text:
出典: meddic
WordNet [license wordnet]「an acute contagious disease caused by herpes varicella zoster virus; causes a rash of vesicles on the face and body」
PrepTutorEJDIC [license prepejdic]「水ぼうそう,水痘」
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/09/26 18:00:47」(JST)
wiki en[Wiki en表示]
|Classification and external resources
Lower leg of female child with varicella disease
|ped/2385 derm/74, emerg/367
|Patient UK
Chickenpox is a highly contagious disease caused by primary infection with varicella zoster virus (VZV).[1] It usually starts with a vesicular skin rash mainly on the body and head rather than on the limbs. The rash develops into itchy, raw pockmarks, which mostly heal without scarring. On examination, the observer typically finds skin lesions at various stages of healing and also ulcers in the oral cavity and tonsil areas. The disease is most commonly observed in children.
Chickenpox is an airborne disease which spreads easily through coughing or sneezing by ill individuals or through direct contact with secretions from the rash. A person with chickenpox is infectious one to two days before the rash appears.[2] They remain contagious until all lesions have crusted over (this takes approximately six days).[3] Immunocompromised patients are contagious during the entire period as new lesions keep appearing. Crusted lesions are not contagious.[4]
Chickenpox has been observed in other primates, including chimpanzees[5] and gorillas.[6]
The origin of the term chicken pox, which is recorded as being used since 1684,[7] is not reliably known. It has been said to be a derived from chickpeas, based on resemblance of the vesicles to chickpeas,[7][8][9] or to come from the rash resembling chicken pecks.[7][9] Other suggestions include the designation chicken for a child (i.e., literally 'child pox'), a corruption of itching-pox,[8][10] or the idea that the disease may have originated in chickens.[7] Samuel Johnson explained the designation as "from its being of no very great danger."[11]
- 1 Signs and symptoms
- 2 Diagnosis
- 3 Pathophysiology
- 3.1 Pregnancy and neonates
- 3.2 Shingles
- 4 Prevention
- 4.1 Hygiene measures
- 4.2 Vaccine
- 5 Treatment
- 5.1 Children
- 5.2 Adults
- 6 Prognosis
- 7 Epidemiology
- 8 See also
- 9 References
- 10 External links
Signs and symptoms
The early (prodromal) symptoms in adolescents and adults are nausea, loss of appetite, aching muscles, and headache. This is followed by the characteristic rash or oral sores, malaise, and a low-grade fever that signal the presence of the disease. Oral manifestations of the disease (enanthem) not uncommonly may precede the external rash (exanthem). In children the illness is not usually preceded by prodromal symptoms, and the first sign is the rash or the spots in the oral cavity. The rash begins as small red dots on the face, scalp, torso, upper arms and legs; progressing over 10–12 hours to small bumps, blisters and pustules; followed by umbilication and the formation of scabs.[12][13]
At the blister stage, intense itching is usually present. Blisters may also occur on the palms, soles, and genital area. Commonly, visible evidence of the disease develops in the oral cavity & tonsil areas in the form of small ulcers which can be painful or itchy or both; this enanthem (internal rash) can precede the exanthem (external rash) by 1 to 3 days or can be concurrent. These symptoms of chickenpox appear 10 to 21 days after exposure to a contagious person. Adults may have a more widespread rash and longer fever, and they are more likely to experience complications, such as varicella pneumonia.[12]
Because watery nasal discharge containing live virus usually precedes both exanthem (external rash) and enanthem (oral ulcers) by 1 to 2 days, the infected person actually becomes contagious one to two days prior to recognition of the disease. Contagiousness persists until all vesicular lesions have become dry crusts (scabs), which usually entails four or five days, by which time nasal shedding of live virus also ceases.
Chickenpox is rarely fatal, although it is generally more severe in adult men than in women or children. Non-immune pregnant women and those with a suppressed immune system are at highest risk of serious complications. Arterial ischemic stroke (AIS) associated with chickenpox in the previous year accounts for nearly one third of childhood AIS.[14] The most common late complication of chickenpox is shingles (herpes zoster), caused by reactivation of the varicella zoster virus decades after the initial, often childhood, chickenpox infection.
The diagnosis of varicella is primarily clinical, with typical early "prodromal" symptoms, and then the characteristic rash and oral-cavity sores. Confirmation of the diagnosis can be sought through either examination of the fluid within the vesicles of the rash, or by testing blood for evidence of an acute immunologic response.
Vesicular fluid can be examined with a Tzanck smear, or better by testing for direct fluorescent antibody. The fluid can also be "cultured", whereby attempts are made to grow the virus from a fluid sample. Blood tests can be used to identify a response to acute infection (IgM) or previous infection and subsequent immunity (IgG).[15]
Prenatal diagnosis of fetal varicella infection can be performed using ultrasound, though a delay of 5 weeks following primary maternal infection is advised. A PCR (DNA) test of the mother's amniotic fluid can also be performed, though the risk of spontaneous abortion due to the amniocentesis procedure is higher than the risk of the baby developing fetal varicella syndrome.[16]
Exposure to VZV in a healthy child initiates the production of host immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) antibodies; IgG antibodies persist for life and confer immunity. Cell-mediated immune responses are also important in limiting the scope and the duration of primary varicella infection. After primary infection, VZV is hypothesized to spread from mucosal and epidermal lesions to local sensory nerves. VZV then remains latent in the dorsal ganglion cells of the sensory nerves. Reactivation of VZV results in the clinically distinct syndrome of herpes zoster (i.e., shingles), postherpetic neuralgia,[17] and sometimes Ramsay Hunt syndrome type II.[18] Varicella zoster can affect the arteries in the neck and head, producing stroke, either during childhood, or after a latency period of many years.[19]
Pregnancy and neonates
During pregnancy the dangers to the fetus associated with a primary VZV infection are greater in the first six months. In the third trimester, the mother is more likely to suffer from the adverse effects of the infection.[20] For pregnant women, antibodies produced as a result of immunization or previous infection are transferred via the placenta to the fetus.[21] Women who are immune to chickenpox cannot become infected and do not need to be concerned about it for themselves or their infant during pregnancy.[22]
Varicella infection in pregnant women could lead to viral transmission via the placenta and infection of the fetus. If infection occurs during the first 28 weeks of gestation, this can lead to fetal varicella syndrome (also known as congenital varicella syndrome).[23] Effects on the fetus can range in severity from underdeveloped toes and fingers to severe anal and bladder malformation. Possible problems include:
- Damage to brain: encephalitis,[24] microcephaly, hydrocephaly,[25] aplasia of brain
- Damage to the eye: optic stalk, optic cup, and lens vesicles, microphthalmia, cataracts, chorioretinitis, optic atrophy
- Other neurological disorder: damage to cervical and lumbosacral spinal cord, motor/sensory deficits, absent deep tendon reflexes, anisocoria/Horner's syndrome
- Damage to body: hypoplasia of upper/lower extremities, anal and bladder sphincter dysfunction
- Skin disorders: (cicatricial) skin lesions, hypopigmentation
Infection late in gestation or immediately following birth is referred to as "neonatal varicella".[26] Maternal infection is associated with premature delivery. The risk of the baby developing the disease is greatest following exposure to infection in the period 7 days prior to delivery and up to 7 days following the birth. The baby may also be exposed to the virus via infectious siblings or other contacts, but this is of less concern if the mother is immune. Newborns who develop symptoms are at a high risk of pneumonia and other serious complications of the disease.[16]
After a chickenpox infection, the virus remains dormant in the body's nerve tissues. The immune system keeps the virus at bay, but later in life, usually as an adult, it can be reactivated and cause a different form of the viral infection called shingles (scientifically known as herpes zoster).[27] The United States Advisory Committee on Immunization Practices (ACIP) suggests that any adult over the age of 60 years gets the herpes zoster vaccine as a part of their normal medical check ups.
Many adults who have had chickenpox as children are susceptible to shingles as adults, often with the accompanying condition postherpetic neuralgia, a painful condition that makes it difficult to sleep. Even after the shingles rash has gone away, there can be night pain in the area affected by the rash.[28]
Shingles affects one in five adults infected with chickenpox as children, especially those who are immune suppressed, particularly from cancer, HIV, or other conditions. However, stress can bring on shingles as well, although scientists are still researching the connection.[29]
Shingles are most commonly found in adults over the age of 60 who were diagnosed with chickenpox when they were under the age of 1.[30]
A shingles vaccine is available for adults over 50 who have had childhood chickenpox or who have previously had shingles.[31]
Hygiene measures
The spread of chickenpox can be prevented by isolating affected individuals. Contagion is by exposure to respiratory droplets, or direct contact with lesions, within a period lasting from three days prior to the onset of the rash, to four days after the onset of the rash.[32] The chickenpox virus is susceptible to disinfectants, notably chlorine bleach (i.e., sodium hypochlorite). Also, like all enveloped viruses, it is sensitive to desiccation, heat and detergents.
A varicella vaccine was first developed by Michiaki Takahashi in 1974 derived from the Oka strain. It has been available in the US since 1995 to inoculate against the disease. Some countries require the varicella vaccination or an exemption before entering elementary school. Protection from one dose is not lifelong and a second dose is necessary five years after the initial immunization,[33] which is currently part of the routine immunization schedule in the US.[34] The chickenpox vaccine is not part of the routine childhood vaccination schedule in the UK. In the UK, the vaccine is currently only offered to people who are particularly vulnerable to chickenpox. A vaccinated person is likely to have a milder case of chickenpox if infected.[35]
Treatment mainly consists of easing the symptoms as there is no actual cure of the condition. Some treatments are however available for relieving the symptoms while the immune system suppresses the virus in the body. As a protective measure, patients are usually required to stay at home while they are infectious to avoid spreading the disease to others. Also, sufferers are frequently asked to cut their nails short or to wear gloves to prevent scratching and to minimize the risk of secondary infections.
The condition resolves by itself within a couple of weeks but meanwhile patients must pay attention to their personal hygiene.[36] The rash caused by varicella zoster virus may however last for up to one month, although the infectious stage does not take longer than a week or two.[37]
Although there have been no formal clinical studies evaluating the effectiveness of topical application of calamine lotion, a topical barrier preparation containing zinc oxide and one of the most commonly used interventions, it has an excellent safety profile.[38] It is important to maintain good hygiene and daily cleaning of skin with warm water to avoid secondary bacterial infection.[39] Scratching may also increase the risk of secondary infection.[40]
Acetaminophen (paracetamol) but not aspirin may be used to reduce fever. Aspirin use by someone with chickenpox may cause the serious, sometimes fatal disease of the liver and brain, Reye syndrome. People at risk of developing severe complications who have had significant exposure to the virus may be given intra-muscular varicella zoster immune globulin (VZIG), a preparation containing high titres of antibodies to varicella zoster virus, to ward off the disease.[41][42]
Antivirals are sometimes used.[43][44]
If oral acyclovir is started within 24 hours of rash onset it decreases symptoms by one day but has no effect on complication rates.[45][46] Use of acyclovir therefore is not currently recommended for immunocompetent individuals (i.e., otherwise healthy persons without known immunodeficiency or on immunosuppressive medication). Children younger than 12 years old and older than one month are not meant to receive antiviral medication unless they are suffering from another medical condition which would put them at risk of developing complications.[47]
Treatment of chickenpox in children is aimed at symptoms while the immune system deals with the virus. With children younger than 12 years cutting nails and keeping them clean is an important part of treatment as they are more likely to scratch their blisters more deeply than adults.[48]
Aspirin is highly contraindicated in children younger than 16 years as it has been related with a potentially fatal condition known as Reye's syndrome.[49]
Some parents believe that it is better for children to contract chickenpox than to get the vaccine, and they deliberately expose their children to the virus, sometimes by taking them to "chickenpox parties." Some doctors counter that children are safer getting the vaccine, which is a weakened form of the virus, than getting the disease, which can be fatal.[50]
Infection in otherwise healthy adults tends to be more severe.[51] Treatment with antiviral drugs (e.g. acyclovir or valacyclovir) is generally advised, as long as it is started within 24–48 hours from rash onset.[47] Remedies to ease the symptoms of chickenpox in adults are basically the same as those used on children. Adults are more often prescribed antiviral medication as it is effective in reducing the severity of the condition and the likelihood of developing complications. Antiviral medicines do not kill the virus, but stop it from multiplying. Adults are also advised to increase water intake to reduce dehydration and to relieve headaches. Painkillers such as paracetamol (acetaminophen) are also recommended as they are effective in relieving itching and other symptoms such as fever or pains. Antihistamines relieve itches and may be used in cases where the itches prevents sleep, because they are also sedative. As with children, antiviral medication is considered more useful for those adults who are more prone to develop complications. These include pregnant women or people who have a weakened immune system.[52]
Sorivudine, a nucleoside analogue has been reported to be effective in the treatment of primary varicella in healthy adults (case reports only), but large-scale clinical trials are still needed to demonstrate its efficacy.[53]
After recovering from chickenpox, it is recommended by doctors that adults take one injection of VZV immune globulin and one injection of varicella vaccine or herpes zoster vaccine.[citation needed]
The duration of the visible blistering caused by varicella zoster virus varies in children usually from 4 to 7 days, and the appearance of new blisters begins to subside after the 5th day. Chickenpox infection is milder in young children, and symptomatic treatment, with sodium bicarbonate baths or antihistamine medication may ease itching, it is recommended to keep new infants from birth up to age 6 months away from an infected person for 10 to 21 days as their immune systems are not developed enough to handle the stress it can bring on.[54] Paracetamol (acetaminophen) is widely used to reduce fever. Aspirin, or products containing aspirin, should not be given to children with chickenpox as it can cause Reye's Syndrome.[55]
In adults, the disease is more severe,[56] though the incidence is much less common. Infection in adults is associated with greater morbidity and mortality due to pneumonia (either direct viral pneumonia or secondary bacterial pneumonia),[57] hepatitis,[58] and encephalitis.[59] In particular, up to 10% of pregnant women with chickenpox develop pneumonia, the severity of which increases with onset later in gestation. In England and Wales, 75% of deaths due to chickenpox are in adults.[16] Inflammation of the brain, or encephalitis, can occur in immunocompromised individuals, although the risk is higher with herpes zoster.[60] Necrotizing fasciitis is also a rare complication.[61]
Varicella can be lethal to adults with impaired immunity. The number of people in this high-risk group has increased, due to the HIV epidemic and the increased use of immunosuppressive therapies.[62] Varicella is a particular problem in hospitals, when there are patients with immune systems weakened by drugs (e.g., high-dose steroids) or HIV.[63]
Secondary bacterial infection of skin lesions, manifesting as impetigo, cellulitis, and erysipelas, is the most common complication in healthy children. Disseminated primary varicella infection usually seen in the immunocompromised may have high morbidity. Ninety percent of cases of varicella pneumonia occur in the adult population. Rarer complications of disseminated chickenpox also include myocarditis, hepatitis, and glomerulonephritis.[64]
Hemorrhagic complications are more common in the immunocompromised or immunosuppressed populations, although healthy children and adults have been affected. Five major clinical syndromes have been described: febrile purpura, malignant chickenpox with purpura, postinfectious purpura, purpura fulminans, and anaphylactoid purpura. These syndromes have variable courses, with febrile purpura being the most benign of the syndromes and having an uncomplicated outcome. In contrast, malignant chickenpox with purpura is a grave clinical condition that has a mortality rate of greater than 70%. The cause of these hemorrhagic chickenpox syndromes is not known.[64]
Primary varicella occurs in all countries worldwide. Varicella has a prevalence that is stable from generation to generation.[65] As of 2010 it caused about 6,800 deaths, down from 11,200 in 1990.[66]
In temperate countries, chickenpox is primarily a disease of children, with most cases occurring during the winter and spring, most likely due to school contact. It is one of the classic diseases of childhood, with the highest prevalence in the 4–10 year old age group. Like rubella, it is uncommon in preschool children. Varicella is highly communicable, with an infection rate of 90% in close contacts. In temperate countries, most people become infected before adulthood, and 10% of young adults remain susceptible.
In the tropics, chickenpox often occurs in older people and may cause more serious disease.[67] In adults the pock marks are darker and the scars more prominent than in children.[68]
In the United States, the Centers for Disease Control and Prevention (CDC) does not require state health departments to report infections of chicken pox, and only 31 states currently volunteer this information.[69] However, in a 2013 study conducted by the social media disease surveillance tool called Sickweather, anecdotal reports of chickenpox infections on Facebook and Twitter were used to measure and rank states with the most infections per capita, with Maryland, Tennessee and Illinois in the top 3.[70]
See also
|Medicine portal
|Viruses portal
- Measles
- Smallpox
- ^ Wood MJ (October 2000). "History of Varicella Zoster Virus". Herpes 7 (3): 60–65. PMID 11867004.
- ^ MedlinePlus Encyclopedia Chickenpox
- ^ UHS Tang Center
- ^ Centers for Disease Control and Prevention (2012). "Ch. 21: Varicella". In Atkinson W, Wolfe S, Hamborsky J. Epidemiology and Prevention of Vaccine-Preventable Diseases (12th ed.). Washington DC: Public Health Foundation. pp. 301–323. "The virus has not been isolated from crusted lesions."
- ^ Cohen JI, Moskal T, Shapiro M, Purcell RH (December 1996). "Varicella in Chimpanzees". Journal of Medical Virology 50 (4): 289–92. doi:10.1002/(SICI)1096-9071(199612)50:4<289::AID-JMV2>3.0.CO;2-4. PMID 8950684.
- ^ Myers MG, Kramer LW, Stanberry LR (December 1987). "Varicella in a gorilla". Journal of Medical Virology 23 (4): 317–22. doi:10.1002/jmv.1890230403. PMID 2826674.
- ^ a b c d Chicken-pox is recorded in Oxford English Dictionary 2nd ed. since 1684; the OED records several suggested etymologies
- ^ a b Belshe, Robert B. (1984). Textbook of human virology (2nd ed.). Littleton MA: PSG. p. 829. ISBN 0-88416-458-6.
- ^ a b Teri Shors (2011). "Herpesviruses: Varicella Zoster Virus (VZV)". Understanding Viruses (2nd ed.). Jones & Bartlett. p. 459. ISBN 978-0-7637-8553-6.
- ^ Pattison, John; Zuckerman, Arie J.; Banatvala, J.E. (1994). Principles and practice of clinical virology (3rd ed.). Wiley. p. 37. ISBN 0-471-93106-3.
- ^ Johnson, Samuel (1839). Dictionary of the English language. London: Williamson. p. 195.
- ^ a b Anthony J Papadopoulos. "Chickenpox Clinical Presentation". In Dirk M Elston. Medscape Reference. Retrieved 4 August 2012.
- ^ "Symptoms of Chickenpox". Chickenpox. NHS Choices. Retrieved 14 March 2013.
- ^ Askalan R, Laughlin S, Mayank S, Chan A, MacGregor D, Andrew M, Curtis R, Meaney B, deVeber G (June 2001). "Chickenpox and stroke in childhood: a study of frequency and causation". Stroke 32 (6): 1257–62. doi:10.1161/01.STR.32.6.1257. PMID 11387484.
- ^ Pincus, Matthew R.; McPherson, Richard A.; Henry, John Bernard (2007). "Ch. 54". Henry's clinical diagnosis and management by laboratory methods (21st ed.). Saunders Elsevier. ISBN 1-4160-0287-1.
- ^ a b c Royal College of Obstetricians and Gynaecologists (September 2007). "Chickenpox in Pregnancy" (PDF). Retrieved 22 July 2009.
- ^ Kanbayashi Y, Onishi K, Fukazawa K, Okamoto K, Ueno H, Takagi T, Hosokawa T (2012). "Predictive Factors for Postherpetic Neuralgia Using Ordered Logistic Regression Analysis". The Clinical Journal of Pain 28 (8): 712–714. doi:10.1097/AJP.0b013e318243ee01. PMID 22209800.
- ^ Pino Rivero V, González Palomino A, Pantoja Hernández CG, Mora Santos ME, Trinidad Ramos G, Blasco Huelva A (2006). "Ramsay-Hunt syndrome associated to unilateral recurrential paralysis". Anales otorrinolaringologicos ibero-americanos 33 (5): 489–494. PMID 17091862.
- ^ "The varicella zoster virus vasculopathies: clinical, CSF, imaging, and virologic features.". Neurology. March 2008.
- ^ Heuchan AM, Isaacs D (19 March 2001). "The management of varicella-zoster virus exposure and infection in pregnancy and the newborn period. Australasian Subgroup in Paediatric Infectious Diseases of the Australasian Society for Infectious Diseases.". The Medical journal of Australia 174 (6): 288–92. PMID 11297117.
- ^ Brannon, Heather (22 July 2007). "Chickenpox in Pregnancy". Dermatology. About.com. Retrieved 20 June 2009.
- ^ "Chickenpox in Pregnancy". March of Dimes. April 2014.
- ^ Boussault P, Boralevi F, Labbe L, Sarlangue J, Taïeb A, Leaute-Labreze C (2007). "Chronic varicella-zoster skin infection complicating the congenital varicella syndrome". Pediatr Dermatol 24 (4): 429–32. doi:10.1111/j.1525-1470.2007.00471.x. PMID 17845179.
- ^ Matsuo T, Koyama M, Matsuo N (July 1990). "Acute retinal necrosis as a novel complication of chickenpox in adults". Br J Ophthalmol 74 (7): 443–4. doi:10.1136/bjo.74.7.443. PMC 1042160. PMID 2378860.
- ^ Mazzella M, Arioni C, Bellini C, Allegri AE, Savioli C, Serra G (2003). "Severe hydrocephalus associated with congenital varicella syndrome". CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne 168 (5): 561–563. PMC 149248. PMID 12615748.
- ^ Sauerbrei A, Wutzler P (December 2001). "Neonatal varicella". J Perinatol 21 (8): 545–9. doi:10.1038/sj.jp.7210599. PMID 11774017.
- ^ "Chickenpox". NHS Choices. UK Department of Health. 19 April 2012.
- ^ "Shingles & Chickenpox: What's the Link?". WebMD.
- ^ "An Overview of Shingles". WebMD.
- ^ "Shingles". PubMed Health.
- ^ "Shingles Vaccine". WebMD.
- ^ Murray, Patrick R.; Rosenthal, Ken S.; Pfaller, Michael A. (2005). Medical Microbiology (5th ed.). Elsevier Mosby. p. 551. ISBN 0-323-03303-2. , edition (Elsevier), p..
- ^ Chaves SS, Gargiullo P, Zhang JX, Civen R, Guris D, Mascola L, Seward JF (2007). "Loss of vaccine-induced immunity to varicella over time". N Engl J Med 356 (11): 1121–9. doi:10.1056/NEJMoa064040. PMID 17360990.
- ^ "Child, Adolescent & "Catch-up" Immunization Schedules". Immunization Schedules. Centers for Disease Control and Prevention.
- ^ "Chickenpox (varicella) vaccination". NHS Choices. UK Department of Health. 19 April 2012.
- ^ "Chickenpox (varicella)". Retrieved 6 November 2010.
- ^ "Varicella Zoster Virus". Retrieved 6 November 2010.
- ^ Tebruegge M, Kuruvilla M, Margarson I (2006). "Does the use of calamine or antihistamine provide symptomatic relief from pruritus in children with varicella zoster infection?" (Abstract). Arch. Dis. Child. 91 (12): 1035–6. doi:10.1136/adc.2006.105114. PMC 2082986. PMID 17119083.
- ^ Domino, Frank J. (2007). The 5-Minute Clinical Consult. Lippincott Williams & Wilkins. p. 248. ISBN 978-0-7817-6334-9.
- ^ Brannon, Heather (21 May 2008). Chicken Pox Treatments. About.com.
- ^ Parmet S, Lynm C, Glass RM (February 2004). "JAMA patient page. Chickenpox". JAMA 291 (7): 906. doi:10.1001/jama.291.7.906. PMID 14970070.
- ^ Naus M et al. (15 October 2006). "Varizig™ as the Varicella Zoster Immune Globulin for the Prevention of Varicella In At-Risk Patients". Canada Communicable Disease Report 32 (ACS-8).
- ^ Huff JC (January 1988). "Antiviral treatment in chickenpox and herpes zoster.". Journal of the American Academy of Dermatology 18 (1 Pt 2): 204–6. doi:10.1016/S0190-9622(88)70029-8. PMID 3339143.
- ^ Gnann Jr, John W. (2007). "Chapter 65Antiviral therapy of varicella-zoster virus infections". In Arvin, Ann; et.al. Human herpesviruses : biology, therapy, and immunoprophylaxis. Cambridge: Cambridge University Press. ISBN 978-0-521-82714-0. Retrieved 20 January 2014.
- ^ Kay AB (2001). "Allergy and allergic diseases. First of two parts". The New England Journal of Medicine 344 (1): 30–7. doi:10.1056/NEJM200101043440106. PMID 11136958.
- ^ Kay AB (2001). "Allergy and allergic diseases. Second of two parts". The New England Journal of Medicine 344 (2): 109–13. doi:10.1056/NEJM200101113440206. PMID 11150362.
- ^ a b "Antiviral medications for chickenpox". Retrieved 27 March 2011.
- ^ "Chickenpox in Children Under 12". Retrieved 6 November 2010.
- ^ "Reye's Syndrome-Topic Overview". Retrieved 27 March 2011.
- ^ "Chicken Pox parties do more harm than good, says doctor". KSLA News 12 Shreveport, Louisiana News Weather & Sports.
- ^ Tunbridge AJ, Breuer J, Jeffery KJ (August 2008). "Chickenpox in adults - clinical management". The Journal of Infection 57 (2): 95–102. doi:10.1016/j.jinf.2008.03.004. PMID 18555533.
- ^ "What is chickenpox?". Retrieved 6 November 2010.
- ^ Chickenpox~treatment at eMedicine
- ^ Somekh E, Dalal I, Shohat T, Ginsberg GM, Romano O (2002). "The burden of uncomplicated cases of chickenpox in Israel". J. Infect. 45 (1): 54–7. doi:10.1053/jinf.2002.0977. PMID 12217733.
- ^ US Centers for Disease Control and Prevention. "Varicella Treatment Questions & Answers". CDC Guidelines. CDC. Retrieved 23 August 2007.
- ^ Baren JM, Henneman PL, Lewis RJ (August 1996). "Primary Varicella in Adults: Pneumonia, Pregnancy, and Hospital Admissions". Annals of Emergency Medicine 28 (2): 165–169. doi:10.1016/S0196-0644(96)70057-4. PMID 8759580.
- ^ Mohsen AH, McKendrick M (May 2003). "Varicella pneumonia in adults". Eur. Respir. J. 21 (5): 886–91. doi:10.1183/09031936.03.00103202. PMID 12765439.
- ^ Anderson, D.R.; Schwartz, J.; Hunter, N.J.; Cottrill, C.; Bissaccia, E.; Klainer, A.S. (1994). "Varicella Hepatitis: A Fatal Case in a Previously Healthy, Immunocompetent Adult". Archives of Internal Medicine (JAMA) 154 (18): 2101–2106. doi:10.1001/archinte.1994.00420180111013.
- ^ Abro AH, Ustadi AM, Das K, Abdou AM, Hussaini HS, Chandra FS (December 2009). "Chickenpox: presentation and complications in adults". Journal of Pakistan Medical Association 59 (12): 828–831. PMID 20201174. Retrieved 17 April 2013.
- ^ "Definition of Chickenpox". MedicineNet.com. Retrieved 18 August 2006.
- ^ "Is Necrotizing Fasciitis a complication of Chickenpox of Cutaneous Vasculitis?". atmedstu.com. Retrieved 18 January 2008.
- ^ Strangfeld A, Listing J, Herzer P, Liebhaber A, Rockwitz K, Richter C, Zink A (February 2009). "Risk of herpes zoster in patients with rheumatoid arthritis treated with anti-TNF-alpha agents". JAMA 301 (7): 737–44. doi:10.1001/jama.2009.146. PMID 19224750.
- ^ Weller TH (1997). "Varicella-herpes zoster virus". In Evans AS, Kaslow RA. Viral Infections of Humans: Epidemiology and Control. Plenum Press. pp. 865–92. ISBN 978-0-306-44855-3.
- ^ a b Chicken Pox Complications
- ^ Abendroth A, Arvin AM (February 2001). "Immune evasion as a pathogenic mechanism of varicella zoster virus". Seminars in immunology 13 (1): 27–39. doi:10.1006/smim.2001.0293. PMID 11289797.
- ^ Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, et al. (15 December 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. PMID 23245604.
- ^ Wharton M (1996). "The epidemiology of varicella-zoster virus infections". Infect Dis Clin North Am 10 (3): 571–81. doi:10.1016/S0891-5520(05)70313-5. PMID 8856352.
- ^ "Epidemiology of Varicella Zoster Virus Infection, Epidemiology of VZV Infection, Epidemiology of Chicken Pox, Epidemiology of Shingles". Retrieved 22 April 2008.
- ^ "Georgia ranks 10th for social media admissions of chickenpox". Retrieved 13 June 2013.
- ^ "Chickenpox in the USA". Retrieved 12 June 2013.
External links
|Wikimedia Commons has media related to Chickenpox.
- Chickenpox at DMOZ
- "Chicken pox care map". Map of Medicine. London, UK: Map of Medicine Limited. (registration required)
- "Prevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP)". Centers for Disease Control and Prevention (CDC). 12 July 1996. Retrieved 18 May 2013.
- "Management of Varicella Zoster Virus (VZV) Infections". Federal Bureau of Prisons: Clinical Practice Guideline. December 2011. Retrieved 18 May 2013.
- John W. Gnann Jr. (2007). Chapter 65 Antiviral therapy of varicella-zoster virus infections. PMID 21348091.
- Sarah McSweeney-Ryan; Megan Sandel. "The Health Care of Homeless Persons - Part I - Varicella (Chickenpox". Boston Health Care for the Homeless Program. Retrieved 18 May 2013.
UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
- 1. 水痘帯状疱疹ウイルス感染の臨床的特徴:水痘 clinical features of varicella zoster virus infection chickenpox
- 2. Treatment of varicella (chickenpox) infection
- 3. Vaccination for the prevention of primary varicella infection (chickenpox)
- 4. 妊娠中の水痘帯状疱疹ウイルス感染 varicella zoster virus infection in pregnancy
- 5. 病院における水痘・帯状疱疹ウイルスの予防および管理 prevention and control of varicella zoster virus in hospitals
- The role of temperature in reported chickenpox cases from 2000 to 2011 in Japan.
- Harigane K1, Sumi A2, Mise K3, Kobayashi N2.
- Epidemiology and infection.Epidemiol Infect.2015 Sep;143(12):2666-78. doi: 10.1017/S095026881400363X. Epub 2015 Jan 14.
- Annual periodicities of reported chickenpox cases have been observed in several countries. Of these, Japan has reported a two-peaked, bimodal annual cycle of reported chickenpox cases. This study investigated the possible underlying association of the bimodal cycle observed in the surveillance data
- The ORF61 Protein Encoded by Simian Varicella Virus and Varicella-Zoster Virus Inhibits NF-κB Signaling by Interfering with IκBα Degradation.
- Whitmer T1, Malouli D1, Uebelhoer LS1, DeFilippis VR1, Früh K2, Verweij MC2.
- Journal of virology.J Virol.2015 Sep 1;89(17):8687-700. doi: 10.1128/JVI.01149-15. Epub 2015 Jun 17.
- Varicella-zoster virus (VZV) causes chickenpox upon primary infection and establishes latency in ganglia. Reactivation from latency causes herpes zoster, which may be complicated by postherpetic neuralgia. Innate immunity mediated by interferon and proinflammatory cytokines represents the first line
- Increased large unstained cells value in varicella patients: A valuable parameter to aid rapid diagnosis of varicella infection.
- Shin D1, Lee MS1, Kim do Y1, Lee MG1,2, Kim DS1.
- The Journal of dermatology.J Dermatol.2015 Aug;42(8):795-9. doi: 10.1111/1346-8138.12902. Epub 2015 Apr 28.
- Varicella is a highly contagious infection caused by varicella zoster virus. Sometimes it is difficult to differentiate between other viral infections such as Kaposi's varicelliform eruption (KVE) and disseminated herpes zoster (HZ). The large unstained cells (LUC) value is a differential count para
- Testicular Nocardiosis Accompanied by Cutaneous Lesions in an Immunocompetent Man
- Yamaguchi Hiroshi,Sekimoto Etsuko,Shirakami Atsuhisa,Shibata Hironobu,Ozaki Shuji,Shigekiyo Toshio,Noda Toshinori,Shikiji Takanori,Kanda Kazuya,Hirose Takanori,Matsuzawa Tetsuhiro,Gonoi Tohru
- Internal Medicine 52(1), 129-133, 2013
- … He was suspected of having complications from chickenpox or bullous impetigo as the initial diagnosis. …
- 臨床報告 水痘に合併した網膜血管炎の1例
- 堅田 利彦,近藤 雄司,村瀬 寛紀 [他]
- 臨床眼科 66(8), 1245-1251, 2012-08
- 臨床研究 帯状疱疹・水痘・Kaposi水痘様発疹症患者における単純ヘルペスウイルスおよび水痘-帯状疱疹ウイルスの抗体価の解析
- 稲岡 峰幸,狩野 葉子,倉田 麻衣子 [他]
- 皮膚科の臨床 54(1), 67-72, 2012-01
- 英語ではChicken poxと呼ばれる。水痘は感染症法の第5類感染症に指定されており、 学校保健安全法による第2類学校感染症に分類されている。季節的には毎年12 - 7月に 多く8 - 11月には減少し、罹患年齢の多くは9歳以下。水痘ウイルスの自然宿主はヒト ...
- Chickenpox (or chicken pox) is a highly contagious disease caused by primary infection with varicella zoster virus (VZV). It usually starts with vesicular skin rash mainly on the body and head rather than at the periphery and becomes itchy, raw ...
|「水痘」「chicken pox」「水疱瘡」
|「chickenpox vaccine」
- 一般用語と専門用語の組合せで誤っているのはどれか。
- 日
- すいとう
- 英
- varicella, chickenpox
- 同
- 水疱瘡(みずぼうそう)
- 関
- 水痘・帯状疱疹ウイルス、帯状疱疹、水痘生ワクチン
- 五類感染症(小児科定点)(週)
- 100%顕性感染
- 潜伏期:11-21(平均15日)
- 空気感染?
- 年齢:5-9歳。(熱帯、亜熱帯では成人が感染する)。ほとんどが10歳以前に感染
- 免疫不全患者や新生児では重症化
- 季節性:12-1月ピーク。8-10月谷。
- 感染率:家族内感染70-90%
- 新生児の死亡率は30%
- 白血病児では死亡率が高い。
- 米:130-200人死亡/年。白血病児の死亡率:7-28%
- 日:白血病児の死亡数、死亡率:水痘 36/118(30.5%)、帯状疱疹 1/48(2.1%)、麻疹 7/48(12.1%)
- 全身倦怠感、小紅斑(掻痒感。頭皮にも出現。口腔粘膜、眼瞼粘膜。紅斑→丘疹→水疱→膿疱→痂皮→瘢痕無し)
- 細菌感染
- ライ症候群
- 神経合併症
- 脳炎
- 小脳失調症
- (1000例中1例以下)
- 成人での合併例が多い 20%
- 母胎は水痘に感染しやすい。発症したらアシクロビルによる治療を行う。
- 妊娠初期に罹患した例の5%(61例中3例)で起こる
- 眼症状、大脳萎縮、皮膚瘢痕、四肢欠損、萎縮
母胎の発症 新生児の発症 ----------------------------- 出産5日以前 生後0-4日 →正常 前4日-後2日 生後5-10日 →重症 播種性・出血性水痘 死亡率30% -----------------------------
- 水痘の既往やワクチン投与のない妊婦が分娩5日前-分娩2日後に水痘を発症した場合、胎児の水痘が重症化する(死亡率30%)
- →抗体が母体から新生児に移行しないため
- 分娩間近や分娩前の発症:母胎に免疫グロブリンを投与。
- 産後2日以内の発症 :新生児に免疫グロブリンの投与
- 7-10日で治癒
- 水痘皮内反応。8hrで判定できる。陰性ならワクチン接種。
- 水痘生ワクチン。
- 免疫の獲得率が90%程度。水痘の感染防除、帯状疱疹の発症予防にも効果有り
- 免疫不全症患者も接種可能。ただし全く免疫が0の患者にはいけない。
- 日本にはない
- 免疫グロブリン製剤
「chicken pox」
「chickenpox vaccine」


text: Letters: 10th Mountain Division, Iran and Yawns News & Features NPR · Sep 27, 2007 Listen Story audio Copyright 2017 NPR. Stay Informed The news on your schedule from MPR News Update Email Address* Zip Code MPR News Update AM Edition MPR News Update PM Edition See our Privacy Policy. Must be age 13.

subset: commoncrawl


text:
Computer Associates (CA) has hired former Novell chief technology officer Alan Nugent to lead its Unicenter business, CA said late Wednesday, ending speculation about which software company the executive had jumped to.
Nugent's appointment as senior vice president and general manager of Unicenter comes as CA, in Islandia, New York, plans a restructuring of its business units to focus on greater accountability, it said. Unicenter is CA's largest business unit, covering infrastructure management products.
Nugent announced last week that he was leaving Novell to head up a software business at another IT vendor, just days ahead of Novell's BrainShare user conference. Nugent's exit follows the November departure of Novell vice chairman Chris Stone.
As CTO and senior vice president at Novell, Nugent helped lead its move into open source and identity-management driven products, CA said. Previously, he was chief technologist and chief software architect for BellSouth, working on Internet and e-commerce issues, enterprise application architecture, and integration.
His background will be key to leading CA's Unicenter division, CA said.
Nugent will start in his new position on April 8 and report to CA's executive vice president of products, Russell Artzt, CA said.


text:
|Item type
|Call number
|Date due
|Mesa Lab
|Q175.5 .R365 2011 (Browse shelf)
Includes bibliographical references and index.
pt. I. Scaling reality. What's so small to you is so large to me ; Unlocking secrets ; Living in a material world ; Looking for answers -- pt. II. Scaling matter. The magical mystery tour ; "Seeing" is believing ; The edge of the universe -- pt. III. Machinery, measurements, and probability. One ring to rule them all ; The return of the ring ; Black holes that will devour the world ; Risky business ; Measurement and uncertainty ; The CMS and ATLAS experiments ; Identifying particles -- pt. IV. Modeling, predicting, and anticipating results. Truth, beauty, and other scientific misconceptions ; The Higgs boson ; The world's next top model ; Bottom-up versus top-down -- pt. V. Scaling the universe. Inside out ; What's so large to you is so small to me ; Visitors from the dark side -- pt. VI. Roundup. Think globally and act locally ; Conclusion.
"From the one of Time magazine's "100 Most Influential People in the World"-- and bestselling author of Warped Passages--an exhilarating and readable overview of the latest ideas in physics and a rousing defense of the role of science in our lives"--Provided by publisher.
Any questions? Ask a Librarian.
Not finding what you are looking for? Request-It - InterLibrary Loan.


text:
The Utah Grizzlies have treated their home fans to some exciting, down-to-the-wire hockey at the Maverik Center this season. Including Saturday's contest, the Grizz have played six straight home games where the game has been tied in the third period.
Unlike their past two home games, however, the Grizzlies failed to deliver a win Saturday, as the Colorado Eagles scored twice in the third period to beat Utah, 4-2.
Despite the loss, Utah continued its trend of dominant first-period play, outshooting the Eagles 10-9 and scoring the game's first goal with less than five minutes remaining in the period on Kris Hogg's rebound and goal from the right side.
Through seven home games, the Grizzlies have outshot their opponents 117-77 in the opening periods and have scored first in all but two games at the Maverik Center.
But as quickly as Utah started, it faded early in the second period.
Colorado tied the game at 4:23 in the second period, and just over three minutes later took a 2-1 lead on Greg Gardner's short-handed, breakaway goal. The goals came quickly, with the Eagles scoring on two of their first three shots in the second period.
"We came out hard again today," said Grizzlies coach Tim Branham. "We just didn't keep the pace. There were too many spots where they took it to us."
Just when it seemed momentum shifted to the Eagles, Utah countered with a goal of its own, tying the game 2-2 at 13:39 in the second period.
The power-play goal came off the stick of Rylan Galiardi a slap shot from the right side. Galiardi has scored goals in three consecutive games and in all but one game since being acquired by the Grizzlies to add scoring depth to the roster.
Colorado recaptured the lead at 3:33 in the third period on a power-play goal of its own and put the Grizzlies away for good with less than a minute remaining, after Utah emptied the net for one last push.
Utah will look to bounce back in a rematch against Colorado on Monday night.
Eagles 4, Grizzlies 2
O Igor Bobkov returns to the net for the Grizzlies after a two-game absence. The goaltender allows three goals on 20 shots.
• After starting the year 27 of 27 on the penalty-kill, Utah allows its second power-play goal in consecutive games.


text:
Currency Displayed in
Hover over image to zoom
Sorry but this item is currently unavailable. Please check back at a later stage.
What's in the Box:
View All Products
Black Friday Deals On Now! Asmus Toys - Lord of the Rings and Hobbit …
Urban Samurai Hobbies has MOVED to 101-9952 Lougheed Hwy!To our amazing …
With the potential disruptions in Canada Post's service, we have taken the …
All prices are in USD.
Click the button below to add the DAM - Chinese People's Liberation Army Special Forces Recon to your wish list.


text:
Arcél 300
Arcél -750
Arcél 600
The Ħomtso, Hurtso, and Tsyeʔ valleys were now dotted with Uyram villages. Like the hunter/gatherer tribes they evolved from, they were frequently at war with each other. The more successful villages grew ever larger, absorbing or conquering nearby villages till they had become small city-states. Around 300 the Homtso delta had been unified by the priest-kings of Srethun; its chief rivals were Tsopwan on the Hurtso and Pheʔ on the Tsyeʔ.
Though there were some shadowy creator gods and a world of spirits and demons, the Uyram chiefly venerated their own ancestors (uy), who had once led them to game and now watched over their crops, their wars, and their morals. Indeed, Uytai simply means 'the land of (our) ancestors'.
The ancestors were the legal rulers of the Uyram cities— indeed, they led their cities' armies into battle, in the form of macabre constructions of bones (uywar) adorned with animal hides, feathers, jewels, and gold, held aloft by an honored caste (uyħwa, the ancestor-bearers). Only the priests could speak for the ancestors; naturally enough, pauram 'interpreter' became simply the name for the ruler.
An important distinction to the Uyram was between the good ancestors (puruy) and the mad ancestors (fretuy). Everyone had ancestors of both types, and either could be revered, though in the case of the fretuy this was more appeasement than worship. The good ancestors provided blessings, protection, order, fertility, and wisdom; the mad ancestors offered creativity, humor, madness, intoxication, and power.
Authoritarians and moralists tended to see madness as opposed to goodness, but to most people madness was a necessary complement. It might take benign forms, such as getting drunk or entering a musical trance, but could also be quite literal— insane people, for instance, were made into priests. Nor was fret 'mad' the same as tsrat 'evil'. There was occasional talk of tsratuy 'evil ancestors', but it was best not to think much about these.
In theory the ancestors, through the pauram, dictated everything from the crops grown to marriage partners to punishment for criminals. The city-states (if not the outlying villages) were certainly tightly organized, and developed rudimentary tally systems to keep track of production and the passage of time.
About this time the Kereminthic peoples learned to add outriggers to their canoes for additional balance. This innovation allowed them, despite the tiny size of the canoes, to greatly increase their range, and they boldly paddled across long stretches of open water. From the southernmost of the islands south of Ȟaibalai it's about 400 km to the coast of Arcél; the coast was first explored, then colonized.
Mnesean tribes have settled the upper Šrun river.
Characteristic figure
|Historical Atlas of Arcél
| Terrain • -8000 • -4000 • -2500 • -750 • 300 • 600 • 782 • 950 • 1112 • 1300 • 1510 • 1690 • 1850
1997 • 2200 • 2370 • 2550 • 2700 • 2900 • 3050 • 3200 • 3314 • 3400 • 3480 • Languages • Cities


text:
|Yantis sweeps Lady Trojans
|Joseph Elerson | News-Telegram Sports Writer
Oct. 19, 2005 - CUMBY - The Cumby Lady Trojans could not get anything going Tuesday night against the Yantis Lady Owls until Game 3 as they were swept at Trojan Gymnasium.
The Lady Owls won by scores of 25-18, 25-12, 25-22 to improve to 15-8 overall and 6-2 in District 19-A. Cumby is now 13-15 overall and 2-6 with three games to play.
"We just concentrated on accuracy and keeping the ball in play and we didn't have nearly the mistakes that we did last time," said Yantis coach Bill Magness. "The girls played really well and I am proud of them."
With the win, Yantis is tied for second in the district with Fruitvale, who they play next Tuesday in the regular season finale. The Lady Owls must play district-leader North Hopkins, who is riding an 11-game winning streak, on Friday.
Magness said the Lady Owls need to step up their game this week because of the talent they will encounter the final two matches in hopes of making the playoffs.
"They have to play really well and we have North Hopkins on Friday and Fruitvale on Tuesday, and the girls have got to play well this week," the coach said. "We have got to give credit to Fruitvale because they are very good and North Hopkins, we know how they are, and we have got our work cut out for us."
In Game 1, Yantis held a consistent five-point lead as Jayna Bevill once again gave the Lady Trojans trouble throughout the match and in Game 1 had five kills for the Lady Owls. Bevill finished with 11 kills and three aces in the match.
But it was the serving of Esther Fernandez for Yantis that controlled the pace of Game 1 as she had six aces in the game and finished with 12 aces in the match. She also had three kills and two assists.
Magness praised the play of Bevill and Fernandez in picking up the sweep of Cumby.
In the first game, Cumby senior Mary Ugalde got the Lady Trojans to within 13-10 on a kill, and then Yantis went on a 6-0 run courtesy of Fernandez and Bevill for a 19-10 lead.
In Game 2, the Lady Trojans started out strong, taking a 3-2 lead on a kill by Jenna Deeds, but that would be the final time they would hold the lead in the game.
Later in Game 2, Fernandez once again went on a run as Yantis held a 12-7 lead before she went on a 7-0 run with four aces, aided by a kill from Bevill.
Sophomore Scarlett Tarno had four of her six kills during Game 2 and got the Lady Trojans to within nine at 20-11, but that was the closest they would get the remainder of the game.
The Lady Trojans started to put things together in Game 3, forcing Yantis into miscues with them either hitting the net or going long on attempted kills but could never get a run going of more than three points during the game.
Cumby tied the game at 6-6 on a kill from Tarno off an assist from Ugalde and held the lead only twice the rest of the way at 8-7 on an ace from Tarno and at 11-10 on a block from Erin Templeton.
With match point on the line for the Lady Owls at 24-21, Fernandez served the ball out to put Cumby within two at 24-22 and then Karen Lacey miss-hit the ball on an attempted kill for the 25-22 finish.
Ugalde led the way for Cumby with seven kills, six assists and one ace, while teammate Lacey had three kills, Templeton had three kills, one ace and one block.
Isabel Reyna had three kills and one assist for Yantis, and teammates Christina Bean had three kills and two assists, Starla Burchfield had three kills and two aces, and Jamie Gilliland had one kill, one ace and seven assists in the match.
Older Archives
Looking for News-Telegram Sports and News Archives for January 2004 - November 2008


text:
Exclusive Interview: Asking Alexandria's Ben Bruce on New Remix Album 'Stepped up and Scratched'
Metalcore group Asking Alexandria have just released a remix album titled Stepped Up and Scratched, featuring an infusion of electronic music, courtesy of a host of renowned DJs. The band has also been busy opening for Guns N' Roses, as well as touring with Avenged Sevenfold, Hollywood Undead, and the Black Veil Brides. We caught up with guitarist Ben Bruce recently to get the details on the remix album, what it was like opening for GN'R, and the band's appearance on new get-fit reality series The Warrior Show.
REVOLVER Why did you decide to do a remix album now?
BEN BRUCE It's funny, 'cause it happened three or four years ago or something. When we recorded Stand Up and Scream, which is our first album, obviously there was a lot of synthesizers and dance and trance and stuff incorporated within that album. And back then we were really, really into sort of dance music and dubstep and all that stuff and we thought, Oh, wouldn't it be cool if we could do this whole album as sort of a dubstep, dance, trance, sort of mix kind of thing. And it just never ended up happening.
Why do you think more hard-rock and metal bands are incorporating electronic music into what they do?
Metal has a really driving sound. It's really energetic, and if you listen to a lot of dubstep and stuff it's got the same feel. It's around a similar tempo, it's just driven. In many ways, it's just as heavy as a metal song.
Was it important for you to keep that original heaviness from the songs?
Originally, we didn't think of doing that, but after everyone started releasing these remix albums we thought, We need to do something to stand out. And just the way it came about it is just Stand up and Scream was mainly a guitar album—guitars, vocals, drums—with a little bit of synth mixed in it. So we thought, What happens if we literally flip-flopped that, have a synth-driven album, with heavy guitars and drums and stuff playing a smaller role, but still there keeping the heavy vibe that the original album's had.
Were you nervous about how your fans would react?
Oh, definitely. I was like This is gonna go one of two ways: It's gonna completely flop or it's gonna do really well, so. It seems to be doing well, it was No. 1 on the iTunes electronic chart for ages, I don't know if it still is, but I know it was there for at least a week, which is pretty cool.
Did you know many of the producers before choosing them?
I knew a few of them. Like, we knew Big Chocolate, and we knew some of the Born of Osiris guys, who did some of the remixes. And we knew Borgore, so it was just DJs that we like. And then our record label suggested a bunch of other DJs and stuff, so we figured we'd take their word for it and see if they worked out.
Did you learn a lot working on this album that you didn't know before?
No, it's beyond me. I still don't understand all that shit. People can say it's just pushing buttons and stuff but I think it's a lot more than that. It's quite complicated. It's quite difficult. There's a lot of counter melodies and stuff that people don't really notice that are there that goes into it. It's kind of like rewriting a song, almost. It's crazy.
Do you see yourself incorporating electronic elements into future albums?
Yeah, having done this, it's sort of opened our eyes into doing an electronic style album in a different way. Before we used to go into the studio with [producer] Joey [Sturgis] and do them in the studio, but I think for this next album we're gonna try and incorporate some of these DJs into making our electronic sounds throughout the album, just because they're better at it than we are, obviously.
How's the Buried Alive Tour with Avenged Sevenfold going so far?
It's going really, really well. A lot better than expected 'cause before we were a bit apprehensive and a bit nervous, just because Avenged Sevenfold is more of a radio rock band. I didn't know how well we would go with their crowd. But it's been really, really good.
You also recently opened up for Guns N' Roses. What was that like?
That was the most terrifying thing in my life. I never get nervous before I play, but I was shitting myself before this show. There was probably about 15,000 people there, something like that. And half of them were like, What the fuck are these kids doing onstage? Why are they screaming down the mic at us and telling us to mosh and stuff? But then the other half were really open to it and really cool. So it was kind of a 50/50 thing. But even if it was 100 percent of the crowd that hated us, at the end of the day I would have still enjoyed it and taken away nothing but good things, because, Guns N' Roses, man—they're one of my favorite bands. How many people get to say, especially a band in our sort of genre and scene, how many bands get to say, "Yeah, we opened for Guns N' Roses"? It's just awesome.
What was the worst thing to come of your nervousness?
Except for two seconds before we had to go on stage, when Cam [Liddell, guitar] was puking in a garbage can.
Lastly, did you enjoy being on The Warrior Show, it looked intense?
Ah, yeah. It was, it was fucking horrible. He asked us to do, like, 500 squats or something with these chains round our neck. And he wasn't really paying attention, because some people were doing different things, and some of those doing the squats were cheating. He was like, "What are you on" And they were like, "480." And he was like, "OK, 20 more." And I was honest, 'cause I wasn't thinking, I was like, "I'm on 200." And he was like, "OK, go." And he watched me do the rest of them. And I was like, Ah, fuck. I could barely walk the next day, it sucked.
Next Article


text:
Construction of B.T. Renewal Work n Rajnadgaon to Bailadila Road in Km 135 to 140 = 6.00 KM.
Request For Proposals
We try our best to have the most accurate and up-to-date information available on our web site, but we cannot guarantee that all of the information provided is error-free.
If you have any updates, corrections, or complaints related to this notice, please contact the responsible purchaser directly.


text:
Denver • Leaders in the historic Colorado mining town of Crested Butte have unanimously approved a plan to turn it into the fictional "Whatever" town for a Bud Light ad campaign.
Town councilors only gave their OK only after Bud Light maker Anheuser-Busch InBev doubled its payment to $500,000.
The Denver Post reports fencing already has been installed for the Sept. 5-7 event that has divided the town.
The beer company has been working with town officials on the plan since the spring, but word only leaked out recently. In the meantime, the mysterious Bud Light event has been promoted online.


text:
Christmas Coloring Page: Mandala
Celebrate Christmas and partake in creating Hindu and Buddhist traditional art by coloring in this Christmas mandala! Preschoolers will have a blast adding color and cheer to this mandala which is made up of various holiday icons including candy canes, stockings, Christmas tree balls, and jingling bells.
Click to find similar content by grade or subject.


text:
(NSU Newsroom—November 13, 2013)—The Norfolk State University Office of Communications and Marketing has appointed Stanley Donaldson Jr., a 2004 graduate from the University's Department of Mass Communications and Journalism and award-winning journalist, as its new Director of Media Relations.
Donaldson will serve as a liaison to Cheryl Bates-Lee, assistant vice president of university relations, and will write articles related to the University's College of Liberal Arts, School of Social Work, School of Graduate Studies and Research and the School of Extended Learning. He will post updates about NSU to the Communications and Marketing Newsroom website and will contribute stories to school publications such as Behold Magazine and the Making Waves newsletter.
Bates-Lee said the office is pleased to have Donaldson on board to help advance stories about programs and events at Norfolk State.
"We're excited to have someone with Stan's experience as a part of the Office of Communications and Marketing staff," Bates-Lee said. "He has a love for Norfolk State and wants to help promote NSU's good news."
Donaldson was most recently a reporter at The Plain Dealer in Cleveland, Ohio. He reported on social service, social justice and urban issues at the publication, produced multimedia projects and served on several award-winning investigative projects. He also has covered statehouse issues, death-penalty and federal trials, gangs and police use-of-force complaints.
In 2010, he spent time working on a news series, The Women of Imperial Avenue, which he co-authored at the newspaper, that examined the lives of 11 women who were found dead inside and around the home of convicted serial killer Anthony Sowell. The series won a 2012 Salute to Excellence Award from the National Association of Black Journalists for best news series and a 2011 award from the Associated Press Society of Ohio. His former publication nominated his work into the 2012 Pulitzer Prize competition. Donaldson currently serves as a producer for an upcoming documentary about the victims.
Donaldson has written for news publications that include the Detroit Free Press, Agence France-Presse, Chicago Tribune, The Virginian-Pilot, Fort Worth Star-Telegram, The Star-Gazette (Elmira, N.Y.), Akron Beacon Journal and The Vindicator (Youngstown, Ohio) and others.
He has served as a fellow in several journalism education programs that include the Chips Quinn Scholars Program, Knight Digital Media Center at the University of California at Berkeley, Casey Journalism Center at the Phillip Merrill College of Journalism at the University of Maryland and is a former Knight-Ridder Inc. Rotating Internship participant.
Donaldson is a member of the National Association of Black Journalists. He has also served as a volunteer for Big Brothers Big Sisters in Detroit and Cleveland and has been a mentor for several youth programs. Donaldson can be reached at (757) 823-2119.


text:
In West Virginia, critics warn public health and safety are threatened by coal waste from power plants that is stored in hundreds of slurry ponds or injected underground. (Video: Assignment Earth)
"Assignment Earth" features compelling video reports from the front lines of major environmental stories from around the globe. Topics include global warming, pollution, habitat destruction and endangered species.


text: ISLAMABAD : Chief Justice Tassaduq Hussain Jillani Friday took suo moto notice of non-availability of machine readable passports in Pakistan Embassy, China. M Azam Khawaja, a resident of Najing, China, sent an application to the Human Rights Cell of Supreme Court. The applicant stated that about 7,500 overseas Pakistanis in China are facing hardships due to non-availability of MRPs. The applicant also alleged lack of interest of embassy in solving the issues of overseas applicants.Taking cognisance of the application of overseas Pakistani the chief justice issued notice to attorney general for Pakistan, secretary ministry of foreign affairs and director general passport for 17th February, 2014.This news was published in The Nation newspaper. Read complete newspaper of 15-Feb-2014 here.


text:
Proofread Something
Presupuesto $10-30 USD
Proof reading approx. 950 words English. Project will be approved Friday morning 9 am CET latest. Needs to be finished by Friday afternoon 13h00 CET latest. I will contact the preferred bidder to confirm price and deadline. Failure to answer by 9am CET will make me move to the next one.
26 los freelancers están ofertando un promedio de $28 para este trabajo.
Experienced, professional, accurate and reliable. Top notch quality and timely completion will be ensured. My work is double proofread and I can start immediately. I do not believe in overcharging, therefore my bid is Más
Hi I'm a native English speaker and have been working as a writer and proofreader for 4 years now. I would love to work with you and help you with content development. Currently, I'm working as a content developer at Más
Hi I am Monica I will proofread your 950 words and make it error free.Please message me for more details
Hi, I have done similar projects in the past. I would like to use my experience to serve you better. You can trust my sincere indulgence both in quality and time frame. If you will give me a chance, I will ensure that Más
Dear Client, I have seen your instructions and would be the ideal freelancer for this project. I am a native English speaker, and I have experience handling similar projects. I have carried out numerous proofre Más
Hello I'm creative with superb writing skills and a passion for the job. I don't just get over projects but I always effort to deliver the best as per clients' requirements and leave them satisfied. Kindly give me more Más
Hello! I am an experienced editor and proofreader who can easily have this for you in less than an hour after acceptance. Feel free to contact me to discuss further.
I am an enthusiastic, talented, and dedicated academic and article writer offering you the best of my experience. I am detail oriented, extremely organized and look forward to taking on your project and exceeding your Más
I have worked on similar projects of proofreading and would be pleased to do this job for you. Look forward to hearing from you soon. Regards, Haris
I will be there to give you quality and timely response. you will not regret choosing me.
Effectively active since 2010, We are a digital marketing agency focused on creative and results-driven solutions for companies ranging from start-ups to Fortune 5,000. ✓✓ Stunning Results ✓✓The Impact of Teamwork Más
HI I have read out all the description given in your project for Prof Reading. I have completed Prof Reading for many assignments e.g. Research Papers, Dissertation, Essays, Business Plans, Reports, Book writing etc i Más
I am a native English speaker and experienced creative writer who speaks perfect English. Aside from article and ebook writing experience, I have proofreading and editing experiencing. I currently am an editor for a li Más
Hello. I can do that proofreading for you. I've worked as a research assistant where I proofread many academic articles and textbooks for publication. My background is in physics and geography.


text:
WSJ's Top China Stories: Huawei in Iran, Exotic Commodities, Cloudy Bank Risks
Your round up of the best of The Wall Street Journal's China coverage over the weekend:
Huawei to Scale Back Business in Iran: Chinese telecom-equipment maker Huawei Technologies will scale back its business in Iran, following reports that Iranian police were using mobile-network technology to track down and arrest dissidents. (Subscriber Content)
Commodities Lose Allure: Increased speculation that a drop off in demand from China could herald the end of the boom in commodities prices is leading investors to search out more exotic plays, the prices of which are not necessarily linked to Chinese growth. (Free)
IMF Official Cites 'Gaps' in China Data: Chinese regulators need to improve the data they use to assess whether their banks could withstand a sudden economic downturn, the IMF's director of monetary and capital markets said. (Subscriber Content)
China Deploys Patrols Along Mekong River: China, Thailand, Laos and Myanmar launched armed joint patrols along the Mekong River in response to the killing of 13 Chinese sailors in attacks on two cargo ships. (Subscriber Content)


text:
Quick Links
RSS 2.0 Feeds
Lottery News
Event Calendar
Latest Forum Topics
Web Site Change Log
RSS info, more feeds
Topic closed. 24 replies. Last post 5 years ago by goherd14.
Take the pledge with me, and do not even waste your money on the Millionaire Jingle Jumbo Bucks. The odds are terrible, and not anywhere close to what you can do with Maximum Green or $100 Million Lucky Fortunes. Odds of hitting $100 are 1 in 60, about 2x worse than the other two games PLUS you cannot enter your $20 loser into a second chance drawing. It has odds of a $10 ticket, not even a really good one. You can win $1,000,000, $2,000,000 or $3,000,000 as top prizes, but I bet there will only be one or two prizes tops in each category. I would rather buy $10 Jingle Jumbo Bucks for half the price, as worthless as they were, but I don't think they are going to be available this year. i bought two which lost, and I very seriously doubt that I will buy another. These are about the worst odds of any $20 out there. If you get a JUMBO symbol, you get 5 times the amount, and if you get the Jingle Bells, you get all 20 prizes. What BS! No instant $500 on a $20 ticket, not even $300, $200, or EVEN $100. How pathetic. I like to judge tickets by the likelihood that I will win $100, which you will do with some regularity if you play the right $20 games. You may not know it, but odds of winning $100 in a $20 ticket range from 1 in 28 to 1 in 120! That is over4.25 times better odds, for the same money. Sure I like to dream big, but once again, most all $10 tickets have a top prize of $1,000,000, all $20 tickets have a top prize of anywhere from $1,000,000 to $7,000,000, but the chances of getting that ticket almost do not exist. If I can win $100 regularly, and $250, $300 occasionally, and $5000, then I am doing OK.
FOR ONCE, LET'S KICK THEM WHERE IT COUNTS. There is absolutely no reason to waste money on a ticket that has worse odds, the top prize of $10 tickets in some cases ($1,000,000). If we just keep on buying progressively worse tickets, they will keep Selling them to us. I quit buying $7,000,000 Jackpot a long time ago, because there were only two top prizes, and one has already been claimed. I personally like Maximum Green and $3,000,000 Taxes Paid in that you get a chance to enter either weekly or monthly drawings, and the others you only get a chance to win at the conclusion of the game. You are not likely to win at the weekly drawings, but you are far less likely to win where there is only one last chance drawing, when the game is over. This sorry game, just like regular Millionaire Jumbo Bucks, does not even give you a chance to win any second chance drawings, even despite the horrible odds.
Stand with me, and don't be a fool. This is the only $20 game that has the best odds of winning a ticket. With the other games, you usually had a better chance of winning $20 (same as a ticket), but more often $25 or $30. Won't you stand with me and let's teach them a lesson. I would have NEVER wasted the money on the two tickets I did if I had seen the odds. If you are curious about the odds of winning any prize for a particular ticket, go to Galottery.com, and select Instant Games. If you see one on the left you like click on it, otherwise choose a dollar amount for the tickets, choose a ticket, and at the bottom it will have Overall odds of winning. If you click on the odds, it will give you all of the odds.
Let's all stand together and tell these losers that enough is enough. I expect to be able to win at least $100, if not $500 by hitting a symbol, and I expect weekly or monthly drawings. I am going back to Maximum Green and $3,000,000 Taxes Paid, and occasionally $100 Million Lucky Fortunes, only because it has pretty decent odds at or below $500. I guess after the Georgia Lottery sells out of those tickets, I will quit playing. The Georgia lottery is very quickly going from a lottery that you can do well at to a lottery you can do well without.
Let me know if you stand with me, and write to the Georgia Lottery as well. If we keep playing their new junk games, then they will keep selling them to us. A $20 Ticket should share these three characteristics, and if not, they are a ripoff: 1) They should have a star or some other symbol that wins $500, should have odds of 1 in 33 or better of winning $100, and should have weekly or monthly drawings. Anything else is a ripoff for the most part. Tell me if you agree or disagree, why, and if you will boycott this garbage game
We have a bs 20$ tic that iis 1:73 too win 100$. Tried it a few times and never won 1$ on it.
I bought 2 yesterday and got nothing. I saw one roll up to #9 and the guy said it produced a $50 winner. All of these games are starting to suck. I played every holiday game yesterday & the biggest win was $8. Lucky Fortunes is horrible now too. I can't tell you how many times I have bought at least four tickets to finally win $40! I have only won $100 once & $50 multiple times but it is not worth it. If I didn't want to win some of my money back I would quit all together. By the way there is only one $250,000 prize left and I think one top prize so they are making all their money off of us right now. So you have my promise! Lol
Ive cut back on scratchers drastically, where last year the winnings would roll over to buy new tickets, i started finding myself having to take money out of the bank to play and im not going to do that anymore.
Last year i did pretty good with the 10 dollar xmas card, but when i saw the new one is at 20 dollars i knew it was just another way to rip me off.
Im sure they have statistics and know what they are doing with their pricing but it would just seem logical to me that if people start noticing they are losing more, they arent going to buy as much resulting in lower sales.
I usually do very well on the scratch off. I bought 7 Jingle jumbo bucks The ($2) ones tonight and I won $20 on 5 of them and a ticket on 1. I think it depends on where you buy your tickets to. wqhat I do is I stand and watch to see what people are buying and if they dont win and they leave the store I buy behind them. I never buy $20 tickets and I rarely buy the $10. I won 11,000 year before last on 2 $10 tickets and it put me into a higher tax bracket. When I went to turn in my tickets I bought one $2 ticket at the lottery office and won $500. My son told me to stop. lol
It's like 1 of each prize for a big whopping total of 3 top prizes. .They should have just reprinted the regular Jumbo Millionae game .
I played the $5 & $2 game today and they are terrible as well. One had the Jumbo symbol with a $1 prize under it. I got another one with 10 matches and all were $1 prizes. On the $2 game all I get are free tickets. GA games are starting to suck inmy area even worse. I used to average a $100 hit per week now I am lucky to get anything. I think I need to become one of these random players then my luck may get better.
Not only do I agree with you, but if you haven't noticed, the best lottery ticket has been taken away by the Georgia lottery. The $10 scratch off called "CASH BLAST" had the odds of winning a POW symbol and you would win $100 and this ticket only costs $10 NOT $20. The best one out there is the one you are referring to "THE $100 MILLION LUCKY FORTUNES". It has an odds of winning $100 of 1 in 28 tickets, but it costs $20. That's like buying almost 2 "Cash Blast" tickets. Unless, the Georgia Lottery can invent a new ticket with almost identical odds of winning $100 for a scratch off that costs $10. You are quite right, the citizens should boycott playing any more scratch off games or any games for that matter. Maybe they will listen to us and the other millions of citizens in Georgia and Alabama (they have no lottery but do have a casino) If Georgia stays fair, I believe they will, they most likely will come out with a new $10 lottery ticket with similar odds as "Cash Blast" to win a $100 prize in the next month or two.
These new holiday games have been killing me, I cant seem to win anything over $20 and that was on a $1 Jingle Bucks!!!! The $2 and the $5 Jingles are horrbile too and the $20 is probably the worst ticket I have ever seen in Georgia. I dont play the $20 but I saw a guy this morning start at number 005 on the roll and finish a roll on 014 WITHOUT A SINGLE WINNER!!! (For those not in Georgia reading this, all the rolls equal $300 so the $20 tickets have 15 tickets from 000-014.) That is crazy to me, you would think there would be at least a ticket somewhere in there.... I dont understand with the Cash Blast closing out why we havent seen a good $10 to replace it. The $1,000,000 Grand Casino is alright but no where near as good as cash blast. And this month we wont see a new $10, just new 1, 2, 3, and 5 dollar games. Hopefully new month we will have some better luck.
Finally got a decent win on the $2 game. Got a Jumbo symbol with $20 under it for $100. Out of the other ton I have gotten a $20 win a $10 & the rest Free Tickets & $3 wins. Someone did win the grand prize not too for from where I live.
December is the month all those grand prizes get hit.
Yeah I think so. Still no winners on the $20 tickets for either of the top 3 prizes. Bad thing is I don't want to play the $20 games anymore.
well got some small results after a long losing streak. picked up just 20 $25M and got back $675 (2x $200 winners + 2x $100 $50 $25)
2014 Highest Winner: $500
Congrats James
That is pretty good!
If you haven't already, check out the About Us page that explains the main features of our site.
Also, please take a few moments and review the rules for posting at Lottery Post.
Any time you see a gray-underlined link, you can click the link to see a popup menu of options.
Popular features:
We try to include instructions on each page. Check for help content on the page that's giving you trouble.
The next place to seek help is our dedicated Help forum that contains detailed assistance for frequently requested topics.
If something isn't working properly, our automated Browser Test page can quickly identify common problems.
Finally, the Contact Us page has an incredible wealth of self-help material that answers 95% of the questions we are asked.
We always welcome feedback and suggestions.
About Us • Site Map • Membership Features • Advertising Opportunities • Change Log • Rules • Linking to Lottery Post
Index of Feeds • Lottery News • Event Calendar • Latest Forum Posts • Web Site Change Log
Search the news, forums, blogs, and even your private messages at our Search page.
This page was generated in 0.0560 seconds.Copyright © 1999-2017 Speednet Group. All rights reserved.


text:
V8 Supercars champion Jamie Whincup used his contract renewal negotiations as part of a successful campaign to improve drivers' rights.
Whincup, who begins his quest for a record sixth V8 title at the season opening Adelaide 500 this weekend, has extended his deal with the top-ranked Triple Eight Holden team until the end of next year.
He delayed re-signing as leverage to get team owner Roland Dane to support his efforts to give all drivers more say in how they were used in the promotion of V8 racing.
Dane's influence as a member of the V8 Supercars board of directors added weight to Whincup's campaign, which took up long-running concerns among drivers about some of the terms of their racing licence agreement.
Their main grievance is that V8 Supercars has the right to unlimited use of their name and likeness to advertise and promote the sport, which they regard as an infringement on their intellectual property (IP) rights.
The drivers have also objected to the demands put on them for promotional and media appearances, with their licence agreement allowing V8 Supercars to enforce their participation.
Leading drivers like Whincup had become frustrated at the sheer number of pre-event promotional appearances they had to make.
Following discussions with V8 executives that started late last year, Whincup has achieved some progress in moderating demands on the drivers' time.
"They're really making sure that when they do ask us to make appearances and stuff that we're maximising the benefit to the team and the sport," he said. "That's what it's all about.
"The (promotional) events we do now are going to be at a higher level. We're not going to do too much; we're going to do fewer, more high quality events, which is perfect.
"We just want a few minor things looked at and, to be honest, so far they've done a good job and we're heading in the right direction."
While his campaign hasn't resulted in revisions of the terms and conditions of the drivers' licence agreement – and the issue of unfettered use of their IP remains unresolved – Whincup is confident that ongoing talks will result in significant improvements of their rights.
"As far as rule changes and things like that go, no, there hasn't been any of that, but it's work in progress," he said. "It's got discussion going, which is all I was after."
Whincup, who won a record-equalling fifth V8 championship last year, completed his preparations for the Adelaide 500 by mountain biking up Mount Lofty with his veteran Red Bull Racing Australia teammate Craig Lowndes on Thursday.
"I'm not over-confident, but I feel like I'm as good a chance as anyone," Whincup said of his chances of a successful start to his title defence. "We have all the tools to win. I'm sure our car will be competitive and I feel physically fit and ready to go, so I think it's up to us.
"If we do a good job on the weekend, we should be there are thereabouts."
The Adelaide 500, run on the 3.2 km Parklands street circuit on the edge on the city, features a new format, with twin 125 km races on Saturday preceding Sunday's traditional 250 kilometre decider.
Grid positions for each of the opening races – the second of which will be the event's first twilight race – will be decided in two qualifying sessions on Friday.


text:
1200AP fails to aquire IP address, 10.0.0.1 doesn't work
I'm having a problem connecting to a 1231 AP. It was working previously, but I reset to factory default to clear the config. Now, it won't pick up an IP address from the DHCP server, and the default address of 10.0.0.1 doesn't work either. I have tried resetting the config again with the mode key, with the same problem.
If I plug a laptop into the Ethernet cable it does get a dhcp lease. The switch it's connected to shows "ap" for show cdp neighbor detail, but no IP address. I tried the IPSU utility, but it doesn't return an address either.
Any ideas on how to reset this?
Thanks, Randy


text:
Nancy Padian, PhD, MPH
Adjunct Professor of Epidemiology
Faculty, Center for Evaluation for Global Action
University of California, Berkeley
Nancy Padian, PhD, MPH, is an internationally-recognized leader in the epidemiology and prevention of sexually transmitted infections including HIV. She is a senior technical advisor at the Office of the Global AIDS Coordinator (PEPFAR), a consultant for the Bill and Melinda Gates Foundation, and a faculty member at the University of California, Berkeley in the Department of Epidemiology. Dr. Padian is an elected member of the Institute of Medicine, the American Epidemiology Society, and the International Society for Sexually Transmitted Disease Research. She frequently consults for UNAIDS (where she is a member of the Prevention Reference Group and the Evaluation Reference Group) and also for the WHO on programs related to care, treatment and prevention of HIV. For more than two decades, Dr. Padian has developed and directed a range of research and intervention projects on HIV, sexually transmitted infections, and contraception in high-risk populations in the U.S. and internationally. Her portfolio includes an ongoing evaluation of the Elizabeth Glaser Pediatric AIDS Foundation's program to eliminate pediatric HIV/AIDS in Zimbabwe; a large phase III randomized controlled trial (RCT) to evaluate the effectiveness of female-initiated HIV prevention methods in southern Africa; and an RCT of a combined vocational training and social support intervention designed to increase economic independence and reduce HIV risk among adolescent female orphans in Zimbabwe. She is the scientific advisor to numerous World Bank and UNAIDS impact evaluations. While focusing on HIV and other sexually transmitted diseases, Dr. Padian's research addresses the broader context of economic development, empowerment, and gender-based violence. In addition, she has expertise in the rigorous design and evaluation of public health interventions, especially those that focus on implementation science and addressing supply and demand side challenges.