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> Multiple chemical sensitivity (MCS)
Multiple chemical sensitivity (MCS)
Also listed as:
MCS, Chemical sensitivity, Sick building syndrome, Environmental illness
Related Terms
Author information
Integrative therapies
Common triggers
Other types of chemical sensitivities
Integrative Therapy Quick Links:
Applied kinesiology
Black seed
Cat's claw
Folate (folic acid)
Hypnotherapy, hypnosis
Lactobacillus acidophilus
Thymus extract
Related Terms
Allergen, allergic, allergic reaction, allergic response, annoyance reactions, anxiety, carbon monoxide, cigarette smoke, chemical irritants, chemical spill, chemicals, chlorine, depression, depressive disorder, formaldehyde, hypersensitive, hypersensitivity, immune hypersensitivity, indoor allergens, intoxication syndrome, irritational syndrome, limbic system, pollutants, TILT, toxic-induced loss of tolerance, toxins.
Multiple chemical sensitivity (MCS) describes an allergy-like reaction or sensitivity to chemicals. Patients who have MCS experience symptoms, including headache, skin rash, dizziness, and nausea, after exposure to chemicals that most healthy individuals can tolerate. Symptoms may develop after exposure to chemicals from products, such as perfumes, gasoline, smoke, or chlorine.
The duration of exposure and quantity of the chemical that can elicit a reaction varies among patients. MCS may occur if a patient was exposed to high levels of toxins from a chemical spill. It may also occur after long-term contact with low-levels of chemicals, which may be present in an office with poor ventilation. If chemicals from inside a building appear to be causing the symptoms, the condition is often called sick building syndrome.
Several organizations, including the American Academy of Allergy and Immunology, the American Medical Association, the California Medical Association, the American College of Physicians, and the International Society of Regulatory Toxicology and Pharmacology, do not recognize MCS has an established disease. This is because a clear relationship between chemical exposure and symptoms has not been established. Even though symptoms develop after exposure to chemicals, researchers have not discovered how the chemicals trigger the reaction. It has been suggested that MCS may be an allergic or toxic reaction to chemicals, but there is no evidence to support either of these claims.
Some researchers believe that symptoms are caused by psychological factors rather than physiological factors. It has been reported that 50% of patients with symptoms of MCS meet the criteria for having anxiety or depressive disorders. However, it remains unclear whether these psychological disorders are simply associated with MCS or whether they cause the condition. Studies are being conducted to determine the pathology of the disease.
Despite limited information about the disease, MCS is considered a valid condition for workmen's compensation claims, liability, tort, and regulatory actions.
MCS appears to be most common among patients who are 30-50 years old. According to the U.S. Environmental Protection Agency (EPA), about one-third of individuals who work inside buildings claim to be sensitive to one or more common chemicals.
Since little is known about MCS, specific treatments are unknown. However, symptoms generally subside once the patient avoids exposure to known chemical irritants. Patients can minimize exposure by purchasing hypoallergenic products. Patients who have sick building syndrome should talk to their colleagues and/or bosses to find ways to improve ventilation in the building.
Author information
This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Asthma and Allergy Foundation of America. .
Arnold Llamosas PA, Arrizabalaga Clemente P, Bonet Agusti M, et al. Multiple chemical sensitivity in sick-building syndrome. Med Clin (Barc). 2006 May 27;126(20):774-8. .
Das-Munshi J, Rubin GJ, Wessely S. Multiple chemical sensitivities: A systematic review of provocation studies. J Allergy Clin Immunol. 2006 Dec;118(6):1257-64. Epub 2006 Sep 25. .
Glinton GJ. Multiple-chemical sensitivity. Medsurg Nurs. 2005 Dec;14(6):365-9; quiz 370. .
Kolstad HA, Silberschmidt M, Nielsen JB, et al. Multiple chemical sensitivity, a well-defined illness? .
Multiple Chemical Sensitivity (MCS). .
Natural Standard: The Authority on Integrative Medicine. .
U.S. Department of Labor. .
The cause of multiple chemical sensitivity (MCS) remains unknown. Healthcare providers disagree about whether symptoms are caused by physiological or psychological factors.
Some researches suggest that once airborne chemicals are inhaled, they may affect an area of the brain called the limbic system. The limbic system is involved in emotions, memory, and motivated behavior, which may make a patient more sensitive to a chemical odor. Scientific evidence to support this theory is lacking in the available literature.
It has also been suggested, but not scientifically proven, that patients with MCS have a damaged immune system.
Another theory, called toxic-induced loss of tolerance (TILT), suggests that exposure to chemicals may cause individuals to become sensitive to chemicals that they were once able to tolerate. The more the individual is exposed to the chemical, the more severe the reaction. However, research is needed to verify this claim.
Symptoms of multiple chemical sensitivity (MCS) vary widely among patients. Common symptoms include headache, fatigue, dizziness, nausea, irritability, intolerance to heat or cold, confusion, difficulty concentrating, earache, stuffy nose, itchy skin, sneezing, sore throat, impaired memory, difficulty breathing, changes in heart rate, chest pain, muscle pain or stiffness, gas or bloating, hives, skin rash, mood changes, and diarrhea.
Because little is known about the pathology of multiple chemical sensitivity (MCS), diagnostic tools are unavailable. Healthcare providers will conduct a physical examination and detailed medical history. Some patients may be asked to record when symptoms occur and how long they last. A diagnosis is typically made after the healthcare provider identifies a relationship between a patient's symptoms and exposure to chemicals.
Since little is known about MCS, specific treatments are unknown. However, symptoms generally subside once the patient discontinues exposure to known chemical irritants.
Proper ventilation can help decrease the number of chemicals and irritants in the air.
Keep the windows closed when driving, especially in areas of high traffic. Many chemicals in gasoline and diesel can trigger a reaction in patients who have MCS.
Integrative therapies
: Currently, there is insufficient available evidence on the safety and efficacy of integrative therapies for the treatment or prevention of multiple chemical sensitivity (MCS). The therapies listed below have been studied for related conditions such as allergies and chemical toxicity, should be used only under the supervision of a qualified healthcare provider, and should not be used in replacement of other proven therapies or preventive measures.
Good scientific evidence
: EDTA chelation became well known during the 1950s, when it was proposed as a method to cleanse the blood and blood vessel walls of toxins and minerals. For many years, chelation therapy has been used with calcium disodium EDTA to treat heavy metal toxicity. It is still an accepted medical therapy for lead toxicity, and several studies report lower levels of lead in the blood and slower progression of kidney failure. Chelation therapy may also be used to treat iron, arsenic, mercury, or cobalt poisoning. However, some research results are mixed. More studies are needed to clarify.
Avoid in patients taking anticoagulants or antiplatelets. Avoid during root canal therapy. Avoid if pregnant or breastfeeding.
Unclear or conflicting scientific evidence
Applied kinesiology
: Applied kinesiology is commonly used for food allergy diagnosis. However, there is conflicting scientific evidence as to whether applied kinesiology is an effective diagnostic tool. Further research is warranted before a firm conclusion can be drawn.
Applied kinesiology techniques in themselves are generally considered to be safe. However, medical conditions should not be treated with AK alone, and should not delay appropriate medical treatment.
Black seed
: Studies in patients with allergies found that black seed decreased allergic disease severity. The effect of black seed for allergies is still not clear and further study is required.
Avoid with a known allergy/hypersensitivity to black seed, its constituents, black seed oil, or to members of the Ranunculaceae family. Allergic contact dermatitis has been reported after topical use of black seed or the oil from the seed.
: A chelating treatment of calcium has been suggested to reduce blood levels of lead in cases of lead toxicity. Reduced symptoms have been observed in most, but not all, patient case reports and case histories. Adequate calcium intake appears to be protective against lead toxicity. Treatment of lead toxicity should only be done under supervision of a qualified healthcare professional.
Avoid if allergic or hypersensitive to calcium or lactose. High doses taken by mouth may cause kidney stones. Avoid with high levels of calcium in the blood, high levels of calcium in urine, high levels of parathyroid hormone, bone tumors, digitalis toxicity, ventricular fibrillation, kidney stones, kidney disease, or sarcoidosis (inflammation of lymph nodes and various other tissues). Calcium supplements made from dolomite, oyster shells, or bone meal may contain unacceptable levels of lead. Use cautiously with achlorhydria (absence of hydrochloric acid in gastric juices) or irregular heartbeat. Calcium appears to be safe during pregnant or breastfeeding women; talk to a healthcare provider to determine appropriate dosing during pregnancy and breastfeeding.
Cat's claw
: It has been suggested that cat's claw may help treat allergies. However, there is limited scientific evidence to support this claim. More well-designed trials are needed to determine whether cat's claw is a beneficial treatment.
Avoid if allergic to cat's claw or
plants or plants in the Rubiaceae family such as gardenia, coffee, or quinine. Avoid with a history of conditions affecting the immune system (such as AIDS, HIV, some types of cancer, multiple sclerosis, tuberculosis, rheumatoid arthritis, lupus). Use cautiously with bleeding disorders or a history of stroke, or if taking drugs that may increase the risk of bleeding. Discontinue use two weeks before surgery/dental/diagnostic procedures with bleeding risk, and do not use immediately after these procedures. Cat's claw may be contaminated with other
species. Reports exist of a potentially toxic, Texan grown plant,
Acacia gregii
being substituted for cat's claw. Avoid if pregnant, breastfeeding, or trying to become pregnant.
: Chlorophyll is a chemoprotein commonly known for its contribution to the green pigmentation in plants, and is related to protoheme, the red pigment of blood. It can be obtained from green leafy vegetables (broccoli, Brussels sprouts, cabbage, lettuce, and spinach), algae (
), wheat grass, and numerous herbs (alfalfa, damiana, nettle, and parsley). Yusho poisoning is caused by ingestion of rice oil contaminated with polychlorinated biphenyls, specifically polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs). A chlorophyll-rich diet may increase PCDF and PCB elimination, but further high quality research is needed.
Avoid if allergic or hypersensitive to chlorophyll or any of its metabolites. Use cautiously with photosensitivity, compromised liver function, diabetes, or gastrointestinal conditions or obstructions. Use cautiously if taking immunosuppressants or antidiabetes agents. Avoid if pregnant or breastfeeding.
: Clay lozenges have been used historically in the treatment of mercuric chloride poisoning and were officially mentioned in several European pharmacopoeias, including the Royal College, until the middle 19th Century. However, there is not enough scientific evidence to recommend the use of clay by mouth for mercuric chloride poisoning at this time, as there is a risk of clay itself containing contaminants.
There is a lack of reports of allergy to clay in the available scientific literature. However, in theory, allergy/hypersensitivity to clay, clay products, or constituents of clay may occur. Avoid if pregnant or breastfeeding.
Folate (folic acid)
: Folate and folic acid are forms of a water-soluble B vitamin. Folate occurs naturally in food, and folic acid is the synthetic form of this vitamin. Folate may lower blood arsenic concentrations and thereby contribute to the prevention of arsenic poisoning. Additional research is needed in this area.
Avoid if allergic or hypersensitive to folate or any folate product ingredients. Use cautiously if receiving coronary stents or with anemia or seizure disorders. It is recommended that pregnant women consume 400 micrograms of folate daily in order to reduce the risk of fetal defects. Folate is likely safe if breastfeeding.
Hypnotherapy, hypnosis
: It has been suggested that hypnotherapy may be effective for allergies. However, further research is necessary to determine whether it is an effective treatment.
Use cautiously with mental illnesses like psychosis/schizophrenia, manic depression, multiple personality disorder or dissociative disorders. Use cautiously with seizure disorders.
: Iron deficiency may increase the risk of lead poisoning in children. However, the use of iron supplementation in lead poisoning should be reserved for those individuals who are truly iron deficient or for those individuals with continuing lead exposure, such as continued residence in lead-exposed housing.
Iron is a trace mineral, and hypersensitivity is unlikely. Avoid with known allergy/hypersensitivity to products containing iron. Avoid excessive intake. Avoid iron supplements with blood disorders that require frequent blood transfusions. Use iron supplements cautiously with a history of kidney disease, intestinal disease, peptic ulcer disease, enteritis, colitis, pancreatitis, hepatitis, alcoholism, or with a history of heart disease. Use cautiously in those who plan to become pregnant, or in those older than age 55. Pregnant or breastfeeding women should consult their healthcare professionals before beginning iron supplementation.
Lactobacillus acidophilus
: Limited available study suggests that the
Lactobacillus acidophilus
) strain L-92 (L-92) may be effective for the treatment of Japanese cedar-pollen allergy. Further research is needed to confirm these results.
may be difficult to tolerate if allergic to dairy products containing
Avoid with history of an injury or illness of the intestinal wall, immune-disease, or heart valve surgery. Avoid with prescription drugs, such as corticosteroids, because of the risk of infection. Use cautiously with heart murmurs. Antibiotics or alcohol may destroy
Therefore, it is recommended that
be taken three hours after taking antibiotics or drinking alcohol. Some individuals may use antacids, such as famotidine (Pepcid®) and esomeprazole (Nexium®), to decrease the amount of acid in the stomach one hour before taking
: Research shows that topical application of an alcoholic onion extract significantly reduced responses to allergies. Although intriguing, more research is needed in this area to establish the efficacy and dosing of topical onion extracts.
Avoid if allergic or hypersensitive to onion (
Allium cepa
), its constituents, or members of the Lilaceae family. Use cautiously with hematologic (blood) disorders, diabetes, hypoglycemia (low blood sugar), and hypotension (low blood pressure). Use cautiously if taking anticoagulants or antiplatelets (blood thinners). Avoid medicinal doses if pregnant or breastfeeding.
: Preliminary evidence suggests some benefit of perilla extract for allergies. Further clinical trials are required before conclusions can be made.
Avoid if allergic/hypersensitive to perilla or members of the Lamiaciae/Labiatae family. Use cautiously with cancer, low HDL-cholesterol, and immune disorders. Use cautiously if taking NSAIDS or barbiturates. Avoid if pregnant or breastfeeding.
: Only a few types and combinations of probiotics have been studied as a possible allergy treatment. They have been studied mostly in children, teenagers, and young adults. Further research is necessary before a firm conclusion can be made.
Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.
: Reishi mushroom (
Ganoderma lucidum
), also known as
ling zhi
in China, grows wild on decaying logs and tree stumps. Reishi occurs in six different colors, but the red variety is most commonly used and commercially cultivated in East Asia and North America.
Ganoderma lucidum
has shown a beneficial effect in treating
Russula subnigricans
(RSP) poisoning in limited study. Further well-designed clinical trials are needed to confirm these results.
Avoid if allergic or hypersensitive to any constituents of
Ganoderma lucidum
or any member of its family. Use cautiously with diabetes, blood disorders (including hemophilia), low blood pressure, or ulcers. Reishi is likely safe when consumed in amounts generally found in foods in non-allergic pregnant or breastfeeding women.
: Based on preliminary study, safflower (
Carthamus tinctorius
) oil may effectively remit the symptoms of neurotoxicity from lithium. However, more studies are needed to better understand safflower's effect on lithium toxicity.
Avoid if allergic/hypersensitive to safflower, safflower oil, daisies, ragweed, chrysanthemums, marigolds, or any related constituents. Use parenteral safflower oil emulsions cautiously in newborns. Use cautiously if taking anticoagulants (blood thinners) or anti-platelet drugs, immunodepressants or pentobarbital. Use cautiously with diabetes, low blood pressure, liver problems, bleeding disorders, or skin pigmentation conditions. Use cautiously if pregnant or breastfeeding.
: The term spirulina refers to a large number of cyanobacteria or blue-green algae. Spirulina extract plus zinc may be useful for the treatment of arsenic poisoning. Additional research is needed to confirm early study findings.
Avoid if allergic or hypersensitive to spirulina or blue-green algae. Use cautiously with phenylketonuria, autoimmune diseases, bleeding disorders, diabetes, osteoporosis or if taking products containing the blue-green algae species
spp., and
spp. Use cautiously in underweight patients or in those taking antiobesity agents or appetite suppressants. Use cautiously if consuming a high-protein diet. Avoid in children and pregnant or breastfeeding women.
Thymus extract
: Thymus extract may reduce allergy symptoms due to its potential immune stimulating effects. More clinical trials are required before recommendations can be made involving thymus extract for this use.
Avoid if allergic or hypersensitive to thymus extracts. Use bovine thymus extract supplements cautiously due to potential for exposure to the virus that causes "mad cow disease." Avoid use with an organ transplant or other forms of allografts or xenografts. Avoid if receiving immunosuppressive therapy, with thymic tumors, myasthenia gravis (neuromuscular disorder), untreated hypothyroidism, or if taking hormonal therapy. Avoid if pregnant or breastfeeding; thymic extract increases human sperm motility and progression.
: Limited available study has shown that a combination of spirulina extract plus zinc may be useful for the treatment of chronic arsenic poisoning with melanosis and keratosis. More research is needed to confirm the effects of zinc alone.
Zinc is generally considered safe when taken at the recommended dosages. Avoid zinc chloride because evidence of safety and effectiveness are currently lacking. Avoid with kidney disease. Use cautiously if pregnant or breastfeeding.
: Selenium is a mineral found in soil, water, and some foods. Selenium has been proposed as a potential treatment for arsenic poisoning, although reliable evidence is currently lacking in this area.
Avoid if allergic or sensitive to products containing selenium. Avoid with a history of non-melanoma skin cancer. Selenium is generally regarded as safe for pregnant or breastfeeding women. However, animal research reports that large doses of selenium may lead to birth defects.
Avoid or minimize exposure to known chemical irritants. Patients can purchase hypoallergenic products. If food additives, preservatives, or artificial sweeteners are suspected triggers, patients can purchase organic or "all natural" foods.
Proper ventilation can help decrease the number of chemicals and irritants in the air. Consider installing central air conditioning with a high-efficiency particulate air (HEPA) filter attachment. These air filters can remove many airborne pollutants that may trigger a reaction.
Keep the windows closed when driving, especially in areas of high traffic. Many chemicals in gasoline and diesel can trigger a reaction in patients who have multiple chemical sensitivity (MCS).
Common triggers
: Multiple chemical sensitivity (MCS) may occur after exposed to high levels of toxins from a chemical spill. It may also occur after long-term contact with low-levels of chemicals that may be present in an office with poor ventilation. If chemicals from inside a building appear to be causing the symptoms, the condition is often called sick building syndrome. Areas of poor ventilation increase the number of chemicals and irritants in the air.
: Sick building syndrome occurs most often in new buildings that are designed to be energy-efficient, have windows that do not open, and have poor ventilation. These buildings often have high levels of carbon dioxide, which is a frequent cause of sick building syndrome. Chemicals found in renovation supplies, cleaning agents, and office machinery may also cause the reaction.
Cigarette smoke
: Cigarette smoke is one of the most common causes of MCS. The smoke from cigarettes contains many chemicals, irritants, and gases, including formaldehyde, nacrolein, polycyclic aromatic hydrocarbons, hydrogen cyanide, carbon monoxide, nitrogen dioxide, and acrolein. Exposure to smoke indoors or in areas of poor ventilation significantly increases the amount of chemicals and toxins in the air.
: Formaldehyde, which is also present in cigarette smoke, is present in gasoline and diesel combustion as well. Individuals are often exposed to these chemicals when they are waiting in traffic, especially if the windows are rolled down.
Wood-burning stoves
: A gas called carbon monoxide is released into the air when wood is burned. When wood is burned during cold temperatures (e.g. fireplaces during the winter months), the amount of carbon monoxide released into the air increases. Also, poorly ventilated stoves release carbon monoxide, nitrogen, sulfur oxides, formaldehyde, and benzopyrene. All of these chemicals can potentially trigger a reaction in MCS patients.
: Other common triggers include perfume, nail polish remover, newspaper ink, hairspray, paint or paint thinner, insecticides, artificial colors, artificial sweeteners, food preservatives, adhesive tape, new carpets, flame retardants on clothing and furniture (such as mattresses), felt tip pens, chlorine in swimming pools, as well as chemicals from dust, pollens, animal dander, and molds.
Other types of chemical sensitivities
Annoyance reactions
: Annoyance reactions occur when the patient is overly sensitive to unpleasant odors. Some patients are born with this sensitivity, while others become sensitive after they develop an infection, abuse tobacco, overuse nasal decongestants, or after the lining of the nose becomes inflamed.
Immune hypersensitivity (allergic reaction)
: An immune hypersensitivity is an allergic reaction to chemicals. This occurs when the body's immune system overreacts to chemicals that enter the body. The white blood cells launch an attack against chemicals because they are mistaken for harmful invaders, such as bacteria or viruses. This reaction causes allergy symptoms, such as hives, skin rash, and headache, to develop. Allergic reactions usually occur in response to chemicals that are found in pollens, dust mites, and molds. Only a few industrial chemicals, which are used to produce consumer goods, have been shown to cause an allergic reaction. Examples include acid anhydrides and isocyanates.
Intoxication syndrome
: Intoxication syndrome is the most severe type of reaction to chemicals. This typically occurs after long-term exposure to harmful chemicals, which may be present in pesticides, cleaning fluids, or paints. Intoxication syndrome is not an allergic reaction because it does not involve the immune system. Intoxication syndrome may cause a serious illness, which may lead to death in some patients.
Irritational syndromes
: Irritational syndromes may occur after a patient is exposed to significant amounts of irritating chemicals. These chemicals may affect nerves in the body involved with physical sensations. As a result, patients with irritational syndromes often experience burning sensations in the nose, eyes, and throat after exposure to certain chemicals. Symptoms usually come and go, and they do not cause permanent damage.
Copyright © 2011 Natural Standard (
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
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Data controllers in the private and public sectors hold increasing amounts of personal data on individuals. The decreasing cost of electronic storage and processing has greatly contributed to this. Organisations also increasingly outsource data processing to third parties (data processors). Many organisations also continue to hold large quantities of personal data in manual form – often in off-site locations. This large increase in the quantity of personal data processed and held gives rise to security challenges for the organisations that collect the data. Data controllers need to regularly audit their holdings of personal data and the procedures they have in place to protect this data. Questions they should ask include:
- Do we know what types of personal data we hold:
- electronically (including less obvious data such as CCTV images)?
- on paper?
- Can we justify the collection of this information?
- Why do we collect it?
- What it is used for?
- How long do we hold it?
- Who has access to it?
- To whom do we disclose it?
- Is it held securely?
- How we dispose of the data?
- If we outsource processing of personal data to a data processor (including a 'cloud computing' service provider), are we satisfied that their security procedures are adequate?
The Data Protection Act 2018 and the GDPR do not detail specific security measures that a data controller or data processor must have in place, though the European Communities (Electronic Communications Networks and Services) (Privacy and Communications) Regulations 2011 detail some requirements specific to the electronic communications services sector. The GDPR (Article 32(1)) does however place an obligation on controllers and processors to implement 'appropriate technical and organisational measures' to ensure a level of security appropriate to the risk, taking into account; the state of the art; the costs of implementation; the nature, scope, context and purposes of processing; and the likelihood and severity of the risk to the rights and freedoms of individuals. It goes on to suggest the following indicative list of appropriate measures;
- the pseudonymisation and encryption of personal data;
- the ability to ensure the ongoing confidentiality, integrity, availability and resilience of processing systems and services;
- the ability to restore the availability and access to personal data in a timely manner in the event of a physical or technical incident; and
- a process for regularly testing, assessing and evaluating the effective of technical and organisational measures for ensuring the security of the processing.
Data controllers and data processors are also obliged to ensure that their staff and "other persons at the place of work" are aware of security measures and comply with them. The legal obligation to keep personal data secure applies to every data controller and data processor, regardless of size. While most of the guidance below applies to any such organisation, some aspects would only apply to a larger organisation using an IT network. In this guidance note we identify certain issues that data controllers and data processors should consider when developing their security policies.
The most effective means of mitigating the risk of lost or stolen personal data is not to hold the data in the first place. Data retention and replication should always be assessed against business need and minimised, either by not collecting unnecessary data or by deleting data as soon as the need for it has passed. An example is organisations manually collecting full credit card details including expiry date and CVV number and storing such information beyond the processing of the transaction. A data controller 1should always know what data it holds, where it is held and how it flows through the organisation. Without this oversight, effective protection of personal data within the organisation is a difficult task.
1 Data processors are subject to the same security obligations as data controllers. Therefore references to 'data controllers' in this guidance note also cover data processors, unless the context indicates otherwise.
A data controller has a duty to limit access to personal data on a "need to know" basis. Greater access limitations or controls should apply to more sensitive data. A data controller must be aware of the different users who access their systems/records and their requirements. The different types of users could include:
- staff at various levels;
- third party contractors / data processors
- customers
- business partners
Consideration must be given to the different requirements of each of these types of user and their access privileges to personal data should fully reflect these requirements. The nature of access allowed to an individual user should be set and reviewed on a regular basis. Individual staff members should only have access to data which they require in order to perform their duties. Specific procedures sometimes referred to as a "movers, leavers and joiners" policy are required in all organisations with access to personal data to increase or restrict previous access where a user role changes, prevent use of shared credentials (multiple individuals using a single username and password) and detect use of default passwords. This must be supported by regular reviews of actual access to ensure that all authorised access to personal data is strictly necessary and justifiable for the performance of a function.
Particular attention should be paid to the deployment of IT administrator accounts with unrestricted access to personal data. Policies should be in place in regard to vetting and oversight of the staff members allocated these accounts. A staff member with such responsibilities should have separate user and administrator accounts.
There should be strict controls on the ability to download personal data from an organisation's systems. Such downloading can be blocked by technical means (disabling drives etc). Many organisations have taken a decision to block access to USB ports having examined the inherent risks involved in leaving such ports open by default for all users.
4.1 Access authentication
Users should have a unique identifier (such as a password, passphrase, smart card or other token)2 to allow access to personal data.
Passwords / Passphrases
Passwords are a word or string of characters. A strong password should include a minimum of twelve characters and contain one or more of each of the following:
- letters (upper and lower case);
- symbols (e.g. &, *, @, €, $ etc);
- numbers ( 0 - 9 );
- punctuation (?, ", !)l
Passwords should be reasonably easy for the user to remember but very difficult for anyone else to guess. Examples might include:
- M1_s0n, "The_Av1at0r"! (based on 'My son, "the aviator"!' with numbers replacing certain vowels)
- Te@m5Rb@dp@55word5 (based on 'Teams are bad passwords' with numbers and symbols replacing certain letters)
Please do not use these examples as actual passwords!
Passphrases are similar to passwords, but represent a sentence or sequence of words. They should include twenty characters or more and should also include symbols, numbers and punctuation marks, e.g.
- "I Love the musical, The Sound of Music2!"
- Ilike2swim@thelocalswimingpool.
Data controllers should ensure that users are made aware that their password / passphrase is unique to them and must not be disclosed to anyone else. Data controllers should enforce password complexity and length. Shared credentials should never be permitted. Vendor supplied defaults for system passwords and other security parameters should never be left in place. Data controllers must ensure that partner organisations with access to their systems or data respect these controls.
Smart card / tokens
These are devices that provide authentication either by generating a code to be entered or containing a chip that authenticates with the system being accessed. The token generates a PIN number that is valid for a very short period of time. This is used in conjunction with a username and password to authenticate the user.
2 This list is not exhaustive. For example, a biometric (e.g. a fingerprint, voice or retina scan) can also be used as a unique identifier. However, as biometrics in themselves raise serious data protection and privacy issues (see our guidance on biometrics), their use should only be considered where other authentication methods are demonstrably insufficient.
Most systems allow for screensavers to activate after a period of inactivity on a computer, requiring a password to re-establish access. This automatic lock activation is useful as the alternative manual locking of a workstation requires positive action by the user every time he/she leaves the computer unattended. Regardless of which method an organisation employs, computers should be locked when unattended. This applies not just to computers in public areas, but to all computers. It is pointless having an access control system in place if unattended computers may be accessed by any staff member.
Encryption is the process of encoding information stored on a device and can add a further useful layer of security. It is considered an essential security measure where personal data is stored on a portable device or transmitted over a public network. As with passwords, this measure is pointless unless the key to decrypt the data is kept secure. The key should meet the standards of complexity required for passwords under section 4.1 above3.
3 In view of the rapid rate of technological development, it is not possible to be prescriptive about the standard of encryption that would ensure that data is inaccessible to unauthorised individuals. At present, 256 bit whole disk encryption would be viewed as an acceptable standard. We acknowledge that the market is bringing forward other options to securely encrypt data which may not require whole disk encryption and where properly applied by the user these can achieve the same security outcome.
Anti-virus software is not only required to prevent infection from the internet (either e-mail or web-sourced) but to prevent viruses that may also be introduced from portable devices, such as memory sticks (the use of which should be strictly limited). No anti-virus package will prevent all infections, as they are only updated in response to infections. It is essential that such software is updated on a regular basis and that policies support vigilance in regard to potential threats. A policy of not opening e-mail attachments from unexpected sources can be a useful way of preventing infection.
A firewall is essential where there is any external connectivity, either to other networks or to the internet. It is important that firewalls are properly configured, as they are a key weapon in combating unauthorised access attempts. The importance of firewalls has increased as organisations and individuals increasingly avail of "always-on" internet connections, exposing themselves to a greater possibility of attack.
Patches are the latest updates from the creator of your operating system software or application software. They usually contain fixes to potential security concerns and can be an important tool in preventing hacking or malware attacks. Organisations should ensure that they have regular, consistent and comprehensive patch management procedures in place. Where possible, before installing the very latest patches, it is good practice to install these patches in a test environment to ensure that the patches do not create other issues with your systems. A record should also be kept of the date and patch installed on a system.
Where a staff member / contractor is allowed to access the network from a remote location (e.g. from home or from an off-site visit) such access creates a potential weakness in the system, not least when accessed from a wireless network. For this reason the need for such access should be properly assessed and security measures reassessed before remote access is granted. If feasible, the access should be limited to specific IP addresses. Security should be the first consideration in granting access to partner organisations. Technical security measures, security assessments, contractual agreements in line with the requirements of the GDPR and the Data Protection Act 2018, and agreed standards of management of shared assets are all important aspects in managing this risk. It is the responsibility of the data controller to ensure that, regardless of the means by which a user remotely accesses their system, the security of the system cannot be compromised.
Access to a server by means of a wireless connection can expose a network to attack. The physical environment in which such systems are operated may also be a factor in determining whether weaknesses in the system security exist. As with remote access, wireless networks should be assessed on security grounds rather than solely on apparent ease of use. Data controllers must ensure that adequate security is in place on the network through, for example, appropriate encryption measures or specification of authorised devices.
Particular vulnerabilities are associated with the use of third party unsecured WiFi networks (e.g. those provided in airports, hotels etc). A device using such a network may be open to attacks from other machines on the network. A good firewall should be installed on the portable device to prevent such attacks. The device should only connect to the network when necessary. When using unsecured WiFi to transmit personal or sensitive data, a secure web session should be in place to protect the data.
Laptops, USB keys, smart phones and other forms of portable device are especially vulnerable to theft and accidental loss. Where a data controller considers it essential to store personal data on a portable device, these devices should be encrypted. Whole disk encryption should be used to mitigate against storage of files outside of an encrypted segment of the disk. In the case of smart phones, a strong password should be required at start up and also after several minutes of inactivity. When such a device is lost steps should be taken immediately to ensure that the remote memory wipe facility is activated. Staff allocated such devices should be familiar with the relevant procedures.
Access control systems and security policies are undermined if the system cannot identify abuses. Consequently, a system should be able to identify the user name that accessed a file and the time of the access. A log of alterations made, along with author / editor, should also be created. Logs and audit trails can help in the effective administration of the security system and can deter staff members tempted to abuse the system. Staff should be informed that logging is in place and that user logs are regularly reviewed. Monitoring processes should focus not only on networks, operating systems, intruder detection systems and firewalls, but should include remote access services, web applications and databases.
An intruder detection system (IDS) acts as an internal alarm system that monitors and reports on malicious activities on a network or system. Such systems also aim to detect attacks that originate from within the system. Any organisation processing large volumes of personal data should have an IDS deployed and activated. Where alerts/events are generated by any such systems there must be a meaningful system in place to examine them in a timely fashion. This is to assist in identifying unusual activity and take immediate corrective action if there is an ongoing breach of security.
A back up system is an essential means of recovering from the loss or destruction of data. While some system should be in place, the frequency and nature of back up will depend, amongst other factors, on the type of organisation and the nature of data being processed. The security standards for back-up data are the same as for live data.
Even with the best designed systems, mistakes can happen. As part of a data security policy, an organisation should anticipate what it would do if there were a data breach so that it can be ready to respond. Some questions you might ask yourself:
- What would your organisation do if it had a data breach incident?
- Have you a policy in place that specifies what a data breach is? (It is not just lost USB keys/disks/laptops. It may include any loss of control over personal data entrusted to organisations, including inappropriate access to personal data on your systems or the sending of personal data to the wrong individuals).
- How would you know that your organisation had suffered a data breach? Does the organisation's staff (at all levels) understand the implications of losing personal data?
- Has your organisation specified whom staff tell if they have lost control of personal data?
- Does your policy make clear who is responsible for dealing with an incident?
- Does your policy cover the requirements of mandatory breach reporting (where applicable) under the Data Protection Act 2018, the GDPR, and/or the ePrivacy Regulations (SI 336/2011)?
When disposing of obsolete or redundant equipment many data controllers offer the equipment for sale to staff or donate it to charities. It is the responsibility of the data controller to ensure that all data previously stored on the devices has been removed prior to disposal. It is not sufficient to merely format the hard drives of the devices, as data can still be retrieved. Software is available that will overwrite the contents of the hard drive with a series of 1's and 0's to ensure that previous data can not be retrieved. Dependant on the nature of the data stored, it is recommended that hard drives should be overwritten between three and five times.
Where the devices are not being recycled / reused the hard drives can either be physically destroyed or degaussed4.
It is important to consider the different types of equipment that may hold personal data. Besides obvious examples, such as servers, computers and laptops, there are a number of other devices that may store personal data. These may include smart phones, digital photocopiers, fax machines etc. Any data stored on these devices must also be erased prior to disposal.
4 method of erasing data from a magnetic storage device.
Physical security safeguards should include the following considerations:
- perimeter security (monitoring of access, office locked and alarmed when not in use);
- restrictions on access to sensitive areas within the building (such as server rooms);
- computer location (so that the screen may not be viewed by members of the public);
- storage of files (files not stored in public areas with access restricted to staff with a need to access particular files); and
- secure disposal of records (effective "wiping" of data stored electronically; secure disposal of paper records).
No matter what technical or physical controls are placed on a system, the most important security measure is to ensure that staff are aware of their responsibilities. Passwords should not be written down and left in convenient places; passwords should not be shared amongst colleagues; unexpected e-mail attachments should not be opened unless first screened by anti-virus software. Effective employee training about the risks of data compromise, their role in preventing it and how to respond in the event of problems can be a very effective line of defence. Many organisations set security policies and procedures but fail to implement them consistently. Controls focused on individual and organisational accountability and ensuring that policies are carried out are an important part of any system designed to protect personal data. Identify essential controls first and ensure that these controls are implemented across the organisation without exception. Once this is in place, move on to more advanced controls designed to mitigate the risks specific to the organisation and the type(s) of data processed.
Data controllers must have procedures in place to manage staff turnover, including retrieval of data storage devices and quick removal of access permissions.
Certification can be a useful means of demonstrating compliance with security obligations, where certification indicates that data security controls have been subject to audit or review against a recognised standard by a reputable third party organisation. In the context of Cloud computing, customers should look to see whether cloud services providers can provide a copy of this third party audit certificate. Where Cloud Service Providers offer Model Clauses, a relevant third party audit report may satisfy in lieu of an individual right to audit. Individual audits of data hosted in a multi-party, virtualised server environments may be impractical technically and in fact serve to increase risks to those physical and logical network security controls in place.


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This section explains how to set up a connection service based on the Secure Socket Layer (SSL) standard, which enables delivery of encrypted messages over the connection. Message Queue supports the following SSL-based connection services:
The ssljms service delivers secure, encrypted messages between a client and a broker, using the TCP/IP transport protocol.
The httpsjms service delivers secure, encrypted messages between a client and a broker, using an HTTPS tunnel servlet with the HTTP transport protocol.
The ssladmin service creates a secure, encrypted connection between the Message Queue Command utility (imqcmd) and a broker, using the TCP/IP transport protocol. Encrypted connections are not supported for the Administration Console (imqadmin).
The cluster connection service is used internally to provide secure, encrypted communication between brokers in a cluster, using the TCP/IP transport protocol.
A JMX connector that supports secure, encrypted communication between a JMX client and a broker's MBean server using the RMI transport protocol over TCP.
The remainder of this section describes how to set up secure connections over TCP/IP, using the ssljms, ssladmin, and cluster connection services. For information on setting up secure connections over HTTP with the httpsjms service, see Appendix C, HTTP/HTTPS Support.
To use an SSL-based connection service over TCP/IP, you generate a public/private key pair using the Key Tool utility (imqkeytool). This utility embeds the public key in a self-signed certificate that is passed to any client requesting a connection to the broker, and the client uses the certificate to set up an encrypted connection. This section describes how to set up an SSL-based service using such self-signed certificates.
For a stronger level of authentication, you can use signed certificates verified by a certification authority. The use of signed certificates involves some additional steps beyond those needed for self-signed certificates: you must first perform the procedures described in this section and then perform the additional steps in Using Signed Certificates.
Message Queue's support for SSL with self-signed certificates is oriented toward securing on-the-wire data, on the assumption that the client is communicating with a known and trusted server. Configuring SSL with self-signed certificates requires configuration on both the broker and client:
Setting Up an SSL-Based Connection Service Using Self-Signed Certificates
Configuring and Running an SSL-Based Client Using Self-Signed Certificates
The following sequence of procedures are needed to set up an SSL-based connection service for using self-signed certificates:
Starting with release 4.0, the default value for the client connection factory property imqSSLIsHostTrusted is false. If your application depends on the prior default value of true, you need to reconfigure and to set the property explicitly to true. In particular, old or new clients using self-signed certificates should set this property to true; for example:java -DimqConnectionType=TLS -DimqSSLIsHostTrusted=true MyApp
The administration tool imqcmd is also affected by this change. In addition to using the –secure option to specify that it uses a SSL-based admin connection service, the imqSSLIsHostTrusted should be set to true when connecting to a broker configured with a self-signed certificate. You can do this as follows:imqcmd list svc -secure -DimqSSLIsHostTrusted=true
Alternatively, you can import the broker's self-signed certificate into the client runtime trust store. Use the procedure in To Install a Signed Certificate.
Generate a self-signed certificate.
Enable the desired SSL-based connection services in the broker. These can include the ssljms, ssladmin, or cluster connection services.
Start the broker.
Run the Key Tool utility (imqkeytool) to generate a self-signed certificate for the broker. (On Solaris and Linux operating systems, you may need to run the utility as the root user in order to have permission to create the keystore file.) The same certificate can be used for all SSL-based connection services (ssljms, ssladmin, cluster connection services, and the ssljmxrmi connector).
Enter the following at the command prompt:
imqkeytool -broker
The Key Tool utility prompts you for a key store password:
At the prompt type a keystore password.
The Keystore utility prompts you for identifying information from which to construct an X.500 distinguished name. The following table shows the prompts and the values to be provided for each. Values are case-insensitive and can include spaces.
X.500 Attribute
What is your first and last name?
commonName (CN)
Fully qualified name of server running the broker
What is the name of your organizational unit?
organizationalUnit (OU)
Name of department or division
What is the name of your organization?
organizationName (ON)
Name of larger organization, such as a company or government entity
Acme Widgets, Inc.
What is the name of your city or locality?
localityName (L)
Name of city or locality
San Francisco
What is the name of your state or province?
stateName (ST)
Full (unabbreviated) name of state or province
What is the two-letter country code for this unit?
country (C)
Standard two-letter country code
The Key Tool utility displays the information you entered for confirmation. For example,
Is CN=mqserver.sun.com, OU=purchasing, ON=Acme Widgets, Inc., L=San Francisco, ST=California, C=US correct?
Accept the current values and proceed by typing yes.
To reenter values, accept the default or enter no. After you confirm, the utility pauses while it generates a key pair.
The utility asks for a password to lock the key pair (key password).
Press return.
This will set the same password for both the key password and the keystore password.
Be sure to remember the password you specify. You must provide this password when you start the broker, to allow the broker to open the keystore file. You can store the keystore password in a password file (see Password Files).
The Key Tool utility generates a self-signed certificate and places it in Message Queue's keystore file. The keystore file is located in a directory whose location depends upon the operating system platform, as shown in Appendix A, Platform-Specific Locations of Message Queue Data.
The following are the configurable properties for the Message Queue keystore for SSL-based connection services:
Path to directory containing keystore file (see Appendix A, Platform-Specific Locations of Message Queue Data for default value)
In some circumstances, you may need to regenerate a key pair in order to solve certain problems: for example, if you forget the key store password or if the SSL-based service fails to initialize when you start a broker and you get the exception:
java.security.UnrecoverableKeyException: Cannot recover key
(This exception may result if you provided a key password different from the keystore password when you generated the self-signed certificate.)
Remove the broker's keystore file.
The file is located as shown in Appendix A, Platform-Specific Locations of Message Queue Data.
Run imqkeytool again.
The command will generate a new key pair, as described above.
To enable an SSL-based connection service in the broker, you need to add the corresponding service or services to the imq.service.activelist property.
Open the broker's instance configuration file.
The instance configuration file is located in a directory identified by the name of the broker instance (instanceName) with which the configuration file is associated (see Appendix A, Platform-Specific Locations of Message Queue Data):
Add an entry (if one does not already exist) for the imq.service.activelist property and include the desired SSL-based service(s) in the list.
By default, the property includes the jms and admin connection services. Add the SSL-based service or services you wish to activate (ssljms, ssladmin, or both):
The SSL-based cluster connection service is enabled using the imq.cluster.transport property rather than the imq.service.activelist property (see Cluster Connection Service Properties). To enable SSL for RMI-based JMX connectors, see SSL-Based JMX Connections.
Save and close the instance configuration file.
Start the broker, providing the key store password.
When you start a broker or client with SSL, you may notice a sharp increase in CPU usage for a few seconds. This is because the JSSE (Java Secure Socket Extension) method java.security.SecureRandom, which Message Queue uses to generate random numbers, takes a significant amount of time to create the initial random number seed. Once the seed is created, the CPU usage level will drop to normal.
Start the broker, providing the keystore password.
Put the keystore password in a password file, as described in Password Files and set the imq.passfile.enabled property to true. You can now do one of the following:
Pass the location of the password file to the imqbrokerd command:
imqbrokerd -passfile /passfileDirectory/passfileName
Start the broker without the -passfile option, but specify the location of the password file using the following two broker configuration properties:
If you are not using a password file, enter the keystore password at the prompt.
You are prompted for the keystore passwrd.
The procedure for configuring a client to use an SSL-based connection service differs depending on whether it is an application client (using the ssljms connection service) or a Message Queue administrative client such as imqcmd (using the ssladmin connection service.)
For application clients, you must make sure the client has the following .jar files specified in its CLASSPATH variable:
Once the CLASSPATH files are properly specified, one way to start the client and connect to the broker's ssljms connection service is by entering a command like the following:
java -DimqConnectionType=TLS clientAppName
This tells the connection to use an SSL-based connection service.
For administrative clients, you can establish a secure connection by including the -secure option when you invoke the imqcmd command: for example,
imqcmd list svc -b hostName:portNumber -u userName -secure
where userName is a valid ADMIN entry in the Message Queue user repository. The command will prompt you for the password.
Listing the connection services is a way to verify that the ssladmin service is running and that you can successfully make a secure administrative connection, as shown in Example 9–6.
Signed certificates provide a stronger level of server authentication than self-signed certificates. You can implement signed certificates only between a client and broker, and currently not between multiple brokers in a cluster. This requires the following extra procedures in addition to the ones described in Using Self-Signed Certificates. Using signed certificates requires configuration on both the broker and client:
The following procedures explain how to obtain and install a signed certificate.
Use the J2SE keytool command to generate a certificate signing request (CSR) for the self-signed certificate you generated in the preceding section.
Information about the keytool command can be found at
Here is an example:
keytool -certreq -keyalg RSA -alias imq -file certreq.csr -keystore /etc/imq/keystore -storepass myStorePassword
This generates a CSR encapsulating the certificate in the specified file (certreq.csr in the example).
Use the CSR to generate or request a signed certificate.
You can do this by either of the following methods:
Have the certificate signed by a well known certification authority (CA), such as Thawte or Verisign. See your CA's documentation for more information on how to do this.
Sign the certificate yourself, using an SSL signing software package.
The resulting signed certificate is a sequence of ASCII characters. If you receive the signed certificate from a CA, it may arrive as an e-mail attachment or in the text of a message.
Save the signed certificate in a file.
The instructions below use the example name broker.cer to represent the broker certificate.
Check whether J2SE supports your certification authority by default.
The following command lists the root CAs in the system key store:
keytool -v -list -keystore $JAVA_HOME/lib/security/cacerts
If your CA is listed, skip the next step.
If your certification authority is not supported in J2SE, import the CA's root certificate into the Message Queue key store.
Here is an example:
keytool -import -alias ca -file ca.cer -noprompt -trustcacerts -keystore /etc/imq/keystore -storepass myStorePassword
where ca.cer is the file containing the root certificate obtained from the CA.
If you are using a CA test certificate, you probably need to import the test CA root certificate. Your CA should have instructions on how to obtain a copy.
Import the signed certificate into the key store to replace the original self-signed certificate.
Here is an example:
keytool -import -alias imq -file broker.cer -noprompt -trustcacerts -keystore /etc/imq/keystore -storepass myStorePassword
where broker.cer is the file containing the signed certificate that you received from the CA.
The Message Queue key store now contains a signed certificate to use for SSL connections.
You must now configure the Message Queue client runtime to require signed certificates, and ensure that it trusts the certification authority that signed the certificate.
By default, starting with release 4.0, the connection factory object that the client will be using to establish broker connections has its imqSSLIsHostTrusted attribute set to false, meaning that the client runtime will attempt to validate all certificates. Validation will fail if the signer of the certificate is not in the client's trust store.
Verify whether the signing authority is registered in the client's trust store.
To test whether the client will accept certificates signed by your certification authority, try to establish an SSL connection, as described above under Configuring and Running an SSL-Based Client Using Self-Signed Certificates. If the CA is in the client's trust store, the connection will succeed and you can skip the next step. If the connection fails with a certificate validation error, go on to the next step.
Install the signing CA's root certificate in the client's trust store.
The client searches the key store files cacerts and jssecacerts by default, so no further configuration is necessary if you install the certificate in either of those files. The following example installs a test root certificate from the Verisign certification authority from a file named testrootca.cer into the default system certificate file, cacerts. The example assumes that J2SE is installed in the directory $JAVA_HOME/usr/j2se:
keytool -import -keystore /usr/j2se/jre/lib/security/cacerts -alias VerisignTestCA -file testrootca.cer -noprompt -trustcacerts -storepass myStorePassword
An alternative (and recommended) option is to install the root certificate into the alternative system certificate file, jssecacerts:
keytool -import -keystore /usr/j2se/jre/lib/security/jssecacerts -alias VerisignTestCA -file testrootca.cer -noprompt -trustcacerts -storepass myStorePassword
A third possibility is to install the root certificate into some other key store file and configure the client to use that as its trust store. The following example installs into the file /home/smith/.keystore:
keytool -import -keystore /home/smith/.keystore -alias VerisignTestCA -file testrootca.cer -noprompt -trustcacerts -storepass myStorePassword
Since the client does not search this key store by default, you must explicitly provide its location to the client to use as a trust store. You do this by setting the Java system property javax.net.ssl.trustStore once the client is running:


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Ottawa (indigenous people of North America)
Ottawa (ŏt´əwə) or Odawa (ōdä´wə), Native Americans whose language belongs to the Algonquian branch of the Algonquian-Wakashan linguistic stock (see Native American languages). Traditionally of the Eastern Woodlands cultural area (see under Natives, North American), the Ottawa have a well-developed creation myth that states that they were descended from three families: the Michabou, or Great Hare, the Namepich, or Carp, and the Bear's Paw. According to tradition the Ottawa, the Ojibwa, and the Potawatami were originally one family, dwelling N of the Great Lakes; after the separation, some of the Ottawa settled on Manitoulin Island in Lake Huron and along the shores of Georgian Bay.
In 1615, when noted by Samuel de Champlain, many Ottawa lived near the mouth of French River on Georgian Bay. Known as great traders, they claimed the Ottawa River region and controlled trade with the French on that river. They allied themselves with the French and the Huron. Their alliance with the Huron, however, made them the enemies of the Iroquois, who forced the Ottawa to flee to the islands off Green Bay. After a few years some moved on to Keweenaw Bay in Lake Superior, while another section joined the Huron and went to the Mississippi near Lake Pepin. From there the Sioux drove them northward to Chequamegon Bay in N Wisconsin.
Promised protection by the French, the Ottawa returned (1670) to Manitoulin Island, where the mission of St. Simon was established among them. Next they joined the Huron at Mackinac in Michigan, and soon after they dispersed over a wide area. The Ottawa were active in the Indian wars of the Old Northwest; Pontiac was an Ottawan. Eventually part of the Ottawa settled on Walpole Island in Lake St. Clair and part on Manitoulin Island, while others have settled in Kansas, Oklahoma, and Michigan. In 1990 there were close to 8,000 Ottawa in the United States.
See A. S. Blackbird, History of the Ottawa and Chippewa Indians of Michigan (1897); M. A. McDonnell, Masters of Empire (2016).


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API Introduction Libraries C# Wrapper Account Functions Obtaining API Key Create an Account Transfer Credits Retrieve Agency Customers Groups Adding a Group Listing Groups Deleting a Group Listing Segments Add a Segment Update a Segment Delete a Segment Subscribers Adding Subscribers Listing Subscribers Listing Unsubscribers Update A Subscriber Unsubscribe a Subcriber Bulk Add Subscribers Bulk Add Query Forms Add a Signup Form List all Signup Forms Newsletters Adding Newsletters Uploading Images Listing Newsletters Campaigns Adding Campaigns Listing Campaigns Retrieving a Campaign View Opened Emails View Links Clicked View Unsubscribers View Bounced Emails Add a Junk Report Need a hand? Contact us Return to MPZMail ©2019 Callway Ltd
MPZ API > Add a GroupUse the API to add a new subscriber group.
RequestSubmit an XML Request with the following details:
Post URL: https://mpzmail.com/api/v3.0/groups/addGroup/
Sample request XML
Sample response XML


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Zlata hokejka 2009 "Golden Hockey Stick"
Ms. Petra Pavelková, head of production team BPA sport marketing, a.s.
"On behalf of BPA Sport Marketing, a.s. I would like to cordially thank Grandhotel Pupp for its cooperation with our successful events, the Zlatá hokejka 2009 (Golden Hockey Stick) and the Czech Hockey Games 2009.We were very satisfied with the location and with all provided accommodations, as well as with the impeccable service that we received. We highly appreciate the excellent quality of the hotel staff and their flexibility during both the event planning and its execution.
Special thanks goes out to Květa Koubková, Katrin Houšková and Petra Kozičková, who co-operated with our production team. We also extend our gratitude to the GH Pupp chef, Ms. Vlaďka Příhodová, and her entire staff for preparing delicious refreshments, and last but not least to Car Park Security, who contributed to the smooth flow of these events.
It was a pleasure to work with the Grandhotel Pupp during these successful events and we welcome the possibility of future cooperation with the hotel."


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Chicago-based photographer Evan Baden has captures the world of adolescent sexting in his series cleverly titled Technically Intimate. The word "sexting" was officially added to the dictionary in 2012—that is how common this word and action is. Selfies and nudes being sent back and forth to people via smart phones has become commonplace. The fact of the matter is, these explicit photos never truly disappear. Evan Baden shines light on the privacy issues at hand concerning digitally sent photos, especially ones that are meant to be intimate or private. Interestingly enough, the title of this series, Technically Intimate, refers to a level of intimacy that is perhaps supposed to be felt between the people doing the sharing of sexual photos. Although the intention of these photos may have started out as intimate between two lovers, they remain forever in the public sphere. Therefore, no intimacy can be achieved.
Evan Baden starts each photograph with an image from real life, found online. He then hires a model to pose in a similar way, in a similarly adolescent environment. The final result is a re-imagined version of the original photos that has been shared online, accessible for anyone to see. In this uncomfortably close series, we are a fly on the wall, looking into a both private and public situation. For more amazing photography with an eye on pop-culture and its digitalization, Evan Baden is in an exhibition that will be on view September 19th until January 17th at the NRW-Forum Düsseldorf Contemporary Culture Center titled Ego Update: The Future of the Digital Identity.
Baden delves deeper into his intriguing series explaining this incredibly relevant topic. (via FeatureShoot)
"The poses in my images emphasize the repetitiveness of the sexual images that pervade our society while the rooms that the scenes are staged in and the ages of the room's occupant clash with those highly sexualized poses, causing an unease in the viewing of those pictured and reminding the viewer that with every leap we take in technology and convenience there is an equally deep crevasse into which we can fall."


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Listen to Andy talk about his passion for the Museum's collections.More about Andy Currant
From microscopic worms to gigantic mammoth skeletons, the Museum's 70-million specimens represent the astonishing diversity of the natural world. In caring for these collections, our curators can trace the intricacies of evolution and adaptation across periods of history, ensuring the specimens' preservation for future generations of researchers.
Caring for these collections requires devotion from our curators, considering the time and love spent maintaining and preserving individual specimens for future use. In these clips, staff underline the importance of the Museum's collections and how they can be used to understand the natural world.
Listen to Andy talk about his passion for the Museum's collections.
Discover how the Museum prepares large specimens like Guy the gorilla.
Learn how Barry made bespoke cases for Museum specimens.
Find out about Brian's research.
Discover how different curators across the Museum departments look after their collections.
Explore the fascinating world of parasitic worms.
Find out what really goes on behind the scenes at the Museum.
Hear Eileen describe her feelings about the Museum's collections.
Discover which insects have been named after Judith.
Find out how insects are preserved for the collection.
Discover how retirement gives further opportunities to work on the collections.
Listen as Keith remembers collecting Guy the gorilla from London Zoo.
Find out how Keith learnt to skin small mammals.
Find out about the skills needed to be a conservator.
Listen to Lorraine describe the skills needed to paint replicas of Museum specimens.
Listen to Lorraine describe the skills needed to paint replicas of Museum specimens.
Hear how Lorraine forms a connection with important specimens like the Archaeopteryx specimen.
Hear about an unusual procurement method for the Museum's collection!
Find out how flesh-eating beetles are used to prepare specimens.
Learn about Miranda's quest to understand the history of the Blaschka glass models.
Hear Ollie describe how he helped the police in a case regarding a stolen sturgeon.
Listen to Ollie Crimmen talk about one of his favourite specimens in the collection, the football fish.
Listen to Ollie describe his work with Damien Hirst preserving his famous shark artwork.
Discover how shark skin is the perfect solution for improving the performance of Olympic swimmers.
Find out about the future of the collections.
Find out about Richard's favourite specimens.
Explore the different ways the Museum's collections are used.
Listen to Robert talk about how a curator develops a relationship with the collections.
Explore how historical collections can be used in current scientific research.
Robin explains the differences in how the collections are displayed.
Watch Robin showing us around his office.
Hear Robin describe interacting with other staff after retirement.
Find out when scientists first identified meteorites.
Find out about some of the more bizarre objects in the collection.


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As backdrop to an editorial story for July 2009 Wallpaper* magazine, Peter Saville's febrile imagination constructs an imaginary 'Erotic House' of Pop perversity, sexualising an entire post-modern environment and fetishising furniture, fashion and flesh alike.
Editorial Gallery
Nick Knight's editorial images for the 'Sex issue of Wallpaper*, July 2009
Fashion: Knickers by Lascivious from Bordello, thigh-boots by Azzedine Alaïa.
Interior: Sheepskin rug by ABC Carpet, 'Karuselli' chair by Yrjö Kukkapuro, revolving wheel by Fetters.
Fashion: Leather bodysuit by Yves Saint Laurent, stockings by Fogal, leather shoes by Sergio Rossi, rubber shorts by Expectations, silk gown by Tom Ford.
Interior: 'Phat Knit' couch by Bauke Knottnerus, shimmer curtain from DZD.
Fashion: Black bodysuit by Paradiso Boudoir, blush bodysuit by Stella McCartney.
Interior: Sheepskin rug by ABC Carpet, 'EnergyPod' by MetroNaps.
Fashion: Rubber shorts by Expectations, silk dressing gown by Richard James, catsuit by Pam Hogg.
Interior: 'Lei' chair by Monica Förster, foam sheet from Pentonville Rubber.
Fashion: Leather coat and belt by Prada, knickers with belt by Jean Yu, thigh-boots by Azzedine Alaïa, rubber dress by House of Harlot, ankle boots by Beatrix Ong.
Interior: 'Velour Palace' curtain by Edmond Petit, 'Pi Mega' light, by Jean-Luc le Deun for Le Deunn Luminaires, 'Organic Pixel' vase by Jamie Hayón for Bisazza.
Fashion: Leopard-print gloves by Atsuko Kudo, bodysuit by Maison Martin Margiela, platform shoes by John Galliano, dress by Versace, tights by Fogal, shoes by Alexander Wang.
Interior: 'Shiraz' sofa by Philipp Mainzer and Farah Ebrahimi for E15, 'Traditional Octagonal' tray (part of tea and coffee set) by Asprey, 'Diamante Round Chandelier 30' by Rainbow.
Fashion: Gloves by Cornelia James, dress with collar by Chanel, shoes by Gina, lambskin trousers by Jitrois, knitted dress by Mark Fast, shoes by Jil Sander, silk dressing gown by Tom Ford. On tray: thick collar, thin collar, ring and cuffs all by Betony Vernon.
Interior: 'I Am A Coat Hanger' frame and hangers by Karolina Lagerkvist, '1001' lamp by Mirjam Hüttner & Claude Muller, 'Pause' bench by Olle Anderson.
Fashion: Women's shoes by Salvatore Ferragamo, lambskin trousers by Jitrois.
Interior: Armchair by Jacques Adnet, bondage table by Fetters, latex from The Cloth Shop, vintage stool from Mint.
Interior: 'Kinesis Personal Vision' by Antonio Citterio, 'UP 5 & UP 6' armchair and ottoman by Gaetano Pesce for B&B Italia, revolving wheel and stretching rack, both by Fetters, 'DalRollo Jais' rubber flooring from Dalsouple.
Interior: 'Merendero' dining cube by José A Gandia for Gandia Blasco.
Fashion: 'Patricia' dress by Paradiso Boudoir, shoes by Jil Sander, top, skirt and sandals all by Givenchy by Riccardo Tisci.


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Little Marina
Navy Striped Polo Shirt & Shorts Set
Great quality t-shirt and shorts set for a toddler's Summer outfit!
100% cotton
*Please note that, although every effort is made to photograph these baby and toddler Summer shorts accurately and describe our products in detail, we cannot guarantee every computer monitor will accurately depict the actual colour of the merchandise. Please feel free to contact us with any questions about the colour or size of any item before purchasing.
Please ensure that the delivery address provided via the website is the same as the delivery address you provide via PayPal.
Delivery - UK
We offer free postage for orders over £45 to any UK address.
All order less than £45 will be charged a standard shipping charge of £3.95.
Please allow 4-5 working days for UK delivery.
Delivery - Europe
International Delivery to Europe is £10.
Delivery - Rest of the World
International Delivery is £14 however please note, your order will be sent via Royal Mail to your national postal service.
In some countries, it is not possible to track the parcel once it enters your country.
So, if you're not completely happy within the first 30 days after receiving your items, just send it back to us and we can offer you store credit.
To be eligible for a store credit, your item must be unused and in the same condition that you received it and if applicable, in its original packaging.
Customers are responsible for return shipping and it must be within 30 days of receiving your order.
Shipping costs are non-refundable. Once we receive your returned package, it will be inspected & processed within 5-7 business days.


text:
LAWRENCE, Kan. (AP) San Jose State coach George Nessman needed a spark with his team trailing big in Allen Fieldhouse. He turned to James Kinney and let him loose.
The senior guard wound up scoring 19 of his 30 points in the second half against No. 10 Kansas, helping the Spartans rally within seven points in the closing minutes before falling 70-57 on Monday night.
The Jayhawks went on a 20-2 run to start the second half, but Kinney responded with nine straight points to spark a 16-0 run that got the Spartans within 60-52 with about 5 minutes left.
``I wasn't going give up,'' Kinney said. ``I'm not going to get embarrassed out here.''
Kinney was the only effective option for San Jose State against the Jayhawks' Jeff Withey, who had 16 points, 12 rebounds and a school-record 12 blocked shots for only the second official triple-double in Kansas' long, storied basketball history.
``I think at some point you have to let your main guy go,'' Nessman said. ``You have to give him a little freedom to attack. Out system wasn't getting it done.''
Kinnney, who had two 30-point games last season, was the logical choice to let loose.
``They saw I had the hot hand,'' he said. ``They kept feeding me and I kept delivering.''
So did Withey, who scored 10 points for Kansas during a 20-2 run early in the second half, and achieved the Jayhawks' first triple-double since Cole Aldrich in an NCAA tournament game against Dayton in 2010 when the 7-footer blocked Xavier Jones' shot with 7:43 left in the game.
Kansas (5-1) used its big run to take a 60-36 lead with just over 11 minutes remaining, but the Spartans (2-3) answered with an 18-2 run to climb back in the game.
The Jayhawks finally put it away when Elijah Johnson hit a floater with just over a minute left for a 66-57 lead, and when Withey's rejection of J.D. Brown turned into a run-out that Ben McLemore finished off with a windmill dunk with about 30 seconds remaining.
``We didn't back down. We kept bucking up and sticking our chest out there, and that was important for us,'' Nessman said. ``This is one of the hardest places to play in the country.''
McLemore finished with 13 points despite missing all seven of his 3-point tries, and Travis Releford also had 13 points for the Jayhawks. Kevin Young added eight rebounds.
Playing its first game since romping to victory in the CBE Classic last week, the Jayhawks looked fresh and smooth in building a double-digit lead late in the first half.
San Jose State answered with nine straight points spanning halftime to get back into it.
That's when Kansas went on its big run.
It began with a 3-pointer by Johnson, and the momentum really started to build when Young followed up Withey's miss with an easy basket down low.
Withey scored six of the Jayhawks' next eight points as the lead slowly grew, and the crowd at Allen Fieldhouse began to realize that he was making history. He surpassed the 10-rebound mark midway through the second half before getting his 10th block to mark the triple-double.
``He was the only guy who played worth a flip,'' Kansas coach Bill Self said. ``He did a good job covering up for a lot of mistakes, because we made a ton of them tonight.''
Unofficially, it was Withey's second time reaching the milestone.
The senior had 18 points, 12 rebounds and 10 blocks against Pittsburg State in an exhibition game last season, when All-America forward Thomas Robinson missed the game due to injury.
It also comes with an asterisk in the Kansas record books.
The school didn't keep records for blocked shots during the 1950s, when Wilt Chamberlain was plying his trade on the hardwood. He undoubtedly had his share of triple-doubles while playing for the Jayhawks - but officially, only Aldrich and Withey have done it.
``I've been wanting that for a while now, and it's only me and Cole that have it, so it's pretty special to me,'' Withey said.
Kinney nearly stole his thunder late in the game.
The spunky guard hit consecutive jumpers to end the Jayhawks' big run, and then added a fall-away 3-pointer with just over 10 minutes remaining to start closing the gap.
He added another 3-pointer with 6:44 left to trim the lead to 60-51, and then hit his fourth 3 of the game as the shot clock was winding down to make it 64-57 with 2:39 to go, before the Jayhawks finally put it away in the final minute.
``I just don't think we have any fold in us. That's not who we are. We have a great group of kids,'' Nessman said. ``We came here to play for a full 40 minutes.''


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Conferences & Events
The McCrery-Pomeroy SSDI Solutions Initiative Unveils Project's Recommendations
Wednesday, April 6, 2016
9:00 am – 11:00 am
Hyatt Regency Washington on Capitol Hill
Capitol Room (Lobby Level)
400 New Jersey Ave. NW Washington, DC 20001
|8:30 am - 9:00 am
|Continental Breakfast
|9:00 am - 9:10 am
|Welcome and Opening Remarks
|9:10 am - 9:45 am
|Remarks by Former Congressmen and Initiative Co-Chairs Jim McCrery & Earl Pomeroy
|9:45 am - 10:10 am
Keynote Presentation
|10:10 am - 11:00 am
|Panel Discussion
Moderator: Paul Krawzak, CQ Roll Call
Romina Boccia: Deputy Director and Grover M. Hermann Research Fellow in Federal Budgetary Affairs, The Heritage Foundation
Marc Goldwein: Senior Vice President and Senior Policy Director, Committee for a Responsible Federal Budget
Kathleen Romig: Senior Policy Analyst, Center on Budget and Policy Priorities
Art Spencer: Retired Associate Commissioner, Social Security Administration
Jennifer Dexter: Assistant Vice President for Government Relations, Easter Seals
McCrery-Pomeroy SSDI Solutions Conference
Tuesday, August 4, 2015
8:45 am – 5:00 pm
District Architecture Center
421 7th St NW, Washington, DC 20004
Next year the Social Security Disability Insurance (SSDI) trust fund will deplete its reserves, prompting a discussion in Washington about how to improve the program. The McCrery-Pomeroy SSDI Solutions Initiative seeks to provide policymakers with a menu of innovative ideas to improve the SSDI program and other services for people with disabilities.
The SSDI Solutions Conference featured presentations of numerous policy proposals selected by the McCrery-Pomeroy SSDI Solutions Initiative and brought together experts, advocates, policymakers and interested stakeholders for an engaged dialogue about how SSDI and other programs can better serve those with disabilities, taxpayers and society as a whole.
Conference Agenda
Presentation Slides Available in PDF next to their respective paper when applicable
|8:00 am - 8:45 am
|Continental Breakfast and Registration
|8:45 am - 9:00 am
|Welcome and Opening Remarks by Congressmen McCrery and Pomeroy
|9:00 am - 9:15 am
|Remarks by Senator Orrin Hatch (R-UT), Chairman of the Senate Finance Committee
|9:15 am - 10:30 am
|Panel One: Early Intervention and Work Support
Discussant: Lisa Ekman, Ekman Advocates for Progress, LLC
Papers discussed:
Ben-Shalom, Mann, and Stapleton – Integrated employment support and eligibility determination system (Presentation)
Christian, Burton, and Wickizer – Expanding community-focused work and health services (Presentation)
Kerksick, Riemer, and Williams – Using transitional jobs and tax incentives to encourage employment (Presentation)
|10:45 am - 12:00 pm
|Panel Two: Structural Reforms
Discussant: Art Spencer, Former Associate Commissioner for Disability Programs, Social Security Administration (Presentation)
|12:00 pm - 1:00 pm
|Lunch and Remarks by Bob Greenstein, President, Center on Budget and Policy Priorities
|1:00 pm - 2:15 pm
Panel Three: Determination and Adjudication Reform
|2:30 pm - 3:45 pm
Panel Four: Interaction with other programs
|4:00 pm - 5:00 pm
Closing Panel Discussion
|5:00 pm - 6:30 pm
|Closing reception


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Movie theater is a venue, usually a building, that contains an auditorium for viewing movies (films) for entertainment. Most, but not all, movie theaters are commercial operations catering to the general public, who attend by purchasing a ticket.The movie is projected with a movie projector onto a large projection screen at the front of the auditorium while the dialogue, sounds and music are played through a number of wall-mounted speakers.
Vista Theatre
AMC Del Amo 18
CGV Cinemas Movie Theater
Granada Hills 9
Rave Cinemas Baldwin Hills 15
Cinefamily at Silent Movie Theatre
Rolling Hills Plaza
ArcLight Cinemas
Landmark Theatres
El Capitan Theatre
Regal Cinemas LA LIVE 14
LAEMMLE NoHo 7
Los Feliz
Academy Cinemas
Pacific Theatres at The Grove
New Beverly Cinema
Highland Theatres
Laemmle's Town Center 5
Laemmle Playhouse 7
AMC Burbank 16
Los Angeles Theatre
Downtown Independent
United Artists La Canada 8
AMC Burbank Town Center 8
Pacific Theatres
AMC Atlantic Times Square 14
Pacific Theatres Sherman Oaks 5
Edwards Alhambra Renaissance 14 & IMAX
Nuart Theatre
TCL Chinese Theatre
Cinemark At the Pike
AMC Santa Monica 7
AMC Loews Broadway 4
Regent Theatre
Pacific Winnetka 21
Edwards Calabasas 6
Park Twin
Tiki Theatre Inc
Bruin Theatre
The Egyptian Theatre
Pacific Northridge Fashion Center All Stadium 10
Aero Theatre
Warner Grand Theatre
Vine Theatre
Crest Westwood
AMC Universal CityWalk 19 with IMAX (Los Angeles)
Roxie Theatre
Mgn Five Star Cinema
James Bridges Theater
Landmark Theatres
Westwood Village Theatre
California Science Center - IMAX Theater
Arena Cinema
TCL Chinese 6 Theatres
AMC South Bay Galleria 16
Demille Theatre
Eileen Norris Cinema Theatre
Cinema Props
Bianchi Theatres
Edwards South Gate 20 & IMAX
For more Movie Theater in Los Angeles click here : http://us.wowcity.com/losangeles/?what=Movie+Theater
Traditionally a movie theater, like a stage theater, consists of a single auditorium with rows of comfortable padded seats, as well as a foyer area containing a box office for buying tickets, a counter and/or self-service facilities for buying snacks and drinks in the movie theater lobby, film posters, arcade games, movie schedules, theater entrances, entrance halls, entrance signs, and washrooms.


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Student experiments offered spin on ESA's Large Diameter Centrifuge
ESA is offering European students a rare opportunity to conduct hypergravity experiments, with a call for proposals for the third 'Spin Your Thesis!' campaign, which will take place in 2012.
The Spin Your Thesis! programme enables university students to carry out experiments in hypergravity, using the Large Diameter Centrifuge based at the Agency's ESTEC technical centre in Noordwijk, the Netherlands.
The centrifuge subjects samples to accelerations of 1–20 times Earth's gravity. Each of the four arms can support two gondolas, with a maximum payload of 80 kg per gondola. In practice, six gondolas are available, plus one in the centre for control experiments.
The centrifuge is flexible in terms of experiment scenarios, duration and possible equipment. It supports experiments that can last for anything up from one minute to six months.
Spin Your Thesis! calls for each team of students to design a scientific or technology experiment that requires hypergravity for a few hours or days, as part of their syllabus.
Teams from ESA Member States and Cooperating States are encouraged to register on the ESA Education Office's project portal and upload their proposals by 12 December 2011.
A review board will select up to four teams to develop and perform their experiment during the third ESA Spin Your Thesis! campaign, to be held in ESTEC during September-October 2012. This campaign will last two weeks, with up to two teams using the centrifuge equipment each week.
During the Spin Your Thesis! project, the teams will be supported by ESA's Education Office, hypergravity experts from ESA and members of the European Low Gravity Research Association (ELGRA). ESA will offer financial support to cover part of the cost of the experiments, travel and accommodation.
The first Spin Your Thesis! campaign took place in June and September 2010 and was a great success, with four student teams conducting hypergravity experiments related, amongst others, to the biological processes that affect living cells, and asteroid impacts.
As a direct result of their research during Spin Your Thesis! 2010, the ETH Space Biology team, comprising three students from the Swiss Federal Institute of Technology in Zurich, the University of Konstanz and the University of Zurich, recently published a paper in the journal 'Lab on a Chip'.
The second Spin Your Thesis! campaign is on-going. The four teams are investigating bubble processes in conditions of high gravity, how hypergravity stresses plants, the behaviour of a liquid droplet on a flat solid surface in hypergravity, and the effects of hypergravity on growing cells. Two teams will be conducting their experiment in ESTEC from 19 to 23 of September 2011
Details about eligibility and how to apply for Spin Your Thesis! 2012 are available on the Spin Your Thesis! pages of the ESA Education portal.
If you require further information about the 2012 campaign, contact the Spin Your Thesis! team: spinyourthesis @ esa.int


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Instead of working on my WIP, I spent time this weekend indexing my Medical Mondays posts in a handy tab, up there. See?
(I should get a medal in procrastinating, or at least a degree. PD, Doctor of Procrastination. Can you imagine? It would take 30 years just to finish the thesis!)
Anywho...today's question comes from Elizabeth Arroyo. She asks:
"My character suffers from something that is slowly degenerative and ultimately kills her. She's been sick for about five-seven years. She has on and off moments, so she gets better than sick again until finally her body can't take it anymore. Too much meds and her insides are failing. We see her through the eyes of her daughter and I don't need anything specific to give the reader, but a name would be nice. She's currently about 42 years old."
Okay, so I picked out a few diseases for Elizabeth to choose from. The main thing they had to have in common was that it has to be potentially fatal; degenerative; hit women (and/or men) in middle age. Here are the awful contenders:
- Lupus. Systemic Lupus Erythematosis (SLE) is a disease whereby the body attacks itself and can causes all kinds of problems involving the skin, heart, joints, blood vessels, nervous system and inner organs (basically--almost everything). Most of the time it's manageable with medications that suppress the immune system, but can have life-threatening flares and can "wear down" the body causing kidney failure and other issues that can eventually kill.
- Multiple Sclerosis. MS is caused by a loss of the special fatty sheath around nerves of the brain and spinal cord. It can cause a host of neurological symptoms, and is often managed as chronic illness. Many patients have long and productive lives. However, there are a subset of patients that progress faster and might not tolerate the medications used to control the disease. Elizabeth's character might be one of them.
- Huntington's Disease. This is a neurodegenerative disorder that causes jerky body movements, psychiatric symptoms and eventually dementia. It is inherited by 50% of the children of those patients with this disease. Heart attacks, pneumonias, and sadly, suicide, are all causes of death. Generally, though, people live until about 20 years after the start of their symptoms, which usually start in early middle age but can occur even earlier in some.
- ALS. Amyotrophic Lateral Sclerosis, or Lou Gehrig's Disease, is also a neurodegenerative disease. Unlike Huntington's Disease, most cases of ALS are not inherited. The symptoms include muscle weakness, twitching, difficulty talking, swallowing, and eventually breathing. Most people with ALS die within 2-3 years of diagnosis, and usually of pneumonia or respiratory failure. This disease may move too quickly for Elizabeth's fictional needs.
- Cardiomyopathy. This is a bit of a baggage term for anything that causes the heart muscle to be "ill." There are several causes, but the one that might fit Elizabeth's situation is dilated cardiomyopathy, whereby the heart muscle degenerates and balloons out, causing heart failure symptoms. Causes include viruses, alcohol, toxins, and unknown causes. These days, dilated cardiomyopathy can be controlled as a chronic condition with medications, defibrillators/pacemakers, and even heart transplant, but even so, it can be a very difficult disease that can kill. Other organs can take a hit from the effects of a poorly pumping heart, like the kidneys, for example.