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Allergic rhinitisHay fever; Nasal congestion - allergies
An in-depth report on the causes, diagnosis, treatment, and prevention of common nasal allergies.
Allergic Rhinitis
Allergic rhinitis is theway some people respondto outdoor or indoor allergens:
- Outdoor triggers of allergic rhinitis include ragweed, grass, tree pollen, and mold spores, Outdoor allergens cause seasonal allergic rhinitis (also known as hay fever), which typically occurs during the spring and summer.
- Indoor triggers include dust mites, pet dander, or mold that grows in humid indoor places such as carpets. Indoor allergens can cause perennial (year-round) allergic rhinitis.
Allergic rhinitis tends to run in families. If one or both parents have allergic rhinitis, there is a high likelihood that their children will also have allergic rhinitis. People with allergic rhinitis have an increased risk of developing asthma and other allergies. They are also at risk for developing sinusitis, sleep disorders (including snoring), nasal polyps, and ear infections.
Common symptoms of allergic rhinitis include:
- Runny nose or nasal congestion
- Frequent sneezing
- Itchy watery eyes
- Itching in nose, throat, or roof of mouth
Home remedies for allergic rhinitis include nasal washes with a saline solution. Many different over-the-counter and prescription drugs are used to treat allergic rhinitis. These medications include oral and nasal antihistamines, corticosteroid nasal sprays, cromolyn, leukotriene antagonists such as montelukast (Singulair), and decongestants. Many of these drugs have side effects. Immunotherapy ("allergy shots") may also be an option for some patients.
In addition to avoiding exposure to allergy triggers, people with allergic rhinitis can take precautions to control their environment. These measures include bathing pets weekly, using vacuum cleaners and air conditioners with high efficiency particulate air (HEPA) filters, frequent washing of bedding and curtains, reducing humidity in the house, and removing sources of mold.
Drug Approval
In 2013, the FDA approved a liquid form of antihistamine for treatment of seasonal and perennial allergic rhinitis. Carboxamine (Karbinal ER) is approved for patients ages 2 years and older.
Rhinitis is inflammation of the mucous membrane of the nasal passages. It results from severe nasal congestion or other changes that irritate the nose.
Allergic rhinitis is caused by a substance (allergan) that triggers an allergic response. As part of the allergic response, the body's immune system launches a defensive attack by releasing histamine and other chemicals.
Allergic rhinitis is generally classified as either:
- Seasonal (also called hay fever)
- Perennial (year-round)
Allergens involved in allergic rhinitis come from either outdoor or indoor substances:
- Outdoor allergens such as pollen or mold spores are usually the cause of seasonal allergic rhinitis.
- Indoor allergens such as animal dander or dust mites are common triggers of perennial allergic rhinitis.
Rhinitis can also be due to non-allergic causes such as infections, temperature changes, hormonal changes, certain medications, cigarette smoke, stress, exercise, structural problems in the nose, or other factors. In non-allergic rhinitis, the immune system does not play a role in the body's response to these factors.
Basic symptoms of both allergic and non-allergic rhinitis include:
- Runny nose
- Nasal congestion
- Nasal itching
- Sneezing
- Watery eyes
The allergic process, called atopy, occurs when the body overreacts to a substance that it senses as a foreign "invader". The immune system works continuously to protect the body from potentially dangerous intruders such as bacteria, viruses, and toxins. However, for reasons not completely understood, some people are hypersensitive to substances that are typically harmless.
When the immune system inaccurately identifies these substances (allergens) as harmful, an allergic reaction and inflammatory response occurs.
- When an allergen enters the body, the immune system produces immunoglobulin E (IgE) antibodies. These IgE antibodies then attach themselves to mast cells, which are found in the nose, eyes, lungs, and digestive tract.
- The mast cells release inflammatory chemical mediators, such as histamine, that cause atopic symptoms (sneezing, coughing, wheezing). The mast cells continue to produce more inflammatory chemicals that stimulate the production of more IgE antibodies, continuing the allergic process.
There are many types of IgE antibodies, and each are associated with a specific allergen. This is why some people are allergic to cat dander, while others are not bothered by cats yet are allergic to pollen. In allergic rhinitis, the allergic reaction begins when an allergen comes into contact with the mucous membranes in the lining of the nose.
Triggers of Seasonal Allergic Rhinitis (Hay Fever)
Seasonal allergic rhinitis occurs only during periods of intense airborne pollen or spores. It is commonly, although inaccurately, called hay fever. No fever accompanies this condition, and the allergic response is not dependent on hay. In general, triggers of seasonal allergy in the U.S. include:
- Ragweed. Ragweed is the main cause of allergic rhinitis in the United States. Ragweed season generally lasts from mid-August through the first frost. One plant can release 1 billion pollen grains during the course of a season. Pollen counts are usually highest between 10am – 3pm.
- Grasses. Grass pollen, especially from ryegrass, is another common cause of allergic rhinitis. Grasses affect people from late spring to early summer. Grass allergies are experienced more in the late afternoon.
- Tree Pollen. Small pollen grains from certain trees usually produce symptoms in the early spring.
- Mold Spores. Mold spores grow on dead leaves and release spores into the air. They peak in the spring in warmer climates and in the fall in cooler climates. In some warmer parts of the United States, they may be prevalent year round.
Triggers of Perennial (Year-Round) Allergic Rhinitis
Allergens in the House. Allergens in the home are the most common triggers of perennial (year-round) allergic rhinitis. Household allergens include:
- House dust and mites. Dust mites, specifically mite feces, are coated with enzymes that contain a powerful allergen.
- Cockroaches
- Pet dander
- Molds growing on wallpaper, house plants, carpeting, and upholstery
Risk Factors
Allergic rhinitis usually first appears in childhood or early adulthood but it can affect people of all ages.
Family History
Allergic rhinitis appears to have a genetic component. People with a parent who has allergic rhinitis have an increased risk of developing allergic rhinitis themselves. The risk increases significantly if both parents have allergic rhinitis.
Environmental Exposure
Home or workplace environments can increase the risk for exposure to allergens (mold spores, dust mites, and animal dander) associated with allergic rhinitis.
Exclusively breastfeeding for the first 4 months of life appears to help prevent or delay allergies in high-risk infants. It is not clear if breastfeeding helps prevent the development of allergic rhinitis. There is some evidence that breastfeeding may help prevent wheezing and other symptoms of asthma, a condition that is sometimes associated with allergic rhinitis.
Seasonal allergic rhinitis tends to diminish as a person ages. The earlier the symptoms start, the greater the chances for improvement. People who develop seasonal allergic rhinitis in early childhood tend not to have the allergy in adulthood. In some cases, allergies go into remission for years and then return later in life. People who develop allergies after age 20, however, tend to continue to have allergic rhinitis at least into middle age.
Asthma and Other Allergies
Asthma and allergies often coexist. Patients with allergic rhinitis often have asthma or are at increased risk of developing it. Allergic rhinitis is also associated with eczema (atopic dermatitis), an allergic skin reaction characterized by itching, scaling, and red swollen skin. Chronic uncontrolled allergic rhinitis can worsen asthma attacks and eczema.
Quality of Life
Although allergic rhinitis is not considered a serious condition, it can interfere with many important aspects of life. Nasal allergy sufferersoften feeltired, miserable, or irritable. Allergic rhinitis can interfere with work or school performance.
People with allergic rhinitis, particularly those with perennial allergic rhinitis, may experience sleep disorders and daytime fatigue. Often they attribute this to allergy medication, but congestion may be the cause of these symptoms. Patients who have severe allergic rhinitis tend to have worse sleep problems, including snoring, than those with mild allergic rhinitis.
Chronic Swelling in the Nasal Passages (Turbinate Hypertrophy)
Any chronic rhinitis, whether allergic or nonallergic, can cause swelling in the turbinates, which may become persistent (turbinate hypertrophy). The turbinates are tiny shelf-like bony structures that project into the nasal passageways. They help warm, humidify, and clean the air that passes over them. If turbinate hypertrophy develops, it causes persistent nasal congestion and, sometimes, pressure and headache in the middle of the face and forehead. This condition may require surgery.
Other Complications
Other possible complications of allergic rhinitis include:
- Sinusitis
- Middle ear infections (otitis media)
- Nasal polyps
- Sleep apnea
- Dental overbite
- Palate malformations caused by mouth breathing
Symptom Phases
Symptoms of allergic rhinitis often occur in two phases, early and late.
Early Phase Symptoms. The early phase occurs within minutes of exposure to the allergens and includes:
- Runny nose
- Frequent or repetitive sneezing
- Watery or itchy eyes
- Itching in the nose, throat, or roof of the mouth
Late-Phase Symptoms. Symptoms that may develop several hours or later include:
- Nasal congestion. This is a common symptom in children. Children may push their nose upward with the palm of their hand or twitch their nose rabbit-like to clear the obstruction.
- Plugged ears
- Poor sleep and fatigue, which can lead to irritability and difficulty concentrating
- Eye sensitivity to light. In severe allergies, dark circles may develop under the eye. The lower eyelid may be puffy and lined with creases.
- Postnasal drip
- Sinus headache
- Decreased sense of smell or taste
Symptom Classification
A newer classification system groups allergic rhinitis by how long symptoms last and how severe they are:
- Intermittent rhinitis occurs less than 4 days a week and for less than 4 weeks per year
- Persistant rhinitis occurs at least 4 days during a week and for at least 4 weeks in the year
- Mild rhinitis causes minimal symptoms that do not impact sleep and daily life
- Moderate-to-severe rhinitis has symptoms that cause enough discomfort to affect day-to-day, work, or school activities as well as to disrupt sleep
In most cases, a doctor can diagnose allergic rhinitis based on the patient's symptoms. Your doctor will take your medical history and will ask about:
- When your rhinitis occurs. Rhinitis that appears seasonally is typically due to pollens and outdoor allergens. If symptoms occur throughout the year, the doctor will suspect perennial allergic or non-allergic rhinitis.
- Exposure to household or occupational allergans, including pets.
- Personal history of asthma or other allergies.
- Any family history of allergies.
Physical Examination
The doctor may examine the inside of the nose with an instrument called a speculum. This is a painless procedure that allowsthe doctor to check for redness and other signs of inflammation. The doctor will also usually check the eyes, ears, and chest.
Allergy Skin Tests
Allergy testing may be used to confirm an allergic trigger identified by symptoms. A skin test is a simple method for detecting common allergens. Patients are usually tested for a panel of common allergens. Skin tests are rarely needed to diagnose milder seasonal allergic symptoms before a trial of treatment. Skin tests are not completely accurate and are not appropriate for children younger than age 3.
The procedure is as follows:
- Patients should not take antihistamines for at least 12 - 72 hours before the test. Otherwise an allergic reaction may not show up.
- Small amounts of suspected allergens are applied to the skin with a needle prick or scratch or are injected a few cells deep into the skin. The injection test may be more sensitive than the standard prick test.
- If an allergy is present, a hive (a swollen reddened area) forms within about 20 minutes.
In most situations, before testing occurs patients would have tried to avoid any of their known allergens, as well as tried medications, including nasal corticosteroid sprays. However, patients with more severe symptoms, particularly those with asthma, significant eczema, or nasal polyps, may benefit from earlier skin testing.
Laboratory Tests
Nasal Smear. The doctor may take a nasal smear. The nasal secretion is examined microscopically for factors that might indicate a cause, such as increased numbers of white blood cells, indicating infection, or high counts of eosinophils. High eosinophil counts indicate an allergic condition, but low counts do not rule out allergic rhinitis.
Tests for IgE. Blood tests for IgE immunoglobulin production may also be performed. Newer enzyme-based assays using IgE antibodies have replaced an older test called RAST (radioallergosorbent test). The tests detect increased levels of allergen-specific IgE in response to particular allergens. Blood tests for IgE may be less accurate than skin tests. They should be performed only on patients who cannot undergo skin testing or when skin test results are uncertain.
Nasal Endoscopy
Insome cases of chronic or unresponsive seasonal rhinitis, a doctor may use endoscopy to examine for any irregularities in the nose structure. Endoscopy uses a tube inserted through the nose that contains a miniature camera to view the passageways.
Ruling Out Other Conditions
Rhinitis always precedes and accompanies sinusitis, which is inflammation or infection of the mucosal lining of the sinuses. Acute sinusitis usually clears up on its own. Chronic sinusitis can be more difficult to treat.
Allergic rhinitis also needs to be distinguished from the cold or flu:
- Allergic rhinitis symptoms begin right after exposure to an allergen. Colds or flu develop several days after exposure to a virus.
- Allergic rhinitis symptoms last as long as you are exposed to the allergen. Cold and flu symptoms generally last 2 – 14 days.
- The nasal discharge in allergic rhinitis is usually clear. In colds or flu it is yellow.
- Colds and flu are often accompanied by aches and pain. A fever is a definite sign that the condition is a cold or flu and not allergic rhinitis.
Patients with allergic rhinitis have many treatment options available to them:
- Environmental control measures can help reduce exposure to allergens.
- Nasal washes may provide good symptomatic relief for some patients.
- Nasal medication sprays include nasal corticosteroid sprays, nasal antihistamine sprays, ipratopium bromide nasal spray, nasal cromolyn, and nasal decongestant sprays. DO NOT USE DECONGESTANT SPRAYS FOR MORE THAN THREE DAYS AT A TIME.
- Antihistamine pills are available in many brandsby prescription and over-the-counter. Some are combined with decongestants. Decongestant pills may also be used by themselves.
- Other anti-inflammatory drugs may be used,including leukotriene antagonists.
- Immunotherapy ("allergy shots") are another option.
All drug treatments have side effects, some very unpleasant and, in rare cases, serious. Patients may need to try different drugs until they find one that relieves symptoms without producing excessively distressing side effects.
Treatment of Mild Allergic Rhinitis
Treating mild allergy attacks usually involves little more than reducing exposure to allergens and using a nasal wash. Medications may also be used. Most medications for mild allergic rhinitis are available without a prescription.
Treatments for mild allergic rhinitis include:
- Nasal washes
- Decongestants that relieve nasal congestion and itchy eyes for children over the age of 2 and adults
- Second-generation, non-sedating antihistamines such as cetirizine (Zyrtec, generic), loratadine (Claritin, generic), fexofenadine (Allegra, generic), or desloratadine (Clarinex). These medicationscause less drowsiness than older antihistamines such as diphenhydramine (Benadryl, generic). They are also available as decongestant/antihistamine combinations.
Treatment ofModerate-to-Severe Allergic Rhinitis
For people who suffer from moderate-to-several seasonal allergies, doctors recommend:
- Prescription drugs are required only in severe cases. Because seasonal allergies generally last only a few weeks, most doctors do not recommend the stronger prescription treatments for children. However, in children with both asthma and allergies, treatments for allergic rhinitis may also improve asthma symptoms.
- Patients with severe seasonal allergies should start medications a few weeks before the pollen season and continue taking them until the season is over.
- Immunotherapy ("allergy shots") may be an option for patients with severe seasonal allergies that do not respond to other treatments.
Patients with perennial (year-round) allergic rhinitis or those who have bothersome symptoms that are active during most of the year may require daily medications. This is especially true if patients also have asthma.
Drug treatments for moderate-to-severe allergic rhinitis include
- Anti-inflammatory drugs. Nasal corticosteroids are recommended for patients with moderate-to-severe allergies, either alone or in combination with second-generation antihistamines.
- Antihistamines. The second-generation, non-sedating antihistamines -- such as cetirizine (Zyrtec, generic), loratadine (Claritin, generic), fexofenadine (Allegra, generic), or desloratadine (Clarinex) -- cause less drowsiness than older antihistamines, such as diphenhydramine (Benadryl, generic). They are recommended alone or in combination with nasal corticosteroids for treatment of moderate-to-severe allergic rhinitis. Nasal antihistamine sprays also work well.
- Leukotriene-antagonists and nasal cromolyn may be beneficial in specific cases.
- Immunotherapy ("allergy shots") works well for many patients with severe allergies who do not respond to other treatments. It can also help reduce asthma symptoms and the use of asthma medications in patients with known allergies.
Nasal Washes
For mild allergic rhinitis, a nasal wash can help remove mucus from the nose. You can purchase a saline solution at a drug store or make one at home (2 cups of warm water, a teaspoon salt, pinch of baking soda). If you prepare your own saline solution, use bottled or boiled water, not plain tap water.
Here is a simple method for administering a nasal wash:
- Lean over the sink head down.
- Pour some solution into the palm of the hand and inhale it through the nose, one nostril at a time.
- Spit the remaining solution out.
- Gently blow the nose.
Neti pots have also become popular in recent years for prevention and treatment of allergic rhinitis. Nasal irrigation with a saline solution through a neti pot involves:
- Lean over the sink with your head tilted to one side.
- Insert the spout of the neti pot in the upper nostril.
- Slowly pour the salt water into your nose while continuing to breathe through your mouth.
- The water will flow through the upper nostril and out through the lower nostril.
- When the water finishes dripping out, blow your nose.
- Reverse the tilt of your head and repeat the process with the other nostril.
Treating Itchy Eyes
Antihistamine pills can sometimes help itching and redness in the eyes. Eye drops provide faster relief, and a combination of the two may be best. Eye drops for itchy eyes include.
- Antihistamine eye drops: azelastine (Optivar, generic), olopatadine (Patanol), ketotifen (Zaditor, generic), levocabastine (Livostin) for relief of both nasal symptoms and itchy red eyes
- Decongestant eye drops: naphazoline (Naphcon, , generic), tetrahydrozoline (Visine, Tyzine, generic)
- Combination decongestant/antihistamine: Visine-A, Opcon-A
- Corticosteroids: loteprednol (Lotemax, Alrex), pemirolast (Alamast)
- Non-steroidal antiinflammatory eye drops: ketorolac (Acular, generic)
General Side Effects and Warnings.
- All eye drops can cause stinging, and some may result in headache and nasal congestion.
- No one should continue taking eye drops if they experience pain, changes in vision, worsened redness, or irritation, or if the condition lasts more than 3 days.
- Do not touch the tip of the device to the eye or touch other surfaces with it. Replace the cap after using. Discard any solution that changes color or becomes cloudy.
- People who have heart disease, high blood pressure, an enlarged prostate gland, or glaucoma should talk to their doctor before taking these types of eye drops.
Other Treatments (Alternative and Complementary Medicine)
Some patients with allergies report symptom relief through modalities such as acupuncture and Chinese herbal medicine. While some studies have reported symptom improvement, it is not clear if this is due to a placebo effect.
Histamine is one of the chemicals released when antibodies overreact to allergens. It is the cause of many symptoms of allergic rhinitis. Antihistamine drugscan help relieve:
- Itching, sneezing, and runny nose (unless combined with a decongestant, antihistamines do not work well for relieving nasal congestion).
- Other allergy symptoms unrelated to rhinitis, including hives and some rashes
If possible, take anantihistamine before an anticipated allergy attack.
Many antihistamines are available. They include short-acting and long-acting forms, and come in oral pill and nasal spray forms.
Antihistamines are generally categorized as first- and second-generation. First-generation antihistamines, which include diphenhydramine (Benadryl, generic) and clemastine (Tavist, generic) cause more side effects (such as drowsiness) than most newer second-generation antihistamines. For this reason, second-generation antihistamines are generally preferred and recommended over first-generation antihistamines.
There are some notes of caution when taking any antihistamine:
- Antihistamines may thicken mucus secretions and can worsen bacterial rhinitis or sinusitis.
- Antihistamines can lose their effectiveness over time and a different one may need to be tried.
Second-generation antihistamines are sometimes referred to collectively as nonsedating antihistamines. However, cetirizine (Zyrtec, generic) and the nasal spray antihistamines (Astelin, Patanase)may cause drowsiness when taken at recommended doses. Loratidine (Claritin, generic) and desloratadine (Clarinex) can cause drowsiness when taken at doses exceeding the recommended dose.
Brand Names. Second-generation antihistamines in pill form include:
- Loratadine (Claritin, generic). Loratadine is available over-the-counter and is approved for children ages 2 and older. Loratine-D (Claritin-D) combines the antihistamine with the decongestant pseudoephedrine. Desloratadine (Clarinex) is similar to Claritin but stronger and longer-lasting. It is available only by prescription.
- Cetirizine (Zyrtec, generic). Cetirizine is approved for both indoor and outdoor allergies. It is the only antihistamine to date approved for infants as young as 6 months. It is available over-the-counter. Cetirizine-D (Zyrtec-D) is a pill that combines the antihistamine with the decongestant pseudoephedrine.
- Fexofenadine (Allegra, generic) is also available over-the-counter.
- Levocetirizine (Xyzal) is a prescription medication approved to treat seasonal allergic rhinitis in patients age 2 years and older. It is available in both pill and liquid form.
- Acrivastine and pseudoephedrine (Semprex-D) is a pill that combines an antihistamine and decongestant.
Second-generation antihistamines in nasal form are as good as or better than the oral forms for treatment of seasonal allergic rhinitis. However, they can cause drowsiness, and are not as effective for allergic rhinitis as nasal corticosteroids. Nasal spray antihistamines are available by prescription and include:
- Azelastine (Astelin, Astepro, Dymista)
- Oloptadine (Patanase)
In 2013, the FDA approved a liquid form of antihistamine for treatment of seasonal and perennial allergic rhinitis. Carboxamine (Karbinal ER) is approved for patients age 2 years and older.
Side Effects and Precautions.
- Common side effects include headache, dry mouth, and dry nose. (These are often only temporary and go away during treatment.)
- Drowsiness may occur. The nasal spray forms of second-generation antihistamines cause more drowsiness than the pill forms.
- Extended-release forms of loratadine and cetirizine have other ingredients that can cause other symptoms, including nervousness, restlessness, and insomnia.
Nasal Corticosteroids
Corticosteroids help reduce the inflammatory response associated with allergic reactions. Nasal-spray corticosteroids (commonly called steroids) are considered the most effective drugs for controlling the symptoms of moderate-to-severe allergic rhinitis. They are often used either alone or in combination with second-generation oral antihistamines.
The benefits of nasal spray steroids include:
- Reducing inflammation and mucus production
- Improving night sleep and daytime alertness in patients with chronic allergic rhinitis
- Treating polyps in the nasal passages
Nasal-Spray Brands. Corticosteroids available in nasal spray form include:
- Triamcinolone (Nasacort, generic). Approved for patients age 2 and older.
- Mometasone furoate (Nasonex). Approved of patients age 3 and older.
- Fluticasone (Flonase, generic). Approved for patients age 2 and older.
- Fluticasone and azelastine (Dymista). Approved for patients age 12 and older.
- Beclomethasone (Beconase, Vancenase, generic). Approved for patients age 6 and older.
- Flunisolide (Nasarel, generic). Approved for patients age 6 and older.
- Budesonide (Rhinocort, generic). Approved for patients age 6 and older.
- Ciclesonide (Alvesco, Omnaris). Approved for patients age 12 and older
Side Effects. Corticosteroids are powerful anti-inflammatory drugs. Although oral steroids can have many side effects, the nasal-spray form affects only local areas and has less risk for widespread side effects unless the drug is used excessively. Side effects of nasal steroids may include:
- Dryness, burning, stinging in the nasal passage
- Sneezing
- Headaches and nosebleed (uncommon but should be reported to your doctor immediately)
Possible Long-Term Complications. All corticosteroids suppress stress hormones. This effect can produce some serious long-term complications in people who take oral steroids. Researchers have found far fewer concerns with nasal administration or inhaled forms, but there may be certain problems:
- Effect on growth. The major concern for children is whether nasal steroids, like other forms of steroids, will adversely affect growth. Research indicates that most children who only take recommended dosages of nasal sprays, and do not also take inhaled corticosteroids for asthma, will not have any problems.
- Effect on eyes. Glaucoma is a known side effect of oral steroids. Studies to date have not shown that nasal steroids increase risk for glaucoma. Still, patients should have periodic eye exams.
- Use during pregnancy. Steroids are most likely safe during pregnancy but if you are pregnant talk to your doctor before taking them.
- Nasal passage injury. Steroid sprays may injure the nasal septum (the bony area that separates the nasal passage) if the spray is directed onto it. This complication is very rare.
- Lower resistance to infection. People with any infectious disease or injury in the nose should not take these drugs until the disease or wound has been treated and cured.
Cromolyn serves as both an anti-inflammatory drug and a specific blocker for allergens. The standard cromolyn nasal spray (Nasalcrom, generic) is not as effective as steroid nasal sprays but does work well for many people with mild allergies. It is one of the preferred first-line therapies for pregnant women with mild allergic rhinitis. It may take up to3 weeks to experience full benefit.
Side Effects. Cromolyn has no major side effects, but minor ones include nasal congestion, coughing, sneezing, wheezing, nausea, nosebleeds, and dry throat. The spray can cause burning or irritation.
Leukotriene Antagonists
Leukotriene antagonists are oral drugs that block leukotrienes, powerful immune system factors that cause airway constriction and mucus production in allergy-related asthma. They appear to work as well as antihistamines for treatment of allergic rhinitis, but are not as effective as nasal corticosteroids.
Leukotriene antagonists include zafirlukast (Accolate) and montelukast (Singulair). These drugs are mainly used to treat asthma. Montelukast is also approved to treat seasonal allergies and indoor allergies.
The FDA warns that these drugs have been associated with behavior and mood changes, including agitation, aggression, anxiousness, dream abnormalities, hallucinations, depression, insomnia, irritability, restlessness, tremor, and suicidal thinking and behavior. Patients who take a leukotriene antagonist drug such as montelukast should be monitored for signs of behavioral and mood changes. Doctors should consider discontinuing the drug if patients exhibit any of these symptoms.
Decongestants work by shrinking blood vessels in the nose. Many over-the-counter decongestants are available, which can be either taken by mouth or applied to the nose.
Nasal Decongestants. Nasal-delivery decongestants are applied directly into the nasal passages with a spray, gel, drops, or vapors. Nasal decongestants come in long-acting or short-acting forms. The effects of short-acting decongestants last about 4 hours. Long-acting decongestants last 6 - 12 hours. The active ingredients in nasal decongestants include oxymetazoline, xylometazoline, and phenylephrine. Nasal forms work faster than oral decongestants and may not cause as much drowsiness. However, they can cause dependency and rebound.
The major problem with nasal-delivery decongestants, particularly long-acting forms, is a cycle of dependency and rebound effects. The 12-hour brands pose a particular risk for this effect.
- With prolonged use (more than 3 - 5 days), nasal decongestants lose effectiveness and can cause swelling in the nasal passages.
- The patient then increases the frequency of the dose. As the congestion worsens, the patient may respond with even more frequent doses.
- This causes dependency and increased nasal congestion.
The following precautions are important for people taking nasal decongestants:
- When using a nasal spray, spray each nostril once. Wait a minute to allow absorption into the mucosal tissues, and then spray again.
- Do not share droppers and inhalers with other people.
- Discard sprayers, inhalers, or other decongestant delivery devices when the medication is no longer needed. Over time, these devices can become reservoirs for bacteria.
- Discard the medicine if it becomes cloudy or unclear.
Oral Decongestants. Oral decongestants also come in many brands, which have similar ingredients. The most common active ingredients are pseudoephedrine (Sudafed, other brands, generic) and phenylephrine, sometimes in combination with an antihistamine. Oral decongestants can cause side effects such as insomnia, irritability, nervousness, and heart palpitations. Taking pseudoephedrine in the morning, as opposed to later in the day or before bedtime, can help patients avoid these side effects.
Individuals at Risk for Complications from Decongestants. People who may be at higher risk for complications are those with certain medical conditions, including disorders that make blood vessels highly susceptible to contraction. Such conditions include:
- Heart disease
- High blood pressure
- Thyroid disease
- Diabetes
- Prostate problems that cause urinary difficulties
- Migraines
- Raynaud's phenomenon
- High sensitivity to cold
- Chronic obstructive pulmonary disorder (COPD). People with emphysema or chronic bronchitis should avoid high-potency, short-acting nasal decongestants.
No one with these conditions should use oral or nasal decongestants without a doctor's guidance. Other people who should not use decongestants without first consulting a doctor include:
- Pregnant women
- Children. Children metabolize decongestants differently than adults. Decongestants should not be used at all in infants and children under the age of 4 years, and some doctors recommend not giving them to children under the age of 14. Children are at particular risk for central nervous system side effects, including convulsions, rapid heart rates, loss of consciousness, and death.
Decongestants can cause dangerous interactions when combined with certain types of medications, such as the antidepressant MAO inhibitors. They can also serious problems when combined with methamphetamines or diet pills. Be sure to tell your doctor about any drug or herbal remedy you are taking. Caffeine can also increase the stimulant side effects of pseudoephedrine.
Nasal Ipratropium
Ipratropium bromide (Atrovent, generic) is a prescription nasal spray that can help relieve runny nose. It works best when given in combination with a nasal corticosteroid. Side effects include nasal dryness, nosebleeds, and sore throat. It should not be used by people who have glaucoma or men who have an enlarged prostate gland.
Immunotherapy (commonly called "allergy shots") is a safe and effective treatment for patients with allergies. It is based on the premise that people who receive injections of a specific allergen will lose sensitivity to that allergen. The most common allergens for which shots are given are house dust, cat dander, grass pollen, and mold.
Immunotherapy benefits include:
- Targeting the specific allergen
- Reducing sensitivity in airways in the lungs as well as in the upper airways
- Preventing the development of new allergies in children
- Reducing asthma symptoms and the use of asthma medications in patients with known allergies. Research suggests it may also help prevent the development of asthma in children with allergies.
Candidates for Immunotherapy. Immunotherapy may be given to anyone with allergies that do not get better with medication and who has had a positive allergy test to specific allergens. The latest guidelines indicate that immunotherapy is safe for young children. Immunotherapy is safe for pregnant women who are already receiving it, although half-strength doses are generally recommended, and it should not be started during pregnancy.
Individuals at Risk for Complications. People who should probably avoid immunotherapy include those who have:
- An extreme response to skin tests (this may predict an allergic reaction).
- Wheezing.
- Uncontrolled severe asthma or lung disease.
- Patients taking certain medications (such as beta blockers).
- The health status of anyone should be determined before starting treatment.
Administering Therapy
The major downside to immunotherapy is that it requires a prolonged course of weekly injections. The process generally includes:
- Injections of diluted extracts of the allergen are given on a regular schedule, usually twice a week to weekly at first, then in increasing doses until a maintenance dose has been reached. It usually takes several months and may take up to 3 years to reach a maintenance dose.
- At that time, intervals between shots can be 2 - 4 weeks, and the treatment is continued for another 3 - 5 years.
- Patients can experience some relief within 3 - 6 months. If there is no benefit within 12 - 18 months, discontinue the shots.
- Injections are usually administered subcutaneously into the skin of the arm.
The use of an injection series is effective, but patients often have difficulty complying with the regimens. Some other schedules and delivery methods are being investigated that might make the program easier:
- Rush Immunotherapy uses several shots a day over a period of 3 - 5 days to achieve the full dose. Studies suggest that it is effective and safe, but anaphylaxis and severe reactions can occur. Patients must be selected carefully and must be monitored closely during this period for severe reactions.
- Sublingual Immunotherapyis an oral form of immunotherapy that uses an under-the-tongue tablet. Although sublingual immunotherapy is prescribed in many countries in Europe and South America, it is not approved in the United States.
Recent reviews indicate that sublingual therapy may be helpful for asthma in particular, and may also be beneficial for allergic rhinitis and rhinoconjunctivitis. However, many questions remain including dosage and duration of treatment. At this time, sublingual immunotherapy is not considered standard practice in the United States. Other studies indicate that subcutaneous immunotherapy is more effective than sublingual immunotherapy.
Side Effects and Complications of Immunotherapy
Injections for ragweed and, sometimes, dust mites have higher risks for side effects than other allergy shots. If complications or allergic reactions develop, they usually occur within 20 minutes, although some can develop up to 2 hours after the shot is given.
Side effects of immunotherapy include:
- General itching, swelling, red eyes, hives, soreness at the injection site.
- Less common side effects are low blood pressure, asthma worsening, or difficulty breathing. This is due to an extreme hypersensitivity response called anaphylaxis. It can also occur if excessive doses are given.
- In rare cases, particularly because of excessive doses or if a patient has a serious lung problem, severe reactions can occur, which can be life threatening.
- Pre-medicating patients with antihistamines and corticosteroids may help reduce the risk of reactions to immunotherapy, although this could mask early warning signs.
Lifestyle Changes
People with existing allergies should avoid irritants or allergens. These triggers include:
- Pollen. This is the primary cause of allergic rhinitis.
- Dust mites, specifically mite feces, which are coated with enzymes that contain a powerful allergen. These are the primary allergens inside the home.
- Animal dander (flakes of skin) and hair from cats, house mice, and dogs. House mice are a significant source of allergens, particularly in urban children.
- Molds.
- Fungi.
- Cockroaches are major asthma triggers and may reduce lung function even in people without a history of asthma.
Some studies suggest that early exposure to some of these allergens, including dust mites and pets, may actually prevent allergies from developing in children.
Indoor Protection against Allergens
Controlling Pets. People who already have pets and are not allergic to them are probably at low risk for developing such allergies later on. When children are exposed to more than one dog or cat during their first year, they have a much lower risk for not only pet allergies but also seasonal allergies and asthma. (Pet exposure does not protect them from other allergens, notably dust mites and cockroaches).
For children who have an existing allergy to pets:
- If possible, pets should be given away or kept outside.
- If this isn't possible, they should at least be confined to carpet-free areas outside the bedroom. Cats harbor significant allergens, which can even be carried on clothing. Dogs usually present fewer problems.
- Washing animals once a week can reduce allergens. Dry shampoos, such as Allerpet, that remove allergens from skin and fur and are available for both cats and dogs and are easier to use than wet shampoos.
Preventing Exposure to Cigarette and Cooking Smoke. Although cigarette smoke is not a trigger for allergic rhinitis, parents who smoke should quit. Studies show that exposure to second-hand smoke in the home increases the risk for asthma and asthma-related emergency room visits in children.
Controlling Dust. Spray furniture polish is very effective for reducing both dust and allergens. Air cleaners, filters for air conditioners, and vacuum cleaners with High Efficiency Particulate Air (HEPA) filters can help remove particles and small allergens found indoors. Neither vacuuming nor the use of anti-mite carpet shampoo is, however, effective in removing mites in house dust. Vacuuming actually stirs up both mites and cat allergens. People with these types of allergies should avoid having carpets or rugs in their homes. For children with allergies, vacuuming should be performed when the child is not around.
Bedding and Curtains:
- Replace curtains with shades or blinds, and wash bedding using the highest temperature setting.
- Encase mattress and pillows in special dust mite proof covers (however, washing is very important since impermeable covers alone do not help prevent allergies and studies have not proven benefit with these covers).
- Wash pillows in water hotter than 150 °F, or in cooler water with detergent and bleach.
- Wash sheets and blankets weekly in hot water.
- Avoid sleeping or lying on cushions or furniture that is cloth covered.
- Stuffed toys should be kept away from the bed and washed weekly as described above. Placing toys in a dryer or freezer may help but is not considered enough protection.
- Children should sleep as high off the floor as possible (avoid the bottom bunk of a bunk bed).
Reducing Humidity in the House. Living in a damp environment is counterproductive:
- Humidity levels should not exceed 30 - 50%.
- Fix all leaky faucets and pipes, and eliminate collections of water around the outside of the house.
- Dehumidify basements, but empty and clean humidifier daily with a vinegar solution.
- Clean often any moldy surfaces in basement or in other areas of the home.
Exterminating Pests (Cockroaches and Mice):
- Use professional exterminators to eliminate cockroaches. (Cleaning the house using standard housecleaning techniques may not eliminate the cockroach allergens themselves.)
- Exterminate mice and attempt to remove all dust, which might contain mouse urine and dander.
- Keep food and garbage in closed containers.
- Keep food out of bedrooms.
Outdoor Protection
Avoiding Outdoor Allergens. The following are some recommendations for avoiding allergens outside:
- Start taking allergy medications 1 - 2 weeks before ragweed season begins. Be sure to take allergy medications before going outside. If regular medications do not work, ask your doctor about allergy shots.
- Camping and hiking trips should not be scheduled during times of high pollen count (May and June for grass pollen and September to October for ragweed).
- Patients who are allergic should avoid barns, hay, raking leaves, and mowing grass. (A mask can be worn during outdoor chores to help reduce pollen exposure.)
- Sunglasses can help prevent pollen from getting into eyes.
- After being outdoors, clean off pollen residue by bathing, washing hair and clothes, and using a nasal salt water rinse.
- Keep doors and windows closed during pollen season.
Dietary Factors
Some evidence suggests that people with allergic rhinitis and asthma may benefit from a diet rich in omega-3 fatty acids (found in fish, almonds, walnuts, pumpkin, and flax seeds) and fruits and vegetables (at least five servings a day).Researchers are also studying probiotics -- so-called good bacteria, such as lactobacillus and bifidobacterium-- which can be obtained in supplements. Some studies have found that probiotics may help reduce allergic rhinitis symptom severity and medication use.
- www.aaaai.org -- American Academy of Allergy, Asthma & Immunology
- www.acaai.org -- American College of Allergy, Asthma & Immunology
- www.niaid.nih.gov -- National Institute of Allergy and Infectious Diseases
Al Sayyad JJ, Fedorowicz Z, Alhashimi D, Jamal A. Topical nasal steroids for intermittent and persistent allergic rhinitis in children. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD003163.
Bahls C. In the clinic. Allergic rhinitis. Ann Intern Med. 2007 Apr 3;146(7):ITC4-1-ITC4-16.
Blaiss MS. Safety considerations of intranasal corticosteroids for the treatment of allergic rhinitis. Allergy Asthma Proc. 2007 Mar-Apr;28(2):145-52.
Brinkhaus B, Ortiz M, Witt CM, Roll S, Linde K, Pfab F, et al. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. Ann Intern Med. 2013 Feb 19;158(4):225-34.
Brozek JL, Bousquet J, Baena-Cagnani CE, Bonini S, Canonica GW, Casale TB, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010 Sep;126(3):466-76.
Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011 Jan;127(1 Suppl):S1-55. Epub 2010 Dec 3.
Di Bona D, Plaia A, Leto-Barone MS, La Piana S, Di Lorenzo G. Efficacy of subcutaneous and sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: a meta-analysis-based comparison. J Allergy Clin Immunol. 2012 Nov;130(5):1097-1107.e2. Epub 2012 Sep 27.
Dykewicz MS, Hamilos DL. Rhinitis and sinusitis. J Allergy Clin Immunol. 2010 Feb;125(2 Suppl 2):S103-15.
Frew AJ. Allergen immunotherapy. J Allergy Clin Immunol. 2010 Feb;125(2 Suppl 2):S306-13.
Frew AJ. Sublingual immunotherapy. N Engl J Med. 2008 May 22;358(21):2259-64.
Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011 Dec 17;378(9809):2112-22. Epub 2011 Jul 23.
Lin SY, Erekosima N, Kim JM, Ramanathan M, Suarez-Cuervo C, Chelladurai Y, et al. Sublingual immunotherapy for the treatment of allergic rhinoconjunctivitis and asthma: a systematic review. JAMA. 2013 Mar 27;309(12):1278-88.
Matricardi PM, Kuna P, Panetta V, Wahn U, Narkus A. Subcutaneous immunotherapy and pharmacotherapy in seasonal allergic rhinitis: a comparison based on meta-analyses. J Allergy Clin Immunol. 2011 Oct;128(4):791-799.e6. Epub 2011 May 26.
Rabago D, Zgierska A. Saline nasal irrigation for upper respiratory conditions. Am Fam Physician. 2009 Nov 15;80(10):1117-9.
Saleh HA, Durham SR. Perennial rhinitis. BMJ. 2007 Sep 8;335(7618):502-7.
Scow DT, Luttermoser GK, Dickerson KS. Leukotriene inhibitors in the treatment of allergy and asthma. Am Fam Physician. 2007 Jan 1;75(1):65-70.
Sheikh A, Hurwitz B, Shehata Y. House dust mite avoidance measures for perennial allergic rhinitis. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD001563.
Sicherer SH, Wood RA; American Academy of Pediatrics Section On Allergy And Immunology. Allergy testing in childhood: using allergen-specific IgE tests. Pediatrics. 2012 Jan;129(1):193-7. Epub 2011 Dec 26.
Smits WL, Giese JK, Letz KL, Inglefield JT, Schlie AR. Safety of rush immunotherapy using a modified schedule: a cumulative experience of 893 patients receiving multiple aeroallergens. Allergy Asthma Proc. 2007 May-Jun;28(3):305-12.
Sur DK, Scandale S. Treatment of allergic rhinitis. Am Fam Physician. 2010 Jun 15;81(12):1440-6.
Vliagoftis H, Kouranos VD, Betsi GI, Falagas ME. Probiotics for the treatment of allergic rhinitis and asthma: systematic review of randomized controlled trials. Ann Allergy Asthma Immunol. 2008 Dec;101(6):570-9.
Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug;122(2 Suppl):S1-84.
Advanced Studyec
Related Informationec
Review Date: 6/24/2013�
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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"Though she be but little, she is fierce!" —W.S.
Get moving with these sports-specific spots across the USA.
It's just like Tetris, minus the 8-bit music.
Ride your stereo to work, because you can.
It's a high-speed folding bike you can fit in your trunk or under your desk!
The beloved actor and comedian was also a cycling enthusiast.
Carrying your golf bag is one thing. These are another.
Todd Orr wins the manliness award forever.
One dozen mad, manufactured adrenaline rushes.
This could turn you into the next Dustin Johnson. In theory.
Gear up and get outside this summer with the best.
In Episode 5, a guy and his grandma catch some air.
Possibly the most versatile bike ever created.
From cruisers to e-cycles, here are some of our favorites.
So you want to join the spandex army? Know these things first.
Improve performance and comfort from city streets to wild trails for National Bike Month.
This rust-free ride withstands wear and tear of the beach.
This hybrid bike just took winter sports to another level.

subset: commoncrawl


text: Admin on July 22, 2013 0 Comments Double tap kegerators are designed to store not one, but two kegs of your favorite beer. Just like a single tap kegerator, the double taps allow you to serve your favorite brews at the perfect temperature any time you want, with the added bonus of choosing between two brews. Using a double tap kegerator is an ideal solution if you are throwing a house party, both large and small. Save your money and eliminate the need for beer runs in the middle of your party. Even if your guests don't drink all the beer, the kegerator will keep your beer fresh for months to come. An EdgeStar double tap kegerator turns any room in your home into your favorite pub. EdgeStar kegerators offers ultra-low temps, so you serve your brew at the perfect temperature every time. EdgeStar double kegerators are capable of reaching temps well into the low 30s. There's plenty of brands of kegerators out there, and we even carry multiple brands on the site, but it's hard to beat an EdgeStar. For those who love to brew their own beer, the kegerators come complete with a conversion kit and two ball-lock cornelius kegs. These kegs are exactly what you need to serve up your own home brew at your next gathering. If you are not a brewmaster, or if you just like the taste of a beer already on the market, commercial kegs fit perfectly as well. When it comes to EdgeStar kegerators, all of the parts are made in the U.S. and are NSF approved. Commercial-grade parts include a five-pound C02 cylinder, faucets, tap handles, regulator and a stainless steel draft tower. All beer lines and air lines are included, making it incredibly easy to set up your kegerator. A double tap kegerator is a great addition to your man cave, game room, garage, kitchen or home bar. The ability to store, chill and dispense two of your favorite beers from one source makes this a versatile system that keeps your party going for longer. These full-size kegs are available in black or stainless steel, and look great wherever you decide to place them. Recommended Reading 4 Ways to Convert a Single Tap Tower to a Double Tap 5 Tips for Buying the Perfect Outdoor Kegerator Must-Have Kegerators for Your Summer Parties Which Kegerator is Right for Me?


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Harrogate, Tenn. - Brandon Armstrong scored 18 of his team-high 20 points in the second half and Darryl Garrett also added 20 points as host Lincoln Memorial overcame five three-pointers by Gaither Hendrix as the Tornados fell in Tex Turner Arena on Wednesday night,
Hendrix led Brevard (7-4, 5-2 SAC) on the night, tying a season-high with 24 points, hitting a game-high five three-pointers and added six assists as Brevard shot 44.0 percent (11-25) from behind the arc in the contest. Josh Roper added 14 of his 18 points in the second half, while Josh Jordan scored 16 points and pulled down five rebounds in the loss.
Armstrong and Garrett led the #11-ranked Railsplitters (15-0, 7-0 SAC) with 20 points apiece, while Desmond Johnson added 15 points and completed the double-double with 15 rebounds, hitting 11 of 14 free throws in the game. D'Mario Curry also achieved double figures scoring in the contest with 14 points and six rebounds.
Curry and Hendrix traded jumpers as both teams scored in the first possessions of the game, but Johnson scored the next four points and Curry added another jumper as Lincoln Memorial opened up the contest with an 8-2 lead, 16:33 into the game. The Railsplitters continued to build their lead, opening up a 17-point advantage over the Tornados following a three-pointer by Jordan at the 9:52 mark, putting LMU up 27-10.
Brevard brought it back to single digits with an 8-0 run as Schauss and Hendrix hit back-to-back three-pointers and Roper converted a pair of free throws, cutting the game to 27-18 with 9:01 remaining in the opening period, but LMU responded with another run in going back up 16 at 38-22 on a Jordan jumper inside the arc with 5:43 to play.
Hendrix ended the run and cut the lead again, hitting back-to-back three-pointers, scoring a game-high 16 points in the first half, hitting four three-pointers, with the last one coming at the 3:13 mark to put the score at 41-33. Moose and Roper sandwiched a Brandon Armstrong layup with jumpers of their own, before Curry closed out the first half with a turnaround jumper in the paint to send the teams to the locker room with Lincoln Memorial holding the 45-37 lead.
Armstrong took over the second half for the Railsplitters, scoring 13 points in the first 12 minutes of the second period, hitting a layup to put Lincoln Memorial up 70-55 with 9:45 remaining in the game. The Tornados again cut it back to within single digits, scoring eight straight points, capped by Ryson Felder connecting on a three-pointer as he was fouled and converted the four-point play to put the score at 70-64 with 8:25 left in the contest.
Down 16 again, with 6:32 to go following a pair of free throws by Garrett, the Tornados put together their final run of the game, cutting the lead back to eight at 82-74 on another three-pointer by Hendrix with 4:16 to play, but this was as close as Brevard would get the remainder of the game as the Tornados fell in Tex Turner Arena on Wednesday night, 96-82.
The Tornados shot 43.5 percent (30-69) from the floor in the game, but committed 13 turnovers in the loss. Lincoln Memorial held the 42-30 rebounding edge in the game, hitting 50.8 percent (30-59) from the field in the contest in their 15th consecutive victory.
Brevard continues on the road in conference play this weekend, traveling to Wingate, N.C. and Cuddy Arena as they take on Wingate University. Tipoff between the SAC opponents is set for 4 p.m.


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The annual Eagle Scout Recognition Dinner will be on Saturday, February 15, 2014 at Laborers Union Hall, 108 E Anthony Dr, Urbana. It is not too late to make reservations with payment to the council office. The price is now $35 per person (Eagles and Silvers being honored come free), and no reservations will be accepted after Thursday, February 13
Come salute the Eagle Class of 2013!


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Water Compliance Resources
Drinking Water | Wastewater | Water Quality | Edwards Aquifer
Many documents on this page are in Adobe Acrobat Portable Document Format (PDF) or Microsoft Word . (Help with downloading files).
Drinking Water
Public Water Supply: Compliance Resources — Information, guidance, and forms for public water systems in Texas.
Obtaining Approval for a New or Existing Public Water System
- Submit Public Water System Plans for Review — Information for new water systems to submit plans before construction begins.
- You're a Public Water System…Now What? (RG-496) — Guide for owners of existing water systems who have recently learned they own a PWS.
Water Funding
- Water and Wastewater Funding Sources — View a list of financial assistance programs for water and wastewater projects.
Drought Planning for Public Water Systems
- Drought and Public Water Systems — Information about water use restrictions, drought contingency planning, and water conservation.
Asset Management for Public Water Systems
- Managing Small Public Water Systems (RG-501) — A five-part series helping owners, managers, or operators of small water utilities understand and comply with rules and develop tools for planning and operation.
Water at Your R.V. Park or Temporary Housing Site
- RV Parks: Am I Regulated (RG-499) — How to comply with TCEQ rules at your RV park.
Sampling, Record Keeping and Reporting
- Public Water System Monitoring Plans — How to comply with requirements for monitoring plans for public water systems in Texas.
- Managing Small Public Water Systems: Compliance (RG-501d) — Pages 13-22 of this guide cover sampling and report requirements for public water systems.
- Security Vulnerability Self-Assessment Guide for Water Systems - This Security Vulnerability Self-Assessment Guide is designed to help small water systems determine possible vulnerable components and identify security measures that should be considered. This document is designed particularly for systems that serve populations of 3,300 or fewer.
- Emergency Response Planning for Public Drinking Water Systems - Preparing an emergency response plan (ERP) is an essential part of managing a drinking water system.
- Managing Small Domestic Wastewater Systems (RG-530) – A five-part series helping owners, managers, or operators of small wastewater systems understand and comply with rules and develop plans to manage and operate a sustainable utility.
- Wastewater Treatment Plants — Provides reporting and compliance information for wastewater treatment plants, including wastewater compliance spreadsheets and compliance tools.
- Troubleshooting Bacteria Effluent from Wastewater Treatment Plants (RG-515) — regulatory guidance to help wastewater systems minimize bacteria in effluent
Notification Forms and Reporting
- Water Quality Noncompliance Notification (TCEQ-00501) (PDF) — form to notify the TCEQ of a water quality noncompliance or unauthorized discharge
- Accidental Discharge or Spill Monthly Summary Form (TCEQ-20756) (DOCX) — form to report any single, accidental discharge or spill of treated or untreated domestic wastewater that occurs at a wastewater treatment or collection system owned or operated by a local government
- Public Notification Form for Wastewater Discharges (TCEQ-20627) (DOCX) — form to notify the public that an unauthorized discharge has occurred
- EPA NPDES Reporting Requirement Handbook — Walks users through how to report using DMRs
- Reporting on Monthly Effluent Report (MER) Forms — Resources for small business owners and local governments who have state-only (non TPDES) wastewater permits
Wastewater Compliance Spreadsheets and Tools
- Geometric Mean Calculator for Wastewater — Interactive calculator to compute the geometric mean on a set of numbers to assist with completion of discharge monitoring reports (DMR) for domestic wastewater facilities.
- Minor Discharge - Rectangular Weir with End Contractions
- Minor Discharge V-Notch Weir
- Texas Land Application Permits (TLAP) - Rectangular Weir with End Contractions
- TLAP V-Notch Weir
Septic Systems
- On-Site Sewage Facilities — Information on permitting a Septic System
Water Quality
- Check the status of your stormwater permit online.
- Industrial Stormwater General Permit - Industrial facilities with an applicable Standard Industrial Classification (SIC) code that discharge stormwater into a storm drain system or to surface waters in the state of Texas must comply with stormwater permitting requirements.
- Construction Stormwater General Permit - Operators of construction sites that disturb one or more acres of land must comply with stormwater permitting requirements.
- Municipal Separate Storm Sewer Systems (MS4s) – MS4s consist of a conveyance or system of conveyances, including roads with drainage systems, streets, catch basins, curbs, gutters, ditches, human-made channels, or storm drains. MS4s with Urbanized Areas must comply with stormwater permitting requirements.
Pesticide Applications
- Pesticides General Permit: Am I Regulated? - Those applying certain pesticides in, over, or near waters of the United States (U.S.) in Texas must comply with permitting requirements.
Aggregate Production Operations
- Dirt, Sand, and Rock Quarries and Aggregate Processing Plants: Compliance Resources - If you own or operate a rock quarry, gravel pit, borrow pit, or similar aggregate production operation, you may be required to register with the TCEQ as an Aggregate Production Operation.
Edwards Aquifer
- Edwards Aquifer: Compliance Resources — Information and resources for small-business owners and local governments planning any construction activity over the Edwards Aquifer in Texas.
- Edwards Aquifer Protection Program — Tools, guidance and other information regarding the Edwards Aquifer Protection Program which serves to regulate activities, including construction, that have the potential for polluting the Edwards Aquifer.
Where can I find more information and assistance?
The TCEQ's Small Business and Local Government Assistance Section offers free, confidential help to small businesses and local governments working to comply with state environmental regulations. Call us at 800-447-2827 or visit our Web page at TexasEnviroHelp.org.


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Well Mr Fitz, I'm fitter, stronger and healthier than I've ever been, thanks to knowledge which comes from experience.
Printable View
Well Mr Fitz, I'm fitter, stronger and healthier than I've ever been, thanks to knowledge which comes from experience.
You suggest that advancement consists of conformity?Quote:
New designs by "mainstream" companies aim to do, and have done, just that, allowing surfers who enjoy surfing in a more similar style to the rest of us
Lol ok
Yes you have, in fact most of what you have seen can't be replicated on a BIC or any of the common longboard types.Quote:
Because I have not seen a single "maneuver" in your videos that cannot be replicated on a 10' Bic board
Build one if you want to ride one cheaply.Quote:
You constantly say how none of the commenters have "experienced both sides of the coin" the way you have....maybe make a board that will retail for less than a quarter million dollars and more people will have the opportunity to do so.
There isn't one, except that it suits us to price them thus.Quote:
I'm a little curious to hear your justification for the prices of your boards.... (cue the "Stay on topic, please" response from Roy).
gotta be Roy's cousin
The last session with an appropriate soundtrack... I once owned a waterfront pole house on the point here, which I built myself back in '88.. good times.
Thanks to Heavy Hitters for the track
my thoughts from yesterday are confirmed.... I caught myself in one of the biggest yawns while watching this.
Roy... you've mastered the art of boring... I guess its a byproduct of efficency? there's a both a compliment and truth in my statements.
in all honesty i don't think my front door would ride any worse than this. it floats, it's wood and it's heavy. put those together on the face of a perfect peeling point break and it goes. all for under $500k.. there are shapers doing very interesting things with wood. roy isn't one of them.
Whatever...here's a brief overview of the break during the session, that's my dog on the rocks. This will be part of a ten minute documentary which will be out in a month or so, including me yapping on camera.


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Saint Louis University is one of the region's leading centers for the treatment of diseases and conditions of the head and neck. The physicians of SLUCare, who make up the University's department of otolaryngology, offer head and neck tumor surgery and facial reconstruction, and treat hearing loss and ear disease; laryngology and voice disorders; pediatric ear, nose and throat problems; disorders of the nose and paranasal sinuses; and conditions affecting geriatric patients.
Through SLUCare's Center for Cerebrovascular and Skull Base Surgery, Saint Louis University Sinus Institute, the Dizziness Clinic, the Cochlear Implant Program and other programs within Saint Louis University, our specialists provide treatment and diagnosis for thousands of patients in the St. Louis area each year.
Their association with Saint Louis University — a major research institution — allows our otolaryngologists to incorporate the very latest research into your care. It is the kind of treatment you will find only at an academic medical practice and only through SLUCare.
Doctors Office Building [map]
3660 Vista Ave., Suite 312
St. Louis, MO 63110
(314) 977-5110
SLUCare Otolaryngology Services at Mercy [map]
621 S. New Ballas Road, Suites 307A and 482A
St. Louis, MO 63141
(314) 251-6362
Saint Louis University Cancer Center [map]
3655 Vista Ave., St. Louis, MO 63110
(314) 577-8880
SSM Health Cardinal Glennon Children's Hospital [map]
1465 S. Grand Blvd., St. Louis, MO 63104
(314) 268-4010
St. Anthony's Medical Center - South County [map]
12700 Southfork Road, Suite 155D, St. Louis, MO 63128
(314) 842-3535
Mercy Medical Building - Washington, Mo. [map]
851 E Fifth St., Suite 306
Washington, MO 63090
(314) 977-4440
Perry County Memorial Hospital [map]
424 N. West St., Perryville, MO 63775
(573) 547-4288


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Reid: More taxes. Obama lays out immigration plan. Shurtleff to woo LDS on reform.
Happy Wednesday. Senate Majority Leader Harry Reid says lawmakers should try again to replace soon-to-be-implemented cuts to the Pentagon and domestic programs with alternative spending cuts and tax hikes. Reid's comments are likely to fire up the right, and with it the House, a month before the March 1 deep cuts are set to go into place. [HuffPost]
Topping the news: In a major policy speech in Las Vegas, President Barack Obama outlined his four-pronged plan for immigration reform, including cracking down on those who hire illegal immigrants, and providing a fast track to citizenship for people who came to the country illegally as young children, as long as they pursue college or a military stint. [Politico] [NYTimes] [WaPost] [APviaTrib]
-> Obama has an ally on immigration reform in former Utah Attorney General Mark Shurtleff, who will lobby LDS officials about supporting the comprehensive overhaul. [Trib]
-> Meanwhile, Sen. Orrin Hatch is co-sponsoring a bipartisan immigration bill, which would increase the number of visas available to highly-skilled immigrants in science, math, engineering and technology fields by at least 50,000 visas per year. [Trib] [NYTimes]
Tweets of the day: From @CameronMVM: "Pro tip: The public ed appropriations committee meeting feed is way less boring with the Black Keys playing in the background."
From @paulmero: "Finally an Obama speech I can agree with: immigration"
From @BenWinslow: "I will resist the taffy at the #utleg. I will resistthe taffy at the #utleg."
In other news: The U.S. Attorney for Utah is asking a judge to force Jeremy Johnson to stop talking to the news media, saying that his statements could affect his own legal proceedings. [Trib] [DNews]
-> Utah's government fared well as far as providing information to the public online, earning a 'B' rating from a non-profit dedicated to government transparency. [Trib]
-> Deficit reduction talks in Congress mean smaller, tighter budgets for some state agencies, which may face even deeper cuts if the congressional stalemate isn't resolved. [Trib]
-> The BLM says they've pulled three parcels totaling about 5,000 acres in Eastern Utah from an oil and gas lease sale to check out environmental concerns about the land.[APviaTrib] [DNews]
-> Paul Rolly lays out his case for enacting immigration reform. [Trib]
-> After meeting with transportation officials, Gov. Gary Herbert urged Utahns to use public transit to clean up the murky winter air. His office said they had other "innovative" solutions from the meeting, but wasn't ready to go public. [Trib] [Fox13]
From the Hill: The Utah Senate offers all its ways to connect, from Facebook to Twitter to YouTube and all other forms of social media available to constituents. [SenateSite]
-> The House moved to change the way legislators are paid, by continuing to give out the $16,380 that lawmakers already make, but requiring further expenses like hotels and food to be documented by receipts for reimbursement. [Trib] [DNews] [UtahPolicy]
-> A group of mothers are calling on state lawmakers to sign a pledge to clean up Utah's air. The specific language is still being worked out. [Trib]
-> Utah lawmakers are trying to shorten the age gap in statutory rape laws, bringing the maximum age difference down to seven years. [Herald] [Fox13]
-> Computer problems yesterday meant that some new lawmakers couldn't read the text of what bills they were voting on. [UtahPolicy]
-> The Utah Sheriff's Association got a pat on the back from Rep. Curtis Oda at a committee hearing for its gun rights manifesto sent Obama. [Trib]
-> Lawmakers moved closer in a committee hearing to allowing drivers to turn right on red lights at some unique interchanges, introducing "In God We Trust" license plates and cutting down how many non-carpoolers can use express lanes. [Trib] [DNews]
-> A bill that would make it easier to restrict target shooting on state lands during wildfire season passed unanimously in a subcommittee hearing. [Trib] [Herald]
-> Bryan Schott says House Speaker Becky Lockhart wasn't wise in trying to set a trap for Herbert on his lack of vetoes. [UtahPolicy]
-> A bill that would have allowed judges to consider fault when determining alimony payments was nixed in a subcommittee, with opponents saying it would make already heated divorces even more contentious. [DNews]
Nationally: Some of the more conservative Republicans with tea party ties aren't happy with a proposed immigration overhaul, calling it amnesty for millions of illegal immigrants. [NYTimes]
-> Embracing immigration reform, however, may not be the remedy for bringing Latino voters back en masse to the GOPonly 34 percent of voters said they care about immigration issues in a new Pew Hispanic Center poll. [WaPost]
-> Fancy yourself an immigration policy wonk? Take a look at the full plan here.[WaPost]
-> Sen. John Kerry was widely and swiftly confirmed by the Senate yesterday as the 68th Secretary of State. While no date for his resignation has been set, Massachussets Gov. Deval Patrick, a fellow Democrat, will appoint a replacement until a special election is held. [NYTimes] [Globe] [WaPost]
-> The special envoy assigned to shuttering Guantanamo Bay is being "reassigned" without a replacement a signal from the administration that closing down the notorious prison isn't a top priority. [NYTimes]
-> Transportation Secretary Ray LaHood is leaving his post as soon as a successor is confirmed, just as insiders expected him to. [WaPost]
-> Coming soon to bookstores: Hillary Clinton's memoir. [WaPost]
Where are they?
Utah Governor Gary Herbert has an interview with Comcast Capitol Journal, meets with the family of fallen Utah State Trooper Aaron Beesley and then delivers his State of the State speech.
Utah Attorney General John Swallow heads to a budget hearing at the Capitol and then flies to Los Angeles for a conference.
SLC Mayor Ralph Becker meets with his public utilities director Jeff Niermeyer and his senior staff, and then hits a meeting about a proposed performing arts center.
WVC Mayor Mike Winder hits the Local Officials Day at the legislature.
President Barack Obama has lunch with outgoing Secretary of State Hillary Clinton, and has interviews with reporters from Telemundo and Univision.
Got a tip? A birthday, wedding or anniversary to announce? Email us at email@example.com. If you haven't already, sign up for our weekday email and get this sent directly to your inbox. [Trib]
Thomas Burr and Emily AndrewsTwitter.com/thomaswburr and Twitter.com/emilytandrews


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The way search warrants are served on Utah homes will likely be up for debate during the next legislative session as civil-rights groups call for restrictions on when police can break down doors.
Connor Boyack, director of Libertas Institute, said the libertarian group is leading a legislative campaign to change search-warrant policy, which he called overly broad.
Boyack says the Libertas Institute will lobby to amend the state law so that forcible entry is authorized only in cases where there is a "pre-existing risk to someone's life."
"In cases where there is no risk to other lives, with police officers busting down the door, in our view, it creates dangerous circumstances rather than trying to neutralize," Boyack said Tuesday.
The American Civil Liberties Union of Utah may also lobby for changes.
Marina Lowe, legislative and policy council for ACLU of Utah, said Tuesday that the group has been in talks with Libertas Institute, but it is still early and nothing substantial has been presented yet.
She said the ACLU is concerned with police becoming "more militarized," adding that it is troubling that the drug raid at Matthew David Stewart's home led to death.
The deadly January 2012 raid at Stewart's Ogden home is at the heart of the debate.
The Weber Morgan Narcotics Strike Force served a knock-and-announce warrant that quickly turned into a gunbattle in which Agent Jared Francom was killed and five other officers were wounded. Stewart, who was being investigated for marijuana cultivation, was also wounded.
According to court documents, 16 pot plants were found in his house after the raid.
Stewart, 39, was charged with aggravated murder, seven first-degree felony counts of attempted aggravated murder and one second-degree felony count related to alleged marijuana cultivation.
In May, just days before Stewart committed suicide at the Weber County jail, his attorneys argued unsuccessfully in Ogden's 2nd District Court that Agent Jason Vanderwarf used a stale tip and lied to obtain the search warrant.
Defense attorney Randall Richards suggested in his motion that Vanderwarf may have illegally entered Stewart's backyard to look through a rear window to see evidence of humidifiers, bright lights and extension cords which Vanderwarf said was indicative of a marijuana grow. Vanderwarf said in the search warrant that he observed those items through a window on the south door while knocking on the door in an effort to speak with Stewart.
On Tuesday, Stewart's family released an affidavit to The Salt Lake Tribune from a private investigator who was investigating the shootout that seems to support Richards' assertion that the warrant was obtained illegally.
Investigator David Doddridge wrote in the affidavit, signed in July, that he was investigating Stewart's backyard last April when he was approached by Ogden Officer Brian Eynon.
"During our discussions, [Eynon] pointed at the rear basement window and stated that it was indeed through this window that task force officers observed the grow to develop PC [probable cause] for the warrant," Doddridge wrote, adding that the conversation was recorded.
That conversation was not presented during the May arguments about the legality of the search warrants. Ultimately, Judge Noel Hyde denied the defense motion for a hearing about the search warrant, saying there was insufficient evidence that Vanderwarf would not have been able to see what he said he saw through the side door.
Richards said Tuesday that the conversation was not used because prosecutors likely would have tried to disqualify it as hearsay. The defense attorney said he is not involved in the push to change search-warrant laws, but added he has offered his help if needed, since he was the lead counsel in Stewart's case.
He said he is concerned about the frequency with which home search warrants are served in Weber County in connection with small amounts of drugs.
"I deal with half a dozen searches in Weber County that involved minuscule amounts of drugs," Richards said. "In every one of these searches, there is the potential of someone getting hurt or killed, whether that is the resident of the home or the police officer."
Richards said he believes limiting search warrants to crimes that put people's lives at risk would be a move in the right direction.
"If there is a danger to the community, a risk to somebody, I'm OK at that point [to enter a home] to save a life," Richards said. "But for a drug bust? I have a hard time with that. And the fact of the matter is, there's a lot of other ways to do it."
Boyack said there has been a "great deal of interest" from legislators in sponsoring the bill. He said that the Stewart case is just one of several Utah police incidents that have pushed the group to ask for changes in the law regarding search warrants.
"There have been enough news stories in the recent years to merit legislative discussion about whether current policies are sufficient," Boyack said. "So the Matthew David Stewart case clearly catalyzed it, but because a police officer died, it allows people to better understand that our effort is not to protect just the victims, but to protect police officers. If our policy was in place, it is extremely likely Officer Francom would be alive today."


text: To determine your maximum heart rate, subtract your age from 220. This number represents how many times your heart should beat per minute at its maximum rate. Multiply that number by 0.6 and 0.85 to determine the range of heart rate to strive for. Healthy people can build up gradually to sustain this heart rate for 30 to 45 minutes at least 3 times a week to build aerobic fitness. The health benefits of exercise depend more on regular activity than on pace, intensity, and heart rate.


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The rockfall that killed an Emery County miner Friday occurred during a process known as retreat mining "pulling pillars" in mining vernacular, according to the federal Mine Safety and Health Administration, which is investigating the accident.
It's the same process that killed six men at the Crandall Canyon Mine in 2007. On Saturday, MSHA spokesman Jesse Lawder said Elam Jones, a continuous mining machine operator at the Rhino coal mine, was struck by a falling slab of rock 10 feet wide by 10 feet long and 22 inches thick.
Retreat mining is a widely used and MSHA-regulated process for removing as much coal as possible from sections of a coal seam.
Once a mining section reaches its limits, and all that's left is a checkerboard series of coal pillars left behind to hold up the roof, crews start at the deepest pillars and start cutting them out in a methodical manner described in detail in MSHA permits. They do this row after row, backing out toward the surface as they go, until most of the recoverable coal has been excavated.
But it is dangerous. MSHA's website has a number of pages devoted to "best practices" for safely pulling pillars, including one that notes that between 1997 and 2008, 29 miners were killed while engaging in this form of mining.
That toll includes the six men who were buried by a catastrophic implosion of the walls in the Crandall Canyon Mine on Aug. 6, 2007. They were pulling pillars in an aged section of that Emery County Mine when the walls blew in, entombing them.
Three more men died and six were injured 10 days later in another implosion.


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Forget injured Queensland halfback Daly Cherry-Evans.
It seems NSW should be wary of wounded Maroons pivot Johnathan Thurston in Wednesday night's State of Origin game two in Sydney.
Queensland captain Cameron Smith said potential matchwinner Cherry-Evans (knee) would be given until the last minute to prove his fitness after admitting it would be a "big ask" for understudy Ben Hunt to make his Origin debut in a must-win clash.
However, the threat Cherry-Evans poses if fit may pale in comparison to what Thurston has planned judging by Smith's assessment of the disgruntled Maroons playmaker at training.
Thurston was arguably hurting the most after NSW's 12-8 game one win in Brisbane after successfully being targeted in defence by Jarryd Hayne and missing six tackles - two of them leading to the Blues' only two tries.
And Hayne will again have Thurston in his sights after statistics revealed the Queensland No.6 had missed a total of 16 tackles in three games against the 100kg fullback, including the NRL.
Not that Thurston had to be told.
The North Queensland Cowboys five-eighth revealed post match he was filthy with his game one performance that was compounded by a 0-2 goalkicking record.
Smith said he did not believe Thurston had a bad game but sensed something ominous brewing for NSW.
"He's certainly been very focused for this game, very vocal at training," Smith warned.
"He's a champion and I will never knock a champion.
"I don't think I have seen him play a bad game.
"He might have been quiet by his standards in game one but I don't think he played all that bad.
"But I have no doubt he will bounce back and have one of his best games on Wednesday night."
Smith said Thurston had taken Hunt under his wing as they sweat on the last-minute fitness call on Cherry-Evans.
If Cherry-Evans is passed fit, Queensland will use a No.7 who has never trained as Maroons halfback for a game they must win to keep their quest of nine straight Origin series alive.
If Cherry-Evans is cut, Hunt will be asked to don the Maroons No.7 shirt after just 13 games as Broncos halfback.
"It's a big ask," Smith said of Hunt stepping up.
"But we have all been there before, we have all had to debut at some stage.
"His form for the Broncos has been outstanding this year.
"And from what I have seen at training he is a confident kid - and that is what you need from a seven.
"He will be able to handle it if Cherry-Evans doesn't play."


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Burton Apollo Backpack
Don't be fooled by its simplicity, this pack has just what you need for a creative commute, without the added fluff.
The streamlined organization of the Burton Apollo Pack makes it easy to navigate from point A to point B and everywhere else in the alphabet. With fleece-lined tablet storage, dual mesh water bottle pockets, and a front stash pocket that offers easy access on the fly, the Apollo has a place for everything, in a clean and simple pack that's 100% focused on function.
- Fleece-Lined Sleeve for Tablet or Small Laptop [11.5in x 7.5in] [29cm x 19cm]
- Dual Mesh Water Bottle Pockets
- Front External Stash Pocket for Magazines or Jacket
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Return to site home page
Seeyond Select's movable walls and wall facings are ready to ship. Simply select your feature, specify the options (tessellation, mobility, or lighting) and place your order. Then your new architectural feature will ship to a certified local partner who will deliver and install your new Seeyond Select wall or facing.


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LONG BEACH - Council members are expected to approve a pension reform deal with the city's largest union today that would save $125.5million over the next 10 years.
Officials consider the agreement with the 3,600-member International Association of Machinists and Aerospace Workers the capstone of a three- year effort to overhaul city pensions.
Members of the union-endorsed contract changes last week that combine increased employee retirement contributions with reduced benefits for future workers.
Current workers will pay 6 percent more of their salaries toward retirement costs, an increase from 2 percent to what is considered a full employee's share of 8 percent, while continuing to receive 2.5 percent of their pay as pension for each year worked and being able to retire at age 55.
Employees hired after Jan. 1 will contribute 7 percent of pay toward their pensions, receive 2 percent as pension for each year on the job and reach retirement eligibility at age 62.
The union also negotiated an extension of its current contract, to Sept. 30, 2014, and a guarantee that no more of its employees would be laid off this fiscal year.
According to a memorandum, the amendments, which would go into effect Jan. 26, will save Long Beach $2.5 million in its general fund and $7.6 million in all funds for the current fiscal year ending Sept. 30. Next year, the annual savings going forward are estimated at $3.8 million for the general fund and $11.8 million across all funds.
Last year, Long Beach financial planners estimated a $10.9 million general fund deficit for 2014.
firstname.lastname@example.com, 562-499-1254, twitter.com/EricBradleyPT
Add your voice
What: Long Beach City Council meeting
When: 5 p.m. Tuesday
Where: Council chambers,
City Hall, 333 W. Ocean Blvd.
Watch: The meeting can be viewed live on Charter Communications Channel 3, Verizon FiOS Channel 21 and online at www.longbeach.gov.


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The 2016 Board Compensation Tables provide foundation board and staff with the tools they need to benchmark their board compensation policies and practices against peers in the field. This report contains data collected through the Council's 2016 Grantmaker Salary and Benefits Survey and presented by foundation type, asset group, and U.S. Census region.
The 2016 Salary Tables provide aggregate information on staff salaries among U.S. foundations and corporate giving programs.
Understanding the challenges of currency fluctuations on international grantmaking, and taking action to minimize their impact can ensure that this natural process does not become an added barrier to overseas giving. This resource focuses on some of the challenges foundations and giving programs and their grantees face as a result of fluctuating currency exchange rates, and highlights various ways that U.S. grantmakers are dealing with them in their international grantmaking activities. It offers insights from the field that may be useful to grantmakers considering starting an international giving program and to more seasoned ones wishing to improve their practices.
Built on Principle will help family foundations achieve excellence using the Stewardship Principles for Family Foundations as a blueprint for excellence.
Closing a nonprofit charitable institution presents a range of unknowns to the grantmaking community. In this analysis, authors John Dickason and Duncan Neuhauser provide guidance to foundations considering whether to create a time-limited foundation or bring a foundation to an end. Topics include managing finances, grants, human and physical resources, archives, history and records.
The report explores the ways in which infrastructure organizations think about the value and the mechanics of collaboration—the drivers and barriers to collaborative work—and to determine ways to encourage more effective partnerships. The publication features a framework for understanding different types of collaboration, a set of recommendations for better collaboration, and a series of case studies that show a range of partnerships that tease out the potential benefits and challenges of various kinds of collaboration.
Family foundations can find opportunities even in times of great change and crisis. Facing Forever will arm you with the tools, stories, and resources to help you prepare for current and future transitions. At the very least, the difficult issues it raises will help get your board talking about and planning for highly personal and highly probable possibilities.
The Council conducted the foundation management survey in March 2010 in cooperation with the Foundation Center. Respondents were asked to provide information on their boards' demographics, compensation and reimbursement practices, liability insurance, ethics policies, and information on their foundations' administrative expenses and fiscal oversight. All reports in the series provide detailed breakdowns of survey data by foundation type and asset size. The second report of the series, Administrative and Investment Expenses, provides a variety of administrative and investment expense ratios.
The Council on Foundations' Foundation Management Series provides foundation boards and staff with the tools needed to benchmark their practices and operations against peers in the field. Containing data from the Council's 2009 Foundation Management survey, the series will consist of three reports: Board Composition and Compensation, Administrative and Investment Expenses, and Fiscal Oversight. The first report of the series, Board Composition and Compensation, offers a summary of key findings on foundation policies regarding board compensation and board diversity. The report also provides detailed breakdowns of survey data by foundation type and asset size.
Fiscal Oversight covers the use of independent auditors, the fiscal responsibilities of board committees, and the impact of audit results. The study also provides data on conflict of interest policies, directors and officers liability insurance, and board discretionary giving and matching gifts.
Foundation CEOs and trustees share insights and personal stories related to significant paths of change and how they overcame setbacks. Download a copy and gain best practices to help you successfully lead your foundation, boards and staff.
The Principles were created by representatives of more than 40 charitable sector organizations including the Council on Foundations (the working group coordinator), Independent Sector, InterAction and Grantmakers Without Borders, as an alternative to the U.S. Treasury Department's Voluntary Anti-Terrorist Guidelines.
Many people want to start foundations, but few start out knowing exactly what sort of organization they are going to create. The purpose of this e-book is to help potential donors understand the many different entities that are commonly referred to as foundations and to provide an understanding of the legal framework necessary to establish a foundation.
The Giving Family offers parents dozens of simple family activities to teach children of any age how to give their time, their talents, and (yes!) their money to people and causes they care about
The Grandparent Legacy Project is an oral history tool that helps grandparents communicate their stories—their legacies—across the generations. Created by 21/64 and the Association of Small Foundations, this resource excerpts interviews with 15 well-known philanthropic grandparents, a CD to hear their voices, and a workbook.


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Stephen F. Austin Wins Allstate Sugar Bowl Collegiate Bowling Invitational
Sunday, October 20, 2013
Stephen F. Austin University, ranked No. 9 in the country, captured the title at the inaugural Allstate Sugar Bowl Collegiate Bowling Invitational on Sunday afternoon at the AMF All-Star Lanes in Kenner. The Ladyjacks defeated sixth-ranked Sam Houston to claim the tournament title. Alabama State placed third and Texas Southern was fourth, while the host, Tulane University, finished in eighth place.