Dark circles under the eyes. Home ». Topics A–Z » Dark circles under the eyes. Author: Brian Wu Ph. D. MD Candidate, Keck School of Medicine, Los Angeles, USA. Chief Editor: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, July 2. What are dark circles under the eyes? Dark circles under the eyes describes a common appearance of the lower eyelids that has various causes. The dark appearance can be due to: Increased pigmentation (melanin)Loss of fatty tissue in the eyelid or around the eye. Bulging fat and muscle loss. Puffy eyelids. Thin, translucent skin. How to Get Rid of Black Circles Under Your Eyes. Dark circles under the eyes tend to age your. 10 Tips to Remove Dark Circles Under Eyes Permanently and Easily; 10 Tips to Remove Dark Circles Under Eyes Permanently and Easily. Dark circles under the eyes. Remove the patches gently. Hydrogel Under-Eye Recovery Patch: Unfortunately, the skin under my eyes wrinkled and puffed. Know how to get rid of dark circles under eyes effectively. Learn about causes, effects, and prevention of dark circles. Login Create an Account. Shadowing due to anatomic shape of the orbit. The appearance can be challenging to treat. Who gets dark circles under the eyes? Those prone to dark circles under the eyes include: The elderly (but they are also a common complaint in adolescents)People of non- white ethnic background. People with a genetic predisposition to dark circles under the eyes. What causes dark circles under the eyes? Pigmentation under the eyes is associated with dermal deposition of melanin. Dermalmelanin deposition is often due to post- inflammatory pigmentation, which may follow: Loss of fatty tissue in the eyelid or around the eye (tear trough) is associated with: Bulging or puffy eyelids may be due to systemic conditions, particularly: Thin translucent skin is commonly observed with: Shadowing is more noticeable at times, due to: Fatigue or lack of sleep. Periorbital oedema (puffy eyelids)Dehydration (sunken eyes)Superficially located blood vessels and blood stasis may contribute to the darkened appearance. How are dark circles under the eyes diagnosed? Correct diagnosis of dark circles under the eyes can be difficult. It involves: Personal, medical and family history. Physical examination. Wood lamp evaluation, which allows the clinician to assess depth of pigmentation. How are dark circles under the eyes treated? Treatment of dark circles under the eyes depends on its nature. General measures include: Adequate sleep. Smoking cessation. Sleep with extra pillows to elevate head and reduce eyelid swelling. Massage temporary swelling while applying a cold compress. Cold compresses also minimise the appearance of prominent blood vessels. Cosmetic camouflage. Light- reflecting concealers (these are often yellow or gold in colour) covered by translucent face powder. These should be applied in the shadows, not on the puffy skin. Unfortunately, many of the remedies on the market lack evidence of efficacy. Medical treatments to reduce pigmentation can include: Loss of tissue (hollowing) and tear trough can be managed by aesthetic medical and surgical procedures: Considerable training and experience is required to optimise results. Improvement may be partial. Incorrect technique may make the dark circles look more prominent that before the procedure. Related information.
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Criticism of Alcoholics Anonymous and Twelve-Step programs is nothing new, but every now and then the widely accepted approach to addiction and recovery. Why 12 Step Programs Don’t Work . Twelve-step treatment is also.
American adults (8. The most widely known option in the world for people who want to quit drinking is Alcoholics Anonymous (AA), with an estimated membership of over 2,0. However, is AA the best and only option for recovery from an alcohol problem? In this four- part article, I will provide a critique of AA's 1. Step model, and provide alternatives to AA that are not as widely known, but have been very effective in helping many people recover from an alcohol problem. Part One: Steps 1- 3 Step One: We admitted we were powerless over alcohol- that our lives had become unmanageable. If one is powerless over alcohol, how can one ever stop drinking? If AA means by this that a person needs to accept that alcohol is destroying his life, this makes perfect sense. But accepting that one has a problem and saying that one is powerless against that problem are two different things. In fact, those who attend AA are not powerless. They take many actions within their own power, such as attending the meetings, reading the AA literature, and eventually, refraining from drinking. As a clinician, both theoretically and clinically, I would never hold the view that a client is powerless. Even quadriplegics can accomplish many things through their own free will, even though they are paralyzed from the neck down. To communicate to a client that he or she is powerless, whether it's to depression, anxiety, or drinking, is to communicate to them that they have no control over their lives and that they are fated to their current condition. Not only is this untrue, it would be extremely damaging to a client's self- esteem and his ability to help himself get better. The fact is, countless people have quit drinking using AA and other approaches (including quitting on their own), which means they did exert power over their problem. Step Two: Came to believe that a Power greater than ourselves could restore us to sanity. AA says that you must give yourself up to a Higher Power in order to overcome your drinking problem. However, the concept . AA says that a Higher Power does not necessarily refer to God or religion, but it is described as a . This sounds like hair splitting to me, and I wonder why AA does not just say that Higher Power refers to a mystical force based on faith, instead of trying to distance itself from God and religion. Whichever way AA defines Higher Power, the idea requires one to give up his own personal power to a . How is this actually accomplished? This is not stated clearly in the AA philosophy. In part two, I continue with my critique, focusing on Steps 4- 6. At the end of this article I provide the first (of several) alternative approaches to recovery from a drinking or other substance abuse problem. These approaches differ from AA's Twelve- Step model in that they emphasize self- reliance over powerlessness and rationality over spirituality (among other differences). I will provide more alternatives in parts three and four. Step Four: Made a searching and fearless moral inventory of ourselves. This is a positive message in the Twelve- Step Model, because it requires a person to evaluate his or her own moral system in order to become explicitly aware of it. However, this step does not explain how to judge whether one's moral system is healthy or unhealthy, rational or irrational, consistent or contradictory. Does AA believe in a rationally defined morality based on how a person needs to live in order to survive and thrive? Or is it based on a religious (or other mystical) morality, which requires one to blindly follow the morality of one's chosen deity on faith? The vagueness of this step would make it difficult for someone to utilize in a practical way. I also provide several more alternatives to AA. As a special note, because of the many comments this series of articles has generated on this site and on many of the Linked. In mental health group sites, I plan to add a part five to this series to respond to these comments. My primary purpose for writing the articles is to create better awareness of the inherent problems and contradictions within the 1. Step approach, and to provide several alternatives to AA that many people (including within the mental health field) are not aware of. The articles have generated a strong and passionate reaction both in support of the critique and in disagreement with it. Some comments suggest AA's 1. However, I believe it's only through this type of analysis that we can truly understand the benefits and/or faults of any and all treatment approaches within the mental health field. Step Seven: Humbly asked Him to remove our shortcomings. Like Step Six, this step requires the individual to ask God or one's Higher Power to . I assume this is to be done through prayer. But how does one's Higher Power actually remove one's shortcomings? Again, I see a problem with asking a mystical power to change one's flaws for the same reasons I noted in Step Six. Step Eight: Made a list of all persons we had harmed, and became willing to make amends to them all. This step seems to be a very positive aspect of the twelve- step model, because it requires the individual to take responsibility for the actions he has taken that have harmed others. In order to accomplish this, he has to examine the actions he has taken while an alcoholic, and then judge which of these actions were harmful to others in his life. It also requires him to be willing to pay restitution to others for any wrongs he has done to them. What I like most about this step is the requirement of self- responsibility, which I think is vital in making any kind of change in one's life. If one cannot take responsibility for the actions he has taken, then he can never really be in control of his life, because he can always blame something or someone else (his parents, his genes, the alcohol) for his problems. What is important, though, is for the person to make a distinction between what is and is not his responsibility, so that he is not trying to make amends for things he did not cause. Michael Hurd, in his excellent book Effective Therapy (which also includes a detailed and reasoned critique of the twelve- step approach), refers to this as distinguishing between earned and unearned guilt. Unearned guilt consists of taking responsibility for something which one did not directly cause. He should not, however, take responsibility for the sobriety of his peers at AA or feel guilty if they fall off the wagon. In addition, not mentioned in this critique (although somewhat implied) is AA's view that alcoholism is a disease, which in essence means: once an alcoholic, always an alcoholic, no matter how long you've been sober. AA also uses an abstinence- only approach to recovery. Addressing these latter two points requires another article (or two), so I will leave it to readers to ponder these additional aspects of AA on their own (or you can go to Stanton Peele's website for in depth information on these points and many more). Stay tuned for part five of this series in which I will respond to several of the comments posted by readers about this series of articles critiquing AA and the 1. Step model.> > Continued in original article Part 4. See original article : Alcoholics Anonymous: A critique of the twelve- step model. Ohio Association of County Boards of DDNews / State of Ohio files motions to dismiss DRO lawsuit (Ball v. Kasich)On June 2. Ohio Department of Developmental Disabilities (DODD) and the Ohio Department of Medicaid (ODM) jointly filed a motion to dismiss in the Ball v. The remaining defendant, Opportunities for Ohioans with Disabilities, filed its motion to dismiss on May 9. The defendants cite several reasons why they believe the lawsuit should not be permitted to continue. The state contends that past lawsuits have already settled the questions posed by Ball v. Bill of Rights; Self Determination; Self Determination. Committees and Programs; Incident Tracking System and Training. Welcome to the Ohio Department of Developmental Disabilities. Ohio Department of Medicaid - HCBS. A level of care is a non-financial eligibility component of the Medicaid long-term care programs. The Ohio Department of Medicaid and the Ohio Department of Aging administer the. Fairfield County Community Resource List It is an exciting time in Fairfield County and there are many things to do in our community. As the Community Connections Coordinator for Fairfield DD, I am constantly searching for. MRDD services: Programs on the line Levy assists 10,000 disabled Cincinnati Enquirer October 27, 1999 by Dan Klepal. DD MEDICAID WAIVER PROGRAM CERTIFICATION SURVEY INSTRUMENT Revised January 1, 2015 Comments: Page 8 Individual’s entitlements-administrative review of violations 630.115 1. The Ohio Developmental Disabilities Council (DD Council) is one of a national network of state councils, committed to self-determination and community inclusion for people with developmental disabilities. Ohio became the first state in the nation to offer STABLE Accounts. A full summary of the opinion, including legal definitions, timelines for next steps, and other information, has been assembled in the form of an FAQ document for OACB members and stakeholders. OACB will continue monitoring this lawsuit very closely and will notify members and stakeholders of future developments as they occur. News / OACB, BHN Alliance, and DD Council release videos showing value of technology in EIOACB, the Ohio DD Council, and the Belmont, Harrison, Noble Alliance have collaborated to produce a series of eight online videos showing technology's applications for early intervention practitioners in Ohio. These videos show how video and remote conferencing technology can increase efficiency of and access to early intervention services in rural counties. OACB's team of children and family consultants helped obtain much of the technology shown in the videos and train practitioners on its use. OACB team members were also instrumental in the videos' production. Click here to view the videos on the DD Council's website. Mainstream Employment Programme - Ministry of Social Development. About the Mainstream Employment Programme. The Mainstream Employment Programme provides a package of subsidies, training, and other support to help people with significant disabilities get work and to enable them to gain sustainable employment. By taking part in the Programme, employers are tapping into the benefits of employing someone with a disability and future- proofing their workforce. We are now accepting applications - please see information about the application process below. What the Mainstream Employment Programme provides. Program (American spelling) or programme (British spelling) may refer to: Business and management. Program management, the process of managing several related. About us The Blogger Programme is one of the fastest growing platforms for brands and bloggers to connect and collaborate on. A 1. 00% salary subsidy for the first half of an agreed term of a maximum of 1. Funding for agreed external training for Mainstream participants and their direct supervisors. Program Or Programme NzoneFunding to meet participants’ agreed adaptive technology or specialised assistance costs. Follow- up support for participants and their direct supervisors. Who can apply? People with a significant disability who have been unable to get work can apply. To make sure that the funding is used for the greatest benefit for the most people, we’ll be prioritising applications according to six factors as shown in the table below. A person does not need to be a priority in all six factors to be offered a placement. Factors to be considered. Priority. Age. Youth (aged 1. Qualification level. People with higher qualifications particularly those who have recently completed a post- secondary school qualification within the last 2 years (e. Flexi- wage) or supported employment. Program Or Programme NzxtSustainability of employment. The role is likely to be maintained at the end of the placement or there is a clear plan that shows how the placement will provide a pathway into alternative employment using the skills and knowledge gained. Benefit Status. People who are at risk of long- term benefit receipt and for whom the long- term benefit liability is likely to be reduced. To be considered you must also: have a disability that severely restricts and significantly disadvantages your employment prospects, which requires assistance in addition to MSD’s general jobseeker support or wage subsidieshave had the disability for a minimum of six months, and expect it to continue for at least four years be 1. New Zealand citizen or permanent resident ordinarily resident in New Zealand generally not have been in paid employment for more than 1. Accident Compensation Act 2. ACC. Employers. Mainstream is available in a large range of state sector and private sector businesses and organisations. If you are an employer and you would like to offer a position to someone with a significant disability, please contact Work and Income. If you don’t already have a suitable person in mind, we’ll put you in touch with supported employment agencies in your area who might have someone who, with the help of the Mainstream Employment Programme, could make a valuable contribution to your organisation. Applications for the 2017 Engineering Graduate Programme are currently open. All other 2017 graduate programmes have now closed. We are looking for Auckland’s. Kindercare's Early Childhood Education Program is about fostering a love of learning, through play, for your baby, toddler or preschool child. Principal Translations: English: Spanish: program, UK: programme n noun: Refers to person, place, thing, quality, etc. US (plan, schedule) programa nm nombre. Email us at the address below: Note: Organisations where there is already a Mainstream placement are not ordinarily eligible for a further placement at the same time. Placements in schools must be non- teaching positions (participants cannot work in teacher or teacher aide positions). Requirements for Mainstream positions. In the past, Mainstream positions were usually created specifically for the participant, additional to the staff establishment and not an existing vacancy. From 1 July 2. 01. Mainstream is considered in these cases if it will address barriers to employment by providing disability related support to build the knowledge and skills of the participant. Generally funding for existing vacancies will be for a maximum of 1. The employer must guarantee that: the Placement is not replacing or displacing someone in existing employmentfor existing vacancies that the processes for selecting the employee were correctly followed, that the employee was chosen on merit and that no other applicants (where applicable) were disadvantaged by the availability of a subsidythe employee has an employment agreement that is fixed term for the length of the placement for a created position and permanent for an existing vacancy. Generally positions must be for a minimum of 1. Supported employment agents. The Mainstream Employment Programme is very popular – so popular we’ve had to stop taking in applications for quite some time. The good news is that we are now accepting applications again. If you are already registered with Work and Income, you will have received information about our new application process and priorities for placement. Process changes include: There is a single application form, replacing the eligibility and job proposal processes. Requirements for Mainstream positions have changed. Applications are prioritised, and eligibility does not guarantee that a placement and funding will be available Costs for the placement are agreed up front and will include setting a maximum salary subsidy for each year and funding for training and equipment in advance of a placement starting. To find out more, or to get the new application form, contact us. Features of the Programme. It's a four- way partnership among Work and Income, supported employment or other agencies, employers, and people with disabilities. The specially created or adapted positions are tailored to the skills and aptitude of the participants, and the needs of the employers. Participants are not expected to be 'job- ready' when they start. They are trained on the job and have access to extra training funding from Mainstream. Because Mainstream follows the principles of supported employment, pay is comparable to the pay of others performing similar duties. Knowledge and skills are built up over time, with the support and goodwill of co- workers. After two years, it is expected that participants will be much better equipped to compete for advertised vacancies. Mainstream participants work throughout New Zealand, from large cities like Wellington to small centres like Kaikohe. Mainstream participants work in a large range of state sector and private sector businesses and organisations. Ideally a participant gets the opportunity of continuous employment over the term of the placement, unless they find a suitable permanent position during the term of the placement (e. To apply for the Mainstream Internship Programme, use the application form for the Mainstream Employment Programme. Email us if you need a copy on mainstream@msd. Program management - Wikipedia, the free encyclopedia. For the Microsoft Windows application, see Program Manager. In the software industry, program management is an aspect of software product management. Program management or programme management is the process of managing several related projects, often with the intention of improving an organization's performance. In practice and in its aims it is often closely related to systems engineering, industrial engineering, change management, and business transformation. The program manager has oversight of the purpose and status of the projects in a program and can use this oversight to support project- level activity to ensure the program goals are met by providing a decision- making capacity that cannot be achieved at project level or by providing the project manager with a program perspective when required, or as a sounding board for ideas and approaches to solving project issues that have program impacts. In a program there is a need to identify and manage cross- project dependencies and often the project management office (PMO) may not have sufficient insight of the risk, issues, requirements, design or solution to be able to usefully manage these. The program manager may be well placed to provide this insight by actively seeking out such information from the project managers although in large and/or complex projects, a specific role may be required. However this insight arises, the program manager needs this in order to be comfortable that the overall program goals are achievable. Overview and definition. Only when that capability is transferred to the line management and utilized by the host organization will the benefits actually be delivered. On this view, a program team cannot, on their own, deliver benefits. Benefits can only be delivered through the utilization of a new capability. Programs are normally designed to deliver the organisation's strategy or business transformation, such as an ambition to be the fourth biggest supermarket in a region by 2. According to one source, . Programs may include elements of related work outside of the scope of the discrete projects in the program.. Some projects within a program can deliver useful incremental benefits to the organization before the program itself has completed. Program managers should not micromanage, but should leave project management to the project managers. However, program management might need to deal with interdependencies, conflicts and resource or knowledge sharing among the projects it manages. In public sector work in Europe, the term normally refers to multiple change projects: projects that are designed to deliver benefits to the host organization. For example, the Office of Government Commerce for the UK government. An alternative to the Office of Government Commerce's methodology for program management is that of the private sector Project Management Institute. Many organizations only run one program at a time, a program containing all their projects. In Project Management Institute terminology, this is more likely to be a project portfolio than a program. Some larger organizations may have multiple programs each designed to deliver a range of improvements. Some organizations use the concept of Systems Engineering where others use program management. Key factors. Governance must include a set of metrics to indicate the health and progress of the program in the most vital areas. Alignment. The program must support a higher level vision, goals and objectives. Assurance. Verify and validate the program, ensuring adherence to standards and alignment with the vision. Management. Ensure there are regular reviews, there is accountability, and that management of projects, stakeholders and suppliers is in place. Integration. Ensure that component parts fit together properly to make the intended whole. Optimize performance across the program value chain, functionally and technically. Finances. Track basic costs together with wider costs of administering the program. Infrastructure. Allocation of resources influences the cost and success of the program. Infrastructure might cover offices, version control, and IT. Planning. Develop the plan bringing together the information on projects, resources, timescales, monitoring and control. On one view, projects deliver outputs, discrete parcels or . By combining these projects with other deliverables and changes, their programs might deliver increased income from a new product, shorter waiting lists at the hospital or reduced operating costs due to improved technology. On this second view, the point of having a program is to exploit economies of scale and to reduce coordination costs and risks. The project manager's job is to ensure that their project succeeds. The program manager, on the other hand, is concerned with the aggregate outcome(s) or end- state result(s) of the collection of projects in a particular program. For example, in a financial institution a program may include one project that is designed to take advantage of a rising market and another that is designed to protect against the downside of a falling market. The former seeks to leverage the potential upside; the latter to limit the possible downside. Consider a simple analogy: Fix- A- Flat. This highly- pressurized aerosol product injects a leak sealant into a punctured tire to stop the outflow of air (project A) and concurrently re- inflates the tire (project B), resulting together in the outcome that is a tire that is once again functional (the program comprised projects A and B). The program manager has been described as 'playing chess' and keeping the overview in mind, with the pieces to be used or sacrificed being the projects. And also according to this view, successful projects deliver on time, to budget and to specification, whereas successful programs deliver long term improvements to an organization. Improvements are usually identified through benefits. An organization should select the group of programs that most take it towards its strategic aims while remaining within its capacity to deliver the changes. On the other hand, the view that programs are simply large projects or a set of projects allows that a program may need to deliver tangible benefits quickly. According to one source, the key difference between a program and a project is the finite nature of a project. A program is ongoing and implemented within a business to consistently achieve certain results for the business. A project is designed to deliver an output or deliverable and its success will be in terms of delivering the right output at the right time and to the right cost. Program management includes management of projects which, together, improve the performance of the organization. A program's success will be measured in terms of benefits. Benefits are the measures of improvement of an organization and might include increased income, increased profits, decreased costs, improved market position (ability to compete), reduced wastage or environmental damage, more satisfied customers. In central or local government organizations, benefits might include providing a better service to the community. In the course of achieving required results, business programs will normally understand related business constraints and determine the processes required to achieve results based on resources allocated. Improvement of processes is a continuous operation that very much contrasts a program from a project. At the lowest level project managers co- ordinate individual projects. They are overseen by the program manager who accounts to the program sponsor (or board). There will normally be a process to change the predetermined scope of a project. Programs often have to react to changes in strategy and changes in the environment in which the organization changes. Another view and another successful way of managing does not see any of the factors listed above as distinguishing projects from programs, but rather sees the program as being about portfolio management. On this view, program management is about selecting projects, adjusting the speed at which they run, and adjusting their scope, in order to the maximize the value of the portfolio as a whole, and as economic or other external conditions change. Yet another view is that a program management is nothing more than a large, complex project, where the integration aspect of project management is more important than in smaller projects. Integration management is a key feature of the Project Management Institute's approach to project management. In practice it is not clear that there is such a clear- cut distinction. Projects (or programs) vary from small and simple to large and complex; what needs to be a managed as a program in one culture or organization may be managed as a project in another. Community Support Funding Program . The online application system allows you to save, develop and print out applications before you submit them. More information. If you need further information about this grant, phone Council on 0. Grants Unit. Alternatively you can read the grant guidelines for the latest round. IGH Institute Community Support (ICS) Program (2015-2016) The CIHR Institute of Gender and Health. Planning and Dissemination Grants – Institute Community Support funding opportunity on the CIHR Funding Opportunities. Community Funding Program. The Community Funding program invests in viable non-profit community-based organizations in order to sustain a strong social infrastructure of community services that supports equal access to the. Community Support Agency Grant Program. Provide funding to not-for-profit. NIH Institutes and Centers issue funding opportunity announcements to indicate their interest in funding this type of program. Since 1995, Environment Canada's EcoAction Community Funding Program has provided financial support to community-based, non-profit organizations for projects that have measurable, positive impacts on the environment. Funding of Federal, State, And Local Programs. Funds under this program are. Changes to the Community Support Programme for Family Day Care Service Operators. Sussan Ley MP, announced changes to the Community Support Programme (CSP) which took. FDC Operational Support is funding to support FDC. Community Support Funding Program 2013/2014 Guidelines. These are the guidelines for the Community Support Funding Program. Applications are now open. Learn about the Community Support Funding Program. Contact your council for information about community-based funding and grants for projects like activities for young people. Apply for Youth Opportunity Funding; Find a community support group or organisation. Information for service providers. The Community Support Program (CSP) provides individual funding to enable people with high support needs due to physical and/or neurological disability to live as independently as possible. IIS 7. 0 Server Sizing. Hi All. we are building a web application. Im quite happy with HP Server Sizing Tool but i couldnt find one for IIS Web Server. Any help is apprecited. Article Installing IIS 7 on Windows Server 2008 or Windows Server 2008 R2; Article Understanding Setup in IIS 7; Article Compatibility and Feature. Windows Server 2008; Windows Server 2003; Windows 8; Windows 7; Windows Vista. Optimizing IIS Performance. Microsoft offers the Web Capacity Analysis Tool (WCAT) and the Web Application Stress. Minimum Required OS: Windows 2008, 2008 R2. The suggested amount of RAM can be estimated using the 'Identity Finder Console Database Sizing Tool' attached. Windows Server; SQL Server; Web App Gallery; Microsoft Azure; Tools. Windows Server 2008, Windows Server 2008 R2. Malicious Software Removal Tool; Contact Us Contact Us. Report a support scam. New Server - Database Sizing. This topic provides you with a method that shows how to determine your server sizing requirements. Calculate Your Server Size. You can use the Jetstress tool. Experts Exchange > Questions > Server Sizing Tool Want to Advertise Here? Server Hardware; Apache Web Server; Windows Server 2008. Microsoft IIS Web Server 16. Windows Server 2008 7.
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