First, as a cardiovascular physician I want to reinforce that no one should stop or alter their aspirin regimen before speaking with their doctor or health care provider. And second, I will help sort through the news and the research on this topic.

There are two main categories of patients who take a daily low-dose aspirin for cardiovascular (CV) event prevention: patients who have not yet had serious cardiovascular problems but may be at risk of having these problems AND patients who have already experienced serious cardiovascular problems like a heart attack or clot-related stroke. What the updated guidelines tell us is that certain individuals in the first category (have not yet had an event, often called primary prevention) may not need to continue taking aspirin due to the increased risks of bleeding outweighing the cardio-protection benefit. Whether or not you are one of these individuals in this category depends on your own personal risk factors, which is why it is important to consult your doctor who can help you understand the benefits and risks and what is best for your health.

For people in the secondary category - those who have already experienced a cardiovascular event - aspirin can be a lifesaver. Not only is it proven to help prevent another heart attack or clot-related stroke, aspirin is also one of the most extensively studied drugs in history. This is why aspirin remains the cornerstone preventative therapy for secondary prevention. In the United States, aspirin's professional label is approved for secondary prevention of a CV event.

Some of the media coverage around the new guidance was not clear on this crucial distinction. For those who have already experienced a heart attack, or clot-related stroke there is evidence that discontinuing an aspirin regimen without a doctor's guidance can increase the risk of another heart attack by 63 percent and a clot-related stroke due to a blood clot by 40 percent.

Cardiovascular disease is the number one cause of death in the United States, affecting more than 92 million American adults and causing about 2,200 deaths per day. That's one life every forty seconds. Each year 790,000 Americans alone will suffer from a heart attack, while another 795,000 will have a stroke.

Many factors can contribute to a person's risk of cardiovascular disease, including high blood pressure, high cholesterol and smoking - and almost half of Americans (47 percent) have at least one of these risk factors.

Clinical studies and cardiovascular professional guidelines have continued to support the lifesaving benefits of aspirin. Studies have found that an aspirin regimen under the direction of a doctor can help reduce the chances of a second heart attack by 31 percent and a second clot-related stroke by 22 percent.

Importantly, even though aspirin is the gold standard of preventative therapy for those who have experienced a heart attack, clot-related stroke, chronic stable and unstable angina, a stent placement (PCI) or open heart surgery (CABG), it may not be for everyone. Anyone who has questions about starting or continuing an aspirin regimen should talk to their doctor.

Aspirin is not appropriate for everyone, so patients should talk to their doctor before they begin an aspirin regimen. For more information on safe and responsible use of OTC medicines, visit www.KnowYourOTCs.org.

Disclosure: Dr. Gurbel is compensated by Bayer to advise on cardiovascular health issues.

Dr. Gurbel is the Director of Cardiovascular Research at Sinai Hospital of Baltimore, MD and Director of the Sinai Center for Thrombosis Research and Drug Development. He is also Professor of Medicine at Johns Hopkins University School of Medicine and Adjunct Professor of Medicine at Duke University School of Medicine.

Doctors and patient groups say it doesn't have to stay this way.

"Lung cancer is the leading cause of cancer death in men and women. Finally, we have a screening exam that will make a major impact and change the face of lung cancer for the future to a survivable cancer, not a death sentence," says Ella Kazerooni, MD, MS, chair of the National Lung Cancer Roundtable and Professor of Radiology and Internal Medicine at the University of Michigan.

Screening older current and former smokers each year with low-dose computed tomography or "CAT" scans is a cost-effective system proven to significantly reduce lung cancer deaths.

CT lung cancer screening exams for high-risk individuals are recommended by the American Cancer Society, the American Lung Association, the National Lung Cancer Roundtable, The U.S. Preventive Services Task Force, GO2 Foundation for Lung Cancer and many other medical and scientific organizations.

"After decades of having little to offer adults at high risk for lung cancer, we've entered a new era where we now have evidence that lung cancer screening saves lives, and new targeted therapies and immunotherapy are offering new hope to patients diagnosed with advanced lung cancer," says Richard Wender, MD, Chief Cancer Control Officer at the American Cancer Society.

"CT lung cancer screening is a game changer. We finally have a weapon to fight back against this terrible disease - if patients who need this screening get tested," says Debra Dyer, MD, chair of the American College of Radiology Lung Cancer Screening 2.0 Committee.

"Most lung cancers are not diagnosed until it is too late. This screening provides critical early detection that saves lives," says Carolyn Aldigé, founder and chief executive officer of the Prevent Cancer Foundation.

Insurance companies cover these exams with no copay for people 55-80 years of age with a history of heavy smoking who are current or former smokers. Medicare ends coverage at age 77. If you were a heavy smoker, meet the age specifications and stopped tobacco use in the last 15 years, you are covered.

However, unlike breast and colon cancer screening, if you are covered by Medicare, your health care provider must discuss the risk and benefits of a lung cancer screening CT exam with you during a "shared-decision making visit" before ordering your first screening CT.

Lung cancer care advocates urge those who think lung cancer screening can help them or a loved one to have that conversation with their doctor.

"Lung cancer screening is a proven, valuable tool in finding the number-one cancer killer at its most treatable, and even curable, stage," says Laurie Fenton Ambrose, Co-Founder of the GO2 Foundation for Lung Cancer.

For more lung cancer screening information, visit NLCRT.org and RadiologyInfo.org

Source: National Lung Cancer Roundtable (NLCRT.org)

So when Gunnar started having difficulty hearing at work and home, he did what he preaches to his clients: he attacked the problem and got a pair of hearing aids. Now as a hearing loss advocate, Gunnar offers the following tips to get your hearing in shape this fall.

* Be "present" with your hearing: Being present with your hearing means being aware of how you hear throughout the day. If your family members are complaining the TV is too loud, or if you're the one complaining that everyone else is mumbling, you may have a hearing problem that needs to be corrected.

* Get your hearing checked: At least once a year, you go to the doctor for a physical, or to get your eyesight checked. But when was the last time you got your hearing checked? Even if you're not having issues right now, just go and get a baseline to compare it to in the future.

* Preserve your current hearing: Noise-induced hearing loss is a problem that is completely preventable. If you work around a lot of noise, you need to use protection. If you go to loud concerts or enjoy firing up the leaf blower or lawnmower on the weekend, use protection. Remember, once you lose your hearing, it doesn't come back.

* Don't brush off tinnitus: If you have an annoying ringing or buzzing in your ears, especially when it's quiet, it may be tinnitus. Tinnitus and hearing loss often go hand-in-hand, so don't brush it off as a minor annoyance. Go see a hearing care professional and have it checked out.

Consider invisible hearing aids: If you need hearing aids but are worried people will judge you if they see you wearing them, know that invisible hearing aids such as the Phonak Lyric exist. They are 100 percent invisible and can stay in your ears for months at a time. A recent study even showed that Lyric relieves tinnitus faster than regular hearing aids, thanks to 24-hour amplification.

Not only did a whopping 84 percent of parents surveyed say they'd "welcome" such contributions to their 529 college savings plans instead of more traditional presents, according to new data from Fidelity Investments, but 33 percent have actually already asked for such assistance. 

And the other 51 percent? Maybe they're waiting for Santa to climb down their chimneys - the Tooth Fairy also makes house calls, it's said - or maybe they haven't heard about programs like the free online one at Fidelity that lets family and friends easily chip in to lessen the burden. Specifically, as the College Board reports, an average annual total cost (including tuition, fees, room and board) of $49,870 at private four-year colleges, $38,330 at out-of-state four-year public colleges, and $21,950 at in-state four-year public colleges. 

See full-sized image here.

Not so fast.

Those seasons may be the most popular time of year for a project such as this, but when you take a deeper dive into the world of home remodeling, you'll find October and November are actually the best times to remodel your kitchen. By taking advantage of the fall season, you can get your project done before the holidays (and save a ton of money.) 

Slower season means better values 

Spring and summer may seem the ideal time to begin a remodel project, but it's the busy season for contractors and retailers know it. High demand can mean higher prices and longer lead times to get things done. More people are recognizing this and getting their kitchen done in the fall. They can find better deals and, just as importantly, get their house ready for the holidays.

Here are some insider tips:

* Watch for the sale. Retailers will push great savings in October and November to clean out inventory heading into the new year.

* Find an expert. The Internet is great for research, but for a big project such as a kitchen, find a retailer that offers personal one-on-one design help.

* Remodel the whole kitchen, not just one part. You can get the best deals from retailers that do it all: cabinets, countertops, sinks, faucets - even flooring. And you'll be able to design the full kitchen without driving to three different stores.

* Plan installation. Ask if they offer installation. This time of year, that can be a real positive.

Try to find a store such as Cabinets To Go in your area. Unlike online retailers, they have experts in every store. They also offer free, 3D-kitchen design, installation and hundreds of style options for cabinets, countertops, sinks, faucets, and flooring. Better yet, they also offer some of their best deals of the year right now. For more information, visit www.cabinetstogo.com/. 

Show it off for the Holidays 

Home blogger Cassie Bustamante also encourages taking advantage of this season for a remodel.

"The fall is a financially wise time to undertake a new kitchen, but it also makes sense for a lot of other reasons," she says.

"The holidays are about family time and the kitchen is the heart of it all."

Bustamante also feels there's a more personal reason."Maybe you'll finally get up the nerve to host Thanksgiving dinner since you'll have such a gorgeous new space."

The kitchen is the heart of the holiday experience. It's the place we gather with loved ones to prepare meals and share stories. Now, imagine how amazing it would feel to host the holidays in your newly-remodeled kitchen knowing you saved a lot of money? Great family time during the holidays is more than just a kitchen, but it's the perfect place to bring it all together.

You'd almost certainly identify traditional public school, the most common K-12 education choice. More than 85 percent of students attend traditional public schools, which are free to attend. In some states, you can choose traditional public schools outside of your zone or even your district.

Public charter schools are also available to an increasing number of students across the U.S. Available in more than 40 states, these tuition-free public schools are unique because they have extra freedom to innovate.

Have you heard of a public magnet school? These public, district-run schools teach all subjects through the lenses of a particular track or "magnet." For example, the magnet could be health sciences or performance arts.

You've also likely heard of private schools, which charge tuition and offer learning environments that may pass on a particular faith tradition or provide a unique curriculum or focus. There are more scholarship options for private education today than ever before.

There are also full-time, tuition-free online schools in many states. These flexible, technology-based schools offer a blend of online coursework and in-person activities.

Finally, don't forget homeschooling. Families who choose to educate their children in the home can access a broad variety of in-person and web-based resources to support them in their work.

Of course, there aren't just six options. Each type of learning environment overflows with customizable options: No two public schools are exactly alike, just as no two families homeschool quite the same way.

Having these choices makes a world of difference to families, allowing them to look for a school that matches their child's unique interests and skills. During National School Choice Week, we invite families across the country to discover their options - and find learning environments where their children will thrive. You can learn more at schoolchoiceweek.com/mystate/.

Andrew Campanella is president of National School Choice Week and the author of The School Choice Roadmap: 7 Steps to Finding the Right School for Your Child.

The transportation industry in the United States continues to experience a workforce shortage, and may be the ideal path for hands-on learners whose talents and interests may be well suited for a successful and satisfying technician career.

The nonprofit TechForce Foundation has launched the "Be a Pathfinder" campaign to help students with natural talents for hands-on professions discover their strengths and learning styles, and explore a career they might not have considered: that of a transportation technician.

The "Be a Pathfinder" campaign features a free learning-styles quiz on the TechForce website that generates a report for students and parents with personalized career tips based on their unique learning styles. Students who take the quiz are entered to win a TechForce Foundation gift package that includes a $50 Shell gift card and other prizes.

"The learning style quiz and personalized resources not only help students and parents recognize the opportunities of a career as a transportation technician, but also help them understand how and why they're a fit for these careers," says TechForce Foundation Executive Director Jennifer Maher.

The campaign encourages students to be "pathfinders" by helping them discover and understand their unique strengths and use that knowledge to choose an educational and career path. TechForce Foundation's mission is to promote the potential of professional technician careers, and to encourage parents, teachers, and other influential figures in teens' lives to recognize and support technical careers that may be a good fit for those students.

Studies suggest that the U.S. will need 1.2 million new technicians within the next decade, which translates to about 120,000 new jobs per year for aspiring professionals with interest in and aptitude for automotive, diesel, motorcycle, and other transportation fields.

"Though there are many viable, high-paying job opportunities in STEM-related careers like those in the transportation technician field, students have been told a traditional four-year degree is the only path to success," Maher emphasizes.

"The truth is that we're all wired differently, and hands-on learners can thrive in these positions."

Students and parents can take the learning-styles quiz at TechForce.org/MyPath.

Additional stories, videos, and resources are available on TechForce Foundation's website, Facebook, Twitter, LinkedIn, and Instagram accounts.

Visit techforce.org for more information about TechForce's work and pathways to rewarding careers.

The real impact of school choice is what gives the Week such energy. A learning environment can change a life, sometimes unexpectedly. Remember the Dr. Seuss story featuring a character who, until he actually tries it, insists a dish of green eggs and ham is not for him? As President of National School Choice Week, I have the joy each month of hearing students, parents, and educators around the country share their own "green eggs and ham" moments.

A teacher who was ready to leave the education field - until she overcame her skepticism about teaching in a virtual school. A mom who never dreamed she'd homeschool - until her son's medical needs led her to discover its benefits. A student who felt out of place in his previous school, but is now happy and thriving in a different traditional public school.

That's the power of school choice. All children learn differently and families' needs vary. In the midst of healthy differences and human change, choice empowers families to access the learning environments that work for them now.

School choice recognizes that parents are best positioned to know their child's passion for botany, reading struggles, or penchant for drawing quirky cartoons. And those same parents are best qualified to choose their children's learning environments.

National School Choice Week celebrates traditional public, public charter, magnet, private, online, and home education. We celebrate and support families, too, whichever type of school they choose. That's because when families and schools bring their gifts together, students succeed.

All children deserve to close their school books at the end of each week inspired and equipped to give back. So, if you love your school, celebrate it during School Choice Week! If you're searching for a school, be willing to try something new to find the right fit. You might have a green-eggs- and-ham moment, when your child's frustration with learning turns into an excited "I do love it!"

For more information, visit schoolchoiceweek.com.

Andrew Campanella is president of National School Choice Week and the author of The School Choice Roadmap: 7 Steps to Finding the Right School for Your Child.

Making a commitment to your professional fitness doesn't have to take a bite out of your bottom line, either.

The Professional Development Academy, an online leadership training company with top-notch faculty from business, industry, and government, offers programs in areas including high performance leadership, frontline information technology leadership, and maximizing your personal brand, all for a fraction of the cost of a traditional MBA program and easily accessible at your convenience.

The Professional Development Academy Faculty includes individuals who are proven outstanding leaders in a range of fields, including Colin Powell, former Secretary of State and retired 4-star general; Cheryl Smith, IT expert and former CIO of McKesson Corp.; and Peter H. Thomas, one of the most savvy and successful entrepreneurs of the modern era, whose six-decade career highlights include founding Century 21 Real Estate Canada, and the Four Seasons Resort in Scottsdale, Arizona, along with developing emerging companies such as Dogtopia.

Some top tips from the Professional Development Academy experts:

"Perpetual optimism is a force multiplier," says General Powell. When you bring an optimistic attitude to the office every day, others will follow your lead. The Professional Development Academy curriculum includes practical insights from Powell and other world-known thought leaders highlighting the power of a positive mindset.

Smith notes that the best leaders don't just dictate, they listen.

"Ask for feedback," she emphasizes. "Then listen and learn." Constructive and critical feedback can feel harsh, but it can provide tremendous insight for future growth.

Finally, be true to your values, says Peter Thomas.

"To be truly successful, ensure your decisions at work align with your core values. When your values are clear, your decisions will be easier," he says, and "be open to opportunities and be ready to move on them."

Starting in 2020, the Professional Development Academy is partnering with Peter H. Thomas to launch the Peter Thomas High Performance Leadership Academy, a 12-week course divided into "learning bursts" that can be completed in 4-5 hours per week at any time to suit busy schedules. The course is designed to share Thomas's secrets for success at nurturing an entrepreneurial spirit in conjunction with a values-based life.

For more can't-miss ways to boost your leadership skills in 2020, visit the Professional Development Academy at pdaleadership.com.

In fact, International Living magazine named Costa Rica number three, ahead of Spain, France, and Mexico, on its 2020 list of top places to retire. Other appealing features include the low cost of living and ease of buying real estate.

One of the reasons for capturing the top spot is that Costa Rica offers a diverse history and culture that make it an enriching location for travel, as well as retirement. Many retirees from the United States who are interested in living abroad have discovered the elements that make Costa Rica unique and special.

Anyone contemplating retirement either sooner or farther down the road can become familiar with Costa Rica through a fully escorted tour. Many time-share organizations will target tourists and can be scams, so it is important to make informed decisions about how to travel and explore. Companies such as Caravan Tours provide immersive experiences that include meals, transportation, and excursions across more than 750 miles of the country.

The Caravan Costa Rica Natural Paradise tour offers nine days of carefully chosen hotels, delicious meals, and entertaining excursions for an all-inclusive price. The relaxed, yet engaging, itinerary is designed to balance single- night and two-night stays for an unhurried pace, and each day includes scenic and rest stops. Comprehensive sightseeing with local guides provides an ideal opportunity for retirees and future retirees to become familiar with the country.

The Natural Paradise tour kicks off in San Jose, where Caravan tours provides easy transportation from the airport to the hotel. Day trips from San Jose include visits to a coffee plantation and an artists' village in the Central Mountain Range.

Other highlights of the tour include the Cano Negro Cruise, which passes through a wildlife refuge that is home to a variety of animals, including whistling ducks, howler monkeys, and water-walking lizards, followed by an evening soak in volcanic hot springs. In addition, travelers have opportunities to hike the suspension bridges of Guanacaste with a naturalist guide, and visit to the Manuel Antonio National Park with its spectacular rain forest and beach cove, as well as enjoy the amenities of a world class beach resort.

Caravan Tours is a member of ASTA (American Society of Travel Agents), NTA (National Tour Association), CLIA (Cruise Lines International Association), and an allied member of ACTA (Alliance of Canadian Travel Agencies).

For more information about fully escorted tours to Costa Rica, visit caravan.com.