So, your bokashi has become soil. How strong is it and what can you plant in it?
As a completely general rule of thumb, around one-third bokashi and two-thirds soil is a good guide for most plants.
If you’re planning to plant rhubarb, pumpkin, or any type of demanding plant you might want to aim for a stronger mix, say half and half. Any stronger than that is probably too strong.
If you plant more normal plants in a strong mix they should probably still be fine, they will develop plenty of fruit and flowers etc, but the risk is everything may be larger than you want it. You may get cherry tomatoes that look like regular tomatoes, for example, and even if they still taste great it wasn’t quite what you intended…
The problem normally for us gardeners is that we can’t produce enough bokashi for our gardens. A normal family just doesn’t produce enough food waste to fertilize a vegetable garden that would feed a family. So you need to take in bokashi from friends and neighbours, or complement with other forms of fertiliser.
So, typically we end up rationing our bokashi, building up one bed at a time.
It may take a few years this way to really improve the soil in your beds, but you’ll notice it coming along.
After some years you’ll have such great soil that the bokashi probably won’t make such a difference anymore; however you have to feed the soil in some way to compensate what you harvest, so it’s just to continue on a maintenance level; a bucket here and a bucket there.
How can you see when your soil is improving?
Actually, you can normally feel it.
Good soil looks and smells amazing. It’s full of worms, has some nice variation in texture — some chunky bits, some grainy, sandy bits, and usually a few other small crawly things.
The real action, the micro-life, we don’t have a chance of seeing. But it’s the foundation for everything else to work, so if you see worms you know you’ve got a good micro-life.
The worms, where do they come from?
Well, who knows. They seem to just turn up.
So many people have told me about gardens devoid of worms, which is a great sadness if you have a gardener’s soul. No worms pretty much equates to impoverished soil. There’s nothing there for them to snack on, basically.
And when these same gardeners have been adding bokashi for a while, they worms just suddenly turn up. From somewhere, we don’t know where, but one day they are just there.
If the food is good and they like the conditions otherwise — not too many poisons, moist and airy in the soil, good variety in food supply — they thrive. Multiply efficiently, and get going on their work of building tunnels, moving nutrients around, converting food from one form to another (in one end, out the other basically) and aerating the soil.
Worms should never, ever be underestimated.
They are the magic that you can see in a garden.
And if you have worms, be happy. Everything is working.
It’s their message to us: we’re here, therefore it’s good. You’ve done the right thing. This garden is good.
/Jenny Harlen, Bokashi World


The team sponsor (product/project manager) either gives or works with the team to define its mission or objectives based on a project/product need. This is documented in the form of a team charter.
A charter is…
A declaration or document setting forth the aims and principles of a group
Webster’s New World Dictionary
A team charter is a clear description of the team’s mission, as well as the authority and resources provided to accomplish that mission. The charter typically includes a statement of mission, objectives or statement of work; background; authority or boundary conditions (scope, constraints, resources, and schedule); membership; requirements or specifications, and interface responsibilities. (See team charter example.)
The charter should be specific enough to get the team started in the right direction, but not so limiting as to dictate process or outcome at the outset. Teams will establish more specific goals and plan once they comprehend the scope of their work, and the original charter may be re-negotiated with the sponsor.
At The Outset: Confusion, conflicts, or disagreements about the charter must be resolved to the mutual satisfaction of the team and sponsor as soon as possible. Negotiate to change the initial mission, broaden or narrow its scope, or shift its focus. The team charter provides a common vision that keeps a team focused on its objective.
During the Project: the charter:


Durrell, Lawrence dŭ´rəl, dûr´əl [key]
, 1912–90, British author, b. India, of Irish parents. Durrell traveled widely, often serving in diplomatic positions; most of his works are set in exotic locations and convey an extraordinary sense of place. His novel The Black Book
(1938) is steeped in an atmosphere of moral decadence. Durrell's masterpiece is The Alexandria Quartet,
consisting of Justine
(1958), and Clea
(1960). Purporting to be a study of the many ramifications of love, the quartet's excellence lies mainly in its technique—its rich, ornamental language, its experiments with point of view, and its evocation of the exotic, frequently bizarre atmosphere of the city of Alexandria, Egypt.
Durrell's later novel sequences include the literary satire of Tunc (1968) and Numquam (1970), and The Avignon Quincunx (1974–85), which brought together his study of southern France and his obsession with multiple perspective. Durrell's diplomatic service is reflected in Bitter Lemons (1957), Esprit de Corps (1958), and Stiff Upper Lip (1959), spoofs of diplomatic life, and in Reflections on a Marine Venus (1953), Prospero's Cell (1960), and Spirit of Place (1969), travel books. Among Durrell's other works are volumes of poetry including The Red Limbo Lingo (1971) and Vega and Other Poems (1973), and the novel Monsieur (1975).
See The Durrell-Miller Letters, 1935–80 (1988), ed. by I. S. MacNiven; biographies by G. Bowker (1997) and I. S. MacNiven (1998); studies by J. Unterecker (1965), G. S. Fraser (1968), and R. Pine (1988).
His brother, Gerald Durrell, 1920–95, English conservationist and author, b. Jamshedpur, India, was noted for his pioneering efforts to have zoos participate in the preservation of endangered species through captive breeding programs. He wrote 37 books, most dealing with animals. His charmingly written works include The Overloaded Ark (1953), the autobiographical My Family and Other Animals (1956), and The Aye Aye and I (1993). He also wrote novels and was involved in radio and television.
See biography by D. Botting (1999).
The Columbia Electronic Encyclopedia, 6th ed. Copyright © 2012, Columbia University Press. All rights reserved.
See more Encyclopedia articles on: English Literature, 20th cent. to the Present: Biographies


World War II
As World War II began erupting across Europe in 1939, the nation faced changes that effected day-to-day activities. Many Edmond men and women participated in the war effort by serving in the military or supporting the troops from the homefront. An Edmond elementary school, Russell Dougherty, is named after the first Edmond man to be killed during World War II.
The Edmond Armory, which now houses the Edmond Historical Society Museum, was built in 1936 just prior to the beginning of the war. The 179th Regiment, a part of the Oklahoma National Guard’s 45th Division, was mobilized from the armory in 1940. The 179th Regiment made more amphibious landings on beaches while under artillery fire than any other regiment in the 45th Division.
A variety of shortages occurred due to the volume of supplies needed overseas. Salvage campaigns helped save items such as scrap metal, rubber, cooking fat, and nylon/silk stockings. From these items weapons, ammunition, gas masks, and explosives were made. The U.S. Government placed rations on sugar, vegetables, butter, coffee, meat, gasoline, and tires. A family was issued a ration book that contained stamps needed in order to buy these supplies.
Communication was difficult during the war. Letter writing was the soldier’s lifeline to home. Letters, written on V-mail, were sent postage free for members of the Armed Forces. Families on the homefront spent evenings surrounding the radio to listen about news of the war. Newspapers were filled with information and casualties of the war.
By 1945 the war was ending and life began to return to happier times as Edmond and the nation moved into the second half of the 20th century.
LibertyFest: Patriotic Traditions
Every year on the Fourth of July, Edmond hosts its annual celebration. LibertyFest in Edmond, Oklahoma was selected as one of the top 10 places to be in America on July 4th by CNN & USA Today. It is a week long celebration of the birthday of this great nation and the heritage of our fine state.
LibertyFest entertains an attendance of over 125,000 annually and is organized and produced by a group of over 500 volunteers.
Original Statue of Liberty Replica on Display at EHSM
In 1950, The Boy Scouts of America celebrated their 40th anniversary with their national fundraiser “Strengthen the Arm of Liberty.” Scouts across America raised money to repair the Statue of Liberty in New York’s harbor. Between 1949 and 1952, approximately two hundred, 100-inch replicas of the statue, made of stamped copper, were purchased by Boy Scout troops and donated in 39 states in the U.S. and several of its possessions and territories. The project was the brainchild of Kansas City businessman, J.P. Whitaker, who was then Scout Commissioner of the Kansas City Area Council. The copper statues were manufactured by Friedley-Voshardt Co. (Chicago, Illinois) and purchased through the Kansas City Boy Scout office by those wanting one. The statues are approximately eight and a half feet tall without the base, constructed of sheet copper, weighed 290 pounds, and originally cost $350 plus freight.


Many people do not, or do not consistently, distinguish in pronunciation between instance and incidence.
An incident is “an event, especially one that is unusual, important, or violent” (LDOCE); incidence [usually singular] is “the number of times something happens, especially crime, disease etc”. Despite these dictionary definitions, a quick Google search throws up 35,000 instances (yes!) of isolated incidences.
I wrote about this on 9 May 2008. Here’s what I said then.
The confusion arises because instance and incidence may be pronounced identically in rapid speech. This is because of the possible disappearance of the vowel of the middle syllable of incidence. We can, and often do, go straight from the s to the d, omitting the weak vowel (ə, or a conservative ɪ) that would otherwise stand between them. Since under these circumstances the d, now abutting on a voiceless consonant, gets devoiced, the result is that the -sd̥- of incidence ends up very similar to the -st- of instance.
In moderately-paced speech the deleted vowel seems to leave some compensatory lengthening of the preceding consonant: ˈɪn(t)sːd̥ən(t)s.
In rapid speech, however, I think this subtlety of timing can be lost, making incidence as good as homophonous with instance.
At UCL some of us at one time called this phenomenon ‘pseudo-elision’, as opposed to true elision where the deleted segment supposedly leaves no trace at all.
We find the same thing in words such as trinity, comedy, Cassidy, quality, university (can it rhyme with thirsty?). In trinity the tongue tip may remain in place on the alveolar ridge as we pass from the (lengthened?) [n] to the [t], with no intervening vowel.
At the time I wrote that, dear readers, you could not comment on it. Now (if you wish) you can.


Learning Logs are used for students' reflections on the material they are learning. This type of journal is in common use among scientists and engineers. In the log, students record the process they go through in learning something new, and any questions they may need to have clarified. This allows students to make connections to what they have learned, set goals, and reflect upon their learning process. The act of writing about thinking helps students become deeper thinkers and better writers. Teachers and students can use Learning Logs during the formative assessment process, as students record what they are learning and the questions they still have, and teachers monitor student progress toward mastery of the learning targets in their log entries and adjust instruction to meet student needs. By reading student logs and delivering descriptive feedback on what the student is doing well and suggestions for improvement, the teacher can make the Learning Log a powerful tool for learning.
Response Logs are a good way to examine student thinking. They are most often connected with response to literature, but they may be used in any content area. They offer students a place to respond personally, to ask questions, to predict, to reflect, to collect vocabulary and to compose their thoughts about text. Teachers may use Response Logs as formative assessment during the learning process.
Instructional Strategies Online: What Are Learning Logs?
Writing to Learn: Learning Logs
Field Trip Planner: Active Learning Log
Learning (B)logs: Time to Give Students a Voice
Learning Logs Online: Examples and Photos of Learning Logs
Response Logs for Content Classrooms
Reading Response Logs - PDF
Rubric for Response Logs


Colima Terracotta Funerary Mask - PF.2308, Origin: Western Mexico, Circa: 300 BC to 300 AD, Dimensions: 7.75" (19.7cm) high, Catalogue: V6, Collection: Pre-Columbian, Style: Colima, Medium: Terracotta. One of the most magnificent Pre-Columbian art styles belongs to the ancient artisans of the pacific coast region of Mexico that lies in the shadow of the 13,000-foot-high volcano, "Colima". The full flourishing of the Colima art style produced masterpieces, such as this terracotta funerary mask, that are among the high points in pre-Columbian art. The sculptors brilliantly solved the technical problems inherent in clay and transcended the limitations of their medium. The smooth and shiny tactile quality of this mask coupled with an extraordinary sense of mysterious presence invites us to envision the mystical ritual that this mask most certainly played a role in. In an ancient nocturnal setting, the moon's ancient and haunting rays can still be imagined shining on the mask's glossy surface. This is a face, simple of line but complex of spirit that continues to evoke emotion over the centuries. Who was the face behind the mask? We may never know. But the spirit of that individual will be with us forever in the spirit of this powerful mask.
Ancient Central America & Mexico


Bats are often unfairly depicted as the direct culprit in the current COVID-19 pandemic, yet the real causes of this and other zoonotic spillover events should be sought in the human impact on the environment, including the spread of domestic animals. Here, we discuss bat predation by cats as a phenomenon bringing about zoonotic risks and illustrate cases of observed, suspected or hypothesized pathogen transmission from bats to cats, certainly or likely following predation episodes. In addition to well-known cases of bat rabies, we review other diseases that affect humans and might eventually reach them through cats that prey on bats. We also examine the potential transmission of SARS-CoV-2, the causal agent of COVID-19, from domestic cats to bats, which, although unlikely, might generate a novel wildlife reservoir in these mammals, and identify research and management directions to achieve more effective risk assessment, mitigation or prevention. Overall, not only does bat killing by cats represent a potentially serious threat to biodiversity conservation, but it also bears zoonotic implications that can no longer be neglected.
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Christmas 2004 'Decorations'
Christmas 2004 'Decorations' (view technical specs)
The first Christmas tree decorations were strictly edible. Biscuits, sweets, little cakes and apples were hung on the trees for centuries - to be happily eaten after Christmas. The first nonedible ornaments came in the late 1500's when Martin Luther decided to add candles. This immediately became the new tradition despite the fire hazard. People kept a bucket of water near the tree and hoped for the best. The American version of the decorations added popcorn, cranberries and ribbons.
But, we still had candles - and buckets of water. ‘Godey's Ladies Book’ published during the 1800's gave people lots of ideas for homemade ornaments such as colourful paper flowers to make the trees more festive.
In the 1850’s, a German company called Lauscha, started making glass bead garlands for Christmas trees. They also introduced the Rauschgoldengel (the Tingled-angel), dressed in pure gilded tin. This was the first Christmas angel on top of a Christmas tree. The glass ornaments reached Britain in the 1870’s, and North America around 1880.
In 1882, ornaments were changed forever by Thomas Edison and electricity. The first string of Christmas lights was made by Edward Johnson, a colleague of Edison. He used 80 small electric
light bulbs to light up a Christmas tree. By 1890, strings of Christmas lights were being mass-produced.
By the turn of the century, large illuminated Christmas trees were a common site.
Today, we have synthetic Christmas trees, but the decorations haven't really changed over the last 100 years.
|Illustration / Photography:||Stephen Perera|
|Printer:||Cartor Security Printers, France|
|Stamp size:||31.75 x 31.75mm|
|Stamp Values:||7p, 28p, 38p, 40p, 47p, 53p|


Look at the amazing things going on in Science at St Paulinus
How do we intend to achieve our curriculum vision in Science lessons?
At St. Paulinus, during our Summer term we take part in a whole school STEAM week, where children focus their learning around a Scientific matter. Children are encouraged to be creative, think outside the box and develop their Scientific enquiry skills. This is great fun and a fantastic opportunity for children to explore a range of global issues, work together and develop their love of Science.
What does Science teaching look like?
At St Paulinus we follow the national Curriculum. The aims of Science at St. Paulinus are that:
Pupils develop scientific knowledge and conceptual understanding through the specific disciplines of biology, chemistry and physics
Pupils develop understanding of the nature, processes and methods of science through different types of science enquiries that help them to answer scientific questions about the world around them
Pupils are equipped with the scientific knowledge required to understand the uses and implications of science, today and for the future.
Science is a body of knowledge built up through the experimental testing of ideas. Science is also methodology, a practical way of finding reliable answers to questions we may ask about the world around us. Science in our school is about developing children’s ideas and ways of working that enable them to make sense of the world in which they live through investigation, as well as using and applying process skills. Science is also a collaborative activity where ideas and suggestions are shared and investigated together. Through practical activities and team work, children experience and learn how to work together have mutual respect for one another and value social cohesion.
At St. Paulinus Catholic Primary School, we believe that a broad and balanced science education is the entitlement of all children, regardless of ethnic origin, gender, class, aptitude or disability. Our aims in teaching science include:
- Preparing our children for life in an increasingly scientific and technological world.
- Fostering concern about, and active care for, our environment.
- Helping our children acquire a growing understanding of scientific ideas.
- Helping develop and extend our children’s scientific concept of their world.
- Developing our children’s understanding of the international and collaborative nature of science.
- Encouraging the development of positive attitudes to science.
- Building on our children’s natural curiosity and developing a scientific approach to problems.
- Encouraging open-mindedness, self-assessment, perseverance and responsibility.
- Building our children’s self-confidence to enable them to work independently.
- Developing our children’s social skills to work cooperatively with others.
- Providing our children with an enjoyable experience of science, so that they will develop a deep and lasting interest and may be motivated to study science further.
- Giving our children an understanding of scientific processes.
- Helping our children to acquire practical scientific skills.
- Developing the skills of investigation – including observing, measuring, predicting, hypothesising, experimenting, communicating, interpreting, explaining and evaluating.
- Developing the use of scientific language, recording and techniques.
- Developing the use of ICT in investigating and recording.
- Enabling our children to become effective communicators of scientific ideas, facts and data.
Our teaching aims
- Teach science in ways that are imaginative, purposeful, well managed and enjoyable.
- Encourage and support children to ask questions about the world and use scientific processes to try and answer them.
- Support children to make links between science and other subjects.
Science is a core subject in the National Curriculum.
3How science is structured at St. Paulinus Catholic Primary School
At St. Paulinus Catholic Primary School, planning for science is a process in which all teaching staff are involved. Delivering a broad and balanced science education to our children is a core principle of our school. Science teaching in the school is about excellence and enjoyment. We adapt and extend the curriculum to match the unique circumstances of our school.
KS1, KS2 and Foundation stage teachers teach science for a minimum of one hour each week.
In KS1 and Foundation stage, we aim for a minimum of one third of lessons overall to include practical scientific enquiry.
In KS2, we aim for a minimum of 50% of lessons overall to include practical scientific enquiry.
St. Paulinus Catholic Primary School ensures that a broad and balanced science curriculum is followed in which enquiry is at the heart of our children’s scientific learning.
Our science scheme of learning ensures progression between year groups and guarantees topics are revisited. Teachers adapt and modify the model plans to suit their children’s interests, current events, their own teaching style, the use of any support staff and the resources available. We ensure that any modification does not omit any of the NC.
To better suit the needs of individual classes, units may have been moved between years or amalgamated, where appropriate. However science is taught every half term throughout the school year. Some units may be taught in collaboration with outside agencies, including neighbouring secondary schools.
What do our outcomes in Science look like? How successful is our Science teaching?
You can see some of the impact of our curriculum in the work at the top of the page. We also have some quotes from our children when asked about Science lessons here at St Paulinus…


This week’s illustrations come from an album of watercolours of St Andrews compiled by John Cook in 1797. It contains the usual views which one might expect to see in this sort of scrapbook: St Andrews from all angles, featuring its distinctive skyline of spires and towers, much the same now as then. But there are also portraits preserved in this album, featuring some of the significant and insignificant inhabitants of the town at the end of the eighteenth century. Unusually, many of these are only shown from the back. These powerfully evocative portraits are full of delightful wigs, brightly-coloured coats, bandy legs, knee breeches and stockings. Almost caricature-like, they bring to life many local men and a small number of women, and, thanks to the captions added by the artist, we can identify some of them.
So, why did Cook paint these rear views? Was it just that he couldn’t paint faces? Some of the profiles and full-face paintings which are pasted into the scrapbook do show some strange-looking people, and he does seem to have had particular difficulty with noses!
I think he just liked looking at things from a different perspective. This view of St Mary’s College must have been done from on top of the wall which extended from the end of the west range across the garden. It shows in sketch the part of the north range which had accommodated the stables and carriage house of the Principal’s House. This was rebuilt in 1828 when the present archway was formed.
Cook also painted views of St Andrews which obviously look unusual to us today, either because the subject of the painting has changed or it contains something out of place to our eyes. This familiar perspective of the town from the West Sands requires a second look (left). Can anyone out there in the blogosphere identify this two-wheeled, single-horse carriage or cart? Is it a gig? Can it be more specifically labelled?
Even this view of St Mary’s (below) requires today’s viewer to remove walls and trees from the foreground to map to make the painting equate to the present quadrangle.
So who was this John Cook? There is an inscription in the album, recording its donation to the University Library in 1904, which outlines his career: lived 1771-1824, minister of the parish of Kilmany in Fife 1793-1802, and occupant of two chairs in the University. He studied and taught in the University under the ‘Hill regime’, when the institution was dominated by George Hill, Professor of Greek from 1772, and Principal of St Mary’s College from 1791-1819. Hill was the outstanding Scottish theologian of the day and leader of the Moderate party in the church but his nepotism has become part of University legend. At one time, six of the thirteen posts on the University senate were occupied by members of his family. Psalm 121 was proverbially popular in St Andrews at this time: “I lift mine eyes to the Hills, from whence cometh my help…”
John Cook, the painter whose work is featured here, held successively the Chairs of Hebrew (1802-9) and Biblical Criticism (1808-24). He married his cousin Elisabeth, eldest daughter of George Hill, since his mother Janet was George Hill’s sister. His father was another John Cook, Professor of Humanity (1769-73) and Moral Philosophy (1773-1815). His brother George was Professor of Moral Philosophy (1828-45) and his son, yet another John Cook, was Professor of Ecclesiastical History (1860-68).
The Hill-Cook dynasty contained 36 professors over 150 years. The genealogical details are spelled out in an appropriately backwards and upside-down Register full of biographical information about our Professors, which records the births of, and sadly the deaths of some of, the painter’s 12 siblings and 7 children, as well as the 12 children of George Hill.
This nice album is an unusual form of legacy from one of our academic forebears.


Department of Civil Engineering, W348 NH, University of Nebraska-Lincoln, Lincoln, NE, 68588-0531, 402-472-3431
This research was undertaken to simplify the selection of the least-cost treatment option for treating waters contaminated with synthetic organic chemicals (SOCs). Five aqueous treatment processes were considered: air stripping, liquid-phase adsorption, steam stripping, biofilm reactor, and combined biodegradation and adsorption (bio-adsorption). Because off gases from air stripping towers are frequently regulated, four off-gas treatment processes also were considered: gas-phase adsorption (both on- and off-site regeneration), thermal incineration and catalytic oxidation. Mathematical process performance and cost models were developed for each process. The least-cost design for each process was identified for a set of typical contaminated waters, and the results were synthesized to create generalizations concerning process selection based on fundamental process variables.
For example, the cost of treating air stripper off gases was found to be primarily a function of a compound's adsorbability, volatility, flow rate and influent concentration. A set of diagrams was created to identify the least-cost off-gas treatment for a given set of conditions.
For aqueous processes, the least-cost air stripping tower design changed when off-gas treatment was added. A methodology for comparing the costs of air stripping with off-gas treatment and liquid-phase adsorption was created in the form of a process selection diagram. The comparison methodology is based upon physical parameters of the target chemical.
In considering bio-adsorption, it offered longer bed lives than adsorption alone in nearly every case, though the degree of improvement varies. Diagrams were created to identify cases where bio-adsorption is particularly economical. Situations were identified where a biofilm reactor and where steam stripping may be economically viable. Heuristics concerning when processes-in-series are valuable were also developed. As discussed, tools and generalizations were created to aid engineers in making intelligent decisions concerning preliminary treatment process selection, with the overall goal of better, cost-effective designs and more rapid selection.
organic chemicals, treatment, remediation, heuristics
This paper is from the Proceedings of the 10th Annual Conference on Hazardous Waste Research 1995, published in hard copy and on the Web by the Great Plains/Rocky Mountain Hazardous Substance Research Center.


A work of monumental scale with a magnificent finale, the five-part Vienna Waltzes is set in moonlit Austrian forests and the regal ballrooms of Vienna.
The waltz became popular in the late 1700s. It was banned at first by some authorities who thought it immoral for couples to dance so closely, but by the mid-1800s, it was accepted everywhere. The faster Viennese form, characterized by swift, gliding turns, expressed the vivacity, and brilliance of the Hapsburg court. The waltz was a dance form Balanchine revisited and explored often over his career, but never on as grand a scale as he did for the 1977 Vienna Waltzes.
The ballet — Balanchine’s homage to the pleasures and delights of an age that epitomized imperial grandeur — transforms from sylvan forest glen to sassy dance hall to glittering society café to, at last, a majestic mirrored ballroom through Rouben Ter-Arutunian’s evolving scenery. The music selected for each section of the ballet is associated with the transformation of the waltz across society and over the years. The many elaborate costumes are the last that Karinska created for New York City Ballet.
For most of the 20th century, first in Paris, and, after 1938, in New York, Karinska, who left Russia after the October Revolution, designed and created many legendary costumes for Broadway, ballet, and opera. As one of Balanchine’s longtime collaborators, she was for many years New York City Ballet’s principal costume-maker.
VIEW A SLIDESHOW OF IMAGES FROM VIENNA WALTZES >


Urbanization is a complex process, the understanding of which is treated differently by different specialties. If for the sociologist the main relations in this process are urban relations, even if they are taken in the whole breadth of their social content, then for the ecologist the manifestations of the biological consequences of urbanization are more important – the city’s attack on the living nature, the entire amount of negative impacts of urbanization on the ecosystems of the Earth. Urban formations act as extremely powerful centers of perturbation and degradation of the biosphere.
Luzhkov, Yu.M., (1996) Environmental problems of the large cities and the way of their decision,” Industrial and civil engineering, No. 9, pp.4-9.
Leggett R. (1976) Cities and Geology, 558 pp. Fedorenko N.N., Reimers N.F. (1974) Nature, economics, science // Nature, №3, pp.11-24
Marks K. and Engels F. Works, vol.2 Pozdnyakov A.L, Samokhvalov A.M (2014) Urbanization and its impact on the ecology of cities and settlements: News of Southwest State University №6 (57), pp. 74-78.
Pivovarov Yu.L. (1974) Concentration of functions and tendencies of urbanized settlement, p.140-150
Pozdnyakov AL, Pozdnyakova EV (2016) The Main Trends in the Development of Industry in the Cities and Towns of the Position of Environmental Safety // International Journal of Applied Engineering Research, Volume 11, Number 23, pp. 11331-11334.
Rodoman B.B. (1974) Polarization of the landscape as a means of preserving the biosphere and recreational resources, p.150-163.


We’ve all heard of Banned Books. According to the American Library Association,
A challenge is an attempt to remove or restrict materials, based upon the objections of a person or group. A banning is the removal of those materials. Challenges do not simply involve a person expressing a point of view; rather, they are an attempt to remove material from the curriculum or library, thereby restricting the access of others. As such, they are a threat to freedom of speech and choice.
The American Library Association keeps an active list of books that are either banned or challenged and sponsors an annual Banned Books Week to draw attention to these tomes, lest they be banished from the public eye. Keep in mind that the books on the list range from I Am Jazz to the Holy Bible, because anyone can be offended by anything nowadays. Which is probably why publishers are anxious to nip the offense in the bud—so anxious, in fact, that they want to eliminate potentially offensive books before they’re event printed.
Before a book is published and released to the public, it’s passed through the hands (and eyes) of many people: an author’s friends and family, an agent and, of course, an editor.
These days, though, a book may get an additional check from an unusual source: a sensitivity reader, a person who, for a nominal fee, will scan the book for racist, sexist or otherwise offensive content. These readers give feedback based on self-ascribed areas of expertise such as “dealing with terminal illness,” “racial dynamics in Muslim communities within families” or “transgender issues.”
Need a job in publishing? Try becoming a “sensitivity reader.” If you are of a pre-defined “minority group” you could qualify to read books for any number of publishers before they go to print, or even before they’re opted by the publisher. Why? So that when the publisher faces a lawsuit for offending another person belonging to the minority group you represent, you can provide a deposition or even attest in court to the fact that you were not offended when screening the book. That’s what the role of a “sensitivity reader” boils down to in real world terms. But, for the safe-space inclined, a sensitivity reader is another victory in the culture wars. Wars whose primary victims happen to be under the age of 18.
Plenty of parents screen the media their young children encounter. However, as a child gets older and gains more independence it becomes impossible for us to keep track of everything they encounter on a daily basis. Having been a teenager with a proclivity for both libraries and used bookstores, I’m anything but grateful for the sensitivity readers looking to acculturate my child to an ever-changing politically correct point of view. These readers aren’t being hired to weed out gratuitous sex and violence in tween lit; they’re being hired to teach your child what attitudes are and aren’t acceptable when it comes to sexuality, gender and race relations. If your white son finishes a book about African American women and tells you he feels guilty, thank a sensitivity reader for having no sensitivity regarding the reality that a book’s reach transcends marketing demographics.
From a historical perspective the idea of a “sensitivity reader” is downright dangerous. You aren’t just banning books after they’ve been published, leaving them to be consumed by readers who can access sources beyond an official reach. Sensitivity readers literally ban written ideas before they can reach a mass audience. In another time and another context, a sensitivity reader would’ve been referred to as a military censor, or worse: a propagandist.
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Online Health Chat with Julie Honaker, PhD
October 11, 2017
Dizziness is defined as feelings of unsteadiness, wooziness and lightheadedness; and sensations of moving, spinning, floating, swaying, tilting or whirling (sensations known as vertigo). These sensations occur even when standing still or lying down. More than four out of 10 people experience an episode of dizziness significant enough to send them to a doctor. Dizziness changes your sense of balance and can increase your risk of falling.
Dizziness is generally not serious. However, it may result from problems associated with the inner ear, brain or heart. It can also be the result of medications.
If you have suffered dizziness that does not go away, please join Cleveland Clinic vestibular and balance specialist Julie Honaker, PhD in a free online chat. She will answer your questions about dizziness and balance disorders.
About the Speaker
Julie Honaker, PhD is the director of the Vestibular and Balance Disorders Laboratories within the Head & Neck Institute. She was previously an assistant professor in the Department of Special Education and Communication Disorders at University of Nebraska-Lincoln where she taught graduate courses on vestibular and balance disorder assessment and management. She received her master’s training and PhD in audiology from the University of Cincinnati. She completed a post-doctorate fellowship at the Mayo Clinic in Rochester, MN. Dr. Honaker has a passion for the clinical assessment and rehabilitation of balance disorder patients, and this is the focus of her clinical research endeavors.
Let’s Chat About Dizziness and Balance Disorders
johnspol: A viral inner ear infection following Bell's palsy left me with permanent dizziness, vertigo and deafness in my right ear, as well as four destroyed facial nerves.
Julie_Honaker_PhD,_CCC-A: I’m sorry to hear that. In cases of dizziness, there are measures to improve your symptoms following viral infection. Vestibular rehabilitation helps to restore your balance and reduce symptoms. Also, you may find benefit in speaking with an audiologist regarding your hearing loss.
cwadsl: In 2014, I turned over in bed with my eyes open and experienced a severe bout of room-spinning vertigo. My dresser appeared to be flying over my head in a perfect circle, as if I was looking through a kaleidoscope. This lasted about five minutes, but I was terribly ill the rest of the day and suffered from severe dizziness 24 hours a day over the next eight weeks. I visited many specialists and had many tests, which found nothing. Canalith repositioning maneuvers for BPPV did not work. Doctors suspected Meniere's disease or a vestibular infection or disorder. The only thing that seemed to lessen the symptoms was steroids. After about six weeks, the dizziness finally began to subside in the evenings, then earlier and earlier in the day until it was gone about three weeks later. Nothing has happened since then except that I feel a bit more sensitive to motion.
Do you have any recommendations for what my plan of attack should be if this happens again? Thank you.
Julie_Honaker_PhD,_CCC-A: I'm sorry to hear about your episode of true spinning vertigo. While I may not be able to provide clarity on if/when this may happen again, I can give you tips on what to document to help your physician/other specialists better identify the cause. 1) Try to note what brought on the symptoms (e.g., rolling over in bed, sitting up too quickly in bed, etc.) 2) Try to note how long the symptoms last (seconds then go away if sitting very still, minutes, hours, etc.) 3) Try to document any associated symptoms (headache, double vision, changes in speech, etc.) This will help your physician or other specialist better identify if this is truly an inner ear disorder or perhaps another reason (headache, migraine, viral infection) for your symptoms.
Cecelia: I have the same symptoms as cwadsley. It has now been eight months. My current symptoms include a spinning sensation when rolling over in bed at night or first thing in the morning and dizziness when looking up. The more movement I do, the more unsteady I feel. I am becoming more active but by two or three p.m., but I begin to fatigue and morning light, noise or other stimuli increase fatigue and dizziness. I have been getting vestibular therapy, but the therapist is finding I am not responding to it. A neurologist diagnosed vestibular neuronitis. I am currently on 8 mg twice a day of beta-histamine, which seems to help. Any further suggestions would be SO appreciated.
Julie_Honaker_PhD,_CCC-A: I'm sorry to hear about your ongoing symptoms. It may be a good idea to have a thorough vestibular evaluation with an audiologist to determine how your vestibular system is functioning or if there is another cause for your ongoing symptoms since you have not responded to therapy. The beta-histamine helps with symptom relief, but is not a cure.
Suereed43: Does getting dizzy often have anything to do with heart disease?
Julie_Honaker_PhD,_CCC-A: Good question. There are many causes of dizziness, and heart disease is actually a common cause. Sometimes, this has to do with problems with blood pressure or the medications that are used to control heart-related problems. Patients with heart disease may even experience problems with balance and are often at greater risk of falling. It is important to speak with the doctor who is managing your heart-related condition to discuss your concerns of dizziness and see if it is related to the condition or a possible side effect of medication.
Jode9297: Can thrombocytosis cause vertigo? I was diagnosed about 30 years ago.
How about the medication Agrelyn (anagrelide)? Thanks.
Julie_Honaker_PhD,_CCC-A: Thank you for your question. Your symptoms may be related to your disease, as well as a side effect of the medication. I would suggest discussing these symptoms with your primary care physician who can review your medications and possibly refer you to a specialist regarding your condition.
pilatesgirl: How do concussions from the past affect long term balance?
Julie_Honaker_PhD,_CCC-A: We are learning more and more about concussions and their effect on the balance system. There are known cases/research to support long-term effects on balance. If you are noticing problems with your balance, it is recommended that you discuss this with your primary care physician who can then refer you to a specialist to evaluate your balance and make appropriate recommendations to improve your balance and keep you safe from falls.
MineOrYours2: Hi. I get dizzy every now and then. I also feel spinny. I work out almost daily and am fine doing that. I don't know why I would get dizzy when not exercising. Would a lack of a daily dose of water cause dizziness?
Julie_Honaker_PhD,_CCC-A: There are numerous causes for symptoms of dizziness. Sometimes, dehydration can cause symptoms of lightheadedness or dizziness. This may be a good first factor to check. Also, it is always a good idea to discuss these concerns with your primary care physician, as medication and diet changes can also cause symptoms.
MarL: Good Afternoon. Do you have any data on how dizziness and balance might have an effect on lupus patients?
Julie_Honaker_PhD,_CCC-A: I do not have data on hand, but there are known medication side effects, as well as possible consequences of the disease on your peripheral nervous system that can result in symptoms of dizziness, imbalance and even blurred vision. If you are experiencing these symptoms, it would be good to discuss this with your managing physician to first rule out medication effects and then explore other causes for the symptoms.
derekl: Can migraines cause dizziness?
Julie_Honaker_PhD,_CCC-A: Good question. Dizziness, vertigo, imbalance, blurred vision, etc. are all consequences of migraines. There are even variants of migraines that can cause vertigo or dizziness without migraine head pain. If you think you are experiencing any of these symptoms and have a diagnosis of migraine, it would be important to discuss this with your physician. There are criteria that your physician would need to determine if migraines are the cause of your symptoms.
TimboBear: Could thyroid medication or it not being on the right dose affect dizziness, lightheadedness and feeling off balance?
Julie_Honaker_PhD,_CCC-A: I cannot comment on medication doses, but symptoms of dizziness, lightheadedness and feeling off balance may result in other disorders, including problems with the thyroid. It would be best to discuss these concerns with your managing physician to better determine if this is related to your condition or another possible cause.
sbdav: I have a problem with lightheadedness due to blood pressure medications, but have much more of the problem when walking in large expanses like a mall parking lot. I feel very unstable and out of balance. I have to walk looking down at the ground because looking up or turning my head makes me feel even more unbalanced. Is this something you've heard of?
Julie_Honaker_PhD,_CCC-A: It is not uncommon for people with balance problems to experience visually provoked symptoms such as those described in your question. If you have already worked with your physician to adjust your blood pressure medications, then you may want to have a more thorough evaluation to determine if you have a balance problem causing your symptoms when in large spaces, looking up, etc.
internetkat01: I'm about to have back surgery because there is a cyst on my spine. While the doctor is in there, he will be putting a screw in the two lower bones of my spine to hold them together because they are moving and there is no cartilage left in between the bones. I've stopped taking my steroids weeks before the surgery. He doesn't want me starting my steroids for 12 weeks after the surgery. If I start before, he says the steroid will weaken my bones and the screw will not hold. Do you have any advice on how to not lose the cartilage between your bones?
cerim: Would inner ear issues cause balance to be thrown off upon standing?
Julie_Honaker_PhD,_CCC-A: Good question. Yes, an inner ear balance disorder could cause your balance to be thrown off when standing. In cases of inner ear problems, imbalance is very common, and when we move we are activating our inner ear balance system. If this is not working properly, you could experience strange symptoms when moving in different positions such as standing.
clihea2: Quite a few years ago I lost hearing in one ear almost completely overnight and that has affected my balance as well. Eventually, I was told that I blocked my internal auditory artery. I still can't be fitted for a hearing aid and I still can't do things such as stand on one leg much. I do a few exercises a few times a week, but it doesn't keep me from being twirly headed when I look up or make a turn other than very slowly. Do you have any suggestions? Thanks Le Ann.
Julie_Honaker_PhD,_CCC-A: Sorry to hear about your sudden hearing loss. Some patients who suddenly lose their hearing on one side may also have the other part of the ear involved (vestibular system). Do to this, you may be experiencing symptoms related to loss of inner ear function (hearing and balance) on one side. It may be beneficial to meet with an audiologist and vestibular rehab therapist to discuss additional exercises to perform to help with your balance concerns, as well as newer options for single-sided hearing loss.
weya: How can you get rid of fluid on the ears, which causes my dizziness?
Julie_Honaker_PhD,_CCC-A: Thank you for your question. It would depend on the problem with the fluid. We have fluid in our inner ear that is important for our sense of hearing and balance. In cases of disease, where there is an overabundance of fluid (for example, Meniere’s disease), conservative treatment of a low-salt diet and water pills to reduce water retention may be of benefit. Some individuals have fluid in other parts of the ear (for example, in the middle ear space, which is normally air filled), and this can cause symptoms of imbalance and sometimes even dizziness. In these cases, it would be important to try to remove the fluid in that part of the ear. In either case, it is important to speak with a health care professional, ear, nose and throat specialist and perhaps an audiologist (hearing specialists) to determine where the fluid is located to help determine the best management option.
SDsummer: I have Meniere's disease. Is there anything I can do to help keep this from progressing? I was told I could eventually have hearing loss. My sense of balance is affected at random times, with bouts of dizziness and balance issues. Also, I’m wondering if years of dental work and TMJ issues are related since the jaw is near the ears? Thank you.
Julie_Honaker_PhD,_CCC-A: Thank you for your question. There is no cure for Meniere’s disease, but there is treatment available to manage the symptoms and sometimes reduce how often and severe the attacks are. The most common treatment option is a low-sodium diet and water pills to reduce water retention. If this approach is not beneficial, steroid injections are another option to reduce severity and number of attacks. Vestibular rehabilitation is also of benefit to help with symptoms of dizziness/imbalance between attacks. It would be best to have an expert evaluate any additional symptoms (TMJ issues) to see if there are other causes of symptoms (hearing related/tinnitus) contributing to your symptoms of dizziness.
MarL: What is Meniere's disease, and how does it affect you?
Julie_Honaker_PhD,_CCC-A: Good question. Meniere's disease is an inner ear disorder that causes spontaneous episodes of decreased hearing, vertigo, tinnitus and even a fullness feeling in one ear (sometimes both ears). It is believed to be due to an overabundance of fluid in the inner ear. This disease can be very debilitating for patients, as it can come on without warning. There are treatment options if you or someone else believes you have this condition.
SDsummer: I have Meniere's disease and struggle with bouts of dizziness. Can this lead to eventual hearing loss? What is the root cause of the disease? I've had a lot of orthodontic work over the years since early childhood. Could that be related?
Julie_Honaker_PhD,_CCC-A: It would be best to have an expert evaluate additional symptoms, (specifically dental issues) to see if there are other causes of symptoms (hearing related/tinnitus) contributing to your symptoms of dizziness. As far as I know, there are no credible studies that link Meniere's with multiple dental procedures.
Thoughts on Treatment
sbdav: Would a cane or walking poles help with a balance problem?
Julie_Honaker_PhD,_CCC-A: A cane or walking poles provide extra support (widen the base of support on which you are standing) and may assist with your balance. It is always recommended that you meet with a specialist (for example, a physical therapist) to discuss assistive mobility options such as a cane to ensure that you are using the correct device.
colo157: I've been diagnosed with BPPV. I received much benefit from the Epley treatments early on, but now the symptoms come back within two weeks after a maneuver, no matter how careful I am. Is there any reason for this?
Julie_Honaker_PhD,_CCC-A: I'm glad you received benefit with the Epley maneuver. It is not uncommon for symptoms to return, as the Epley is not a cure but a treatment for the problem. Given that you are experiencing your symptoms so frequently, it may be of benefit to look into other reasons aside from the BPPV for your symptom to return. It may be beneficial to have a comprehensive vestibular assessment to better identify why this is returning so frequently. I recommend discussing this with your primary care physician and asking about a referral to a vestibular therapist or audiologist for a more thorough evaluation.
Happy70: What are the treatment options if no reason is found for the dizziness? I have had hearing tests, VG and VEMP, which ruled out an inner ear problem. I’ve also had an ophthalmologic checkup, MRI and MRA of the brain to check for blood flow and tumor, and physical therapy. Is there anything I can do to help control the dizziness and help prevent a fall?
Julie_Honaker_PhD,_CCC-A: Treatment options would really depend on the cause for your symptoms of dizziness. There are numerous causes including inner ear disorders, but this does not sound like the case, as you have had normal tests of inner ear function. You may benefit from further evaluation of other causes (not inner ear-related causes, but mediation, anxiety, neurological conditions) for your dizziness. You should discuss this with your primary care physician. Fall prevention tips can be found on the Centers for Disease Control and Prevention (CDC) website. These include ways to keep you safe in and around your home, as well as group exercise programs that can help with your balance.
Gail Ann: Are there any techniques, exercises, medications or supplements to help with an off balance issue? What role, if any, does stress play? I never experience dizziness, only a continuous off balance feeling in my head accompanied by a headache. Thank you for answering my question.
Julie_Honaker_PhD,_CCC-A: Good question. There are options to help with your balance if we better understand the cause. It appears that you are experiencing your symptoms with a headache. This may indicate that further investigation and possible treatment is needed for the underlying headache. I would recommend following up with your primary care physician to discuss your balance concerns/headache and to determine if a medication would benefit you or perhaps balance therapy to keep you safe from falling.
Chrysanthemum: What is the most accurate way of getting a proper diagnosis? There are so many variables, even conditions, that overlap, and sometimes it feels that each doctor feels the problem falls under his or her particular specialty. Sometimes, treatments contradict one another. In the meantime, years have passed and I'm still afflicted and greatly limited in life. Thank you.
Julie_Honaker_PhD,_CCC-A: You are correct that it can be very challenging to get an accurate diagnosis. There are many overlapping conditions and professionals that may need to be involved to get the most correct diagnosis. The Cleveland Clinic Head and Neck institute now offers a Dizziness and Imbalance Shared Medical Appointment. (To schedule an appointment, call 216.444.8500.) In this group visit with other patients, two providers evaluate the patients in a group and private setting to help sort out the many causes for dizziness and come up with a proper diagnosis and management plan.
Ed95: If you've never had an episode of serious dizziness or the feeling of almost passing out, what are the first things a person should check if this happens, blood pressure, O2 levels, heart rate, etc.? I recently experienced the feeling of almost passing out after some strenuous activity. I'm a 62-year-old male and wonder what could have caused this. It’s never happened before and hasn't happened since. Thanks.
Julie_Honaker_PhD,_CCC-A: Thank you for your question. It is always best to first discuss your concerns of almost passing out with your primary care physician, as this may be related to issues described above such as blood pressure changes or heart related conditions. If this is ruled out, then we need to look into changes in medication as the cause. Finally, if those are all ruled out, other causes including inner ear-related problems will need to be evaluated.
Jode9297: With so many people suffering with vertigo, why is there no cure?
Julie_Honaker_PhD,_CCC-A: It can be frustrating both for the patient as well as the clinician to determine the cause of vertigo/dizziness. There are many reasons for vertigo: medications, cardiovascular issues, neurological issues, anxiety, depression and inner ear problems to just name a few. Medications often are not beneficial and only mask the real problem. It may be beneficial to speak with your primary care physician and see about referral to a vestibular specialist (audiologist, physical therapist or physician) to better evaluate and determine the cause of the vertigo.
Jode9297: In addition to my right ear feeling full, a few seconds before a vertigo episode, always to the right, I hear what I can only describe as a "rubbing "sound in my right ear. What might this indicate?
Julie_Honaker_PhD,_CCC-A: Both symptoms relate to a possible ear-related cause to the symptoms. It would be best to be evaluated by an ear specialist (ear, nose and throat physician and audiologist) to evaluate your symptoms and hearing to better determine the ear-related condition.
Voices on Vertigo
Nanat426: Once you get vertigo, are you prone to getting it again? Why does it last so long and is not just a quick day-long thing? Mine have been going on for three weeks. I was given medication and am now trying physical therapy.
Julie_Honaker_PhD,_CCC-A: It really depends on the cause for the vertigo. Sometimes, vertigo can be related to a common inner ear disorder, such as something called benign paroxysmal positional vertigo or BPPV. This condition causes brief episodes of vertigo when changing positions (bending over, rolling over in bed). The best course of treatment for this is exercises that can be provided by a physical therapist, audiologist or physician. Medication is often not the cure, but helps to reduce symptoms. It is best to wean off of medications and treat vertigo with other management solutions such as rehabilitation exercises.
pollyjohnsey: A viral inner ear infection following Bell's palsy left me with total deafness in my right ear, destruction of four facial nerves and permanent vertigo. The distortion of my facial features never returned to normal. I have been told that medication will not help the condition, and I am wondering if research has shown any indication of help for the vertigo.
Julie_Honaker_PhD,_CCC-A: Provided your left inner ear balance system (since your viral infection was on the right) is working properly, and you do not have any other problems with your balance system, you should be a good candidate for a vestibular rehabilitation program to help promote the brain's "recalibrating" from your viral infection. This will help reduce your symptoms of vertigo, improve your balance and maintain activities of daily living.
Jode9297: My vertigo episodes come on unpredictably when I’m sitting, standing, sleeping and at various times of the day. All the tests came back inconclusive. Do you have any suggestions on what to do next?
Julie_Honaker_PhD,_CCC-A: I'm sorry to hear that. It would depend on which tests you have had, and also how long your symptoms last when they come on spontaneously. I would start tracking patterns and having this conversation with your physician to better identify the cause or other avenues to explore to determine why you are experiencing these symptoms.
Xomue: I've had BPPV in the past, so I am familiar with the feeling of waking up turning my head and feeling the room spin briefly. It stops after 10 to 15 seconds. This has happened to me every few years for the past 20 years. Yesterday, I woke up and experienced the same spinning when I turned my head in both directions. In the past, I was told that in order to get rid of it, I can have the Epley procedure or I can practice the positions that make your head spin a little, that is lying down, turning the head to one side and holding it for 30 seconds. Since it's so hard to get an appointment in my area with a doctor for a non-emergent condition, I would like to try the "home method." I am putting my head in the positions that cause dizziness and holding it for 30 seconds? I don't want to overdo and make it worse. My question is: Is it possible to make it worse by overdoing? It usually clears up in a week or so. Do you have any suggestions on how to prevent BPPV?
Julie_Honaker_PhD,_CCC-A: I am not concerned with you overdoing it, but rather displacing the crystals (what is causing the BPPV) to be moved into other parts of your inner ear system (other semi-circular canals), which can make it more challenging to treat. There are home treatment options that you can try if you know exactly what type of BPPV you have. You may want to go to vestibular.org as a resource to help you find a specialist near you. Choose the "find a specialist tab" to see if you can get in with someone sooner to be evaluated and treated properly.
pilatesgirl: What does it mean when your balance is OK with your eyes open, but is much harder to impossible when your eyes are closed? I was told it is related to the temporal lobe.
Julie_Honaker_PhD,_CCC-A: Good question. We use three sensory systems to help us with our balance: vision, inner ear balance organs/vestibular system and prioprioception. When we have our eyes open and are standing on a firm surface, we use our vision and prioprioception to help maintain our balance. When our eyes are closed, we must rely on our vestibular system to keep us upright. This system is not as strong as the other systems when trying to stand still. This is why it is important to utilize our sensory systems together to help us maintain our balance.
Lois Johnson: I have issues with my vision, dizziness, etc. I have been told it involves vestibular-ocular reflex (VOR). Would you please explain the VOR?
Julie_Honaker_PhD,_CCC-A: I’m happy to discuss the VOR. The vestibular-ocular reflex is a reflex between the inner ear vestibular system and the muscles that control eye movements. These muscles help us maintain stable vision when our head/body is in motion. For example, when I turn my head to the right, the VOR moves my eyes to the left so I am able to see clearly.
keroppi: I had extensive workups (ENT, neurology, vision-vestibular, etc.), and no official cause of the constant lightheadedness/dizziness I’ve had for decades has been found. It’s been chalked up to underlying condition of dysautonomia/POTS. Vestibular rehab and medicines like meclizine haven't worked. I also get episodes of true vertigo for hours, after which my baseline level of dizziness/floatiness increases for a long time. I’m currently going on two months since my last episode. Is there anything one can do to try to "reset" back to the former "dizziness baseline" at least? I used to try some vestibular exercises and Ativan, and sometimes I've gotten it down to two weeks, but this time nothing is working. Also, this year, months before this last vertigo episode, I developed a chronic stuffiness in my left ear that never goes away. The ENT just said it was a "fluid imbalance/endolymphatic hydrops," probably due to dysautonomia, and lowering salt intake didn’t help. Does this ever resolve on its own? Is there anything else noninvasive to be tried (my brain MRI was negative)?
Julie_Honaker_PhD,_CCC-A: You are not alone in experiencing symptoms of dizziness, and it is very frustrating when you do not have a clear answer as to the cause. As for how to “reset” back to the former dizziness baseline, it would depend on the reason for the dizziness in the first place and how your system is responding at the moment. It may be beneficial to have a comprehensive vestibular evaluation with an audiologist to better understand your current symptoms and reasons for the longstanding dizziness. You may want to speak with your primary care physician regarding your questions and a possible referral for vestibular assessment with an audiologist. For more information on services at Cleveland Clinic, you may call 216.444.8500.
Chrysanthemum: With aging and having a host of issues, it seems each specialist sees my dizziness/imbalance from their own area of expertise and they don't always agree. Can there be multiple causes for dizziness at the same time?
Julie_Honaker_PhD,_CCC-A: Good question/concern. To answer your question, yes. There can be multiple causes for dizziness. With that said, each specialist may be focused on a specific area that may be a cause for the symptoms.
F94jL63: Apart from issues/symptoms related to ear dysfunctions, can vertigo be triggered by visual disturbances? My episode of extreme dizziness was preceded by distorted vision in one eye, where images appeared wavy and moving rather than being in a fixed and focused orientation. That anomaly eventually subsided, but dizziness remained for several hours.
Julie_Honaker_PhD,_CCC-A: Yes. There are visual causes for dizziness. Our visual system is an important part of our balance system; if this is off, you may experience symptoms of dizziness or imbalance. And, if you have an underlying vestibular/ear dysfunction, it is not uncommon to have visually provoked symptoms. Sometimes, patients will experience symptoms when walking down a grocery store aisle, reading on a phone or computer, etc. Vestibular therapy is of help to reduce some of the visually provoked symptoms.
Allison0502: Hello. Thank you for hosting this chat. I have tinnitus and have heard that certain hearing aids can be helpful in coping with this issue. Which brands or kinds of hearing aids do you typically recommend?
Julie_Honaker_PhD,_CCC-A: Thank you for your question. We are actually having a web chat on October 18 regarding hearing loss during which two specialists will be discussing management options for tinnitus. Please visit ClevelandClinic.org/webchat to register for that chat and submit your question.
Julie_Honaker_PhD,_CCC-A: Thank you for participating in the Cleveland Clinic dizziness web chat. If I was unable to respond to your inquiry, please feel free to submit your question at: https://my.clevelandclinic.org/WebContact/WebMail.
That is all the time we have for questions today. Thank you, Dr. Honaker, for taking time to educate us about dizziness and balance disorders.
On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online at http://my.clevelandclinic.org.
To make an appointment with Julie Honaker, PhD or any of the other specialists in Cleveland Clinic’s Head & Neck Institute, please call 216.444.8500, toll-free at 800.223.2273 (extension 48500) or visit us at clevelandclinic.org/headandneck for more information.
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About Cleveland Clinic Vestibular and Balance Disorders
The Section of Vestibular and Balance Disorders provides laboratory diagnosis, medical neurotology and vestibular rehabilitation of patients with dizziness, disequilibrium and imbalance. An outpatient clinic manages self-referred patients and those referred from Otolaryngology, Neurology, Internal Medicine and other departments. Residents rotate through the Section of Vestibular and Balance Disorders to learn about test administration and interpretation.
The section has state-of-the-art, computer-based electronystagmography and rotational chair and posturography, with the world’s largest database of laboratory test results. As Northeast Ohio’s only comprehensive laboratory, the section offers regional referral laboratory services for physicians outside Cleveland Clinic.
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- the doctrine that there are two mutually antagonistic principles in the universe, good and evil
- the doctrine that man has two natures, physical and spiritual
- The condition of being double; duality.
- Philosophy The view that the world consists of or is explicable as two fundamental entities, such as mind and matter.
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- Theology a. The concept that the world is ruled by the antagonistic forces of good and evil.b. The concept that humans have two basic natures, the physical and the spiritual.
- Duality; the condition of being double.
- (philosophy) The view that the world consists of, or is explicable in terms of, two fundamental principles, such as mind and matter or good and evil.
- (theology) The belief that the world is ruled by a pair of antagonistic forces, such as good and evil; the belief that man has two basic natures, the physical and the spiritual.
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