6 Ideas for Sensible Homes — YES! Magazine

6 Ideas for Sensible Homes — YES! Magazine

Nigerian Petroleum Minister Lied: By SaharaReporters, New York

Petroleum Minister Lied: Companies Indicted for Fuel Subsidy Fraud Receive Juicy Import Contracts

Posted: July 29, 2013 - 19:00

Nigeria's minister of Petroleum Resource, Diezani Allison-Madueke

By SaharaReporters, New York

Nigeria’s Petroleum Minister Diezani Allison-Madueke recently spiritedly denied that she offered fuel importation contracts to companies indicted for fraudulent fuel subsidy claims. However, an investigation by Saharareporters has revealed that Ms. Allison-Madueke lied to Nigerians. As part of that investigation, we obtained the list of companies to which the minister, Petroleum Products Pricing Regulatory Agency (PPRA) and the Petroleum Ministry have granted juicy petroleum import contracts in the third quarter.
The roster of fuel importers reveals that several rogue businesses that had defrauded Nigerians by making hugely inflated subsidy claims benefited from current import contracts. “I can tell you that the minister personally authorized each and every beneficiary,” a source in the Petroleum Ministry told our correspondent. He added: “Madam [Ms. Diezani Allison-Madueke] has tight control of every contract given out within the ministry, the NNPC, and other agencies in the oil industry.”
Included in the third quarter allocations awarded by the ministry is also a company owned and run by a relative of Reginald Stanley, the Executive Secretary of the Petroleum Products Pricing Regulatory Agency (PPRA).
One of the beneficiary companies, NEPAL Oil, was referred to the Special Fraud Unit of the Nigerian Police for investigations relating to extensive fraud.
The company was accused as one of the participants in a massive fuel subsidy scam that cost Nigerians $6.5 billion. The fuel subsidy scam came to light early in 2012 shortly after Nigerians rose in massive protests against the decision by President Goodluck Jonathan to remove fuel subsidies in January 2012. NEPAL Oil was later charged along with Anonsyke Group by the Economic and Financial Crimes Commission (EFCC).
In 2012, the EFCC charged both companies with forgery and obtaining money under false pretense. Even though the trial is ongoing, Ms. Allison-Madueke personally approved the allocation of an import volume of 30,000 metric tons to NEPAL Oil in the second and third quarters. Mr. Stanley of PPPRA attended the official launching of a small tank farm established in Oghara last May.
Another indicted company, IMAD Oil, which was referred to the police for investigations, received fuel import allocations at Ms. Allison-Madueke’s instance.
Two other companies, Matrix Energy and Masters Limited, were originally investigated, but the police later issued letters clearing both companies of involvement in fuel subsidy scams.
SaharaReporters discovered that a company, Rahamaniyya Oil and Gas Company, received ministerial allocation to import fuel despite the fact that the EFCC is still investigating the company for subsidy scam. Owner of Rahamaniyya, Abdulrahaman Musa–Bashir, a Sokoto-born oil dealer, was one known as the future bridegroom of Aisha Yar’Adua, a daughter of the late President Umaru Yar’Adua. However, he abandoned the would-be bride as soon as her father died. Last year, the oil businessman caused a stir within the Yar’Adua family when he wrote a letter to Mr. Yar’Adua’s widow, Turai Yar’Adua, demanding that she refund $3 million he reportedly gave her in preparation for the aborted wedding.
Also on the list of fuel import beneficiaries is Blacklight Limited, an oil company owned by Lucky Igbinedion, a former governor of Edo State. Mr. Igbinedion is a convicted felon, found guilty of fraud during his tenure as governor. In 2008, the EFCC struck a controversial plea deal with the ex-governor, clearing the way for a judge of the Federal High Court in Enugu to give Mr. Igbinedion a paltry fine of N3 million that was widely condemned as a slap on the wrist.
“So why is the government rewarding a man like Lucky Igbinedion whose track record is one of corruption, fraud and scam?” asked a labor leader based in Abuja. He added: “This administration promised to address the irregularities in fuel importation. That has not been done. They promised to pursue the building of new refineries and to revamp existing ones. That, too, has not been done.”
Two sources in the Petroleum Ministry told SaharaReporters that the award of allocations to companies indicted for fraud was not the only problem. “If you look at the recent allocations, you will notice something skewed in the manner certain marketers are favored with huge allocations which runs at variance with their ability to store the imported products,” said one of them. He stated, “That’s a major reason why so many of them were able to scam the Nigerian government of billions of dollars over three years.”
For instance, Conoil, owned by Mike Adenuga, reportedly owns huge storage tanks in Lagos and Port Harcourt. In the latest round of allocations, Conoil was awarded 60,000 metric tons. By contrast, companies like A-Z, run by Chika Okafor, Shorelink, which is run by Obiamarije Stanley, a cousin to the PPPRA’s Reginald Stanley, and Nkechi Peter Obi's Techo Oil, got huger allocations of 80, 000, 75,000 and 60,000 metric tons respectively. A-Z does not have any known storage tank farms.
Another source at the Petroleum Ministry pointed to the fact that the beneficiaries topping the list of ministerial allocations are the same players who were offered massive bribes to several legislative committees and security agencies to shield them from indictment. These big-time players include Mr. Adenuga, Femi Otedola, Sayyu Dantata of MRS Oil and Gas, and Mr. Rahamaniyya.
A different aspect of the scam is that all the big players named above, and a few others, were in 2009 named by the Central Bank of Nigeria (CBN) as huge debtors to commercial banks. SaharaReporters found out that none of the businessmen ever paid the hundreds of billions of naira they borrowed from banks. Instead, the Federal Government and CBN struck a shady deal with the debtors under which a bogus agency called Assets Management Corporation of Nigeria (AMCON), run by Mr. Mustafa Chike-Obi, took over some assets owned by the debtors in lieu of payment.
But AMCON’s management of the debts was so bad that the International Monetary Fund earlier this year called for the scrapping of AMCON. “The AMCON deals were simply meant to free the billionaire debtors from their debt obligations,” a Lagos-based financial analyst told SaharaReporters. He explained: “Under the deal, each of the debtors handed one or two assets of their assets to AMCON. The shady part of it, then, was that AMCON officials overvalued each asset, making it possible for possible for the debtors to wriggle free of their debt obligations, leaving the creditor-banks out in the cold.”
The analyst disclosed that most of the debtors had originally obtained the bank loans ostensibly to finance fuel imports. “This is one of the worst scams in Nigerian history,” he said. “The fuel was often not imported, but these businessmen claimed fuel subsidies – and they failed to pay back the loans they took.”

S/N	COMPANY	VOLUME (KT)
1	Acorn	15,000
2	Aiteo	120,000
3	Ascon	45,000
4	Avidor	15,000
5	A - Z	60,000
6	BlackLight Ltd	30,000
7	Bovas	45,000
8	Capital
9	Conoil	60,000
10	Cybernetics	15,000
11	Dee-Jones	45,000
12	Dozzy	30,000
13	Fatgbems	*
14	First Deepwater	*
15	Fresh Synergy	15,000
16	Folawiyo	90,000
17	Forte	75,000
18	Gulf Treasures	30,000
19	Heyden	*
20	Honeywell	0
21	Hudson	15,000
22	Hyde Energy	30,000
23	Ibafon	15,00
24	Imad Oil and Gas	30,000
25	Index
26	Integrated	60,000
27	Linc Nigeria Ltd
28	Mainland	15,000
29	Masters	80,000
30	Matrix	30,000
31	Mettle Energy	15,000
32	MRS Plc.	60,000
33	MRS Oil & Gas	60,000
34	Mobil	60,000
35	Nepal	30,000
36	Nipco	120,000
37	NNPC	1,350,000
38	NorthWest	75,000
39	Oando	135,000
40	Obat	30,000
41	Optima	15,000
42	Rahamaniyyah	45,000
43	Rainoil	80,000
44	Sahara	60,000
45	ShoreLink	80,000
46	Swift	45,000
47	Techno Oil	70,000
48	TempoGate	20,000
49	Total Nig.	90,000
50	TSL Logistics	30,000
	original reports>	3,405,000   http://saharareporters.com/

Nigeria’s Oil-Rich Delta Boils Over Longstanding Grievances

Nigeria’s Oil-Rich Delta Boils Over Longstanding Grievances 

 "Since our people's livelihoods have been destroyed through oil spillage and gas flaring, coupled with the poor quality of human potential owing to poor education, the easiest option is illegal business such as oil bunkering," said Ebipade.Failure to address longstanding grievances such as a chronic lack of development and environmental degradation, and the reintegrating of former fighters into peaceful society, risk reigniting violence in Nigeria’s oil-rich delta region five years after it was contained through a government amnesty.

"The reasons for the armed actions that necessitated the amnesty five years ago – mass unemployment and deep socio-economic injustices – still beg for a response," Nnimmo Bassey, director of the Health of Mother Earth Foundation, told Anadolu Agency. "Those who are classified as militants, and to whom the amnesty program has been directed, are a minority in the army of the discontented.”

Under the 2009 amnesty, as many as 26,000 fighters who renounced violence were pardoned and offered vocational training in Nigeria or abroad.Each pardoned person receives a $410 monthly allowance until they find work. There is no official data as to precisely how many of them have since secured jobs.

Daniel Alabrah, a media aide at the Amnesty Office Abuja, was not unavailable for comment on the issue until the filing of the report. Ledum Mittee, president of the Movement for the Survival of the Ogoni People (MOSOP), agreed, accusing the government of failing to adequately address longstanding socio-economic grievances. He said what the government did amounted to “surface-scratching which to my mind does not guarantee long-term stability." "There has been no improvement in livelihoods in the region," he told AA.

“What has happened…is that we have been able to buy peace (but) it is not sustainable - you can’t sustain paying that amount of money. Armed resurgence is as certain as daylight.” The government first proposed the amnesty following a record spike in violence in the delta region in 2008. In the first nine months of that year, some 1,000 people were killed in attacks and 300 taken hostage. During the same period, the government lost an estimated $23.7 billion due to attacks, oil theft and sabotage, accordng to official data.

Killer Environment
Bassey, who is also chairman of the Environmental Rights Action (ERA), a renowned environmentalist agency fighting to end gas flaring and oil spillage, said the amnesty deal had neglected longstanding development and environment-related issues. “Some of the armed groups clearly stated environmental concerns as one of the major grouses. That has not been addressed," he insists. "That to me is the greatest violence in the Niger Delta, indeed in the entire Nigerian environment. Our environment poisons and kills our people." Citing a United Nations Environmental Program assessment, Bassey insisted Nigeria's Ogoni region should have been declared a disaster zone.

"The president ought to have declared a state of environmental emergency in Ogoniland and the Niger Delta," he said. "This would have required the oil companies, including the NNPC, to halt their oil spills, gas flares and pollutions," he explained. "But these acts of aggression against our people and the environment continue unabated. This remains a major flaw in the amnesty exercise." Bassey went on to assert that a safe environment supports the local economy by ensuring that the livelihoods of the people are supported."As we see clearly, neither farming nor fishing thrives in polluted and severely degraded places like the Niger Delta. This entrenches unemployment, poverty and disease."

Worrying Signs
Mittee, the MOSOP president, cites several worrying signs in the delta region."We're seeing this already with the rise in militancy, kidnapping and killings." Acts of kidnapping and other violent crimes are gradually returning to their pre-2009 levels.

In April, unidentified persons killed 11 policemen in Bayelsa, President Goodluck Jonathan's oil-rich home state, which was a hotbed of militancy. “That incident, which was just a tiny part of the brewing crisis, points the way for what to expect in the future unless the government truly addresses the main issues," ex-fighter Christopher Muoka told AA."It also tells you there are still a large number of unemployed and disenfranchised young men very eager to take up arms."

There are claims that most of the amnesty participants had been directly or indirectly involved in crimes including attacking oil infrastructure, oil bunkering, and kidnapping oil workers- charges the Amnesty Office had denied in the past.Oil theft and illegal bunkering currently account for the loss of some 400,000 barrels of oil a day. Nigerian Finance Minister Ngozi Okonjo-Iweala recently admitted that mounting oil theft had led to a 17 percent drop in the country's international oil sales.According to a high-level official at the Nigerian National Petroleum Corporation (NNPC), who asked not to be named for fear of official retribution, militant attacks on oil pipelines is gradually returning to pre-2009 levels. “Nigeria has lost at least 2.9 million barrels of oil over the last three years to vandalism of oil pipelines alone. That is in the delta," he told AA.

"Despite the presences militancy remains rife, although it may not be as deadly as it was in 2008. But it is a case of a falling rain, no one knows to what extent it could last.”
Former fighter Anthony Ebipade is not surprised. "Since our people's livelihoods have been destroyed through oil spillage and gas flaring, coupled with the poor quality of human potential owing to poor education, the easiest option is illegal business such as oil bunkering," he told AA.

Abiodun Aremu, secretary-general of the Joint Action Forum (JAF), a prominent pro-democracy group, seems to share the same opinion. "I didn't expect anything less. The amnesty was just window dressing," he told AA. He believes that the recent resurgence in violence and illegal oil bunkering "confirms that the whole amnesty deal was just a jamboree.""The armed conflict at that time was just a symptom of the diseases which were – and are still – known to all," he said. "This will continue for as long as issues of development and environmental degradation are not addressed."

http://www.worldbulletin.net - See more at: http://www.homef.org

Namibia Is Oh So Disappointing

Namibia Is Oh So Disappointing

China's Consumers Reject GMOs

China's Consumers Reject GMOs

Towards a Post-Oil Civilization. Yasunization and other initiatives to leave fossil fuels in the soil by EJOLT

Towards a Post-Oil Civilization. Yasunization and other initiatives to leave fossil fuels in the soil

May 21st, 2013

Ejolt report 6: Towards a Post-Oil Civilization. Yasunization and other initiatives to leave fossil fuels in the soil

The low resolution report can be downloaded here.

The high resolution report can be downloaded here.

Abstract

This Report traces the birth and growth of the idea of leaving oil in the ground. This arose after many decades of cruel conflicts caused by major oil companies, Shell and Chevron (Texaco) in the Niger Delta (involving the Ogoni and Ijaw peoples) and in the Amazon of Ecuador. Environmental justice organisations and networks (ERA, Acción Ecológica, Oilwatch) put forward the proposal to leave fossil fuels in the ground. This proposal makes much sense because of the need to combat climate change and, in many places, also to preserve biodiversity and to safeguard the livelihoods and survival of local populations. Such proposals are known around the world as Yasunization, from the name of the national park in Ecuador, Yasuní, where the government agreed in 2007 to leave 850 million barrels of heavy oil in the soil. The Report analyses in detail the history of the activist-led initiatives to leave oil in the soil in Nigeria and Ecuador. It shows how the idea of Yasunization has reached other areas in Latin America (in the San Andrés and Providencia islands, in the Peten, and in the Amazon of Bolivia), and describes several examples of current local struggles against shale gas fracking in Quebec, Europe and South Africa, some of which are inspired by Yasunization. It explains how attempts are being made to resist coal mining in New Zealand, tar sand extraction in several African countries including again Nigeria, and offshore oil extraction in the Canary islands, in Ghana and in the Lofoten islands in Norway. The last chapter analyses the links between Yasunization (leave fossil fuels in the ground) and the world movement in defense of indigenous peoples, and also the difficult collaboration between Yasunization and the Conservation movement. It discusses the financial aspects of the Yasuni ITT proposal, and sides against ‘carbon trading’. The final conclusions show the roots of Yasunization in local conflicts in concrete places or territories, and its decisive importance for a post-oil economy and civilization.

Keywords: oil extraction, gas flaring, gas fracking, tar sands, Nigeria, Ogoni, Ecuador, Oilwatch, Climate change policies, unburnable carbon, biodiversity conservation, indigenous territorial rights, yasunisation

Authors: Leah Temper (UAB), Ivonne Yánez (Acción Ecológica), Khadija Sharife (CCS), Godwin Ojo (ERA), Joan Martinez-Alier (UAB) with chapter contributions by Coal Action Network Aotearoa (CANA), Maxime Combes (ATTAC), Kim Cornelissen (AQLPA), Helga Lerkelund (FoE Norway), Marina Louw (ELA CT), Esperanza Martínez (Oliwatch Sudamérica), Joan Martinez-Alier (UAB), Jolynn Minnaar (Unearthed), Patricia Molina (FOBOMADE), Diana Murcia (Instituto de Estudios Ecologistas del Tercer Mundo), Godwin Ojo (ERA), Temitope Oriola (University of Massachusetts), Asume Osuoka (ERA), María del Mar Pérez, Tatiana Roa Avendaño (CENSAT), Leah Temper (UAB), Leire Urkidi (EKOPOL), Mercedes Valdés (Savia), Noble Wadzah (Oilwatch Ghana), Sarah Wykes

Policy recommendations are in the EJOLT briefing linked to this report.

Fossil Fuels, Forests & Fires (highlights)

what you need to know about Asthma by Mayo clinic

Asthma

Definition

By Mayo Clinic staff

Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust treatment as needed.

Symptoms

Asthma symptoms range from minor to severe and vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

• Shortness of breath
• Chest tightness or pain
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

• Asthma signs and symptoms that are more frequent and bothersome
• Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)
• The need to use a quick-relief inhaler more often

For some people, asthma symptoms flare up in certain situations:

• Exercise-induced asthma, which may be worse when the air is cold and dry
• Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
• Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollen

When to see a doctor

Seek emergency treatment
Severe asthma attacks can be life-threatening. Work with your doctor ahead of time to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:

• Rapid worsening of shortness of breath or wheezing
• No improvement even after using a quick-relief inhaler, such as albuterol
• Shortness of breath when you are doing minimal physical activity

Contact your doctor

• If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from worsening over time.
• To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better on a daily basis and can prevent a life-threatening asthma attack.
• If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often. Don't try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may make your asthma worse.
• To review your treatment. Asthma often changes over time. Meet with your doctor on a regular basis to discuss your symptoms and make any needed treatment adjustments.

Causes

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and genetic (inherited) factors.

Asthma triggers
Exposure to various substances that trigger allergies (allergens) and irritants can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

• Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
• Allergic reactions to some foods, such as peanuts or shellfish
• Respiratory infections, such as the common cold
• Physical activity (exercise-induced asthma)
• Cold air
• Air pollutants and irritants, such as smoke
• Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin, others) and naproxen (Aleve)
• Strong emotions and stress
• Sulfites and preservatives added to some types of foods and beverages
• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
• Menstrual cycle in some women

Risk factors

A number of factors are thought to increase your chances of developing asthma. These include:

• Having a blood relative (such as a parent or sibling) with asthma
• Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
• Being overweight
• Being a smoker
• Exposure to secondhand smoke
• Having a mother who smoked while pregnant
• Exposure to exhaust fumes or other types of pollution
• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
• Low birth weight

Exposure to allergens, exposure to certain germs or parasites, and having some types of bacterial or viral infections also may be risk factors. However, more research is needed to determine what role they may play in developing asthma.

 Complications

Asthma complications include:

• Symptoms that interfere with sleep, work or recreational activities
• Sick days from work or school during asthma flare-ups
• Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe
• Emergency room visits and hospitalizations for severe asthma attacks
• Side effects from long-term use of some medications used to stabilize severe asthma

Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

 Preparing for your appointment

You're likely to start by seeing your family doctor or a general practitioner. However, when you call to set up an appointment, you may be referred to an allergist or a pulmonologist.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. Here's some information to help you get ready for your appointment, as well as what to expect from your doctor.

What you can do
These steps can help you make the most of your appointment:

• Write down any symptoms you're having, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Note when your symptoms bother you most — for example, if your symptoms tend to get worse at certain times of the day, during certain seasons, or when you're exposed to cold air, pollen or other triggers.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements that you're taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to recall all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For asthma, some basic questions to ask your doctor include:

• Is asthma the most likely cause of my breathing problems?
• Other than the most likely cause, what are other possible causes for my symptoms?
• What kinds of tests do I need?
• Is my condition likely temporary or chronic?
• What's the best treatment?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist?
• Is there a generic alternative to the medicine you're prescribing me?
• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:

• What exactly are your symptoms?
• When did you first notice your symptoms?
• How severe are your symptoms?
• Do you have breathing problems most of the time, or only at certain times or in certain situations?
• Do you have allergies, such as atopic dermatitis or hay fever?
• What, if anything, appears to worsen your symptoms?
• What, if anything, seems to improve your symptoms?
• Do allergies or asthma run in your family?
• Do you have any chronic health problems?

 Tests and diagnosis

Physical exam
To rule out other possible conditions — such as a respiratory infection or chronic obstructive pulmonary disease (COPD) — your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems.

Tests to measure lung function
You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe. These tests may include:

• Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
• Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings.

Lung function tests often are done before and after taking a bronchodilator (brong-koh-DIE-lay-tur), such as albuterol, to open your airways. If your lung function improves with use of a bronchodilator, it's likely you have asthma.

Additional tests
Other tests to diagnose asthma include:

• Methacholine challenge. Methacholine is a known asthma trigger that, when inhaled, will cause mild constriction of your airways. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal.
• Nitric oxide test. This test, though not widely available, measures the amount of the gas, nitric oxide, that you have in your breath. When your airways are inflamed — a sign of asthma — you may have higher than normal nitric oxide levels.
• Imaging tests. A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems.
• Sputum eosinophils. This test looks for certain white blood cells (eosinophils) in the mixture of saliva and mucus (sputum) you discharge during coughing. Eosinophils are present when symptoms develop and become visible when stained with a rose-colored dye (eosin).
• Provocative testing for exercise and cold-induced asthma. In these tests, your doctor measures your airway obstruction before and after you perform vigorous physical activity or take several breaths of cold air.

How asthma is classified
To classify your asthma severity, your doctor considers your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests.

Determining your asthma severity helps your doctor choose the best treatment. Asthma severity often changes over time, requiring treatment adjustments.

Asthma is classified into four general categories:

Asthma classification	Signs and symptoms
Mild intermittent	Mild symptoms up to 2 days a week and up to 2 nights a month
Mild persistent	Symptoms more than twice a week, but no more than once in a single day
Moderate persistent	Symptoms once a day and more than 1 night a week
Severe persistent	Symptoms throughout the day on most days and frequently at night

Treatments and drugs

Prevention and long-term control are key in stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers and taking steps to avoid them, and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler, such as albuterol.

Medications
The right medications for you depend on a number of things, including your age, your symptoms, your asthma triggers and what seems to work best to keep your asthma under control. Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary.

Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you'll have an asthma attack. Types of long-term control medications include:

• Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flonase), budesonide (Pulmicort, Rhinocort), mometasone (Nasonex, Asmanex Twisthaler), ciclesonide (Alvesco, Omnaris), flunisolide (Aerobid, Aerospan HFA), beclomethasone (Qvar, Qnasl) and others. You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively low risk of side effects and are generally safe for long-term use.
• Leukotriene modifiers. These oral medications — including montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo) — help relieve asthma symptoms for up to 24 hours. In rare cases, these medications have been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual reaction.
• Long-acting beta agonists. These inhaled medications, which include salmeterol (Serevent) and formoterol (Foradil, Perforomist), open the airways. Some research shows that they may increase the risk of a severe asthma attack, so take them only in combination with an inhaled corticosteroid. And because these drugs can mask asthma deterioration, don't use them for an acute asthma attack.
• Combination inhalers. These medications — such as fluticasone-salmeterol (Advair Diskus), budesonide-formoterol (Symbicort) and mometasone-formoterol (Dulera) — contain a long-acting beta agonist along with a corticosteroid. Because these combination inhalers contain long-acting beta agonists, they may increase your risk of having a severe asthma attack.
• Theophylline. Theophylline (Theo-24, Elixophyllin, others) is a daily pill that helps keep the airways open (bronchodilator) by relaxing the muscles around the airways. It's not used as often now as in past years.

Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your doctor recommends it. Types of quick-relief medications include:

• Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair). Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer — a machine that converts asthma medications to a fine mist, so they can be inhaled through a face mask or a mouthpiece.
• Ipratropium (Atrovent). Like other bronchodilators, ipratropium acts quickly to immediately relax your airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it's sometimes used to treat asthma attacks.
• Oral and intravenous corticosteroids. These medications — which include prednisone and methylprednisolone — relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so they're used only on a short-term basis to treat severe asthma symptoms.

If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if your long-term control medications are working properly, you shouldn't need to use your quick-relief inhaler very often. Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication.

Allergy medications may help if your asthma is triggered or worsened by allergies. These include:

• Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years.
• Omalizumab (Xolair). This medication, given as an injection every two to four weeks, is specifically for people who have allergies and severe asthma. It acts by altering the immune system.
• Allergy medications. These include oral and nasal spray antihistamines and decongestants as well as corticosteroid and cromolyn nasal sprays.

Bronchial thermoplasty
This treatment — which isn't widely available nor right for everyone — is used for severe asthma that doesn't improve with inhaled corticosteroids or other long-term asthma medications. Generally, over the span of three outpatient visits, bronchial thermoplasty heats the insides of the airways in the lungs with an electrode, reducing the smooth muscle inside the airways. This limits the ability of the airways to tighten, making breathing easier and possibly reducing asthma attacks.

Treat by severity for better control: A stepwise approach
Your treatment should be flexible and based on changes in your symptoms, which should be assessed thoroughly each time you see your doctor. Then, your doctor can adjust your treatment accordingly. For example, if your asthma is well controlled, your doctor may prescribe less medicine. If your asthma isn't well controlled or is getting worse, your doctor may increase your medication and recommend more-frequent visits.

Asthma action plan
Work with your doctor to create an asthma action plan that outlines in writing when to take certain medications, or when to increase or decrease the dose of your medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them.

Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your asthma.

Lifestyle and home remedies

Although many people with asthma rely on medications to prevent and relieve symptoms, you can do several things on your own to maintain your health and lessen the possibility of asthma attacks.

Avoid your triggers
Taking steps to reduce your exposure to things that trigger asthma symptoms is a key part of asthma control. It may help to:

• Use your air conditioner. Air conditioning reduces the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce your exposure to dust mites. If you don't have air conditioning, try to keep your windows closed during pollen season.
• Decontaminate your decor. Minimize dust that may worsen nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses and box springs in dust-proof covers. Remove carpeting and install hardwood or linoleum flooring. Use washable curtains and blinds.
• Maintain optimal humidity. If you live in a damp climate, talk to your doctor about using a dehumidifier.
• Prevent mold spores. Clean damp areas in the bath, kitchen and around the house to keep mold spores from developing. Get rid of moldy leaves or damp firewood in the yard.
• Reduce pet dander. If you're allergic to dander, avoid pets with fur or feathers. Having pets regularly bathed or groomed also may reduce the amount of dander in your surroundings.
• Clean regularly. Clean your home at least once a week. If you're likely to stir up dust, wear a mask or have someone else do the cleaning.
• Cover your nose and mouth if it's cold out. If your asthma is worsened by cold or dry air, wearing a face mask can help.

Stay healthy
Taking care of yourself and treating other conditions linked to asthma will help keep your symptoms under control. For example:

• Get regular exercise. Having asthma doesn't mean you have to be less active. Treatment can prevent asthma attacks and control symptoms during activity. Regular exercise can strengthen your heart and lungs, which helps relieve asthma symptoms. If you exercise in cold temperatures, wear a face mask to warm the air you breathe.
• Maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts you at higher risk of other health problems.
• Eat fruits and vegetables. Eating plenty of fruits and vegetables may increase lung function and reduce asthma symptoms. These foods are rich in protective nutrients (antioxidants) that boost the immune system.
• Control heartburn and gastroesophageal reflux disease (GERD). It's possible that the acid reflux that causes heartburn may damage lung airways and worsen asthma symptoms. If you have frequent or constant heartburn, talk to your doctor about treatment options. You may need treatment for GERD before your asthma symptoms improve

Alternative medicine

Certain alternative treatments may help with asthma symptoms. However, keep in mind that these treatments are not a replacement for medical treatment — especially if you have severe asthma. Talk to your doctor before taking any herbs or supplements, as some may interact with medications you take.

While some alternative remedies are used for asthma, in most cases more research is needed to see how well they work and to measure the extent of possible side effects. Alternative asthma treatments include:

• Breathing techniques. Examples include the Buteyko breathing technique, the Papworth method and yoga breathing. These exercises may reduce the amount of medication you need to keep your asthma symptoms under control. Yoga classes increase fitness and reduce stress, which may help with asthma as well.
• Acupuncture. This technique involves placing very thin needles at strategic points on your body. It's safe and generally painless.
• Relaxation techniques. Techniques such as meditation, biofeedback, hypnosis and progressive muscle relaxation may help with asthma by reducing tension and stress.
• Herbal remedies. A few herbal remedies that may help improve asthma symptoms include butterbur, Indian frankincense and pycnogenol. Blends of different types of herbs are commonly used in traditional Chinese, Indian and Japanese medicine. However, more studies are needed to determine how well herbal remedies and preparations work for asthma.
• Omega-3 fatty acids. Found in fish, flaxseed and other foods, these healthy oils may reduce the inflammation that leads to asthma symptoms.