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Results 26 to 30 of 90
October 14th, 2013 09:07 AM #26Senior Member
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Ruolan; Pleiades is gorgeous, and Pleione too (mother of the Pleiades). Chryseis, I could use this as a middle, maybe. I love it, but it's not quite substantial enough as a first. I love the Tolkien names too, Théoden's on my boy list! Finnish is from an entirely different language group (Uralic) the Scandinavian languages (Germanic), but I know some Sami which is spoken by the Sami people in Northern Norway so the pronunciation comes easy to me.
Jasmine; Galilea's too place namey to me. And it hasn't got the magnificent starry beauty of Galileo.
Rosey; yeah, Aphro & Juno might be too much. Besides, it I add it I would have three -o ending names on my list. Zephyrine Hespera Plum is lovely, but we know a little Plum.
Harlow; yes, I do love Zephyrine. I think I would only add this if we took Morgana off the list though, they feel pretty similar to me.
Yael; yup, long and tedious... blah!!! Happy to see you like Zephyrine!
Liza; thanks for your gushing!! So sweet! Sylvana's definitely mysterious to me as well. Like a fairy tale forest or something... Thanks for your words on Zephyrine and Halcyone too - a little cyclone! Phaedra, oh I just find this name so sad. Her story is just terrible. Demeter I do love, and her story is very powerful, maternal and haunting. I love Lavinia! But not for my baby. Lanuvina would be better. Signe's on my middle list.
Rollo; Lilith is on my middle list I think. And maybe Ianthe too.
Seazuno; Marigold is very sweet but not my style. I love Delphine, but I know one and only think of her when I see it.
Philomena; that doesn't bother me at all. I don't mind porn stars. Might be weird, but I don't...
Our list:
Chione (but unsure about Husband's feelings on this one, he gave it a meh)
Morvoren (if we cut Morgana too)
Persephone (but Husband isn't keen on it right after Dita)
Vespera or Vespertine
Last edited by ottilie; October 14th, 2013 at 09:18 AM.My darling Marian Illyria Aphrodite, March 2013 & Little Bunny (a girl!) due 9th of February 2014
October 14th, 2013 09:14 AM #28Seraphina Isolde Paige Cressida Melody Charlotte Cecily Despina Bridget Rosalyn Cvijeta Dorothea Millicent Gwenllian Beatrice Aurora Rosamund Matilda Nimue Sunniva Giselle Griselda Amoret Helena Anastasia Elaine Isabella Briseis Freya Blanche Paisley Flora Robin Magnus Percy Tristan Ansel Lysander Arthur Edmund Balthazar Dimitri Emil Amaury Erik Dylan Dorian Florian Gustav Harley Roland Ludwig Arlo Orpheus Amadeus Lucius Remy Thorin Hugo Edgar David Beowulf Wesley Roman Sylvan Maximilian Storm
October 14th, 2013 09:27 AM #30
Going to jump on the Zephryine wagon. I like it with your other choices and it feels most like Hespera to me.Zoe Milena and Lucas Emmanuel
October 14th, 2013 10:55 AM #32
Oh no, I loved Hespera. But alright: Challenge Accepted!
No A, C, E, G, I, M, O, P, or T names.
Belladonna - I totally get why you like Belladonna but I don't know how I'd feel about naming a daughter after a poison. Especially if you don't like Bella as a nn. Though I guess Bonnie would be cute.
Elbereth - I love this. So different from Dita. Pretty awesome.
Vespertine - I like Vespertine more than Vespera. I also like Vesper but with Vespera feels like you are just trying to replace Hespera.
Too bad Zenobia might not make it back on the list. She would be beautiful.
Have you considered Hecate? She's on your mn list.
OTHER SUGGESTIONS: (some might be a little out there - even for you. But this was fun!)
H- NAMES: Hannelore, Hedviga, Harmony/Harmonia, Haven, Herodota, Heliodora, Herewynn, Hephzibah (nn Eppie), Hesione, Hippolyta (wasn't she on your list once as well?)
OTHER NAMES: Frieda/Freyde, Feodore, Freidolina, Fulgora, Keziah, Leceline, Quennelle, Renaissance, Solveig, Soligena, Sauvain, Saturnalia, WalburgaLittle Lorelei - May 2016Endora - Freya - Merida - Viola - Zelda
Dexter - Felix - Gideon - Hendrik - Victor
Etsy Shop: Pineapple & Fox
October 14th, 2013 11:07 AM #34Senior Member
- Join Date
- Dec 2012
- Posts
- 4,930


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Keep calm & get funky with the cool new Micromax Canvas Fun A63 kicking with the 1.3 GHz Dual Core processor and discover the brilliance of Android Jelly Bean v4.2.2 operating system on a 4.0 inch capacitive touchscreen. Have all the fun on the run and capture crazy moments of fun and frolic with its 2.0 megapixel rear camera with Flash .Live every moment to the fullest and discover fun in all its crazy colors on the fabulous Canvas A63! Watch colors come alive with the vivid quick response 10.16cm multi-touch screen that adds a whole new visual dimension to your phone! Put life on the fast-track with the 1.3 GHz processor!
Enjoy an immersive gaming experience that's even more exciting with the superior graphics on the A63. Record videos, click selfies and put a face on your video chats with its 0.3 megapixel front-facing camera! Light up the dull moments with its bright flash light and click moments to relive in the times to come.
Unleash the power of the Android operating system with the rich multimedia technology of the Android v4.2.2 Jelly Bean. With an evolved user interface and a faster, more intuitive text input and spell check, the Android Jelly bean brings about enhanced applications and power management. Download all your favourite applications through the preloaded Google play store and let the android experience take over!
Connect to your world, anytime anywhere with the endless connectivity options on the Canvas A63. Transfer files easily with its USB 2.0, share files with friends or talk hands free, all through its Bluetooth 2.0 connectivity. Surf the web faster through Wi-Fi and live life in the fast lane with its superior 3G connectivity speed upto 21Mbps. With its sleek ad slim design Micromax Canvas A63 is thus trendy to hold and slips into your pocket easily.
The images represent actual product though color of the image and product may slightly differ.

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Newborn Baby Boy Chalkboard Framed Art Print
They will be celebrating the arrival of their little baby boy for quite some time. Help keep the celebration going with this adorable chalkboard art that can be personalized with baby's name, birth date, weight and length.


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Welcome to Passport Motors - Used Lexus Dealer servicing Dallas
Thanks for visiting our website, please view our Used Lexus Inventory.
If you live in Dallas and are in search of a used Lexus dealer, Passport Motors is for you! Passport Motors is a used Lexus dealer and we are very excited to provide great used Lexus deals to our Dallas customers. Passport Motors knows that Dallas residents have many used Lexus dealer options. But we'd love the opportunity to impress you with our premium selection of used Lexus vehicles. We also have many great sales professionals that will keep you coming back for all of your used luxury vehicle purchases! Our customer service philosophy is to not only get you a great used Lexus but to ensure that the process is seamless and enjoyable. We encourage you to first take a look at our used Lexus inventory online right now! You can also apply for your used Lexus financing, Learn about available shipping or read our customer testimonials. Then make sure you call and schedule a time to come out to Passport Motors to speak with a sales professional. They are ready and willing to help you make a great decision on your next used Lexus for your Dallas driving! Passport Motors has over 15 years of experience in the Industry, excellent customer service, low financing rates and free vehicle history reports! So, come see us at Passport Motors today and be on your way to used Lexus ownership.


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Criminal defendants in Riverside County using public defenders may soon have to pay $50 for the service.
The Board of Supervisors will consider establishing the registration fee at its meeting Tuesday, Sept. 11. The 9 a.m. meeting is at the County Administrative Center, 4080 Lemon St. in Riverside.
County officials suggested the fee to avoid using taxpayer dollars to recoup court costs. As much as $1 million annually could be raised through the fee, according to a county staff report.
The fee would apply to defendants during arraignments who say they can't afford their own lawyer. Defendants fill out confidential affidavits under penalty of perjury about their finances, which the courts examine to determine their ability to pay toward their defense.
The fee would be waived if the defendants prove they can't pay it and legal services would not be denied if there's no payment, the staff report read.
Faced with hundreds of millions in falling revenue, the county is looking at various ways to cover expenses. Supervisors in November passed an ordinance requiring jail inmates to pay the $142.42 a day it costs to lock them up.
Follow Jeff Horseman on Twitter: @JeffHorseman


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ETM: Double Down - Dorrance Dance
Kde Sadler's Wells
Michelle Dorrance brings tap into the age of electronic music with collaborator Nicholas Van Young. Tap has always been a way of talking to the stage, now with Van Young's electronic tap boards, the stage is able to talk back, as every step, swipe, and scrape sets off an element of sound, building musical loops, turning the stage into a musical instrument in its own right. With Afro-Brazilian, indie-pop, and even a bit of Adele triggered by the eight dancers' fabulous footwork, ETM: Double Down takes the first American dance form to a new level.
Zakoupit zde
Předprodej od
Předprodej do
Délka představení:
1 hour 45 minutes


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Quest for Cosmic Justice
Back by popular demand: Thomas Sowell's essay on his three propositions of the quest for cosmic justice:
- The impossible is not going to be achieved.
- It is a waste of precious resources to try to achieve it.
- The devastating costs and social dangers which go with these attempts to achieve the impossible should be taken into account.


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A forum for providers of educational services and support to schools in Victoria.
The inaugural Educational Services Forum 2016 provides a timely opportunity for all contributing stakeholders in the Victorian education landscape:
Forum delegates will include leaders and representatives from participating authorities, professional associations and organisations, industrial organisations, tertiary institutions, commercial interests, business and banking supporters, special educational settings, teacher recruitment, principals, teachers, CRT networks, education journalists, researchers, curriculum publishers and distributors, professional learning providers and more.
Thursday, 23 November, 2017 9:15 AM - 1:15 PME. Australia Time
Lindsay Hassett RoomMelbourne Cricket GroundYarra ParkJolimont, Victoria 3002
Forum Executive
Cvent Online Event Registration Software | Copyright © 2000-2017 Cvent, Inc. All rights reserved.


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Beckett Baseball: Ask the editor
Post: #761
RE: Beckett Baseball: Ask the editor
(07-26-2012 08:12 AM)willtrips1 Wrote: Hi Chris - do you guy have a way to verify if a card is authentic - I bought off eBay a 2003 Bowman Draft Robison Cano "BuyBack" Auto card, supposedly seeded as a box-topper in the 2007 Bowman's Best series (photos attached). There is a Holograph sticker on the back, but I've been told by an avid Cano collector that the card is likely a fake and that the sticker could be from another card. The concern he shared is that the auto on my card is not the same as the one's on the cards he has in his collection (he owns a bunch, including /6, /15, /72, /79, /101, /222 and shared photos of those cards with me). in addition, the hand numbering on my card is in a different ink and color from the autograph. What do you recommend I do? Can you help me? Thanks! Bill
That product is problematic for fakes because the slabs are not tamper-proof and the 3M stickers can just be taken off of commons and put onto a card that has been signed by someone else. You would have to submit it to JSA though BGS.
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Drug Crime
Thailand: Tourists Drugged, Robbed in PattayaDate: November 1st, 2013 | No Comments
Two tourists were drugged and robbed by a woman in Pattaya, the second reported incident of its kind in the past month. The woman took the two to a local bar, where they were given drinks laced with drugs. Several hours later, the two Omani nationals woke up to find that several belongings and $400 [read more]
United Kingdom: Officials Crack Down on Drug TourismDate: September 25th, 2013 | No Comments
Officials are cracking down on drug tourism in southwestern England. Not often thought of as a major drug-related or wild party destination, the UK has created a taskforce to address a growing issue of illicit drug sales in Avon and Somerset, Gloucestershire, Wiltshire, Devon and Cornwall, and Dorset. The crime unit Zephyr recently seized nearly [read more]
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A private jet slammed into empty offices inside a hangar at an airport in Chino California Thursday evening, According to the FAA No one was hurt. Tena Ezzeddine reports for NBC4 News.
Published at 9:52 AM EST on Jun 14, 2013 | Updated at 12:12 PM EST on Jun 14, 2013


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"Gmail has a superior spam detection system that gives users ultimate control over the messages that are filtered into their spam folders," said Eileen Rodriguez from Google Corporate Communications.
AOL and Yahoo have already signed deals with Goodmail Systems but Google has finally refused to implement an email certification system like Goodmail's Certified Email ending months of speculation.
Related: What is Goodmail Certified e-mail
Source: No Goodmail For Gmail


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Video games tend to exist within their own space. Most of the time, we only have to deal directly with the companies that make the games. Whether it's good or bad, the buck pretty much stops with the publisher or developer. But new rules the FCC is proposing could ultimately end up forcing companies like Microsoft, Sony and Nintendo to charge us more for the services we use. If these rules go through, internet service providers could end up controlling how we access content online and how much we pay for it.
The proposed rules gives ISPs such as Comcast, Time Warner or any other company that provides internet service the right to charge other companies for fast access to services they provide to customers. For example, Comcast could require Microsoft to pay it a certain amount of money to prevent them from throttling connection speeds to Xbox Live. If Microsoft refuses, our connection speeds to Xbox Live will get slower. It doesn't matter if you pay for a 100Mbps plan. You won't get what you pay for unless the companies that provide your service is willing to pay your ISP for special treatment.
This could result in higher prices for us. In a way, it's already happening. In February, Netflix agreed to pay Comcast to make sure its customers could have smoother streaming experiences. Before that agreement, people suddenly started complaining about how lousy their Netflix service had become. Now Netflix speeds through Comcast have supposedly increased by around 65%. That comes at a cost though. Yesterday, Netflix announced it would be increasing the price of its service by one or two dollars for new customers. Sure, one could argue the increased price will help Netflix produce more original content. I'm sure it would, but I also think the timing of this and the Comcast agreement are more than coincidental.
If this proposal is approved, it will have a tremendous negative effect on the internet. Nothing will be safe. The more popular a service is, the more of a target it becomes. Naturally, there's nothing stopping the ISPs from pushing their services on us without such restrictions. It's so mind-mindbogglingly corrupt, you'd think this was something out of a prime time TV show.
This is something we should all be keeping an eye on. As we use the internet to enjoy more and more content, the potential for us paying higher premiums goes up.


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Hi. My name is Robert and I recently got my Wii up and running with a USB Loader. Its working beautifully thanks to everyone.
I was wondering, what are some cool apps and games to download for the Wii? I like world of goo and virtual console games (from sega and snes).
Just wondering if anyone would like to share some neat programs.
I would go to wiibrew and see what they have. Easiest way is to install the homebrew browser, it will allow you to browse and install all the homebrew they have. Any of the VC and wiiware is considered piracy and we won't discuss that here.


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The beef between the U.S. Justice Department and HP shows no sign of abating.
Still reeling from the fallout of its admission to bribery and money laundering charges in April in which it agreed to pay the feds a $108 million fine, HP now faces charges that it allegedly stiffed the U.S. Postal Service on a government technology contract and has agreed to reimburse the feds $32.5 million for its supposed indiscretion.
The situation stems from the government's contention under the False Claims Act that HP overcharged the postal service for products delivered between 2001 and 2010. Namely, that HP failed to comply with agreed on pricing terms for a contract called the "Acquisition of Desktop Extended Processing Technology."
According to the feds:
"The United States alleged that under a contract between HP and the USPS, HP overcharged USPS by failing to comply with pricing terms of the contract, including a requirement that HP provide prices that were no greater than those offered to HP customers with comparable contracts. The United States also alleged that HP made misrepresentations during the negotiation of the contract regarding its pricing and its plans to ensure it would provide the required most favored customer pricing."
"Protecting the federal procurement process from false claims is central to the mission of the Department of Justice," said Assistant Attorney General Stuart F. Delery for the Justice Department's Civil Division in a statement to the press. "We will continue to ensure that when the government purchases commercial products, it receives the prices to which it is entitled."
An HP spokeswoman said in an emailed statement to VentureBeat: "HP is happy to find a mutually acceptable resolution to this matter. HP values its ongoing relationship with the US Postal Service, and looks forward to continuing to deliver high-quality products and solutions to its valued customer."
The U.S. Postal Service, Office of the Inspector General and the Department of Justice's Civil Division all were involved in the investigation. It is worth noting, that, according to the feds in this case, "the claims resolved by the settlement are allegations only and there has been no determination of liability."
The bribery and money-laundering charges in April, announced by the Justice Department and the Securities and Exchange Commission, were more serious. In that case, HP admitted to violating terms of the Foreign Corrupt Practices Act because, as they said, HP Russia was involved in bribery and money laundering operations.
According to the feds release at the time: "Hewlett-Packard subsidiaries created a slush fund for bribe payments, set up an intricate web of shell companies and bank accounts to launder money, employed two sets of books to track bribe recipients, and used anonymous email accounts and prepaid mobile telephones to arrange covert meetings to hand over bags of cash."


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The links on this page will take you to external websites, which we have no control of the content.
Milton-next-Gravesend – A history of Milton-next-Gravesend parish
Gravesham Borough Council – The local council
The Church of England – The website of the Church of England
The Diocese of Rochester – The Diocese to which we belong
Rochester Link – The Diocesan Newspaper
Holy Trinity C of E Primary School – Our local Church primary school
Gravesend Deanery Churches – The deanery churches in and around Gravesend
Churches Together – In Kent. Drawing together the Churches in south-east England to develop partnership in mission and evangelism
Churches Together – In Gravesham. Drawing together news and events from all the Churches in Gravesham


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Tag Archives: Ben Jones
THIS WEEK IN COMICS! (2/29/12 – Hot Young Things)
Kramers Ergot: the early years – EXPOSED. Feel free to scroll down for upcoming comics! Continue reading
Layout Workbook 8
This week we're going to look at the proportions of the Mome comics anthology. Continue reading
Artistic Modern Funnies: Ben Jones' Problem Solverz
The ideas and visuals that Ben Jones has developed and celebrated over the last 15 years are suddenly, amazingly, going to be shown to millions of people. A very biased interview. Continue reading
Spidey in Trouble?
News for TCJ subscribers, links, photos and other notes from vacation land. Continue reading
I Work Here, Too!
Some brief entertainments for you from the other guy. Continue reading
The Comics Journal No. 238, October 2001
Featuring interviews with Neil Fitzpatrick and Glen Dakin; reviews by the likes of Ben Jones, Seth, and Tom Spurgeon. Continue reading


text: Hello all and SMF! I just purchased my new smoker last weekend and I love it. This site has been a great help to me and I'm glad I found it. Thanks SMF, I look forward to learning from you. Today I'm gonna do chicken wings in the smoker I'll let you all know how they turn out. Reed


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SALT LAKE CITY — The Utah Utes won in decisive fashion, 67-47, at home Friday night over the Oregon Ducks.
The Utes took over the game in the second half as their efficient shooting and lockdown defense propelled the squad to victory.
Utah's defense held the Ducks to 31.3 percent shooting in the game (20-64) and recorded eight steals and five blocks, which had a huge impact in the game.
The Utes were so effective because of "transition defense. They don't press the ball like they used to. We did a really good job constantly getting back," Utah head coach Anthony Levrets said.
The Utes' offense was constantly pushing the issue, as it had 18 points off Duck turnovers and 14 points on second-chance putbacks.
The starting point was a 9-0 run the Utes went on midway through the first half to go up 20-11. The Utes didn't look back from there as they led 35-23 at halftime.
Iwalani Rodrigues came out firing after halftime as she scored seven of her 14 points early in the second half.
"We need to get ourselves ready to play in the beginning, just get that fire," said Rodrigues on her overall game, which included five rebounds and five assists. "I just have fun just playing."
The Utes (3-8, 12-10) were hitting on all cylinders Friday night as they ran up their largest lead to 27 points, 65-38, late in the second half.
Down low in the post Taryn Wicijowski was active all night as she collected eight rebounds, two blocks and 13 points.
Wicijowski also held the Ducks' leading scorer coming into the game, Jillian Alleyne, to only seven points and nine rebounds.
"I just tried to play good defense on her, and box her out to keep her off the boards," Wicijowski said.
The Ducks (1-10, 3-20) were never close in the second half, but forward Liz Brenner had herself a game with 11 points and 15 rebounds.1 comment on this story
The Utes were passing exceptionally well to find the open player as they had 17 assists.
Michelle Plouffe had a team-high 15 points with three steals to lead the Utes. The Utes' bench came to play as Cheyenne Wilson led the second unit with eight points. Chelsea Bridgewater played with great effort off the bench as well with six points and four rebounds.
"I'm proud of our team. We had a tough road stretch but are now back home and had a solid basketball game with everyone contributing to a good team win," Levrets said.


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developed to treat people who have gotten infected with the pathogen.
By leading with the food safety application, AvidBiotics is hoping to clear regulatory hurdles from the U.S. Department of Agriculture and FDA in about 18 to 24 months—a far less arduous pathway than it would encounter through the drug development route. And once that product reaches the market, it will help finance further development of the antibiotic treatment.
AvidBiotics' anti-E. coli compounds have already shown that they can prevent infections, and treat active infections, in rabbit models, Martin says. Certain non-specific chemicals can be sprayed on beef or vegetables today to fight bacteria, but AvidBiotics is banking on a couple key advantages. As a biodegradable protein, the new treatment has an environmental advantage. And by being specifically tailored for the bad bug, and leaving the rest of bacteria to do their thing in nature, the AvidBiotics approach doesn't cause "collateral damage" against good bacteria, Martin says.
Besides going after E. coli, the AvidBiotics founders are working on programs to target specific bugs that cause all kinds of trouble for the healthcare system. One is pseudomonas, and another is clostridium difficile, or "C. diff." Another niche idea, believe it or not, is a targeted treatment for Yersinia pestis, otherwise known as the bubonic plague, which the U.S. government just might want to stockpile for biodefense purposes, Martin says.
Really pursuing any of these options is going to take some serious time, money, and help from partners.
Martin and Knighton have all kinds of experience, which might lead them to think this is all pie in the sky. But once Martin got going he sounded almost like he was back in graduate school, on the cusp of the early biotech wave. He pointed out that the National Institutes of Health is pouring millions into a Human Microbiome Project that is seeking to catalog the vast diversity of bacteria. Over time, it could help scientists determine whether pathogens could be the hidden culprits at work in certain forms of diabetes, cancer, obesity, and arthritis. Having super-specific proteins that can be made to knock out certain bugs in a laboratory could be a useful enabling tool for this scientific journey, he says. "It's all really quite amazing what's happening now," Martin says.


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Contact Info / Websites
Entry #224
*For starters, I would like to thank everyone who has read or even looked at my blogs. I do not believe in the destruction of the planet during 2012. And if you read my blogs you would've known that, rather I am 'hopeful' that people will grow up from their personal melodramas and look towards altruism and love.
Though the 'End of the World' is still a possibility.
In fact, the US government has actually invested in a plan in case of a Zombie Break-Out.
We have been living in more chaos than ever before. And those who do not think so, are very VERY oblivious to the events that have been occurring to us. Or you are simply complacent with it and do not care.
Kinda like an ostrich sticking its head in the sand. *(Ignoring)
A turtle sleeping in its shell. *(unaware)
Or a mouse making a home in a wheel of swiss-cheese. Eating it's safety from inside and out. Till it becomes weakened and collapses. *(Complacent)
My point is...we need to start being Generous NOW. more than ever before.
If Atrology is to be taken into consideration. We are in the age of Aquarius. The spirit of 'generosity' and 'ever giving life.'
And what better time to be generous than during the Holidays.
And forget about all that religion biasses and 'war on christmas' bull. It doesn't matter the holiday.
All that matters is the heart.
"The Religion of the Future will be a cosmic religion, it should transcend personal theology and dogma."
-Albert Einstein
It is in the Buddha nature to not be so concerned with the accuracy of theology.
But rather to go with your heart and individual sense of morality and personal responsibility.
Now is the time to be selfless and generous. There is SO MANY that is IN NEED of money, food, water, etc. BASIC STUFF FOR SURVIVAL. The United States is such a country where many 'count how many calories NOT to eat' vs countries that need to eat ANYTHING they can find.
Start within your family. Then community. Then cities. Then the world.
I encourage you to share love and not hate.
We can all find happiness if we all try.
Consider how your hardship is compared to others. And how much easier you could someone's life if you helped, donated, or offered time, food, money, etc. Offer whatever you can whenever you can.
Imagine what we could achieve in the future....
And what about 50 YEARS in the future.
But anything you want is in reach.
And if I had my choice...I would be like "Doctor Who"
True perfection isn't absolute. It is ever changing and growing, learning and evolving. There is no pinnacle. Just something new and different.
ANYTHING YOU WANT IS IN REACH. For yourself, or for others.
You simply have to be proactive towards it.
"There must be no regrets, no tears and no anxieties Just go forward in all your beliefs, and prove to me that I am not mistaken in mine. Which is believing in you."
-Doctor Who
Good luck to all those who believe in Hope, Altruism, Love, and Peace.
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The date for the 2018 Convention will be Saturday 14th April. Venue The King Robert Hotel Stirling.
2018 is the 25th anniversary of the founding of the GMDX Group
Further information here Convention
The GMDX Dxpedition Of the Year Award being presented to the Intrepid-Dx Group by GM3POI, for their excellent VP8STI / VP8SGI operation.
at King Robert Hotel


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Corsi--who seems similar to Lou Dobbs--fairly summarizes other influential thinkers' views, such as Joseph Stiglitz, who believes globalization has failed because it has operated without sufficient protection for developing countries; however, Corsi's own ideas have several issues:
1. When America was exporting its own values and products all over the world and imposing its influence worldwide, Americans did not complain about globalization. Quite the contrary--American writers proudly proclaimed the 21st century the era of "soft power." Now that other countries are gaining sufficient power and influence to export their images and perspectives to other countries, suddenly Americans are unsure of globalization. America seems hypocritical and small for taking such a view rather than seeking to compete on its merits.
2. Corsi assumes that international governance necessarily requires a loss of sovereignty. Yet, he never considers that it's worth giving up a small or measured loss of sovereignty to gain a substantial benefit, especially when so much of American innovation and prosperity come from its multinational corporations, which make most of their money overseas.
3. Corsi assumes that all international governance mechanisms will harm American values; however, if American values are superior, why wouldn't they prevail in negotiations and other economic "battles"? Corsi writes that in "a world economy, the United States was valued as a consumer country, not as a producer, manufacturer, or exporter." (pp. 162) There is no reason such a scenario must always be true. With the appropriate level of tax credits and proper negotiations, the U.S. could produce (and export) whatever it likes. Thus far, however, its tax incentives have failed to be on par with China's, creating predictable consequences.
When America's major source of innovation comes from military R&D, it's no wonder countries like Japan have been more innovative than America with respect to quality-of-life matters and domestic infrastructure. Of course spending to kill will result in entertainment-oriented and consumer applications rather than constructive ones. Ships and aircraft carriers don't have too many transferable uses in a landlocked domestic economy other than supply chain advantages (logistics), which benefit transporting consumer goods worldwide, not making everyday life easier for residents. Innovation is different when it seeks to control and monitor populations in unknown or rural areas compared to when it seeks to make life more efficient in densely populated cities. America once again looks small when it complains about trade deficits while creating budgeting incentives that guarantee them.
4. Corsi correctly identifies America's relatively high wages as an impediment to eliminating trade deficits. However, he once again fails to address them in a concrete or constructive way, assuming always that negotiations cannot resolve such issues. Even if we assume that wages in America will stagnate over x number of years, there are ways to negotiate against artificial financial manipulation, such as devaluation in other countries' currencies. One way would be to increase tariffs only one way by x percent relative to any devaluation. (That one I got off the top of my head, so you can see that an almost infinite number of ways exist to balance trade in ways that force countries to compete based on quality or merits rather than price or labor costs.)
Another example would be the granting of x dollars to the country or corporation whose products are being copied due to lax copyright or IP enforcement. The real problem is how to calculate such penalties and how to encourage domestic IP enforcement without resorting to lengthy or expensive litigation, and Corsi offers no solutions here. Corsi and other protectionists lament the idea of international tribunals, but their whole point is to protect companies from having to litigate in other countries' "home courts," where they would be at a disadvantage due to language and cultural barriers, even if using local counsel. The fact that international tribunals are slow or clunky is no reason to stop globalization. A hardy people would seek to reform court systems or to implement better oversight, not to give up substantive economic activity due to slow lawyers and ill-prepared judges. No one argues we shouldn't have the Olympics because some referees make terrible decisions.
5. Corsi is fantastic when it comes to evaluating and explaining other economists' positions, but his own haven't stood the test of time. Chapter 7 is titled, "The Plan to Destroy the Dollar." From pp. 186: "Regional currencies like the euro are merely stepping-stones on the path to the Holy Grail of a one-world currency."
About a decade later, the US dollar and the Japanese yen are the world's strongest currencies, and the euro has been in steady decline. This is one example of Corsi's narrow academic focus.
Here's another, from pp. 211: "Ironically, the United States may be approaching an era where it will be impossible to buy a U.S.-manufactured auto, or an era marked by a global economy in which the only manufacturers that survive will be the multi-national corporations with car-manufacturing capacity in China, aimed at taking China's low-cost labor markets." Last time I checked, not only do Ford and GM make cars in the southern U.S., but even Volkswagen and other foreign car companies make cars in the U.S.
One more, from pp. 228: "Avoid Investing in Stocks and Bonds." Since the publication of Corsi's book, both stocks and bonds have increased substantially.
6. I did not see any substantive opinions on the state of American K-12 education, which is an interesting omission to the extent the quality of one's education matters as workers compete not just domestically but worldwide.
Corsi would benefit from adding a review of actual terms and conditions of the trade agreements he complains about, but the first half of his book is fantastic because it so clearly lays out many of the issues we face today.


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P&G builds on partnership with Habitat for HumanityOctober 2013
American FMCG titan Procter & Gamble (P&G) is partnering with Habitat for Humanity to fund the construction, repair, and cleaning of homes in 12 countries around the world.
The commitment represents Habitat's highest level of global volunteer engagement in a single year, with nearly 3,000 P&G employees volunteering alongside Habitat partner families in countries including the US, Singapore, Malaysia, South Africa, Poland and Costa Rica.
In the Philippines, for example, five homes are being built and families provided with critical training on financial literacy, sanitation and hygiene while in the US, P&G will provide a gift basket of family and home care products to all new Habitat families – an estimated 6,000. Baskets include products like Charmin, Dawn and Tide.
"For the past 175 years, Procter & Gamble has focused on turning houses into homes," Brian Sasson, global manager of social investments at P&G told Ethical Performance. He said that the gift basket initiative is to be taken a step further soon with the inclusion of a new booklet which is aimed at first-time home owners as a quick resource on how to look after the home. Starting in the US and Latin America , the guide will cover areas such as air conditioning and heating systems as well more fundamental issues "like taking care of your yard" Sasson explained.
Sasson agreed that P&G brands get a lot of positive reputation associations out of its social responsibility policy and that it was an important part of it. The company does look at the ROI of its programmes. "We look at how many people we can help and how many people we do help. We measure outputs and are looking at how we develop those metrics," Sasson said.
He explained that there were two strands to his role: setting social responsibility strategy (looking at where the corporation will invest its money) and looking at implementing that strategy. He also looks at who P&G should work with and fosters partnerships with organizations such as Save The Children, World Vision and the Red Cross. P&G has been partnering with Habitat for Humanity for close to10 years.
"Disaster relief is an area where P&G can have tremendous value," Sasson said and revealed that the next big challenge was within personal care, where the company is ramping up its efforts with the introduction of a personal care kit for disaster areas and people who have been displaced (the kit uses P&G personal care brands). "We are currently scaling that up. Hundreds of employees have recently been putting together those kits and put aside for when they are needed," he said.
Sasson is thrilled that 3000 employees have already stepped up to the volunteering challenge and is hoping for steady, significant growth of that number in 2014 [the 3000 applies only to the Habitat programme]: "We have 127,000 employees around the world and we need to harness those talents and pitch those resources against solving society's challenges and issues."
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Ophthalmic Technician Continuing Education
Increasing Your Clinical Value:
Opportunities for Ophthalmic Technicians to Get Involved with Allergy Patients
Faculty/Editorial Board:
Jodi Luchs, MD, FACS, and Loraine Huemmer, COT, CRC
Supported by an Independent Educational Grant from Allergan, Inc.
This course has been submitted to JCAHPO for consideration of CE credit.
This course is not sponsored by JCAHPO; only reviewed for compliance with JCAHPO standards and criteria and awarded continuing education credit accordingly; therefore, JCAHPO cannot predict the effectiveness of the program or assure its quality in substance and presentation.
Copyright 2012, Review of Ophthalmology®. All rights reserved. The opinions expressed in this supplement to Review of Ophthalmology do not necessarily reflect the views, or imply endorsement, of the editor or publisher. Copyright 2012, Review of Ophthalmology. All rights reserved.
One of the most common conditions that lead patients to make an ophthalmic appointment is a red, itchy eye. In fact, each year, more than 50 million Americans suffer from allergic diseases. Allergies are the sixth leading cause of chronic disease in the United States, with an estimated 20 percent of the general population suffering from allergic conjunctivitis.1 Because the patient history can offer important clues to making a diagnosis, the role of the ophthalmic technician is an important one—and a well-trained tech is an invaluable asset to the clinician. Not only will this monograph provide a comprehensive review of this common condition, but it will also detail the care of the allergy patient, including the part of the ophthalmic technician in the process. First and foremost, a basic understanding of ocular allergies is crucial to any healthcare professional successfully managing allergy patients.
The 411 on Ocular Allergies
Interestingly, the prevalence of allergic disease in general has increased over the past several decades, likely due to a combination of environmental, cultural and technological factors. One hypothesis for this increase, known as the "hygiene hypothesis", suggests that early exposure to nonpathogenic microorganisms in childhood may promote immune system maturation and protect from the development of an allergy later on, whereas a lack of exposure in early life may disrupt normal development of regulatory immune activity and increase the risk of allergic disease.2,3 Thus, according to this hypothesis, as our societies and cultures evolved and became cleaner—with the advance of industrialization and technology—the incidence of allergy increased.
Contrary to the statistic mentioned in the previous section, one study suggests that up to 40 percent of the population is currently affected by ocular allergies.4 In another study of 5,000 children with allergies, almost one-third of them had ocular-only symptoms.5,6 Ocular allergy can affect patients' lives in multiple ways. It can limit where patients can go, take away the enjoyment of outdoor activities, affect work-related activities, leisure time activities, the ability to read or work on a computer, social functioning, and it can also make contact lens wear, which is very important to many patients, unpleasant or even impossible. Thus, this prevalent condition deserves our attention as eyecare professionals.
Many people who suffer from chronic allergies are often undiagnosed. Furthermore, many individuals who have chronic ocular allergies self-medicate their symp toms with over-the-counter (OTC) products, rather than seek medical attention. When OTC products no longer control their symptoms, these patients will then present to an eyecare professional for help. However, these patients generally don't walk in identifying themselves as ocular allergy patients. They may present with a variety of stories, clinical signs or symptoms, and it is up to the eyecare professional to sort out the underlying cause(s). Because ocular allergy shares many signs and symptoms with other ocular surface diseases and can present in a wide variety of ways, this task of identifying the cause is not always straightforward. To help make the task of correctly identifying ocular allergies easier, let's delve even deeper, with a look at the biologic and physical manifestations of this common condition.
Back to Basics
Allergic conjunctivitis is inflammation of the conjunctiva that is caused by an allergic reaction. Because the large majority of eye allergies involve the conjunctiva, the terms "ocular allergy," and "allergic conjunctivitis" are often used synonymously.
The pathophysiology of this common condition involves a type-1, IgE-mediated hypersensitivity response facilitated by the exposure of a sensitized mast cell in the conjunctiva to a particular antigen. Antigen in the air dissolves in the tear film and penetrates the conjunctiva, where it can bind to the antigen-specific IgE on the surface of mast cells. This binding triggers a cascade of intracellular events, including calcium influx and phosphorylations, leading to the release of pre-formed granules from the mast cell cytoplasm. These pre-formed granules contain pre-formed inflammatory mediators, the most notable of which is histamine.
At the same time, the mast cell is stimulated to produce other inflammatory mediators, including prostaglandins and other cytokines. Of all of the mediators produced and released by the mast cell, it is primarily the histamine that is responsible for the classic signs and symptoms of allergic conjunctivitis: itch, redness and swelling. Histamine binds to histamine receptors on nerve endings in the conjunctiva to produce an itching sensation. It also binds to the histamine receptors on the conjunctival vasculature to produce vasodilation and an increase in vascular permeability— producing redness and swelling (chemosis).
The release of histamine and other mediators also attracts other inflammatory cells into the conjunctiva such as eosinophils, neutrophils, macrophages, monocytes, lymphocytes and others. Once these cells arrive in the conjunctiva, they too become activated and secrete inflammatory mediators, which prolong and propagate the allergic inflammatory response. Thus, it is clear that allergic conjunctivitis is much more than merely itchy eyes and mast cells. It is a multicellular, allergic inflammatory cascade. Not surprisingly, treatment of the allergy patient requires a comprehensive approach. But before we get into the treatment of this condition, we should review the clinical signs and symptoms that are often associated with allergic conjunctivitis.
When It's More Than Just Allergy…
Two unique situations deserve a special mention: contact lens wearers with ocular allergy and patients who have co-existing dry eye and allergy.
Contact lens wear and allergy. One-third (33 percent) of respondents to an online survey about eyes and allergies identified themselves as contact lens wearers and of these, 12 percent admit to having dropped out of their lenses because of allergies.7 Ocular allergy is a well-known cause of reduced contact lens wearing time and contact lens intolerance. Contact lenses can trap antigen in the tear film against the ocular surface, thereby precipitating or worsening ocular allergy symptoms.
While contact lens wearers who also suffer from ocular allergies may come in complaining of itching, they may not volunteer information that they are increasing the frequency of rewetting drop use to enhance their comfort, or that they are taking their lenses out earlier. In fact, a survey by the Allergy and Asthma Foundation of America revealed that almost three-quarters of patients who wear contact lenses and suffer from ocular allergies use one of those strategies to cope with continued wear, while more than 40 percent stop wearing their lenses altogether during allergy season.7 Those behaviors are probably overlooked by many eyecare providers, but are important to elucidate because we can make a major impact on the quality of these patient's lives by effectively treating their ocular allergy.
Reduced contact lens comfort can have detrimental effects on work performance, impair enjoyment of leisure time, interfere with the ability to perform activities of daily living, and reduce self-perception of appearance if patients switch from contact lens to spectacle wear. Therefore, clinicians should not overlook the potential for effectively treating allergies, which are causing contact lens intolerance, in order to produce important secondary benefits for patients' lives. For allergy sufferers who want to remain in contact lenses, many physicians recommend the use of single-use contact lenses.
Dry eye and allergy. Because many allergic conjunctivitis patients have some degree of dry eye, treating both conditions is often necessary in order to achieve an optimal outcome.
The use of artificial tears can be very beneficial in these patients and thus should not be overlooked. In addition to relieving dry eye symptoms by lubricating the eye, they also reduce allergy symptoms by diluting or washing away antigens and inflammatory mediators from the tear film. Topical cyclosporine is also an effective treatment for patients with allergic conjunctivitis and dry eye disease. In addition to reducing ocular surface inflammation, improving tear production and stabilizing the tear film, this drug's immunomodulatory activity may have some therapeutic benefit in the allergic inflammatory cascade as well as the cycle of inflammation in dry eye disease.
Clinical Signs and Symptoms
The clinical signs of allergic conjunctivitis include conjunctival hyperemia, chemosis, lid edema and a stringy mucous discharge. That said, it is rare for patients to present to their ophthalmologist's office with these signs. Usually, by the time they have arrived in our offices, the acute redness and swelling have resolved, leaving a relatively white and quiet eye. Occasionally, a fine papillary reaction can be observed on the palpebral conjunctiva, which can help aid in the diagnosis. Thus, because a patient's appearance may be deceiving, it is crucial to take a complete history in order to ensure a proper diagnosis and treatment regimen.
The ophthalmic technician is often the first point of contact and the first history taker in the patient encounter; therefore, it is crucial that they have a high index of suspicion for allergy and ocular surface disease. Furthermore, it is critical that they ask the appropriate questions, thus allowing the physician to key in on the issue of allergy and treat appropriately.
As we are all aware, the hallmark symptom of ocular allergy is itch. However, many patients don't present to our offices simply complaining of itch, or with acute findings of red, swollen eyes. Sometimes, similar to what happens with their clinical signs, patients with ocular allergy start out with itch symptoms, which lead to rubbing and secondary redness and irritation. But often, their episode of itchiness and redness occurred days or weeks prior to their visit, and by the time they present to our offices, their eyes look relatively white and quiet upon presentation. And occasionally, some of these even forget about their prior episode of itch. They may present complaining about dry eyes, contact lens intolerance, difficulty working on a computer, episodic redness, etc.—all symptoms that may also suggest other ocular surface diseases such as dry eye or blepharitis.
The most common forms of allergic conjunctivitis fall into two major categories: seasonal and perennial. Both are—by far—the most common presenting forms of ocular allergic disease, however, they are (fortunately) the least severe and generally don't produce sight-threatening sequelae.
Seasonal or Perennial?
Not sure if a patient is suffering from seasonal allergic conjunctivitis (SAC) or perennial allergic conjunctivitis (PAC)? Following is an explanation of the differences between the two forms.
SAC. This is the most common form of allergic conjunctivitis.5 Approximately 90 percent of all ocular allergy cases are seasonal and are linked to pollen-related allergies, according to Mark B. Abelson, MD, senior clinical scientist at Schepens Eye Research Center.8 Patients suffering from this form of allergic conjunctivitis present most commonly in the spring and/ or fall, although symptoms can last throughout the summer. Symptoms include itchy eyes and/or a burning sensation and are usually bilateral, though there may be asymmetric involvement. It is helpful to keep in mind that ocular symptoms are often accompanied by nasal and pharyngeal symptoms, such as a runny nose and scratchy throat. Clinical signs include watery discharge, white exudates that become stringy with chronicity, mild injection of the conjunctival surfaces with varied levels of conjunctival edema and papillary hypertrophy along the tarsal conjunctival surface.
Airborne pollens from trees, grasses and weeds are the most common allergens for this type of allergy. However, it is incorrect to conclude that these patients only experience symptoms for a few weeks out of the year. Consider, for example, the fact that one study, which surveyed 124 allergic conjunctivitis patients, found that 46 percent—almost half—of eye allergy patients are affected by two allergy seasons per year. Furthermore, 18.5 percent of these patients reported that a single allergy season lasts more than 3 months.9,10 Another large survey demonstrated that ocular allergic symptoms were present in almost every month of the year—not only during peak spring or fall allergy season.4 Because the onset of SAC symptoms is seasonally related to specific circulating airborne allergens, it is important to consider the location and climate where the patient resides when assessing them. For example, mango pollen peaks in the air in December and January, whereas grass pollens are associated with increased ocular symptoms during the spring as well as during "Indian summer" in the fall. Considering these points, patients with SAC may experience ocular allergy symptoms throughout most of the year.
PAC. As the name suggests, PAC tends to produce year-round symptoms because the causative antigens are always present. Additionally, it is more likely than SAC to be associated with perennial rhinitis.5 The prevalence of PAC is considered a variant of SAC and is much lower than that of SAC.11 And while symptoms of PAC are the same as those of SAC, they tend to be less severe.12 Dust mites are the most common cause of this type of allergy, although pet dander—especially cat dander—is another common offending agent. Pet dander remains suspended in the air for extended periods of time, which allows it to settle on just about everything including carpets, furniture, clothing, etc., thereby producing chronic exposure and consequently, chronic symptoms for susceptible individuals. Interestingly, even patients suffering from PAC can experience seasonal worsening of their symptoms. Other antigens that can cause PAC include mold, cockroaches, dust, cosmetics, tobacco smoke and pollutants.
More severe forms of ocular allergic diseases include vernal keratoconjunctivitis and atopic keratoconjunctivitis, which are less common and can produce sight-threatening consequences in some patients. Also of importance, many patients with allergic conjunctivitis may also suffer from other ocular surface diseases such as blepharitis and dry eye.
Keep in Mind the Possibility of Co-existing Conditions
For example, the ocular surface inflammation created by allergic conjunctivitis may act as a trigger for the inflammatory cycle at the heart of the pathophysiology of dry eye.14,15 Similarly, many patients with ocular allergies may take oral antihistamines for their ocular symptoms or associated nasal symptoms. However, these medications can often dry the eyes, thereby paradoxically worsening ocular allergy symptoms. Ultimately, as the dry eye symptoms worsen, so will the symptoms of ocular allergy. Why is this? Dry eye syndrome limits the eye's ability to flush antigens from the ocular surface, allowing them to become concentrated in the tear film, thereby increasing the potential for antigens to access mast cells in the conjunctiva. Furthermore, a compromised ocular surface, as is often demonstrated by the ocular surface staining pattern we see in patients with dry eyes, may allow antigens in the tear film to gain greater access to mast cells in the conjunctiva.
Blepharitis can also increase ocular allergy symptoms in several ways. Posterior blepharitis, which is associated with meibomian gland dysfunction, can result in an abnormal lipid layer of the tear film, which can interfere with the spreading of tears over the ocular surface and increased evaporative loss of the tear film, resulting in a concentration of dissolved antigen on the ocular surface. This, in turn, may result in an exacerbation of allergic signs and symptoms. Anterior blepharitis may produce itching of the lid margins often confused with allergy. Furthermore, both posterior and anterior blepharitis can produce red eyes, lid swelling and symptoms of burning, irritation and foreign body sensation often confused with ocular allergy.
Identification of allergy patients begins with a patient history, which is the key diagnostic tool for detecting ocular allergies, often making it possible for clinicians to diagnose allergic conjunctivitis even before examining the patient.
All Hands on Deck
In today's fast-paced world, ophthalmic medical personnel (OMPs, i.e., certified ophthalmic technicians, certified ophthalmic assistants, certified ophthalmic medical technologists and those working toward certification while employed in an ophthalmological office) play an important role in providing data that are important to the physician in order to provide the appropriate level of care and treatment to patients. Securing a history takes skill and requires a team effort between the OMPs and the physician.
The role of the ophthalmic technician will vary a bit with the attitudes and instructions of the supervising eye doctor. It is always advisable to know how in-depth your physician wants the history and workup. It is best to develop a systematic method of questioning and to perform the history in a friendly yet professional manner. If a patient has confidence in you and trusts you, then you will be able to obtain more information from them.
When ocular allergies are involved, the accuracy, consistency and efficiency of the ophthalmic technician becomes extremely important. The patient's presenting symptoms are an important aspect of the history and invariably include some degree of itch—usually ocular itch or periocular itch, or both.
The Allergy Cascade
Although not specifically part of the ophthalmic technician's scope of responsibility and training, knowledge of the allergic cascade will aid in the understanding of the body's response to allergens in general.
The allergy cascade can be a multi-faceted complex set of cause and reaction, setting off other allergens in the body. Patient perception of their allergies' interference with daily life activities, cosmetic appearance and overall quality of life is gaining importance. Keeping pace with this emphasis, there are now tools such as questionnaires with which to measure quality of life. Many present clinical research projects are including specifically designed quality-of-life questionnaires in their studies to better understand the psyche of the patients involved and the effect on lifestyle. Our body's immune system is designed to constantly be on the lookout for intruders. It has the ability to distinguish between "self" and "non-self" (foreign substances such as inhaled ragweed) from which it will tirelessly work to protect us. An allergic response is the body's overreaction to some substance it believes to be a threat to the body. The substance is perceived as an attacker that threatens the bodily system, and the immune system will subsequently produce specific antibodies to combat this threat.
An allergic cascade refers to the chain of events that takes place when an allergen triggers an allergic response. It is the unique sequence of chemical releases in the body that take place in response to an allergen. The end result of this chain is the release of histamines and other chemicals that bring on typical allergy symptoms. Individuals may first become sensitive to an allergen before an allergic reaction can take place. This process involves the immune system mistakenly perceiving an allergen again. Links in the chain that make up an allergic cascade include:
When inhaled, the same allergen that produces allergic conjunctivitis can cause nasal symptoms. If it goes into the lower airway, the patient can get lung symptoms. The physician will decide what specifically to target with treatment. The target depends on the type of allergy the patient is suffering from and the severity (mild, moderate or severe) of that allergic condition.
Other common symptoms include burning, tearing, sensitivity to light or a gritty or foreign body sensation. Physical examination and slit lamp exam are, of course, also important for ruling out other causes of the patient's symptoms, including dry eyes, blepharitis, rosacea and medication toxicity. The physician will be interested in known allergens or exposures, including pets, as well as the frequency, severity and duration of the patient's symptoms. The patient history should also include the presence of any associated systemic allergic conditions such as asthma, allergic rhinitis or eczema.
A family history of allergies is also important to note because it is a significant risk factor for the development of ocular allergies. The history should also include the efficacy of any previous medical treatments the patient has used, including OTC formulations. These pieces of information only take a moment to collect, but are crucial in helping the physician distinguish patients who have occasional allergy symptoms from those with more chronic long-term and recurrent disease. Many physicians find that it is also helpful to include some degree of the severity of the itch.16 Some even use the patient's own words in quotes, such as "I could not stop rubbing" or "I wanted to rub my eyes out" versus " they itch occasionally".
When inquiring with a patient about allergies, one question not to ask is "Do you have any allergies?". It is too general a question. Instead, by breaking the question down into categories, you can elicit are more accurate responses. In general, specific types of allergic responses should be inquired about such as:
- Do you have any allergy to medication, either prescriptions or over-the-counter?
- Do you have any allergies to food, tape, latex, animals or any general substances?
- Do you have any seasonal al lergies, or do you have allergies throughout the year?
- Do you use any over-the-counter allergy medications? (This question is extremely important because the patient may be masking signs of an allergy through the use of these medications.)
- Do you have problems using eye drops? (This question will help evaluate how compliant the patient will be during the course of treatment and assists the physician in determining whether the patient will do better trying a once-a-day drop approach versus drops throughout the day.)
Any positive response should concisely document the type of allergen, the reaction the patient suffers, when it occurs and how long it lasts. It is important not to interpret for the patient. The interpretation of history and symptoms is the domain of the physician who assembles all information gathered from the history and the ophthalmic exam to develop a diagnosis and treatment plan. Some allergies can be genetic, such as those to cow's milk or animal dander, while others, such as poison ivy or a wasp sting, are not. Some physicians may want their technicians to question patients regarding family allergies in general.
When gathering information for the physician, ophthalmic technician can also incorporate specific questions such as:
- Do you ever suffer from red eyes, itchy eyes, watery eyes or swollen eyelids?
- Do you use OTC eye drops to treat red, itchy, watery eyes or swollen eyelids?
- Do you take any oral allergy medications?
Always remember to note the frequency of use of any affirmative answers to the above, as well as when the last dose was taken if presently in use.
A thorough history is the foundation for the examination and diagnosis of patients, as well as their successful treatment. Once a good history is obtained, the ophthalmologist can direct the examination with greater purpose and take it to the next level with regard to history, symptoms and level of discomfort. Here, the next logical step in the management of a patient with allergic conjunctivitis is the determination of a treatment plan. While ophthalmic technicians are not directly involved in this area, it is still of great benefit for us to possess knowledge about what therapies patients are using in the event that any issues arise.
Treating Ocular Allergy with Success
Because patients have access to an array of OTC medications, it is important for ophthalmic technicians to bring this into their history taking and to record self-medication attempts for the doctor. Some medications may mask symptoms, while others may become addictive and cause a rebound effect when the patient attempts to discontinue the use of the medication. It is also important to note how compliant the patient is when treatments are attempted. Topical ophthalmic products for the treatment of ocular allergies at the disposal of the physician include artificial tears, vasoconstrictor/antihistamines, antihistamines, mast cell stabilizers, mast cell stabilizers/antihistamines, NSAIDs, and steroids. Side effects of topical steroids may make the physician reluctant to prescribe these medications. Side effects can include some or all of the following: increase of intraocular pressure, cataract formation or exacerbation of cataracts, and worsening of ocular infections such as viral or fungal keratitis.18
Initial treatment strategies flow directly from the patient's presenting history. The long-term management of chronic allergy patients often involves a combined approach, including medical therapy for the ocular disease along with co-management with an allergist to better identify the underlying causative allergens and to help manage any associated systemic findings. However, these patients must also be educated about their allergic disease. It is essential to teach them about the difference between instant gratification and long-term control of their symptoms. Because many of these patients self-medicate their symptoms, they must be educated that while these products may produce instant relief of their itch, their long-term use can produce chronic symptoms that may prove difficult to clear up until the underlying allergic process is controlled. Again, co-management with an allergist can be helpful when attempting to discuss with patients how to change their current patterns of exposure to allergen and self-medication.
Brush Up On Your Reporting Skills
The importance of taking a careful history in ocular allergy patients is clear. Doing so can help us gain insight into the presence of underlying allergy, as well other ocular surface diseases. Introduce yourself while escorting the patient to the examination lane. Explain to the patient that the physician has asked you to obtain information and measurements to assist them with the patient's eye exam. Some patients are extremely nervous, and a smile can go a long way to make them more comfortable with the process. For us it may just be a job and we may participate in many exams each day, but to the patient, it's their eyes.
While performing a work-up, the ophthalmic tech becomes a reporter focusing on the patient, just as a newspaper reporter will develop their stories by filling in the "who, what, where, when, how and why". We already know "who" the patient is, and can leave the "why" for the physician to focus on as a diagnosis and treatment. History questions can fill in the "what" (the chief complaint), "where" (the complaint or symptom and the location), the "when" (the start of the complaint) and finally, the "how" (how long the complaint lasts).
It's extremely helpful—and often necessary—for us to report on the "who, what, where, when, how and why" of each patient that sets foot in the exam room. Obviously the "who" is the patient, and the "why" can be left up to the physician. But the rest—the "what, where, when and how"—will need filling in.
What. The chief complaint (CC) tells us why the patient has come in for an exam. It is an essential part of every chart note, significantly affecting coding and reimbursement. According to the 1997 Documentation Guidelines for Evaluation and Management Services, "the CC is a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return, or other factor that is the reason for the encounter usually stated in the patient's words". Whenever necessary, the ophthalmic technician can use the patient's exact words in quotes. It is also important to note whether or not the complaint is unilateral or bilateral. Family history may hold a clue to the source of their allergy, as well as their work situation (factory allergens, etc.) or environment (new construction, job change, new pet, new detergent, and move to a new section of the country).
Where, when and how. The history of present illness (HPI) is related directly to the chief complaint and delves further into it. Evaluation and Management (E/M) guidelines define it as "a chronological description of the development of the patient's present
illness from the first sign and/or symptom or from the previous encounter to the present." HPI may be reported using one or more of the following elements: location, quality, severity, duration, timing, context, modifying factors and associated signs and symptoms. Subjective symptoms relate to how the patient actually feels (e.g., pain and nausea) and are not observable by another. Objective symptoms (e.g., redness or swelling) are observable by another. Two Medicare carriers, Palmetto GBA and Noridian, have determined that "ancillary staff may question the patient regarding the CC, but that does not meet criteria for documentation of the HPI. Information gathered may be used as preliminary information but needs to be confirmed and completed by the physician."17 The ophthalmic tech and the physician need to work as a team to accomplish this aspect of the history.
In keeping with Medicare instructions, "a medical assistant or technician may take the chief complaint and note it but only the physician may perform the HPI." By providing details in the history portion of a workup, the ophthalmic technician makes it easy for the physician to review the information for accuracy and provide an arena for the doctor to discuss the issue with the patient to direct the conversation toward a diagnosis and a treatment plan.
Ask patients to describe their symptoms. When do they occur? When are their symptoms worse? Is there anything that can make it better? Is there anything that makes it worse? Are there pets in the home? What type of work does the patient do? Where do they work? Where do they spend most of their time? What are their hobbies?
It is also important to ask about a family history of allergy because when both parents have allergies, their children have a greater than 50 percent chance of having an allergy as well.2 We also need to ask patients about exposure to dusts, pollutants, vapors or other occupational exposures. Additionally, it is important to ask about symptoms of ocular surface disease in general, such as dry eyes, irritation, burning, foreign body sensation, tearing or contact lens intolerance. Patients may not report these symptoms because they may not consider them "abnormal" for them, yet they may have a significant functional impact on their lives. Many patients will admit that they thought these symptoms were "normal for age" or that they have simply "learned to deal" with them. Thus, a positive review of symptoms should prompt additional questions regarding specific allergy symptoms such as itch, as well as many of the factors mentioned above.
Key elements in the patient history may provide crucial information about lifestyle modifications, which may greatly benefit our patients. For example, we may counsel patients to try to avoid outdoor activities when pollen counts are high, drying clothes outside on the clothesline, driving with the car windows open during allergy season, having the household pet enter or sleep in the bedroom, and to close windows in the house. It is important to remind patients to minimize their exposure to the allergens that trigger their symptoms whenever possible. Aside from making lifestyle changes—be they temporary or permanent—patients may also find relief from a variety of products.
Non-pharmacological treatments. Options such as artificial tears and cool compresses are helpful, especially in milder cases, for relief of itch and swelling. The use of artificial tears can be very beneficial in these patients, and should not be overlooked. In addition to relieving dry eye symptoms by lubricating the eye, artificial tears also reduce allergy symptoms by diluting or washing away antigens and inflammatory mediators in from the tear film.
Medical therapy. When conservative non-pharmacological measures prove insufficient, medical therapy is indicated. Typically, topical therapy is more effective than systemic therapy with oral antihistamines for treating ocular symptoms. Topical therapy, unlike systemic therapies, is also less likely to produce ocular surface drying, which might paradoxically worsen allergy symptoms. When systemic therapy is indicated (e.g., when the patient exhibits nasal allergy symptoms), it may be necessary to counteract ocular surface drying with artificial tears and ointments.
Historically, several different classes of topical medication have been used to treat the symptoms of allergic conjunctivitis. OTC topi cal antihistamine/vasoconstrictor preparations are certainly effective in relieving redness, swelling and itching, but these drugs have no significant effect on the underlying allergic inflammatory cascade. Additionally, they are only useful for short-term relief; long-term use can be associated with the rebound phenomenon, where withdrawal can lead to more severe symptoms or even ocular surface toxicity.
First-generation mast cell stabilizers, such as lodoxamide tro-methamine 0.1% (Alomide, Alcon Laboratories, Inc.) and cromolyn sodium 4% (Crolom, Bausch + Lomb, Opticrom, Allergan Pharmaceuticals), are effective in stabilizing mast cells from releasing their preformed cytoplasmic granules, which contain histamine. However, these first-generation medications often require dosing four to six times daily and complete stabilization of the mast cells can take several weeks. In general, these agents are no longer routinely used or available.
Topical antihistamines, such as levocabastine hydrochloride 0.05% (Livostin, Novartis Ophthalmics) or emedastine difumarate 0.05% (Emadine, Alcon Laboratories, Inc.), can be effective in blocking histamine receptors on immune cells, and relieving itch symptoms. However, like the first-generation mast cell stabilizers, these drugs require multiple dosing during the course of a day and tolerance can develop to these drugs, making them less effective over time.
Topical nonsteroidal anti-inflammatory drugs such as ketoro-lac tromethamine 0.5% solution (Acular, Allergan) can also be effective for relieving symptoms of itch, but these drugs are often associated with significant burning and stinging side effects, which can adversely affect patient compliance with therapy.
The biggest problem with all of the above-mentioned classes of drugs is that they only treat the symptoms of allergic conjunctivitis. However, as described above, allergic conjunctivitis is much more than just itchy eyes; it's a multi-cellular disease. And although mast cells certainly play an important role in eliciting the immediate signs and symptoms of allergic conjunctivitis (e.g., the immediate itching, redness and swelling), other cell types, including eosinophils, neutrophils and macrophages, are involved in the allergic inflammatory cascade. All of these cells secrete many inflammatory mediators, which propagate this allergic response. Therefore, treatment of allergic conjunctivitis with a drug that blocks only one particular cell type or mediator involved in this process may increase the likelihood of breakthrough symptoms due to the short- and long-term effects of all of the cells and mediators not inhibited by that drug. That said, the treatment of ocular allergy with medication that has an effect on multiple aspects of this cascade may prove more effective.
Newer medications have an effect on multiple cells and mediators involved in the entire allergic pathway, so they may be likely to provide more comprehensive relief than the older drugs. The most frequently prescribed agents fall into the category of dual-action antihistamine/mast cell stabilizers. This class of medication includes olopatadine HCl 0.1% (Pata-nol, Alcon Pharmaceuticals) and olopatadine HCl 0.2% (Pataday, Alcon Pharmaceuticals), ketotifen fumarate 0.025% (Zaditor, Novar-tis), azelastine HCl 0.05% (Optivar, Meda Pharmaceuticals), epinastine HCl 0.05% (Elestat, Allergan Pharmaceuticals), bepotastine besilate 1.5% (Bepreve, ISTA Pharmaceuticals) and alcaftadine 0.25% (Lasta-caft, Allergan Pharmaceuticals).
These agents also have effects on other cells involved in the allergic cascade, most notably eosinophils. Furthermore, these agents are dosed twice daily, or in the case of olopatadine or alcaftadine, once daily, which can significantly improve compliance with these drugs, compared to the older-generation agents. Chronic use of these multi-action medications for our patients suffering from chronic or perennial allergies provides both relief of symptoms as well as long-term control of the underlying allergic process while preventing new symptoms from arising. They are therefore effective therapy both before and during an allergic reaction.
More severe cases of allergic conjunctivitis may require the addition of a topical corticosteroid to control the process. In these cases, a low-dose steroid, such as loteprednol etabonate 0.2% (Alrex, Bausch + Lomb) is often effective, although selected cases may require more potent topical steroids, such as loteprednol etabonate 0.5% (Lotemax, Bausch + Lomb) or prednisolone acetate 1.0% (Pred Forte, Allergan Pharmaceuticals). In such cases, it is essential to ensure that the diagnosis is correct, and that there is no sign of any ocular infectious process. Furthermore, steroids should be used with caution in patients with recent contact lens use due to the increased risk of infection. The use of topical steroids always carries the risk of classical steroid-related adverse events, including a rise in intraocu-lar pressure and cataract formation. Accordingly, when topical steroids are used in these cases, it us usually for a short term—usually 1 to 2 weeks—to get the acute inflammation under control and provide relief. Once the patient's clinical status improved, these agents can be rapidly tapered and the patient can be maintained on one of the combination antihistamine/mast cell stabilizers mentioned above.
To get the maximum benefit from these therapies, patients with chronic allergy need require consistent periodic monitoring. In addition to following patients on steroids to ensure that they are responding appropriately to the drug, physicians also need to encourage patients to continue taking their longer-term medications. Most antihistamine/mast cell stabilizing drugs perform best when used consistently; however, patients with chronic allergy tend to become noncompliant when symptoms ameliorate unless they are reminded of the importance of taking these drops regularly.
The physician may call upon his technician to educate a patient regarding the mode of treatment that he has decided to use for this particular person. Some aspects of the treatment, such as use of cold compresses, instillation of drops, punctal occlusion, and keeping an allergy diary, might be delegated to a trained employee.
After the Diagnosis
The ophthalmic technician's work really begins once all the symptoms have been presented to the ophthalmologist, the ocular exam has been performed and a diagnosis of ocular allergy has been made. The clinician may have a really good idea of the allergy cause and what will cure it, or may just be targeting allergy as the diagnosis. At this point, the value of a well-trained technician comes into the picture. We may be called upon to do some or all of the following:
Ensure patient understanding. Should a medication be prescribed, it is our job to make sure the patient understands the directions. Frequency of use, when to use, how to instill into the eyes, side effects to report to the ophthalmologist, as well as when to call if the medication is not working are part of making sure the patient understands their treatment plan. It's also important to communicate to the patient that their non-compliance will complicate their care and that use of OTC medications can mask symptoms or work against a prescribed medication. Have them check with the doctor before taking any OTC allergy medication. If you have a forgetful patient, help them with a plan of action to remember their medication use, such as posting a chart on the refrigerator and checking off when the medication is used. With your physician's approval, watch them instill an artificial tear to make sure they have an effective instillation technique.
Follow up. If necessary, your ophthalmologist may ask that you call the patient in a few days to make sure they are following directions or to determine whether they need to be seen again in the event treatment plan is not effective. Tell the patient you will be calling, and ascertain they understand that if not compliant with their treatment plan/ medications they may not get the relief that their physician is expecting. It may also be helpful to make sure they understand sometimes finding the right combination of medications to help them may take work, and possibly different medications or combinations of meds. The answer is not always a quick fix or a sure thing.
Introduce the patient to the allergy diary. Sometimes an allergy diary is called for and you can assist the ophthalmologist by helping the patient to understand not only how to keep one, but the need for this aide. There is even an iPhone app that patients can be referred to, iPollenCount, which allows patients to electronically keep a diary of their allergy symptoms and correlates them with the daily pollen counts. Patients can then e-mail this information to their doctor. It is helpful for the tech to explain to the patient that if the allergy trigger can be discovered, it can either be avoided or medicated as soon as possible once exposed. Explain that by recording the date and time of their allergic reaction and backtracking; where you were, what you did, what you ate or touched, times and places, are always helpful in discovering the trigger, especially when a pattern is noticed. If the trigger cannot be avoided, at least the patient can be prepared to deal with the allergy before it becomes severe.
From initial questions to signs and symptoms, keep in mind that the most important thing to the patient is that they get relief. And to achieve that goal, it takes knowledge and work—both on the part of the patient's eyecare physicians and the ophthalmic technician.
Final Thoughts
To summarize the information presented here, practitioners need to remain alert for patients' year-round allergies to allergens such as cat dander, mold and dust, as well as vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC), and drug-related allergic reactions. Itching is the absolute hallmark of ocular allergies.
Signs and symptoms can be the key to determining the allergen. Some patients will report that their allergies produce significant suffering and that they have a severe effect on their lifestyle. On the other hand, another patient will become so acclimated to their allergy symptoms that they accept their discomfort as a normal or almost normal state of life. The many OTC preparations available to our patients make it easy for them to self-treat their symptoms. Dependency upon drops that whiten the eye and have a rebound effect can complicate a history and a treatment plan.
A careful conversational method of performing an ophthalmic history will help the tech record a patients' symptoms and level of discomfort. Then, with the aid of a clear and concise history, a physician can often narrow down a diagnosis even before examining the patient. Usually, if it itches, it's an allergy, if it burns and stings it's dry eye or blepharitis, and if it's crusty and sticky in the morning, it's bacterial. However, this is not universal, and there is a significant overlap of these symptoms across all of these ocular surface diseases. Redness alone can signify several different problems. Proper gathering of information by the technician can give the physician the key to unlock the diagnosis that will lead to the ultimate goal: a happy patient who has their ocular allergies under control, is once again comfortable, and experiencing an improvement in their quality of life. Happy patients lead to successful practices, and word of mouth referrals to the practice!
The front desk of the office may be the first personal contact with the office that a patient experiences, but the technician is the most personal as the point of contact before the physician. Professional and confident interactions between the technician and the patient assist the clinician in the medical care of the patient. By working with our physicians, continuing our education, harnessing our strengths and communicating clearly with physicians, can we enhance our care of our patients. A history that is complete, concise and thorough is the basic step in providing care for patients and directs the remainder of the office exam. It also assists the clinician in determining a modality of treatment that will be effective for each patient as an individual.
Dr. Luchs is Co-Director, Department of Refractive Surgery, North Shore/Long Island Jewish Health System and Assistant Clinical Professor of Ophthalmology at Hofstra University School of Medicine. He is also Director of Clinical Research and Director of Cornea/External Disease at South Shore Eye Care, LLP in Wantagh, NY.
Ms. Huemmer is Clinical Research Manager at South Shore Eye Care, LLP in Wantagh, NY.
- BSM Consulting. Clinical Course: History Taking: Building the Foundation. 2008.
- Risk Factors for Allergic Conjunctivitis. Virtual-cancercentre.com. Available at: http://www.virtualcancercentre.com/diseases.asp?did=766#Risk_ Factors. (Accessed December 9, 2010.)
- Bielory L. Allergic conjunctivitis and the impact of allergic rhinitis. Curr Allergy Asthma Rep. 2010;10(2):122-134.
- Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988-1994. J Allergy Clin Immunol. 2010;126(4):778-783.
- Bielory L. Allergic and immunologic disorders of the eye. Part II: ocular allergy. J Allergy Clin Im-munol. 2000;106(6):1019-1032.
- Bielory L, Friedlaender MH. Allergic conjunctivitis. Immunol Allergy Clin North Am. 2008;28:43-58.
- AAFA. Eye Allergy Survey Results. Available at: www.aafa.org/display.cfm?id=7&sub= 100&cont=688. (Accessed April 2012.)
- Abelson MB, Gomes P. Allergy: The latest news in ocular allergy. EyeWorld Week No.7, April 2006.
- Lorenz D, Walt J, Lee J, Buchholz P, Burk C. The impact of allergic conjunctivitis as measured by the Eye Allergy Patient Impact Questionnaire (EAPIQ). J Outcomes Res. 2003;7:21-33.
- Alexander M, Berger W, Buchholz P, Walt J, Burk C, Lee J, Arbuckle R, Abetz L. The reliability, validity, and preliminary responsiveness of the Eye Allergy Patient Impact Questionnaire (EAPIQ). Health Qual Life Outcomes. 2005;3:67.
- Dart JK, Buckley RJ, Monnickendan M, et al. Perennial allergic conjunctivitis: definition, clinical characteristics and prevalence. A comparison with seasonal allergic conjunctivitis. Trans Ophthalmol Soc UK 1986; 105(Pt 5): 513-520.
- Chisholm-Burns M, Wells B, Schwinghammer T, et al. Pharmacotherapy Principles and Practice. New York: McGraw-Hill Medical; 2007:939-940.
- Glazer C, Johnson T. Allergic Cascade. UT Southwestern Medical Center Occupational Health Department Worker Protection Program. October 2007.
- Stern ME, Beuerman RW, Fox RI, et al. The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea. 1998;17:584-589.
- Nelson JD, Helms H, Fiscella R, et al. A new look at dry eye disease and its treatment. Adv Ther. 2000;17:84-93.
- Luchs J. Ocular Allergic Diseases: Managing Chronic "Repeater" Allergy Patients. Ocular Surgery News. October 18, 2002.
- BSM Consulting. Clinical Course: History Taking: Building the Foundation. 2008.
- Slonim CB and Boone R. The ocular allergic response: A pharmacotherapeutic review. Formulary. April 2004/Vol.39.


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New Tennessee TNReady scores released Friday show a third of all high school students are on track or have mastered their grade level in English and reading and 20 percent are on track in math.
The new release of the standardized testing scores mirror a national college readiness assessment, an expected outcome of the state moving to tougher grading standards this year as it sets a new benchmark on student achievement.
The numbers are almost parallel to ACT college readiness scores released in August, which showed 34 percent of Tennessee public school students met ACT's college readiness benchmark in reading and 27 percent of Tennessee students met that mark in math.
Tennessee Education Commissioner Candice McQueen has for weeks warned that the state's TNReady scores will read lower than any other year because the state wanted to mirror national grading standards. She also warned the numbers can't be compared to the test data from previous years.
"For the first time, we are able to provide educators, families, and students with better information about where students truly are on their path to college and careers," McQueen said in a news release. "Tennessee's students are growing into problem solvers and critical thinkers, and they are rising to meet the higher standards that are based on what our colleges and employers expect."
Year-end high school test scores in history also read lower than previous year tests, while science was graded under the previous benchmark. The state hopes to release district TNReady numbers within the next month, although no date has been set.
The new TNReady test was administered for the first time last school year in high school. Grades 3-8 tests were canceled in the spring after the state's test vendor couldn't deliver paper tests on time to districts, the final issue in a string of mishaps last year.
The move to tougher grading standards is in part due to the state's standardized test not accurately matching the ACT assessment, she said. The state has been called out by national organizations for its accuracy in reporting scores.
The grading standards were increased to align closer to the ACT, and the goal was to be honest in how proficient students are in their understanding of subjects, McQueen said. Student proficiency on the ACT test is lower than what has been reported in past years on the state's standardized tests.
"These results are an opportunity, and we want our teachers, families, and students to know we will all grow from here," McQueen said. "In past transitions to more rigorous expectations, while scores dropped initially, they rose over the long term—and students performed better on national assessments, including by making our state the fastest improving in the country."
The presentation of scores caps a tumultuous past year for McQueen and the Tennessee Department of Education.
On Feb. 8, the first day of testing, McQueen made the call to halt the online portion of the TNReady test due to issues statewide. The state's testing company later said it couldn't meet the necessary demands of students taking the test.
The education department opted to switch to paper tests. However, the problems only snowballed as Measurement Inc., the vendor, missed repeated deadlines to provide millions of paper versions to the state's 146 school districts.
In April the state canceled Measurement Inc.'s contract. Pearson Education was then contracted to grade high school tests and Questar Assessment was announced in July as the state's new vendor, to the tune of a two year, $30 million contract.
Substantial changes have been announced for the 2016-17 school year's TNReady test, including shorter testing times.
Reach Jason Gonzales at 615-259-8047 and on Twitter @ByJasonGonzales.


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I do not have any indication that CWS or its variants are on my box. However, would there be a problem in running CWShredder? I guess as a Network Security geek, I'm just curious what the results would be, if any.
CWShredder Use
Started by cissp, Jun 20 2004 10:30 AM
3 replies to this topic
Posted 20 June 2004 - 10:30 AM
Posted 20 June 2004 - 10:59 AM
If there is no infection, nothing will happen.
SpywareInfo: How are you gentlemen?? All your base are belong to us!!
Spyware: What you say!!
SpywareInfo: You have no chance to survive. Make your time!
Spyware: What you say!!
SpywareInfo: You have no chance to survive. Make your time!
Posted 20 June 2004 - 03:55 PM
Thanks, Mike. Tried it and nothing was detected.
If there is no infection, nothing will happen.
Posted 21 June 2004 - 08:51 AM
Might occasionally give false positives though, depending on the hosts file you are using.
Please note that the software I recommend above is entirely based on only my own experience and testing. In no way should my comments,opinions and endorsements be construed as an endorsement by the forum, nor do they reflect the advise or recommendations by the experts or helpers at spywareinfo.
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0 members, 0 guests, 0 anonymous users


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WA still making up its mind on federal ed waivers
Washington state education officials haven'treally decided yet if the state will apply for a waiver...
Long sentence sought in Wenatchee slaying
The Chelan County prosecutor says he'llseek an exceptional sentence against a man accused of...
Pasco Fire Started by 9-Year Old
Investigators say a fire that damaged abathroom at Pasco's Markham Elementary School was started by...
Fake Baby Bump - Movie Deal
Faking her pregnancy is the high school projectthat keeps paying off for one Toppenish teenager....
Finance Minister resigns over protester deaths in Cairo
Egyptian minister resigns over protester deaths
Egyptian Coptic Christians feel like second class citizens
Christians under siege in post-revolution Egypt
Category: General News
Pope Francis To Visit Home
VATICAN CITY (AP) — Pope Francis will return to the roots of his ministry during a trip to Brazil this July for World Youth Day. The Vatican says the pontiff will visit one of Rio de Janeiro's slums as part of his week-long visit. As archbishop of Buenos Aires, the former Cardinal Jorge Mario Bergoglio (HOHR'-hay behr-GOHG'-lee-oh) often worked and preached in Argentina's slums.


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Legal Question in Real Estate Law in Pennsylvania
I have a mortgage out on my house. The problems are The foundation (basement walls) are falling down, Has plumbing problems, and just found extensive termite damage from basement up to the 2nd floor (1 wall is almost completely destroyed). What rights do I have to get out of this mortgage and home other than just a forclosure?
1 Answer from Attorneys
None. The problems have nothing to do with the mortgage lender. If it is only a short time since your settlement, you MAY have claims against the seller if it did not disclose issues that existed at the time of the sale, and against the home inspector and the company that did the wood destroying insect inspection, if none of those issues were flagged in their reports.
Consult a local real estate lawyer to find out if you have any such claims.
This response is not legal advice, since I do not have all of the information that would be required, and I do not have a representation agreement with you.
* If the answers to your question confirm that you have a valid issue or worthwhile claim, your next step should almost always be to establish a dialog with a lawyer who can provide specific advice to you. Contact a lawyer in your county or township.
* Another reason for contacting a lawyer is that it is often impossible to give a good answer in the Internet Q&A format without having more information. The unique circumstances of your situation and things that you may not have thought to mention in your question may completely change the answer. If you want to be sure that you have a complete answer to your question and an understanding of what that answer means, establish a connection with a lawyer who practices in the area of your concern.