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Visit Edmunds.com for a complete listing of local car dealerships in Springville, New York. Find the best deal on your next vehicle with online discount price quotes on car, truck, SUV, and minivan models. With the ability to compare prices on new and used vehicles in Springville, Edmunds.com makes the car buying process convenient and cost-effective. Search for car dealerships in Springville, New York with our comprehensive dealership network and avoid the common hassles associated with car shopping.
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Information for Current Nursing Students
Information for students in clinical courses
Information for graduating students
Advising and Registration Instructions (updated prior to each advising/registration period)
Handbooks, Policies, Calendars and NURS 410
NOTE: Updates to handbooks will be posted on this site and students notified of updates as they occur.
- HIPAA Confidentiality Agreement From Handbook
- Previous handbooks are located here on the Student Handbook Archives page.
- Academic Calendar 2015-2016
- NURS 410 Syllabus Packet
Information and Forms for Students in Clinical Courses
READ this: Required Documentation for Students in Clinical Courses
Year One Clinical Course Students (BSN Sophomores, Year 1 MIDAS Students & FNP Students)
- FOR all BSN AND MSN MIDAS students in clinical courses: Uniform Policy
- Sophomore TO DO Packet 15F
- Year 1 MIDAS TO DO Packet 2015 (includes background check information)
- FNP Packet 2015
Forms for Nursing Students Continuing in Clinical Courses
- Annual Health and TB Form (Health status update and tuberculosis test)
- TB Symptom Screen Form (required annually instead of TB skin test ONLY for students who previously submitted negative x-ray results for TB)
Other Individual Forms to Use as Needed
- CPR Registration Form 2015
- Background Check Instructions
- Physical Examination Form
- Immunization Record
- TB Form (NEW)
- Flu Vaccine Form (DUE OCTOBER 15)
The Student Center for select clinical sites can be accessed via the drop-down menu on the Student Center tab at http://www.tristatenrc.org/
Information for Graduating Students
This information will be updated for 2016 as it becomes available.
- BSN Senior Picture Day is Mon., Feb. 23, 2015 11:30-5:30 in the OT Lab. Schedule your time on the sign-up sheet to be posted in the OT Student Lounge (COH 19) on 2/2. Sitting fee of $23.50 is payable on photo day by credit card, check or money order (no cash please) and includes FREE composite (head shots of entire class). Watch your email. A nursing pin will be available to wear for your photo in the OT Lab on picture day.
Order form for packages/additional photos (also available in COH 19 and on picture day).
- BSN Road to NCLEX
- MIDAS Road to NCLEX
- The School of Nursing Pinning & Recognition Ceremony is May 13, 2016 at 2:00 pm for all graduating nursing students. See details ⇒
- Pin Order Form 2015 A tradition in nursing education is the nursing pin. Graduating students who order a nursing pin
- will be handed their pin after their name is announced as they walk across the stage.
- UPDATED: Commencement is May 14, 2016 at 9:00 am for undergraduate students and 3:00 pm for graduate students
Learn more at the Commencement website
Advising and Registration Instructions
BSN 2016 Fall Freshmen: See Road to Xavier for advising information.
All BSN Continuing Students
2016 Spring advising starts 10/19/15. All BSN students must meet with their advisor.
Advising appointment sign-up sheets are posted in the COH 128 hallway. Clinical assignment lists will be posted on a table in the same hallway on October 12. Additional advising and registration information was sent by email. Go to the links below for general advising/registration instructions.
NOTE: BSN students will receive information about internships and NURS 410 in the fall semester of Junior year
Math guidelines for nursing majors fall 2015
Information for 2016 Spring Advising and Registration for BSN Student in Clinical Courses
- Sophomores (16S NURS 230/231) - Information Flyer. Each sophomore must also obtain a pre-assigned schedule in COH 109. The schedules are expected to be available October 12.
- Juniors (16S NURS 360/361 or 372/373) - Information Flyer
- Seniors (16S 473) - Information Flyer
Current Graduate Students: Priority registration for 2016 Spring opens on November 9.
New Graduate Students: Registration for 2016 Spring opens on November 16.
New graduate students who are not in the MIDAS program will receive information by email.
Scholarship Opportunity (posted 1/2/14)

subset: commoncrawl


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Luxury 3 bedroom apartment @ 90 rue d'Antibes
From $969 / night
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Description from the owner
Description from the owner
Bedrooms: 3/
Bathrooms: 3/
Sleeps: 8/
Type: Apt. / Condo
This is a luxury three bedroom newly constructed apartment - located at 90 rue d'Antibes. Only 3 minutes from Palais & Convention Centre. Ideally located for all the major conferences & conventions in Cannes, including - Midem (January) Mipim (March) Miptv (April) Festival du Film (May) Fipa (June) Mipcom (October) Tax Free (October) and of course it goes without saying, it is great for a beach holiday too!
Fully air-conditioned, 3-bedroom apartment, right on Rue D'Antibes, 100m from La Croisette & very near the Cannes Convention Centre. Nearest city is Nice and nearest airport is Nice (15 miles), alternatively Marseille Airport (60 miles),Toulon ...Read more
About the owner
About the owner
Joel K.
Joel K.
- Response rate: 90%
- Response time: A few hours
- Calendar updated: 5 months ago
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Additional Location Information
This 3 bedroom/3 bathroom apartment with terrace is on the 3rd floor, in a residence called Le Jardin Florian, situated at 90, Rue D'Antibes. The apartment is approximately 120 sqm (+15sqm of terrace) and has south-west exposure. It is fully air-conditioned. There is a video entry-phone system, and an elevator. A parking space is also available in the private underground car park, right underneath the building, with a private elevator up to the apartment level. This accommodation is available for weekly rentals throughout the year. The living room is furnished with a double size sofa bed, two armchairs, a dresser and a rectangular glass dining table seating 6. For your entertainment there is SKY TV (UK), cable TV, ADSL Wi-Fi internet, a DVD, & a stereo with CD player. Numerous DVD discs are offered in the apartment. A French window opens onto the terrace. Outside is a table seating 6, if you wish to have lunch/dinner outside. The terrace overlooks a beautiful landscaped garden.
Please note that during the Cannes Film Festival, the minimum rental period charged is 14 nights
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City of Heroes is the fourth MMO shut down by NCSoft in NA/Europe. The previous three were Auto Assault, Tabula Rasa & Exteel. Tabula Rasa is the interesting one as Wiki indicates:MasterChief said:I'm actually surprised that City of Heroes is shutting down. I was always under the impression that the game was somewhat successful. Any other NCSoft games getting the axe that people should know about?
Richard Garriott announced that he was leaving NCAustin and Tabula Rasa in an open letter to the community, though he now claims this letter was in fact written by NCsoft as a means of forcing him out. The announcement was made while Garriott was in quarantine after returning from his spaceflight in October, and the announcement claimed he was inspired by the space travel experience to pursue other interests.
Richard Garriott sued NCsoft for $24,000,000 USD.[35] Garriott sued for damages relative to his termination from the parent company NCsoft.[36] Garriott's allegation states that NC Soft terminated his employment, then fraudulently reported his termination as willful resignation in order to preserve the right to terminate Garriot's stock options unless he exercised them himself within 90 days of termination, forcing Garriott into a decision to purchase stock with which a loss was incurred worth dozens of millions in profit for Mr. Garriott. Additionally, the news of the termination was issued while Mr. Garriott was confined to quarantine from the space flight, which was originally intended to be a publicity move to further promote the game and increase revenue. In July 2010, an Austin District Court awarded Garriott US$28 million in his lawsuit against NCsoft, finding that the company did not appropriately handle his departure in 2008. NCsoft stated that it intended to appeal the decision.
Oh, I know, I was just indicating NCSoft's history of shuttering MMOs that don't meet their financial expectations. No clear reason has been given for CoH's shutdown, but blame has been leveled at NCSoft wanting to focus on ArenaNet/Guild Wars 2, or the fact they're bringing over their own TERA-like Blade & Soul.MasterChief said:Quin - I said "Getting," not "got." I wonder what else NC is shutting down atm that I haven't heard about. More importantly, why shut down CoH? Was it not as successful as I believed? Or are there just not enough people paying for things?
That would be an... Interesting reason, if it turned out to be true. Sad and shortsighted, but interesting. I'm all for a company narrowing down their line-up and figuring out what they're best suited for, but it makes no sense at all to scuttle profitable ventures that could be used to help fund other initiatives.Ocelot said:Scuttlebutt is that NCSoft has decided to (with the exception of ArenaNet/GW2) focus primarily on its Korean-style products. As one of its older "Western" MMOs, City of Heroes supposedly just didn't make the cut, despite being more profitable than some of NCSoft's other titles. I don't know if this rumor is actually true, but it's what's going around.


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"Sexy, strong and feminine," are the three words Alon Livne told us sums up his design for the Mrs. Carter Show World Tour: a silk chiffon gown with built-in gold jewelry and Swarovski Elements crystals. What surprised him most about working with Beyonce?, "she is sincerely modest," Livne shared with ESSENCE.com.
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Every time I go for an appointment, I have to wait minimum 30 minutes to be seen. She is pretty good at remembering things about me and my health, but she often goes on tangents about things that I don't really care about at the moment since I know my time with her is pressed. The staff always opens the door during the appointment to say how behind she is ("Thirty"). I always feel like I can't ask her about everything I want to because it will take too long and I feel like I'm taking up too much of her time. Recently she booked me for a pap test, I came for the appointment and then she says that I don't need one and to come back in a few months. Okay? Waste of time. I never feel completely satisfied about my health after leaving and sometimes I don't even understand what she is talking about and I leave confused.
Rude VERY RUDE and unknowlegable. Just google the internet and you'll have the same knowledge. Misdiagnosed my son 3 times for pneumonia and I state THREE times. She sent him for an x-ray at hospital and they said that he only had a cold and an ear infection. Second time same thing and for the third time a doctor AND a student.. Get it? A STUDENT checked my son and they both said that he had an ear infection not pneumonia And they told us that my son is 2 years old and shouldn't be exposed to x-rays this much. If a doctor cannot diagnose an ear infection than that is questionable. I don't really care if she's rude or cold or crappy. I just want a doctor that has knowledge and not worry about her misdiagnosis. I also agree about her being disgusted by little kids. The way she acts around them is so pethatic. Her clinic is always empty and I always wait for an hour for some reason. I would not recommend her to anyone not even to the people I hate.
Have been with this DR. for over 20 years and has always nailed everything that has been wrong with me. Sometimes she is very blunt and other times shows compassion .I totally trust her with my health but find sometimes i get a short answer to a question but understand if it was more serious she would spend the time needed for me to understand my situation. Most of the time she is late but I understand some patients need more time like I have in a few cases. Have had 9 operations that were successful .If you need a hug or your hand held this wont happen but if your looking to stay healthy DR.Pyper is excellent in her field.Also Debra is amazing at her organization of follow ups,booking test at other locations.Have never had to call wondering if my tests were ok.An appointment to discuss was always made very close to the time the results were in. I understand everyone has a different opinion of what a DR. should be like. This is mine and at 58 im very healthy because I have a good DR. who has done her job very well . Very happy with the care I receive.
After many visits with long wait times and not being able to ask more then 2 questions per visit came the final straw. I was left in the middle of a Pap test for her to take a personal call regarding real estate while my feet were in the stirrups and the exam room door not closed all the way. She may have knowledge in the medical field, but poor social skills and bedside manner.
Dr. Pyper may have the requisite medical knowledge (I can't say firsthand since I only had very routine medical care with her in the years she was my doctor), but she lacks a basic ability to relate to people and has very poor bedside manner. She made several very strange, offensive remarks to me while I was in her care about "fatties" (referring to the fact that it was strange that I was having issues with my menstrual cycle because normally that happens to "the fatties"); also told me not to drink milk while I was pregnant because I would get too fat; and treated me like a teenager when discussing birth control. I don't know how anyone can feel comfortable in her care. She's one odd lady.
Dr. Pyper went exceedingly above and beyond for our family during the most difficult time in our lives. I cannot thank her enough for being so accessible and for all she did for our family. She has been and continues to be a wonderful professional in our corner.
Misdiagnosed shingles as a fever rash. Very rude, cold and uncaring. happiset time was when i left te office and found another Dr.
The first—AND LAST—appointment I had with Pyper was in 1996. I still remember how cold, arrogant and uncaring she was…and from other comments I've read here it seems nothing has changed! We were expecting our second child and had just moved to the area and were looking for a new family doctor. After waiting an eternity to see her, understandably our daughter (who was 18 months at the time) was fidgety by the time Pyper saw us. Pyper looked at our daughter with absolute disgust for even daring to wiggle an inch so my husband became uncomfortable with Pyper's glares and left the office. Unfortunately, I did not have that luxury which was when the she tried to tell me that I didn't know when it was that I got pregnant—a woman knows her body. She sent me for blood work and tests which I promptly had the lab forward to a different doctor I hadn't even met yet, but I knew from that first and last visit that I wouldn't be staying with Pyper. She scores a 5 for worst/rudest doctor ever!
I was very happy when I started with this MD as compared to my previous MDs, at least she listened and wrote everything I told her on her sheets. But then I realized all that is in vain as she never remembers or even consults her notes when seeing u in future visits. Also, she has an issue with references. I have a medical issue and have been requesting to see a specialist as her treatment hasn't worked for the last year or so. She never refers, as if it's gonna cost her some fortune. And she just laughs at alternate medicine references. Also, for my last 5 annuals, no blood work ever taken, no urine test etc, and now she tells me she wants to see me every 2 years for my "annual", lol - figure that out ;~( I have seen her for over 5 years now, and am glad I found this site. I'll try to book elsewhere from now on.
I would not recommend to anyone, especially parents who have kids.Always late, very difficult to keep the kids entertained for that time and Doctor would hardly spend any time with you. If you are late for appointment, she would sent you back home .In 5 years I was late twice for 20 mins. No excuse for getting late, but I can argue that I have a newborn child and a toddler and I had both there appointments on that day and was late for 20 mins. She sent me back home that day saying I am late even though my daughter was sick and baby had a wellness check. You can at-least deal with doctor, but can't with the staffs, they are so rude sometimes. When my daughter was down with fever, staff asked me to contain her in one seat so that she wont spread germs and she don't need to wipe wherever she touches. In our extremely busy and tensed life , we don't need our doctor's office to upset us.
Dr. Cynthia Pyper's Credentials
Facility Affiliations
Accepting New Patients
Other Specialties
Areas of Expertise
Awards & Recognitions
Publications & Research
Insurance accepted by this Doctor
Website has been updated from "http://drpyper.com" to "http://drpyper.com/". Postal_Code has been updated from "L9T0" to "L9T 3Z9". Address has been updated from "None" to "311 Commercial Street". Phone_Number has been updated from "None" to "19058644747".June 3, 2015
A new 2.8-star rating has been posted. "Every time I go for an appointment, I have to wait minimum 30 minutes to be seen. She is pretty good at remembering things about me and my health, but she often..."March 14, 2015
A new 1.5-star rating has been posted. "Rude VERY RUDE and unknowlegable. Just google the internet and you'll have the same knowledge. Misdiagnosed my son 3 times for pneumonia and I state THREE times..."November 17, 2014
2 negative duplicate or disallowed ratings automatically removedAugust 16, 2009
3 negative duplicate or disallowed ratings automatically removedAugust 10, 2008
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Here, there's no need for any politician to waterboard companies with the green Kool-Aid. The hottest item at this year's show is Airbus' A320 NEO, a "green" plane that netted a record 730 orders for a total of $72.2 billion. If America's Boeing hopes to compete and move beyond its $22 billion in orders, it'll have to catch up and produce something similar. The NEO's big attraction is that it's 15 percent more fuel-efficient than a classic A320. With fuel costs representing one-third of airline expenses, no government official has to legislate this plane into existence.
From free-market success also comes employment explosion. Among the 2,100 exhibitors, nearly all those with whom I spoke said they were hiring. Specifically, they're in desperate need of workers with technical skills -- engineers, builders, producers -- and they couldn't find enough people to fill these positions. Several were recruiting on-site.
These are highly skilled jobs you can't fake. The negative consequences of faking one's abilities in manufacturing a plane or defense system should be obvious. It's therefore highly unlikely that jobs in this field will be snapped up by some hombre fresh off of jumping the southern border. They're mostly globalization-proof.
So where are all our workers in this field? This is the West's top-tier manufacturing base, in which democracies are outperforming oppressive regimes such as China and Russia. Malaysia's AirAsia, for example, bought $18.2 billion worth of Airbuses, not a Chinese or Russian brand. This is the playing field on which we are beating our ideological enemy.
The fact that companies can't fill these jobs suggests a serious systemic problem in Western society: economic deindustrialization. According to the American Prospect, manufacturing represented only 11.5 percent of America's economic output in 2008, compared with 28 percent in 1959.
I Was A Woman In The Marine Corps In the Mid-70s. Hillary Clinton's Story Doesn't Add Up | Susan Hutchison
Colorado governor: This Planned Parenthood shooting may be a function of inflammatory rhetoric from bloggers and talk shows | Allahpundit


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VisionAware Blog
New Survey: Less than Half of United States Adults with Diabetes Understand Their Risk for Vision LossPosted on 11/24/2015 at 7:30 AM
by Maureen Duffy
A new survey released this month by Regeneron Pharmaceuticals, Inc. reveals that less than half of recently surveyed United States adults with diabetes recognize their risk for vision loss. Regeneron is a science-based biopharmaceutical company that discovers, invents, develops, manufactures, and commercializes medicines for the treatment of serious medical conditions.
[Please note: Regeneron Pharmaceuticals, Inc., which commissioned this survey, is also the developer of the injectable drug EYLEA, approved by the FDA in 2014 for the treatment of diabetic macular edema.]
About the Survey
Excerpted from New Survey of U.S. Adults with Diabetes Reveals Less than Half Understand Their Risk for Vision Loss, via PR Newswire:
The Diabetes Eye Health Survey was conducted by Everyday Health, Inc., a provider of digital health and wellness solutions. Everyday Health, Inc. conducted a quantitative online survey among a representative sample of 1,074 U.S. adults diagnosed with diabetes, from August 4 – 17, 2015.
Less than one-fifth (18 percent) of respondents said they were familiar with diabetic macular edema (DME), a term that refers to swelling of the macula and is a complication of diabetic retinopathy, the most common diabetic eye disease.
The survey found that nearly one third (30 percent) of respondents reported they do not get an annual comprehensive dilated eye exam, a test that can help to detect DME and diabetic retinopathy.
Of those respondents who do not get an annual dilated eye exam, more than half (56 percent) were not aware that the exam is recommended by the National Eye Institute for people with diabetes or that it could help protect against vision loss associated with the disease.
"Getting an annual comprehensive dilated eye exam is a critical step that may help to prevent future vision loss by identifying issues early," said Dr. Allen Ho, MD, FACS, Director of Retina Research, Wills Eye Hospital and Professor of Ophthalmology at Thomas Jefferson University. "These survey findings underscore the need for more awareness among the diabetes community about their risk for vision loss and what they can do help protect their vision."
Additional findings from the online survey of 1,074 people living with diabetes include:
- When thinking about diabetes complications, those surveyed said eye disease is the number two concern, behind cardiovascular disease.
- Despite concerns, however, less than half (44 percent) of respondents said they were very knowledgeable about eye diseases that could result in vision loss.
- Only one third (35 percent) of respondents said they were familiar with diabetic retinopathy, specifically.
About Diabetic Eye Disease
Diabetic Retinopathy
Although people with diabetes are more likely to develop cataracts at a younger age and are twice as likely to develop glaucoma as people who do not have diabetes, the primary vision problem caused by diabetes is diabetic retinopathy, the leading cause of new cases of blindness and low vision in adults aged 20-65:
What a person with diabetic retinopathy sees
- "Retinopathy" is a general term that describes damage to the retina.
- The retina is a thin, light-sensitive tissue that lines the inside surface of the eye. Nerve cells in the retina convert incoming light into electrical impulses. These electrical impulses are carried by the optic nerve to the brain, which interprets them as visual images.
- Diabetic retinopathy occurs when there is damage to the small blood vessels that nourish tissue and nerve cells in the retina.
- "Proliferative" is a general term that means to grow or increase at a rapid rate by producing new tissue or cells. When the term "proliferative" is used in relation to diabetic retinopathy, it describes the growth, or proliferation, of abnormal new blood vessels in the retina. "Non-proliferative" indicates that this process is not yet occurring.
- Proliferative diabetic retinopathy affects approximately 1 in 20 individuals with the disease.
Four Stages of Diabetic Retinopathy
According to the National Eye Institute, diabetic retinopathy has four stages:
- Mild non-proliferative retinopathy: At this early stage, small areas of balloon-like swelling occur in the retina's tiny blood vessels.
- Moderate non-proliferative retinopathy: As the disease progresses, some blood vessels that nourish the retina become blocked.
- Severe non-proliferative retinopathy: Many more blood vessels become blocked, which disrupts the blood supply that nourishes the retina. The damaged retina then signals the body to produce new blood vessels.
- Proliferative retinopathy: At this advanced stage, signals sent by the retina trigger the development of new blood vessels that grow (or proliferate) in the retina and the vitreous, which is a transparent gel that fills the interior of the eye. Because these new blood vessels are abnormal, they can rupture and bleed, causing hemorrhages in the retina or vitreous. Scar tissue can develop and can tug at the retina, causing further damage or even retinal detachment.
Diabetic Macular Edema
Diabetic macular edema [edema = a swelling or accumulation of fluid] (DME) can occur in people with diabetes when retinal blood vessels begin to leak into the macula, the part of the eye responsible for detailed central vision. These leakages cause the macula to thicken and swell, which, in turn, creates a progressive distortion of central vision.
Although this swelling does not always lead to severe vision loss or blindness, it can cause a significant loss of central, or detail, vision, and is the primary cause of vision loss in people with diabetic retinopathy. DME can occur at any stage of diabetic retinopathy, but it is more likely to occur as the disease progresses.
What is a Comprehensive Dilated Eye Examination?
A comprehensive dilated eye examination generally lasts between 30 and 60 minutes, and is performed by an ophthalmologist or optometrist. It should always include the following components:
A Health and Medication History
- Your overall health and that of your immediate family
- The medications you are taking (both prescription and over-the-counter)
- Questions about high blood pressure (hypertension), diabetes, smoking, and sun exposure.
A Vision History
- How well you can see at present, including any recent changes in your vision
- Eye diseases that you or your family members have had, including macular degeneration and glaucoma
- Previous eye treatments, surgeries, or injuries
- The date of your last eye examination
As part of the vision history, your doctor may ask you the following questions:
- Are you having any problems with your vision?
- How long have you had these problems?
- When do these problems occur?
- When was your last eye examination?
- Do you have any family history of eye problems?
- How is your general health?
- What medications are you taking?
- Do you have any allergies?
This history of your own health and that of your family can give the doctor an indication of any issues that may be affecting, or could affect, your vision.
An Eye Health Evaluation
- An examination of the external parts of your eyes: the whites of the eyes, the iris, pupil, eyelids, and eyelashes.
- A dilated internal eye examination: Special eye drops will dilate, or open, your pupil, which allows the doctor to observe the inner parts of your eye, such as the retina and optic nerve. This can help to detect subtle changes of the optic nerve in persons without any visual symptoms and potentially lead to early detection of disease.
- A test of the fluid pressure within your eyes to check for the possibility of glaucoma.
A Refraction, or Visual Acuity Testing
A refraction helps determine the sharpness or clarity of both your near (reading) and distance vision.
This includes testing your vision with different lenses (sometimes contained in a machine called a phoropter, pictured at right) to determine if your vision can be improved or corrected with regular glasses or contact lenses.
Visual Field Testing
Visual field testing helps determine how much side (or peripheral) vision you have and how much surrounding area you can see.
The most common type of visual field test in a comprehensive eye exam is called a confrontation field test, in which the doctor briefly flashes several fingers in each of the four quadrants (above, below, right, and left) of your visual field while seated opposite you.
In some cases, your doctor may also want to perform a more precise visual field measurement, using a computerized visual field analyzer, such as the Humphrey Field Analyzer (pictured at left).
Your Examination Results
The doctor will be able to determine if the visual problems you are experiencing are normal age-related changes or are disease-related, and if additional testing, referral to another doctor or specialist, or treatments are needed.
You can read more about the comprehensive dilated eye examination, including questions to ask your eye doctor, at The Difference between a Vision Screening and a Comprehensive Eye Examination and Questions You Should Ask When Seeing an Eye Care Specialist on VisionAware.org.
Additional Information
- Treatments for Diabetic Eye Disease
- New Research: Lucentis Is Effective in Treating Proliferative Diabetic Retinopathy and More Effective than Traditional Laser Treatment
- The FDA Approves EYLEA Injection for the Treatment of Diabetic Macular Edema
- The FDA Approves Injectable Implant ILUVIEN for Treatment of Diabetic Macular Edema
- New Research: African-Americans with Diabetes Experience the Highest Rates of Vision Loss
New Research: Lucentis Is Effective in Treating Proliferative Diabetic Retinopathy and More Effective than Traditional Laser TreatmentPosted on 11/17/2015 at 7:24 AM
by Maureen Duffy
Results from a new clinical trial have revealed that the injectable drug Lucentis is highly effective in treating proliferative diabetic retinopathy, a serious vision-related complication of diabetes.
"These findings," said Dr. Paul Sieving, Director of the National Eye Institute (NEI), "provide crucial evidence for a safe and effective alternative to laser therapy against proliferative diabetic retinopathy." The clinical trial was funded by NEI, which described Lucentis as the first major advance in therapy for proliferative diabetic retinopathy in nearly 40 years. Although longer-term follow-up is needed, Lucentis may provide a reasonable treatment alternative, at least through two years, for persons with proliferative diabetic retinopathy.
From The Journal of the American Medical Association
The research, entitled Panretinal Photocoagulation [i.e., laser treatment] vs Intravitreous Ranibizumab [i.e., Lucentis injection] for Proliferative Diabetic Retinopathy: A Randomized Clinical Trial, has been published online as an open-source article in the November 13, 2015 edition of The Journal of the American Medical Association and was timed to coincide with a presentation by the study authors at the 2015 Annual Meeting of the American Academy of Ophthalmology. The authors are the members of the Writing Committee for the Diabetic Retinopathy Clinical Research Network.
The Diabetic Retinopathy Clinical Research Network (DRCR.net) is a collaborative research group that supports the identification, design, and implementation of multi-center clinical research studies focused on diabetes-related eye and retinal disorders, including diabetic retinopathy and diabetic macular edema. The DRCR.net was formed in September 2002 and currently includes over 115 participating sites with over 400 physicians throughout the United States. It is funded by the National Eye Institute (NEI).
About Diabetic Eye Disease and Diabetic Retinopathy
Although people with diabetes are more likely to develop cataracts at a younger age and are twice as likely to develop glaucoma as people who do not have diabetes, the primary vision problem caused by diabetes is diabetic retinopathy, the leading cause of new cases of blindness and low vision in adults aged 20-65:
What a person with diabetic retinopathy sees
- "Retinopathy" is a general term that describes damage to the retina.
- The retina is a thin, light-sensitive tissue that lines the inside surface of the eye. Nerve cells in the retina convert incoming light into electrical impulses. These electrical impulses are carried by the optic nerve to the brain, which interprets them as visual images.
- Diabetic retinopathy occurs when there is damage to the small blood vessels that nourish tissue and nerve cells in the retina.
- "Proliferative" is a general term that means to grow or increase at a rapid rate by producing new tissue or cells. When the term "proliferative" is used in relation to diabetic retinopathy, it describes the growth, or proliferation, of abnormal new blood vessels in the retina. "Non-proliferative" indicates that this process is not yet occurring.
- Proliferative diabetic retinopathy affects approximately 1 in 20 individuals with the disease.
Four Stages of Diabetic Retinopathy
According to the National Eye Institute, diabetic retinopathy has four stages:
- Mild non-proliferative retinopathy: At this early stage, small areas of balloon-like swelling occur in the retina's tiny blood vessels.
- Moderate non-proliferative retinopathy: As the disease progresses, some blood vessels that nourish the retina become blocked.
- Severe non-proliferative retinopathy: Many more blood vessels become blocked, which disrupts the blood supply that nourishes the retina. The damaged retina then signals the body to produce new blood vessels.
- Proliferative retinopathy: At this advanced stage, signals sent by the retina trigger the development of new blood vessels that grow (or proliferate) in the retina and the vitreous, which is a transparent gel that fills the interior of the eye. Because these new blood vessels are abnormal, they can rupture and bleed, causing hemorrhages in the retina or vitreous. Scar tissue can develop and can tug at the retina, causing further damage or even retinal detachment.
In addition, fluid can leak into the macula, the small sensitive area in the center of the retina that provides detailed vision. This fluid can cause macular edema (or swelling), which can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses.
Lucentis: An Anti-Angiogenic Drug to Treat Retinal Bleeding
Angiogenesis is a term used to describe the growth of new blood vessels and plays a crucial role in the normal development of body organs and tissue. Sometimes, however, excessive and abnormal blood vessel development can occur in diseases such as cancer (tumor growth) and retinal disease.
Substances that stop the growth of these excessive blood vessels are called anti-angiogenic (anti=against; angio=vessel; genic=development), and anti-neovascular (anti=against; neo=new; vascular=blood vessels).
The focus of current anti-angiogenic drug treatments for retinal disease is to reduce the level of a particular protein (vascular endothelial growth factor, or VEGF) that stimulates abnormal blood vessel growth in the retina and macula; thus, these drugs are classified as anti-VEGF treatments and are administered by injection directly into the eye after the surface has been numbed.
At present, these anti-VEGF drugs (Lucentis, Avastin, and Eylea) require monthly injections or a pro re nata [meaning "as needed"] (PRN) regimen, with monthly controls and injections for recurrent or persistent blood vessel growth and retinal bleeding.
More about Lucentis and Diabetic Retinopathy Research
Excerpted from Lucentis proves effective against proliferative diabetic retinopathy, via Science Codex:
A clinical trial among more than 300 patients has found that the drug ranibizumab (Lucentis) is highly effective in treating proliferative diabetic retinopathy (PDR), a complication of diabetes that can severely damage eyesight. The results demonstrate the first major therapy advance for the condition in nearly 40 years.
The trial compared Lucentis injections with a type of laser therapy called panretinal photocoagulation, which has remained the gold standard for PDR since the mid-1970s. Although laser therapy preserves central vision, it can damage night and side vision, so researchers have sought therapies that lack these side effects.
"Patients who received Lucentis showed a little bit better central vision, much less loss of their side vision, and substantially less risk for surgery than patients who received laser treatment," said Lloyd Paul Aiello, M.D., Ph.D., director of the Beetham Eye Institute at Joslin Diabetes Center and Professor of Ophthalmology at Harvard Medical School. "These findings will change the available treatment options for patients with PDR."
The DRCR.net enrolled 305 participants (394 eyes) with PDR in one or both eyes at 55 clinical sites across the country. Eyes were assigned randomly to treatment with Lucentis or laser. About half of the eyes assigned to the laser group required more than one round of laser treatment. In the other group, Lucentis was injected into the eye once per month for three consecutive months, and then as needed until the disease resolved or stabilized.
Because Lucentis is commonly injected to treat diabetic macular edema (DME) – a build-up of fluid in the center of the retina – the study permitted the use of Lucentis for DME in the laser group, if necessary. Slightly more than half (53 percent) of eyes in the laser group received Lucentis injections to treat DME. About 6 percent of eyes in the Lucentis group received laser therapy, mostly for issues other than DME.
At two years, vision in the Lucentis group improved by an average of about half a line on an eye chart, compared with virtually no change in the laser group. Participants treated with laser generally lost substantial peripheral vision, but those given injections did not. Additionally, the need for vitrectomy surgery was lower in the Lucentis group (8 of 191 eyes) than in the laser group (30 of 203 eyes).
Overall, the drug's benefits are particularly clear for people with both PDR and DME. "We know that this drug will help treat both conditions at the same time, so this is an especially appealing treatment alternative for these patients," Dr. Aiello noted.
The study also suggested that Lucentis may help prevent DME. Among people without this condition at the start of the study, only 9 percent of Lucentis-treated eyes developed it, compared with 28 percent in the laser group. Scientists will follow up on that result as the DRCR.net continues to track patients for a total of five years.
More about the Study from The Journal of the American Medical Association
Excerpted from the article abstract, with the full article available online:
Importance: Panretinal photocoagulation (PRP) is the standard treatment for reducing severe visual loss from proliferative diabetic retinopathy. However, PRP can damage the retina, resulting in peripheral vision loss or worsening diabetic macular edema (DME).
Objective: To evaluate the non-inferiority of intravitreous ranibizumab [i.e., Lucentis injections] compared with [laser] for visual acuity outcomes in patients with proliferative diabetic retinopathy.
Design, Setting, and Participants: Randomized clinical trial conducted at 55 US sites among 305 adults with proliferative diabetic retinopathy enrolled between February and December 2012 (mean age, 52 years; 44% female; 52% white). Both eyes were enrolled for 89 participants (1 eye to each study group), with a total of 394 study eyes. The final 2-year visit was completed in January 2015.
Interventions: Individual eyes were randomly assigned to receive PRP treatment, completed in 1 to 3 visits (n=203 eyes), or [Lucentis], 0.5 mg, by intravitreous [i.e., within the eye] injection at baseline and as frequently as every 4 weeks based on a structured re-treatment protocol (n=191 eyes). Eyes in both treatment groups could receive [Lucentis] for DME.
Main Outcomes and Measures: The primary outcome was mean visual acuity change at 2 years (5-letter non-inferiority margin; intention-to-treat analysis). Secondary outcomes included visual acuity area under the curve, peripheral visual field loss, vitrectomy, DME development, and retinal neovascularization.
Results: Mean visual acuity letter improvement at 2 years was +2.8 in the [Lucentis] group vs +0.2 in the PRP group. The mean treatment group difference in visual acuity area under the curve over 2 years was +4.2. Mean peripheral visual field sensitivity loss was worse, vitrectomy was more frequent, and DME development was more frequent in the [laser] group vs the [Lucentis] group, respectively. Eyes without active or regressed neovascularization at 2 years were not significantly different. One eye in the [Lucentis] group developed endophthalmitis [i.e., an inflammation of the eye, usually caused by infection]. No significant differences between groups in rates of major cardiovascular events were identified.
Conclusions and Relevance: Among eyes with proliferative diabetic retinopathy, treatment with [Lucentis] resulted in visual acuity that was non-inferior to (not worse than) [laser] treatment at 2 years. Although longer-term follow-up is needed, [Lucentis] may be a reasonable treatment alternative, at least through 2 years, for patients with proliferative diabetic retinopathy.
Related Diabetes Information
On Veterans Day: VisionAware Thanks Our Veterans and Provides Critical Information and Veteran-Specific ResourcesPosted on 11/10/2015 at 5:23 PM
by Maureen Duffy
Master Sergeant Jeffrey Mittman
According to the Blinded Veterans Association (BVA), there are 165,000 blind or visually impaired veterans in the United States. BVA data also indicates that some 7,000 veterans become newly blind or visually impaired each year, due to age-related macular degeneration, glaucoma, diabetic retinopathy, and retinitis pigmentosa. In addition, approximately 17 percent of the evacuated wounded service members in Iraq and Afghanistan have suffered a serious war-related eye injury.
For all service members and their families, VisionAware's Information for Veterans Coping with Vision Loss offers a one-stop hub of information and support, ranging from daily living tips and techniques to a directory of regional services and local agencies:
- Veterans' Services and Other Resources
- Legal Resources for Veterans
- Veterans, Brain Injury, and Vision
- A Veterans' Administration Comprehensive Neurological Vision Rehabilitation Program
- Concussion and Traumatic Brain Injury: What Do I Ask My Eye Doctor?
- Statistics on Vision Loss and Military and Policy Implications
- Information for Older Veterans
- Veterans' Forum message board
Resources and information for family members include:
- Essential skills for living with vision loss
- Emotional support and help for families
- Support groups and other resources
- Employment issues and support
Personal Stories and Interviews with Blinded Veterans
Vietnam veteran Paul Mimms
One of the most compelling veteran-related features on VisionAware is our series of interviews with, and personal stories about, veterans who have grappled with vision loss – in both active duty and retirement – and discovered a wide range of personal strengths, supportive services, and rehabilitation options:
- Paul Mimms, Vietnam-era veteran and advocate
- Dan Standage, Director of Disability in Education for the Student Veterans of America
- Staff Sgt. Brian Pearce, USA-Ret. and his struggle with traumatic brain injury
- Master Sgt. Jeffrey Mittman, who was wounded by a roadside bomb in Baghdad, Iraq
- Timothy E. Hornik, LMSW CPT, US Army, Retired, who was injured by a sniper during combat operations in Iraq
- Vietnam veterans Gerry Fitzpatrick and Jim Hammond, who provide volunteer services at the Martinsburg, West Virginia Veterans Affairs (VA) Medical Center
The Military Origins of the Orientation and Mobility Profession
Iraq veteran Timothy E. Hornik
Did you know that the profession of Orientation and Mobility has its origins in the military? The profession began to develop during, and immediately after, World War II, when soldiers who had been blinded in battle were sent to recuperate at Valley Forge Army General Hospital before entering Avon Old Farms Convalescent Hospital, the U.S. Army's former experimental rehabilitation center for blind soldiers in Avon, Connecticut.
In order to better serve the large number of blinded soldiers who required special training and services, the military recruited Richard E. Hoover, an Army sergeant, who was assigned to the center for the treatment of blinded soldiers at Valley Forge Army Hospital in 1944.
During the same year, Russell Williams, who was blinded by enemy action in France, received medical rehabilitation at the Valley Forge Army Hospital, and in 1947, C. Warren Bledsoe joined the Hospital. Both Hoover and Bledsoe had worked previously at the Maryland School for the Blind. These three men made significant contributions to the development of a new profession: Orientation and Mobility.
The blinded soldiers were highly motivated to be successful, and Richard Hoover believed that the traditional strategies taught and used to travel independently were inadequate. In response, he developed a technique for using a cane that is lightweight and longer than support canes. This technique and cane revolutionized independent travel for blind people and are still used today. You can read more about the profession at An Introduction to Orientation and Mobility Skills.
Our Commitment
VisionAware remains deeply committed to providing veterans' information and promoting rehabilitation-related services to all blind and visually impaired veterans and their families. We thank our veterans and active-duty personnel for your extraordinary service to our country, and support you in your quest to be as independent as possible after vision loss.
Additional Information
Ten New Tips for Braille Users of iDevices: Scott Davert, AppleVis Editorial TeamPosted on 11/9/2015 at 9:03 AM
by Maureen Duffy
Guest blogger Scott Davert, M.A., VRT, is an AppleVis Editorial Team Member and the Coordinator of the New York Deaf-Blind Equipment Distribution Program, administered by the Helen Keller National Center for Deaf-Blind Youths and Adults. The Program provides no-cost communication and technology training to persons with significant combined vision and hearing loss who meet federal income guidelines. Equipment can include smartphones, tablets, computers, screen readers, braille readers, and adaptive software.
Last month, Scott reviewed Apple's new iOS 9 release, with an emphasis on accessibility features for users who are blind and deaf-blind. In this week's review, Scott updates his previous "Top Ten Braille Tips" list and provides 10 all-new helpful tips for braille users of the iPod, iPhone, and iPad, based upon his personal experience and his work with individuals who are deaf-blind and use braille with their iDevices.
According to Scott, "As a power user of braille devices on iOS, it's very liberating to me, as a deaf-blind person, to be able to take full advantage of the technology we have in our society today. Just a decade ago, my access to resources was much more limited if braille was my only means of accessing the world. Today, with the help of technology, I can be just as well-informed about what's going on around me as my sighted and hearing counterparts."
1. Unlock the First Tip
On iOS 9, when you press the Home button and are on the Lock Screen, you can use Touch ID to unlock your device. However, if you happen to be using a finger that doesn't work with Touch ID, or if you have a device that doesn't feature Touch ID, you may be looking for a faster way to unlock it. Here's a tip: Once the braille display has connected, press Space with dots 2-4-6 and you will unlock your iDevice without having to scroll. You will still need to enter your passcode if you have set one up, but this method can save some time when Touch ID is not a convenient or available option.
2. Inputs and Outputs, Oh My!
The ability to quickly toggle the type of braille you want to read and/or write was introduced in iOS 8. This comes in handy when you do not want to fight with the quirky Apple braille translator, which you can read more about in my iDevice Primer 109: Braille at the AppleVis website. Another reason you might want to toggle a different braille input (i.e., what you type) from braille output (i.e., what you read) is to read contracted braille without necessarily being comfortable writing it just yet.
The three different types of braille you can select are Contracted, Uncontracted Six-Dot, and Eight-Dot. To toggle the input, press Space with dots 2-3-6. VoiceOver and the braille display should report the status of the currently selected setting. To toggle the output, press Space with G (dots 1-2-4-5). You can also change these options by going to Settings > General > Accessibility > VoiceOver > Braille and selecting either input or output and configuring it to your preferences.
3. Speed it Up!
For users running iOS 8 or 9 on older devices, braille input has become a bit less rapid. While there is currently no way to get braille back to iOS 7 levels of responsiveness, you can speed up how quickly the text gets sent from the display through VoiceOver and on to your device.
There are several settings you can change which have proven helpful on some devices. Go to Settings > General > Accessibility > VoiceOver > Typing Feedback. Under the hardware and software keyboard settings, choose "nothing." You should see an increase in the speed of your text as it goes from the braille display to the iDevice; however, the tradeoff is that you will not hear any spoken words or characters. Because I almost never use speech on my iDevices, this doesn't bother me, but it may be helpful information for some users.
The other setting to change if iOS doesn't translate your braille input fast enough is to turn automatic braille translation to "on." On devices running iOS 8 and later, this is set to "off" by default. Once you've upgraded from iOS 7, it's worth verifying that it is set the way you want it, since it was disabled on many devices when they were upgraded.
Find it by going to Settings > General > Accessibility > VoiceOver > Braille > Braille Display Input. Under the options for input, you will find the option to turn on automatic braille translation. This will help users who are confident braille inputters/typers, but it will introduce some quirkiness if you are using contracted braille. You can read more about this feature in my iDevice Primer 109: Braille.
4. Here and Gone in a Flash
Many users like (but some definitely do not like!) alerts flashing on their braille displays. Some of the more common announcements are VoiceOver hints, which usually don't apply to users who only use a braille keyboard on their braille displays. However, some information can be very useful, such as recognizing a bill in LookTel Money Reader or seeing possible moves in Dice World.
You can configure the duration of these alerts in iOS 9 by going to Settings > General > Accessibility > Braille > Braille Display Alert Duration. Enter the duration time in the text field provided, or press Space with dot 4 to activate either a Decrement or Increment button. Although you cannot turn these alerts off altogether, entering "0" will set it to the smallest duration, which is 0.5 seconds, while the longest duration is 20 seconds. You can also review a list of recent announcements by pressing Space with N. You can read more about this option in my previous "Top Ten Braille Tips" list.
5. So Many Choices, So Many Items
Sometimes it's quicker to jump right to something with just a few direct keystrokes when you're in an app. In many (but not all) apps, any item that can be activated by VoiceOver can be put into a list. This is called the Item Chooser. Pressing Space with I (dots 2-4) will present you with a list of available items.
Before you get to that list, however, you will find a search box in which you can type what you are looking for. Then press Space with dot 4 until you find it. Pressing a cursor routing button or Space with dots 3-6 will take you directly to that item. You can then press either a cursor routing button or Space with dots 3-6 again to activate the item currently in focus.
6. Making the Web a Bit More Manageable
The Item Chooser is a great way to locate items quickly on an app. However, if a certain string of text is what you're looking for, the Item Chooser isn't going to help. If you want to find text – on a web page, for example – press Space with F (dots 1-2-4), enter the text, and then press Space with dot 8. VoiceOver should jump directly to the first occurrence of that string of text on a web page. Interestingly, in apps this often appears to function like the search box on the Item Chooser, but in Safari, for example, the "Find" function works quite well.
7. Now Hold It Right There
With some applications, such as Twitterific 5 for Twitter, a way to launch a quick menu for options to work with tweets is to double-tap with one finger and then hold. However, you can also access this function by pressing Space with dots 3-6-7-8. You can also use this command to delete apps from your Home Screen. It will not, however, enable you to move apps around various screens like you can with touchscreen gestures or their Bluetooth keyboard equivalents.
8. Start and Stop at Will
Another useful keyboard command rolled out with iOS 9 is Space with dots 1-5-6. This is sometimes referred to as the "Magic Tap" gesture: the equivalent of double-tapping with two fingers on the touchscreen, or pressing VO with – on a Bluetooth keyboard. You can now answer and hang up calls, start or stop dictation, interact more easily with stories on Facebook, and pretty much whatever else double-tap with two fingers can achieve on iOS.
It's worth noting that sometimes dictation doesn't work in text fields. I believe this is some kind of bug related to whether the onscreen keyboard is visible or not. If you try Space with 1-5-6 and dictation doesn't start, try pressing Space with dots 1-4-6 to unhide the onscreen, or as Apple calls it, the Virtual Keyboard. It's a good idea to toggle it back off when you're done, since the onscreen keyboard can sometimes get in the way of reading text you've typed.
9. Containers Aren't Just for Storing Stuff
Containers are another way app developers can assist VoiceOver users to navigate quickly between different sections of their apps. In the Mail app, for example, the screen is divided into containers which allow you to jump from the header information, to the body of the message, and to the actions you can take on the open message at the bottom of the screen.
While Containers is a Rotor option, it could take a while to get them set on your rotor, thus losing the time you may save by using the actual function. And while there is not a gesture to jump by container, there are a series of braille keyboard commands that will help braille display users take advantage of this feature. To move to the previous Container, press Space with dots 1-7. To move to the next Container, press Space with dots 4-7. Remember that dot 7 is typically to the left of dot 3.
10. Send it Off Quickly!
Many people love to text on their iDevices; in fact, some prefer texting to talking. So when anyone comes up with a faster way to use the Messages app, I think that's rather awesome, and Apple has done just that with iOS 9.
To activate the "Send" button after typing a message, you can press Space with dot 8 and then activate the "Send" button, or just press Space with dot 8 after you complete the text of your message. Also note that Space with E (dots 1-5) will do the same thing. It's too bad this article wasn't a text – I could just do that now and send it immediately. It would be a long text to read, but that's a problem for the recipient, not me!
My Conclusion
Apple continues to lead the way in terms of native braille support for its products, and it's quite impressive when compared to any of the other mainstream devices on the market. Hopefully, armed with these new tips, you will enjoy your braille device and iDevice working together even more. Do you have a handy tip that's not listed here? If so, feel free to leave it in the comments below.
Veterans Day: A Perfect Time to Review Your Benefits for Eye Health and Rehabilitation ServicesPosted on 11/3/2015 at 5:39 AM
by Priscilla Rogers
With Veterans Day on the horizon, we thought it would be timely to highlight the vision rehabilitation services that are available through the Veterans Administration. You may be interested in some profiles of veterans who have received services. We will be adding more as we honor veterans during this month.
Also later this week, the Association for Education and Rehabilitation of the Blind and Visually Impaired is holding a Conference on Vision Loss in Older Adults and Veterans in Norfolk, Virginia. It's not too late to come! More details are available at the conference website.
The Veterans Administration has shared several resources with VisionAware including a Continuum of Care Fact Sheet that lays out the services the VA offers for Veterans and service members (such as those returning from Iraq and Afghanistan) who are blind or visually impaired as follows:
Overview of Blind Rehabilitation Services
In FY 2009, the VA became the first national health care system to integrate rehabilitation services for patients with visual impairment seamlessly and completely into its health benefits, providing rehabilitation care to Veterans and Service members with visual impairments ranging from mild visual impairment to total blindness.
The Blind Rehabilitation Service (BRS) continuum of care ensures early intervention for patients whose vision loss results from progressive diseases like age- related macular degeneration, diabetic retinopathy, and glaucoma, as well as those Veterans and Service members whose vision loss results from the wounds and trauma of war.
BRS Care System
VIST Coordinator
BRS is a tiered system of care with severely disabled blind Veterans receiving life-long case management services by Visual Impairment Service Team (VIST) Coordinators. The VIST coordinator is often the first contact and serves as a "gateway" to VA benefits for Veterans and servicemembers with vision issues. Almost 50,000 Veterans receive life-long casemanagement services.
Blind Rehabilitation Outpatient Specialist (BROS)
BROS are professionals skilled in an array of rehabilitation such as daily living training and orientation and mobility training. They offer services in the home, at the VA, or other appropriate sites.
Inpatient Blind Rehabilitation Centers
Through these centers, individuals receive comprehensive rehabilitation from an interdisciplinary team.
Visual Impairment Services Outpatient Rehabilitation Program (VISOR)
These are multi-day outpatient rehabilitation services for local Veterans and servicemembers. Blindness and low vision rehabilitation services are provided.
Low Vision Clinics
These clinics are staffed with optometrists, ophthalmologists, and BROS. Patients receive low vision exams and assistive technology and rehabilitation assessment and training such as visual motor and orientation and mobility as needed.
Eligibility for Health Services
A veteran may qualify if he/she served in active military service and was discharged under any condition other than dishonorable. There are minimum duty requirements and enhanced eligibility criteria.
Applying for Health Benefits
Veterans must be enrolled in VA Health Benefits to get BRS services. Applications are available online or Veterans can go to their local VA health care facility. For help filling in the form, call 1-877-222-VETS (8387) Monday through Friday a.m to 8 p.m. eastern standard time.
After application, the next step would be assigned to a VHA medical team, and getting a vision exam. The Veteran should request rehabilitation as a part of his/her vision care.
Does One's Vision Loss Have to Be Service Connected to Obtain VA Services?
According to the Office of Public Affairs Benefits Manual, Veterans receiving VA care for any condition may receive VA prosthetic appliances, equipment and services, such as home respiratory therapy, artificial limbs, orthopedic braces and therapeutic shoes, wheelchairs, powered mobility, crutches, canes, walkers, special aids, appliances, optical and electronic devices for visual impairment and other durable medical equipment and supplies. Veterans who are approved for a guide or service dog may also receive service dog benefits including veterinary care and equipment. VA medical services include diagnostic audiology and diagnostic and preventive eye care services.
Needed services should be discussed with the VIST coordinator.
In addition to this information, Gale Watson, M.Ed., CLVT, National Director of the Blind Rehabilitation Service for the Department of Veterans Affairs (VA) has written an article for VisionAware on "Re-Dedicating Ourselves to Veterans."
Veterans Administration Resources
Veterans Crisis Line: 1-800-273-8255
VisionAware Resources
Information for Veterans Coping with Vision Loss
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Recent Posts
- New Survey: Less than Half of United States Adults with Diabetes Understand Their Risk for Vision Loss
- New Research: Lucentis Is Effective in Treating Proliferative Diabetic Retinopathy and More Effective than Traditional Laser Treatment
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Published by Touchstone on 2014-07-29
Genres: Contemporary Women, Family Life, Fiction, General
Pages: 368
Format: eARC
Source: Touchstone
Add to Goodreads
Buy the Book at Amazon • Buy the Book at Indiebound •
In this warm and winning first novel, a recently divorced woman rises to the challenge and experiences the exhilaration of independence with the unlikely help of her brother with Asperger's, who she takes in to help pay the rent.
Seven months after her husband leaves her, Lana is still reeling. Being single means she is in charge of every part of her life, and for the first time in nineteen years, she can do things the way she always wanted to do them. But that also leaves her with all the responsibility. With two teenage children—Byron and Abby, who are each dealing with their own struggles—in a house she can barely afford on her solo salary, her new life is a balancing act made even more complicated when her brother Matt moves in.
Matt has Asperger's syndrome, which makes social situations difficult for him and flexibility and change nearly impossible. He only eats certain foods in a certain order and fixates on minor details. When Lana took him in, he was self-medicating with drugs and alcohol to numb his active mind enough to sleep at night. Adding Matt's regimented routine to her already disrupted household seems like the last thing Lana needs, but her brother's unique attention to detail makes him an invaluable addition to the family: he sees things differently.
Complex, smart, and genuinely moving, The Art of Adapting is a feel-good story that celebrates the small moments and small changes that make one big life.
I received this book for free from Touchstone in exchange for an honest review. This does not affect my opinion of the book or the content of my review.
I struggled with THE ART OF ADAPTING because in some ways, I really loved it and in others I found it predictable and a bit boring. In this story by Cassandra Dunn, a newly-separated mother of teenagers has to deal with putting herself back out there, adapting to life without her husband (but still with him in it some, as they are only separated), and watching out for a grown brother who has struggles with Asperger's Syndrome. It seems like it's almost too much for one book to handle, but that's where the beauty of the story came in.
THE ART OF ADAPTING is told from four different viewpoints. Lana, the mother mentioned above, her brother Matt, her daughter Abby, and her son Byron. In reading the synopsis, I figured Abby and Byron to be the secondary characters but what I found instead was that they shone – quite a bit. In fact, I became very quickly attached to Abby and I continuously craved more of her story.
What I was disappointed in was the somewhat limited view we have of Matt. Very little is explained about his lifestyle or how he managed to fall as deeply as he did into a life with Spike (or who Spike even was to him? I first thought a lover but then later wasn't so sure). Instead, Dunn latches on to some Asperger's traits and uses them to tell the story of Matt. The result was that I felt I was reading the story of a diagnosis and not the story of a man. I really struggled with it, and it's hard to put my finger on just what didn't work for me but that's the best that I can explain it.
In spite of its failings, THE ART OF ADAPTING is a read that caught my attention from the first set of narratives. Each character teased me with just enough to keep me turning the pages until I saw them again and before I knew it, I'd come to the end of the book. I will say that the story did drag a bit as well about 250 pages in – I was somewhat surprised to check my pages and saw that I still had over a hundred more to go. Dunn took the story further, involving some characters in it at the last minute and, while it worked, it also led to an ending that was a bit too clean-cut to be realistic.
Still, if you are looking for a good, end-of-the-summer, poolside book, you wouldn't be disappointed in THE ART OF ADAPTING. Just don't go into it expecting a lot from the Asperger's angle and maybe you won't be as disappointed there as I was.
Check out these reviews!
- "Told through the voices of each of the family, the story of how Lana gets her groove back is by turns humorous and touching, and infused with reality, which is a refreshing change for women's fiction." – BrodartVibe


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But while film tie-in games tend to be a bit hit and miss - mostly due to the short development time that goes hand in hand with having to release in sync with a film - we're fairly confident that this one may be something to keep an eye on. Developed by WayForward, the folks behind the amazing Batman: The Brave and the Bold and the newly-announced DuckTales remake, the Smurfs are certainly in good hands on the developer side of things, while the publisher, Ubisoft, managed to rustle up a surprisingly good dancing game to tie-in in with the previous Smurfs film too, packed with songs and clips from the film.
From what we've heard so far, it sounds like the game will mostly follow the storyline of the film, with you roaming round Smurf town before jetting off to the likes of Paris and New York – but you'll also be able to visit arctic tundras and lava jungles not seen on the big screen. There's a total of six worlds to explore and around thirty stages to play though, suggesting that it might be a bit more substantial than your average tie-in.
The Smurfs 2 also promises four player co-operative along the lines of the New Super Mario Bros. games – and if you happen to pick up the Wii U version, this rises to five players, with the final player controlling Clockwork Smurf on the GamePad's Touch Screen. Over the course of your adventure, you'll unlock nine different Smurfy characters, each of which comes with their own special abilities – Papa Smurf can stun enemies with magic potions, while Grouchy Smurf can stomp on anyone that gets in his way, and Vanity Smurf can strike a pose, working as a platform to help you reach hard to reach spots.
The Smurfs 2 is set to hit the Wii, Wii U, Playstation 3 and Xbox 360 on the 19th of July, while an interactive storybook packed with mini-games launches for the DS. Check out the first Smurf-tastic trailer below:


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Original clothing for babies & children 0-8 years, birth gifts, baby bags / changing bags, childcare & much more...
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Coming straight from the Netherlands, Baby's Only is a luxury childcare brand which puts forward quality and comfort for babies and children.
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|Restaurant Name up
|Rating up
2555 Tamiami Trl N,
Naples, FL
13 reviews
2122 2nd St,
Fort Myers, FL
21200 State Road 80,
Alva, FL
3853 Cleveland Ave,
Fort Myers, FL
12995 S. Cleveland Avenue,
Fort Myers, FL
280 Vanderbilt Beach Rd,
Naples, FL
6 reviews
6900 Daniels Pkwy # 37,
Fort Myers, FL
1129 Homestead Rd N,
Lehigh Acres, FL
707 Tarpon Bay Rd,
Sanibel, FL
2132 Tamiami Trl N,
Naples, FL
799 Walkerbilt Rd,
Naples, FL
4820 S Cleveland Ave,
Fort Myers, FL
12th Ave S # 840B,
Naples, FL
1390 9th St N,
Naples, FL
4947 Tamiami Trl N,
Naples, FL
Hilton Naples and Towers N. Tamiami.tr.,
Naples, FL
16250 North Cleveland Ave,
Fort Myers, FL
@ Tween Waters Inn Resort Captiva Road,
Captiva, FL
Cor. of Mcgregor & Cypress Lake Drive,
Fort Myers, FL
"collier Blvd & Us 41 E.",
Naples, FL
|Marco Polo's Restaurant
Sigmund - This was a horrible meal and the staff was rude and had a lot of attitude on top of that! The meal took 3 hours!!! and we were not the only ones. Some ... more
Sigmund - This was a horrible meal and the staff was rude and had a lot of attitude on top of that! The meal took 3 hours!!! and we were not the only ones. Something MUST have been SERIOUSLY wrong in that kitchen! My mother hosted a wedding celebration for my daughter. There were 12 of us. From the very start the Limo driver was rude and difficult. He said repeatedly to me "are you getting in?" and I replied "do we all fit?" and he said "that's up to you." So I was unsure of what to do, and he was just annoyed and discourteous. Next, we arrived at the restaurant. when we entered we told them there was an additional child with us. She looked at us with complete disdain and told us she didn't know if that would be possible. The table was already set. (Let me say that they were extremely well behaved children who sat quietly and watched a video for 2 1/5 hours while we waited for our meal. I was quite impressed, since I hate to be disturbed by children without manners). Then ... we sat... and sat... FINALLY we got our wine and sat some more. then one roll each, we waited ... and it goes on. I ordered hearts of palm. They were inedible. Like wood. 3 of the meals were brought out a good 5 minutes ahead of the rest. My husband had pork chops that were raw. When he sent them back they had obviously been microwaved, were tough and dry. Honestly we have had better on a road trip from waffle house! The vegetables were uncooked and cold. The baked potato was old dry hard and cold. we didn't eat either of these items. I did not get the correct order, but I took it because I was starving. My niece's entire meal was cold. The waitress was apologetic, and complimentary of the children's behavior, but offered nothing to compensate, as well as seeming out of control of the situation and she mentioned that they were understaffed. We had taken a wedding cake in with us to have for desert, but we opted to take it home and had our Champaign and cake at home instead of waiting another 2 hours for desert plates and new glasses. We left without making any disturbance out of respect to my mother. But, Please. I have grown up in 5 star restaurants all over the world. If you think that this is acceptable you are sadly lacking discrimination. less
|Bianca's Ristorante Italiano
WineAdvisor - The focus of this review of Biancas Ristorante will be less on the food, and more on staffing issues, and what is appropriate conduct for a restaurant ... more
WineAdvisor - The focus of this review of Biancas Ristorante will be less on the food, and more on staffing issues, and what is appropriate conduct for a restaurant's employees. I arrived a Biancas shortly after they opened on a Friday afternoon. I asked the barmaid about wines by the glass. Her response was "we have red and white". I asked if that was all, to which she replied "yes". So, I ordered a draught beer. Then, I asked for a menu. Because I had spent many years in the restaurant and wine businesses, the first thing that I looked for was their wine offerings. In fact, there were 6 to 8 selections available by the glass, including two that were Italian imports - not just a red and a white as I had been told. It should be noted that all of those wines were uninspiring, at best. From the menu, I decided on their antipasto, which is often an excellent gauge of the quality of an Italian restaurant's kitchen. Well, they were "out of stock" - just after opening, and on a Friday night? Really? At about this time, a woman came in a sat down at the bar next to me. Her immediate and prolific conversations with the aforementioned barmaid indicated that she was a "regular". In a relatively short period of time, I got to know a lot more than I ever wanted to about both of them. By the time that my lasagna arrived, the barmaid was persistently posing rather specific questions to the customer about why her 'significant other' was not with her. Because the barmaid was about twice as far away from the customer as my right ear, a futile attempt at whispering resulted in me being on the receiving end of details of the absent spouse's medical condition and treatment. Unable to avoid a rather detailed conversation, which was continually provoked by the barmaid, about the final parts of the human digestive track, and associated ailments, I quickly lost my appetite. Wikipedia is the Internet's foremost dictionary. "A derogatory slang term for an attractive but unintelligent female" defines a "bimbo". Another online dictionary also generally associates that term with blondes. Coincidentally, the origin of the term is Italian. Did I mention that the barmaid was a bleached-blonde? If you think that I am being unfairly judgmental, then be advised that this woman's idol is/was Elizabeth Taylor - not for her later-in-life philanthropy, nor her earlier-in-life career acting skills, but because she had been divorced eight times! Don't think that you might entirely avoid the bad experience that I had at the bar, by sitting elsewhere - allow me to add some notes. In addition to the missing antipasto, there was a salad that was also not available that night (Arugula), meaning that there were no choices in that category. Absent by omission was the world famous Caesar salad, which was invented by an Italian immigrant. The garlic "bread" offered in the menu was far from it: commercial dinner rolls were served brushed or dunked in a greasy liquid that covered their entire exterior, and didn't really taste much like either butter or garlic. They were served with hard-as-a-rock, individually wrapped butter patties. If you don't want to create a legitimate garlic bread loaf, then why not make a compound garlic butter to serve with the rolls, rather than creating an absolutely necessity for extra napkins, and wiping your hands every single time that you picked up the roll? The lasagna was not the worst that I've ever had, but the pasta was thoroughly overcooked, and the texture was, perhaps, more suitable to be eaten with a spoon than a fork. This textural issue was only exacerbated by neighboring conversation. The first thing that I did, after leaving Biancas, was to erase the location from my car's G.P.S. less
|Beefstro's Gourmet Beefs
|Angelina's Ristorante
Lee H. - ANGELINA'S RISTORANTE OF BONITA SPRINGS IS NOT RECOMMENDED! We just dined at this restaurant and were automatically charged 25% gratuity! There was ju ... more
Lee H. - ANGELINA'S RISTORANTE OF BONITA SPRINGS IS NOT RECOMMENDED! We just dined at this restaurant and were automatically charged 25% gratuity! There was just the two of us and our 4 year old! Since when does a restaurant apply 25% gratuity on the bill, automatically??? Well, this place does. Disgusting! We choose the gratuity, not Dan the waiter. I would have left around 18%. That is my choice and I do not accept the waiter making such a decision for me. This is not a fine dining establishment, the food is not the greatest and the service is not the best. Overpriced? Yes! There are better places such as the Ritz Carlton and The Capital Grille near by. We would never go back here and we would never recommend this place. Enter at your own risk and be prepared to line the waiter's pocket with plenty of $$$ ! less
|Old Florida Pub
|Backstage Tap & Grill
|The Sea Catch Restaurant
hippiephil - My girlfriend stopped in after spending the day at the beach and found a small, friendly atmosphere. My girlfriend had never heard of whole bellied cl ... more
hippiephil - My girlfriend stopped in after spending the day at the beach and found a small, friendly atmosphere. My girlfriend had never heard of whole bellied clams so we got those and a haddock dinner. The fried clams were even better than I remembered and the haddock was grilled nicely with not too much seasoning. I would definately recommend this place to anyone. The owners were nice and the prices were decent for New England seafood. less
|Schnitzel House
|Oasis Restaraunt
|The Veranda Restaraunt
|View More | View on Map
|The Sandy Butler
|Fort Myers, FL
|Maria's Pizza and Pasta
|Lehigh Acres, FL
|Fort Myers, FL
|Jimbo's Waterside Restaurant
|Cape Coral, FL
|The Beached Whale
|Fort Myers Beach, FL
|Crazy Fish
|Cape Coral, FL
|Alvino's Pizzeria & Family Resta
|Naples, FL


text:
Click on a thumbnail to go to Google Books.
Mexico (original 1992; edition 1994)
by James A. Michener
Work details
Mexico by James A. Michener (1992)
No current Talk conversations about this book.
Michener's genre of sweeping historical novels has long been a favorite collection for me given the intertwinings of history with sometimes a good story. Enjoyed this but not as much as some of his other efforts, perhaps because he didn't spend as much time as I would have liked on other periods of history than those he examined here. Might have been better if he'd focused on the bullfighting stories but that might have been too much like Hemingway - and a focus on the other stories of Mexico might have been too much like a history text book
This is about generations of the Clay/Palafox family extending back to the Altomec indians and beyond.
The nucleus of the story revolves around bullfighting, and I learned more about bullfighting than I ever wanted to know, but the descriptiveness of the author drew me in, and I was captivated by the history; especially the ancient history.
$1 today at a Lifeline store.
I loved this. Another of my favorite Michener books. As usual, rich characterization and plotting mix with history and historical figures. Certainly a good look at upper class Mexican life and culture. Helpful to me in understanding Mexico better and a very worthwhile read.
I would call this one a historical epic! This is my first Michener epic, and I am sure I will read others. This novel was very long, but still a great story with great characters. Seems to me you need to have a decent amount of patience and time to devote to a book like this. It is centered on Mexico, specifically, the narrator's family history from ancient times to present. It shows a grand view of Mexico and its people and gives you many sides to the story of this very intriguing place. The narrator, Norman Clay, comes from a Mexican family with very important ancestry. Indeed this story could not be told from an average person's viewpoint. Norman's family line goes all the way back to important Indians who lived and worked to build the giant pyramid and on the other side, the Spanish settlers who came to bring Christianity and to see what they could take. Norman is an important journalist, back in Mexico after many years away to cover an important bullfight, mano y mano—two matadors (one Spanish, one Indian) who are going to fight it out. Mexico is an amazing history of bullfighting, a well constructed novel with subplots that are all tied together. An epic, definitely a learning experience.
References to this work on external resources.
Wikipedia in English (1)
Amazon.com Product Description (ISBN 0449221873, Mass Market Paperback)"Astounding...Fast-moving, Intriguing...James Michener is back in huge, familiar form with MEXICO."
Here is the story of an American journalist who travels to Mexico to report on the upcoming duel between two great matadors, but who is ultimately swept up in the dramatic story of his Mexican ancestors. From the brutality and brilliance of the ancients, to the iron fist of the invading Spaniards, to the modern-day Mexicans battling through dust and bloodshed to build a nation upon the ashes of revolution, James Michener weaves it all into an epic human story that ranks with the best of his beloved, bestselling novels.
(retrieved from Amazon Thu, 12 Mar 2015 18:25:46 -0400)
Norman Claysan, an American, arrives in Mexico to report on two matadors and to learn more about his family's past.
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November 1, 2012
A group of people file into the doors of the Flint River Resource Center to vote Thursday afternoon. Voters have until 5 p.m. today to vote early before all precincts across Georgia open at 7 a.m. Tuesday.
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Early voting ends today
More than 13,000 people have already cast ballots in Dougherty County.
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Lars Jannick Johansen
Chief Executive Officer
The Social Capital Fund
MA in Political Science, University of Copenhagen; MA (Hons) in Central and East European Studies, UCL. Formerly: Director, Monday Morning; Development Director, INDEX: Founder and CEO, Den Sociale Kapitalfond, Det Sociale Vækstprogram and Social StartUp - the first Danish social venture fund and accelerator for social enterprises and entrepreneurs, respectively. Member of the Board: Den Sociale Kapitalfond; Specialisterne; Telehandelshuset.


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Lost Battalion of the Revolutionary War, PA., National Genealogical Society Quarterly, Vol XVI, No. 3, p 44-51
This site powered by The Next Generation of Genealogy Sitebuilding ©, v. 10.0.3, written by Darrin Lythgoe 2001-2015.
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The Roots are set to both play their own set at Boston Calling and they will
collaborate with Nas. Girl Talk, The War On Drugs, White Denim
and Lake Street Dive are among the other acts on the bill, which was co-curated by
Aaron Dessner of The National.
Early-bird tickets go on sale tomorrow at 10 a.m. ET via the event's website.
Here's a look at the Boston Calling September lineup:
The National, Lorde, The Replacements, Nas x The Roots, Neutral Milk Hotel, Childish
Gambino, Spoon, Girl Talk, The 1975, Volcano Choir, Twenty One Pilots, The War On Drugs,
Hold Steady, Lake Street Dive, Bleachers, White Denim, Future Islands, Sky Ferriera, San
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'Tron: Legacy' team mount a 'Black Hole' remake
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Re: 'Tron: Legacy' team mount a 'Black Hole' remake
I'd say, that if Tron Legacy ends up being any good, it will foster any hope of a Black Hole remake being any good. Ironically enough I ordered Tron Special Edition along with Black Hole recently.
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2005 Ford F-350 • 56,000 miles
I have a 05 f350 v10. When it 45 degrees or colder trucks turns off when I start it and press the brake. Truck runs great when its its warm.I had givin me a po191.I cleaned trottle body, mas airflow sensor. Replaced fuel pump. And fuel pump moduel. Very frusterated please help.
February 7, 2013.
February 7, 2013.
Check out the related content below while we wait for the question to be answered by a professional mechanic.
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The Broncos will reportedly let WR Eric Decker test the free agent market before trying to sign him. Will the Redskins take a serious look?
Regardless of his performance on the big stage, Decker will still command substantial interest in the free agent market after catching 87 passes for 1,288 yards. And it appears that the Broncos will let him test the market. Could the Redskins be one of the teams in competition for his services?


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AGRILIFE: Tenacious bedbugs tough to get rid of
DALLAS — The old children's bedtime rhyme "good night, sleep tight, don't let the bedbugs bite" is unfortunately relevant once more as bedbugs are again among us, said a Texas A&M AgriLife Extension Service expert.
Mike Merchant, an AgriLife Extension urban entomologist at Dallas, said bedbugs have become increasingly common because of stepped-up immigration, international travel and the loss of effective insecticides. He said this combination of factors has helped bedbugs spread faster than any other urban insect pest in recent times.
To help the public cope with the annoying onslaught, Merchant and Wizzie Brown, AgriLife Extension integrated pest management specialist for Travis County, have released Extension publication Ento-033: "How to Select a Bed Bug Control Provider."
The publication can be found at https://agrilifebookstore.org/publications_details.cfm?whichpublication=3206.
"The publication offers practical advice on how to seek professional help in dealing with these tenacious pests," Merchant said. "When it comes to bedbug control, not just any pest control company will do. We describe in this publication how best to interview a company and compare the different firms to ensure you are getting the best service for your particular situation."
The seven-page publication explains the control approaches available, helping clients know what to ask a prospective exterminator. Approaches range from the unusual — including heat treatments, steam, solar heating of bagged items, spot freezing and bedpost barriers — to the more common pest controls such as sprays, dusts and fumigation.
The publication also includes information on preparing for treatment, warranties, follow-up visits and costs associated with control.
"We've even provided tips for handling personal items such as clothes, books and electronics that can't be treated," he said. "There's also a special section for apartment managers and a handy interview page to help you compare the different companies."
In the publication, Merchant and Brown note that the small, bloodsucking insects can be tough to eliminate because home remedies and consumer-strength pesticides are largely ineffective.
"We hope you never need this publication," Merchant said. "But if you ever do, it will provide you the best information quickly so you can get a good night's sleep again."
For more information on urban pest-related topics, visit citybugs.tamu.edu.
For more bedbug information, visit citybugs.tamu.edu/factsheets/biting-stinging/bed-bugs.
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Need Help? Call us at 1-877-304-7763.
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Archive for Wednesday, March 12, 2008
Bradley Joseph Roberts
March 12, 2008
Funeral Mass for Brad Roberts, 53, of Las Vegas, were Friday, March 7, at Holy Angels Catholic Church in Basehor. Private burial of cremains is to be at a later date.
Mr. Roberts died Saturday, March 1, 2008, at his sister's home in Basehor.
He was born Jan. 8, 1955, in Topeka.
Mr. Roberts was a 1973 graduate of St. Joseph High School in Shawnee and had attended Kansas State University.
Survivors include his parents, Don and Eleanor Roberts, Topeka; three sisters, Karen Horn, Basehor, Kathy Van Dyke, Tonganoxie, and Mary Abernathy, McLouth; and a brother, Jeff Roberts, Las Vegas.
The family suggests memorials to the Kansas City Hospice & Palliative Care, 10100 W. 87th St., Suite 100, Overland Park, KS 66212.
Arrangements: Alden-Harrington Funeral Home, Bonner Springs.
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Gauri Khan
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Panopto Lecture Capture
For access to content available only to the St. Catherine University community please log in using your Kateway portal login.
Panopto Lecture Capture
Panopto is the lecture capture system currently supported at SCU. This versatile system allows recording of any combination of:
- Video (can have more than one video source in special circumstances)
- Voice
- Desktop screen (e.g., web tours; software demos)
In addition, existing video files, or files saved out of the older Podcast Producer system can be uploaded.
Instructors are given a "work" folder to hold practice recordings and materials you are still working on. As an instructor, you have control over the recordings you make and are able to move them in and out of your work folder and all of your course folders. Students are also able to create recordings on MAC or PC with the easy to install Panopto recorder. Instructors are also able to create sub-folders within any course folder they control to accomodate:
- Recordings that all class members should view.
- Small group work where only members of a small group should view the recordings.
- Assignment recordings to be submitted by students, where students should view only their own submission.
Room Recording
A very limited number of rooms currently have recording equipment on campus, but that number will be increased each year.
- St. Paul: Jeanne d'Arc: Audio + Slides or Screen Capture
- Mpls: Education 6th fl. Auditorium: Audio + Slides or Screen Capture
Laptop Recording
The Panopto recorder can be downloaded to allow recording from your office or home via the built-in webcam in your laptop, or the use of an external webcam. **It's essential that you work with an Academic Technology Team member to install the recorder along with the necessary settings for successful recording.
Get Panopto Training
Call or email Joe Lipari (x6006)(firstname.lastname@example.com) or Janet Winsand (x7710) (email@example.com) to set up a training session and begin using this exciting tool!


text: ...just use the phone on your camera for lighting reference and learn how to meter better and you won't have to spend a dime. If you can see how the light reacts with your subject from a shot on your phone (I'm assuming you have a phone that takes photos), then pull out the meter and take the appropriate readings based on what your preference is. This is assuming that you have pretty good visualizing skills and you are a little beyond the basics of metering.