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Allergy - Related Links
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Hives are a common allergic symptom.
|Classification and external resources
|Patient UK
An allergy is a hypersensitivity disorder of the immune system.[1] Symptoms include red eyes, itchiness, and runny nose, eczema, hives, or an asthma attack. Allergies can play a major role in conditions such as asthma. In some people, severe allergies to environmental or dietary allergens or to medication may result in life-threatening reactions called anaphylaxis. Food allergies and reactions to the venom of stinging insects such as wasps and bees are more often associated with these severe reactions.[2] Not all reactions or intolerances are forms of allergy.[3]
Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid. Allergy is one of four forms of hypersensitivity and is formally called type I (or immediate) hypersensitivity. Allergic reactions are distinctive because of excessive activation of certain white blood cells called mast cells and basophils by a type of antibody called immunoglobulin E (IgE). This reaction results in an inflammatory response which can range from uncomfortable to dangerous.
A variety of tests exist to diagnose allergic conditions. If done they should be ordered and interpreted in light of a person's history of exposure as many positive test results do not mean a clinically significant allergy.[4] Tests include placing possible allergens on the skin and looking for a reaction such as swelling and blood tests to look for an allergen-specific IgE.
Treatments for allergies include avoiding known allergens, steroids that modify the immune system in general, and medications such as antihistamines and decongestants which reduce symptoms. Many of these medications are taken by mouth, although epinephrine, which is used to treat anaphylactic reactions, is injected. Immunotherapy uses injected allergens to desensitize the body's response. Mild allergies like hay fever are very common.
- 1 Signs and symptoms
- 2 Cause
- 3 Pathophysiology
- 4 Diagnosis
- 5 Prevention
- 6 Management
- 7 Epidemiology
- 8 History
- 9 Medical specialty
- 10 See also
- 11 References
- 12 External links
Signs and symptoms
|Affected organ
|swelling of the nasal mucosa (allergic rhinitis) runny nose, sneezing
|allergic sinusitis
|redness and itching of the conjunctiva (allergic conjunctivitis, watery
|Sneezing, coughing, bronchoconstriction, wheezing and dyspnea, sometimes outright attacks of asthma, in severe cases the airway constricts due to swelling known as laryngeal edema
|feeling of fullness, possibly pain, and impaired hearing due to the lack of eustachian tube drainage.
|rashes, such as eczema and hives (urticaria)
|Gastrointestinal tract
|abdominal pain, bloating, vomiting, diarrhea
Many allergens such as dust or pollen are airborne particles. In these cases, symptoms arise in areas in contact with air, such as eyes, nose, and lungs. For instance, allergic rhinitis, also known as hay fever, causes irritation of the nose, sneezing, itching, and redness of the eyes.[5] Inhaled allergens can also lead to asthmatic symptoms, caused by narrowing of the airways (bronchoconstriction) and increased production of mucus in the lungs, shortness of breath (dyspnea), coughing and wheezing.[6]
Aside from these ambient allergens, allergic reactions can result from foods, insect stings, and reactions to medications like aspirin and antibiotics such as penicillin. Symptoms of food allergy include abdominal pain, bloating, vomiting, diarrhea, itchy skin, and swelling of the skin during hives. Food allergies rarely cause respiratory (asthmatic) reactions, or rhinitis.[7] Insect stings, antibiotics, and certain medicines produce a systemic allergic response that is also called anaphylaxis; multiple organ systems can be affected, including the digestive system, the respiratory system, and the circulatory system.[8][9][10] Depending on the rate of severity, it can cause cutaneous reactions, bronchoconstriction, edema, hypotension, coma, and even death. This type of reaction can be triggered suddenly, or the onset can be delayed. The severity of this type of allergic response often requires injections of epinephrine, sometimes through a device known as the EpiPen or Twinject auto-injector. The nature of anaphylaxis is such that the reaction can seem to be subsiding, but may recur throughout a prolonged period of time.[10]
Substances that come into contact with the skin, such as latex, are also common causes of allergic reactions, known as contact dermatitis or eczema.[11] Skin allergies frequently cause rashes, or swelling and inflammation within the skin, in what is known as a "wheal and flare" reaction characteristic of hives and angioedema.[12]
Risk factors for allergy can be placed in two general categories, namely host and environmental factors.[13] Host factors include heredity, sex, race, and age, with heredity being by far the most significant. However, there have been recent increases in the incidence of allergic disorders that cannot be explained by genetic factors alone. Four major environmental candidates are alterations in exposure to infectious diseases during early childhood, environmental pollution, allergen levels, and dietary changes.[14]
A wide variety of foods can cause allergic reactions, but 90% of allergic responses to foods are caused by cow's milk, soy, eggs, wheat, peanuts, tree nuts, fish, and shellfish.[15] Other food allergies, affecting less than 1 person per 10,000 population, may be considered "rare".[16]
The most common food allergy in the US population is a sensitivity to crustacea.[16] Although peanut allergies are notorious for their severity, peanut allergies are not the most common food allergy in adults or children. Severe or life-threatening reactions may be triggered by other allergens, and are more common when combined with asthma.[15]
Rates of allergies differ between adults and children. Peanut allergies can sometimes be outgrown by children. Egg allergies affect one to two percent of children but are outgrown by about two-thirds of children by the age of 5.[17] The sensitivity is usually to proteins in the white, rather than the yolk.[18]
Milk-protein allergies are most common in children.[19] Approximately 60% of milk-protein reactions are immunoglobulin E-mediated, with the remaining usually attributable to inflammation of the colon.[20] Some people are unable to tolerate milk from goats or sheep as well as from cows, and many are also unable to tolerate dairy products such as cheese. Roughly 10% of children with a milk allergy will have a reaction to beef. Beef contains a small amount of protein that is present in cow's milk.[21] Lactose intolerance, a common reaction to milk, is not a form of allergy at all, but rather due to the absence of an enzyme in the digestive tract.
Those with tree nut allergies may be allergic to one or to many tree nuts, including pecans, pistachios, pine nuts, and walnuts.[18] Also seeds, including sesame seeds and poppy seeds, contain oils in which protein is present, which may elicit an allergic reaction.[18]
Balsam of Peru, which is in various foods, is in the "top five" allergens most commonly causing patch test reactions in people referred to dermatology clinics.[22][23][24]
Allergens can be transferred from one food to another through genetic engineering; however genetic modification can also remove allergens. Little research has been done on the natural variation of allergen concentrations in the unmodified crops.[25][26]
Non-food proteins
Latex can trigger an IgE-mediated cutaneous, respiratory, and systemic reaction. The prevalence of latex allergy in the general population is believed to be less than one percent. In a hospital study, 1 in 800 surgical patients (0.125 percent) reported latex sensitivity, although the sensitivity among healthcare workers is higher, between seven and ten percent. Researchers attribute this higher level to the exposure of healthcare workers to areas with significant airborne latex allergens, such as operating rooms, intensive-care units, and dental suites. These latex-rich environments may sensitize healthcare workers who regularly inhale allergenic proteins.[27]
The most prevalent response to latex is an allergic contact dermatitis, a delayed hypersensitive reaction appearing as dry, crusted lesions. This reaction usually lasts 48–96 hours. Sweating or rubbing the area under the glove aggravates the lesions, possibly leading to ulcerations.[27] Anaphylactic reactions occur most often in sensitive patients who have been exposed to a surgeon's latex gloves during abdominal surgery, but other mucosal exposures, such as dental procedures, can also produce systemic reactions.[27]
Latex and banana sensitivity may cross-react. Furthermore, those with latex allergy may also have sensitivities to avocado, kiwifruit, and chestnut.[28] These patients often have perioral itching and local urticaria. Only occasionally have these food-induced allergies induced systemic responses. Researchers suspect that the cross-reactivity of latex with banana, avocado, kiwifruit, and chestnut occurs because latex proteins are structurally homologous with some other plant proteins.[27]
Toxins interacting with proteins
Another non-food protein reaction, urushiol-induced contact dermatitis, originates after contact with poison ivy, eastern poison oak, western poison oak, or poison sumac. Urushiol, which is not itself a protein, acts as a hapten and chemically reacts with, binds to, and changes the shape of integral membrane proteins on exposed skin cells. The immune system does not recognize the affected cells as normal parts of the body, causing a T-cell-mediated immune response.[29] Of these poisonous plants, sumac is the most virulent.[30] The resulting dermatological response to the reaction between urushiol and membrane proteins includes redness, swelling, papules, vesicles, blisters, and streaking.[31]
Estimates vary on the percentage of the population that will have an immune system response. Approximately 25 percent of the population will have a strong allergic response to urushiol. In general, approximately 80 percent to 90 percent of adults will develop a rash if they are exposed to Script error: No such module "convert". of purified urushiol, but some people are so sensitive that it takes only a molecular trace on the skin to initiate an allergic reaction.[32]
Genetic basis
Allergic diseases are strongly familial: identical twins are likely to have the same allergic diseases about 70% of the time; the same allergy occurs about 40% of the time in non-identical twins.[33] Allergic parents are more likely to have allergic children,[34] and those children's allergies are likely to be more severe than those in children of non-allergic parents. Some allergies, however, are not consistent along genealogies; parents who are allergic to peanuts may have children who are allergic to ragweed. It seems that the likelihood of developing allergies is inherited and related to an irregularity in the immune system, but the specific allergen is not.[34]
The risk of allergic sensitization and the development of allergies varies with age, with young children most at risk.[35] Several studies have shown that IgE levels are highest in childhood and fall rapidly between the ages of 10 and 30 years.[35] The peak prevalence of hay fever is highest in children and young adults and the incidence of asthma is highest in children under 10.[36]
Overall, boys have a higher risk of developing allergies than girls,[34] although for some diseases, namely asthma in young adults, females are more likely to be affected.[37] These differences between the sexes tend to decrease in adulthood.[34]
Ethnicity may play a role in some allergies; however, racial factors have been difficult to separate from environmental influences and changes due to migration.[34] It has been suggested that different genetic loci are responsible for asthma, to be specific, in people of European, Hispanic, Asian, and African origins.[38]
Hygiene hypothesis
Allergic diseases are caused by inappropriate immunological responses to harmless antigens driven by a TH2-mediated immune response. Many bacteria and viruses elicit a TH1-mediated immune response, which down-regulates TH2 responses. The first proposed mechanism of action of the hygiene hypothesis was that insufficient stimulation of the TH1 arm of the immune system leads to an overactive TH2 arm, which in turn leads to allergic disease.[39] In other words, individuals living in too sterile an environment are not exposed to enough pathogens to keep the immune system busy. Since our bodies evolved to deal with a certain level of such pathogens, when they are not exposed to this level, the immune system will attack harmless antigens and thus normally benign microbial objects — like pollen — will trigger an immune response.[40]
The hygiene hypothesis was developed to explain the observation that hay fever and eczema, both allergic diseases, were less common in children from larger families, which were, it is presumed, exposed to more infectious agents through their siblings, than in children from families with only one child. The hygiene hypothesis has been extensively investigated by immunologists and epidemiologists and has become an important theoretical framework for the study of allergic disorders. It is used to explain the increase in allergic diseases that have been seen since industrialization, and the higher incidence of allergic diseases in more developed countries. The hygiene hypothesis has now expanded to include exposure to symbiotic bacteria and parasites as important modulators of immune system development, along with infectious agents.
Epidemiological data support the hygiene hypothesis. Studies have shown that various immunological and autoimmune diseases are much less common in the developing world than the industrialized world and that immigrants to the industrialized world from the developing world increasingly develop immunological disorders in relation to the length of time since arrival in the industrialized world.[41] Longitudinal studies in the third world demonstrate an increase in immunological disorders as a country grows more affluent and, it is presumed, cleaner.[42] The use of antibiotics in the first year of life has been linked to asthma and other allergic diseases.[43] The use of antibacterial cleaning products has also been associated with higher incidence of asthma, as has birth by Caesarean section rather than vaginal birth.[44][45]
Other environmental factors
International differences have been associated with the number of individuals within a population have allergy. Allergic diseases are more common in industrialized countries than in countries that are more traditional or agricultural, and there is a higher rate of allergic disease in urban populations versus rural populations, although these differences are becoming less defined.[46]
Alterations in exposure to microorganisms is another plausible explanation, at present, for the increase in atopic allergy.[14] Endotoxin exposure reduces release of inflammatory cytokines such as TNF-α, IFNγ, interleukin-10, and interleukin-12 from white blood cells (leukocytes) that circulate in the blood.[47] Certain microbe-sensing proteins, known as Toll-like receptors, found on the surface of cells in the body are also thought to be involved in these processes.[48]
Gutworms and similar parasites are present in untreated drinking water in developing countries, and were present in the water of developed countries until the routine chlorination and purification of drinking water supplies.[49] Recent research has shown that some common parasites, such as intestinal worms (e.g., hookworms), secrete chemicals into the gut wall (and, hence, the bloodstream) that suppress the immune system and prevent the body from attacking the parasite.[50] This gives rise to a new slant on the hygiene hypothesis theory — that co-evolution of man and parasites has led to an immune system that functions correctly only in the presence of the parasites. Without them, the immune system becomes unbalanced and oversensitive.[51] In particular, research suggests that allergies may coincide with the delayed establishment of gut flora in infants.[52] However, the research to support this theory is conflicting, with some studies performed in China and Ethiopia showing an increase in allergy in people infected with intestinal worms.[46] Clinical trials have been initiated to test the effectiveness of certain worms in treating some allergies.[53] It may be that the term 'parasite' could turn out to be inappropriate, and in fact a hitherto unsuspected symbiosis is at work.[53] For more information on this topic, see Helminthic therapy.
Acute response
In the early stages of allergy, a type I hypersensitivity reaction against an allergen encountered for the first time and presented by a professional antigen-presenting cell causes a response in a type of immune cell called a TH2 lymphocyte, which belongs to a subset of T cells that produce a cytokine called interleukin-4 (IL-4). These TH2 cells interact with other lymphocytes called B cells, whose role is production of antibodies. Coupled with signals provided by IL-4, this interaction stimulates the B cell to begin production of a large amount of a particular type of antibody known as IgE. Secreted IgE circulates in the blood and binds to an IgE-specific receptor (a kind of Fc receptor called FcεRI) on the surface of other kinds of immune cells called mast cells and basophils, which are both involved in the acute inflammatory response. The IgE-coated cells, at this stage, are sensitized to the allergen.[14]
If later exposure to the same allergen occurs, the allergen can bind to the IgE molecules held on the surface of the mast cells or basophils. Cross-linking of the IgE and Fc receptors occurs when more than one IgE-receptor complex interacts with the same allergenic molecule, and activates the sensitized cell. Activated mast cells and basophils undergo a process called degranulation, during which they release histamine and other inflammatory chemical mediators (cytokines, interleukins, leukotrienes, and prostaglandins) from their granules into the surrounding tissue causing several systemic effects, such as vasodilation, mucous secretion, nerve stimulation, and smooth muscle contraction. This results in rhinorrhea, itchiness, dyspnea, and anaphylaxis. Depending on the individual, allergen, and mode of introduction, the symptoms can be system-wide (classical anaphylaxis), or localized to particular body systems; asthma is localized to the respiratory system and eczema is localized to the dermis.[14]
Late-phase response
After the chemical mediators of the acute response subside, late-phase responses can often occur. This is due to the migration of other leukocytes such as neutrophils, lymphocytes, eosinophils and macrophages to the initial site. The reaction is usually seen 2–24 hours after the original reaction.[54] Cytokines from mast cells may play a role in the persistence of long-term effects. Late-phase responses seen in asthma are slightly different from those seen in other allergic responses, although they are still caused by release of mediators from eosinophils and are still dependent on activity of TH2 cells.[55]
Allergic contact dermatitis
Although allergic contact dermatitis is termed an "allergic" reaction (which usually refers to type I hypersensitivity), its pathophysiology actually involves a reaction that more correctly corresponds to a type IV hypersensitivity reaction.[56] In type IV hypersensitivity, there is activation of certain types of T cells (CD8+) that destroy target cells on contact, as well as activated macrophages that produce hydrolytic enzymes.
Effective management of allergic diseases relies on the ability to make an accurate diagnosis.[57] Allergy testing can help confirm or rule out allergies.[58][59] Correct diagnosis, counseling, and avoidance advice based on valid allergy test results reduces the incidence of symptoms and need for medications, and improves quality of life.[58] To assess the presence of allergen-specific IgE antibodies, two different methods can be used: a skin prick test, or an allergy blood test. Both methods are recommended, and they have similar diagnostic value.[59][60]
Skin prick tests and blood tests are equally cost-effective, and health economic evidence shows that both tests were cost-effective compared with no test.[58] Also, early and more accurate diagnoses save cost due to reduced consultations, referrals to secondary care, misdiagnosis, and emergency admissions.[61]
Allergy undergoes dynamic changes over time. Regular allergy testing of relevant allergens provides information on if and how patient management can be changed, in order to improve health and quality of life. Annual testing is often the practice for determining whether allergy to milk, egg, soy, and wheat have been outgrown, and the testing interval is extended to 2–3 years for allergy to peanut, tree nuts, fish, and crustacean shellfish.[59] Results of follow-up testing can guide decision-making regarding whether and when it is safe to introduce or re-introduce allergenic food into the diet.[62]
Skin prick testingSkin testing is also known as "puncture testing" and "prick testing" due to the series of tiny punctures or pricks made into the patient's skin. Small amounts of suspected allergens and/or their extracts (e.g., pollen, grass, mite proteins, peanut extract) are introduced to sites on the skin marked with pen or dye (the ink/dye should be carefully selected, lest it cause an allergic response itself). A small plastic or metal device is used to puncture or prick the skin. Sometimes, the allergens are injected "intradermally" into the patient's skin, with a needle and syringe. Common areas for testing include the inside forearm and the back.
If the patient is allergic to the substance, then a visible inflammatory reaction will usually occur within 30 minutes. This response will range from slight reddening of the skin to a full-blown hive (called "wheal and flare") in more sensitive patients similar to a mosquito bite. Interpretation of the results of the skin prick test is normally done by allergists on a scale of severity, with +/- meaning borderline reactivity, and 4+ being a large reaction. Increasingly, allergists are measuring and recording the diameter of the wheal and flare reaction. Interpretation by well-trained allergists is often guided by relevant literature.[63] Some patients may believe they have determined their own allergic sensitivity from observation, but a skin test has been shown to be much better than patient observation to detect allergy.[64]
If a serious life-threatening anaphylactic reaction has brought a patient in for evaluation, some allergists will prefer an initial blood test prior to performing the skin prick test. Skin tests may not be an option if the patient has widespread skin disease, or has taken antihistamines in the last several days.
Patch testing
Patch testing is a method used to determine if a specific substance causes allergic inflammation of the skin. It tests for delayed reactions. It is used to help ascertain the cause of skin contact allergy, or contact dermatitis. Adhesive patches, usually treated with a number of common allergic chemicals or skin sensitizers, are applied to the back. The skin is then examined for possible local reactions at least twice, usually at 48 hours after application of the patch, and again two or three days later.
Blood testing
An allergy blood test is quick and simple, and can be ordered by a licensed health care provider (e.g., an allergy specialist), GP, or PED. Unlike skin-prick testing, a blood test can be performed irrespective of age, skin condition, medication, symptom, disease activity, and pregnancy. Adults and children of any age can take an allergy blood test. For babies and very young children, a single needle stick for allergy blood testing is often more gentle than several skin tests.
An allergy blood test is available through most laboratories. A sample of the patient's blood is sent to a laboratory for analysis, and the results are sent back a few days later. Multiple allergens can be detected with a single blood sample. Allergy blood tests are very safe, since the person is not exposed to any allergens during the testing procedure.
The test measures the concentration of specific IgE antibodies in the blood. Quantitative IgE test results increase the possibility of ranking how different substances may affect symptoms. A rule of thumb is that the higher the IgE antibody value, the greater the likelihood of symptoms. Allergens found at low levels that today do not result in symptoms can nevertheless help predict future symptom development. The quantitative allergy blood result can help determine what a patient is allergic to, help predict and follow the disease development, estimate the risk of a severe reaction, and explain cross-reactivity.[65][66]
A low total IgE level is not adequate to rule out sensitization to commonly inhaled allergens.[67] Statistical methods, such as ROC curves, predictive value calculations, and likelihood ratios have been used to examine the relationship of various testing methods to each other. These methods have shown that patients with a high total IgE have a high probability of allergic sensitization, but further investigation with allergy tests for specific IgE antibodies for a carefully chosen of allergens is often warranted.
Challenge testing: Challenge testing is when small amounts of a suspected allergen are introduced to the body orally, through inhalation, or via other routes. Except for testing food and medication allergies, challenges are rarely performed. When this type of testing is chosen, it must be closely supervised by an allergist.
Elimination/Challenge tests: This testing method is used most often with foods or medicines. A patient with a suspected allergen is instructed to modify his diet to totally avoid that allergen for a set time. If the patient experiences significant improvement, he may then be "challenged" by reintroducing the allergen, to see if symptoms are reproduced.
Unreliable tests: There are other types of allergy testing methods that are unreliable, including applied kinesiology (allergy testing through muscle relaxation), cytotoxicity testing, urine autoinjection, skin titration (Rinkel method), and provocative and neutralization (subcutaneous) testing or sublingual provocation.[68]
Differential diagnosis
Before a diagnosis of allergic disease can be confirmed, other possible causes of the presenting symptoms should be considered.[69] Vasomotor rhinitis, for example, is one of many maladies that shares symptoms with allergic rhinitis, underscoring the need for professional differential diagnosis.[70] Once a diagnosis of asthma, rhinitis, anaphylaxis, or other allergic disease has been made, there are several methods for discovering the causative agent of that allergy.
The consumption of various foods during pregnancy has been linked to eczema; these include celery, citrus fruit, raw pepper, margarine, and vegetable oil.[71] A high intake of antioxidants, zinc, and selenium during pregnancy may help prevent allergies. This is linked to a reduced risk for childhood-onset asthma, wheezing, and eczema.[72] Further research needs to be conducted. Probiotic supplements taken during pregnancy or infancy may help to prevent atopic dermatitis.[73] After birth, an early introduction of solid food and high diversity before week 17 could increase a child's risk for allergies. Studies suggest that introduction of solid food and avoidance of highly allergenic food such as peanuts during the first year does not help in allergy prevention.[71]
Aerobiology is the study of biological particles passively dispersed through the air. One aims is the prevention of allergies due to pollin.[74][75]
In recent times, there have been enormous improvements in the medical practices used to treat allergic conditions. With respect to anaphylaxis and hypersensitivity reactions to foods, drugs, and insects and in allergic skin diseases, advances have included the identification of food proteins to which IgE binding is associated with severe reactions and development of low-allergen foods, improvements in skin prick test predictions; evaluation of the atopy patch test; in wasp sting outcomes predictions and a rapidly disintegrating epinephrine tablet, and anti-IL-5 for eosinophilic diseases.[76]
Traditional treatment and management of allergies consisted simply of avoiding the allergen in question or otherwise reducing exposure. For instance, people with cat allergies were encouraged to avoid them. However, while avoidance of allergens may reduce symptoms and avoid life-threatening anaphylaxis, it is difficult to achieve for those with pollen or similar air-borne allergies. Nonetheless, strict avoidance of allergens is still considered a useful treatment method, and is often used in managing food allergies.
New technology approaches to decreasing IgE overproduction, and regulating histamine release in allergic individuals have demonstrated statistically significant reduction on Total Nasal Symptom Scores.[77]
Several antagonistic drugs are used to block the action of allergic mediators, or to prevent activation of cells and degranulation processes. These include antihistamines, glucocorticoids, epinephrine (adrenaline), theophylline and cromolyn sodium. Antileukotriene agents, such as montelukast (Singulair) or zafirlukast (Accolate), are FDA approved for treatment of allergic diseases.[citation needed] Anti-cholinergics, decongestants, mast cell stabilizers, and other compounds thought to impair eosinophil chemotaxis, are also commonly used. These drugs help to alleviate the symptoms of allergy, and are imperative in the recovery of acute anaphylaxis, but play little role in chronic treatment of allergic disorders.
Desensitization or hyposensitization is a treatment in which the person is gradually vaccinated with progressively larger doses of the allergen in question. This can either reduce the severity or eliminate hypersensitivity altogether. It relies on the progressive skewing of IgG antibody production, to block excessive IgE production seen in atopys.[78] In a sense, the person builds up immunity to increasing amounts of the allergen in question. Studies have demonstrated the long-term efficacy and the preventive effect of immunotherapy in reducing the development of new allergy.[79] Meta-analyses have also confirmed efficacy of the treatment in allergic rhinitis in children[80] and in asthma.[81] A review by the Mayo Clinic in Rochester confirmed the safety and efficacy of allergen immunotherapy for allergic rhinitis and conjunctivitis, allergic forms of asthma, and stinging insect based on numerous well-designed scientific studies.[82] In addition, national and international guidelines confirm the clinical efficacy of injection immunotherapy in rhinitis and asthma, as well as the safety, provided that recommendations are followed.[83]
A second form of immunotherapy involves the intravenous injection of monoclonal anti-IgE antibodies. These bind to free and B-cell associated IgE; signalling their destruction. They do not bind to IgE already bound to the Fc receptor on basophils and mast cells, as this would stimulate the allergic inflammatory response. The first agent of this class is omalizumab. While this form of immunotherapy is very effective in treating several types of atopy, it should not be used in treating the majority of people with food allergies.[citation needed]
A third type, sublingual immunotherapy, is an orally administered therapy that takes advantage of oral immune tolerance to non-pathogenic antigens such as foods and resident bacteria. This therapy currently accounts for 40 percent of allergy treatment in Europe.[citation needed] In the United States, sublingual immunotherapy is gaining support among traditional allergists and is endorsed by doctors treating allergy.[84]
Allergy shot treatment is the closest thing to a 'cure' for allergic symptoms. This therapy requires a long-term commitment.[78]
An experimental treatment, enzyme potentiated desensitization (EPD), has been tried for decades but is not generally accepted as effective.[85] EPD uses dilutions of allergen and an enzyme, beta-glucuronidase, to which T-regulatory lymphocytes are supposed to respond by favouring desensitization, or down-regulation, rather than sensitization. EPD has also been tried for the treatment of autoimmune diseases but is not approved by the U.S. Food and Drug Administration or of proven effectiveness.[85]
Systematic literature searches conducted by the Mayo Clinic through 2006, involving hundreds of articles studying multiple conditions, including asthma and upper respiratory tract infection, showed no effectiveness of homeopathic treatments and no difference compared with placebo. The authors concluded that, based on rigorous clinical trials of all types of homeopathy for childhood and adolescence ailments, there is no convincing evidence that supports the use of homeopathic treatments.[86]
The allergic diseases — hay fever and asthma — have increased in the Western world over the past 2–3 decades.[87] Increases in allergic asthma and other atopic disorders in industrialized nations, it is estimated, began in the 1960s and 1970s, with further increases occurring during the 1980s and 1990s,[88] although some suggest that a steady rise in sensitization has been occurring since the 1920s.[89] The number of new cases per year of atopy in developing countries has, in general, remained much lower.[88]
|Allergy type
|United States
|United Kingdom[90]
|Allergic rhinitis
|35.9 million[91] (about 11% of the population[92])
|3.3 million (about 5.5% of the population[93])
|10 million have allergic asthma (about 3% of the population). The prevalence of asthma increased 75% from 1980 to 1994. Asthma prevalence is 39% higher in African Americans than in Europeans.[94]
|5.7 million (about 9.4%). In six and seven year olds asthma increased from 18.4% to 20.9% over five years, during the same time the rate decreased from 31% to 24.7% in 13- to 14-year-olds.
|Atopic eczema
|About 9% of the population. Between 1960 and 1990 prevalence has increased from 3% to 10% in children.[95]
|5.8 million (about 1% severe).
|At least 40 deaths per year due to insect venom. About 400 deaths due to penicillin anaphylaxis. About 220 cases of anaphylaxis and 3 deaths per year are due to latex allergy.[96] An estimated 150 people die annually from anaphylaxis due to food allergy.[97]
|Between 1999 and 2006, 48 deaths occurred in people ranging from five months to 85 years old.
|Insect venom
|Around 15% of adults have mild, localized allergic reactions. Systemic reactions occur in 3% of adults and less than 1% of children.[98]
|Drug allergies
|Anaphylactic reactions to penicillin cause 400 deaths per year.
|Food allergies
|About 6% of US children under age 3 and 3.5–4% of the overall US population.[citation needed] Peanut and/or tree nut (e.g. walnut) allergy affects about three million Americans, or 1.1% of the population.[97]
|5–7% of infants and 1–2% of adults. A 117.3% increase in peanut allergies was observed from 2001 to 2005, an estimated 25,700 people in England are affected.
|Multiple allergies (Asthma, eczema and allergic rhinitis together)
|2.3 million (about 3.7%), prevalence has increased by 48.9% between 2001 and 2005.[99]
Although genetic factors fundamentally govern susceptibility to atopic disease, increases in atopy have occurred within too short a time frame to be explained by a genetic change in the population, thus pointing to environmental or lifestyle changes.[88] Several hypotheses have been identified to explain this increased prevalence; increased exposure to perennial allergens due to housing changes and increasing time spent indoors, and changes in cleanliness or hygiene that have resulted in the decreased activation of a common immune control mechanism, coupled with dietary changes, obesity and decline in physical exercise.[87] The hygiene hypothesis maintains[100] that high living standards and hygienic conditions exposes children to fewer infections. It is thought that reduced bacterial and viral infections early in life direct the maturing immune system away from TH1 type responses, leading to unrestrained TH2 responses that allow for an increase in allergy.[51][101]
Changes in rates and types of infection alone however, have been unable to explain the observed increase in allergic disease, and recent evidence has focused attention on the importance of the gastrointestinal microbial environment. Evidence has shown that exposure to food and fecal-oral pathogens, such as hepatitis A, Toxoplasma gondii, and Helicobacter pylori (which also tend to be more prevalent in developing countries), can reduce the overall risk of atopy by more than 60%,[102] and an increased prevalence of parasitic infections has been associated with a decreased prevalence of asthma.[103] It is speculated that these infections exert their effect by critically altering TH1/TH2 regulation.[104] Important elements of newer hygiene hypotheses also include exposure to endotoxins, exposure to pets and growing up on a farm.[104]
The concept of "allergy" was originally introduced in 1906 by the Viennese pediatrician Clemens von Pirquet, after he noted that some of his patients were hypersensitive to normally innocuous entities such as dust, pollen, or certain foods.[105] Pirquet called this phenomenon "allergy" from the Ancient Greek words ἄλλος allos meaning "other" and ἔργον ergon meaning "work".[106]
All forms of hypersensitivity used to be classified as allergies, and all were thought to be caused by an improper activation of the immune system. Later, it became clear that several different disease mechanisms were implicated, with the common link to a disordered activation of the immune system. In 1963, a new classification scheme was designed by Philip Gell and Robin Coombs that described four types of hypersensitivity reactions, known as Type I to Type IV hypersensitivity.[107] With this new classification, the word "allergy" was restricted to type I hypersensitivities (also called immediate hypersensitivity), which are characterized as rapidly developing reactions.
A major breakthrough in understanding the mechanisms of allergy was the discovery of the antibody class labeled immunoglobulin E (IgE) – Kimishige Ishizaka and co-workers were the first to isolate and describe IgE in the 1960s.[108]
Radiometric assays include the radioallergosorbent test (RAST test) method, which uses IgE-binding (anti-IgE) antibodies labeled with radioactive isotopes for quantifying the levels of IgE antibody in the blood.[109] Other newer methods use colorimetric or fluorescence-labeled technology in the place of radioactive isotopes.[citation needed]
The RAST methodology was invented and marketed in 1974 by Pharmacia Diagnostics AB, Uppsala, Sweden, and the acronym RAST is actually a brand name. In 1989, Pharmacia Diagnostics AB replaced it with a superior test named the ImmunoCAP Specific IgE blood test, which uses the newer fluorescence-labeled technology.[citation needed]
American College of Allergy Asthma and Immunology (ACAAI) and the American Academy of Allergy Asthma and Immunology (AAAAI) issued the Joint Task Force Report "Pearls and pitfalls of allergy diagnostic testing" in 2008, and is firm in its statement that the term RAST is now obsolete:
The term RAST became a colloquialism for all varieties of (in vitro allergy) tests. This is unfortunate because it is well recognized that there are well-performing tests and some that do not perform so well, yet they are all called RASTs, making it difficult to distinguish which is which. For these reasons, it is now recommended that use of RAST as a generic descriptor of these tests be abandoned.[110]
The new version, the ImmunoCAP Specific IgE blood test, is the only specific IgE assay to receive FDA approval to quantitatively report to its detection limit of 0.1kU/l.[citation needed]
Medical specialty
An allergist is a physician specially trained to manage and treat allergies, asthma and the other allergic diseases. In the United States physicians holding certification by the American Board of Allergy and Immunology (ABAI) have successfully completed an accredited educational program and evaluation process, including a proctored examination to demonstrate knowledge, skills, and experience in patient care in allergy and immunology.[111] Becoming an allergist/immunologist requires completion of at least nine years of training. After completing medical school and graduating with a medical degree, a physician will undergo three years of training in internal medicine (to become an internist) or pediatrics (to become a pediatrician). Once physicians have finished training in one of these specialties, they must pass the exam of either the American Board of Pediatrics (ABP), the American Osteopathic Board of Pediatrics (AOBP), the American Board of Internal Medicine (ABIM), or the American Osteopathic Board of Internal Medicine (AOBIM). Internists or pediatricians wishing to focus on the sub-specialty of allergy-immunology then complete at least an additional two years of study, called a fellowship, in an allergy/immunology training program. Allergist/immunologists listed as ABAI-certified have successfully passed the certifying examination of the ABAI following their fellowship.[112]
In the United Kingdom, allergy is a subspecialty of general medicine or pediatrics. After obtaining postgraduate exams (MRCP or MRCPCH), a doctor works for several years as a specialist registrar before qualifying for the General Medical Council specialist register. Allergy services may also be delivered by immunologists. A 2003 Royal College of Physicians report presented a case for improvement of what were felt to be inadequate allergy services in the UK.[113] In 2006, the House of Lords convened a subcommittee. It concluded likewise in 2007 that allergy services were insufficient to deal with what the Lords referred to as an "allergy epidemic" and its social cost; it made several recommendations.[114]
See also
- ↑ "allergy" at Dorland's Medical Dictionary
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- ↑ 104.0 104.1 Sheikh A, Strachan DP (2004). "The hygiene theory: fact or fiction?". Current Opinion in Otolaryngology & Head and Neck Surgery 12 (3): 232–6. PMID 15167035. doi:10.1097/01.moo.0000122311.13359.30.
- ↑ Clemens Peter Pirquet von Cesenatico at Who Named It?
- ↑ Von Pirquet C (1906). "Allergie". Munch Med Wochenschr 53 (5): 388–90. PMID 20273584.
- ↑ Gell PGH, Coombs RRA. (1963). Clinical Aspects of Immunology. London: Blackwell.
- ↑ Ishizaka K, Ishizaka T, Hornbrook MM (1966). "Physico-chemical properties of human reaginic antibody. IV. Presence of a unique immunoglobulin as a carrier of reaginic activity". Journal of Immunology 97 (1): 75–85. PMID 4162440.
- ↑ Ten RM, Klein JS, Frigas E; Klein; Frigas (1995). "Allergy skin testing". Mayo Clin. Proc. 70 (8): 783–4. PMID 7630219. doi:10.4065/70.8.783.[dead link]
- ↑ Cox et al. (2008). ". Pearls and pitfalls of allergy diagnostic testing". Annals of Allergy, Asthma & Immunology 101 (6): 580–592. PMID 19119701. doi:10.1016/s1081-1206(10)60220-7.
- ↑ "ABAI: American Board of Allergy and Immunology". Archived from the original on 2010-11-16. Retrieved 2007-08-05.
- ↑ "AAAAI – What is an Allergist?". Archived from the original on 2010-11-16. Retrieved 2007-08-05.
- ↑ Royal College of Physicians (2003). Allergy: the unmet need. London, UK: Royal College of Physicians. ISBN 978-1-86016-183-4. PDF version (1.03 MB)
- ↑ House of Lords – Science and Technology Committee (2007). Allergy – HL 166-I, 6th Report of Session 2006–07 – Volume 1: Report. London, UK: TSO (The Stationery Office). ISBN 978-0-10-401149-2.
External links
|Wikimedia Commons has media related to Allergies.
- Allergies in children at Allergy UK
- American Academy of Allergy, Asthma & Immunology
- European Academy of Allergy & Clinical Immunology
Lua error in Module:Authority_control at line 346: attempt to index field 'wikibase' (a nil value).


text:
Queen Latifah emerged from the Maui surf yesterday, and vented her frustrations with paparazzi by flashing some sort of maritime distress signal.
Latifah, who voiced a mammoth in "Ice Age: The Meltdown," did some snorkeling amongst the whales and fishies off the coastline.
The Cover Girl uncovered and revealed her luscious new fresh-faced look in a form-flattering one-piece swimsuit!
CommentsClick To View
Hot Video

subset: commoncrawl


text:
PPI::Token::QuoteLike::Backtick - A `backticks` command token
isa PPI::Token::QuoteLike
isa PPI::Token
isa PPI::Element
PPI::Token::QuoteLike::Backtick object represents a command output capturing quote.
There are no methods available for
PPI::Token::QuoteLike::Backtick beyond those provided by the parent PPI::Token::QuoteLike, PPI::Token and PPI::Element classes.
See the support section in the main module.
Adam Kennedy <firstname.lastname@example.com>
Copyright 2001 - 2011 Adam Kennedy.
This program is free software; you can redistribute it and/or modify it under the same terms as Perl itself.
The full text of the license can be found in the LICENSE file included with this module.


text:
Customer Reviews
All reviews are from people who have redeemed deals with this merchant.
What You'll Get
After purchasing this deal, you will need to visit the website listed on your Groupon voucher to complete redemption.
The Deal
- $20 for a Party Starter sampler ($39.95 value)
- 15 total pretzels in 5 different varieties
The Party Sampler includes:
- aMMazing: milk chocolate–coated pretzels topped with M&Ms
- ButterCrunch: milk chocolate–coated pretzel topped with butter toffee
- Chocolate Dream: dark chocolate–coated pretzel topped with dark-chocolate chips
- Sparkler: milk chocolate–coated pretzel topped with sprinkles
- Plain Jane: white chocolate–coated pretzel topped with milk-chocolate drizzle
The Painted Pretzel appeared on season 3 of ABC's hit show, Shark Tank, and accepted a deal from the sharks. It has been sold in over 6,000 stores and also appeared on Good Morning America, in People Magazine, and named as one of the "Top 10 Mother's Day Gifts" on Forbes.com.
The Fine Print
Promotional value expires 120 days after purchase. Amount paid never expires. Limit 1 per person, may buy 1 additional as gift. Valid only for option purchased. Shipping not included and is calculated upon checkout (average shipping is ~$8/order). Valid online only at www.thepaintedpretzel.com. Minimum purchase of full offer value required prior to expiration. Upon expiration, unused voucher will be redeemable for the paid value. Merchant is solely responsible to purchasers for the care and quality of the advertised goods and services.
About The Painted Pretzel
These pretzels aren't just covered in chocolate. They're painted in chocolate, as if founder Raven Thomas still handcrafts each sweet-and-savory morsel herself. At one point she did, dipping pretzels into chocolate, butterscotch, and other sweet solutions, but after an appearance on Season 3 of ABC's Shark Tank—and a subsequent deal with Mark Cuban—Raven was able to expand The Painted Pretzel to fill orders nationwide.
At the online store, The Painted Pretzel combines salty snacks and candy coatings into a variety of delectable combinations. The signature item, Pretzel Bark, coats crispy pretzels in white, dark, or milk chocolate, while toppings such as pecans, chocolate chips, and M&Ms snuggle half-covered pretzel rods. All of The Painted Pretzel's items come in simple, elegant packaging, from see-through canisters tied with ribbons to boxes overflowing with enough samplers to last a single Mother's Day morning.


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Friday, March 4, 2011
FRIDAY FIVE (Some Big Things)
1. Today is my youngest daughter's birthday and she's in the double-digits now. She's my firecracker (that's my polite way of saying she's stubborn as hell), but I'm sooo not ready for her to grow up just yet.
2. In case you missed the news on Twitter, I'll be revealing the synopsis of The Pledge either tomorrow or once I reach 2500 Twitter followers...whichever comes first. Let's just call that tomorrow.
3. If you're in Portland, OR, I'm really hoping to see you on Sunday at Powell's Cedar Hills Crossing store in Beaverton. It's at 2:00PM, people, don't make me beg!
4. Today is also the last day to enter the MARCH MADNESS giveaway for a chance to win a signed copy of one of seven fab March releases!!!
5. The Chicago Public Library named THE BODY FINDER as one of its 2011 BEST OF THE BEST Books for Teens. YAY, Chicago! I'll see you in a couple of weeks!!!!
9 comments:
Ahh Happy Birthday to your daughter!! Hope she has a great day!! So ezxited for the Pledge synopsis!!
WOW!! That is a great acheivment!!! Congrats KIm!!!
- March 4, 2011 at 7:10 AM
- Little Ms J said...
Happy Bday to Miss Abby! Have a wonderful day and I'm sure Twitter will implode with the masses dying to click follow shortly. I promise.
- March 4, 2011 at 7:51 AM
- DJ's Life in Fiction said...
Happy birthday to your daughter! :D
- March 4, 2011 at 8:53 AM
- Emily said...
Yay! Tell Abby I wish her a happy birthday!
- March 4, 2011 at 9:58 AM
- Heidi Willis said...
Congrats on all your continued successes. Happy birthday to Abby, and have a great time in Beaverton. I used to have great friends there. Wish I could come.
- March 4, 2011 at 10:30 AM
- Cari said...
Happy Birthday to your little one! She is such a cutie!
- March 4, 2011 at 12:42 PM
- Amber Argyle said...
My son turns 9 today. *sniff* If we put them in the fridge to sleep at night, think it'll slow the growth process?
- March 4, 2011 at 2:01 PM
- Heather said...
Happy birthday to the double digit birthday girl!!!! They do grow so fast. I do not follow twitter :o( I should though. Good luck I am sure you will reach you goal and beyond!!
- March 4, 2011 at 2:40 PM
- Kimberly Derting said...
Heidi - I wish you could be there too :(
Amber - I would love to figure out a way to slow down the clock!
- March 5, 2011 at 7:44 AM


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Make this fun Carrot Castle for a fun snack or a centerpiece for a party. Fill the castle with raisins or grapes for a healthy snack.
Items needed:
- Baby carrots
- Orange
- Raisins or grapes
- Red bell pepper / apple
- toothpick
- optional: peanut butter or ranch dip
- Cut a tiny sliver from the end of the baby carrots so that they can set straight on a plate without toppling over.
- Cut two slices of orange, about 1/4 in. wide, for the front and back door of the castle.
- Cut a small triangular flag from a piece of bell pepper, apple or other fruit.
- Carrots can just be positioned on a plate with the orange slices to make the castle. Or you can glue the carrots together, using peanut butter. Kids love this tasty combination of carrots and peanut butter.
- Another option is to spread some ranch dip onto the plate prior to building the castle and kids can then dip as they remove parts of the castle. Obviously, do not use the peanut butter if using the dip.


text: blog postsThe Calm Before The StormDec 2, 2013 11:25 am by Kendall YoksoulianShare on FacebookTweetEmailI hope you all had a wonderful Thanksgiving full of family, good food, and gratefulness. I think that this Thanksgiving was surrounded by a very unique time – with the typhoon in the Philippines and the destruction from the tornadoes right here in central Illinois. Those extremely devastating situations were a blatant reminder of just how much I have to be thankful for while people across the world and also right next door are suffering from such great loss. Sometimes I think it's healthy to step back from our lives and truly reflect on everything we have been blessed with. I am glad that we have a national holiday for that here in the United States, but I wish that it could be more of a lifestyle – spending time each day being thankful for all that we have. Our entire week of Thanksgiving break was very rejuvenating and came at the perfect time. I spent a lot of time lounging around watching movies, reading, cooking, baking, and spending quality time with family. Now it's Monday and we are back at school and are already crazy. We have a week and a half left of classes and then comes finals week. This time leading up to finals is full of last exams, big presentations, group projects, and lots more. Thanksgiving break was definitely what you can call "the calm before the storm." The good news is that there is a light at the end of the tunnel! In just three weeks we will be home for a month of winter break and finished with first semester…and then will come even more lounging around and watching movies and family time. During these next few weeks when I am busy and stressed, I am going to do my best to remember how much I have to be thankful for – especially the opportunity to go to such a wonderful university.stats36 Views 0 Comments additional actions Add Comment


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Hey look it's Shanky Two Wheels with his "knife pokes and crooked spokes," waiting for you at the start of the next Cross race. Don't know if anyone has thought of a Cross Children Books, but if so, here's your antagonist!
Uploaded by TheGrossUncle | more from the Bike Hugger Photostream.


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JAMESTOWN, N.D.—The nonprofit Farm Rescue group is accepting applications from farmers in need of help with spring planting.
North Dakota-based Farm Rescue helps family farmers in the Dakotas, Montana, Minnesota and Iowa who have suffered a major injury, illness or natural disaster. Volunteers help the farmers plant and harvest up to 1,000 acres of crops.
The effort began in 2006. It helped its 200th farmer last year.
Priority is being given to applications received by April 15. More information can be found at http://www.farmrescue.org.


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Jean_P2 on Family Tree Circles
sort: Date Alphabetical
view: full | list
view: full | list
Journals and Posts
Hello, My name is Jean and i'm looking for info on Abbie Amelia...
My name is Jean and i'm looking for info on Abbie Amelia Elliot. I'm looking for date of birth, place of birth, & occupation. If you have any of this infomation please e-mail and let me know. The only info I have on her is...who she got married to: Floyd Burton Potter, when she got married: June 8, 1910...when she died: July 9,1946 and where she died: Springfield, MA.
- Displaying 1-1 of 1 Journals
- 1
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6:30 am
Market to Market NULL
7:00 am
Second Opinion "Multiple Sclerosis" A debilitating disease of the nervous system where nerve cells become damaged, Multiple Sclerosis (MS) results in a wide variety of symptoms. Learn how research is making treatments for MS more successful, giving individuals a better quality of life. D
7:30 am
Essential Pepin "Family Favorites" Grilled Leg Of Lamb; Pork Loin Tournedos With Cream And Calvados; Puerto Rican Pork And Beans; Lamb Navarin. D
8:00 am
Barbecue University with Steven Raichlen "The Best of the Breast" Pit masters are obsessed with breasts. (Chicken and turkey breasts, that is.) This week, BBQ U Professor Steven Raichlen takes on America's most popular cut of poultry. D
8:30 am
Simply Ming "Ginger & Brown Sugar" Guest Chef: Jody Adams. You can knock on just about any door at the holidays in this country and find today's master ingredients holding court on the sideboard on this week's SIMPLY MING. They met during the days of the spice trade and they haven't been apart since: from the East, ginger and from the West, brown sugar. D
9:00 am
The Jazzy Vegetarian "Nuts About Nut Loaf" Host Laura Theodore prepares a delightful dinner that features hearty "Cashew and Quinoa Loaf," paired with savory "Paprika and Rosemary Roasted Red Potatoes." On the side, mouth watering "Asparagus with Vegan 'Hollandaise' sauce." Quick to prepare "Flourless Oatmeal Lace Cookies" make a crisp and delicious dessert. D
9:30 am
New Scandinavian Cooking "Northern Norway/Italy: Dry But Tasty" Codfish ranks among Norway's most important exports. Host Andreas Viestad follows the codfish from its origin near the Lofoten Islands in Northern Norway to the table in Italy. D
10:00 am
Cook's Country from America's Test Kitchen "Tropical Barbecue" Bridget reveals how to make Huli Huli Chicken right at home. Then, Jack challenges Chris to a tasting of reduced-fat potato chips. Next, Adam reveals his top picks for pastry brushes. D
10:30 am
Cuisine Culture "Josiah Citrin, Los Angeles" Two-Star Michelin chef Josiah Citrin takes us to Santa Monica's farmers market, where we try local and organic produce that go into his main course: a Liberty Duck Breast a l'Orange served with a colorful Blood Orange Reduction and Tender Baby Turnips. He then leads us to his renowned restaurant Melisse where he shows us the intricacies behind the appetizer: a Sweet Onion Parmesan Soup with Crabcake and Meyer Lemon. Perfect harmony is created with Warm Crispy Beignets served with Spiced Chocolate Sauce and Cream Gelato. D
11:00 am
America's Test Kitchen from Cook's Illustrated "Fall Classics" Test cook Julia Collin Davison shows host Christopher Kimball how to make the ultimate Pot-Roasted Pork Loin. Chris then discusses the differences between baking soda and baking powder with science expert Guy Crosby. Next, tasting expert Jack Bishop challenges Chris to a tasting of pork. D
11:30 am
Scrapbook Memories "Flowers" When you're looking for a touch of color on a layout - nothing is easier than adding flowers. They can signify the season, bring a feminine touch, and also add just about any sentiment. First, Julianna Hudgins combines flowers and phrases for a pretty project. D
12:00 pm
Paint This With Jerry Yarnell "Morning Fog, Part 3" In this final episode, Jerry blocks in the seagulls and demonstrates how to add shape and form to the birds using the #4 sable brush. Be careful to remain in the value system for objects that are painted in the distance. Switching to the script brush, Jerry demonstrates the technique of creating seagulls in flight at the beach. D
12:30 pm
Pedal America "Bike The Vine - Napa Valley, California" Come for the wine, but stay for the cycling. From Calistoga to the city of Napa, Ira David pedals his way along wineries and art museums to showcase Napa Valley as a family-friendly bicycling destination. D
1:00 pm
This Old House "Bedford Project, Part 16 of 16" As the Bedford project wraps up, landscape contractor Roger Cook and landscape designer Jenn Nawada Evans install both the new and old plant material, adjusted at the nursery for the change in the color of the house. In the kitchen, tile contractor Mark Ferrante installs the ceramic backsplash tile with a crackle finish that requires sealing three times to prevent seepage and staining through the cracks. In the dining room, interior designer Dee Elms is on hand as wallpaper hanger Mike Bradshaw starts installing the new hand-woven paper from Japan. D
1:30 pm
Ask This Old House "Staining A Cedar Fence; Installing Window Boxes" Host Kevin O'Connor works with painter Mauro Henrique to stain a cedar fence. Then, general contractor Tom Silva helps a homeowner install window boxes; landscape contractor Roger Cook helps plant them. D
2:00 pm
American Woodshop "Kitchen Cabinet" Easy to make raised-panel, native hardwood show-stoppers. D
2:30 pm
Rough Cut - Woodworking with Tommy Mac "Simple Case Construction Book Case" This time, on Rough Cut, Tommy discusses project design and explains how to do basic mortise and tenon joinery for a Simple Case Construction Bookcase project. He takes a Road Trip to the Furniture Divas exhibit at the Fuller Craft Museum in Brockton, Massachusetts. Back in the shop, Tommy is joined by New Hampshire furniture maker Tom McLaughlin. D
3:00 pm
MotorWeek "Cadillac Xts" Road Test: 2013 Cadillac XTS. Road Test: 2012 BMW 3 Series. Goss' Garage: Clock Springs & Airbags. D
3:30 pm
America's Heartland A Florida ranch helps troubled youth turn their lives around. Chef Dave Lieberman crafts some spicy dishes with eggplant and cabbage. Kansas farm wives use the internet to battle misconceptions about agriculture. D
4:00 pm
NOVA "The Fabric of the Cosmos - The Illusion of Time" Brian Greene conducts a time-traveling adventure to demonstrate a new way of thinking about time in which moments past, present, and future exist all at once - in this scenario, ultimate secrets of time may be hidden in the Big Bang. Part 2 of 4G
5:00 pm
Antiques Roadshow "Vintage San Francisco" The City by the Bay had an unusually wet rainy season when the Roadshow visited in 1998 to find a modest-looking Eskimo hunting helmet with an estimated value of $65,000 to $75,000, now increasing past $125,000. But a 1385 English silver spoon seems less in demand today than in 1998.G
6:00 pm
Priceless Antiques Roadshow Specialist Penny Brittain explains how she saved a valuable piece of porcelain from being used for target practice. The show also follows a lucky ROADSHOW visitor all the way to the bank.G
6:30 pm
Rick Steves' Europe "Iran:Tehran and Side Trips" Rick visits Tehran and a small village for a look at some of civilization's important historical sites and a sense of Iran's 21st-century culture.G
7:00 pm
The Lawrence Welk Show "The Great Gershwin" This 1972 show opens with "Of Thee I Sing." Norma Zimmer follows with "Someone To Watch Over Me." Bobby and Cissy dance to "The Man I Love." Bob Ralston plays "Rhapsody in Blue." Joe Livoti sings of "Summertime."G
8:00 pm
Are You Being Served? "It Pays to Advertise" Grace Brothers plans an advertising campaign but plans to use staff members to film a commercial.G
8:30 pm
Keeping Up Appearances - The Memoirs of Hyacinth Bucket "Iron Age Remains" Hyacinth forces Richard to participate in a trip to the countryside to look for Iron Age remains. News from Daisy and Onslow interrupts the excursions.G
9:00 pm
As Time Goes By "Misunderstandings" Jean and Lionel hide their history when faced with Jean's sister-in-law Penny.G
9:31 pm
Outnumbered Cousin Julie is about to be married but must face a grilling about previous boyfriends by Karen, age 6. Meanwhile, her brother, Ben, asks the vicar complex theological questions.G
10:01 pm
The Red Green Show "Historic Site" Red and Mike try to save the Lodge by having it declared a historical site. Then, Red makes a hedge trimmer out of a weed whacker on roller blades.G
10:30 pm
My Family "Once More with Feeling" Roger and Abi announce they have set a date for their wedding. This causes Susan to want to renew her vows with Ben. She begins making necessary arrangements despite protests from Ben, especially when Susan's date conflicts with a big football match.G
11:00 pm
Doctor Who - Specials "The Water of Mars" The Doctor lands on the planet Mars at a base in peril. A creeping infection beneath the Martian surface threatens the human race - and the Doctor's most fundamental beliefs. Together with Adelaide Brooke (Lindsay Duncan), the base's commander, the Doctor must defeat a seemingly unstoppable menace before it can reach Earth.G


text:
Ngāi Tahu - environment - people - kaitiakitanga - space - indigenous rights - politics - Māori - earth - and anything else that catches my eye
Monday, December 3, 2012
underreported struggles 66, 67 and 68
underreported struggles 66
A group of Naso protestors blocked access to the Bonyic Hydroelectric project in Bocas del Toro province, western Panama. The protestors, who issued an urgent plea for international solidarity, say that a new road will cut through an ancient archaeological site, which has already been damaged by bulldozers. They say the site is extensive and that they have collected a variety of ceramic shards, implements, huacas (pre-Colombian ornaments) and a piece of human bone from the area, indicating it was once perhaps a burial ground.
The Chumash Nation raised numerous concerns over the proposed Diablo Canyon Seismic project off the Central Coast of California. Pacific Gas and Electric (PG&E) intends to carpet bomb approx. 580 square nautical miles of sea floor with powerful Air Cannons that will blast every 10 to 20 seconds for 42 days straight. The 260db sonic blasts, which will travel through the water and 10 miles into the earth's crust, will devastate the local marine ecosystem and possibly destroy fragile and sensitive Sacred Chumash Cultural Sites.
The Amoonguna people in Australia's Northern Territory issued a statement requesting the removal of all government workers from their community by the end of September or face charges of trespass. The Amoonguna are also refusing to sign another five-??year lease after being forced to accept the first one (along with 5 dozen other communities) in 2007 as a part of the government's draconian 'intervention' programme.
underreported struggles 67
In a stunning development, villagers in Kurukshetra, India, forced the Haryana Agriculture University authorities to fulfill their promise to completely destroy field trials of Monsanto's GM corn. The welcomed display came only after Monsanto officials--with the support of University staff--tried to sneak out the GM corn. Alert villages stopped them in their tracks.
The Batwa Peoples of southwest Uganda, after being evicted from their traditional territory in 1991, are finally returning to their homeland; but they can only visit, as tour guides. The Batwa are taking tourists on $80 treks deep into Mgahinga to encounter first hand "the lost world of the Batwa". Not all Batwa have been displaced. Over all, there are as many as 500,000 Batwa--more indelicately known as "pygmies"-- who continue to inhabit the rainforest that stretches from Cameroon to Uganda. However, they continue to face the same old threats: encroachment, logging,evictions, racism, health problems, extreme poverty and censorship.
Indigenous Peoples throughout Brazil are mobilizing to repeal a dangerous new law that opens the doors to a full-scale military invasion of Indigenous lands, prohibits the distribution of news lands, restricts autonomy, and permits the construction of various industrial projects (like the Belo Monte Dam) without consultation. Protests against the law known as Decree 303 are ongoing.
underreported struggles 68
Activists from across Canada and the world stepped forward in solidarity with the Unis'tot'en, who grabbed national headlines after evicting shale gas pipeline surveyors from their territories in the interior of BC. The Unis'tot'en have made it clear that no proposed pipelines will proceed in Unist'ot'en territories and that corporations, investors, and governments have no jurisdiction to approve development on their lands.
Alberta's Court of appeal dismissed Athabasca Chipewyan First Nation's plea for a review concerning the Crown's inadequate consultation before deciding to approve Shell's Jackpine Mine expansion project. The First Nation is extremely disappointed and is currently reviewing their options to address the lack of adequate consultation with respect to Shell's tar sands project.
Indigenous Mongolian herders, who have been evicted from their land to make way for a Rio Tinto gold and copper mine, have lodged a complaint with the World Bank which is providing US$900 million of financial backing for the project. The herders have not been adequately compensated for their eviction and loss of herd since the project began, and have their free, prior and informed consent was not obtained in the process of undertaking the project.
Visit Intercontinental Cry to read about these issues and many others.
2 comments:
- Scott Hamilton said...
Hi Marty,
this is off-topic, but I've just found out that, to my absolute and ever-lasting shame, you weren't asked about the inclusion of a couple of your very interesting poems in the Oceania issue of brief which I edited earlier this year. Michael Arnold, who was helping me sound out contributors, thought that I'd gotten the thumbs up from you and that I'd sent you the issue, and I seem to have thought Michael had done the same job. All I can say in my defence is that I was a new father when I put the issue together, and my sense of time, and mush else besides, was rather scrambled!
Have you now gotten the issue of the journal you are owed as a contributor from Michael and Brett Cross? Please let me know if you haven't, and I will flick you an Xmas hamper of briefs and other goodies as some small recompense for my earlier blunders...
Best, Scott firstname.lastname@example.com
- December 13, 2012 at 6:36 PM
- Kia Plantation said...
Hi there, awesome site. I thought the topics you posted on were very interesting. I tried to add your RSS to my feed reader and it a few. take a look at it, hopefully I can add you and follow...
- January 31, 2013 at 11:13 PM


text:
hey there,
I made some recent games, you can check them out here: http://ouyaforum.com/showthread.php?...ammer&p=163029
Drop a post and let me know what you think.
Also if you're an ouya dev and have some free time I could give them to you to help port.
You have no visitor messages, so I shall give you one. You're welcome and are now allowed to feel special.
Send an Instant Message to Jayenkai Using...
OUYA Devotee
Inebriated Staff Ninja
OUYA Developer


text:
Value of Libraries in the Internet Age
From Professionaltips
News articles reporting on the online and Internet aspects of library use.
New Jersey Public Library Survey: Customer Survey of New Jersey Residents About Libraries (PDF) - PowerPoint presentation (Survey conducted June 2007)
"Old Search Engine, the Library, Tries to Fit Into a Google World," by Katie Hafner. New York Times, June 21, 2004.
Additional resources available at Value of Libraries.


text:
After several months of sales activity being below historical levels, sales really took off in June. In Regina and area, residential sales were well above 2014 while the level of listings for sale in the city continued at 25 year highs, according to the Association of Regina Realtors®.
Last month, 433 home sales occurred in Regina and area, up 21% from 357 sales in June 2014. It marks the second-highest number of sales for June (behind 453 in 2007) and the largest number of sales for any month since May 2012.
The MLS® Home Price Index (HPI), reported a composite index level of 258.2 and residential price of $282,700 for the city. These are down 3.4% from last years levels of 277.7 and $292,700. This indicates that residential selling prices have fallen in the Regina market over the past year. The HPI also shows selling prices as being down 5.0% over the past 3-year period. The HPI is a much more accurate measure of housing price trends than average price.
In June, there were 587 new listings in the city placed on the MLS® System, up 1% from 583 in 2014. At the end of the month there were 1,599 homes for sale, an increase of 5% from last years 1,431.
Did you know that when you buy or sell Real Estate with a CENTURY 21 Dome Realty agent in 2015 you are eligible for our monthly AIR MILES® giveaway? Click here for full details.


text:
Difference between revisions of "Kentucky"
Revision as of 00:18, 8 May 2010
Kentucky [3] is a mideastern state of the United States. Its state capital is Frankfort. Attractions include horse racing and beautiful lakes. Kentucky is also culturally part of the American South. It is home to famous food, (Kentucky Fried Chicken) and music, (bluegrass) traditions.
Other destinations
Get in
By car
Kentucky is accessible by five interstates:
The state is also served by major controlled-access roads called "Parkways" administered by the state. These roads were all built as toll roads but have since become freeways, although the portions of these roads that will become part of the new I-66 and I-69 may become tolled again in the future. Nine roads make up the parkway system. All except the Audubon officially bear the names of Kentucky:politicians, but the full names are listed here because Kentuckians generally do not use the politicians' names to describe the roads or give directions.
By air
There are three large airports in the state. Louisville International Airport is served by several major airlines, including Southwest, Frontier, Delta/Delta Connection, US Express, United Express, American Airlines/American Eagle, Continental Express, and Midwest Connect. Cincinnati-Northern Kentucky International Airport, located off of I-275 near Hebron, is a major hub for Delta, and is also served by American Eagle, United Express, US Airways Express, Continental Connection/Continental Express, Comair, Delta Connection, and USA 3000. Lexington's Blue Grass Field offers flights to several cities in the mid western and eastern parts of the country via American Eagle, US Express, United Express, Delta Connection, and Continental Connection/Express. The two smaller commercial airports in Kentucky are Barkley Regional (serving Paducah), served by Delta Connection, and Owensboro-Daviess County Airport, served by Great Lakes Aviation. The Ashland area is served by Tri-State Airport near Huntington, West Virginia. There are many other smaller, general aviation airports throughout the state.
Get around
Along with the interstates and parkways, Kentucky is served by many state and US routes:
See and Do
Get out
Kentucky is bordered by seven other states.


text:
In this series, I am providing pictures of tombstones from Latvian cemeteries, all with death dates prior to 1945. I do not have any further information on the people mentioned.
Photo taken by me, October 2012. Click to enlarge.
Top Inscription (on cross): "Salda atpūta, pēc nobeigta dzīves darba" (Sweet sleep after completing life's work)
Top Inscription (on bottom part): "Še dus Dieva mierā" (Resting here in God's peace)
Names: Augusts Krūmiņš, born January 6, 1867, died August 9, 1917; Marija Krūmiņa (maiden name Slotiņa), born March 18, 1873, died December 26, 1928.
Location:Meža kapi, Rīga
Tombstone Tuesday – Augusts and Marija Krūmiņš


text:
Dr. Herbert Tanowitz
Albert Einstein College of Medicine1300 Morris Park AvenueForchheimer Building, Room 504Bronx, NY firstname.lastname@example.com
Professor, Department of Pathology
Professor, Department of Medicine (Infectious Diseases)
Dr. Tanowitz is the Principal Investigator on a U.S. National Institutes of Health Fogarty International Center Research Training Grant. Interhemispheric Research/Training in Infectious Disease has the overarching objective of this International Training Grant is the training of biomedical scientists and health professionals from Brazil in infectious diseases research in order to enhance their capabilities to combat the intractable infectious diseases endemic in Brazil. He is also the P.I. on a second grant, Geographic Medicine and Emerging Infections, which provides a multidisciplinary educational program for predoctoral fellows, postdoctoral research and clinical fellows at Einstein. In addition, trainees are offered opportunities to pursue translational research in collaboration with international collaborators in Brazil, India and South Africa.