.44 million, opened in October 2016.

    The city's comprehensive plan also shows proposals for new riverfront restaurants and hotels along the east side of the Mississippi River.

    The city and region has worked to embrace the river as an asset in recent years, with a 2009 regional plan earning St. Cloud the River Friendly City of the Year Award from Minnesota Waters.

    "That established a regional vision for how we embrace the river and be good stewards while also using the river for redevelopment purposes," Glaesman told the Times in 2017. "We've certainly made a concerted effort to re-engage the river."

    Read or Share this story: https://www.sctimes.com/story/news/local/2019/12/03/plans-riverwalk-near-hester-park-finalized-coming-months/2590558001/

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    How do you want to enjoy the Mississippi? St. Cloud's Riverwalk plans to be finalized soon - SC Times

    Tasmanian News: Water restrictions coming soon to Hobart and surrounds due to ‘weather patterns’ – ABC News - December 5, 2019 by Mr HomeBuilder

    Updated December 05, 2019 15:27:16

    Here's what you need to know today:

    Stage one water restrictions will come into effect across the greater Hobart area on December 20 due to "below-average rainfall across south-eastern Tasmania", "projected demand" and the "longer-term outlook for weather patterns in the region", the state's water utility says.

    In a statement, TasWater said it was enforcing the following measures:

    Garden and lawn watering is allowed on any day during the following times:

    Watering of sports grounds is allowed on any day during the following times:

    In a statement, Primary Industries and Water Minister Guy Barnett said the restrictions would "ensure that there is sufficient supply for residential and business use, fire preparedness and farmers".

    "These measures are needed due to an extended period of dry conditions coupled with increased demand," he said.

    "While the vast majority of Tasmanians enjoy plentiful access to water, there are those in rural communities in drought for whom, water is liquid gold."

    The restrictions are expected to be in place until the end of February 2020. More information can be found at the TasWater webpage.

    An economic assessment of a second undersea power connector between Tasmania and Victoria has found it is technically feasible and commercially viable.

    The proposed Marinus Link would operate in addition to the Basslink interconnector, which links Tasmania to the national electricity grid.

    The business case study, released overnight by Tasmania's state-owned energy provider Tas Networks, found the 1500-megawatt Marinus link and supporting transmission would deliver broad economic benefits to both Tasmania and Victoria.

    It estimates the project would create more than 2,300 jobs in the construction phase in Tasmania, and over the long-term would add more than $1.4 billion in economic value and create 1,400 jobs in each state.

    It was not clear how the project which could cost up to $3.5 billion would be funded but analysts have suggested Victoria should contribute given it also stands to benefit.

    Tasmania's water provider has revealed it took more than seven hours to send a technician to check its Macquarie Point sewage treatment plant after a power failure in August a fault that resulted in six million litres of untreated sewage and stormwater spilling into Hobart's River Derwent.

    TasWater chief executive Mike Brewster was questioned by the Tasmanian Greens about the incident during government business enterprise scrutiny hearings on Wednesday.

    Mr Brewster said TasWater's operational control centre in Devonport was notified soon after the power went out, but only decided to send someone to check the facility hours later after conducting a complex assessment.

    "When they got to the bottom of it they said 'hang on a minute, we should send someone out' so they sent someone out seven or eight hours later and that's the reality of the situation," Mr Brewster said.

    He said the uninterruptible power supply switched itself off, causing the failure, but it remains unclear how that occurred.

    Scientists at the University of Tasmania are hoping the hatching of a clutch of red handfish could help save the world's rarest fish.

    The 50 juveniles were hatched in an aquarium at the Institute for Marine and Antarctic studies this month.

    Scientists had collected two egg masses from one of the last handfish sites in Southern Tasmania, where fewer than 100 adults survive.

    IMAS researcher Jemina Stuart-Smith said the babies would be released back into the wild when they're about 12 months old.

    "While they're in captivity, we can protect them from things like predation and other adverse environmental conditions and make sure that things like food availability is not a limiting factor," she said.

    "Little is known about red handfish biology, reproduction and early growth, and these juveniles will also allow critical research that can help us to ensure this is not the last generation of their species," Dr Stuart-Smith said.

    The forecast for Tasmania is for showers, more frequent about the west, south and central areas. Fresh to strong and gusty westerly winds.

    Friday is forecast to have showers about the west, south and central areas, and Bass Strait islands. Afternoon showers are possible elsewhere, although less likely about the east coast. Fresh to locally strong and gusty west to south-westerly winds are expected.

    A full and updated list of warnings can be found on the Bureau of Meteorology's Tasmanian Warnings summary webpage.

    As of 6:00am the Pinnacle Road to the summit of Hobart's kunanyi/Mount Wellington was closed at The Springs.

    Check the council website for the updated status of Pinnacle Road.

    Source: Bureau of Meteorology

    Topics:animal-science,science-and-technology,earth-sciences,animals,community-and-society,police,lifestyle-and-leisure,human-interest,fishing-aquaculture,government-and-politics,law-crime-and-justice,crime,hobart-7000,burnie-7320,launceston-7250,queenstown-7467,bicheno-7215,smithton-7330,coles-bay-7215,colebrook-7027,lake-st-clair-7140,mount-stuart-7000,st-helens-7216,st-leonards-7250,st-marys-7215,st-peters-pass-7120,stanley-7331,staverton-7306,steppes-7030,stewarts-bay-7182,stieglitz-7216,stonehenge-7120,stonor-7119,stoodley-7306,stormlea-7184,storys-creek-7213,stowport-7321,strahan-7468,strathblane-7109,strathgordon-7139,strickland-7140,campbell-town-7210

    First posted December 05, 2019 06:53:31

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    Tasmanian News: Water restrictions coming soon to Hobart and surrounds due to 'weather patterns' - ABC News

    Penn State Health St. Joseph schedules classes and support groups – Reading Eagle - December 5, 2019 by Mr HomeBuilder

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    Penn State Health St. Joseph schedules classes and support groups - Reading Eagle

    Earth Matters: Long Island Water suppliers’ plans for reducing peak water consumption – Blog – The Island Now - November 29, 2019 by Mr HomeBuilder

    In 1978, the U.S. Environmental Protection Agency designated Long Island, a Sole Source Aquifer because of its total dependence on groundwater for its water supply. The conservation of this resource continues to be crucial to the future of Long Island.

    Nearly 40 years later, in January 2016, the NYS Department of Environmental Conservation directed all public water suppliers on Long Island to develop plans to reduce peak water consumption (e.g. summer water demand) by 15 percent over the next three to four years and to submit reports on their plans and progress.

    The following information summarizes the progress and plans outlined in the information submitted by the Long Island water suppliers to the DEC around April 2017:

    Non-revenue WaterThere were several actions that nearly all water suppliers reported on. One issue was tracking the amount of water that is pumped from the aquifers but is lost from the water system or is unaccounted for. Water suppliers now refer to this as non-revenue water. This is water the does not reach the customer or generate a payment to the water supplier. A typical level of non-revenue water for a water system is 10 percent. Eleven suppliers reported levels that were above the industry standard of 10 percent.

    Reducing Water ConsumptionMost suppliers are installing new or upgraded water meters that have enhanced features such as remote reading and time of use metering. The new meters provide more accurate information about water use and help improve water use tracking by suppliers.

    Old water meters tend to undercount water use. Unusual spikes in water consumption due to leaks can be detected more quickly with the new meters. Year-to-year comparisons of water use are also easier to generate and report to customers by using the new meters.

    Tiered water rates are becoming the industry standard on Long Island. A tiered rate structure is one that charges higher amounts for a given quantity of water as consumption increases. This is a good tool for promoting water conservation.

    Top 10 Water Users in each water system is reported by most water suppliers. Some water providers are contacting their top 10 and offering them assistance to reduce their water use through actions such as water audits and water conservation strategies.

    Lawn irrigation and outdoor water use is the single highest water-demanding activity reported by most water customers. Water use in cold months is viewed as the baseline water demand level, representing indoor water consumption.

    The aquifers and water infrastructure systems are most stressed during the warm summer months when large amounts of water are used for irrigation. Pumpage in summer is 2 to 3 times greater than groundwater pumpage in the winter.

    Also of note are the benefits of landscaping with native or drought-tolerant plants, including low-maintenance grasses.

    Reducing indoor water demand is promoted by many suppliers who may offer water conservation kits, low-flow showerheads and faucet aerators. Some districts promote the U.S. EPA WaterSense program that provides information to help customers find water-saving devices and practices. Products that can reduce water use by at least 20% or more can display the WaterSense logo.

    Additional benefits of conserving are reported by water suppliers. Pumping and treating water requires a significant amount of energy and other resources. For example, the Suffolk County Water Authority reported that in winter, it can operate with fewer than 100 wells, but in summer over 600 wells are needed to meet demand.

    SCWA is the largest energy consumer in Suffolk County in the summer. A similar demand for energy in summer is likely created by water suppliers in Nassau County. Using less water reduces demand on the energy grid, and saves money on chemicals and other treatment costs.

    Note: In the summer of 2019, various water suppliers promoted the use of smart irrigation system controls that help to reduce or stop irrigation when lawns do not need additional water.

    (Elizabeth Bailey prepared this report.)

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    Earth Matters: Long Island Water suppliers' plans for reducing peak water consumption - Blog - The Island Now

    Trump’s Handwritten Note Gets The Meme Treatment [Videos] – 2oceansvibe News - November 25, 2019 by Mr HomeBuilder

    Hey, do you know what makes you seem really innocent? When you appear in front of the press with handwritten notes that remind you to say how innocent you are.

    As the Trump impeachment inquiry rumbles along, delivering either damning evidence (according to the Democrats) or a look at the Deep State in action (yeah, the Republicans), the president continues to rant about how hard it is being him.

    Witchhunt, total scam, and all the other greatest hits he trots out daily you know the drill.

    Back to those handwritten notes, though, with Rolling Stone setting the scene:

    While EU ambassador Gordon Sondland was testifying during Wednesdays impeachment hearings President Donald Trump attempted to defend himself to the media. The president held a pad of paper with words written in all-caps with a sharpie and read aloud in dramatic fashion.

    Skip ahead to the 30-second mark below for the reading:

    Another totally normal display of human behaviour, there.

    Also, yes, Trump did spell the name of the president of Ukraine, Volodymyr Zelensky, incorrectly.

    His reading of the note lends itself very nicely towards memeification, and it wasnt long before they began to circulate.

    Morrissey, anyone?

    Decent, but that has nothing on the emo reading:

    The Ramones remix is also a work of art:

    Ruined.

    If youre after a rather immature chuckle, fair enough, because its been a long week. This might do the trick:

    You act like a giant toddler, and you get treated like one.

    Expect more inane, and insane, ramblings over the weekend as the impeachment heat is cranked right up.

    [source:rollingstone]

    See more here:
    Trump's Handwritten Note Gets The Meme Treatment [Videos] - 2oceansvibe News

    The Best Lawn Care Services of 2019 | Reviews.com - October 15, 2019 by Mr HomeBuilder

    The Best Lawn Care Services

    A lush green lawn is practically the American dream. Because a beautiful lawn is a healthy lawn, the best lawn care providers tend to the holistic health of your yard the soil, its nutrient balance, the beneficial bugs burrowing through it. We compared national lawn care companies to find which best combine ecological landscape practices with reliable customer service.

    We opted to focus on major lawn care companies doing business in a sizable number of states more than half the country by geographic area. Its important to note that we looked for lawn care providers whose primary task is treating the health of your grass. You may be interested in contracting a local lawn care company to mow once a month, or a full-service landscaping firm to install a water fountain or retaining wall. In those cases, our guide below can still help you find a reputable company.

    For our purposes, we sought out reliable and well-established lawn care companies with the resources to tend to the health of your lawn, not just mow or landscape. We pulled names from customer review sites like Consumer Affairs as well as industry reports of major players, then checked for stand-out companies that hit the following four criteria.

    The diverse benefits of a well-tended lawn (good to look at, nice to roll in, more resistant to invasive weeds and pests) illustrate the importance of hiring a lawn care company that takes them all into account. One promising sign of a mindful provider: membership to national and regional landscaping organizations.

    The national membership we looked for: National Association of Landscape Professionals. As Kathryn Hahne, a water conservationist and landscaper, told MarketWatch, affiliation reflects providers education and professionalism in their field. A conscientious lawn care provider follows landscaping and agronomist best practices, as well as legislature about permitted turf and fertilizer types, that professional networks codify.

    We love the convenience of an online or over-the-phone quote for most services. But when it comes to your lawn, the company shouldnt have a preconceived number. You dont want a company doing half of a job because they quoted you the price of half the necessary work. The size, slope, and state of your lawn can only be accurately assessed in person. Even if a provider offers a ballpark quote to get you through the front door, final rates should be based off of an initial lawn consultation.

    Considerate landscaping feeds the soil, not the grass. We looked for lawn care providers that conduct a soil test before any other service. Healthy soil has the right pH balance for your region, as well as a specific nitrogen-phosphorus-potassium (NPK) balance either 3-1-2 or 6-1-4. Before adding nutrients and recommending grass and ground cover, your lawn care provider has to know your soils current content.

    Landscape practices can either help or hinder the environment: both the micro-environment that is your lawn and the greater biome it takes part in. While fertilizing for growth and spot-treating weeds is necessary for that emerald carpet look, over-fertilizing or spreading weed and seed products hinders your grasss ability to plant deep roots and thrive long term. More globally, the runoff from excess chemicals can damage key species in the food chain. Proper amounts of fertilizer natural and slow-release versus synthetic and quick-release at spaced-out intervals is key. So is opting for manual weeding when feasible. We verified that our top companies ascribe to these fertilization practices.

    Best Full-Service Lawn Care

    Lawn Doctor

    A thoughtful range of services ensures you can pick just the lawn care elements you really want.

    ProsCustomizable treatment optionsThorough pest control servicesUnique lawn mower maintenance

    ConsNot available in 10 states

    Lawn Doctor boasts high customer service ratings on sites like Trustpilot and Yelp, and at least one reason for the companys success is its spread of services. Treatment options are varied and customizable. You can choose whichever specific service best meets your lawn care needs, or opt for the Lawn Maintainer Care Program. This annual program combines all of Lawn Doctors most popular services (fertilization, weed control, pest control), customized to your lawns individual needs. This plan is also available with organic products made exclusively with plant and animal waste.

    While both TruGreen and Weed Man USA have the products and know-how to combat common lawn pests like mosquitos, Lawn Doctor expands pest control into a whole practice area. The company claims to have practiced IPM (integrated pest management) long before the acronym gained popularity.

    This holistic vision of pest management seeks to put a damper on annoying critters rather than exterminate them completely. With it, Lawn Doctor treats the insects that wander onto your property when their season is ripe: mosquitoes, ticks, fire ants, grubs, armyworms, chinch bugs, moles, as well as perimeter pests like ants, spiders, clover mites, fleas, and ladybugs. (For a fuller discussion of IPM, check out our Pest Control Services review.)

    Another pest control service from Lawn Doctor we love: Special Event Sprays. If youre holding a reception or reunion in your backyard, leave mosquitos off the guest list with Lawn Doctors Yard Armour treatment.

    Like most lawn care providers, Lawn Doctor wont mow your grass. But Lawn Doctor goes a step beyond the competition by offering a unique service in select locations: maintaining your personal mower. Lawn Mower Maintenance includes cleaning and winterizing the engine and tank as well as sharpening the blades. This last step is key. The jagged tears made by a dull lawn mower leaves grass vulnerable to rot and disease. In other words, mowing your lawn without a properly sharpened blade could sabotage the very lawn care youre paying for.

    Alaska, Hawaii, Idaho, Maine, Nevada, North Dakota, Oregon, South Dakota, Vermont, and Wyoming are still waiting for a Lawn Doctor outpost. Residents of all the above states save for Alaska, Hawaii, and Vermont can turn to TruGreen. Those remaining three states will need to scout for local lawn care using our guide.

    Best Annual Lawn Care Plans

    TruGreen

    A step up on annual plans and a nation of happy customers. And if you want to see evidence of its work, flip on the golf channel: Its the official lawn care provider of the PGA.

    ProsOutstanding annual planAvailable in the greatest number of states

    ConsNo natural planYearly plans automatically re-up

    If your lawn needs help from many angles, TruGreens four 12-month lawn care plans are some of the best in the business. Each plan offers different combinations of aeration, pH balancing, fertilization, weed control, and tree and shrub care. All include nine visits spread through the course of a year, plus four additional visits if you opt for the larger plans with tree and shrub care included.

    Other companies offer similar long-term plans, but these dont come with as thorough of a work guarantee as TruGreens the Healthy Lawn Guarantee promises return visits from a technician between scheduled visits whenever you feel your lawn needs aid. If you dont want to invest in a full year of lawn care (your first visit is a deal at $29.95, but subsequent visits will likely cost $40 to $50), TruGreen provides la carte services like aeration, overseeding, even mosquito defense.

    Every state save for Alaska, Hawaii, and Vermont can receive lawn care from TruGreen. While TruGreens national and multi-market stance may make its services seem less personalized, the website offers a glimpse into the companys local approach with seasonal precautions and reminders based on your location. Enter your ZIP code at the top of the TruGreen homepage to make the information relevant to you.

    If you're interested in integrating natural lawn care (think organic fertilizer and no pesticides), then TruGreen may not be your best fit. While the website claims on one FAQ page to offer an organic program called TruNatural, the program is not listed alongside other services, and it takes some hunting to find any more information. For now, natural lawn care is likely better secured from a company that puts it front and center.

    Unless you personally cancel service before your 12-month TruGreen plan draws to an end, the company will automatically sign you up for another year. If you want to continue receiving regular visits, this automatic continuation will be a boon. But if you think of lawn care as a solution and not a management system, youll want to keep a weather eye on next years calendar or risk surprise charges.

    Weed Man USA

    A growing franchise company with a focus on residential lawns that get green by going green.

    ProsEncourages a natural yardWell-run and thriving

    ConsNo commercial services availableNot available in 15 states

    Environmentally conscious lawn care encourages the growth of native and pest-resistant plants and attempts to grow grass only where grass belongs off steep embankments and away from shady areas. Weed Man USA checks these boxes with organic lawn dressing options, targeted weed removal services, and affiliation with the EPAs Environmental Stewardship Program.

    Weed Man USA was included in Forbes magazines list of Best Franchises for two of the past three years. The list weighs system sustainability, system demand, value for investment, franchisor support, and franchisor stability to craft rankings, and Weed Man was called out as one of the best.

    Contributing to this major mark of success: the companys environmentally friendly lawn care, which appeals to consumers throughout the US and beyond (Weed Man also operates in Canada and the UK). Even if you arent interested in the landscaping business, Forbes kudos is meaningful. Weed Mans popularity reflects the efficacy of its natural approach and portends its increasing availability.

    Unlike our other top picks, Weed Man USA doesnt explicitly include commercial lawn care in its service menu. A residential-focused company, Weed Man gives your personal real estate its full attention. But if youre looking for a provider with experience handling commercial accounts, Weed Man may not offer the expertise you need.

    Residents of Alaska, Arizona, Delaware, Hawaii, Nevada, New Mexico, New Hampshire, North Dakota, Maine, Mississippi. Rhode Island, South Dakota, Washington, Wyoming, and Vermont do not yet have access to a local Weed Man USA branch.

    While landscaping professionals often advise against choosing a provider that offers quotes sight unseen, plenty of good lawn care providers offer an online quote in conjunction with a free lawn consultation. If getting the best price is important to you, ask for quotes from several. While your price will depend on the state of your lawn and its square footage, Home Advisor provides a list of typical costs.

    Landscapers are not required to carry any official license, but they should provide their own insurance and be able to speak to their horticultural training. Apart from knowledge of native growth and the functions of common groundcovers, they should also be familiar with integrated pest management. Managing invasive pests without scouring the natural environment of your lawn is a cornerstone of responsible landscaping.

    If you want them to preserve the clover, tell them. If you want them to stick to organic products, tell them. Any desires for the treatment process and its outcomes should be relayed to your lawn care provider. Like a tattoo artist or hairdresser, its their responsibility to tell you if your vision wont turn out like you expect.

    If you are concerned about your provider accomplishing the tasks the right way, schedule visits when you can be at home. Just know that some visits will be short five to 10 minutes. Your provider isnt pulling a fast one; not every visit requires action. Quick visits allow your provider to monitor how prior steps are taking effect.

    What is the best grass for my lawn?

    Propagating grasses naturally agreeable to your local climate cuts down on excessive watering and fertilizing demands. But you also want to consider your expectations for look, feel, and maintenance, as well as your standard foot traffic. If your grass takes a beating, you need hearty grass, though these varieties require more maintenance.

    This image from Lowes shows the best zones for cool season grasses (blue) and warm season grasses (orange). The transition zone (green) is best planted with a mix of cool and warm varieties. If you live in this region and want to stick with one grass type, go with cool season.Warm-season grasses

    Cool-season grasses

    Cool- or warm-season

    How often should I water my lawn?

    Water your lawn less often but more deeplyrather than quick, daily showers, soak your lawn slowly two to three times a week. Your lawn needs one inch of water each week, year round. A pro tip is to scatter a few empty tuna cans throughout your yard as you water; when those have filled, its time to turn off the sprinkler. This allows a healthy inch of water to moisturize the roots, promoting a deeper root system. Lawn care experts also recommend watering your lawn as early in the morning as possible.Its also more than okay to let your lawn go brown during the hottest parts of summer. Grass can bounce back from a full month without water. During that time, it enters a harmless period of dormancy. If the grass goes from brown to pale, you know its time to turn on the sprinkler.

    How often should I fertilize?

    Memorial Day and Labor Day. If you live in the South, a little earlier on both ends of the summer. Remember that using organic, slow-release fertilizer is the standing order from modern landscaping. Youll also reduce the odds of harming your lawn if you take a similarly moderate approach to weed-fighting. Mulching grass clippings serves double duty as a nutrient-bearer and a weed-fighter. And if you are wrestling with existing dandelions or other unwanted sprouts, try sprinkling corn gluten meal on them rather than store-bought weed killer or harsh rock salt. This corn-byproduct remedy works by inhibiting the root growth of germinating plants.

    What happens if I over-fertilize my lawn?

    Over-fertilizing your lawn just makes it dependent on fertilizer. Thats because a superabundance of chemicals kills off earthworms and other organisms vital to a healthy lawn. Earthworms burrows allow oxygen and water to seep deeply into soil, and earthworms themselves release nutrients for plants use through their decomposition of dead matter. Without earthworms, your grass is more likely to develop a shallow and undernourished root system.

    What's the problem with fertilizer and pesticides?

    Fertilizers and pesticides in excess will run off from your lawn and potentially pollute bodies of water. The latter is a hazard for humans and wreaks havoc on small water-dwellers. As for fertilizer, it can nourish anything green that grows. Algae will gorge on the stuff, spreading thickly across the surface and denying fish access to light and food in the process.

    How should I water my lawn during a drought?

    While water restrictions during a drought mean you cant water your lawn as frequently as it needs, there are still measures you can take to help your lawn survive longer dry spells.

    How do I find the right lawn care service?

    What services do lawn care providers offer?

    Available services will vary between providers, so be sure to ask if you have a particular service in mind. Generally, most lawn care services perform the following tasks:

    You make a lot of purchasing decisions when it comes to your home. Choosing the best option every time is a tall order but we can give you a boost. Check out some of our home service reviews below:

    Read this article:
    The Best Lawn Care Services of 2019 | Reviews.com

    Seasonal Lawn Care Guide For Lush Lawns – Scotts - October 15, 2019 by Mr HomeBuilder

    Clean up. Kick off the growing and mowing season with a quick spring cleaning. Grab a lawn rake to rake out dead grass and dead remnants of annual grassy weeds, like crabgrass, goosegrass, and barnyard grass. Pick up any sticks or other debris that have accumulated on the lawn over winter.

    Mow high. Double-check your mower deck height, and position it to cut grass at the highest possible setting for your grass type. Cutting high encourages grass plants to grow thicker with deeper roots, which creates a lawn of healthy grass that will help to crowd out weeds.

    Apply fertilizer. Lawns wake up from winter dormancy with an appetite. In the North, apply Scotts Turf Builder Triple Action. Not only will it feed and strengthen your lawn, but it also kills weeds like dandelion and clover and prevents future weeds. Feed again two months later with Scotts Turf Builder Lawn Food to keep grass lush and strong. With all products, be sure to follow label directions.

    In the South, feed your lawn in early spring with Scotts Turf Builder Southern Triple Action to masterfully handle the three big needs of Southern lawns: It prevents and kills fire ants for up to 6 months, kills stubborn weeds like dollarweed and clover, and nourishes and strengthens your lawn to protect it from heat and drought. Two months later, give it a second feeding, this time with Scotts Turf Builder Southern Lawn Food. This will help your lawn grow even thicker and continue to protect it from weather-related stress. Again, be sure to follow label directions.

    Beat weeds. Spot-treat dandelions or wild violets using Scotts Spot Weed Control For Lawns. This weed killer controls weeds without harming grass. By spraying, you avoid disturbing grass roots and unearthing dormant weed seeds, both of which can happen when you hand-weed.

    Patch and thicken. Repair bare spots in both cool- and warm-season turf using Scotts EZ Seed. Timing is crucial for success: Aim for an early spring sowing for cool-season grass and a late spring sowing for warm-season grass. If your lawn is worn and thin, thicken it by overseeding. In the north, overseed with Scotts Turf Builder ThickR Lawn , a product specially designed for thickening up thin lawns that combines grass seed, fertilizer, and a soil improver into an easy-to-use product that is applied with a Scotts spreader. In the south, usethe appropriate Scotts Turf Builder Grass Seed product for your grass type, and get your new grass off to a good start by usingScotts Turf Builder Starter Food for New Grass.

    Follow this link:
    Seasonal Lawn Care Guide For Lush Lawns - Scotts

    Fall Lawn Care Guide | Family Handyman - October 15, 2019 by Mr HomeBuilder

    Ensure a greener yard in the spring by preparing your lawn in the fall

    If you have heavy, clay-rich soil, its really important to aerate. Forget those gadgets that look like golf spikes that you strap to your shoes; rent a power aerator from any rental center for around $40 a day. The aerator extracts plugs from your lawn and topsoil to loosen compacted coil and break up thatch. Your lawn will look like a mess when youre through but dont worry, the plugs will dissolve in a few days. Dont bother aerating if you have sandy soilyoure just wasting your time. The time to aerate in colder climates is after dew begins forming in August. If you live in warmer, or more arid states aerate in the spring before warm-climate grasses go dormant in mid-summer. Mow your lawn and water it the day before aerating. Make two passes across the lawn with the aerating machine, perpendicular to each other, so that the aeration holes are spaced 2-3 in. apart.

    Reseed your lawn in late summer/early fall. Make this apart of your fall lawn care routine

    Late summer and early fall is the best time to reseed those dead areas. Summer is just too hot for the seed to thrive. Water the new seed a couple of times a day until the grass is around 1-1/2 in. high. Dont use normal fertilizers, however. Use a product like Scotts Starter Fertilizer, which is designed for new grass. Spread the seed so that you have around 15 seeds per square inch. Dont overdo it or the grass wont thrive due to overcrowding.

    Use a broadcast spreader for a more consistent coverage.

    Well after the grass appears brown and dormant, the roots are still hard at work absorbing nutrients and moisture. Just as bears gorge themselves before hibernating, your grass is storing up reserves to make it through the winter and thrive in the spring.

    Set your broadcast spreader for half the recommended setting on the bag. Then make a header strip around the perimeter of the lawn. Next fertilize the entire lawn first in one direction, then the other (just as you did with the aerator). Be sure the shut off the spreader as you reach the spreader strip or youll over-fertilize the grass at the end of each pass.

    The last mowing of the season, cut your grass shorter than normal.

    Get out that rake and remove all of those dead leaves before the snow flies. Otherwise theyll be sodden mats in the spring and smother the sprouting grass below. (Plus its lots easier to rake dry leaves!)

    Just this one time of the year, set your mower to cut 1-1/2 or 2-in. and mow your grass short. Thatll do a couple of things. First itll lessen the chance of snow mold forming. And secondly, tall grass blades wont lie down and smother the new grass next spring.

    Major lawn-care manufacturers, such as Scotts, have a full line of fall lawn care fertilizers and other products to help you make your lawn the greenest yard in the neighborhood come spring.

    Excerpt from:
    Fall Lawn Care Guide | Family Handyman

    How to Prepare Your Lawn for Spring – The Spruce - October 6, 2019 by Mr HomeBuilder

    First the bad news: if you neglect spring lawn care (and related concerns about your mower), you could end up paying for it the rest of the year. Now the good news: the chores required of you in spring don't entail nearly the amount of work that you'll have to invest in mowing alone throughout the summer months.

    In fact, you mightneed to implement only about half of the following ten tips for spring lawn care, depending upon your unique circumstances. Furthermore, there are a few instances below that the task in question is better performed as part of your fall lawn careif you can wait that long.

    Raking will be your first task of spring lawn care. You're likely saying, "But we already raked leaves in the fall!" Sorry, but raking is for more than just removing leaves: it's for controlling thatch, too. A thatch build-up of more than 1/2 inch is considered excessive.

    Thatch is the reason whyit's recommended that, when you rake leaves in the fall, you make an effort to rake deeply. Don't just skim the surface so as merely to remove the leaves. A deep raking will remove thatch, too, allowing you to kill two birds with one stone. Even if you followed this advice in fall, a spring raking is still recommended as it will remove grass blades that died over the winter -- dead blades that are just waiting to become thatch.

    But there's often another good reason for a spring raking. As you survey your lawn in spring, see if there are any matted patches, in which the grass blades are all stuck together. This can be caused by a disease known as "snow mold." New grass may have difficulty penetrating these matted patches. But raking will be sufficient to solve this problem.

    When you perform any of these spring lawn care tasks will depend upon the climate of your region. But Mother Nature provides obvious cues in some cases. For instance, when you're pretty sure the snow season (if you have one) is over in your region, begin raking. Applying pre-emergent herbicides (see Tip #6) should be done sometime between the time the local forsythia bushes stop blooming and the time the local lilac bushes begin blooming.

    If your lawn is subjectto high levels of traffic year after year, it may eventually start to show signs of decline. In such cases, your lawn is probably suffering from compacted soil. For instance, the presence of moss signals compaction (among other things). You can get rid of it, but successful eradication begins with the recognition that moss shouldn't be treated as "just another weed."

    Lawn aeration is the remedy for compaction. The good news is that lawn aerators can be rented at your local rental center. The bad news is that the experts recommend postponing lawn aeration until fall. But if during your "spring lawn checkup," you become aware of compaction, at least you can plan on setting aside some time in the fall to take care of it.

    Besides compaction, the presence of moss plants also signals acidity. But grass likes a neutral pH. You can solve this problem by liming your soil. But don't expect a quick fix: the effects of liming are slow to take place.

    But first, send a soil sample to your local county extension to determine the extent of your soil's acidity. The county extension will also be able to advise you on how much lime per square foot you'll need. Apply the lime using a fertilizer spreader.

    But if your lawn has been doing fine and shows no signs of suffering from acidity, don't apply lime. Liming is only a corrective measure, not a preventive measure. A soil that is too alkaline will also cause your lawn problems, so too much lime is as bad as not enough.

    Is your lawn riddled with bare patches due to dog spots, heavy traffic, or neglect? If so, you may need to apply grass seed to fill in those bare patches. This solution is known as "overseeding lawns." Apply a slow-release nitrogen fertilizer when you overseed. Five weeks after the grass germinates, apply quick-release nitrogen fertilizer.

    However, spring isn't the very best time for overseeding lawns. Fall is the preferred time when the new grass won't have to compete with crabgrass, which is killed off by autumn frosts. So postpone overseeding until fall, unless your situation is dire.

    Lawns can be fertilized organically by using compost and mulching mowers. But for those who prefer chemical fertilizers, Scotts provides a schedule for fertilizing lawns. Many experts, however, recommend a lighter feeding in spring and a heavier one in late fall for the types of lawn grasses known as "cool-season grasses." Too much fertilizer in spring can lead to disease and weed problems. And if you have, indeed, already fertilized in late fall, your lawn is still "digesting" that fertilizer in spring.

    For those who prefer weed-free lawns, spring grass care is as much about weed prevention as it is about fosteringhealthy lawn growth. Novices are often surprised to learn that not all lawn weeds are battled in the same manner. Depending upon whether a weed is an annual or perennial, you will use a preemergent herbicide or a post-emergent herbicide against it (although landscapers commonly use bothpreemergent and post-emergent crabgrass killers-- an indication of how tough that weed is to battle).

    If you know that you have a problem with the annual weed, crabgrass, then fertilization in spring should go hand in hand with the application of preemergent herbicides. As their name suggests, preemergent herbicides addressweed control, not after the fact, butbeforetheir seedlings can even emerge. Preemergent herbicides accomplish this by forming something of a "shield" that inhibits seed germination. Don't undertake core aerationafter applying preemergent herbicides: to do so would be to "puncture" this shield, thereby decreasing its effectiveness.

    Crabgrass begins its assault on lawns in spring when its seeds germinate. Overseeding should be carried out in autumn, rather than spring, based in part on the threat posed by a spring crabgrass invasion. "So why not just begin bykilling the crabgrassfirst with a pre-emergent herbicide?" perhaps you ask. Well, the trouble is that most preemergent herbicides work against not onlyweed seeds, butgrassseeds, as well!

    You can appreciate the dilemma here. Overseeding is incompatible with the application of most preemergent herbicides. Facedwith competition from crabgrassin spring, you may find it difficult to establish your new grass. So while it's still possible to overseed in spring, it's simply easier to do so in fall. There will be no competition from crabgrass then because the fall frosts kill off crabgrass.

    If youmustoverseed in the spring, look for a product called, "Tupersan." Unlike other preemergent herbicides, Tupersan will not damagegerminating lawn grass seed. But if you're committed to staying away from chemicals altogether in your spring grass care, postpone overseeding till fall.

    Keep an eye out for the emergence of theperennialweed, dandelion during the spring season, unless you find the presence of their cheerful yellow flowers in your lawn desirable. At the very least, you'll want to snap off their flower stems before they produce seed. If you're more ambitious, you can dig them out by the roots. Sprayingdandelion weedswith post-emergent herbicides is more effective in fall than in spring. If you do choose to spray, you must select an herbicide forbroadleafweeds.

    Besides proper spring grass care, there's more you need to do to get ready for a summer filled with lawn mowing. Don't neglect preparations concerning the lawn mower itself.

    No other power equipment is as intimately associated with and essential to landscaping as is the lawn mower. You need to have one that will consistently get the job done without any hassles throughout the lawn mowing season. And you should also know how to use one to your best advantage. Consequently, the final three of my ten tips focus on caring for, selecting and using these machines.

    Mowing the lawnall summer can be tiring enough, right? Why make it more difficult on yourself by putting up with a lawnmower that doesn't start up immediately? When your unit is stubborn about starting up, that can be a sign that it needs a tuneup.

    Although its often possible to get by without one, it is recommended that you have a mower tuneup each year. Don't put it off till summer or pay someone else to do it. Learn how to tune one up yourself.

    Or perhaps you're fed up with your oldlawnmower? Is it time for a change? Research and decide on which type is best suited to your own unique landscaping needs.

    "What's there to knowabout lawn mowing?" perhaps you ask. "You just push the lawn mower, and it cuts the grass, right?" At the most basic level, Yes. And if lawn mowing is merely a mindless chore that you perform to satisfy other people (and you don't care much about the health of your grass), then you needn't know any more about it.

    However, if youdocare about the health of your grass, there's a bit more to lawn mowing than just keeping your grass short enough to prevent the neighborhood from thinking your house has been abandoned. Spring is a good time to learn (or review) lawn mowing strategiesbefore it becomes so hot outside that it's hard to think!

    Continue reading here:
    How to Prepare Your Lawn for Spring - The Spruce

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