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Attention deficit hyperactivity disorder
ADHD Guidelines
The American Academy of Pediatrics (AAP) has issued guidelines for diagnosis and treatment of ADHD in children. The recommendations include:
- ADHD should be recognized and treated as a chronic illness that can last through adolescence and into adulthood.
- Children as young as 4 years old and as old as 18 years old can be diagnosed with ADHD.
- ADHD should be diagnosed based onbehavioral problems that occur both at home and at school. Symptoms should have lasted for at least 6 months for older children, and at least 9 months for preschoolers (children ages 4 - 5 years old).
- For preschoolers, behavioral therapy should be the first treatment. If behavioral methods don't work, the stimulant drug methylphenidate (Ritalin, generic) may be prescribed in some cases. For older children, a combination of medication and behavioral therapy is recommended.
ADHD Drugs and Heart Risks
All ADHD stimulant drugs, and atomoxetine (Strattera), have warnings on their prescription labels that they should not be used by patients with structural heart problems or pre-existing heart conditions (high blood pressure, heart failure, heart rhythm disturbances, or congenital heart disease). Methylphenidate (Ritalin, generic) is the most commonly prescribed stimulant drug for treating ADHD.
Drug Approval
In 2012, the FDA approved a liquid form of methylphenidate (Quillivant XR) for patients age 6 and older who may have difficulty swallowing pills.
Long-Term Effects of ADHD
ADHD can have serious consequences for long-term functioning according to a study that tracked more than 500 teenagers with ADHD from when they were 14 – 16 years old until they reached age 37. The researchers found that long-term ADHD increased the risks for impaired physical and mental health, poor work performance, and financial stress. The study team suggests that doctors focus on early diagnosis and treatment of adolescent ADHD.
Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder generally characterized by the following symptoms:
- Inattention
- Distractibility
- Impulsivity
- Hyperactivity
Types of ADHD
ADHD is classified into three subtypes:
- Predominantly Hyperactive-Impulsive Type. Behavior marked by hyperactivity and impulsivity, but not inattentiveness
- Predominantly Inattentive Type. Behavior marked by inattentiveness, but not hyperactivity and impulsivity
- Combination Type. A combination of hyperactivity/impulsivity and inattentive symptoms. This is the most common type of ADHD.
Childhood ADHD
In the United States, more than 5 million children under age 18 have been diagnosedwith ADHD at some time in their lives. This accounts for about 8% of all American children in this age range. Symptoms of ADHD usually become apparent at a young age. According to the American Academy of Pediatrics, ADHD symptoms can first emerge in children as young as age four.
ADHD is sometimes described as impairing the "executive functions" of the brain. Executive functioning refers to the cognitive abilities necessary to plan, organize, and carry out tasks. Executive function deficits can cause the following problems:
- Inability to hold information in short-term memory
- Impaired organization and planning skills
- Difficulty in establishing and using goals to guide behavior, such as selecting strategies and monitoring tasks
- Inability to keep emotions from becoming overpowering
- Inability to shift efficiently from one mental activity to another
Hyperactivity. The term hyperactive is often confusing since it may suggest a child racing around non-stop. A boy with ADHD playing a game, for instance, may have the same level of activity as another child without the syndrome. But when a high demand is placed on the child's attention, his brain motor activity intensifies beyond the levels of the other children. In a busy environment, such as a classroom or a crowded store, children with ADHD often become distracted and react by pulling items off the shelves, hitting people, or spinning out of control into erratic, silly, or strange behavior.
Impulsivity and Temper Explosions. Temper tantrums, which are normal in young children, are usually exaggerated and not necessarily linked to a specific negative event in children with ADHD.
Attention and Concentration. Children with ADHD are usually distracted and made inattentive by an overstimulating environment (such as a large classroom). They are also inattentive when a situation is low-key or dull. In contrast, they may exhibit a kind of "super concentration" to a highly stimulating activity (such as a video game or a highly specific interest). Such children may even become over-attentive -- so absorbed in a project that they cannot modify or change the direction of their attention.
Impaired Short-Term Memory. An important feature in ADHD, as well as in learning disabilities, is an impaired working (also called short-term) memory. People with ADHD can't hold groups of sentences and images in their mind long enough to extract organized thoughts. They are not necessarily inattentive. Instead, a person with ADHD may be unable to remember a full explanation (such as a homework assignment), or be unable to complete processes that require remembering sequences, such as model building. In general, children with ADHD are often attracted to activities (television, computer games, or active individual sports) that do not tax the working memory, or produce distractions. Children with ADHD have no differences in long-term memory compared with other children.
Inability to Manage Time. Children with ADHD may have difficulties being on time and planning the correct amount of time to complete tasks. (This may coincide with short-term memory problems.)
Lack of Adaptability. Children with ADHD often have a very difficult time adapting to even minor changes in routines, such as getting up in the morning, putting on shoes, eating new foods, or going to bed. Any shift in a situation cantrigger a strong and noisy negative response. Even when they are in a good mood, they may suddenly shift into a tantrum if met with an unexpected change or frustration. These children can closely focus their attention when directly cued to a specific location, but they have difficulty shifting their attention to an alternative location.
Hypersensitivity and Sleep Problems. Children with ADHD are often hypersensitive to sights, sounds, and touch. They may complain excessively about stimuli that seem low key or bland to others. Many children with ADHD have trouble sleeping through the night.
Adult ADHD
ADHD is a chronic condition that begins in childhood and often persists into adulthood. Adult ADHD is a continuation of childhood ADHD symptoms.
Accompanying Mental Health Disorders. About 20% of adults with ADHD also have major depression or bipolar disorder. Up to 50% have an anxiety disorder. Bipolar disorder plus ADHD can be very difficult to differentiate from ADHD alone in adults, as well as in children.
Accompanying Learning Disorders. About 20% of adults with ADHD have learning disorders, usually dyslexia and auditory processing problems.
Effect on Work. Compared to adults without ADHD, those with the condition tend to reach lower educational levels, earn less money, and be fired more often. They may also be more likely to be self-employed.
Substance Abuse. About 1 in 5 adults with ADHD also contend with substance abuse. Studies indicate that adolescents with ADHD are twice as likely to smoke cigarettes as their peers who do not have ADHD. Cigarette smoking during adolescence is a risk factor for the development of substance abuse in adulthood.
Brain Structure
Research using advanced imaging techniques shows there is a difference in the size of certain parts of the brain in children with ADHD compared to children who do not have ADHD. The areas showing change include the prefrontal cortex, the caudate nucleus and globus pallidus, and the cerebellum.
Brain Chemicals
Abnormal activity of certain brain chemicals in the prefrontal cortex may contribute to ADHD. The chemicals dopamine and norepinephrine are of special interest. Dopamine and norepinephrine are neurotransmitters (chemical messengers in the brain) that affect both mental and emotional functioning. They also play a role in the "reward response." This response occurs when a person experiences pleasure in response to certain stimuli (such as food or love). Studies suggest that increased levels of the brain chemicals glutamate, glutamine, and GABA -- collectively called Glx -- interact with the pathways that transport dopamine and norepinephrine.
Genetic Factors
Genetic factors most likely play a role in ADHD. The relatives of ADHD children (both boys and girls) have much higher rates of ADHD, antisocial, mood, anxiety, and substance abuse disorders than the families of non-ADHD children. Some twin studies report that up to 90% of children with a diagnosis of ADHD shared it with their twin.
Most of the research on the underlying genetic mechanisms targets the neurotransmitter dopamine. Variations in genes that regulate specific dopamine receptors have been identified in a high proportion of people with addictions and ADHD.
Risk Factors
Gender and ADHD
ADHD is diagnosed more often in boys than in girls. Boys are more likely to have the combined type of ADHD. Girls are more likely to have the predominantly inattentive type.
Family History
ADHD tends to run in families. A child who has a parent or sibling with ADHD has an increased risk of also developing ADHD.
Environmental Factors
Some research suggests that maternal alcohol use, drug abuse, and cigarette smoking during pregnancy may lead to the development of ADHD in the child. Low birth weight has been possibly linked to ADHD. Environmental lead exposure before age 6 may also raise the risk for ADHD.
Dietary Factors
Several dietary factors have been researched in association with ADHD, including sensitivities to certain food chemicals, deficiencies in fatty acids (compounds that make up fats and oils) and zinc, and sensitivity to sugar. No clear evidence has emerged, however, that implicates any of these nutritional factors as risk factors for developing ADHD.
Diagnosing ADHD in Children
There is no single test to diagnose ADHD. The doctor will do a physical exam of the child to make sure that no underlying condition, such as a hearing or vision problem, is causing ADHD-like symptoms. Still, a diagnosis of ADHD is based primarily on observations and reports of a child's behavior patterns. Your child's pediatrician may also refer you to a mental health professional who is experienced in childhood disorders such as ADHD.
History of Behavior. The doctor will ask for a detailed history of the child's behavior. Parents should describe specific problems encountered during the child's development, family history of ADHD, and any recent life changes that may have affected the child. The doctor will inquire about your child's behavior at school and other settings outsidethe home. Written reports from teachers, school counselors, or other caretakers involved with the child provide additional important observations.
Physical Exam. A physical exam should include a hearing test to rule out any hearing problems. The doctor will inquire about history of medical problems, including allergies, sleep disturbances, poor vision, or chronic ear infections.
Diagnostic Criteria. The American Psychiatric Association (APA) has specific criteria that must be met for a diagnosis of ADHD. These symptoms should have occurred in two or more settings (home and school) and not be due to a learning disability or another mental health disorder (such as bipolar disorder, depression, anxiety, andschizophrenia). The symptoms must significantly impair the child's ability to function in academic or social settings. These diagnostic criteria evaluate symptoms in comparison to what is considered normal for a child's developmental level.
For a diagnosis of ADHD, at least six of the following symptoms should have been present for at least 6 months (or 9 months in preschoolers).
Symptoms of Inattention (at least six must be present):
- Often fails to give close attention to detail or makes careless mistakes
- Often has difficulty sustaining attention in tasks or play
- Often does not seem to listen when spoken to directly
- Often does not follow through and fails to finish tasks
- Has difficulty organizing tasks and activities
- Avoids or dislikes tasks requiring sustained mental effort
- Often loses things necessary for tasks or activities
- Is often easily distracted by extraneous stimuli
- Is often forgetful in daily activities
Symptoms of Hyperactivity and Impulsivity (at least six must be present):
- Often fidgets or squirms when sitting
- Has difficulty remaining seated when required to do so
- Often runs about or climbs excessively in inappropriate situations
- Has difficulty playing quietly
- Is often "on the go"
- Often talks excessively
- Often blurts out answers to questions before they have been completed
- Has difficulty waiting for his or her turn
- Often interrupts or intrudes on others
Based on these symptoms, a child may be diagnosed with predominantly inattentive type ADHD, predominantly hyperactive-impulsive type ADHD, or combination type ADHD.
Diagnosing ADHD in Adults
Childhood ADHD can affect children ages 4 - 18. ADHD in adults always occurs as a continuation of childhood ADHD. Symptoms that begin in adulthood are due to factors other than ADHD.
ADHD in adults can be difficult to diagnose. The doctor will inquire about childhood history of ADHD or ADHD-type symptoms. The patient may be asked to provide school records or information from parents or former teachers. The doctor will ask the patients about these types of symptoms:
- Inattention and memory problems. (Losing or forgetting things, being absent-minded, not finishing things, misjudging time, depending on others for order, having trouble getting started, changing jobs or projects midway)
- Hyperactivity and restlessness. (Always being on the go, fidgety, easily bored, taking risks, liking active and fast paced jobs and activities)
- Impulsivity and emotional instability. (Saying things without thinking first, interrupting others, being annoying to others, easily frustrated, easily angered, having unpredictable moods, driving recklessly, having high relationship and job turnover)
- Problems with self-worth. (Avoids new challenges, appears confident to others but not to self)
ADHD can pose challenges for children and their families.
Emotional Problems
Children with ADHD, especially those who also have anxiety or depression disorders, are likely to suffer from low self-esteem.
Social Problems
ADHD can affect children's relationships with their peers. Children with ADHD can have difficulty with social skills and appropriate behavior, which can lead to bullying (both as victim and perpetrator) and rejection. Impulsivity and aggression can provoke fights and volatile relationships. Children with ADHD and high levels of aggression may be at higher risk for delinquent behavior in adolescence and criminal activity in adulthood.
Risk of Injury
Impulsivity in young people with ADHD can cause them to take chances without considering the consequences. Children with ADHD are at increased risk for accidents and injuries. For example, a child with ADHD may not check for oncoming traffic while bicycling or may engage in high-risk physical activities.
Substance Abuse
Studies consistently report that young people with ADHD -- in particular those with conduct or mood disorders -- have a higher than average risk for substance abuse and that it starts in younger ages. In one study, by age 11 nearly 20% of children with ADHD had tried smoking cigarettes, drinking alcohol, or both. Biologic factors associated with ADHD may make these individuals susceptible to substance abuse. Many of these young people may actually be self-medicating their condition.
Learning Problems
Although speech and learning disorders are common in children with ADHD, the disorder does not affect intelligence. People with ADHD span the same IQ range as the general population.
Many children with ADHD are underachievers, and half are held back in school at least once. Some evidence suggests that inattention may be a major factor in low academic performance in these children. Reading difficulties and handwriting problems can also pose challenges.
Low academic achievement can affect a child's self-esteem and self-confidence, and contribute to teasing and other social problems with peers.
Effect on Family
The time and attention needed to deal with a child with ADHD can change internal family relationships and create conflicts with parents and siblings.
Problems in Adulthood
ADHD is very often a chronic condition. According to the American Academy of Child and Adolescent Psychiatry, about 30 – 65 percent of children with ADHD continue to experience symptoms through adolescence and into adulthood. ADHD can cause many problems in adulthood including impaired physical and mental health, poor work performance, and financial stress.
Other Disorders Associated with ADHD
Several disorders may mimic or accompany ADHD. Many of these conditions require other modes of treatment and should be diagnosed separately, even if they accompany ADHD.
Oppositional-Defiant Disorder
Oppositional-defiant disorder (ODD) is often associated with ADHD. The most common symptom for this disorder is a pattern of negative, defiant, and hostile behavior toward authority figures that lasts more than 6 months. In addition to displaying inattentive and impulsive behavior, these children demonstrate aggression, have frequent temper tantrums, and display antisocial behavior. A significant number of children with ODD also have anxiety disorders and depression, which should be treated separately. Many children who develop ODD at an early age go on to develop conduct disorder.
Conduct Disorder
Some children with ADHD also have conduct disorder, which describes a complex group of behavioral and emotional disturbances. It includes aggression towards people and animals, destruction of property, deceitfulness and lying, stealing, and general violation of rules.
Pervasive Developmental Disorder
Pervasive developmental disorder (PDD) is rare and usually marked by autistic-type behavior, hand-flapping, repetitive statements, slow social development, and speech and motor problems. If a child who has been diagnosed with ADHD does not respond to treatment, the parents might inquire about PDD, which often responds to antidepressants. Some children with PDD may also benefit from stimulant medications.
Auditory Processing Disorder and Hearing Problems
Hearing problems may mimic ADHD symptoms and should be evaluated during diagnosis. Auditory processing disorder (APD) is another condition that can affect children's ability to process spoken information. Children with ADP have normal hearing, but something in their brain prevents them from filtering out background noise and distinguishing between similar sounds. APD may be misdiagnosed as ADHD and the two conditions can also occur together.
Bipolar Disorder
Children diagnosed with attention-deficit disorder may also have bipolar disorder. Bipolar disorder is marked by episodes of depression and mania (with symptoms of irritability, rapid speech, and disconnected thoughts). Both disorders often cause inattention and distractibility and may be difficult to distinguish from one another, particularly in children. In some cases, ADHD in children or adolescents may be a marker for an emerging bipolar disorder. [For more information, see In-Depth Report #66: Bipolar disorder.]
Anxiety Disorders
Anxiety disorders often accompany ADHD. Obsessive-compulsive disorder is a specific anxiety disorder that shares many characteristics with ADHD and may share a genetic component. Young children who have experienced traumatic events (including sexual or physical abuse or neglect) may exhibit characteristics of ADHD including impulsivity, emotional outbursts, and oppositional behavior. [For more information, see In-Depth Report #28: Anxiety Disorders.]
Sleep Disorders
Sleep disorders or disturbances are often associated with ADHD. Insomnia is common -- as are restless legs syndrome and sleep apnea (sleep-disordered breathing. [For more information, see In-Depth Reports #27: Insomnia; #95: Restless legs syndrome; #65: Sleep apnea.]
Other Conditions
Tourette Syndrome and Other Genetic Disorders. Several genetic disorders cause symptoms resembling ADHD, including fragile X and Tourette syndrome. Many patients with Tourette syndrome also have ADHD, and some of the treatments are similar.
Lead Poisoning. Children who ingest even small amounts of lead may manifest symptoms similar to those of ADHD. A child may be easily distractible, disorganized, and have trouble thinking logically. The major cause of lead toxicity is exposure to leaded paint, particularly in homes that are old and in poor repair.
ADHD is considered to be a chronic condition, like asthma or diabetes, which requires long-term, ongoing monitoring of symptoms and adjustments of medications and other treatment programs. Although symptoms may lessen over time, ADHD does not usually "go away." Patients can, however, learn how to control their condition through behavioral techniques, often supported by medication.
Treatment for ADHD does not cure the condition but focuses on controlling symptoms and improving functioning. Treatment typically includes a combination of a psychostimulant medication, most commonly methylphenidate (Ritalin, generic), and behavioral therapy. (For older children and adults, other drugs may also be used.) Treatment often involves a team approach that includes the child's pediatrician, other health professionals, parents, and teachers.
Guidelines by Age. The American Academy of Pediatrics recommends that children with ADHD be treated according to the following age groups:
- Preschool children (ages 4 -5 years old) should be treated first with behavior therapy provided by parents and teachers. For many children, behavioral therapy alone will produce significant improvement. If further treatment is needed, and benefits appear to outweigh the risks, a doctor may prescribe the stimulant methylphenidate (Ritalin, etc.)
- Elementary school-aged children (ages 6- 11 years old) should be treated with a combination of a stimulant medication and behavior therapy. Alternatives to stimulant medication, in order of recommendation, are atomoxetine (Strattera), guanfacine (Tenex, generic), or clonidine (Catapres, generic).
- Adolescents (ages 12- 18 years old) should be treated with medication, and behavior therapy if necessary. Some patients in this age range may be able to take a "drug holiday" by temporarily stopping medications. The doctor should closely monitor the child during this time. Adolescents may also need to have their medications or dosages adjusted as their bodies change through puberty.
Treatment for Adult ADHD. As with children, adults with ADHD are treated with a combination of medication and psychotherapy. For medication, stimulant drugs or the non-stimulant drug atomoxetine (Strattera) are usually first-line treatments, with antidepressants a secondary option. Most stimulant drugs, as well as atomoxetine, are approved for adults with ADHD. Adults who have heart problems or heart condition risk factors should be aware of the cardiovascular risks associated with ADHD medication. There have been ADHD medication-associated incidents of sudden death in patients with underlying serious heart problems, and reports of stroke and heart attack in adults with cardiac risk factors.
Several types of medication are used to treat ADHD.
Psychostimulants: Methylphenidate (Ritalin) and Similar Drugs
Psychostimulants are the primary drugs used to treat ADHD. Although these drugs stimulate the central nervous system, they have a calming effect on people with ADHD.
These drugs include:
- Methylphenidate (Ritalin, Concerta, Metadate, Daytrana, generic)
- Dexmethylphenidate (Focalin, generic)
- Amphetamine-Dextroamphetamine (Adderall, generic)
- Dextroamphetamine (Dexedrine, Dextrostat, generic)
- Lisdexamfetamine (Vyvanse)
Methylphenidate and Dexmethylphenidate. Methylphenidate drugs (Ritalin, Metadate, Concerta, Daytrana, Quillivant XR) are the most commonly used psychostimulants for treating ADHD in both children and adults. Dexmethylphenidate (Focalin) is a similar drug. These drugs increase dopamine, a neurotransmitter important for cognitive functions such as attention and focus.
With the exception of Daytrana and Quillivant XR, all of these drugs are pills taken by mouth. Daytrana is a skin patch drug for ADHD. A patch is applied to the hip each day and delivers a 9-hour dose of methylphenidate. Quillivant is a liquid form of methylphenidate that is approved for patients age 6 and older who may have difficulty swallowing pills.
These drugs are available in short-acting and long-acting dosage forms. The short-acting forms need to be taken several times a day, including during school hours. As the drug wears off, a rebound effect can occur, and ADHD symptoms can intensify. For this reason, the long-acting dosage forms have become popular.
Amphetamine, Dextroamphetamine, and Lisdexamfetamine. Amphetamine-dextroamphetamine (Adderall), dextroamphetamine (Dexedrine, Dextrostat), and lisdexamfetamine (Vyvanse) work by blocking the reabsorption of the brain chemicals dopamine and norepinephrine.
Side Effects. Decreased appetite, stomach pain, headaches, and sleeplessness are the most common side effects of stimulant drugs. Tics or jerky movements develop in a small percentage of children, but this side effect usually goes away when the dosage is lowered.
Stimulant drugs may also:
- Worsen behavior and thought disturbance in patients with a pre-existing psychotic disorder. These drugs may also slightly increase the risk for auditory hallucinations, paranoia, and psychotic and manic behavior even in patients who do not have a history of psychiatric problems.
- Cause a mixed or manic episode in patients who have both ADHD and bipolar disorder.
- Increase aggressive behavior or hostility. Patients beginning stimulant drug treatment should be monitored for worsening of these behaviors.
- Reduce growth and weight gain in children. Children who take stimulant drugs should have their growth monitored. If they do not gain height or weight at a normal rate, they may need to stop taking the drug.
Cardiovascular Risks. All ADHD stimulant drugs carry warnings that they should not be used by patients with structural heart problems or pre-existing heart conditions (high blood pressure, heart failure, heart rhythm disturbances, or congenital heart disease). These drugs have been associated with sudden death in children with heart problems. They have also been associated with sudden death, stroke, and heart attack in adults with a history of heart disease. According to recent large studies, these medications appear to be safe for children and adults who do not haveunderlying heart disease.
Symptoms of Overdose. Symptoms of overdose include changes in heart rhythm and rate, hypertension, confusion, breathing difficulties, sweating, vomiting, and muscle twitches. If they occur, parents should call the doctor immediately.
Concerns for Abuse. Stimulant drugs can be habit forming, but they are not considered especially addictive, particularly in the doses used for treating ADHD. The primary danger for drug abuse from stimulants appears to occur in young people without ADHD who purchase these drugs illegally. If a child abuses another drug (alcohol, prescription medication) along with the ADHD medication, the chance for serious side effects is increased.
Non-Stimulant: Atomoxetine
Atomoxetine (Strattera) was the first non-stimulant approved for ADHD in children and the first treatment approved for adult ADHD. The drug works by increasing levels of both norepinephrine and dopamine, which are generally lower than normal in ADHD. The most common side effects are drowsiness, decreased appetite, and upset stomach. A few cases of atomoxetine-associated liver injury have been reported, and the FDA warns that the drug should be discontinued at the first signs of jaundice (yellowing of skin and eyes) and liver problems. Long-term effects, such as any impact on growth, are still unknown.
Atomoxetine may cause suicidal thinking in children and adolescents, especially during the first few months of treatment. Parents should monitor children taking atomoxetine for any changes in mood or behavior, and immediately contact their doctor if changes occur.
Alpha-2 Agonists (Guanfacine and Clonidine)
Alpha-2 agonists stimulate the neurotransmitter norepinephrine, which appears to be important for concentration. They include guanfacine (Tenex, generic) and clonidine (Catapres, generic).In 2009, Intuniv (a long-acting form of Tenex) was approved for the treatment of ADHD in children and adolescents ages 6 - 17 years.
Alpha-2 agonists are used for Tourette syndrome and may be beneficial when other drugs have failed for ADHD children with tics or those whose primary symptoms are severe impulsivity and aggression. These drugs may be prescribed in combination with a stimulant.
These drugs have a number of side effects. Sleepiness and dry mouth are the most common, followed by headache and fatigue. A clonidine skin patch, which gradually releases the medication, helps reduce the sedative effect. Because clonidine slows the heart down, it can have adverse effects in some children. Discontinuing the drug abruptly or missing doses can cause rapid heartbeats and other symptoms that may lead to severe problems. Doctors strongly recommend that no child be given clonidine without a preliminary examination for heart problems, and no child with existing heart, kidney, or circulatory problems should take it.
Antidepressants are not FDA-approved for ADHD treatment, but may be helpful in certain circumstances. Because antidepressants appear to work about as well as behavioral therapy, doctors recommend that patients first try psychotherapy before using antidepressants.
Bupropion (Wellbutrin, generic) and tricyclics are the types of antidepressants used for ADHD. Bupropion affects the reuptake of the serotonin, norepinephrine, and dopamine neurotransmitters. Side effects include restlessness, agitation, sleeplessness, headache, and stomach problems. Bupropion should not be used by patients who have a seizure disorder. Bupropion may also be associated with the development of suicidal thoughts and behavior, even in people who have no previous history of depression.
Tricyclics are an older type of antidepressant that can be beneficial but have many side effects. Imipramine (Tofranil, generic) and nortriptyline (Pamelor, generic) are the tricyclics most commonly prescribed for ADHD. A third tricyclic, desipramine (Norpramin, generic) should only be used if patients are not helped by other tricyclics. Desipramine has caused sudden death in some children and adolescents and is especially dangerous for patients with a family history of heart rhythm disturbances.
Tricyclic antidepressants can cause disturbances in heart rhythm. Children should have an electrocardiogram when they first begin to take this drug, and after any dose increase.
[For more information, see In-Depth Report #8: Depression ].
Behavioral Management
Behavioral techniques for managing the child with ADHD are not intuitive for most parents and teachers. To learn them, caregivers may need help from qualified mental health care professionals or from ADHD support groups.
Behavioral Techniques at Home
Bringing up a child with ADHD, like bringing up any child, is a process. No single point is ever reached where the parent can sit back and say, "That's it. My child is now OK, and I don't have to do anything more." The child's self esteem will evolve with an increasing ability to step back and consider the consequences of an action and then to control that action before taking it. But this does not happen overnight. A growing child with ADHD is different from other children in very specific ways, presenting challenges at every age.
Setting Priorities for the Parent. Parents must first establish their own levels of tolerance. Some parents are easygoing and can accept a wide range of behaviors, while others cannot. To help a child achieve self-discipline requires empathy, patience, affection, energy, and toughness. Some tips to help parents include:
- Parents should prepare a list giving priority to those behaviors they think are the most negative, such as fighting with other children or refusing to get up in the morning. The least negative behaviors on the bottom of the list should be ignored temporarily or even permanently (refusing to wear anything but red T-shirts).
- Certain odd behaviors that are not hurtful to the child or to others may be an indication of creative or humorous attempts to adapt (making up silly songs). These should be accepted as part of the child's unique and positive development, even if they seem peculiar to the parent.
- It is important to keep in mind that no one is a saint. Loving parents who occasionally lose their tempers will not damage their children forever. In fact, non-abusive open disapproval or dismay is far less destructive to both parent and child than harboring resentment beneath a false calm.
Establishing Consistent Rules for the Child. Parents must be as consistent as possible in their approach to the child, which should reward good behavior and discourage destructive behavior. Rules should be well-defined but flexible enough to incorporate harmless idiosyncrasies. It is important to understand that children with ADHD have much more difficulty adapting to change than do children without the condition. (For example, the child should do homework every day but might choose to start it after a TV show or computer game.) Parents should establish a predictable routine, and provide a neat, stable home environment (particularly in the child's room).
Managing Aggression. Some useful tips for managing aggression include:
- Parents should try to give little attention to mildly disruptive behaviors that allow this energetic child to let off some harmless steam. The parent will also be wasting energy that will be needed when the negative behavior becomes destructive, abusive, or intentional.
- The use of "time-out," isolating the child immediately for a short period of time, is an effective measure for allowing both the caregiver and the child to cool down. The child should immediately (and without emotion) be removed from a situation in which they are endangered or endangering others. The child should view time out as a way of cooling off and getting a distance on their behavior, not as isolation from others.
- To channel physical aggression and impulsivity in a toddler with ADHD, the parents must teach them to use verbal responses. (A parent may need to allow verbal responses that would be unacceptable in another child.)
- When the child becomes older and if the verbal responses become intentionally abusive and socially undesirable, the parent must redirect this form of aggression into more acceptable activities, such as competitive one-on-one sports, energetic music, video games, or big colorful paintings. Competitive video games, such as sports games, may also be an option.
- Sometimes a parent can anticipate situations when a child with ADHD is likely to misbehave, but all too often the child explodes for no apparent reason. If the blow-up occurs in public, the parents should complete their activities and leave as quickly as possible.
Establishing a Reward System. Children with ADHD respond particularly well to reward systems. One study reported that they performed equally well when encouraged either by a direct reward for a correct response or with the use of a system called response-cost. With this system, the child is given the reward first and allowed to keep it if their behavior remains appropriate.
Some suggested tips for rewarding the ADHD child are:
- Create charts with points or stars for good behavior or for completed tasks. It is important to give points for even simple positive behaviors, which may be taken for granted in other children (responding happily to a change in plans, changing an obscenity to a more acceptable expletive).
- Rewards for any child can include playing a favorite game, extending bedtime by an hour, or allowing an extra half-hour of TV.
- Rewards of food or gifts should be used infrequently, if at all. They can create other problems, such as being overweight, having a bad diet, or making continuous demands for objects.
- To avoid boredom, a reward system should rotate different types of rewards.
- Children with ADHD respond better with small rewards promised in the short-term than large rewards offered in the future. One approach that uses both short- and long-term rewards is a system that gives the child points for specific positive behaviors. As the children accumulate points, they can use them for larger tangible rewards, such as a favorite video game.
- Rewards should be promised only when caregivers are fairly certain they can follow through. Children with ADHD respond with much greater frustration than children without ADHD to disappointment, and are likely to have a strong (and noisy) negative reaction. A parent must remember that this response is part of the child's make-up and not necessarily in their control.
Improving Concentration and Attention. Children with ADHD perform significantly better when their interest is engaged. Parents should be on the lookout for activities that hold the child's concentration. Options include swimming, tennis, and other sports that focus attention and limit peripheral stimuli. (Children with ADHD may have difficulty with team sports require constant alertness, such as football or basketball.)
Martial arts, such as karate, can also offer an appropriate and controlled emotional outlet, and help to focus attention, and teach self-restraint, self-discipline, and tolerance. Learning an instrument can help a child to develop a more rhythmic and balanced sense of self.
Management at School
Even if a parent is successful in managing the child at home, difficulties often arise at school. The ultimate goal for any educational process should be the happy and healthy social integration of children with ADHD with their peers.
Preparing the Teacher. Although teachers can expect at least one student in every classroom to have ADHD, there is generally little training that prepares them for managing these children. The teacher should be prepared for certain behaviors in the child with ADHD:
- Students with ADHD are often demanding, talkative, and highly visible.
- Inattention is a major factor in low academic performance and can cause children to frequently forget homework or miss assignments. Children with ADHD often require frequent reminders or visual cues (such as posters) for rules and regulations. Having the child sit in the front of the classroom may be helpful for both increasing attention and reducing noisy activity.
- Lack of fine motor control makes taking notes very difficult, and handwriting is often poor. Using a computer can compensate for this.
- Rote memorization and math computation, which require following a set of ordered steps, are often difficult. (Children with ADHD may do better with math concepts.)
- Many children with ADHD respond well to school tasks that are rapid, intense, novel, or of short duration (such as spelling bees or competitive educational games), but they almost always have problems with long-term projects where there is no direct supervision.
The Role of the Parent in the School Setting. The parent can help the child by talking to the teacher before the school year starts about their child's situation. The first priority for the parent is to develop a positive, not adversarial, relationship with the child's teacher. Finding a tutor to help after school may also be helpful
Special Education Programs. The Individuals with Disabilities Education Act (IDEA) requires the school to identify and evaluate children who may need help and to provide special services. However, parents sometimes report pressure by the school to put their children on medication or force them into special classrooms without clear educational justification. The schools, in these cases, may be acting illegally.
High-quality special education can be extremely helpful in improving learning and developing a child's sense of self worth. However, programs vary widely in their ability to provide quality education. Parents must be aware of certain limitations and problems with special education:
- Special education programs within the normal school setting often increase the child's feelings of social alienation.
- If the educational strategy focuses only on abnormal behavior, it will fail to take advantage of the creative, competitive, and dynamic energy that often accompanies ADHD behavior.
- There is no federally funded special education category specifically targeted to ADHD.
The best approach may be to treat the syndrome as a variant of the norm and train teachers to manage these children within the context of a normal classroom.
Special programs are also required under the Rehabilitation Act and by the Americans with Disabilities Act (ADA) for students at institutions of higher learning. It is the student's responsibility, however, to inform the administration at their college or university that they need such services.
Other Treatments
Dietary Approaches
A number of diets have been suggested for people with ADHD. Several well-conducted studies have failed to support dietary effects of sugar and food additives on behavior, except possibly in a very small percentage of children. Still, various studies have reported behavioral improvement with diets that restrict potential allergens in the diet. Parents may want to discuss with their doctor a trial of an elimination diet directed at specific foods.Additives and foods that parents and studies report as possible triggers of behavioral changes include:
- Any artificial colorings (particularly yellow, red, or green)
- Other chemical additives -- for example, BHT or BHA
- Milk
- Chocolate
- Eggs
- Wheat
- Foods containing salicylates, including all berries, chili powder, apples and cider, cloves, grapes, oranges, peaches, peppers (bell & chili), plums, prunes, tomatoes
Feingold Diet. The most well-known diet for ADHD is the Feingold diet, a salicylate- and additive-free diet, which requires rigorous vigilance over a child's eating habits. This diet also prohibits aspirin, which contains salicylates. Some parents report success with this diet, although it may be difficult to impose. In any case, it is certainly wise to provide a healthy balance of fresh, natural foods, and perhaps to avoid food with artificial colors and flavors. .
Essential Fatty Acids. Omega-3 fatty acids, found in fatty fish and canola oil, are important for normal brain function and may have some benefits for people with ADHD. There is no evidence that supplements of fatty acids, such as docosahexaenoic acid (DHA) and eicosapentaneoic acid (EPA) fish oils, provide any advantages.
Zinc. Zinc is important for the metabolism of certain neurotransmitters that play a role in ADHD, and deficiencies may be associated with some cases of ADHD. Long-term use of zinc, however, can cause anemia and other side effects in people without deficiencies, and it has no effect on ADHD in these individuals. In any case, testing for trace minerals, such as zinc, is not standard procedure when evaluating children suspected to have ADHD.
Sugar. Although parents often blame sugar for causing children to become impulsive or hyperactive, evidence does not show that sugar plays a role in hyperactivity.
Feedback Approaches
Techniques that use biologic or auditory feedback may be effective tools for improving children's attention.
Other Non-Drug Therapies
A number of alternative approaches are tried by children and adults with mild ADHD symptoms. For example, daily massage therapy may help some people with ADHD feel happier, fidget less, be less hyperactive, and focus on tasks. Other alternative approaches that may be helpful include relaxation training, meditation, and music therapy. Based on existing evidence, these treatments may be helpful for symptom management but are not proven to benefit the underlying disorder.
Herbs and Supplements.Many parents resort to alternative remedies instead of psychostimulants and other medications. These products include St. John's wort, ginkgo biloba, panax ginseng, melatonin, and pine bark extract. There is no scientific evidence that they are effective.
Generally, manufacturers of herbal remedies and dietary supplements do not need FDA approval to sell their products. Just like a drug, herbs and supplements can affect the body's chemistry, and therefore have the potential to produce side effects that may be harmful. There have been a number of reported cases of serious and even lethal side effects from herbal products. Always check with your doctor before using any herbal remedies or dietary supplements.
- www.aap.org -- American Academy of Pediatrics
- www.nimh.nih.gov -- National Institute of Mental Health
- www.chadd.org -- Children and Adults with Attention-Deficit Disorder
- www.add.org -- Attention Deficit Disorder Association
- www.psych.org -- American Psychiatric Association
- http://www.cdc.gov/ncbddd/adhd/ -- Centers for Disease Control (CDC): ADHD
- www.aacap.org -- American Academy of Child and Adolescent Psychiatry
- www.nichcy.org -- National Dissemination Center for Children with Disabilities
- www.ncld.org -- National Center for Learning Disabilities
- www.ldaamerica.org -- Learning Disabilities Association of America
American Academy of Child and Adolescent Psychiatry. Practice parameter on the use of psychotropic medication in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2009 Sep;48(9):961-73.
Brook JS, Brook DW, Zhang C, Seltzer N, Finch SJ. Adolescent ADHD and adult physical and mental health, work performance, and financial stress. Pediatrics. 2013 Jan;131(1):5-13. Epub 2012 Dec 10..
Charach A, Yeung E, Climans T, Lillie E. Childhood attention-deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses. J Am Acad Child Adolesc Psychiatry. 2011 Jan;50(1):9-21. Epub 2010 Dec 3.
Cooper WO, Habel LA, Sox CM, Chan KA, Arbogast PG, Cheetham TC, et al. ADHD drugs and serious cardiovascular events in children and young adults. N Engl J Med. 2011 Nov 17;365(20):1896-904. Epub 2011 Nov 1.
Faraone SV, Glatt SJ. A comparison of the efficacy of medications for adult attention-deficit/hyperactivity disorder using meta-analysis of effect sizes. J Clin Psychiatry. 2010 Jun;71(6):754-63. Epub 2009 Dec 29.
Habel LA, Cooper WO, Sox CM, Chan KA, Fireman BH, Arbogast PG, et al. ADHD Medications and Risk of Serious Cardiovascular Events in Young and Middle-aged Adults. JAMA. 2011 Dec 12. [Epub ahead of print]
Hamilton SS, Armando J. Oppositional defiant disorder. Am Fam Physician. 2008 Oct 1;78(7):861-6.
Millichap JG. Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics. 2008 Feb;121(2):e358-65.
Millichap JG, Yee MM. The diet factor in attention-deficit/hyperactivity disorder. Pediatrics. 2012 Feb;129(2):330-7. Epub 2012 Jan 9.
Mosholder AD, Gelperin K, Hammad TA, Phelan K, Johann-Liang R. Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children. Pediatrics. 2009 Feb;123(2):611-6.
Nigg JT, Breslau N. Prenatal smoking exposure, low birth weight, and disruptive behavior disorders. J Am Acad Child Adolesc Psychiatry. 2007 Mar;46(3):362-9.
Perrin JM, Friedman RA, Knilans TK; Black Box Working Group; Section on Cardiology and Cardiac Surgery. Cardiovascular monitoring and stimulant drugs for attention-deficit/hyperactivity disorder. Pediatrics. 2008 Aug;122(2):451-3.
Pliszka S; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jul;46(7):894-921.
Rader R, McCauley L, Callen EC. Current strategies in the diagnosis and treatment of childhood attention-deficit/hyperactivity disorder. Am Fam Physician. 2009 Apr 15;79(8):657-65.
Steiner H, Remsing L; Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry. 2007 Jan;46(1):126-41.
Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management, Wolraich M, Brown L, Brown RT, DuPaul G, Earls M, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011 Nov;128(5):1007-22. Epub 2011 Oct 16.
Swanson JM, Elliott GR, Greenhill LL, et al. Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. J Am Acad Child Adolesc Psychiatry. 2007 Aug;46(8):1015-27.
Thapar A, Cooper M, Jefferies R, Stergiakouli E. What causes attention deficit hyperactivity disorder? Arch Dis Child. 2012 Mar;97(3):260-5. Epub 2011 Sep 7.
Vetter VL, Elia J, Erickson C, Berger S, Blum N, Uzark K, et al. Cardiovascular monitoring of children and adolescents with heart disease receiving stimulant drugs: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young Congenital Cardiac Defects Committee and the Council on Cardiovascular Nursing. Circulation. 2008 May 6;117(18):2407-23. Epub 2008 Apr 21.
Advanced Studyec
Related Informationec
Review Date: 3/7/2013�
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


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WATCH: 20-minute 'Mandela: Long Walk To Freedom' featurette
Looking forward to the winter movie season? Kick things off with this extended preview of Mandela: Long Walk to Freedom.
On November 29, The Weinstein Company release, Mandela: Long Walk to Freedom, which stars Idris Elba as Nelson Mandela, and Naomie Harris as Winnie Mandela, in a film directed by Justin Chadwick, which highlights Mandela's early life, education and 27 years in prison. It's a much buzzed about Oscar nominee, for sure.
Take a look at the extended featurette which takes viewers behind the scenes to see how the film was made, and includes telling interviews with the cast.

subset: commoncrawl


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Escape Artist to Free Self From Coffin, While Skydiving
"How many of us have never been in a situation that we wished we could get out of?" 47-year-old
He is revisiting arguably his most dangerous escape — a 1988 stunt in which he escaped from a casket dropped from a plane at 13,500 feet (4,115 meters). It was just his 17th skydive.
This time, Martin will lay inside a wooden box with his hands cuffed to a belt around his waist and his right arm chained to the inside of the box. The casket's door will be held tight with a prison door lock for which no key exists; a locksmith scrambled the tumblers.
The box will be rolled out of the plane in flight. Two skydivers will stabilize the box by holding handles on the side while something similar to the parachutes used to slow drag-racing cars and fighter jets will steady it from the top as Martin picks the locks.
He expects to be free and tracking away at around 7,000 feet (2,130 meters) after about 40 seconds of free fall.
"You try to get yourself to the point where there's really not a lot of fear involved," Martin said. "Fear is one of those emotions that kind of distracts from your ability to think clearly and be effective," he said.
Martin said his father shattered his early fascination with magic when he explained the trickery behind a floating pen illusion. So at age 6, he resolved to find a more respectable means of impressing an audience and began studying the art of escape.
"By the time I was 13, the sheriff was locking me in his handcuffs. And I was getting out," Martin said.
Jumping from a raft into a lake at age 11 —with his hands cuffed behind his back — fed his appetite for high-risk escapes.


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Eye Necklace by Marla Studio
By Marla studio
A modern evil eye design by Marla Studio. The evil eye of protection is a good luck symbol. SIZE: 2" wide and 1 1/4" tall. Hangs on 20" sterling silver ball chain. Wow!
FROM MARLA: I've always wanted to use the symbol of the eye: it's a classic, historic and cross cultural with many ascribed powers and meanings. The larger eye is influenced by Egyptian art as well as mid-century modern design (e.g., George Nelson's Eye Clock). Creating this eye felt like making a small scale sculpture. It's elegant but also quite a powerful, a protective eye.
CHOOSE: Bronze or Silver


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Was $399.95 NOW $299.95
Made by a supplier to the U.S. Military, these are the cots that convert into bunk beds and foldaway for storage. The patented powder-coated steel frame and interlocking disc system enable quick, easy assembly without tools, creating comfortable, sturdy sleeping surfaces that hold up to 500 lbs. each. The 600-denier polyester mats provide soft, smooth, supportive sleep surfaces that are about the size of single mattresses. The mats are abrasion- and mildew-resistant and will not stretch or shrink. The bottom mat is 12" above the floor, there's 20" between beds, the top bed is 32" above the floor, and the included leg extensions increase the space between the mats by 7" for ease of entry and exit. Both beds have a hanging organizer with pockets for storing toiletries or reading material. The entire unit stores in two included bags for unobtrusive storage. 81 3/4" L x 39 1/2" W x 36 1/2" H. (63 lbs.)
Lifetime Guarantee
The Foldaway Adult Bunk Beds come with The Hammacher Schlemmer Lifetime Guarantee. If this product ever disappoints you, for any reason, you may return your Hammacher Schlemmer purchase for exchange, credit, or refund.
Should you have any questions, we are available seven days a week (8:00 am – midnight EST). Please call 1-800-321-1484 to speak with a specialist or email us at email@example.com to receive a response within three business hours or less.
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(13 of 14 customers found this review helpful)
bunk beds
By Bob
from Keuka Park ,NY
great for additionanl beds when needed
Bottom Line Yes, I would recommend this to a friend
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well made produce
By Nana Banana
from Idaho Falls, Idaho
These are very well made cots and we easy to put together. They are very sturdy. I bought these for the small grandkids to sleep on when they came to visit. I am pleased with the product.
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We are very delighted with this product.
By Jan
from South Carolina
We needed extra beds for grandkids. They loved the beds. The beds are roomy and comfortable for young and old alike. This product exceeded our expectations.
(4 of 4 customers found this review helpful)
Great for the gran' kids sleepovers
By Vinnie
from Alberta, Canada
These bunk beds are the greatest thing since sliced bread for extra sleeping space for guests or kids sleepovers.The are close to the floor so even the smaller ones can use get into and out of them with ease.Really tough design and ultra-easy to set up. A great buy!!
(3 of 3 customers found this review helpful)
Versatile Bunk Beds
By Steve
from Aargau, Switzerland
Every Swiss house has its own air raid shelter. Usually with uncomfortable rest facilities. It's more than an improvement to have this bed that can be used for camping during times of pease ;-)
Fits the bill
By Misty
from Holland, MI
They were purchased for use at a summer home so haven't had feedback from the family members who will be using them. Assembled the day received and took a nap on one. Very comfortable.Pack away neatly and will be easy to store when not in use. Since there is limited space at the lake, this is a must.
By Biby
from El Paso Tx
The only thing I Wish the y wold be taller.
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(M, 98 minutes.)
Opens Thursday.
A very belated release for Woody Allen's 2010 London-set romp, which espouses a typically atheist viewpoint while mashing up a series of failing relationships. It clearly precedes Allen's return to form with Midnight in Paris, but is infinitely more interesting than last year's To Rome with Love.
In typical Allen fashion, Alfie (Anthony Hopkins) and Helena (Gemma Jones) are an ageing couple whose marriage comes unstuck. Alfie pursues a sudden urge to date younger women, in the form of call girl Charmaine (Lucy Punch), while Helena turns to a psychic (Pauline Collins) for guidance. Their daughter, Sally (Naomi Watts), is having troubles of her own, stuck in an unhappy marriage with novelist Roy (Josh Brolin), whose eye wanders to an Indian girl (Freida Pinto) across the way from his office. Sally, meanwhile, develops a crush on her art gallery boss, Greg (Antonio Banderas).
As with many recent pieces from Allen, the film feels undercooked in both writing and direction. The dialogue is awkward and unconvincing, while the set-ups can come across as afterthoughts that are seldom believable.
Yet despite such shortcomings, Hopkins fares surprisingly well as the late-life-crisis-stricken Alfie, with his antics providing some much-needed lift in an otherwise curiously humourless film. Jones, as his spurned wife, is also, typically, excellent (there was even talk of an Oscar nod at one point), with Watts delivering something rather different to what we've come to expect. Collins, as the psychic, is a natural.
Allen's seven European pictures, as a whole, have provoked a sharply divided critical response. While some point to Vicky Cristina Barcelona - and, to some extent, even Match Point - as being key to a gradual creative resurgence, others roundly dismiss virtually anything shot outside of his native New York.
True, as a tourist, Allen lacks an inherent sense of place in his new old-world locales, but there's no denying the works offer creative ingredients that warrant inspection. Viewing this post-Midnight in Paris can prove an inevitably mixed experience. There is none of the charm of that sparkling story. Allen's mixed experiences with London stand in sharp contrast with his love affair with the French capital.


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Stupid stoppage, looked like a work.
Stupid stoppage, looked like a work.
Jack Hermansson has now gone 0-2 under the Bellator banner previously entering at 5-0. Having a rough spot because he was awesome against Ali Arish.
Page is too cocky imo, someones going to handle him soon and do some damage that'll really humble him.
Coffee drinker, prefer Pepsi and I'm kind of a big deal.
Doesn't even look like he hit him..........
Need to see it in better quality but that does look like the punch whistled past his head, from one angle did look a bit like it may have tapped his chin on the way thru.
Sig awaiting witty quote from someone.
^ From that angle it definitely looked like it missed.
looks like he clipped him. not the cleanest or most visually satisfying KO, but that's not his fault, got the job done quickfast


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Thread: 30th Annual Holiday Tournament
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30th Annual Holiday Tournament
30th Annual Holiday Tournament at the Mid-America Center
Golden Arrow Archery Club, will be hosting its 30th annual "Holiday Tournament" at the Mid-America Center Arena in Council Bluffs, Iowa. This tournament will be held January 14, 15 and 16, 2005 during the River City Hunting & Fishing Expo. One hundred twenty-five plus exhibitors will be on hand for the 12,000 plus expected to attend. Activities in addition to the exhibitors include daily seminars, kids casting competition, video shooting arcade and kids archery range, to name a few.
Our goal is to provide an archery competition similar to a national event to give regional shooters an opportunity to showcase and improve their skills while experiencing the excitement of top level competition at a modest expense and less travel. This tournament is planned as a family event with competitive classes and activities for all ages. Entry into the tournament includes a weekend pass to the "River City Hunting & Fishing Expo."
We will be offering both a trophy and a money division. By offering these levels of awards, we are attempting to compete on the highest level to attract competitors from around the nation to our area, to enjoy local attractions and Midwest hospitality.
If you are interested in shooting the tournament please click on the link listed below to our clubs website from there click on the contacts tab and give one of the clubs tournament contacts a call and we will get you registered. The website will have more information on location, local attractions, hotels, costs, and targets that will be shot at the tournament. More information will be coming on available prize money so continue to check our website for dollar amounts!!
If you or your business might be interested in sponsoring a target at the shoot please feel free to click on the sponsorship tab on our website and fill out the sponsorship form and send it into the club. Its agreat way for your business to be noticed by 12,000 plus people at one of the area's biggest sport shows.
Thanks and hope to see you there!!
Remember Archery is NOT Rocket Science!!!
Golden Arrow Archery Club
E-mail the Club
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Best Of :: Shopping & Services
Annette Baker, the house reflexologist at Metaphysical Matrix, wants to work on infants and babies, but neither is great at paying for services rendered, so she's stuck with the rest of us — whiny adults with grimy, gnarly feet. The Minnesota transplant is not daunted by the hellish Houston weather that forces most of us to wear sandals. "People are worried that they have dirty feet," she says reassuringly. "But that's not the point! It's just generally loving, having someone take care of you." We know the naughty bits of reflexology — for example, the muscle over the inner ankle corresponds to issues with reproductive organs — but Baker notes that most folks seem to have issues with tension in their neck and shoulders, which corresponds to the joint connecting the toes to the rest of the foot. One of Baker's mentors must have worked on her fourth and fifth tiniest toes, because those correspond to the ears — and she's a good and empathic listener.
Kuenhert's Auction house is not quite a store, but there's not a more exciting way in town to shop for fabulous French antiques, plush Persian rugs or even a palette full of kooky knick-knacks, old toys, or strange hats. Every Thursday night, the hearty souls who are game enough pick up a number, sit down in the audience and wait for the auctioneer to start the bidding. Everything goes and there's no minimum bid, so stunning deals are to be had by all. Designers have been going there for years; now it's your chance to get in on the action. All it takes is a quick hand and a strong heart — once that arty armoire is yours, there's no returning it.
Want to add a distinct look to your bedroom furniture? You could always pick up one of the many tree-killing catalogues from your recycling pile, or head to Adkins in Midtown for antique glass drawer pulls. Try those great Grecian urns to flank your apartment's porch, or Art Deco tiles for a kitchen backsplash. But if you like something, buy it. Part of the charm at this rambling, sprawling old house festooned with old lawn furniture is the fact that once an item is gone, you may never see another like it again.
Viet Hoa is the Fiesta of Asian supermarkets and a pure delight for seekers of groceries and colorful oddities alike. It's big, it's clean and on any given day, you can find silk flowers, flip-flops and thousand-year-old eggs within a few steps of each other. The back wall is covered with tanks full of unusual sea creatures and case after case of fresh fish. If seafood isn't your thing, the array of roasted and barbecued meats could turn a vegetarian carnivorous. On the way out, a dizzying and attractive selection of jellied products is tempting enough to make you want to eat white fungus and mung bean...and like it.
Space City Wheels is what you might call a high-end auto parts store. Not a lot of air filters and brake fluid, but a helluva lot of chrome. Space City Wheels strictly sells rims and tires, and the shop's showroom alone is worth a visit. It looks like a strip club or casino filled with a lot of rims. Anything in the showroom is in stock — from the 22-inch Giovannas to the 30-inch Dubs — at Space City's huge warehouse. Full-service installation is included with purchase, and the store can almost guarantee same-day service. Space City is family owned and operated and has been for 15 years. Be sure to check out the yellow and black ATV decked out with ridiculously large rims. Bonus for the store's motto: "We open Sundays."
A beginning fisherman (or woman) could get lost in this sprawling tackle store in south Houston. But the staff can hook you up with all the equipment and knowledge you need to be on your way. Unlike other big-box outdoor stores, Fishing Tackle Unlimited is straight fishing. There's plenty of gear for any kind of angling — in-shore, offshore or fly. The shop hosts a couple instructional classes and demos throughout the year, but on any day a staffer will take you to the parking lot and teach the technique with a casting or fly reel. Fishing Tackle Unlimited also has a nice variety of kayaks, which it rents for $50 a day. If you get serious about kayaking, the rental fee can be applied to the purchase price. You can also try out a kayak in the store's big outdoor pool.


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Akron's surging Diaz plates eight runs
Indians shortstop ties a franchise record, flirts with cycle in win
By Ashley Marshall / Special to MLB.com | July 8, 2012 7:06 PM ET
On Sunday, his historic night surprised even himself.
The switch-hitting shortstop went 4-for-4 and tied a team record with eight RBIs as the Aeros beat the Bowie Baysox, 11-8.
"I think this is the first time in my career," Diaz said of his big night through a translator. "It was a big game. I'm really happy and excited.
"This is my first time with eight RBIs. I think five RBIs was my most before. I have no explanation."
Akron entered Sunday's game having dropped nine of its last 12 games, including six of the previous seven. As a result, the Aeros had seen their lead atop the Western Division shrink to two games.
On Sunday, Diaz took it upon himself to make sure the team will have sole possession of the league lead when the second half of the season gets underway Thursday.
Acquired by Cleveland in the deal that sent Russell Branyan to Seattle in 2010, Diaz hit an RBI single up the middle with two outs in the first inning and he doubled home two runs before the Baysox recorded an out in the third.
"I was attempting to bunt early in the at-bat, but at 1-0, I pulled it back because I was expecting a fastball. I got a fastball and I was able to drive the ball," Diaz said of his 15th double of the season.
The 23-year-old then slugged a grand slam -- his first of the year and the Aeros' second of 2012 -- off new pitcher Zach Clark with two outs in the fourth before driving in an eighth run with a two-out hit to left field in the sixth.
"The previous batter walked on four straight balls to load the bases," he said of his home run at-bat. "In the on-deck circle, I was thinking about a breaking ball. Then I got a first-pitch curveball and I put a good swing on it."
The Baysox intentionally walked Diaz with two outs and a runner on second in the eighth.
"I was definitely thinking that with the night I was having that a fifth hit could have been a possibility," he said.
Diaz's eight RBIs topped his previous single-game high by three, while his four hits tied his personal best. Playing for Class A Advanced High Desert on May 14, 2010, Diaz went 4-for-5 with two homers and five RBIs in an 11-inning 10-9 victory over the Stockton Ports.
It was Diaz's 16th multi-hit game of the season and his fifth career four-hit performance. It was also his fifth game this year with more than one RBI.
The eight RBIs tied a franchise mark first set by Scott Morgan on May 25, 1999, against New Britain and replicated by Matt McBride on July 31, 2009 against Binghamton.
It was also the most RBIs by a single player against Bowie in Baysox history. Altoona's Adam Hyzdu (May 5, 2001) and Binghamton's Ramon Espinoza (June 20, 1997) each plated seven runs more than a decade ago.
Diaz, a native of Bani in the Dominican Republic, raised his season average to .260 in the victory. He is batting .378 with 14 RBIs and eight runs scored over his last 10 outings and he has hit safely in 17 of his last 20 contests.
"The reason for my success over the last few weeks is because I've continued to work hard every day," said Diaz, originally signed by the Mariners as a non-drafted free agent in 2006. "If I don't get it done one day, the next day I will go out and work even harder."
Diaz is now in his second year playing at the Double-A level. Last year, he hit .255 with nine homers and 60 RBIs -- both career highs -- in 133 Eastern League games. He also smacked 24 doubles, another personal best, legged out four triples and swiped nine bases.
In five big league games with the Indians the last week of May, Diaz batted .267 with four singles and four runs scored.
On Sunday, Jose De La Torre (7-0) allowed one run on three hits and two walks over 2 1/3 innings in relief of Brad Brach, who yielded three runs on six hits and a pair of walks over the first 2 2/3 frames.
Bowie starter Bobby Bundy (2-11) surrendered five runs on seven hits and a pair of free passes over the first three innings in the losing effort.
Nick Markakis, rehabbing a fractured right hamate bone, went 1-for-4 with a double and a run scored. Catcher Taylor Teagarden, on the DL with a lower back injury, drew a walk in his only plate appearance before leaving the game after the top of the third.
Ashley Marshall is a contributor to MLB.com. This story was not subject to the approval of the National Association of Professional Baseball Leagues or its clubs.View More


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Duke porn star Belle Knox is building her brand one strip club at a time
The audience Friday at Show Palace, a strip club in Long Island City, Queens, with giant rotating chandeliers and black velour roses on the wall, is far from overwhelming. There are maybe 50 to 70 patrons at most.
But if the crowd isn't as big as Miriam Weeks—better known as Belle Knox—hoped for in her debut as a stripper, she doesn't show it. The Duke University freshman made national headlines in February when she admitted to filming pornography on the side to pay for her private-school tuition. Tonight, she glides into Show Palace and heads straight to the strippers' changing room in the back, greeting her fellow performers with hugs and kisses.
Weeks puts her arm around "Rain," a curvy woman in an animal-print top and faded skirt that seem quaint beside Weeks's matching black stilettos, minidress, and carefully coiffed curls. Rain is also a student, at an urban technical institute where she is earning her associate's degree—a far remove from the rarefied grounds of Duke University. Rain tells me stripping at Show Palace has finally helped her gain control of her finances. Weeks nods her head in agreement, and when Rain excuses herself to take the stage, she cheers out, "Make that money!" Later Rain tells me she had never heard of Weeks, the girl who was clutching her like her favorite sorority sister.
Weeks exudes affection for the strippers we meet as we travel through Show Palace, and she talks enthusiastically about the importance of women finding ways to manage the growing cost of tuition and potentially crippling student debt. She has spoken publicly of how she turned to pornography to pay for Duke's $60,000-a-year price tag and to avoid private loans, which have become a necessary and serious evil of higher education. In 2012, the average debt per college student was $29,400, an increase of 6 percent each year since 2008, according to The Project on Student Debt.
When the Duke scandal first broke, Weeks, 18, made it clear that she wanted to be an advocate for sex workers and eventually become a civil-rights lawyer. "We need to remove the stigma attached to their profession and treat it as a legitimate career that needs regulation and oversight," she wrote in an essay for the Web site xoJanein February. "We need to give a voice to the women that are exploited and abused in the industry."
Read The Full Article On The Daily Beast
More articles from The Daily Beast:
- Economists Slam the War on Drugs in a New LSE Report
- God Save This Honorable Court
- The Idea of Public Land Means Nothing to Utah County Commissioner
© 2013 Newsweek/Daily Beast Company LLC


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PHILADELPHIA - The University of Pennsylvania men's basketball team held its annual banquet on Sunday, May 5 at The Inn at Penn, presenting three players with awards.
Junior guard Miles Cartwright was presented with the Arthur Kiefaber Most Valuable Player Award. Cartwright finished the year averaging 13.5 points per game, good for fifth among Ivy players, and in conference play he averaged 12.9 ppg which was seventh. Cartwright also was second among Ivy players in assists per game in Ivy play (4.1) and sixth in free-throw percentage (.840).
Junior center Cameron Gunter was recipient of the Bus McDonald Award, given to the program's most inspirational player. Gunter ended up playing in 26 of Penn's 31 games this season, averaging 1.5 points and 1.2 rebounds per game. However, he had a strong second half of the season, scoring 30 of his 38 points and grabbing 24 of his 31 rebounds in the season's final 10 games. Gunter's best single-game performance came on Feb. 15 at Harvard, where he scored 10 points and snared nine rebounds.
Freshman guard Tony Hicks was recipient of the G. Fred DiBona Award, given to the program's outstanding newcomer. Hicks ended the season averaging 10.4 points per game overall, a number that jumped to 15.3 ppg in Ivy play which was third. The freshman, who had more than 20 points in four of the Quakers' last seven games, also finished sixth among Ivy players in three-point field-goal percentage in Ivy play (.429) and eighth in free-throw percentage (.824).


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WATCH: Miley Cyrus really enjoyed Britney Spears' opening night in Vegas
Listen to Miley Cyrus on iHeartRadio | Listen to Britney Spears on iHeartRadio
Britney Spears launched her two year Vegas residency at Planet Hollywood last night, drawing rave reviews and celebulous attendees.
The famous fan who made her presence most known was—no surprises here—Miley Cyrus. During Brit's performance of "Till the World Ends," Cyrus started dancing, well, as if the world were ending. Front row, too; isn't she lucky…
Give it a watch here!


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Samsung Galaxy Xcover 2
£TBC, samsung.com/uk
The newly-unveiled successor to the Xcover features Android 4.1 Jelly Bean, a dual-core processor, 5in 800 x 480 screen and 5MP camera, making it (on paper at least) a capable mid-ranger that also happens to have IP67-certified ruggedness in its locker. That means it's dust- and sand-proof, and can withstand all manner of ungentle treatment, as well up to 30 minutes in up to a metre of water. Rather easy on the eyes too, compared to some of its rivals. Look out for it in the shops in March.
JCB Toughphone Pro-Smart TP909
£280 (PAYG), carphonewarehouse.com
Looking every inch the chunky, rugged handset you'd expect from a company like JCB, the TP909 feels like it could probably survive a nuclear war with nary a scratch on it. But there's also a decent level of smartphone-ness on board, thanks to Android 2.3 Gingerbread, the 5MP camera and microSD slot. The 800MHz processor and 256MB of RAM make it a little slower than some of its contemporaries, however.
Sony Xperia Go
£220, sonymobile.com/gb
The Xperia Go doesn't look outwardly tough, and indeed one of the things we most like about it is the way it hides its rugged, waterproof and scratch-resistant nature within the clothes of a compact, svelte, lightweight and affordable smartphone. The screen resolution, storage and battery life are none-too-impressive compared to higher-end Android handsets, but if you're prepared for all that then you'll find this a nicely elegant twist on a tough phone.
Motorola Defy+
£190, motorola.co.uk
Much like the Sony Xperia Go, the Motorola Defy+ features a 1GHz CPU, 5MP camera and Android 2.3 Gingerbread, so it's up to you to decide whether or not its unique features (such as built-in Swype for fast, quick text input) make it a more compelling draw. One advantage it does have over the sleeker Sony is a beefy battery – good to know if you're heading out for a protracted spell in the wild (or just down the pub for a slightly lengthy session).
£310, amazon.co.uk
The second phone in our lineup to boast bulldozer branding, the CAT B10 is certainly the most rugged-looking of the five smartphones here (it weighs almost half a kilo, astonishingly, and is the best part of an inch thick). As with all the others, it features Android (2.3.5 – although an update to 4.0 Jelly Bean has been promised at some point), a 5MP camera and a touchscreen, but the latter is a mere 3.2in in size, which could prove a touch too wee for some.
5 things BlackBerry needs to do to get back on top
Grand Theft Auto V release date revealed


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From the twisted and brilliant mind of Suda 51 comes Black Knight Sword, a platforming adventure with an unprecedented visual style. In this fresh take on the classic fairy tale, The Black Knight treks through a dark and mysterious world filled with whimsical creatures to kill the dark princess and ending her reign of terror. A throwback to classic platformers, Black Knight Sword evokes simple yet addictive and challenging gameplay with an overall aesthetic unlike anything released to date.
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Best Of :: Sports & Recreation
What the Denver Hitting Club lacks in glitzy, suburban, mega-batting-cage luster, it makes up for in elbow grease. Elbow grease provided by Sam Morales. "I used to coach youth teams, and we were always trying to find a place to take the kids to hit, and we'd wind up having to take them out to the suburbs," explains Morales. "I always wondered why there was nothing like that in Denver." So in 1992, after hanging up his cleats as an assistant varsity baseball coach at North High School (Morales is still a mailman by day), he converted an old paint shop downtown, installing three cages and numerous pitching machines. Today the Denver Hitting Club is home to everyone from the Liga Latina de Beisbol to downtown businessmen swinging at softballs on their lunch hour and neighborhood children with big-league dreams. Morales keeps the prices fair -- $8 for thirty minutes, $12 for an hour, team rates available -- and is always around to offer a few pointers. Batter up!
If Miles, that weird horse-head guy who trots the field during Broncos games, was sent to the glue factory, and Dinger, the Rockies' pathetic faux Barney, sank into a tar pit, many sports lovers in these parts would cheer. But were Rocky, the Nuggets' coolest cat, to head for the hills, all of Denver would go into mourning, and rightfully so. For years, Rocky was pretty much the only reason to attend a Nuggets game, thanks to his athletic stunts, crowd-rousing antics and wicked sense of humor -- and even though the team has been playing better recently, on a night-in, night-out basis, Rocky's performance is still more consistent than that of the hottest players. When he shoots, he scores -- even if the ball doesn't go through the hoop.
The worst thing that's happened to the radio broadcasts of Avalanche games is also the best thing that's happened to television coverage of the team. The irrepressible Mike Haynes, who's now a permanent fixture in the TV booth after establishing himself in the older medium, brings the same elements to Altitude that made him such a favorite among the Fan's listeners: seemingly bottomless enthusiasm, an inimitable style and a knack for saying (and, often, screaming) the very thing that Avs boosters are thinking but can't quite articulate. Most announcers merely call games. Haynes brings them to life -- and now he does so in living color.
The Rockies' "Generation R" advertising campaign smacked of desperation. At least, it did until Matt Holliday, the team's exciting young left-fielder, smacked 34 home runs last season -- a real accomplishment in the humidor era. But Holliday's more than just a long-baller. He maintained a .324 batting average in 2006 by hitting all over the park, and he's got better-than-average wheels for a guy who stands six-foot-four, even managing to beat out five triples. At 27, he's about to enter the prime of his career, and if the Rockies want to convince understandably dubious fans that they really mean to compete in the National League West, they need to find a way to lock up both Holliday and outstanding third-bagger Garrett Atkins for the long haul. Otherwise, the stand-alone letter in "Generation R" will stand for "ripoff."
How many Broncos are the best at their position in the NFL? Precisely one -- and he wears number 24. Although the term "shut-down cornerback" is overused by TV commentators, Champ Bailey comes closer than anyone in the league to making it mean something. Any time the ball is thrown to his half of the field, odds are good that he'll get his hands on it one way or another. When Bailey came to the team in a trade for running back Clinton Portis, there were plenty of naysayers -- but those folks are mighty quiet now. In the unlikely event that the Broncos become champs in the next few years, they'll have Champ to thank.
Carmelo Anthony and Allen Iverson have gotten all the attention this year, since both are capable of setting the scoreboard ablaze. But the underappreciated Marcus Camby truly anchors the Nugs. For one thing, he plays great defense every time he hits the court -- something that's all too rare on this squad. For another, he's the team's most reliable rebounder and shot blocker, and he's got a deceptively deadly outside shot. And, most important, he's a stabilizing force in a lineup that desperately needs one, not to mention a true team player who's willing to subjugate his own stats if it means the difference between victory and defeat. Melo and A.I. can't make that claim -- but the Camby man can.


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Dear David: "Sniffing" for Chemical-Free
I suffer from multiple chemical sensitivities. I worked as a project manager for an architectural firm for 16 years. This employer greatly valued my work and did a great deal to enable me to work in this office. If someone came into the office with heavy perfume, I could leave immediately, etc. I specialized in nontoxic building components. Due to lack of building in the area, I was laid off in October. How do I let potential employers know of my condition — on my resume? In an interview? Am I obligated to let them know early in the application process? Should I visit the potential workplace on my own and "sniff" it out?
— Nosey, OR
I've worked in some environments that had clear policies to address chemical sensitivity and some that did not. There have definitely been times when I wished there was one — especially when someone had evidently taken a shower with eau de parfum. Not a fan of heavy cologne either? Here's an entertaining (scent-free) parody of one famous cologne ad.
Whether you choose to reveal your chemical sensitivity before you are hired is a judgment call: being up-front may help build good will if you do get the job, but there's also a risk that a potential employer could consider it a strike against you. Although it's illegal for an employer not to consider you for a job because of your need for a reasonable accommodation, it can be very difficult to prove that that was the reason you didn't get a job.
Your legal rights in terms of applying for jobs and requesting accommodations are determined by the Americans with Disabilities Act ("ADA"). Here are some resources about the ADA; how it applies to allergies; and how it applies when applying for jobs. As you can see from the last link, you don't have an obligation to discuss your need for a reasonable accommodation while applying for a job.
If you are hired somewhere without an existing chemical sensitivity policy, keep in mind that this might be an issue that you could attract others to get behind. Get to know the lay of the land, and once you know your coworkers better, take a temperature reading on the matter. Find out what they think. It's best if you build toward a consensus that works for you and your coworkers. Then, approach your boss as a group. Highlight the ways that a chemical sensitivity policy would be in everyone's best interest, and ask for it to become policy. Good luck!


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Cascading Style Sheet (CSS) information properly. CSS Drop Down Menu by PureCSSMenu.com
Potomac Curling Club Fifth Annual BIG Spiel
Please note that because of the unique draw and seeding of teams, we won't be able to accurately predict the destinations for the winners and non-winners of each game. So just because this page says "done" doesn't make it so. Please consult the draw posted in the warm room for the most accurate results. This page will be updated during the BIG spiel so check back later...
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Homes of Rochester
meets Rochester.
originally meant as a small but beautiful means of coping
with the East Indian sun, are most often associated with
California. They reached their height of popularity at the
time as the Arts and Crafts movement in America. A builder
who saw both come alive in a Pasadena bungalow took the
exact plans to copy in his hometown back east. That bungalow
was voted Most Beautiful Home in Rochester in 1916, several
years after the builder ran out of money before ever getting
to live in his dream. The current owners, Jim and Marie
Via, have brought the original passion for the rough, hands
on beauty of the Arts and Crafts style into the ongoing,
authentic restoration of the bungalow.
in Mendon
Architect Rodney Skirment had never had a client spend 5
years researching the perfect place and style of their dream
house. The style was inspired by the classic lines of 16th
century master Andreas Palladio. For several reasons, the
dream house that became a real life, 3-story Italian villa
has passed on to Robert and Jill Klimasewski. They have
made their own mark from the playful rooster theme in the
fully equipped Tuscan kitchen to the soaring center space
that dominates the home. It is a new home but one destined
to be a classic.


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By Jake Landers
Published October 2012
Some of our native plants can be overlooked despite their importance or because they don't impress us by their looks. Now that I have shifted my living location from a city standard home and lawn to a community retirement center with adjacent park, parking lot, ditch, and cracks in the sidewalks, I see a different mix of plants. None seem to be very important, but I still find them interesting, and I can get to local ranches to see some important ones when I have a gate opener. But my time on pasture ground is becoming more limited, and my time on the scooter going to and from bank, library, court house, drug store, only two blocks away, is exposing me to new plants.
Hairy tube-tongue is one of those with an unusual name, but a regular member of some of our well-managed range sites, park areas, and lawns. It grows no more than 8 inches high from a tough root crown that seems a little woody. If it's in a lawn, it can recover from regular mowing, or from moderate grazing in the deep clay soils of shady pastures. It remains green all summer when there is adequate moisture with small blueish flowers. Black Swallowtail butterflies can often be seen close to the ground sipping nectar and spreading pollen. By nightfall, for some reason, the flowers are kicked out of their calyx cup to lay sideways on the foliage.
Hairy tube-tongue is an important plant in its more natural setting of Liveoak savanna on the uplands and on bottomlands dominated by Pecan and Bur oak trees. It is highly palatable and nutritious for grazing animals, unfortunately being grazed out of many pastures in the past by sheep and goats. It would be high on my list of plants for restoring as a component of high value habitat for deer.
The scientific name of Hairy tube-tongue is Siphonoglossa pilosella. In Greek it means "tube-tongue" and "soft-hairy."
Mormon tea is another one. Its response to severe drought followed by abundant rain last spring was a brilliant display of red bushes. Ordinarily it blends in with the rest of our roadside brush, but this year it stood out. Bushes in the fence lines of roads in Menard County, where they have survived browsing by livestock and deer, were bright red with abundant "berries." ( Mormon tea is related to Cedar which also has cone-like berries on the female plant and pollen bearing cones on the male.) The green stems provide a high protein forage for livestock and deer. It takes more browsing yet survives better than any other woody plant which often results in gnarled stubs instead of branches.
Mormon tea has small scale-like leaves at each joint of the stem, responsible for one of its common names, "Joint fir." It's also called Clapweed, Popote, and Ephedra, the last one from its scientific name, Ephedra antisyphalitica, suggesting some medicinal value. Probably it will not cure Syphilis as the name suggests nor control stomach worms in sheep as a rancher friend suggests. However, an extract from the plant, ephedrine, now synthesized in several forms, is useful in opening up stuffy noses and other health benefits, but it's not without critics. Lawsuits are ongoing concerning severe negative reactions and death when used as supplements to dieting.
Like the display of wildflowers, the colorful display of Mormon tea will not be seen again for many years. The combination of environmental events which triggers such a response is locked in the DNA of the species. It's the way they have survived and prospered when conditions are met or succumbed when adequate conditions did not occur often enough to keep them growing.
Reading The Landscape
Photo taken in late August on Highway 67 near Kickapoo Creek in Concho County. Lower areas cleared of Mesquite 25 years ago seeded to a mixture of range grasses and used for grazing by cattle, hilltops left alone. What is the brush species coming back in the low areas? What is on the hills? What is the plant species making the large light colored patches? Would you consider this a good grazing situation when the photo was taken? —JL
|See below for Jake's answer
Jake's summary: The few plants are mainly Lotebush, probably from root sprouts following the original clearing, Mesquite having been kept under control. Plants on the hills are Liveoaks. The plant of the light colored patches is Snow-on-the Mountain, Euphorbia marginata, of no grazing value, the milky sap of which is strong enough to take off warts, the seeds very attractive to doves and quail; grazing is poor because grasses have been overtaken by Broomweed. —JL