text:
Weatherization Plus Health: The Next Step for WAP
WAP's mission is to reduce energy costs for low-income families by improving the energy efficiency of their homes while ensuring their health and safety.
The connection between health and housing seems clear: we spend most of our time inside our homes, and our surroundings have a great impact on our well-being. What may be less obvious is the connection between health and the home's energy efficiency. Preventable medical bills, rising energy costs, and wages lost due to illness cost Americans hundreds of millions of dollars a year. Nearly six million households have moderate to severe physical housing problems, placing them at increased risk for illnesses and injuries. On top of that, low-income households are disproportionately affected by high energy bills; these households spend 14% of their income on energy costs, compared with 3.5% for all other households. The lowest of low-income households spend far more than that.
The Weatherization Plus Health initiative, implemented by the National Association for State Community Services Programs (NASCSP) on behalf of DOE, seeks to establish a link between the low-income Weatherization Assistance Program (WAP) and healthy-homes programs nationwide, ensuring that homes served by these programs are safer, healthier, and more energy efficient by bridging the gap between these complementary services. I work for NASCSP as the project coordinator for energy services, which supports both WAP and Weatherization Plus Health, assisting in this project.
WAP's mission is to reduce energy costs for low-income families—particularly for the elderly, people with disabilities, and children—by improving the energy efficiency of their homes while ensuring their health and safety. For many years, innovative service providers have creatively leveraged resources to deliver more comprehensive services than are allowed under DOE WAP regulations. For example, the Bellingham, Washington, Opportunity Council has leveraged a wide variety of resources to bundle services and enable employees to address residents' specific health problems and provide appropriate health-related home retrofits. (See "Case Study: Opportunity Council of Bellingham, Washington.")
Another leader is the city of Baltimore, Maryland, which must turn away some weatherization applicants because its housing stock is too degraded. To combat this problem, the city launched several projects to partner with health organizations, create a coordination team, facilitate roof replacements, and digitize files to merge applications and ensure that they are reviewed quickly, helping to coordinate resources and services.
Addressing Health and Safety
WAP already considers health and safety when retrofitting a home; it is a cornerstone of the program and is incorporated into the mission statement cited above. The program's comprehensive whole-house approach recognizes that a house consists of interdependent parts and that any modification of these parts should take into account the interaction between the occupants' behavior, the building envelope, and the mechanical systems. Modifications to one part of a house can lead to unforeseen consequences in another.
Health and safety was not a main focus of WAP until the early 1990s, when the use of blower doors and advanced air-sealing techniques became common. As WAP technicians developed their expertise in air sealing, the potential impact of these procedures on indoor air quality (IAQ) became apparent, spurring more emphasis on health and safety issues. Significant air sealing can affect IAQ through moisture, by-products of combustion, air pressure and backdrafting, and airborne chemicals and pollutants. Poorly performed weatherization can exacerbate existing problems or even create new ones. Conversely, properly performed weatherization can solve some problems and create a healthier indoor environment by conducting combustion appliance zone (CAZ) testing and ensuring a proper draft.
Using DOE and other WAP funds, weatherization technicians can usually address health and safety issues related to heating systems, work lead safe, solve some moisture problems, correct minor electrical and plumbing problems, add or repair ventilation, and provide educational material to residents. In fact, WAP has been a leader in instituting the widespread use of these techniques and standardizing processes for low-income homes nationwide. Although this approach has led to the safe weatherization of millions of homes over the 30-year history of the program, the focus on energy efficiency restricts the use of funds to address more extensive, comprehensive remediation and mitigation projects, including those for asbestos, lead, radon, or structural deficiencies. The result is that projects of this kind are often deferred.
This is not likely to change any time soon and it is not likely that its mission will be broadened to include major health and safety projects (see "Evaluating DOE's Weatherization Assistance Program," HE, July/Aug '10, p. 22). Energy savings, and energy savings per dollar invested, will remain the major focus of all the metrics analyzed in the current national WAP evaluation. Health and safety measures cost money but typically provide no energy savings. In order to qualify for WAP funding, health and safety expenditures must meet a stringent criterion—namely, that it is necessary to eliminate the hazard in question before, or as a result of, the installation of weatherization materials. This restriction is reasonable; funds are limited and WAP's primary mission is to promote energy conservation.
Case Study: Opportunity Council of Bellingham, Washington
What does a WAP and healthy-homes collaboration look like? The following case study will give you a good idea of how it works.
Ms. Jones applied for energy assistance through the Opportunity Council (OC), a private, nonprofit community action agency serving homeless and low-income families and individuals in Island, San Juan, and Whatcom counties in northwest Washington State. The Opportunity Council offers services that range from addressing immediate and crisis-oriented needs (food, emergency shelter, eviction prevention) to long-term programs that promote self-sufficiency in the community (early childhood education, home weatherization). See "Restoring Indoor Health, One House at a Time," HE, Jan/Feb '04, p. 24.
During the eligibility appointment, staff asked whether anyone in the household had asthma, allergies, or other respiratory problems. Ms. Jones responded that both she and her daughter had been diagnosed with asthma. After staff explained the OC's Weatherization Plus Health program to her, Ms. Jones expressed an interest both in the weatherization program, for help lowering her energy bills, and in a Healthy Home visit, to see if anything could be done that might help with her family's asthma. She completed the application for the Healthy Home visit, which would schedule her with the OC's in-home educator trained in conservation education and healthy-home environmental assessment.
The initial education and assessment visit identified several opportunities to improve the indoor environment in Ms. Jones's house. Later, the OC educator noted high humidity, possible mold staining the bathroom, a leaky roof, incomplete ground cover, old carpet in the bedrooms and living room, and evidence of mice and pesticides in the kitchen and pantry areas.
The OC educator worked with the OC's weatherization/home repair project coordinator and Ms. Jones to complete the improvements. The OC used home repair funding to repair the roof and weatherization funding to upgrade the ventilation in the bathroom. Weatherization funding was used to complete the ground cover, improve the insulation over the bedrooms, and conduct combustion safety testing of the old and inefficient heating system. The system failed the test and was upgraded using Sustainable Energy Resources for Consumers (SERC) funding. (For more on the SERC program, see "DOE's WAP: Two New Programs Push the Envelope," HE Sept/Oct '11, p. 28.) The crew completed pest exclusion (by plugging holes with copper wool embedded in foam) at the same time as they air sealed the crawl space.
The OC's privately funded Healthy Homes program changed out the old carpet in two rooms to hard-surfaced, easily cleanable flooring and also provided a HEPA vacuum for the new area rugs. The Healthy Homes funding paid for a green cleaning kit that uses nontoxic cleaning products, walk-off mats at the entryways to minimize dust coming into the house, and dust mite-resistant mattress and pillow covers. The educator and Ms. Jones worked together—the educator gave Ms. Jones a digital humidity gauge to monitor the humidity levels in the house, and she learned the benefit of opening the windows when the indoor humidity rises above 60% in the winter. She also learned the importance of exhausting moisture out of the house and agreed to use her bathroom fan for at least 40 minutes after every shower.
This partnership of funding sources and programs worked. Ms. Jones anticipates lower energy bills, and she and her daughter feel good about the improvements made to their home. From what we know, the work has also reduced conditions known to aggravate asthma symptoms.
WAP and Healthy Homes
WAP providers may be wary of healthy-homes programs, especially since so many health and safety components are taken into account in the course of regular weatherization services. These include, but are not limited to, combustion appliance safety and CO abatement, replacement of unvented space heaters with vented ones, lead-safe work practices, moisture control measures, building tightness assessments, and installation of exhaust fans and added ventilation when necessary. However, with effective partnerships and smart strategizing, WAP and healthy-homes practitioners can work together to achieve the dual goals of health and energy efficiency in the most cost-effective and efficient way possible.
The healthy-homes movement is a comprehensive approach to combating disease and injury in the home. The federal agencies involved include the Centers for Disease Control and Prevention, the U.S. Department of Housing and Urban Development, EPA, and now DOE. The Coalition to End Childhood Lead Poisoning, through its Green & Healthy Homes Initiative™, has initiated community-based, healthy housing intervention programs to test and evaluate combining energy efficiency and healthy homes. The National Center on Healthy Housing, through its National Healthy Homes Training Center, provides evidence-based training and technical assistance, as well as evaluation and hands-on guidance in this field. Scientific evidence links substandard housing to poor health—a finding that has helped to drive the creation of these projects (see "Integrating Energy Efficiency and Healthy Homes," HE July/Aug '11, p. 38).
Healthy homes providers take a holistic approach to the coordinated mitigation of housing-related hazards, rather than addressing them one at a time. Drawing from the experience of healthy-homes programs, the Weatherization Plus Health program is developing means to integrate the seven principles of healthy homes into the WAP process. WAP providers will ultimately be able to use a system of referring clients to agencies and programs that may be able to address their health and safety problems better. Services are intended to be coordinated so that the homes can be weatherized properly and safely. The seven principles are as follows:
Keep It Contaminant-Free. Many contaminants pose health threats. The most common of these contaminants are listed below.
- Lead and lead-based paint can cause learning difficulties and neurological problems. While WAP adheres to the EPA Renovation, Repair and Painting (RRP) rule and follows strict lead-safe weatherization work practices, it has little money to spend on lead abatement. Healthy-homes projects can often perform more-extensive remediation measures, such as replacing windows that have lead-painted frames.
- Environmental tobacco smoke can cause lung cancer, heart problems, and sudden infant death syndrome. Healthy-homes programs often educate clients on ways to stop smoking.
- Radon can cause lung cancer. In homes where radon may be present, precautions should be taken, based on the EPA Healthy Indoor Environment Protocols for Home Energy Upgrades, to reduce the health hazards posed by the presence of radon. WAP crews install ground vapor barriers tight to the foundation perimeter where site conditions permit, and are allowed to test for radon in locations where it is likely to be present. While WAP doesn't usually allow weatherization professionals to perform remediation, the latest DOE guidelines allow remediation where weatherization work is known to have worsened radon levels and when those levels are above the EPA action level of 4 picocuries per liter (4 pCi/l). The remediation work in those cases would probably involve venting the radon away from the house.
- Asbestos can cause cancer, specifically mesothelioma, a rare cancer that occurs in the thin layer of tissue that covers the viscera. Energy upgrades can disturb asbestos. Updated DOE WAP health and safety procedures address work on homes with asbestos siding, asbestos pipe insulation, and suspected vermiculite or asbestos in attic insulation. Partnerships with healthy-homes programs can help to remediate situations that may be beyond WAP's capability to address.
- Volatile organic compounds (VOCs) can cause asthma, allergies, and headaches. To control VOCs, technicians must control the source. This can be done by using no- or low-VOC products, sealing containers of VOC products and storing them away from air intakes, removing unwanted VOC products, ventilating the home properly, and ensuring adequate air sealing between the garage and the home.
- Carbon monoxide can cause headaches, fatigue, and even death. Unvented space heaters should be removed and combustion appliances should be properly tested for spillage, draft, and CO.
Keep It Pest-Free. Pests can trigger or cause asthma and allergies, transmit disease, bite, contaminate food, and lead people to overreact and ignore the directions on pesticide labels. Pesticides also pose many risks. They can cause eye, nose, and throat irritation; skin rashes; stomach cramps; and nausea. They can damage the kidneys and the central nervous system, and they can increase the risk of certain cancers. The principles of integrated pest management (IPM) include keeping pests out to begin with, eliminating hiding spots by changing the landscape, storing and disposing of food properly, keeping the kitchen clean, and killing the existing population using traps and appropriate pesticides. Often pests can be prevented from entering the home under the WAP air-sealing measure by blocking holes with wire mesh or concrete before caulking or foaming. (To learn more about IPM, see "Integrated Pest Management in the Home," HE, Nov/Dec '04, p. 36.)
Keep It Clean. Clean homes help reduce pest infestations and exposure to contaminants. Strategies for keeping homes clean include installing hard-surface flooring, which is easy to clean, and educating the client on proper and effective cleaning methods and products.
Keep It Dry. Moisture on household surfaces can lead to mold growth, and mold in a home can cause many health problems, such as upper respiratory tract symptoms, including coughing, wheezing, asthma, and hypersensitivity pneumonitis. Sources of moisture are poorly managed rainwater or groundwater, plumbing leaks, household sources such as cooking, and condensation of moisture-laden air on cold surfaces. WAP typically installs ground vapor barriers and can address some drainage problems—for example, by installing gutters and downspouts to divert water away from the foundation. Healthy-homes programs may address severe mold and moisture problems that WAP cannot mitigate.
Keep It Well Ventilated. Increasing the fresh-air supply in a home can improve respiratory health. This can be achieved through whole-house ventilation strategies and assessment of existing fans and exhaust. The implementation of ASHRAE 62.2-2010 will further ensure proper home ventilation in WAP and in the home performance industry at large.
Keep It Safe. Most injuries to children occur in the home. Falls are the most frequent cause, followed by injuries from objects in the home, such as cuts or scrapes from sharp corners, sharp objects, burns, and poisonings. Prevention strategies include installing grab bars, adequate lighting, and handrails; removing trip hazards; repairing stair treads; and completing minor repairs.
Keep It Well Maintained. Poorly maintained homes are at risk for contaminants, moisture, and pest problems. Deteriorated lead-based paint in older housing is the primary cause of lead poisoning, which affects some 240,000 U.S. children per year. WAP professionals frequently see poorly maintained heating systems, with all the associated problems. Client education on the importance of maintenance is the primary strategy for keeping homes safe.
Helping Collaboration Happen
Healthy-homes programs following the seven principles exist throughout the nation in a loose confederation. Funded through a variety of federal, state, and local sources, these programs vary widely in scope and focus due to regional needs. Locating a provider of a particular service and navigating the web of nonprofits and other entities providing those services can be challenging. This is where the Weatherization Plus Health initiative steps in.
The connection between WAP and healthy homes is clear: WAP already enters hundreds of thousands of low-income homes every year, has a component to address health and safety and a willingness to expand these services, and is a partner with the Community Services Block Grant. This federal antipoverty block grant provides core funding to local agencies to reduce poverty, revitalize low-income communities, and empower low-income families to become self-sufficient. In so doing, it provides a groundwork for leveraging additional resources and funding.
Using the principles of healthy homes, Weatherization Plus Health seeks to connect WAP and healthy-homes providers in an effort to ensure that low-income homes are best served with comprehensive services to address their energy efficiency, as well as residents' health and safety needs. To do so, NASCSP is creating a number of resources and providing extensive training to facilitate ongoing communication and cooperation between the providers of these complementary services.
A major goal of the project is to identify existing partnerships and then learn how those partnerships can be expanded to serve every county in the nation. NASCSP will produce reports for each state and territory that detail the existing WAP and healthy-homes infrastructure, highlight successful partnerships, and identify possible pathways to future collaboration. These reports will also show where increased cooperation between agencies and providers could improve the provision of services to needy families.
In tandem with the state reports, NASCSP is creating a publicly accessible web site that will map healthy homes and WAP providers nationwide. This interactive application will be available to the general public and will show simply and easily where and how one can get assistance for any particular health, safety, or energy efficiency issue within a specified area.
Training and technical assistance are critical components of Weatherization Plus Health. To that end, NASCSP offers training through conferences, webinars, or other means, to facilitate partnerships and to disseminate best practices throughout the network. These best-practice models and resources will be available publicly online and will detail models of collaboration and proven successes.
learn more
For more information about the NASCSP Weatherization Plus Health initiative, visit www.waptac.org or www.nascsp.org.
In 2011, NASCSP and DOE convened six regional conferences to bring together WAP and healthy-homes providers, identify gaps between existing partnerships, and encourage new opportunities for partnerships. Targeted participants were any interested parties who worked in the fields of energy efficiency or health and safety. They included state directors of WAP, state and local WAP staff, state public health officials, state associations and community action partnerships, Community Services Block Grant staff, community action associations, healthy-homes practitioners, local health departments, health professionals, researchers and advocates focusing on energy efficiency or healthy-homes issues, and housing and community development agencies. These conferences were successful and will be followed up with six additional conferences in 2012 that will track and expand upon the work done at the previous conferences and in the intervening months.
Weatherization Plus Health promises to deliver important resources to the WAP and healthy-homes networks, and to improve housing nationwide. We know that weatherization works to reduce energy usage for low-income consumers. By combining weatherization and healthy homes, the Weatherization Plus Health initiative will work to reduce energy bills while improving the home environment. This will result in healthier homes, healthier families, and ultimately, a healthier nation.
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Applies to: Exchange Server 2010 SP3, Exchange Server 2010 SP2
Topic Last Modified: 2012-07-23
Transport Rules management role enables
administrators to manage transport rules in an organization.
This management role is one of several built-in roles in the Role Based Access Control (RBAC) permissions model in Microsoft Exchange Server 2010. Management roles, which are assigned to one or more management role groups, management role assignment policies, users, or universal security groups (USG), act as a logical grouping of cmdlets or scripts that are combined to provide access to view or modify the configuration of Exchange 2010 components, such as mailboxes, transport rules, and recipients. If a cmdlet or script and its parameters, together called a management role entry, are included on a role, that cmdlet or script and its parameters can be run by those assigned the role. For more information about management roles and management role entries, see Understanding Management Roles.
For more information about management roles, management role groups, and other RBAC components, see Understanding Role Based Access Control.
Management Role Assignments
For this role to grant permissions, it must be assigned to a role assignee, which can be a role group, user, or universal security group (USG). This assignment is done using management role assignments. Role assignments link role assignees and roles together. If more than one role is assigned to a role assignee, the role assignee is granted the combination of all the permissions granted by all the assigned roles.
In addition to linking role assignees to roles, role assignments can also apply custom or built-in management scopes. Management scopes control which recipient, server and database objects can be modified by role assignees. If this role is assigned to a role assignee, but a management scope allows the role assignee only to manage certain objects based on a defined scope, the role assignee can only use the permissions granted by this role on those specific objects. The permissions provided by this role can't be applied to objects outside the scope defined on the role assignment. For more information about role assignments and scopes, see the following topics:
This role is assigned to one or more role groups by default. For more information, see the "Default Management Role Assignments" section later in this topic.
If you want to view a list of role groups, users, or USGs assigned to this role, use the following command.
|Copy Code
Get-ManagementRoleAssignment -Role "<role name>"
Regular and Delegating Role Assignments
This role can be assigned to role assignees using either regular or delegating role assignments. Regular role assignments grant the permissions provided by the role to the role assignee. Delegating role assignments grant the role assignee the ability to assign the role to other role assignees. For more information about regular and delegating role assignments, see Understanding Management Role Assignments.
Adding or Removing Role Assignments
You can change which role assignees are assigned this role. By changing which role assignee is assigned this role, you change who is granted its permissions. You can assign this role to other built-in role groups, or you can create role groups and assign this role to them. You can also assign this role to users or USGs. However, we recommend that you limit assignment of roles to users and USGs because such assignments can greatly increase the complexity of your permissions model.
To assign this role to role assignees, the role must be assigned to a role group you're a member of, directly to you, or to a USG you're a member of, using a delegating role assignment. For more information about delegating role assignments, see the "Regular and Delegating Role Assignments" section.
You can also remove this role from built-in role groups, role groups you create, users, and USGs. However, there must always be at least one delegating role assignment between this role and a role group or USG. You can't delete the last delegating role assignment. This limitation helps prevent you from locking yourself out of the system.
|There must be at least one delegating role assignment between this role and a role group or USG. You can't remove the last delegating role assignment associated with this role if the last assignment is to a user.
For more information about how to add or remove assignments between this role and role groups, users, and USGs, see the following topics:
Changing the Management Scopes on Role Assignments
You can also change the management scopes on existing role assignments between this role and role assignees. By changing the scopes on role assignments, you control what objects can be managed using the permissions provided by this role. You have several choices when changing the scope on a role assignment. You can do one of the following:
- Add a new custom scope using the
Set-ManagementRoleAssignment cmdlet. For more information,
see the following topics:
- Add or change an organizational unit scope using the
Set-ManagementRoleAssignment cmdlet. For more information,
see Change a
Role Assignment.
- Add or change a predefined scope using the
Set-ManagementRoleAssignment cmdlet. For more information,
see Change a
Role Assignment.
- Change the recipient, server, or database scope on a custom
scope associated with a role assignment using the
Set-ManagementScope cmdlet. For more information, see
Change a Role
Enabling or Disabling Role Assignments
By enabling or disabling a role assignment, you control whether that role assignment should be in effect. If a role assignment is disabled, the permissions granted by the associated role aren't applied to the role assignee. This is convenient if you want to temporarily remove permissions without deleting a role assignment. For more information, see Change a Role Assignment.
Default Management Role Assignments
This role has role assignments to one or more role assignees. The following table indicates whether the role assignment is regular or delegating, and also indicates the management scopes applied to each assignment. The following list describes each column:
- Regular assignment Regular role
assignments enable the role assignee to access the permissions
provided by the management role entries on this role.
- Delegating assignment Delegating role
assignments give the role assignee the ability to assign this role
to role groups, users, or USGs.
- Recipient read scope The recipient read
scope determines what recipient objects the role assignee is
allowed to read from Active Directory.
- Recipient write scope The recipient
write scope determines what recipient objects the role assignee is
allowed to modify in Active Directory.
- Configuration read scope The
configuration read scope determines what configuration and server
objects the role assignee is allowed to read from Active
- Configuration write scope The
configuration write scope determines what organizational and server
objects the role assignee is allowed to modify in Active
Default management role assignments for this role
|Role group
|Regular assignment
|Delegating assignment
|Recipient read scope
|Recipient write scope
|Configuration read scope
|Configuration write scope
Management Role Customization
This role has been configured to provide a role assignee with all of the necessary cmdlets, and their parameters, to manage the features and components listed in the beginning of this topic. Other roles have also been provided to enable management of other features. By adding and removing roles to and from role groups, you can create a customized permissions model without the need to customize individual management roles. For a complete list of roles, see Built-in Management Roles. For more information about customizing role groups, see the following topics:
If you decide that you need to create a customized version of this role, you must create a role as a child of this role, and customize the new role.
|The following information enables you to perform advanced management of permissions. Customizing management roles can significantly increase the complexity of your permissions model. You could cause certain features to stop functioning if you replace a built-in management role with an incorrectly configured custom role.
The following are the most common steps to create a customized role and assign it to a role assignee:
- Create a copy of this role using the New-ManagementRole
cmdlet. For more information, see Create a Role.
- Change or remove the role entries on the new role using the
Set-ManagementRoleEntry and
Remove-ManagementRoleEntry cmdlets. You can't add additional
role entries to the new role because it can only contain the role
entries on the parent built-in role. For more information, see the
following topics:
- If you want to replace the built-in role with this new
customized role, remove any role assignments associated with the
built-in role using the Remove-ManagementRoleAssignment
cmdlet. For more information, see the following topics:
- Add the new customized role to the required role assignees
using the New-ManagementRoleAssignment cmdlet. For more
information, see the following topics:
- Add a Role
to a Role Group
- Add a Role
to a User or USG
Important: If you want other users, in addition to the user that created the role, to be able to assign the new customized role, be sure to add a delegating role assignment to at least one role assignee. For more information, see Delegate Role Assignments.
- Add a Role to a Role Group


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1 - Please pick a city
2 - From the second drop down list, Please pick the chain type and length. 16"+2" means, 16inches of chain with 2inches of extender that will allow it to be used up to 18in. If you don't want an extender, leave us a note.
We provided certain lengths for ease of making. if you want custom lengths please state in personalization box as well. We will try to accommodate that request as much as possible and for no additional cost.
- If you would like to add BIRTHSTONE or zodiac sign or initial please purchase them through the listing below and note to us to add it to the necklace and we will do.
• Durable and long-lasting material, perfect for daily wear or special occasion
• Hypoallergenic and Lead, cadmium, and nickel free
👌Gold filled over Stainless Steel (Tarnish-resistant for years)
🔨Processing Time:
Please allow 1 day before the item ships out. We work diligently to ship the orders the same day if ordered by 12PM CDT.
📦Shipping Time:
Please allow 2-3 days for delivery. Upon shipping you will be notified and a tracking number will be provided.
- See our full collection: https://www.etsy.com/shop/DianellaJewelryStore
- Elegant Gift Wrapping is available. Please check the picture at the check out or see listing below. We can also add your personalized notes inside the box on both standard and giftwrap packaing. Fill out "note to seller" section with your special note.
- Please check our shop announcements for bulk order discounts.
1 business day
Buyers are responsible for any customs and import taxes that may apply. I'm not responsible for delays due to customs.
Just contact me within: 3 days of delivery
Ship items back to me within: 7 days of delivery
Buyers are responsible for return shipping costs. If the item is not returned in its original condition, the buyer is responsible for any loss in value.
Please contact me if you have any problems with your order.
We can provide custom lengths for most of necklace/bracelet/anklet chains. If the size you are looking for is not in the menu, please write to us. We can make it happen. For simplicity we provide most common sizes in the drop down list.
For bracelets/anklets, I suggest 0.5 to 1" more than your actual size. If you don't have a measuring tape, get a letter size paper of which the shorter side is 8.5in. You can figure out from there.
For necklaces we can provide a picture for sizing. Please note our chain lengths are given in inches and includes length of clasps and jumper ring.
For rings we cannot adjust the sizes unfortunately, the available sizes are provided in the drop down list. For adjustable rings they fit size 5 to 10
If you need to see more pictures with the jewelry to better understand before making a purchasing decision, please write us. We are limited to uploading 10 pictures in a listing.
We understand you are making a decision without putting your hands and eyes on the actual jewelry, however, exchanges and return requests cost great deal of money due to shipping and Etsy fees. We accept exchanges and returns within 3 days but return shipping is by buyer
All pictures in our listings belong to us.
Btw Our photos and any content in our page are our intellectual property and using these photos without permission is copyright infringement and subject to Etsy and legal action.
Bulk order discounts are available, please check the announcements sections.
Even though our handmade items are very competitively and reasonably priced on this platform, depending on the product, we do whole sale at additional discounts. please contact us.
Even though we try to put enough information and pictures so that our viewers can understand what they will get, things may happen and we know you buy things without actually trying.
So If you want to return, simply ship the item on seller's address, within 3days of receiving, and once we get it as same condition, we will refund in full. Allow additional time for processing the refund. No need to communicate to us on these situation, unless it is a custom order. simply ship back within 3 days.
All items are handcrafted with care therefore we appreciate your understanding.
If the item arrived damaged or fault, please send us a picture, and we will remake and ship you again. Thank you for your understanding and patience.
If you didn't order the correct size or your jewelry doesn't fit, again simply return the jewelry back to us within 3 days of receiving. Just cover the return shipping to us. Once we receive the item we will remake and send you totally free. For resize/resend listing go to this link. https://www.etsy.com/listing/1033161759
If you need to cancel an order, please contact us within 2 hours, as we start creating the item immediately within hours sometimes and ship the item. We keep our processing times short and want to get you the items as fast as possible. We hope your understanding
Our current processing time is 2 business days. This duration varies. Holidays and especially during Christmas processing time goes up. If you are in a hurry to get your order, we kindly ask to purchase this listing https://www.etsy.com/listing/1078967985 to speed up our making the jewelry and carrying them to the drop off location separately as this cost us additional resources. We always strive to process the orders as fast as possible without causing any quality or basic mistakes. Please check our reviews. Quality and Fast Shipping is our #1 priority, as well as our customer's.
All of our orders shipped with USPS. You will receive an email with a tracking number and with a link where you can track your order's shipping status directly
Domestic US orders are shipped with USPS first class by default which takes about 4-6 business days depending on the location.
Priority and Express shipping options are available at checkout. Priority costs about additional $10 and takes about 3 days, whereas Express costs about $30 and takes 1-2 days.
If you forget to choose this options at check out please use this listing https://www.etsy.com/listing/1033161759
For overnight delivery options, please write to us, we can quote it quickly.
For shippings to Canada, We use USPS first class, We experience it takes about 2 weeks.
For other international shippings, we use Etsy's partner Asendia/Global Shipping. It is most affordable option but it takes total about 3-4 weeks. Once purchased you will be provided with a tracking link and can only track it on Etsy's website. We don't have control on int shipping times due to customs and foreign country's carrier. Once your order arrives to your country your state postal service takes and delivers it.
For fastest and most secure international shipping option is Fedex or UPS, takes about 1-2 weeks however the cost might be 5+ times of Global shipping. please write us for quotes.
If your package's shipping takes excessively longer than usual, please write to us. We can remake and ship you again.
If your package tracking status shows the item as delivered but if you haven't received the item, please wait one or two more business days. We experienced it with USPS that tracking shows it delivered but actually they deliver the next business days.
Jan 9, 2023


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Main Content
Top of the pageCheck Your Symptoms
Most people have had a minor knee problem at one time or another. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Knee problems and injuries most often occur during sports or recreational activities, work-related tasks, or home projects.
The knee is the largest joint in the body. The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the bones inside the knee joint is covered by articular cartilage, which absorbs shock and provides a smooth, gliding surface for joint movement. See a picture of the structures of the knee.
Although a knee problem is often caused by an injury to one or more of these structures, it may have another cause. Some people are more likely to develop knee problems than others. Many jobs, sports and recreation activities, getting older, or having a disease such as osteoporosis or arthritis increase your chances of having problems with your knees.
Injuries are the most common cause of knee problems. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. Acute injuries include:
Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the knee. Activities such as stair climbing, bicycle riding, jogging, or jumping stress joints and other tissues and can lead to irritation and inflammation. Overuse injuries include:
Problems not directly related to an injury or overuse may occur in or around the knee.
Treatment for a knee problem or injury may include first aid measures, rest, bracing, physiotherapy, medicine, and, in some cases, surgery. Treatment depends on the location, type, and severity of the injury as well as your age, health condition, and activity level (such as work, sports, or hobbies).
Check your symptoms to decide if and when you should see a doctor.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
Pain in adults and older children
Major trauma is any event that can cause very serious injury, such as:
When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.
There are other reasons for colour and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal colour returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.
Pain in children under 3 years
It can be hard to tell how much pain a baby or toddler is in.
Pain in children 3 years and older
Symptoms of infection may include:
Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:
With severe bleeding, any of these may be true:
With moderate bleeding, any of these may be true:
With mild bleeding, any of these may be true:
Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.
Adults and older children often have several symptoms of shock. These include:
Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.
Babies and young children often have several symptoms of shock. These include:
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
Based on your answers, the problem may not improve without medical care.
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Put direct, steady pressure on the wound until help arrives. Keep the area raised if you can.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Home treatment may help relieve pain, swelling, and stiffness.
Do not smoke. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Smoking.
Try a non-prescription medicine to help treat your fever or pain:
Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.
Be sure to follow these safety tips when you use a non-prescription medicine:
Call your doctor if any of the following occur during home treatment:
The following tips may prevent knee problems.
Sports trainers recommend training programs that help women learn to run, jump, and pivot with knees bent to avoid knee injuries. In sports such as soccer, basketball, and volleyball, women who bend their knees and play low to the ground have fewer knee injuries than women who run and pivot with stiff legs.
Some people use knee braces to prevent knee injuries or after a knee injury. There are many types of knee braces, from soft fabric sleeves to rigid, metal hinged braces, that support and protect the knee. If your doctor has recommended the use of a knee brace, follow his or her instructions. If you are using a knee brace to help prevent problems, follow the manufacturer's instructions for use.
Knee injuries such as bruises, burns, fractures, cuts, or punctures may be caused by abuse. Suspect possible abuse when an injury cannot be explained or does not match the explanation, repeated injuries occur, or the explanations for the cause of the injury change. You may be able to prevent further abuse by reporting it and seeking help.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
Current as of: March 9, 2022
Author: Healthwise StaffMedical Review: William H. Blahd Jr. MD, FACEP - Emergency MedicineAdam Husney MD - Family MedicineKathleen Romito MD - Family MedicineDavid Messenger MD
Current as of: March 9, 2022
Author: Healthwise Staff
Medical Review:William H. Blahd Jr. MD, FACEP - Emergency Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & David Messenger MD
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.
To learn more about Healthwise, visit Healthwise.org.
© 1995-2022 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.


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Jena Malone
We have HD Wallpapers Jena Malone for desktop. High definition and resolution pictures for your desktop. You can use this wallpapers on PC, Android, Iphone and Tablet PC. Also you can download all wallpapers pack with Jena Malone free, you just need click red download button on the right. There's a zip file with all wallpapers for free, we only ask that you share Jena Malone wallpapers with your friends in social networks. If you want to download the photos separately, you need right click on the desired picture and choose "Save As...".


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In a recently published whitepaper titled "Enhancing the performance of Windows Internet Explorer 8," Microsoft detailed browser add-ons, toolbars, malware, restricted sites, plus more advanced topics such as User Agent String and concurrent download settings. In itself, it's a useful guide for IE8 users who are having trouble with their browser's speed. For our purposes, though, there's some interesting information about add-ons included:
Although browser add-ons can add great new features to your browser, they can also introduce performance issues if written poorly. Add-ons cause most browser crashes, accounting for over 70 percent of Internet Explorer 8's crashes. Slowdowns in Internet Explorer 8 are very often caused by add-ons—especially when you open a new browser window or tab.
It's good to see that only 30 percent of IE8's crashes are actually the browser's fault. Theoretically, IE8 users could simply run their browser in "No Add-ons mode" (iexplore.exe -extoff) and have a much more stable experience. In the real world, today's Web expects add-ons.
In the document, Microsoft also outlines the 20 most popular add-ons from IE8 users worldwide as of July 2009:
|Google Toolbar
|KingSoft Browser Shield
|QQ Toolbar
|Windows Live Sign-in Helper
|AVG Security Toolbar
|Baidu Toolbar
|Adobe Acrobat Reader
|Windows Live Toolbar
|Norton Internet Security
|Google Browser Address Error Redirector
|Yahoo! Toolbar
|McAfee VirusScan
|Spybot Search and Destroy
|Java Plug-in
|Kaspersky Internet Security
|Thunder Download Manager
|MSN Toolbar
Interestingly, Flash is noticeably missing from the list, though we're not sure why. It's possible that Microsoft simply did not count ActiveX add-ons. It could be because some businesses disable it. It may also be the way it is invoked (Java is present, but Silverlight is not), compared to other add-ons, though, we do know IE definitely treats it as an add-on (running in "No Add-ons mode" will turn it off, and it is listed in the Manage Add-ons window).
Most of the add-ons listed are installed along with other software. The major search and Web portals are well represented thanks to bundling. There are also numerous security-related add-ons and even some malware at number 20.
Microsoft's two biggest competitors in the browser market, Firefox and Chrome, both put a big emphasis on add-ons. Microsoft claims that IE add-ons are very easy to develop and that it made sure the developer tools are not a separate download. That may be true, but IE still isn't as good an extensibility platform as other browsers: it's harder for plugins to intercept Web traffic and so add-ons like NoScript are much harder to port.
There were only 1,200 add-ons available for IE8 at launch. The Internet Explorer Add-ons Gallery, which doesn't include all the add-ons for the browser, has only about 600 listed today. It appears that the total number has also barely grown since IE8's release in March 2009.
This highlights the lack of third-party interest in IE8 development. Because the browser is hated by so many Web developers and is harder to code for, there are very few add-ons being created for it.
Given that all this telemetry data is coming directly from Microsoft, we can only hope that the software giant is working on a huge overhaul for the add-on system in IE9. First off, add-ons should not be able to commit murder, only suicide. Both Chrome and IE isolate tabs to ensure that a crashing page cannot take down the whole browser. Similarly, they isolate plugins to limit the damage that can be done when they crash. A case could therefore be made that IE should take the same approach to add-ons—spin them off into separate processes so that they cannot take down the browser. Secondly, add-ons should update themselves from within the browser. Users should not have to maintain every single add-on they have, although we admit automatic updating means a poorly written update affects more users.
Internet Explorer general manager Dean Hachamovitch said at MIX10 that he believes the IE extensibility platform is pretty good. It needs to get significantly better in IE9.


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First lady aims to make 'real difference'
Michelle Obama has a new look, both in person and online, and now she has four more years as first lady.
That's got many people wondering: What will she do with them? Take on a new cause? Travel more? Trace the path of another first lady and keep the Obama political brand alive by running for office?
The first lady is a self-described "mom in chief" who also champions healthier eating, is an advocate for military families, a fitness buff and the best-selling author of a book about her White House garden.
For certain, she'll press ahead with her well-publicized efforts to reduce childhood obesity and rally the country around its service members.
"But beyond that, the first lady is exploring ways that she can make a real difference for Americans, not just for these next four years, but for years to come," said Kristina Schake, Mrs. Obama's communications director.
Here are five areas to watch.
New issues
When Parade magazine asked last year whether she'd take up any new issues, the first lady identified women's health. "How do we strengthen families and make them healthier, an issue not just in America but around the world?" she said.
Her marquee causes -- the "Let's Move" campaign against childhood obesity and the "Joining Forces" effort to help military families -- took a backseat last fall as she campaigned doggedly for President Barack Obama's re-election.
Look for her to begin publicizing those efforts anew.
Do not expect to see Mrs. Obama push more contentious issues such as gun control or immigration, both second-term priorities for the president. Her public approval rating was 73 percent in a December poll by CNN and she'd like to keep it there.
Still, some feminists remain unhappy that the Ivy League-educated lawyer hasn't used her position to champion what they view as more substantive issues.
Robert Watson, an American studies professor at Lynn University, said he hopes Mrs. Obama will use her popularity to pivot away from the "velvet-glove" issues first ladies typically embrace and say, "I'm swinging for the fence."
Malia and Sasha
The Obama daughters will be in full teenage mode by the summer of 2014. Malia is already there at 14; sister Sasha is 11.
Could having older, more independent children free Mrs. Obama to pursue other interests? Some first lady watchers say that's unlikely.
After all, the teenage years are often full of angst about dating, proms, learning how to drive, going to college and so on.
Malia will graduate from high school during Obama's final year in office, in 2016, and probably trade the White House for a college dorm. She and her parents will have to navigate the college application process and campus tours. Sasha will be in high school.
Presidents and first ladies often step up the pace of international travel in the second term. But it seems unlikely that the president could make such a pivot just yet, with the U.S. public still so concerned about the economy.
One option would be to send Mrs. Obama abroad in his place. The first lady is popular overseas and has been well-received outside the United States, including in India and in Mexico, both in 2010, and in South Africa and Botswana in 2011.
First lady Laura Bush pursued a grueling foreign travel schedule during President George W. Bush's second term. She visited 77 countries in eight years as first lady, including with the president, but 67 of those trips came during the second term, according to Anita McBride, her then-chief of staff who runs American University's first ladies program.
Run for public office
"I have no interest in politics. Never have, never will," the first lady said last year on ABC's "The View." But even those who at one time say "never" can later change their minds.
Hillary Rodham Clinton gave the same answer in 1995 when asked if she'd ever run for public office, says Myra Gutin, who studies first ladies at Rider University. But five years later, there was Clinton campaigning across New York for a Senate seat, which she won.
Clinton used her time in the Senate as a springboard for her 2008 presidential campaign but lost the Democratic nomination to Barack Obama. She became his secretary of state but is departing soon amid speculation that she will run for president in 2016.
Mrs. Obama will be young -- 53 -- when her husband leaves office in 2017. Friends say she has always believed there are ways to serve the country without running for office.
Personal style
Look for the first lady to continue to be a fashion trendsetter. Everything from her hair to her clothes is scrutinized, with some clothing pieces selling out quickly after she's seen wearing them.
Her new bangs became the talk of this town immediately after she went public with them on her 49th birthday, a few days before the president began his second term.
Michelle Obama also won largely positive reviews for her inaugural wardrobe: Reed Krakoff and Thom Browne by day, and Michael Kors and Jason Wu by night.
She also has a new presence on Twitter -- @FLOTUS.


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Parents group not pleased
ADAMS TWP — The Mars School Board on Tuesday night heard the parents group that opposes five Marcellus Shale gas wells proposed for a farm near the district campus express their disappointment at a meeting they attended that morning with the driller and the state Department of Environmental Protection.
The parents group, along with others who oppose the six wells planned for the Geyer farm on Denny Road, requested the meeting with Rex Energy and the DEP to share information they have gathered on what they say are the potential health risks and adverse effects on the district's 3,200 students.
The meeting took place at the DEP's Northwest Region office in Meadville.
Amy Nassif, a leader of the parents group, told the board the Rex officials said they cannot move the Geyer wells, and they will continue to pursue properties outside of the Geyer site.
She said the Rex representatives stated they do not feel they are putting the Mars students at risk.
"The Mars parent group affirms that the proposed Geyer site is within known evacuation zones and poses significant additional harmful health effects," Nassif told the board. "It does not belong this close to the schools."
Nassif implored the board to also request a meeting with Rex Energy and the DEP to mitigate risk to the schools. She said if such a meeting is requested, the parents should also be invited to attend.
"The group and supporters are not tired, and we are committed to protecting our children," Nassif said. "The only way to truly mitigate risk is to not drill wells near our children."
Crystal Yost, a parent who also attended the Meadville meeting, said she is disappointed with the school board's lack of participation in the discussion regarding the safety of the wells so near the schools."Our kids are in your care," she said.But Superintendent Jim Budzilek said he has been in contact with Rex Energy and county emergency officials regarding the situation.He said the school board has continued to study safety issues and evacuation procedures, among other facets of drilling near the schools."We are doing our homework with this whole process," Budzilek said.But Middlesex Township resident Janice Kennedy said many schools are operating much closer to active wells than Mars will be if the DEP grants the Geyer well permits.Kennedy also said the Middlesex and Adams township supervisors have responded correctly by rejecting the parents group's request for a two-mile, nonindustrial overlay zone around the schools to prevent horizontal drilling.Kennedy said the Geyer wells do not pose a threat to Mars students."The DEP continues to monitor well activity during drilling and afterward," Kennedy said.Rex Energy's senior director of civil and environmental engineering, Mike Endler, said in a statement that the meeting with the parents group is an example of Rex's commitment to foster a constructive dialogue with the communities where the company operates.
Endler said if the DEP approves the Geyer well permits, Rex officials will work with local first responders to ensure that they have the necessary training to take action "in the rare chance of a well site event."Regular, ongoing communication with the school district would also be a focus in each step of the wells' development process, Endler said.He said as a result of the Meadville meeting, Rex agreed to:• Work with the school district to schedule the fracking process during nonschool hours• Use US Environmental Protection Agency-approved green completion technologies at the well site to reduce air emissions• Use sound abatement walls at the well site• Evaluate the possible use of additional air monitoring equipment at the well site.• Not flare natural gas at the location• Enhance community outreach and communicationsIt is not known when the DEP officials will announce their decision on the Geyer well permits.