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Colorectal CancerSkip to the navigation
Topic Overview
Is this topic for you?
This topic will tell you about the early testing, diagnosis, and treatment of colorectal cancer. If you want to learn about colorectal cancer that has come back or has spread, see the topic Colorectal Cancer, Metastatic or Recurrent . If you want to learn about anal cancer, see the topic Anal Cancer .
What is colorectal cancer?
Colorectal cancer means that cells that aren't normal are growing in your colon or rectum . These cells grow together and form polyps. Over time, some polyps can turn into cancer.
This cancer is also called colon cancer or rectal cancer, depending on where the cancer is. It is the third most common cancer in the United States. And it occurs most often in people older than 50.
What causes colorectal cancer?
The exact cause of colorectal cancer is not known. Most cases begin as small growths, or polyps, inside the colon or rectum.
Colon polyps are very common. If they are found early, usually through routine screening tests, they can be removed before they turn into cancer.
What are the symptoms?
Colorectal cancer usually doesn't cause symptoms until after it has started to spread. See your doctor if you have any of these symptoms:
- Pain in your belly
- Blood in your stool or very dark stools
- A change in your bowel habits, such as more frequent stools or a feeling that your bowels are not emptying completely
How is colorectal cancer diagnosed?
If your doctor thinks that you may have this cancer, you will need a test, called a colonoscopy (say "koh-luh-NAW-skuh-pee"), that lets the doctor see the inside of your entire colon and rectum. During this test, your doctor will remove polyps or take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.
Sometimes another test, such as a sigmoidoscopy (say "sig-moy-DAW-skuh-pee"), is used to diagnose colorectal cancer.
How is it treated?
Colorectal cancer is usually treated with surgery, chemotherapy , or radiation .
How can you screen for colorectal cancer?
Screening tests can find or prevent many cases of colon and rectal cancer. They look for a certain disease or condition before any symptoms appear. Experts recommend routine colorectal cancer testing for everyone age 50 and older who has a normal risk for colorectal cancer. Your doctor may recommend getting tested more often or at a younger age if you have a higher risk. Talk to your doctor about when you should be tested.
Screening tests include stool tests that can be done at home and procedures, such as colonoscopy, that are done at your doctor's office or clinic.
Frequently Asked Questions
Learning about colorectal cancer:
Being diagnosed:
Getting treatment:
Ongoing concerns:
Living with colorectal cancer:
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Most cases begin as polyps , which are small growths inside the colon or rectum. Colon polyps are very common. Some polyps can turn into cancer. But doctors can't tell ahead of time which polyps will turn into cancer. This is why people age 50 and older need regular tests to find out if they have any polyps and then have them removed.
Some people who are younger than 50 need regular tests if their medical history puts them at increased risk for colorectal cancer.
Colorectal cancer in its early stages usually doesn't cause any symptoms. Symptoms occur later, when the cancer may be harder to treat. The most common symptoms include:
- Pain in the belly.
- Blood in your stool or very dark stools.
- A change in your bowel habits. (You may have more frequent stools or a feeling that your bowels aren't emptying completely).
- Constant tiredness (fatigue).
- In rare cases, unexplained weight loss.
What Happens
How cancer grows and spreads
Cancer is the growth of abnormal cells in the body. These extra cells grow together and form masses, called tumors. In colorectal cancer, these growths usually start as polyps in the large intestine (colon or rectum). If colon polyps aren't found and removed, they may turn into cancer.
Cancers in the colon or rectum usually grow very slowly. It takes most of them years to become large enough to cause symptoms. If the cancer is allowed to grow, over time it will invade and destroy nearby tissues and then spread farther. Colorectal cancer spreads first to nearby lymph nodes . From there it may spread to other parts of the body, usually the liver. It may also spread to the lungs, and less often, to other organs in the body.
Survival rates
The long-term outcome, or prognosis, for colorectal cancer depends on how much the cancer has grown and spread. Experts talk about prognosis in terms of "5-year survival rates." This means the percentage of people who are still alive 5 years or longer after their cancer was found. It is important to remember that these are only averages. Everyone's case is different. And these numbers don't necessarily show what will happen to you. The estimated 5-year survival rate for colorectal cancer is: footnote 1
- 90% or more if cancer is found early and treated before it has spread. This means that 90 or more out of 100 people will still be alive in 5 years if the cancer is found early and treated before it has spread.
- 71% if the cancer has spread to nearby organs and lymph nodes. This means that 71 out of 100 people will still be alive in 5 years if the cancer has spread to nearby organs and lymph nodes.
- 14% if the cancer has spread to the liver, lungs, or bones. This means that 14 out of 100 people will still be alive in 5 years if the cancer has spread to the liver, lungs, or other organs in the body.
These numbers are taken from reports that were done from 2007 to 2013, before newer treatments were available. So the actual chances of your survival are likely to be higher than these numbers.
What Increases Your Risk
A risk factor for colorectal cancer is something that increases your chance of getting this cancer. Having one or more of these risk factors can make it more likely that you will get colorectal cancer. But it doesn't mean that you will definitely get it. And many people who get colorectal cancer don't have any of these risk factors.
Risks you can change
There are lifestyle actions you can take to lower some of the risk factors for colorectal cancer. These actions include:
- Maintain a healthy weight.
- Be physically active.
- Eat healthy foods, including vegetables, fruits, and whole grains. Avoid eating a lot of red meat or processed meats.
- If you smoke, get help to quit.
- If you drink alcohol, limit how much you drink.
Risks you can't change
Your age
Getting older is a risk factor for colorectal cancer. Experts recommend that people at average risk for colorectal cancer begin screening at age 50, since most cases of colorectal cancer are diagnosed in people older than 50.
Your race and ethnicity
African Americans are at greater risk of getting colorectal cancer (and dying from it) than non-Hispanic whites. And non-Hispanic white people have a higher risk than other major racial or ethnic groups, such as Hispanics, Asians, and Pacific Islanders. footnote 2
Ashkenazi Jews (Jewish people whose ancestors came from Eastern Europe) who have inherited certain genes are also at a higher risk for getting colorectal cancer. footnote 3
Your family's medical history
You are more likely to get colorectal cancer if one of your parents, brothers, sisters, or children has had the disease. Your risk is higher if this family member had colorectal cancer younger than 45 years old, or if more than one family member had the disease.
Some common gene changes increase the chance of colorectal cancer. These changes are familial adenomatous polyposis (FAP) and Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC) . Many people with these changed genes will get colorectal cancer if they aren't carefully watched. Genetic testing can tell you if you carry a changed, or mutated, gene that can cause FAP or HNPCC.
Your medical history
Your chances of getting colorectal cancer are higher if you have had:
- Colorectal cancer in the past.
- Another type of cancer, such as cancer of the ovary or cancer of the endometrium .
- Adenomatous polyps removed from your colon.
- Ulcerative colitis or Crohn's disease for more than 10 years.
- Radiation therapy in your abdomen or pelvis.
When To Call a Doctor
Call your doctor if you have any symptoms of colorectal cancer, such as:
- A change in bowel habits.
- Bleeding from your rectum, including bright red or dark blood in your stools or stools that look black.
- Constant or frequent diarrhea, constipation, or a feeling that your bowel doesn't empty completely.
- Stools that are narrow (may be as narrow as a pencil).
- Belly pain or problems with gas or bloating.
- Unexplained weight loss.
- Constant tiredness (fatigue).
Because colorectal cancer often doesn't cause any symptoms, talk with your doctor about screening tests . Screening helps doctors find a certain disease or condition before any symptoms appear.
Who to see
Health professionals who can evaluate your symptoms of colorectal cancer include:
- Family medicine doctors .
- General practitioners .
- Gastroenterologists .
- General surgeons and colorectal surgeons .
- Internists .
- Nurse practitioners .
- Physician assistants .
If your doctor thinks you may have colorectal cancer, he or she may advise you to see a general surgeon or a colorectal surgeon. Colorectal cancer is treated by surgeons, medical oncologists , and radiation oncologists .
To prepare for your appointment, see the topic Making the Most of Your Appointment .
Exams and Tests
If your doctor thinks you may have colorectal cancer, he or she will ask you questions about your medical history and give you a physical exam. Other tests may include:
- A colonoscopy . Your doctor uses a lighted scope to view the inside of your entire colon. Polyps can be removed during this test. A colonoscopy is recommended when another screening test shows that you may have colorectal cancer. footnote 4
- A sigmoidoscopy . Your doctor uses a lighted scope to view the lower part of your intestine. Doctors can also remove polyps during this test.
- A barium enema . A whitish liquid with barium is inserted through your rectum into your intestine. The barium outlines the inside of the colon so that it can be seen on an X-ray.
- A biopsy . A sample of tissue is taken from the inside of your intestine and examined under a microscope. A doctor called a pathologist can look at the tissue sample and see if it contains cancer.
- A complete blood count , which is a blood test. It is used to look into symptoms such as fatigue, weakness, anemia, bruising, or weight loss.
For people who have an increased risk for colorectal cancer, regular colonoscopy is the recommended screening test. It allows your doctor to remove polyps (polypectomy) and take tissue samples at the same time.
When you are diagnosed with colorectal cancer, your doctor may order other tests to find out if the cancer has spread. These tests include:
- A CT scan to see if the cancer has spread to your liver, lungs, or belly.
- A chest X-ray to see if the cancer has spread to your lungs.
- An MRI or PET scan to see if the cancer has spread into your chest or organs in the belly or pelvis.
- An ultrasound to find the cause of belly pain or increased belly girth. It can also see if the cancer has spread to your liver. An endoscopic ultrasound is used to see how far rectal cancer may have spread.
- A blood chemistry panel to see if the cancer has spread to your liver and bones.
- A carcinoembryonic antigen (CEA) blood test to check the level of this tumor marker .
Early detection
Routine screening can reduce deaths from colorectal cancer.
Talk to your doctor about which test is right for you. People with a higher risk for colorectal cancer, such as those with a strong family history of colorectal cancer, may need to start routine testing before age 50 and have it more often.
Treatment Overview
You and your doctor will work together to decide what your treatment should be. You will consider your own preferences and your general health. But the stage of your cancer is the most important tool for choosing your treatment. Staging is a way for your doctor to tell how far, if at all, your cancer has spread.
Surgery is almost always used to remove colorectal cancer. Sometimes a simple operation can be done during a colonoscopy or sigmoidoscopy to remove small polyps and a small amount of tissue around them. But in most cases, a major operation is needed to remove the cancer and part of the colon or rectum around it. If cancer has spread to another part of your body, such as the liver, you may need more far-reaching surgery.
Chemotherapy uses medicines to destroy cancer cells throughout the body. Several medicines are often used together.
Radiation therapy
Radiation therapy uses X-rays to destroy cancer cells. This is used for some types of cancer in the rectum. Radiation therapy is often combined with surgery or chemotherapy. To learn more, see Other Treatment .
Cancers that have not spread beyond the colon or rectum may need only surgery. If the cancer has spread, you may need radiation therapy, chemotherapy, or both.
Side effects of treatment
Surgery, chemotherapy, and radiation can have serious side effects. But your medical team will help you manage the side effects of your treatment. This may include medicines for pain after surgery or medicines to control nausea and vomiting if you have chemotherapy.
Talk with your doctor and medical team about your side effects. Some side effects, such as pain or tingling in your hands or feet that gets worse (peripheral neuropathy), may be a sign that your medicines need to be changed.
For tips on how to manage side effects at home, see Home Treatment .
Regular checkups
After you have had colorectal cancer, your chances of having it again go up. It's important to keep seeing your doctor and be tested regularly to help find any returning cancer or new polyps early. After your treatment, you will need regular checkups by a family doctor, general practitioner, medical oncologist, radiation oncologist, or surgeon, depending on your case.
When cancer comes back or spreads
Colorectal cancer comes back in about half of people who have surgery to remove the cancer. footnote 5 The cancer may be more likely to come back after surgery if it was not found in an early stage. Cancer that has spread or comes back is harder to treat, but sometimes treatments are successful. For more information, see the topic Colorectal Cancer, Metastatic and Recurrent .
Support and resources
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counselor can really help. Ask your doctor about support groups. Or call the American Cancer Society (1-800-227-2345) or visit its website at www.cancer.org.
To learn more about colon and rectal cancer, go to the website of the National Cancer Institute at www.cancer.gov/cancertopics/types/colon-and-rectal.
Screening for colorectal cancer
Screening tests look for a certain disease or condition before any symptoms appear. Experts recommend routine colorectal cancer screening . The U.S. Preventive Services Task Force says: footnote 6
- People ages 50 to 75 should have a screening test starting at age 50.
- People ages 76 to 85 can work with their doctors to decide if screening is a good option.
- People ages 86 and older are advised that screening for colorectal cancer is usually not helpful.
Your doctor may recommend earlier and more frequent testing if you have a higher risk for colorectal cancer. Talk to your doctor about when you should be tested.
For more information, see:
Genetic testing
If you have a very strong family history of colorectal cancer, you may want to talk to your doctor or a genetic counselor about having a blood test to look for changed genes. Genetic testing can tell you if you carry a changed, or mutated, gene that can cause colorectal cancer. Having certain genes greatly increases your risk of colorectal cancer. But most cases of colorectal cancer aren't caused by changed genes.
Home Treatment
Managing side effects
During treatment for colorectal cancer, you can do things at home to help manage your side effects and symptoms. If your doctor has given you instructions or medicines to treat these problems, be sure to also use them.
In general, healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms.
You can try home treatments:
- For nausea or vomiting , such as ginger tea, peppermint candy or gum, or drinking enough fluids so that you don't get dehydrated .
- For diarrhea , such as taking small, frequent sips of water and bites of salty crackers.
- For constipation , such as getting plenty of water and fiber in your diet. Do not use a laxative without first talking to your doctor.
Other problems that can be treated at home include:
- Sleep problems . If you have trouble sleeping, try having a regular bedtime, getting exercise daily, and avoiding caffeine late in the day.
- Feeling very tired . If you lack energy or become weak easily, try to get extra rest and plan your schedule to make the most of the energy you have.
- Pain . There are many home treatments that can help when you have pain, such as over-the-counter pain relievers, heat packs, or cold packs. Talk to your doctor before using any home treatment for pain.
- Mouth sores . This includes watching what you eat and drink and rinsing regularly with mouthwash or an antacid.
Managing stress from having cancer
Having cancer can be very stressful. Finding new ways of coping with your stress may improve your overall quality of life.
These ideas may help:
- Take steps to reduce your stress . Find new ways to relax, such as yoga or visualization exercises.
- Get the support you need. Spend time with people who care about you. Let them help you.
- Talk about your feelings. Try meeting with a counselor or joining a support group where you can share your experience.
- Ask your doctor to help you find other sources of support and information.
Your feelings about your body may change after treatment. Dealing with your body image may involve talking openly with your partner about your worries and discussing your feelings with a doctor.
Having cancer can change your life in many ways. For help with managing these changes, see the topic Getting Support When You Have Cancer .
For more information about learning how to live with cancer, read "Taking Time: Support for People With Cancer" from the National Cancer Institute. This booklet is available online at www.cancer.gov/cancertopics/takingtime.
Chemotherapy is the use of medicines to control the cancer's growth or relieve symptoms. Often the medicines are given through a needle in your vein. Your blood vessels carry the medicines through your body. Sometimes the medicines are available as pills. And sometimes they are given as a shot, or injection.
Several medicines are used to treat colorectal cancer. There are also several medicines available for treating side effects.
Medicine choices
A combination of drugs often works better than a single drug in treating colorectal cancer. The most commonly used drugs are:
- Fluorouracil (5-FU) combined with leucovorin.
- Oxaliplatin.
- Capecitabine.
- Irinotecan.
Hair loss can be a common side effect with some types of chemotherapy. But hair loss usually isn't a side effect of these drugs.
Treating the side effects
Your doctor may prescribe medicines that can help relieve side effects of chemotherapy. These side effects can include mouth sores, diarrhea, nausea, and vomiting. Your doctor may prescribe medicines to control nausea and vomiting .
There also are things you can do at home to manage side effects. See Home Treatment for more information.
What to think about
Chemotherapy and radiation may be combined to treat some types of colorectal cancer. Radiation or chemotherapy given before or after surgery can destroy microscopic areas of cancer to increase the chances of a cure.
Surgery to remove cancer is almost always the main treatment for colorectal cancer. The type of surgery depends on the size and location of your cancer.
Side effects are common after surgery. You may be able to reduce the severity of your side effects at home. See Home Treatment for more information.
Surgery choices
- Polypectomy. When colorectal cancer is discovered in its very early stages, it can be removed during a sigmoidoscopy or colonoscopy . The surgeon cuts out not just the polyp, but also a small amount of tissue around it. The surgeon does not need to cut into the abdomen.
Bowel resection . This involves cutting out the cancer as well as the sections of the colon or rectum
that are next to it. Then the two healthy ends of the colon or rectum are sewn
back together. This surgery is used when the cancer is larger. It can be done in two ways:
- Open resection. The surgeon makes a long cut (incision) in the belly, completes the bowel resection, and closes the incision.
- Laparoscopic surgery . This is done with several small incisions in the belly for a tiny camera and special tools. But laparoscopic surgery can't always be done, such as when the cancer has spread to areas outside the colon.
Your doctor may suggest radiation therapy or chemotherapy if he or she thinks the cancer may come back (recur). If the cancer has spread to nearby lymph nodes, you may need chemotherapy after your surgery. Or if your surgery shows that the cancer has spread outside your colon or rectum, you may need radiation therapy.
What to think about
Sometimes after a bowel resection, the two ends of the colon or rectum can't be sewn back together. When this happens, a colostomy is performed. But most people don't need a colostomy.
Other Treatment
Radiation therapy
Radiation therapy uses X-rays to destroy colorectal cancer cells and shrink tumors. It is often used to treat rectal cancer, usually combined with surgery. It is used less often to treat colon cancer. It may also be combined with chemotherapy .
Radiation may be given:
- Externally, using a machine outside the body that points a beam of radiation at the tumor.
- Internally, by placing tiny radioactive "seeds" next to or into the cancer.
Compared to surgery alone, radiation given before surgery may reduce the risk that rectal cancer will return, and it may help you live longer. footnote 5
Complementary therapies
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
- Acupuncture to relieve pain.
- Meditation or yoga to relieve stress.
- Massage and biofeedback to reduce pain and ease tension.
- Breathing exercises for relaxation .
Mind-body treatments like the ones listed above may help you feel better. They can make it easier to cope with cancer treatments. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and side effects. Let your doctor know if you are already using any of these therapies. Complementary therapies are not meant to take the place of standard medical treatment. But they may improve your quality of life and help you deal with the stress and side effects of cancer treatment.
Clinical trials
You may be interested in taking part in research studies called clinical trials . Clinical trials are based on the most up-to-date information. They are designed to find better ways to treat people who have cancer. People who don't want standard treatments or aren't cured by standard treatments may want to take part in clinical trials. These are ongoing in most parts of the United States and in some other countries around the world for all stages of colorectal cancer.
Other Places To Get Help
Atlanta, GA 30303
Related Information
- National Cancer Institute (2017). SEER cancer stat facts: Colon and rectum cancer. National Cancer Institute. https://seer.cancer.gov/statfacts/html/colorect.html. Accessed November 10, 2017.
- American Cancer Society (2011). Colorectal Cancer Facts and Figures 2011-2013. Atlanta: American Cancer Society. Available online: http://www.cancer.org/Research/CancerFactsFigures/ColorectalCancerFactsFigures/colorectal-cancer-facts-figures-2011-2013-page.
- Libutti SK, et al. (2011). Cancer of the colon. In VT DeVita Jr. et al., eds., DeVita, Hellman and Rosenberg's Cancer: Principles and Practice of Oncology, 9th ed., pp. 1084-1126. Philadelphia: Lippincott Williams and Wilkins.
- Winawer S, et al. (2003). Colorectal cancer screening and surveillance: Clinical guidelines and rationale-Update based on new evidence. Gastroenterology, 124(2): 544-560.
- Lewis C (2007). Colorectal cancer screening, search date November 2006. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
- U.S. Preventive Services Task Force (2016). Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. JAMA, 315(23): 2564-2575. DOI:10.1001/jama.2016.5989. Accessed June 27, 2016.
Other Works Consulted
- National Cancer Institute (2010). Colon Cancer PDQ: Treatment-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/colon/HealthProfessional.
- National Cancer Institute (2011). Colon Cancer PDQ: Treatment-Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient.
- National Cancer Institute (2011). Rectal Cancer PDQ: Treatment-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/rectal/HealthProfessional/allpages.
- National Cancer Institute (2012). Genetics of Colorectal Cancer PDQ-Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/genetics/colorectal/healthprofessional/allpages.
- National Cancer Institute (2012). Rectal Cancer Treatment (PDQ)-Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/rectal/Patient.
- National Comprehensive Cancer Network (2012). Rectal cancer. NCCN Clinical Practice Guidelines in Oncology, version 3. Available online: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#site.
ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Kenneth Bark, MD - General Surgery, Colon and Rectal Surgery
Adam Husney, MD - Family Medicine
Current as ofNovember 22, 2017
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text:
Oral contraceptives (OCs), or birth control pills, are some of the most effective contraceptive drugs.
These medications include:
- Alesse
- Brevicon
- Demulen
- Desogen
- Estrostep
- Genora
- Jenest
- Levlen
- Levlite
- Levora
- Loestrin
- Lo/Ovral
- Micronor
- Mircette
- Modicon
- Nelova
- Nordette
- Norethin
- Norinyl
- Nor-Q.D.
- Ortho-Cept
- Ortho Cyclen
- Ortho-Novum
- Ortho Tri-Cyclen
- Ovcon
- Ovral
- Ovrette
- Tri-Levlen
- Tri-Norinyl
- Triphasil
- Zovia
- and others
Although the evidence is not consistent, women who are taking OCs may need extra folate. 1-5
Since folate deficiency is fairly common even among women who are not taking OCs, and it's not wise to be lacking in an essential nutrient, taking a folate supplement on general principle is probably a good idea.
Evidence from several studies suggests that OCs might interfere with the absorption or metabolism of magnesium , vitamin B 2 , vitamin C , and zinc . 6-12 With the exception of the trials involving magnesium, these studies used older, high-dose OCs. Modern, low-dose OCs may not affect nutrients to the same extent; still, you should probably make sure you get enough of these nutrients.
Reliable case reports, as well as controlled clinical trials, indicate that St. John's wort interferes with the effectiveness of oral contraceptives and may have led to unwanted pregnancies. 13,20,25
Indole-3-carbinol (I3C) is a substance found in broccoli that is thought to have cancer preventive effects. One of its mechanisms of action is thought to involve facilitating the inactivation of estrogen, as well as blocking its effects on cells. 21-24 The net result could be decreased effectiveness of oral contraceptives.
OCs have been reported to cause increased sensitivity to the sun, amplifying the risk of sunburn or skin rash. Because dong quai and St. John's wort may also cause this problem, taking these herbal supplements while taking OCs might add to this risk.
It may be a good idea to wear sunscreen or protective clothing during sun exposure if you take one of these herbs while using OCs.
Grapefruit juice slows the body's normal breakdown of several drugs, including estrogen, allowing it to build up to potentially excessive levels in the blood. 14 A recent study indicates this effect can last for 3 days or more following the last glass of juice. 15
If you take estrogen, the safest approach is to avoid grapefruit juice altogether.
The supplement resveratrol has a chemical structure similar to that of the synthetic estrogen diethylstilbestrol and produces estrogenic-like effects. 16 For this reason, it should not be combined with prescription estrogen products.
One report has noted that an ingredient of milk thistle, silibinin, can inhibit a bacterial enzyme called beta-glucuronidase. This enzyme helps oral contraceptives work. 17 Taking milk thistle could, therefore, reduce the effectiveness of OCs.
Androstenedione has become popular as a sports supplement, on the theory that it increases testosterone levels as well as sports performance. However, there is no evidence that it is effective. In addition, androstenedione appears more likely to elevate estrogen than testosterone levels. This could increase risks of developing estrogen-related diseases, including breast and uterine cancers. Women taking estrogen should not take androstenedione. 18
Fears have been expressed by some experts that soy or soy isoflavones might interfere with the action of oral contraceptives. However, one study of 36 women suggests that such concerns are groundless. 19
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -

subset: commoncrawl


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Here's Why:
Produce has certainly earned its healthful reputation. It is rich in vitamins, minerals, antioxidants, phytochemicals, and fiber, while being low in calories and fat. All of these factors contribute to many health benefits, such as:
- Lower blood cholesterol levels
- Decreased risk of atherosclerosis (plaque build up in the arteries) and heart disease
- Decreased risk of certain types of cancer
- Lower blood pressure
- Lower risk of being overweight or obese
- Less risk of constipation
Here's How:
How much fruit and vegetables you need is based on your age, gender, and activity level. In general, adults should aim for these amounts every day:
- About 1-½ to 2 cups of fruit (1 cup = 1 cup fresh fruit, 1 cup fruit juice, ½ cup dried fruit)
- About 2-½ to 3 cups of vegetables (1 cup = 1 cup raw or cooked vegetables, 1 cup vegetable juice, 2 cups raw leafy vegetables)
Try to fill half your plate with fruits and vegetables. Visit the ChooseMyPlate website for more information.
Focus on color when eating fruits and vegetables. Dark green, red, and orange vegetables are especially packed with good-for-you nutrients. Also, within your daily servings, try fruits and vegetables rich in vitamin A or beta-carotene and vitamin C . Produce rich in vitamin A and beta-carotene (which is converted to vitamin A in the body) includes:
- Pumpkin
- Sweet potatoes
- Carrots
- Mangoes
- Spinach
- Cantaloupe
- Kale
- Apricots
- Tomato juice
- Nectarines
- Papayas
- Peaches
Produce rich in vitamin C includes:
- Bell pepper
- Papayas
- Oranges and orange juice
- Broccoli
- Strawberries
- Grapefruit
- Cantaloupe
- Tomatoes and tomato juice
- Potatoes
- Cabbage
- Spinach
- Collard greens
Tips for Adding Fruits and Vegetables to Your Diet
- Fresh or dried fruit mixed with cereal or oatmeal
- Bagel or English muffin topped with whole fruit jam or onion and tomato or cucumber and cream cheese
- Glass of tomato juice with a spear of celery
- Bake a sweet potato (microwave on high for 5-8 minutes) and top with black beans
- Stir fresh fruit into yogurt
- Pop open a can of mandarin oranges
- Dip carrot, celery, red pepper, and zucchini sticks into hummus, yogurt, or low-fat dip
- Roast vegetables—onion, squash, peppers, and eggplant—and spread on a pizza crust with tomato sauce and cheese
- Top baked potatoes with steamed broccoli, beans, and salsa
- Add dried fruit to rice and stuffing
- Grate carrots and zucchini into pasta sauce
- Fresh cut-up fruit
- Top frozen yogurt with sauteed apples, fresh peaches, or canned pineapple
- Choose a fruity dessert, such as a cobbler
Smoothies with fruit, yogurt, juice, proteins, and/or vegetables are great option for a fast, nourishing breakfast, snack, or dessert. Consider investing in a blender that can crush ice and frozen fruit. You can use any ingredients you like for a healthy alternative to sweets.
No Cheating!
While it may be tempting to just pop a supplement instead of eating more produce, this is not the best way to go. The majority of the research has shown positive health effects from foods rich nutrients, not from isolated nutrients. Experts think it may be the package of nutrients in fruits and vegetables that delivers the biggest health benefits. Additionally there are hundreds of phytochemicals in each bite of fruits and vegetables that are not available in pill form.
- Reviewer: Michael Woods, MD
- Review Date: 02/2016 -
- Update Date: 02/16/2016 -


text:
Thought I'd take my brand spanking new heels out for a day out. I bought them in the Zara sale after pining after them for a few months. Never ever did I think I'd see the day where I'd choose to buy a pair of kitten heels, but lets face it style changes! I'm really happy with them despite them feeling very strange to wear despite the small heel. I hardly ever wear anything with such a narrow heel so I feel a bit off tottering around with them on! I do love the pointed shape and the ankle strap though, makes me feel very lady like! I filmed a video earlier and this was one of the outfits, but I don't think Im going to have time to edit it tonight so I'll get back to it tomorrow!
Monki is one of my favourite shops at the moment, their simple and often unique approach to the shapes of clothing are spot on. Their patterns, colouring and themes of their collections are fun and really different from the style of clothing on offer in the UK. Basically there is a lot of baggy smocks, oversized tops, monochrome prints and colour pops. It's definitely one of my favourite foreign brands! It's like H&M with more Scandi-influences and I highly recommend checking it out! There is currently only one store in the UK in Carnaby Street but you can shop online!


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Taking the First Steps To Sustainability
A version of this article appears in the May/June 2011 issue of Home Energy Magazine.
May 01, 2011
A business consultant shares what makes some contractors vulnerable to changing market forces and what keeps others on the road to long-term sustainability.
As I consult with top energy contractors across the country, I see that they fall into two types. On the surface, both types appear to be successful, and in many cases they have found success in the short term. But when I "look under the hood," I begin to see which contractors are vulnerable to changing market forces and which ones stand a good chance of long-term sustainability.
To read complete online articles, you need to sign up for an Online Subscription.
Once an order has been placed there is an automatic $10 processing fee that will be deducted with any cancellation.
The Home Energy Online articles are for personal use only and may not be printed for distribution. For permission to reprint, please send an e-mail to email@example.com.


text:
We had friendsgiving last weekend. It was awesome, albeit small. But the people who did come were awesome and the food was great. Really what more can you ask for?
My friend Katy made this. She is a vegetarian and this is one of her favorite thanksgiving dishes. I can see why. The stuffing has a really delicious complex flavor and who doesn't love squash? You should definitely try this.
Stuffed Acorn Squash with Black Rice, Roasted Carrots and Dried Cherries
This recipe is slightly adapted from Delicious Living and made by my friend Katy.
- 4 acorn squashes
- 1 tablespoon and 8 teaspoons canola oil, divided
- 1 teaspoon sea salt, divided
- 2 teaspoons ground coriander, divided
- 1/2 teaspoon ground nutmeg, divided
- 1 pound carrots, peeled and cut into 1/2-inch dice
- 3/4 cup coarsely chopped pecans
- 1 1/2 teaspoons minced fresh ginger
- 10 large sage leaves, chopped
- 3/4 cup coarsely chopped dried cherries
- 2 tablespoons maple syrup
- 3/4 cup finely diced onion
- 1 cup Chinese black rice
- 1/4 teaspoon ground cinnamon
- 2 cups low-sodium vegetable broth
1. Preheat oven to 375 degrees F.
2. Cut squashes in half lengthwise and scoop out seeds. Brush interiors with 4 teaspoons oil, then sprinkle with 1/2 teaspoon salt, black pepper to taste, 1/2 teaspoon coriander, and scant 1/4 teaspoon nutmeg. Arrange halves on a baking sheet, cut-side down. Roast 40-50 minutes on the upper middle oven rack, until tender when pierced.
3. Combine remaining 4 teaspoons oil, 1/2 teaspoon salt, 1 1/2 teaspoons coriander, and 1/4 teaspoon nutmeg with carrots, pecans, and ginger in an 8-inch baking dish; toss to combine. Roast at 375 degrees F for 30-40 minutes on the bottom middle oven rack, stirring every 10 minutes. When carrots are tender, stir in chopped sage, dried cherries, and maple syrup. Roast for another 10 minutes, then remove from oven.
4. While vegetables are roasting, place a medium saucepan over medium heat. When hot, add 1 tablespoon canola oil. Add onion and saute for 2-3 minutes, until onion begins to soften. Stir in rice and cinnamon, then add broth. Stir to combine. Bring to a boil, reduce heat to low, cover, and simmer for 30 minutes. Remove from heat and allow to rest for 10 minutes.
5. Combine rice with carrot mixture. Arrange squash halves, cut side up, on a serving platter; fill with rice mixture, pressing gently to secure.


text:
Minnesota, District 5960, Club #2157
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text: Tuesday, November 06, 2012 AHA and Hospitals Sue CMS for 'Arbitrary and Capricious' Payment Policy Related to the solicitation of public comments regarding Medicare's policy to rebill for subsequently denied inpatient Part A stays under the Medicare Part B outpatient hospital benefit (see News Now article), the American Hospital Association along with a number of hospitals across the country filed a lawsuit in US District Court (The American Hospital Association, et al. v. Kathleen Sebelius, Case No. 1:12-cv-1770) on November 1. In the lawsuit, the plaintiffs contend that the Medicare payment denial policy is "arbitrary and capricious" as it unfairly denies payment to hospitals for medically necessary services that are not statutorily excluded under Medicare Part B. Therefore, the plaintiffs request that the court grant a declaratory judgment affirming that the Centers for Medicare and Medicaid Services' (CMS) payment denial policy is invalid and that CMS has failed to promulgate a regulatory rationale for the application of this arbitrary policy. In addition, the plaintiffs request that the court direct CMS to pay the plaintiffs accordingly for the denied services under the Medicare Part B benefit. In its comments to CMS submitted September 4, APTA urged the agency to consider the effect that payment for inpatient hospital services under Medicare Part B might have on the therapy cap for outpatient therapy services. Due to risk of denials when classifying patients for an inpatient stay, APTA explains, there are instances in which a patient's entire stay in the hospitals, sometimes spanning as much 16 days, is classified as an outpatient hospital stay. Therefore, all physical therapy services received during this period as of October 1, 2012, will count toward the therapy cap. "We believe that this is unfair to these patients as it may limit their access to physical therapy in the outpatient setting, when in fact these services should have been billed as inpatient services," says APTA.


text:
Other Proposed Uses
- AMPD (Congenital Myoadenylate Deaminase Deficiency)
- Angina
- Congestive Heart Failure
- Enhancing Mental Function
Probably Not Effective Uses
- Duchenne Muscular Dystrophy
- McArdle's Disease
- Sports Performance Enhancement (High Intensity Exercise)
Ribose is a carbohydrate vital for the body's manufacture of ATP (adenosine triphosphate), which is the major source of energy used by our cells.
Quite a few studies have been done on ribose, mostly relating to its potential usefulness for individuals with heart disease. When the heart is starved for oxygen, as can occur with a heart attack or angina , it loses much of its ATP, and its ATP levels remain low for several days, even after blood flow is resumed. 1 Scientists have found that supplying extra ribose in the blood helps restore the heart's normal ATP levels more quickly. This finding has raised hopes that ribose supplements might improve heart functioning and increase exercise capacity.
Ribose is better known as a sports supplement . However, current evidence indicates that it is not effective for this purpose.
Ribose is not an essential nutrient. Although it is a common sugar present in the bodies of animals and plants, food sources don't supply recommended dosages.
Therapeutic Dosages
Typical doses recommended by sports supplement manufacturers are 1 to 10 g per day. However, researchers have used much higher doses. For example, in a study focusing on coronary artery disease and exercise-induced ischemia (problems with blood supply to the heart), the participants took 15 grams of ribose 4 times a day for 3 days. 2
Typically provided as a powder to be dissolved in water or in liquid form, ribose is also available commercially in capsules. The dissolved powder has a sweetish taste that some people find unpleasant. 5
Therapeutic Uses
Ribose may be of benefit in improving exercise tolerance in people with angina by helping the heart regenerate its ATP, but the evidence that it works remains highly preliminary. 6 One small study found evidence that ribose supplements might improve heart function in people with congestive heart failure . 17
Sports enthusiasts are more interested in ATP's effects on regular muscles than on the heart muscle. At least one animal study seems to show that skeletal muscle, like heart muscle, replenishes ATP more quickly when ribose is added to the blood. 7 In theory, this could lead to enhanced performance in high intensity anaerobic exercise, such as sprinting. However, six small double-blind, placebo-controlled trials in humans failed to find any benefit. 14-16,18-19,21 In one of these studies, dextrose (a form of ordinary sugar) proved effective while ribose did not. 20
In one small, double-blind study, ribose failed to prove effective for enhancing mental function . 22 The researchers suggest that the dose they used (2 g daily) may have been insufficient.
In a few case reports, ribose apparently has produced an increase in exercise ability in people with a rare condition involving deficiency of the enzyme myoadenylate deaminase (AMPD). 8,9 However, no double-blind studies of ribose in AMPD deficiency have been conducted. Small, double-blind studies have failed to find ribose effective for another rare enzyme deficiency, called McArdle's disease, 10 or for Duchenne's muscular dystrophy. 11
What Is the Scientific Evidence for Ribose?
Individuals with sufficiently severe coronary artery disease suffer reduced blood flow to the heart (ischemia) with exercise and experience angina pain. One small study examined whether giving ribose can improve exercise tolerance for people with angina. 12 In the study, 20 men with severe coronary artery disease walked on a treadmill while researchers noted how long it took for signs of ischemia to develop. For the next 3 days, the men took either oral ribose (60 mg per day) or placebo, after which they repeated the treadmill test. Results of the final test showed that those taking ribose increased the time they were able to walk before developing EKG signs of ischemia, while those taking placebo had no such improvement. This preliminary study was too small to prove anything definitively, but it certainly suggests that further investigation would be worthwhile.
Another small placebo-controlled study enrolled people with coronary artery disease and congestive heart failure and found that use of ribose supplements improved objective measures of heart function and also enhanced subjective "quality of life." 17
Safety Issues
There are no reports of lasting or damaging side effects from ribose, but formal safety studies have not yet been conducted. Reported minor side effects include diarrhea, gastrointestinal discomfort, nausea, and headache. 13
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text:
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Item Code / SKU: 42264
Appraiser / Seller: Day Furs Inc.
Women's mahogany mink fur coat, brown pristine lining, A+ garment, modern style and pristine condition, lots of sweep. European hook and eye closures. Sold in our store new and has been stored and conditioned yearly.
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About Estate Furs:
Founded by Kevin and Ann Day to serve a steadily growing market for luxury pre-owned fur, leather and shearling outerwear, this retail and on-line business (www.estatefurs.com and www.buymyfur.com) has established itself as a world leader in unique, one of a kind pre-owned garments. Estate Furs is a natural extension to their successful family owned business, Day Furs (www.dayfurs.com) based in Carmel, IN for over 30 years.
Size: Womens 12
Condition: LikeNew
Closure: HookAndEyes
Collar: Wing
Cuffs: Banded
Arm pit to Arm pit: 21
Hem Length: 48
Shoulder Width: 18
Sleeve Length: 32
Swing: 71
Years Owned: 15
Appraised Value: $8,500.00
Returns: Free 5 Day Return | See Details ▼
All estatefurs.com purchases may be returned for a full refund of the purchasing price less shipping. Garments to be returned must be back in the mail to us by 5 days after receipt. If returning, call Diane for return authorization number: 1-800-732-9387
If you wish to contact the vendor of this item prior to purchasing it, please give us your information in the form below. The vendor should get back to you within 2 business days.
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text:
Heavy menstrual bleeding (also called menorrhagia) is excessive menstrual blood loss that interferes with a woman's quality of life.
In some cases, the cause is not known. However, many conditions have been associated with menorrhagia, such as:
- Uterine fibroid
- Bleeding disorders, such as von Willebrand disease
- Hormonal imbalance
- Cervical or endometrial polyp
- Ovarian cyst
- Certain medications
- Intrauterine device (IUD)
Risk Factors
Factors that may increase your chances of menorrhagia include:
- Adolescence
- Approaching menopause
Symptoms of menorrhagia include:
- Menstrual bleeding lasting more than 7 days
- Unusually heavy bleeding (soaking through a sanitary napkin or tampon every hour)
- Menstrual flow requiring change of sanitary protection during the night
- Menstrual flow including large clots
- Menstrual flow interfering with lifestyle
- Fatigue and/or shortness of breath (symptoms of anemia)
When Should I Call My Doctor?
Call your doctor if you have symptoms of menorrhagia.
You will be asked about your symptoms and medical history. A physical examination, including a pelvic exam, will be done. Tests may include:
- Pap test
- Blood tests
- Transvaginal ultrasound
- Removal of a sample of endometrial tissue—endometrial biopsy
- Scraping of the inner lining of the uterus—dilation and curettage
- Examination of the uterus and fallopian tubes—hysteroscopy
Treatment depends on the underlying cause of the heavy menstrual bleeding. Treatments may include:
The doctor may advise:
- Hormonal therapy
- An IUD that releases the hormone progesterone
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Iron supplement
Surgical Procedures
In some cases, surgery may be needed, such as:
- Dilation and curettage
- Operative hysteroscopy—may be used along with other tools to remove a polyp
- Removal of the lining of the uterus—endometrial ablation
- Removal of the uterus—hysterectomy
Revision Information
- Reviewer: EBSCO Medical Review Board Beverly Siegal, MD, FACOG
- Review Date: 09/2018 -
- Update Date: 09/30/2013 -


text:
Before Hunting Laws
During the 19th century, many game animals were hunted nearly into extinction. The thundering herds of bison that once roamed the plains were reduced to about 800 head. The beaver was almost wiped out. Once plentiful elk, deer, and pronghorn had been reduced to a fraction of their original numbers.


text:
Forum rules
Please read the following rules before posting a download request in this area:
1. Don't post a request if you have under 10 posts as stated on the front page. If you do anyway, it will be deleted without further notice. This also applies to other members: If you see a request by someone with less than 10 posts and it hasn't been deleted yet, please don't reply to it.
2. Don't request for warez or any copyrighted software. Only betas (no matter how old or new) and finals of operating systems and applications that are at least 10 years old and therefore classified as abandonware are allowed to be uploaded to and shared on the BetaArchive FTP server.
3. If you have your own FTP server where you'd like other members to upload what you're looking for to, please don't post its login details in any open forum as that will probably lead to abuse. Post the login details in the Private Servers section instead.
4. Check that we don't already have the file on our FTP servers. If you don't have access to the FTP servers then ask someone who has (a moderator for example).
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text:
Bling wedding shoes for bride
Wedding and bling wedding shoes for bride
Today we will talk about the wedding and bling wedding shoes for bride. Wedding day is one of the most exciting days in a persons life. Naturally, I want everything to go perfectly. And even the most seemingly insignificant detail can spoil the holiday. What can we say about the unsuccessfully selected shoes of the bride and groom. Look at bling wedding shoes for bride!
What is most important in bling wedding shoes for bride
Naturally, mens and womens shoes, bling wedding shoes for bride, differ in both criteria and style. But still, the most important aspect can be distinguished when choosing wedding shoes for both sexes – Convenience. Yes, this item should be put in the first place. After all, it is in this shoe that you will have to spend the whole day – to stand, walk, sit, and also dance … So, the right size and the right lift, a comfortable shoe and a comfortable model are essential items for wedding shoes. So, bling wedding shoes for bride!
bling wedding shoes for bride Color
For womens shoes the most wedding option is white. However, it still seems to us that simply buying shoes once and storing them on the shelf is wasteful. Therefore, why not try a more neutral option, for example, beige, bling wedding shoes for bride.
Wedding shoes for men
For men there is no such magnificence and diversity. There is a strict dress code. The colors should be harmoniously combined – a black suit with black shoes, a brown suit with brown ones, a gray one with both black and brown ones (the tone of color depends on the season and the particular color of the suit). It so happens that choosing shoes is not so easy for a particular color of the suit. Then push off the color of the tie and belt. So, bling wedding shoes for bride!


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|David F. on 15/11/2018
|Good socks
|Allison S. on 03/12/2019
|Good product & delivered on time
If you have seen this product in stock somewhere else cheaper, then please let us know the details and we will attempt to match the price. We will review your request and get back to you by email to let you know if we can accept your request.
Please bear in mind when looking at other websites, that most of our competitors take orders for items they don't hold in stock. We are the only company to show live stock numbers, so not only are you benefiting from our great prices, but you get superb service and same day dispatch on all orders placed before 2pm Monday-Friday.
Please also be sure to check postage costs, as many competitors will reduce item prices but then charge more for delivery. Any cheaper prices you find elsewhere must include postage costs.


text:
According to Wikipedia, Life magazine published a report back in 1954 that claimed illiteracy among children was due to the fact that they were too bored by the children's books on the market. At the time, the director of the education division at Houghton Mifflin, William Spaulding, who had read the report, challenged Dr. Seuss to create a book that children couldn't put down using a list of 250 words that they felt every 1st grader should know. The result was The Cat in the Hat.
Today, The Cat in the Hat is one of the most recognizable children's book characters. He is made even more popular by the PBS Kids' show of the same name. And to celebrate Dr. Seuss' 108th birthday, this Friday, March 2nd, PBS stations will be hosting THE CAT-IN-THE-HAT-A-THON, a two-hour marathon of THE CAT IN THE HAT KNOWS A LOT ABOUT THAT! The show is designed to help build STEM skills. And this Friday's CAT-IN-THE-HAT-A-THON features two new episodes, "Seasons - Spring and Summer/Fall and Winter" and "When I Grow Up/Doing It Differently."
As a new PBS Ambassador, I received a screener of the new episodes and a Cat in the Hat gift bundle that included the 3-D book, Chasing Rainbows, a DVD from the series, and a $25 gift card to the PBS KIDS Shop.
The book, which was provided by Random House, comes with 3-D glasses. My kids LOVED it! Which is funny, because they don't like 3-D movies. I guess it is different with a book. My son is not old enough to read all the words, yet, but my daughter is, so I let her read to him.
And to increase your chances of winning, you can:
2) Follow me on Twitter and tweet the following: Win a Cat in the Hat gift bundle from @LatinMami & @PBSKIDS for Dr. Seuss' 108th bday! http://bit.ly/ypz6m7 #cithathon #giveaway
Don't forget to let me know by posting a separate comment for each entry!
By entering this giveaway, you agree to the Official Sweepstakes Rules. No purchase required. Void where prohibited.
Disclosure: I am a PBS KIDS Ambassador. I received a screener and gift bundle for review purposes. All opinions are sincere and are my own.


text:
eWEEK: GNOME, KDE Aim at Windows
The eWeek Labs have reviewed the latest releases of both major Free Software desktops. The report focuses on their groupware applications and how the desktops can be locked down. Additionally Kopete gets praised for its improvements and desktop integration. From KDE's executive summary: "KDE 3.3 is another strong release from the prominent KDE project and stands out most for us in the improvements to its Kontact groupware application."
The article:
Pans Kontact in favor of Evolution.
1) "... when we were using the down-arrow key, Kontact insisted on scrolling downward through the current message ..., rather than through messages in its message-list pane."
The first too seem to be genuine usability bugs, but the last is a security *feature*. I don't think we ought to compete with MS and GNOME by enabling security vulnerabilities by default.
Praises Kopete for (in part) having the option to look like Gaim.
1) "We particularly appreciated the option of having Kopete render our chats to mimic other IM clients, such as the Gaim client."
Notes that GNOME 2.8 apparently has a kioskalike although it prefers Waldo's kiosktool GUI to gconf-editor.
"A nice improvement we found in GNOME 2.8 was the capability for auto-mounting removable devices such as USB (Universal Serial Bus) thumbdrives."
Works just fine for me with the default desktop for SuSE 9.1 ;)
By manyoso at Sat, 2004/09/25 - 5:00am
Re: Summary
> 3) "Another thing that annoyed us about KDE's mail handling was the way it dealt with HTML messages."
That part of the story is bogus. Quote: "we'd prefer that Kontact provide the option of rendering the message in a "sanitized" form-one that doesn't fetch remote images or objects." Guess what the deselected "Allow messages to load external references from the Internet" option does?
By Anonymous at Sat, 2004/09/25 - 5:00am
Re: Summary
It's not bogus. Evolution shows the neutered html in rendered form, and KMail shows the html in source form. Personally I like it rendered.
By - at Sun, 2004/09/26 - 5:00am
Re: Summary
Well have you tried changing the settings?
These options have existed in KMail since, not sure but at least since the KDE2.0 or 2.1 days. And when you press on the link in the note box displayed when you see the source of a HTML message and then get the HTML in rendered form. It does not take much brainpower to understand since it can display HTML, it's possible to set this to default behavior. Probably take 1-2 minutest to find in the config-panel, less if you read the note in the nonrendered mail (the part claiming security reasons to not render HTML).
By Morty at Sun, 2004/09/26 - 5:00am
Re: Summary
KMail is lacking the most sensible option however: "Prefer plain text, but display HTML when only HTML is available"
I can set KMail to prefer HTML but then mails which are sent as both HTML and plain text will be rendered as HTML. Or I can set KMail to not render HTML, but then I miss out on HTML-only mails.
By Anonymous at Sun, 2004/09/26 - 5:00am
Re: Summary
You don't miss out on HTML only mail, its just one click away. Haven't you noticed the nifty red box containing this message?
Note: This is an HTML message. For security reasons, only the raw HTML code is shown. If you trust the sender of this message then you can activate formatted HTML display for this message by clicking here.
I don't think the option of displaying HTML when no plaintext are available are particularly sensible, there are reasons to not open HTML mail you know. And besides do you want HTML mails or not. If you don't the sane thing are to be able to manually override when necessary, not the other way.
By Morty at Sun, 2004/09/26 - 5:00am
Re: Summary
This annoys me also. I'd much rather read the text mail when it's available and not the HTML version, but not have the extra click to open HTML only email. It may not seem like much, but when you receive a lot of HMTML only email each day it gets old very fast.
By greg at Mon, 2004/09/27 - 5:00am
Re: Summary
I agree. People only need to read the information Kmail presents. Doing so and they are but a click from reading their html mail. I personally think html mail should be banned but that's me. The vast majority, well over 90% of html mail I get are from spammers anyway. The few I get from trusted sources is not enough IMO to warrant a change in Kmail's behavior. Frankly I am annoyed by those who insist sending html mail.
I remember the first time I saw Kmail's warning about html mail and thought, now that's a nice touch and felt a bit more safer reading my mail.
My two cents say leave the way Kmail handles it the way it is and make those who want html stuff work to get it. I know having to do an extra mouse click or two is really time consuming:)
By stumbles at Mon, 2004/09/27 - 5:00am
Re: Summary
> 1) "... when we were using the down-arrow key, Kontact insisted on scrolling > downward through the current message ..., rather than through messages in its > message-list pane."
Left and right scroll up and down the message list, up and down scroll through the current message. This means that you don't have to switch focus between message pane and list pane but also makes it slightly less intuitive (took me a while to realise).
By Mark at Sat, 2004/09/25 - 5:00am
Re: Summary
Yep, the feature is useful, but unintuitive, and different from the way every other list box in KDE behaves.
Because of that the feature should not be enabled by default.
About usability testing in general: All feedback is good feedback, no matter whether it's from journalists, lab experts or from users participating in a usability study. They are not after us with a hidden agenda to make us look bad, but they highlight cases where our software didn't fulfill their initial expectations. It's up to us what we do with it. In this case I would say that the expectation that a list box should scroll when it has focus and I press the Up and Down arrow keys is a perfectly normal and understandable expectation. I fell into the same trap. When I first noticed it I started debugging and wanted to send Don a patch, unfortunately I wasn't very convincing.
By Matthias Ettrich at Sat, 2004/09/25 - 5:00am
Re: Summary
I'm all for consistency between apps and intuitive defaults, still I cannot see a great workaround in this case...
By John Kmail Freak at Sat, 2004/09/25 - 5:00am
Re: Summary
You can change the focus with the Tab key. Tab goes forward, Shift+Tab goes back. This is the way just about everything else works, and this is how Kantact should do it, too.
By Mitchell Mebane at Sun, 2004/09/26 - 5:00am
Re: Summary
Thanks, I didn't know about Tab/Shift Tab. Again, I like consistency, but you do agree that working that way with kmail would be a pain no? Just imagine scrolling one message, then changing to another folder, select the message you want and scrolling it. Compare both ways of doing it.
By John Kmail Freak at Sun, 2004/09/26 - 5:00am
Re: Summary
From a functionality point of view, the current way is definately better. However, I never noticed the left-right thing for scrolling through messages, and always gave up and used the mouse.
By Mitchell Mebane at Wed, 2004/09/29 - 5:00am
Re: Summary
"Because of that the feature should not be enabled by default."
Only because some users (not developers!) don't understand it?
* Better show a message box the first time somebody uses the arrow keys inside Kmail/Kontact.
By Asdex at Sun, 2004/09/26 - 5:00am
Re: Summary
""Because of that the feature should not be enabled by default."
Only because some users (not developers!) don't understand it?"
Yes, that's exactly why... Pardon me if I misunderstood your tone, and you actually mean that literally rather than as a point-making question. Not everyone who uses KDE is a developer. I would venture even to say that most people who use KDE aren't. And if that isn't the case, I think that's what the desktop is aiming for. Seriously, what is this elitist attitude that the more intuitive way of functioning shouldn't be enabled by default because developers can understand the counterintuitive way of doing things? Those developers are also more capable than regular users of going to find the option to toggle their way on and off.
By Antonio Salazar at Sun, 2004/09/26 - 5:00am
Re: Summary
In Outlook 2003, up / down scroll the list or the message itself, depending on what has focus. But if you're focused on the message window, you can also use Ctl + up / down to change message. This is a nice way of doing things, although I'm happy with KMail's approach now I've figured it out.
This could almost be a configurable setting but you can arguably have too many of those ;-)
By Mark at Sun, 2004/09/26 - 5:00am
Re: Summary
And how many users (besides you) know that one can change the message with Ctrl+up/down? This behavior is at least as unintuitive as KMail's behavior.
By Ingo Klöcker at Mon, 2004/09/27 - 5:00am
Re: Summary
If this feature is not enabled by default then no user will ever notice how efficient using KMail with the keyboard can be. Please implement keyboard shortcut profiles in KDE and then we'll include a "Focus Mode" and an "Efficient Mode".
By Ingo Klöcker at Mon, 2004/09/27 - 5:00am
Re: Summary
I would like to be able to scroll through folders with the keyboard. Am I missing something? Alt up/down arrow scrolls through but doesn't load the message list. It used to work if you pressed spacebar or something, but that was fixed.
By Derek Kite at Sat, 2004/09/25 - 5:00am
Re: Summary
In KMail it is CTRL+up/down for immediate switching and CTRL+left/right for selecting a folder and another time CTRL for making it the current
By Kevin Krammer at Sat, 2004/09/25 - 5:00am
Re: Summary
I just don't understand why not use:
Seems to be more consistent, and we'd get to keep left/right for scrolling messages to the sides.
By John Kmail Freak at Sun, 2004/09/26 - 5:00am
Re: Summary
The interesting part starts when the users clicks into the message list, and the message list indicates (through highlighting and the focus rectangle) that it has focus. What should up/down do then?
IMO there is only one answer: previous message / next message.
If this is unacceptable to the KMail developers, then the message listbox must not take focus. But this would be a hack. I predict that users will consider it a bug, too.
There is really no choice. Trying to make interfaces that are smarter than the users for whom the interfaces are designed is not a good idea. You can only make things behave differently when they look differently. As long as something looks like a list box, it must behave like one. Everything else is making fun of your users, best intentions aside.
But I'm not a KMail developer, I haven't contributed code for it, I haven't even submitted those observations to the the bugs system, so I shut up now. I put my faith in the KMail developers and their user base that in the long run things work out better than what I could imagine in my wildest dreams. So far it always worked :-)
By Matthias Ettrich at Sun, 2004/09/26 - 5:00am
Re: Summary
This issues tends to be discussed about once every six months. Here's a quote from Ingo that I think covers the issue nicely:
"KMail is designed as focus-less application. That means that all keys
So, why is KMail's keyboard support highly efficient? Because the focus
As comparison let's now see what you would do to read two consecutive
Now that's what I call efficient. You don't have to care for which pane
You want to select another folder: Use Ctrl-Left/Right to select and
You don't have to agree with this philosophy, but I hope that you now at
So it's the way it is because no one has come up with an alternative that is convincingly better.
By Don at Mon, 2004/09/27 - 5:00am
Re: Summary
Then don't let the list boxes take focus: QWidget::setFocusPolicy(Qt::NoFocus). But again: people would see that as a bug, and quite rightly so.
I still maintain my position that being standard compliant is an alternative that is convincingly better.
The right way IMO would be to be standard compliant, and then possibly add a "KKmail Advanced Focus-less Keyboard Mode" to some configuration, disabled by default.
By Matthias Ettrich at Mon, 2004/09/27 - 5:00am
One more thing [was: Re: Summary]
> This issues tends to be discussed about once every six months.
Now what does that tell us if not a real need that something needs to be changed? :-)
By Matthias Ettrich at Mon, 2004/09/27 - 5:00am
Re: One more thing [was: Re: Summary]
More likely that KMail doesn't have the perfect solution to a hard and very common problem.
Actually, I think KMail is very usable with the keyboard, much more so than for instance Outlook. Big thanks to the developers! :)
By teatime at Mon, 2004/09/27 - 5:00am
Re: One more thing [was: Re: Summary]
"not the perfect solution" is an understatement for a solution that is seen as a bug by everybody who first tries it. It's counter-intuitive, non-standard and not even self-explanatory (the menus for example display different shortcut keys for the same actions). I needed a KMail developer to explain it to me before I started using it. I'm lucky that I had one in the office next door, not everybody has this luxury. And not everybody is KDE addict enough to read through the startup tips or check the mailing list. Again: trying to be smarter than your users is seldom a good idea.
Seriously, had I not been a KMail user, but a happy-enough evolution user who decided to give KMail a try, that bug alone would have been enough for me to abort the evaluation. My thinking had been along the lines of "if basic focus handling is broken, what else is broken?".
Vi is a lot more usable with the keyboard than notepad, big thanks to the developers. Does that mean we would install vi as default graphical text editor in KDE? No. Why not? Different target group. As long as KMail is called KMail and meant to be the default KDE mail client, users expect standard UI behaviour as opposed to obscure safe-a-few-keystrokes tricks for power users.
By Matthias Ettrich at Mon, 2004/09/27 - 5:00am
Re: One more thing [was: Re: Summary]
The only people who complain are
I don't really care about groups no. 1 and 2. But I agree that the complaints of the 3rd group are a problem, even though the majority of this group has retracted their complaints after they have learned about Left/Right. I'm not aware of any user who has complained about this after he has used KMail for a couple of days.
So yes, I agree that something needs to be changed. But instead of changing the behavior I favor including a short introduction to KMail's keyboard handling.
By Ingo Klöcker at Mon, 2004/09/27 - 5:00am
Re: One more thing [was: Re: Summary]
Users generally don't read dialog boxes. You're not going to change this aspect of human nature by being indignant about it, you can only accept it and move on with your life.
I'm a power user, and find KDE's attempts to "educate me" totally useless. Take, for example, the tips of the day that are enabled by default, or the verbose dialogs for KWallet. Who actually reads those things? If you need to spend that much time explaining how something works, the feature is broken.
By Rayiner Hashem at Mon, 2004/09/27 - 5:00am
Re: Summary
Ok, here is why I think you are wrong: You break standard compliance in order to support a rather special working model of mixed mouse and keyboard usage.
Also in a standard-compliant KMail users would be able to switch messsages with keyboard shortcuts, and the focus would not leave the message area. The focus would change only if they use the mouse to change to a different message or folder, either buttons or the wheel. If they use the mouse for these operations, it can also be expected that they use the mouse to scroll the message in the content area. Observe users. When they use the mouse, they do use the mouse.
On the other hand, if user use P or N (or maybe better Ctrl-Up and Ctrl-Down) to switch to the previous or next message, the keyboard focus never leaves the content area, and Up and Down still scroll the message (and Right and Left also scroll the message if necessary). That's the usage model of the keyboard power user.
So where again was the problem? To me it almost looks like you are trying to solve a problem that does not exist. And you do it in the worst possible way, by breaking standard compliance, something that makes initial users angry and results in bad reviews. That can't be worth the price.
Maybe all we really need is a little checkbox in a configuration dialog that says "Keep keyboard focus on message all the time"? Let the KMail power users activate that one, and let everybody else enjoy a standard compliant app.
That must be the first time in years that I am actually arguing _for_ adding another configuration option.
By Matthias Ettrich at Tue, 2004/09/28 - 5:00am
Re: Summary
On the other hand, if user use P or N (or maybe better Ctrl-Up and Ctrl-Down) to switch to the previous or next message, the keyboard focus never leaves the content area, and Up and Down still scroll the message (and Right and Left also scroll the message if necessary). That's the usage model of the keyboard power user.
Using P/N or Ctrl-Up/Ctrl-Down would be much less ergonomic than Left/Right for changing the current message, especially because Up/Down scroll the message and the Left/Right keys are close to them. I think I would rather use the mouse than these keyboard shortcuts.
So changing to these suggestions would increase consistency at a significant cost in efficiency/productivity. That would be an easy tradeoff to make, and an easy way to achieve consistency, but, I think, not a good one. Instead of an easy solution I would like a good one.
Regarding hiding the focus. The focus still plays several useful roles.
Personally I like Ingo's suggestion to add 'keyboard shortcut profiles in KDE and then we'll include a "Focus Mode" and an "Efficient Mode"', and "I favor including a short introduction to KMail's keyboard handling." (maybe in the what's new page).
Also perhaps showing Left/Right as shortcuts in the Go menu instead of P/N would be in order.
By Don at Tue, 2004/09/28 - 5:00am
Re: Summary
"So changing to these suggestions would increase consistency at a significant cost in efficiency/productivity."
No, not at all, I disagree. The number of keyboard hits requried stays exactly the same, even under a mixed mouse/keyboard usage pattern. It it possible to have efficient keyboard bindings in standard compliant applications.
As an example, you could stick to the binding of Left/Right to mean PreviousMessage/NextMessage if you think that's a big deal (I don't, because it breaks the standard way of scrolling a message horizontally with the keyboard, e.g. a table in a HTML message). All I'm asking for is that Up/Right means PreviousMessage/NextMessage when the message list has focus - like it would do in any other application.
This is so obvious in an environment like KDE that I almost can't believe it gets discussed every few months - and then turned down %-/
The ONLY disadvantage of being standard compliant would be that after selecting a message with the mouse, you cannot use Up/Down to scroll the message content. That's it. That's the big deal. Just that users won't even notice because when the select a message with the mouse the would scroll the message content with the mouse as well.
"Folder list - Ctrl-Left, Ctrl-Right navigation only changes the current folder but not the selected one. This is again for efficiency reasons, selecting a folder and showing it can take a significant amount of time."
Yes, I have noticed that. In fact this is one example where things get worse, because suddenly KMail no longer is a focus-less application but one that uses focus in a non-standard way. Although the folder-list clearly indicates to me as a user that it has focus, it doesn't behave like any other list box that has focus. This is even worse than not taking focus.
There are other solutions to the problem that do not break standard complicance. One could have Alt-Up/Down for switching folders and solve the performance issue by either using a timer to actually load the new current folder or by deferring the loading until the alt-key gets released. This would be a lot better than requiring the user to hit a second key (Space, or Enter or whatever) in order to actually switch folders. The best user interface is the one that is invisible and does not require user interaction to solve technical challenges.
I encourage you guys to discuss this on the KMail mailing list and to come up with a solution that makes these kind of discussions go away and not return in 6 months from now. And please keep in mind that KMail is not the VI of the mail client world, but a standard application for everybody and a central part of the KDE desktop experience.
By Matthias Ettrich at Tue, 2004/09/28 - 5:00am
Re: Summary
People do have some difficulty discovering (i.e. guessing) that KMail uses left/right to change the current message. Unfortunately I think it would be even more difficult for users to discover (guess) that alt + up/down changes the current message.
By Don at Mon, 2004/09/27 - 5:00am
Re: Summary
Why? All those shortcuts would be displayed prominently in the "&Go" menu.
By Matthias Ettrich at Mon, 2004/09/27 - 5:00am
Re: Summary
"Kontact insisted on scrolling downward through the current message"
Oh my god.... if these bloody journalists doing reviews would just decide to keep the "Tip of the Day" enabled and read it for a day or two, they would learn such simple things quite easily. Because it clearly says "Did you know...? ...that you can to go the next and previous message by using the right and left arrow keys respectively?" Stupid journalists, stupid eWeek "lab" "experts".....
By kmail lover at Sat, 2004/09/25 - 5:00am
Re: Summary
'These bloody journalists doing reviews' do what most people do, I think, which is either disable Tip of the Day or just ignore it. That behavior is completely counterintuitive, whether you prefer it or not. I'm not saying that it's bad, but it should be optional and default to intuitive behavior. I know that annoyed me too, and I certainly don't sit there all day reading the Tip of the Day to see if maybe it tells me how to scroll through my message list when click-and-down-arrow doesn't work. Just because you figured it out quickly, doesn't mean one should have had to figure it out. The logical behavior would be scrolling the focused listbox. Different behavior should be an option that is disabled by default.
By kmail appreciator at Sat, 2004/09/25 - 5:00am
Re: Summary
"...do what most people do, I think, which is either disable Tip of the Day or just ignore it"
I agree: it is not intuitive for people who learned other programs with 3 or 4 panes before. It wasnt intuitive for me either. But I learned it from a Tip of the Day. I think it is very useful. Now I even catch myself trying that key on Outlook or Thunderbird (I need to operate various OSes and Mail programs). And every time I am tempted to curse against these KMail contenders for *them* being "unintuitive".
It is all a question of perspective, habits and what has been graved into your mind what you regard as "intuitive".... And Matthias, who posted above about intuitiveness isnt different from me here. He is prone to external influence just as I am. It is just that his influence was different from mine, and now he thinks of the left/right key as being "unintuitive".
By KMail lover at Sat, 2004/09/25 - 5:00am
Re: Summary
So what you're saying is
RTFM, n00b
That's not usability. Nobody said usability was easy.
By - at Sun, 2004/09/26 - 5:00am
Re: Summary
I think your definition of "usability" is a bit on the narrow side. The fact that it does not work like other email clients doesn't mean that there is a usability problem. Also, something that takes a bit of learning before you can handle it completely isn't by definition "un-usable". It might in fact be *very* usable. Considder vi, for example. Most people getting into it for the very first time will be utterly lost on how to even exit the program, let alone use it to edit any piece of text. Does that make it bad usability wise? No! It is actually very good in what it does, it just has a bit of a (steep) learning curve. However, once you get the hang of it, you'll be much more productive than with your traditional editors.
By Andre Somers at Sun, 2004/09/26 - 5:00am
Re: Summary
Vi and KMail are two different beasts targetted at two different kinds of people.
By Rayiner Hashem at Mon, 2004/09/27 - 5:00am
Re: Summary
Tell me the truth here: do you ever read "Tip of the Day"? I can't be the only one who takes a fresh KDE install, then turns off all the intrusive "helpful" dialogs in sight, can I?
By Rayiner Hashem at Mon, 2004/09/27 - 5:00am
Re: Summary
> 3) "Another thing that annoyed us about KDE's mail handling was the way it dealt with HTML messages."
KMail doesn't render inlined images when they are included in mail. At work I send some newsletters and have to test them on other people MUA because of that.
By Hrw at Mon, 2004/09/27 - 5:00am
Re: Summary
""A nice improvement we found in GNOME 2.8 was the capability for auto-mounting removable devices such as USB (Universal Serial Bus) thumbdrives."
Works just fine for me with the default desktop for SuSE 9.1 ;)"
The difference is that SUSE handles it (as does Mandrake. Although I haven't used either one in a long time), and not KDE. In GNOME 2.8 it's the desktop that handles it and not the distro. And that means that it will behave the same way no matter what the underlying distro is. And that is IMO a Good Thing (tm). And KDE should do it as well.
There are distros out there that do not offer automounting and such, they just provide more or less vanilla versions of the software. I mean stuff like Slackware, Gentoo, LFS and Debian(?).
The job of the Desktop Environment is to make it easier for the user to work on the machine. Volume Management as found on GNOME 2.8 is a step in the rigth direction. And since I would be using KDE-tools to work on that USB-thumbdrive, IMO it should be KDE that provides me with an convenient access to it, and not the distro.
By Janne at Tue, 2004/09/28 - 5:00am


text:
Q. How do I get the keys to my cabin?
A. Each cabin has a digital door lock. When you make your reservation you will be given a door code. You return your signed rental agreement, 2 weeks prior to your arrival if there is a balance due on your account it will be put on your credit card. You are then emailed directions straight to your rented cabin and given your door code. NO HASSLE Check IN's at an office.
Q. Do you allow pets?
A. Yes, but only in the cabins that are specifically designated as pet friendly. There is a flat $50.00 per pet fee per reservation. Pet Friendly Cabins.
Q. Do you allow smoking in cabins?
A. No all of our cabins are smoke free. Please smoke outside and dispose of your smoking materials responsibly.
Q. What time is Check in and Check out?
A. Our housekeeping staff makes every effort to get your house ready by 3:00 pm EST. for check-in and check-out is before or at 11:00 am EST.
Q. Can we check in early?
A. If the house is ready and has been inspected we will allow you to check in after 1:00pm, we suggest you call the day before to check but our software will normally send a text message alerting you that your cabin is ready.
Q. What is the cancellation policy?
A. The 1 & 2 bedrooms have to be canceled two weeks (14 days) prior to your arrival date. 3 bedrooms and up is 30 days prior to your arrival date. There is a $75.00 cancellation fee on all reservations.
Q. What happens if I have to cancel my reservation and not within my cancellation period?
A. We make every effort to let your rebook at a later date in the same house, but you must have a new date to move your reservation to.
Q. Are there age restrictions?
A. Yes, Please give our office a call, we do make exceptions No 3 bedrooms or larger are rented to persons under the age of 21 years old.
Q. Do you allow house parties?
A. NO! If one does occur any damages to the property will be billed to the credit card on file.
Q. Will my cell phone work at the cabins?
A. Most cell phones do work in the mountains; it depends on your carrier. Each cabin has its own phone, local calls are free, and some have free long distance. Check with your reservationist.
Q. How are your Hot Tubs maintained?
A. Hot Tubs are drained, filter cleaned and each tub is cleaned with sanitizer after each guest checks out. Our hot tubs are chemically treated with bromine after being cleaned and the tub is refilled with fresh water.
Q. Are your cabins private?
A. Yes, some of our cabins are private, some are secluded. You may see a roof top but none are built side by side. Some of our cabins are more secluded then others. Ask your reservationist if this is an issue.
Q. What do I need to bring?
A. We get you started with a "starter kit" One roll of TP for each bath, one bar of bath soap for each bath. Kitchen garbage bag, dish soap, paper towels, laundry detergent and coffee. If you think you may need an Iron for clothes or a blender for mixed drinks you should bring one.
Q. What if we need more towels?
A. Each unit with the exception of a few has washers/dryers for you to utilize during your stay. If you need more and your unit does not have a washer/dryer give us a call.
Q. What credit cards do you accept? Do you take checks?
A. We accept MC, Visa and Discover; we will accept a check for the 50% deposit however, the check has to be mailed in and have time to clear the bank before your arrival. We do still require a valid credit card that will be kept on file for incidentals. No one's credit card will be charged for anything without notification to the cards owner.


text:
I didn't end up being able to post yesterday, Not that I was too hungover or anything I just ended up spending the day with my friends and striding into 2013! I had a fun new year with the people I love the most and woke up feeling slightly headachey but nothing compared to some weekends! My new years resolutions are pretty standard: lose weight, work out more and be happier. My main one is to take more risks and actually strive towards the things I want in life rather than settle for second best. I've always been a really strong person, I've dealt with a lot of things in my life but I feel I've become complacent with my life at the moment and keep doing the same "safe" things as it's the easiest. I want to be a better person and take more chances, do what I love, FALL in love and keep going and most importantly say YES more!
Blogging goal wise, well I don't know. I want to feel happy and confident with what I do on here again. Although I try and put all my effort into my blogs, I cant help but feel in recent months seems to have slipped I've been so busy working outside of blogging. It's frustrating knowing you have all this stuff to share but not enough hours in the day to do it. Number 1 on my blogging resolutions list is to definitely organise my blogging life more and set myself more of a schedule. I want to make more videos, especially more creative videos as well. I wish I had someone (need to find myself a photographer boyfriend!) to help me get all my videos ideas filmed, but its hard when you're one person and a tripod! One day my vision for my Youtube channel will hopefully come true! But until then I want to keep learning how to film, edit and aim towards making videos at a professional quality. Another goal is to comment more, I feel the ammount of comments on blogs is declining and declining. Part of the thrill of blogging is logging in and seeing those comments in the comment section and people reacting to your posts. I think the rise of immediate reactions (Facebook likes/thumbs up's) has really contributed to that and the number of comments I see on posts go down and down. Although I've never been much of a commenter on the internet, but from now on I'm going to make a conscious effort to comment on at least 5 blogs per day.
What are your resolutions? Blogging or real life! I'd love to know! I wish you all a safe, happy and flourishing start to 2013!


text:
Triptych showing scenes from the Martyrdom of Saint Barbara and scenes from the Life of Christ
Center panel: The Crucifixion (above); Saint Barbara Enthroned (below)
Left panel: A Prophet (above); The Scourging of Barbara (below)
Right panel: A Prophet (above); The Mutilation of Barbara (below)
Master of the Laufen High Altarpiece, Austrian (active Salzburg), dated work 1467
Made in Austria, Europe
c. 1465-1470Medium:
Oil and gold on panelsCuratorial Department:
European Painting
* Gallery 305, European Art 1100-1500, third floorAccession Number:
EW1993-127-2a--cCredit Line:
Purchased with the W. P. Wilstach Fund, the George W. Elkins Fund, and Museum funds, 1993
Social Tagsaltar [x] austrian [x] gabriel [x] gold [x] martyr [x] saint [x] trinity [x] triptych [x]
[Add Your Own Tags]
As described in The Golden Legend, written in about 1267 by Jacopo da Voragine, Saint Barbara converted to Christianity against the wishes of her pagan father. Locked in a tower by him, she ordered workmen to construct a third window inthe building to symbolize the Christian trinity. Enraged, her father turned her over to the Roman authorities for torture, and when her execution was ordered,he himself beheaded her. The left and right panels on the front of this triptychillustrate episodes from Barbara's gruesome martyrdom.
These graphic depictions are intended to help the viewer equate Barbara's physical torments with those of Christ, whose crucifixion is depicted in the top center composition. The figures at the top left and right, probably the apostles John and Luke, hold sayings taken from the last words of Christ on the cross, which here apply also to Barbara's death. The bottom center panel shows Barbara enthroned in heaven, wearing a crown and holding a palm frond as symbols of victory over death. A tower and chalice, her identifying attributes, appear nearby.
Barbara's martyrdom is paralleled on the reverse by the resurrected Christ standing in the tomb. The left and right panels of the back, which are movable and can be folded shut to appear on the front, show the angel Gabriel announcing the incarnation of Christ to the Virgin Mary.
Explore the Collections
ProvenanceGeorge Kriehn (b. 1868), New York, by 1931 [1]. With E. and A. Silberman Galleries, New York, by 1936-1951; sold to Samuel S. Fleisher Art Memorial, Philadelphia, June 1, 1951 [2]; sold to PMA, 1993. 1. Annotations on the reverse of two photos of the triptych in the "Vorbildersammlung" photo archive of the Bayerische Staatsgemäldesammlungen, Munich, (inv. no. 31-108 and 109) list "George Kriehn" as the owner, most likely the American writer and lecturer on art of that name, who received his Ph.D. at the University of Strassburg (now Strasbourg) in 1892 and lived in New York from 1900. The inventory numbers on the photos indicate that they were catalogued in 1931, so presumably Kriehn was the owner at that time. 2. Charles L. Kuhn, A Catalogue of German Paintings of the Middle Ages and Renaissance in American Collections, Cambridge, 1936, p. 73, no. 314; and dated receipt in Samuel S. Fleisher Art Memorial collection files (copy in curatorial file).
* Works in the collection are moved off view for many different reasons. Although gallery locations on the website are updated regularly, there is no guarantee that this object will be on display on the day of your visit.


text:
Other Proposed Natural Treatments
- Aloe vera
- Amino Acid Cream
- Bee Propolis
- Calendula
- Comfrey
- Cartilage
- Essential Oils
- Chamomile
- Chitosan
- Garlic
- Goldenseal
- Gotu Kola
- Honey
- Picrorhiza
- Royal Jelly
- St. John's Wort
- Vitamin A
- Vitamin C
- Vitamin E
- Zinc
Minor cuts are an ordinary fact of life, and nearly always heal on their own. There is no evidence that antibacterial gels and creams will help wounds heal faster, or prevent infection. In fact, by keeping the air away from a wound, these treatments might actually interfere with healing.
The best approach to minor wounds is also the simplest and most natural: clean the wound well, and keep it clean and exposed to the air. If signs of infection develop, such as redness, oozing, or swelling, a physician should be consulted.
Proposed Natural Treatments for Minor Wounds
Application of honey (or concentrated sugar preparations) to wounds might help prevent infection and possibly speed healing. 15-27,30 Honey is thought to work primarily through its high sugar content, which directly kills microorganisms. However, trace substances contained in it might also be at work. Not all studies show clear benefit, however. One trial found that antibacterial honey (Medihoney) did not significantly improve wound healing in 105 patients suffering from mostly leg ulcers. 31 Conversely, topical honey improved healing time compared to saline gauze and silver sulfadiazine in 2 trials of 140 patients with skin ulcers or burns. 33
Highly preliminary evidence suggests that the herb gotu kola might have general wound-healing properties, as well as help to prevent or treat keloid scars (a particular type of scar that is enlarged and bulging). 1,2,3
A small double-blind, placebo-controlled trial found that the amino acids cysteine, glycine , and threonine applied as a combination cream could help the healing of leg ulcers. 4 A variety of nutrients, including vitamins A , C , and E , and zinc , 5 taken both orally and topically, have also been tried as a treatment for minor wounds, and creams containing A and E are common staples in the hospital. A number of topical herbs have been tried as well, including calendula , 6cartilage , 7chamomile , chitosan , 8goldenseal , royal jelly, 9 and St. John's wort , but there is no real evidence as yet that any of these approaches provide any benefits.
Numerous herbs (and their essential oils ) have antibacterial properties, and for this reason might theoretically be helpful for preventing wound infection. However, this has not been proven. In addition, if a wound is serious enough that infection is a real risk, physician supervision is essential.
The gel of the aloe vera plant has a long folk history in the treatment of skin conditions. There is some evidence from human and animal studies that aloe might be helpful for wound healing, 10,11 but one study found that aloe gel actually slowed the healing of surgical wounds. 12 Also, a review of 7 trials involving 347 people did not find evidence that aloe can improve wound healing. 32
In a well-designed trial, two concentrations of comfrey creams were evaluated for the treatment of fresh abrasions among 278 patients. 29 A 10% comfrey formulation was compared to a 1% comfrey formulation, which was considered the reference or placebo cream. The topical application of 10% comfrey led to significantly faster wound healing than the reference cream after 2 to 3 days of application. Although the researchers reported no adverse effects in either group, the use of comfrey has been associated with severe, even life-threatening toxic effects when used orally, and its use over open wounds must be undertaken with extreme caution. Refer to the article on Comfrey ( Symphytum officinale ) for more information on its safety.
Animal studies suggest that the honeybee product propolis applied topically may be of benefit in healing wounds. 13,14 Similarly weak evidence hints at benefits with the herb picrorhiza . 28
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -