Daily Archives: April 19, 2016

What is eczema? Eczema causes and treatment … – Patient

Posted: April 19, 2016 at 11:42 am

What is atopic eczema?

Eczema is sometimes called dermatitis which means inflammation of the skin. There are different types of eczema. The most common type is atopic eczema. In this type of eczema there is a typical pattern of skin inflammation which causes the symptoms.

The word atopic describes people with certain allergic tendencies. However, atopic eczema is not just a simple allergic condition. People with atopic eczema have an increased chance of developing other atopic conditions, such as asthma and hay fever.

Typically, inflamed areas of skin tend to flare up from time to time and then tend to settle down. The severity and duration of flare-ups varies from person to person and from time to time in the same person.

Most cases first develop in children under the age of five years. It is unusual to develop atopic eczema for the first time after the age of 20. At the moment, about 1 in 5 schoolchildren have some degree of atopic eczema. However, statistics show that it is becoming more common year on year. In about 2 in 3 cases, by the mid-teenage years, the flare-ups of eczema have either gone completely, or are much less of a problem. However, there is no way of predicting which children will still be affected as adults.

Between 1-5 in 20 adults have atopic eczema.

The cause is not known. The oily (lipid) barrier of the skin tends to be reduced in people with atopic eczema. This leads to an increase in water loss and a tendency towards dry skin. Also, some cells of the immune system release chemicals under the skin surface, which can cause some inflammation. But it is not known why these things occur. Inherited (genetic) factors play a part. Atopic eczema occurs in about 8 in 10 children where both parents have the condition and in about 6 in 10 children where one parent has the condition. The precise genetic cause is not clear (which genes are responsible, what effects they have on the skin, etc). However, recent research suggests that in some people genetic changes hamper the production of a chemical (filaggrin) involved in the defence barrier of the skin.

As mentioned previously, atopic eczema is becoming more common. There is no proven single cause for this but factors which may play a part include:

There may be a combination of factors in someone who is genetically prone to eczema, which causes the drying effect of the skin and the immune system to react and cause inflammation in the skin.

The usual treatment consists of three parts:

Many people with atopic eczema have flare-ups from time to time for no apparent reason. However, some flare-ups may be caused (triggered) or made worse by irritants to the skin, or by other factors. It is commonly advised to:

House dust mite is a tiny insect that occurs in every home. You cannot see it without a microscope. It mainly lives in bedrooms and mattresses as part of the dust. Many people with atopic eczema are allergic to house dust mite. If you are allergic, you have to greatly reduce the numbers of house dust mite for any chance that symptoms may improve.

However, it is impossible to clear house dust mite completely from a home and it is hard work to reduce their number to a level which may be of benefit. It involves regular cleaning and vacuuming with particular attention to your bedroom, mattress and bedclothes.

Therefore, in general, it is not usually advised to do anything about house dust mite - especially if your eczema is mild-to-moderate and can be managed by the usual treatments of emollients and short courses of topical steroids. However, if you have moderate or severe atopic eczema which is difficult to control with the usual treatments, you may wish to consider reducing the number of house dust mites in your home. See separate leaflet called House Dust Mite and Pet Allergy, which gives more details on how to reduce house dust mites.

About 1 in 2 children with atopic eczema have a food allergy which can make symptoms worse. In general, it is young children with severe eczema who may have a food sensitivity as a trigger factor. The most common foods which trigger symptoms in some people include cow's milk, eggs, soya, wheat, fish and nuts.

If you suspect a food is making your child's symptoms worse then see a doctor. You may be asked to keep a diary over 4-6 weeks. The diary aims to record any symptoms and all foods and drink taken. It may help to identify one or more suspect foods. If food allergy is suspected, it should be confirmed by a specialist. They may recommend a diet without this food if the eczema is severe and difficult to control by other means.

Other possible factors which may trigger symptoms, or make symptoms worse, include:

However, some of these may not be avoidable.

See separate leaflet in this series, called Eczema - Triggers and Irritants, for more details.

People with atopic eczema have a tendency for their skin to become dry. Dry skin tends to flare up and become inflamed into patches of eczema. Emollients are lotions, creams, ointments and bath/shower additives which prevent the skin from becoming dry. They oil the skin, keep it supple and moist and help to protect the skin from irritants. This helps to prevent itch and helps to prevent or to reduce the number of eczema flare-ups.

The regular use of emollients is the most important part of the day-to-day treatment for atopic eczema. Your doctor, nurse or pharmacist can advise on the various types and brands available and the ones which may suit you best.

You should apply emollients as often as needed. This may be twice a day, or several times a day if your skin becomes very dry. Some points about emollients include:

Many people with atopic eczema use a range of different emollients. For example, a typical routine for a person with moderately severe atopic eczema might be:

Note: emollients used for eczema tend to be bland and non-perfumed. Occasionally, some people become allergic (sensitised) to an ingredient in an emollient. This can make the skin worse rather than better. If you suspect this, see your doctor for advice. There are many different types of emollients with various ingredients. A switch to a different type will usually sort out this uncommon problem.

Warning: bath additive emollients will coat the bath and make it greasy and slippery. It is best to use a mat and/or grab rails to reduce the risk of slipping. Warn anybody else who may use the bath that it will be slippery.

See separate leaflet called Moisturisers (Emollients) for Eczema for more details.

Topical steroids work by reducing inflammation in the skin. (Steroid medicines that reduce inflammation are sometimes called corticosteroids. They are very different to the anabolic steroids which are used by some bodybuilders and athletes.) Topical steroids are grouped into four categories depending on their strength - mild, moderately potent, potent and very potent. There are various brands and types in each category. For example, hydrocortisone cream 1% is a commonly used steroid cream and is classed as a mild topical steroid. The greater the strength (potency), the more effect it has on reducing inflammation but the greater the risk of side-effects with continued use.

Creams are usually best to treat moist or weeping areas of skin. Ointments are usually best to treat areas of skin which are dry or thickened. Lotions may be useful to treat hairy areas such as the scalp.

As a rule, a course of topical steroid is used when one or more patches of eczema flare up. You should use topical steroids until the flare-up has completely gone and then stop them. In many cases, a course of treatment for 7-14 days is enough to clear a flare-up of eczema. In some cases, a longer course is needed. Many people with atopic eczema require a course of topical steroids every now and then to clear a flare-up. The frequency of flare-ups and the number of times a course of topical steroids is needed can vary greatly from person to person.

It is common practice to use the lowest-strength topical steroid which clears the flare-up. If there is no improvement after 3-7 days, a stronger topical steroid is usually then prescribed. For severe flare-ups a stronger topical steroid may be prescribed from the outset. Sometimes two or more preparations of different strengths are used at the same time. For example, a mild steroid for the face and a stronger steroid for patches of eczema on the thicker skin of the arms or legs.

For adults, a short course (usually three days) of a strong topical steroid may be an option to treat a mild-to-moderate flare-up of eczema. A strong topical steroid often works quicker than a mild one. (This is in contrast to the traditional method of using the lowest strength wherever possible. However, studies have shown that using a high strength for a short period can be more convenient and is thought to be safe.)

Some people have frequent flare-ups of eczema. For example, a flare-up may subside well with topical steroid therapy. But then, within a few weeks, a flare-up returns. In this situation, one option that might help is to apply steroid cream on the usual sites of flare-ups for two days every week. This is often called weekend therapy. This aims to prevent a flare-up from occurring. In the long run, it can mean that the total amount of topical steroid used is less than if each flare-up were treated as and when it occurred. You may wish to discuss this option with your doctor.

Topical steroids are usually applied once a day but this may be increased to twice a day if there is no improvement. Rub a small amount thinly and evenly just on to areas of skin which are inflamed. (This is different to moisturisers (emollients) which should be applied liberally all over.)

To work out how much you should use each dose: squeeze out some cream or ointment from the tube on to the end of an adult finger - from the tip of the finger to the first crease. This is called a fingertip unit. One fingertip unit is enough to treat an area of skin twice the size of the flat of an adult's hand with the fingers together. Gently rub the cream or ointment into the skin until it has disappeared. Then wash your hands (unless your hands are the treated area).

Note: don't forget you can use emollients as well when you are using a course of topical steroids.

See separate leaflet called Fingertip Units for Topical Steroids for more details.

Short courses of topical steroids (fewer than four weeks) are usually safe and normally cause no problems. Problems may develop if topical steroids are used for long periods, or if short courses of strong topical steroids are repeated often. The concern is mainly if strong topical steroids are used in the long term. Side-effects from mild topical steroids are uncommon.

For more details about side-effects see separate leaflet called Topical Steroids for Eczema for more details.

Most people with eczema will be prescribed emollients to use every day and a topical steroid to use when flare-ups develop. When using the two treatments, apply the emollient first. Wait 10-15 minutes after applying an emollient before applying a topical steroid. That is, the emollient should be allowed to sink in (be absorbed) before a topical steroid is applied. The skin should be moist or slightly tacky but not slippery, when applying the steroid.

Sometimes, one or more patches of eczema become infected during a flare-up. Characteristics of infected eczema include:

If the infection becomes more severe, you may also develop a high temperature (fever) and generally feel unwell. If infected eczema develops then a course of an antibiotic tablet or liquid medicine will usually clear the infection. This is used in addition to usual eczema topical treatments. Sometimes, a topical antibiotic is used if the infection is confined to a small area.

Once the infection is cleared, it is best to throw away all your usual creams, ointments and lotions and obtain fresh new supplies. This is to reduce the risk of applying creams, etc that may have become contaminated with germs (bacteria). Also, if you seem to have repeated bouts of infected eczema, you may be advised to use a topical antiseptic such as chlorhexidine on a regular basis. This is in addition to your usual treatments. The aim is to keep the number of bacteria on your skin to a minimum.

See your doctor if a flare-up of atopic eczema is getting worse or not clearing despite the usual treatments with moisturisers (emollients) and topical steroids. Things which may be considered include:

You may be referred to a skin specialist if a flare-up does not improve with the usual treatments.

Alternative remedies such as herbal medicines are sometimes tried by some people. However, you should be cautious about using them, especially if their labels are not in English and you are not sure what they contain. Some herbal treatments are mixed with steroids and some (particularly Chinese remedies) have been linked to liver damage.

It may be worth breast-feeding a newborn baby for three months or more if several members of the family suffer from allergies such as eczema, hay fever or asthma. There is, however, no evidence to suggest that the mother should avoid any particular foods during pregnancy or breast-feeding.

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What is eczema? Eczema causes and treatment ... - Patient

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Eczema – symptoms, diagnosis and treatment – WebMD Boots

Posted: at 11:42 am

What are the symptoms of eczema?

In some cases itchy, dry and red skin from eczema can be present all of the time, or may appear or become worse during a flare-up.

Eczema symptoms include:

To diagnose eczema, your GP will first talk to you about your symptoms and medical history. He or she will also ask about your family's history of rashes and other allergy-related medical conditions, such as asthma and hayfever. While there is no single test to effectively diagnose eczema, a good medical history combined with an examination of your skin is usually adequate.

Good skin care is a key component in controlling eczema. Appropriate care of the skin can often be enough in many milder cases.

In treating eczema, most doctors will start patients on basic therapies. A good moisturiser (in cream, lotion or ointment form) helps conserve the skin's natural moisture and should be applied immediately after showering or bathing and at least one other time each day. It is also a useful technique to apply them little and often and not vigorously rub them in. They should be applied following the line of the hairs on the skin.

Corticosteroid creams and ointments have been used for many years to treat eczema. Your GP may recommend application of over-the-counter hydrocortisone cream in mild cases but will often prescribe a stronger steroid cream when the eczema is more severe. When other measures fail, the doctor may prescribe oral corticosteroid medication; steroids should always be taken with caution and never without medical supervision. Antihistamines are sometimes used to help relieve itching. If strong topical steroids, oral steroids, antihistamines and loads of applications of emollients dont work, a referral to a dermatologist may be needed.

Newer medicines called topical immunomodulators are available to help treat eczema. These medicines help control inflammation and reduce Newer drugs called topical immunomodulators are available to help treat eczema. These drugs help control inflammation and reduce immune system reactions when applied to the skin. Examples include pimecrolimus and tacrolimus. These drug are thought to be as effective as topical corticosteroids. They are usually considered when other treatments have not been effective.

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Eczema - symptoms, diagnosis and treatment - WebMD Boots

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Ron Paul The Washington Post

Posted: at 11:41 am

Rep. Ron Paul entered the 2012 presidential campaign in April, making it his third run for the White House. When he ran for president in 2008, he lost every single Republican primary. For nearly a decade, he wasnt even a member of the GOP.

But a combination of timing, technology and four decades of political activism on the conservative fringe have turned Paul into a sort of icon with an activist networking and a fundraising list that puts those of his colleagues to shame. In July 2011, Paul announced he would not seek reelection in 2012 regardless of the outcome of the presidential race.

Current Position: U.S. Representative (since January 1997)

Career History: U.S. House (1997 to present); Libertarian Party presidential nominee (1987 to 1988); U.S. House (1976, 1979 to 1985); Ob/Gyn (1968 to 1996)

Birthday: August 20, 1935

Hometown: Green Tree, Penn.

Alma Mater: Gettysburg College, BA, 1957; Duke University, Md., 1961

Spouse: Carol

Religion: Protestant

DC Office: 329 Cannon Building, Washington DC, 20510, 202-225-2831

District Offices: Galveston, 409-766-7013; Lake Jackson, 979-285-0231; Victoria, 361-576-1231

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Lynchburg, Virginia – Wikipedia, the free encyclopedia

Posted: at 7:44 am

Lynchburg is an independent city in the Commonwealth of Virginia. As of the 2010 census, the population was 75,568. The 2014 census estimates an increase to 79,047.[2] Located in the foothills of the Blue Ridge Mountains along the banks of the James River, Lynchburg is known as the "City of Seven Hills" or the "Hill City".[3] Lynchburg was the only major city in Virginia that was not captured by the Union before the end of the American Civil War.[4]

Lynchburg is the principal city of the Metropolitan Statistical Area of Lynchburg, near the geographic center of Virginia. It is the fifth largest MSA in Virginia with a population of 254,171[5] and hosts several institutions of higher education. Other nearby cities include Roanoke, Charlottesville, and Danville. Lynchburg's sister cities are Rueil-Malmaison, France and Glauchau, Germany.

A part of Monacan country upon the arrival of English settlers in Virginia, the region had traditionally been occupied by them and other Siouan Tutelo-speaking tribes since ca. 1270, driving Virginia Algonquians eastward. Explorer John Lederer visited one of the Siouan villages (Saponi) in 1670, on the Staunton River at Otter Creek, southwest of the present-day city, as did Batts and Fallam in 1671. The Siouans occupied the area until c. 1702, when it was taken in conquest by the Seneca Iroquois. The Iroquois ceded control to the Colony of Virginia beginning in 1718, and formally at the Treaty of Albany in 1721.

First settled in 1757, Lynchburg was named for its founder, John Lynch, who at the age of 17 started a ferry service at a ford across the James River to carry traffic to and from New London. He was also responsible for Lynchburg's first bridge across the river, which replaced the ferry in 1812. He and his mother are buried in the graveyard at the South River Friends Meetinghouse. The "City of Seven Hills" quickly developed along the hills surrounding Lynch's Ferry. Thomas Jefferson maintained a home near Lynchburg, called Poplar Forest. Jefferson frequented Lynchburg and remarked "Nothing would give me greater pleasure than to be useful to the town of Lynchburg. I consider it as the most interesting spot in the state."

Lynchburg was established by charter in 1786 at the site of Lynch's Ferry on the James River. These new easy means of transportation routed traffic through Lynchburg, and allowed it to become the new center of commerce for tobacco trading. In 1810, Jefferson wrote, "Lynchburg is perhaps the most rising place in the U.S.... It ranks now next to Richmond in importance..." Lynchburg became a center of commerce and manufacture in the 19th century, and by the 1850s, Lynchburg (along with New Bedford, Mass.) was one of the richest towns per capita in the U.S.[6] Chief industries were tobacco, iron and steel. Transportation facilities included the James River Bateau on the James River, and later, the James River and Kanawha Canal and, still later, four railroads, including the Virginia and Tennessee Railroad and the Norfolk and Petersburg Railroad.

Early on, Lynchburg was not known for its religiosity. In 1804, evangelist Lorenzo Dow wrote of Lynchburg "... where I spoke in the open air in what I conceived to be the seat of Satan's Kingdom. Lynchburg was a deadly place for the worship of God." This was in reference to the lack of churches in Lynchburg. As the wealth of Lynchburg grew, prostitution and other "rowdy" activities became quite common and, in many cases, ignored, if not accepted, by the "powers that be" of the time. Much of this activity took place in an area of downtown referred to as the "Buzzard's Roost[citation needed]."

During the American Civil War, Lynchburg, which served as a Confederate supply base, was approached within 1-mile (1.6km) by the Union forces of General David Hunter as he drove south from the Shenandoah Valley. Under the false impression that the Confederate forces stationed in Lynchburg were much larger than anticipated, Hunter was repelled by the forces of Confederate General Jubal Early on June 18, 1864, in the Battle of Lynchburg. To create the false impression, a train was continuously run up and down the tracks while the citizens of Lynchburg cheered as if reinforcements were unloading. Local prostitutes took part in the deception, misinforming their Union clients of the large number of Confederate reinforcements.

From April 610, 1865, Lynchburg served as the Capital of Virginia. Under Governor William Smith, the executive and legislative branches of the commonwealth escaped to Lynchburg with the fall of Richmond. Then Gen. Robert E. Lee surrendered to Gen. Ulysses S. Grant at Appomattox Courthouse, roughly 20 miles east of Lynchburg, ending the Civil War.

In the latter 19th century, Lynchburg's economy evolved into manufacturing (sometimes referred to as the "Pittsburgh of the South") and, per capita, made the city one of the wealthiest in the United States. In 1880, Lynchburg resident James Albert Bonsack invented the first cigarette rolling machine. Shortly thereafter Dr. Charles Browne Fleet, a physician and pharmacological tinkerer, introduced the first mass marketed over-the-counter enema. About this time, Lynchburg was also the preferred site for the Norfolk & Western junction with the Shenandoah Valley Railroad. However, the citizens of Lynchburg did not want the junction due to the noise and pollution it would create. Therefore, it was located in what would become the City of Roanoke.

In the late 1950s, a number of interested citizens, including Virginia Senator Mosby G. Perrow, Jr., requested the federal government to change its long-planned route for the interstate highway now known as I-64 between Clifton Forge and Richmond.[7] Since the 1940s, maps of the federal interstate highway system depicted that highway taking a northern route, with no interstate highway running through Lynchburg, but the federal government assured Virginia that the highway's route would be decided by the state.[8] A proposed southern route called for the Interstate to follow from Richmond via US-360 and US-460, via Lynchburg to Roanoke and US-220 from Roanoke to Clifton Forge, then west following US-60 into West Virginia. Although the State Highway Commission's minutes reflected its initial approval of the northern route, the issue remained in play,[9] proponents of the southern route ultimately succeeded in persuading a majority of Virginia Highway Commissioners to support the change after a study championed by Perrow demonstrated that it would serve a greater percentage of the state's manufacturing and textile centers. But in July 1961 Governor Lindsay Almond and U.S. Secretary of Commerce Luther Hodges announced that the route would not be changed.[10] This left Lynchburg as the only city with a population in excess of 50,000 (at the time) not served by an interstate.[11]

For several decades throughout the mid-20th century, the state of Virginia authorized compulsory sterilization of the mentally retarded for the purpose of eugenics. The operations were carried out at the Virginia State Colony for Epileptics and Feebleminded, now known as the Central Virginia Training School, located just outside Lynchburg in Madison Heights. An estimated 8,300 Virginians were sterilized and relocated to Lynchburg, known as a "dumping groun
d" of sorts for the feeble-minded, poor, blind, epileptic, and those otherwise seen as genetically "unfit".[12]

Sterilizations were carried out for 35 years until 1972, when operations were finally halted. Later in the late 1970s, the American Civil Liberties Union filed a class-action lawsuit against the state of Virginia on behalf of the sterilization victims. As a result of this suit, the victims received formal apologies and counseling if they chose. Requests to grant the victims reverse sterilization operations were denied.

Carrie Buck, the plaintiff in the United States Supreme Court case Buck v. Bell, was sterilized after being classified as "feeble-minded", as part of the state's eugenics program while she was a patient at the Lynchburg Colony for Epileptics and Feebleminded.

The story of Carrie Buck's sterilization and the court case was made into a television drama in 1994, Against Her Will: The Carrie Buck Story.

"Virginia State Epileptic Colony," a song by the Manic Street Preachers on their 2009 album 'Journal For Plague Lovers,' addresses the state's program of eugenics.

Downtown Lynchburg has seen a significant amount of revitalization since 2002 with hundreds of new loft apartments created through adaptive reuse of historic warehouses and mills. Since 2000, there has been more than $110 million in private investment in downtown and business activity increased by 205% from 2004 - 2014.[13] In 2014, 75 new apartments were added to downtown with 155 further units under construction increasing the number of housing units downtown by 48% from 2010 - 2014.[14] In 2015, the $5.8 million Lower Bluffwalk pedestrian street zone opened to the public in downtown which has seen a significant amount of residential and commercial development around the zone in recent years.[15] Notable projects underway in downtown by the end of 2015 include the $25 million Hilton Curio branded Virginian Hotel restoration project, $16.6 million restoration of the Academy Center of the Arts, and $4.6 million expansion of Amazement Square Children's Museum. [16][17][18][19]

Over 40 sites in Lynchburg are listed on the National Register of Historic Places.[20]

Lynchburg is located at 372413N 791012W / 37.40361N 79.17000W / 37.40361; -79.17000 (37.403672, 79.170205).

According to the United States Census Bureau, the city has a total area of 49.6 square miles (128.5km2), of which 49.2 square miles (127.4km2) is land and 0.5 square miles (1.3km2) (1.0%) is water.[21]

Lynchburg has a four-season humid subtropical climate (Kppen Cfa), with cool winters and hot, humid summers. The monthly daily average temperature ranges from 35.1F (1.7C) in January to 75.3F (24.1C) in July. Nights tend to be significantly cooler than days throughout much of the year due in part to the moderate elevation. In a typical year, there are 26 days with a high temperature 90F (32C) or above, and 7.5 days with a high of 32F (0C) or below.[22] Snowfall averages 12.9 inches (33cm) per season but this amount varies highly with each winter; the snowiest winter is 199596 with 56.8in (144cm) of snow, but the following winter recorded only trace amounts, the least on record.[23]

Temperature extremes range from 106F (41C), recorded on July 10, 1936, down to 11F (24C), recorded on February 20, 2015.[22] However, several decades may pass between 100F (38C) and 0F (18C) readings, with the last such occurrences being July 8, 2012 and February 20, 2015, respectively.[22]

As of the 2010 census,[31] there were 75,568 people, 25,477 households, and 31,992 families residing in the city. The population density was 1,321.5 people per square mile (510.2/km). There were 27,640 housing units at an average density of 559.6 per square mile (216.1/km). The racial makeup of the city was 63.0% White, 29.3% African American, 0.2% Native American, 2.5% Asian, 0.04% Pacific Islander, 0.63% from other races, and 1.7% from two or more races. Hispanic or Latino of any race were 3.0% of the population.

There were 25,477 households out of which 27.8% had children under the age of 18 living with them, 41.6% were married couples living together, 16.0% had a female householder with no husband present, and 38.8% were non-families. 32.7% of all households were made up of individuals and 12.9% had someone living alone who was 65 years of age or older. The average household size was 2.30 and the average family size was 2.92.

The age distribution of the city had: 22.1% under the age of 18, 15.5% from 18 to 24, 25.3% from 25 to 44, 20.8% from 45 to 64, and 16.3% who were 65 years of age or older. The median age was 35 years. For every 100 females there were 84.2 males. For every 100 females age 18 and over, there were 79.1 males.

The median income for a household in the city was $32,234, and the median income for a family was $40,844. Males had a median income of $31,390 versus $22,431 for females. The per capita income for the city was $18,263. About 12.3% of families and 15.9% of the population were below the poverty line, including 22.4% of those under age 18 and 10.7% of those age 65 or over.

Lynchburg ranks below the 2006 median annual household income for the U.S. as a whole, which was $48,200, according to the US Census Bureau.[32]

The city's population was stable for 25+ years: in 2006, it was 67,720; in 2000, it was 65,269; in 1990, it was 66,049; in 1980, it was 66,743.[33]

In 2009 almost 27% of Lynchburg children lived in poverty. The state average that year was 14 percent.[34]

Lynchburg features a skilled labor force, low unemployment rate,[35] and below average cost of living. Of Virginia's larger metro areas, Forbes Magazine ranked Lynchburg the 5th best place in Virginia for business in 2006, with Virginia being the best state in the country for business.[36] Only 6 places in Virginia were surveyed and most of Virginia's cities were grouped together by Forbes as "Northern Virginia". Lynchburg achieved the rank 109 in the whole nation in the same survey.

Industries within the Lynchburg MSA include nuclear technology, pharmaceuticals and material handling. A diversity of small businesses with the region has helped maintain a stable economy and minimized the downturns of the national economy.[37][38] Reaching as high as 1st place (tied) in 2007, Lynchburg has been within the Top 10 Digital Cities survey for its population since the survey's inception in 2004.

The Lynchburg News & Advance reports that while more people are working than ever in greater Lynchburg, wages since 1990 have not kept up with inflation. Central Virginia Labor Council President Walter Fore believes this is due to lack of white-collar jobs. According to the Census Bureau, adjusted for inflation, 1990 median household income was about $39,000 compared to 2009 median household income of $42,740. As of 2009 Forbes has named Lynchburg as the 70th best metro area for business and careers, ahead of Chicago and behind Baton Rouge. The reason for the decent ranking was due to the low cost of living and low wages in Lynchburg. In other areas, the region didn't come in as strong. It ranked at 189 for cultural and leisure and at 164 for educational attainment.[39]

Virginia Busin
ess Magazine reports that Young Professionals in Lynchburg recently conducted a study that clearly showed how much of its young workforce has been lost.[40]

According to Lynchburg's 2012 Comprehensive Annual Financial Report,[41] the top private employers in the city are:

The city is served by the Lynchburg City Public Schools. The school board is appointed by the Lynchburg City Council.

The city is also home to a number of mostly religious private schools, including Holy Cross Regional Catholic School, James River Day School, Liberty Christian Academy, New Covenant Classical Christian School, Appomattox Christian Academy, Temple Christian School, and Virginia Episcopal School.

Lynchburg is also home to the Central Virginia Governor's School for Science and Technology located in Heritage High School. This magnet school consists of juniors and seniors selected from each of the Lynchburg area high schools. As one of eighteen Governor's Schools in Virginia, the Central Virginia Governor's School focuses on infusing technology into both the math and science curriculum.

Further education options include a number of surrounding county public school systems.

Colleges and universities in Lynchburg include Central Virginia Community College, Liberty University, Lynchburg College, Randolph College, Sweet Briar College, and Virginia University of Lynchburg.

The Greater Lynchburg Transit Company (GLTC) operates the local public transport bus service within the city. The GLTC additionally provides the shuttle bus service on the Liberty University campus.

The GLTC has selected a property directly across from Lynchburg-Kemper Street Station as its top choice of sites upon which to build the new transfer center for their network of public buses. They are interested in facilitating intermodal connections between GLTC buses and the intercity bus and rail services which operate from that location. The project is awaiting final government approval and funding, and is expected to be completed around 2013.[42]

Intercity passenger rail and bus services are based out of Kemper Street Station, a historic, three-story train station recently restored and converted by the city of Lynchburg to serve as an intermodal hub for the community. The station is located at 825 Kemper Street.[43]

Greyhound Lines located their bus terminal in the main floor of Kemper Street Station following its 2002 restoration.[43] Greyhound offers transport to other cities throughout Virginia, the US, Canada, and Mexico.

Amtrak's long distance Crescent and a Northeast Regional connect Lynchburg with Boston, New York, Philadelphia, Baltimore, Washington, Charlotte, Atlanta, Birmingham, New Orleans and intermediate points.

In October 2009, Lynchburg became the southern terminus for a Northeast Regional that previously had overnighted in Washington. The forecast ridership was 51,000 for the 180-mile extension's first year, but the actual count was triple that estimate, and the train paid for itself without any subsidy.[44] By FY 2015, the Regional had 190,000 riders. The Lynchburg station alone served a total of 85,000 riders in 2015. It is located in the track level ground floor of Kemper Street Station.[45]

Lynchburg has two major freight railroads. It is the crossroads of two Norfolk Southern lines. One is the former mainline of the Southern Railway, upon which Kemper Street Station is situated. NS has a classification yard located next to the shopping mall. Various yard jobs can be seen. Railfans who wish to visit the NS Lynchburg yard are advised to inquire with an NS official. CSX Transportation also has a line through the city and a small yard.

Lynchburg Regional Airport is solely served by American Eagle to Charlotte. American Eagle, a subsidiary of American Airlines, is the only current scheduled airline service provider, with seven daily arrivals and departures. In recent years air travel has increased with 157,517 passengers flying in and out of the airport in 2012, representing 78% of the total aircraft load factor for that time period.

Primary roadways include U.S. Route 29, U.S. Route 501, U.S. Route 221, running north-south, and U.S. Highway 460, running east-west. While not served by an interstate, much of Route 29 has been upgraded to interstate standards and significant improvements have been made to Highway 460.

In a Forbes magazine survey, Lynchburg ranked 189 for cultural and leisure out of 200 cities surveyed.[39]

The following attractions are located within the Lynchburg MSA:

Lynchburg is home to sporting events and organizations including:

The first neighborhoods of Lynchburg developed upon seven hills adjacent to the original ferry landing. These neighborhoods include:

Other major neighborhoods include Boonsboro, Rivermont, Fairview Heights, Fort Hill, Forest Hill (Old Forest Rd. Area), Timberlake, Windsor Hills, Sandusky, Linkhorne, and Wyndhurst.

Notable residents of Lynchburg include:

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Lynchburg, Virginia - Wikipedia, the free encyclopedia

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