text:
Principal Proposed Uses
Other Proposed Uses
- Hair Loss
- Prostatitis (Prostate Infection)
Saw palmetto is a native plant of North America, and it is still primarily grown in the United States.
The saw palmetto tree grows only about 2 to 4 feet high, with fan-shaped serrated leaves and abundant berries. Native Americans used these berries for the treatment of various urinary problems in men, as well as for women with breast disorders. European and American physicians took up saw palmetto as a treatment for benign prostatic hyperplasia (BPH). In the 1960s, French researchers discovered that by concentrating the oils of saw palmetto berry they could maximize the herb's effectiveness.
Saw palmetto contains many biologically active chemicals. Unfortunately, we don't know which ones are the most important. We also don't really know how saw palmetto works; it appears to interact with various sex hormones, but it also has many other complex actions that could affect the prostate.
What Is Saw Palmetto Used for Today?
Saw palmetto oil is an accepted medical treatment for benign prostatic hyperplasia (BPH) in New Zealand and in France, Germany, Austria, Italy, Spain, and other European countries.
Typical symptoms of BPH include difficulty starting urination, weak urinary stream, frequent urination, dribbling after urination, and waking up several times at night to urinate. Most, thought not all, research suggests that saw palmetto can markedly improve all these symptoms. Benefits require approximately 4 to 6 weeks of treatment to develop. It appears that about two-thirds of men respond reasonably well.
Furthermore, while the prostate tends to continue to grow when left untreated, 1 saw palmetto causes a small but definite shrinkage. 2-4 In other words, it isn't just relieving symptoms, but may actually be delaying prostate enlargement. The drug Proscar does this too (and to a greater extent than saw palmetto) but other standard medications for BPH have no effect on prostate size.
Some studies suggest that saw palmetto is equally effective for reducing BPH symptoms as Proscar, and it has one meaningful advantage: It leaves PSA (prostate-specific antigen) levels unchanged. Cancer raises PSA levels, and lab tests that measure PSA are used to screen for prostate cancer. Proscar lowers PSA measurements, and therefore, its use may have the unintended effect of masking prostate cancer. Saw palmetto won't do this. On the other hand, Proscar has been shown to reduce the need for surgery, unlike saw palmetto or any of the other drugs used for BPH.
Saw palmetto may also be equally as effective as another class of standard drugs known as alpha blockers, but may cause fewer side effects.
Note : Before self-treating with saw palmetto, be sure to get a proper medical evaluation to rule out prostate cancer.
Saw palmetto is also widely used to treat chronic prostatitis . An open trial that compared saw palmetto to the drug Proscar for the treatment of chronic nonbacterial prostatitis found that while the drug was effective, the herb was not. 5 However, these results do not mean that saw palmetto is ineffective for prostatitis. Because this was an open study, researchers and participants knew who was getting saw palmetto and who was getting the drug. If there was any expectation that the drug would be more powerful than the herb, this in itself would be sufficient to skew the results toward that outcome.
Saw palmetto is sometimes recommended as a treatment for hair loss, but there is no evidence at all that it is effective for this purpose.
What Is the Scientific Evidence for Saw Palmetto?
The scientific evidence for the effectiveness of saw palmetto in treating prostate enlargement is inconsistent.
At least 10 double-blind studies involving a total of about 900 people have compared the benefits of saw palmetto against placebo over periods of 1 to 12 months. 6-13,20,29 In all but three of these studies, the herb improved urinary flow rate and most other measures of prostate disease to a greater extent than placebo. However, in the most recent and perhaps best-designed of these studies, a 1-year trial of 225 men, a saw palmetto failed to prove more effective than placebo. 30 Furthermore, a large review of 14 trials with 5,222 men found that saw palmetto did not improve urinary symptom scores or peak urine flow compared to placebo. Subjects taking saw palmetto reported more overall symptom improvement than those taking placebo, but this result is questionable due to inconsistencies among studies. 35 Adding to the unsupportived evidence, a more recent well designed, placebo-controlled trial involving 369 men found that saw palmetto even at high doses (three times the standard dose) did not improve urinary flow rate compared to placebo. 36
A double-blind study followed 1,098 men who received either saw palmetto or the drug Proscar over a period of 6 months. 14 (Unfortunately, there was no placebo group.) The treatments were equally effective, but while Proscar lowered PSA levels and caused a slight worsening of sexual function on average, saw palmetto caused no significant side effects. Both treatments caused the prostate to shrink, but Proscar had a greater effect.
A 52-week, double-blind study of 811 men compared saw palmetto to a standard drug in another class: the alpha-blocker tamsulosin. 15 Once again, both treatments proved equally effective. However, saw palmetto caused fewer side effects than the drug. In addition, the herb caused some prostate shrinkage, while the drug caused a slight prostate enlargement.
A study involving 435 men found that the benefits of saw palmetto endure for at least 3 years. 16,17 However, there was no control group in this study, making the results unreliable.
A 48-week, double-blind trial of 543 men with early BPH compared combined saw palmetto and nettle root against Proscar and found equal benefits. 18 Benefits were also seen with a combination of saw palmetto and nettle root in a 24-week, placebo-controlled study of 257 men. 31
Finally, a 6-month, double-blind, placebo-controlled trial of 44 men given a saw palmetto herbal blend (containing, in addition, nettle root and pumpkin seed oil) found shrinkage in prostate tissue. 19 No significant improvement in symptoms was seen, but the authors pointed out that the study size was too small to statistically detect such improvements if they did occur.
The standard dosage of saw palmetto for the treatment of BPH is 160 mg twice a day of an extract standardized to contain 85% to 95% fatty acids and sterols. A single daily dose of 320 mg may be just as effective for this condition. 21,22 However, taking more than this amount does not, on average, seem to produce better results. 23,27 As with many other herbs, the quality of commercial saw palmetto products may vary widely. 28 For this reason, it is best to purchase a saw palmetto product that has been evaluated by an independent lab, such as Consumer Labs .
Safety Issues
Saw palmetto is thought to be essentially nontoxic. 24 In addition, in clinical trials, it has shown little to no adverse effects. For example, in a one-year randomized trial of 225 men, there was no significant difference in adverse events between the groups receiving saw palmetto and placebo. 34 And, in a 3-year study, only 34 of the 435 participants complained of side effects, and these were primarily only of the usual nonspecific variety seen with all medications, such as mild gastrointestinal distress. 25
There are at least two case reports in which use of saw palmetto was linked to liver inflammation; 32-33 however, a subsequent study in rats failed to find that even very high doses of saw palmetto are injurious to the liver. This case report might have been an instance of an allergic or other idiosyncratic reactions; alternatively, something other than saw palmetto may have gotten into the product. One of the above-mentioned cases also involved pancreatitis. 33
Finally, there is one report of saw palmetto apparently causing excessive bleeding during surgery. 26 The significance of this isolated event isn't clear, but it is probably prudent to avoid saw palmetto prior to and just after surgery, and during the period surrounding labor and delivery. Individuals with bleeding problems (such as hemophilia) should perhaps also avoid saw palmetto, as should those taking any drug that "thins" the blood, such as warfarin (Coumadin), heparin, aspirin , clopidogrel (Plavix) , ticlopidine (Ticlid) , and pentoxifylline (Trental) .
Saw palmetto has no known drug interactions. Safety for pregnant or nursing women, or those with severe kidney or liver disease, has not been established.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


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Table of Contents
Vol. 59 No. 2, March/April 2019
Vol. 59 No. 2, March/April 2019
Errata: In the September/October 2016 issue (volume 56 number 5, pages 836 and 849), there was a technical printing error in Figures 1b and 2 of the article by Ajay Raina that resulted in a loss of data on the graphs. This online article contains the restored figures in their original, correct state. The error is regretted.

subset: commoncrawl


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Pressure in the eye is called intraocular pressure (IOP). Tonometry tests the amount of pressure in the eye.
Reasons for Test
Elevated eye pressure can lead to eye damage. This may be part of a disease called glaucoma. If left untreated, glaucoma can cause blindness. Tonometry is used to screen for glaucoma. It is also used to monitor the treatment of glaucoma.
You may have ocular hypertension. This happens when pressure is elevated but is not caused by glaucoma.
What to Expect
There are 2 main types of tonometry: the noncontact air puff method and the applanation method that flattens the cornea with pressure. The type of tonometry that is done will depend on the equipment your doctor has and the type of test they decide to do.
Prior to Test
You may be asked to remove corrective lenses, such as contacts.
Description of the Test
For both methods, you will be asked to sit in an exam chair. You may be asked to place your chin in a special cradle and rest your forehead against a bar. The chin cup and forehead rest will balance and steady your head.
You will be asked to look into an instrument. A puff of air will be blown into the eye. No instruments come in contact with the eye.
Anesthetic drops will be placed in your eyes before the test. This will numb your eye. A small amount of an orange dye may also be placed into your eye. When your head is balanced and steady, you will be asked to look into an instrument with a blue light. A probe will push against your eye. How hard the probe has to push lets the doctor know how much pressure is in the eye. This test does not hurt because the eye is numb. This test is considered the most accurate method of checking pressure.
Another method of applanation tonometry is the use of a handheld device shaped like a pen. The device will be pushed against the front of your eye to get pressure readings. Again, it does not hurt because the eye is numb.
There are other devices that are used to check eye pressure. The ones listed above are the most common.
After Test
The numbing drops and dye wear off in about 20 minutes. It is important not to rub your eye while it is numb.
How Long Will It Take?
A few seconds
Will It Hurt?
This test is painless. Some people do experience a slight sting or tingling due to the anesthetic drops.
If you are having the procedure for glaucoma screening, your doctor will discuss the results with you and determine treatment options, if needed.
If you are having the procedure to monitor an existing diagnosis of glaucoma, your doctor will determine if your current care is helping to lower your eye pressure.
Call Your Doctor
After the test, call your doctor if you have any of the following eye discomforts:
- Burning
- Excessive itching
- Swelling
- Pink or reddish color that does not go away
- Decreased vision
- Any other eye problem
In case of an emergency, call for emergency medical services right away.
Revision Information
- Reviewer: Michael Woods, MD
- Review Date: 05/2018 -
- Update Date: 05/26/2015 -


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Jackson Grasso
Welcome to my fundraising page! Thank you for visiting. I am participating in the Shatterproof Rise Up Against Addiction 5K Walk/Run in New York on October 13, 2019. Shatterproof is a national nonprofit organization dedicated to ending the devastation addiction causes families. Every dollar we raise together will work to ensure that every American with a substance use disorder has access to treatment that's based on proven research. The Shatterproof mission is very important to me—and I know, with the support of good people like you, I can make a big difference. May I count on your support? Whether you give $50, $25, or $10, any amount will help change lives. Thank you in advance for your generosity. Together, we are stronger than addiction. We Are Shatterproof!


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Considering independent senior living is one of life's major decisions. This guide navigates some of the common misconceptions and gives you a blueprint for what to look for when choosing where to spend your retirement years.
Download the eBook
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text:
Presbyopia is the inability to focus on and clearly see objects that are at a normal reading distance or closer.
Presbyopia is caused by an age-related, gradual loss of flexibility within the lens of the eye. Because the lens is less elastic, it cannot adequately change its shape to sharply focus on objects at close distances.
Symptoms may include:
- Having to hold items at arm's length to focus on them
- Blurred vision when reading
Eye fatigue, discomfort, or drowsiness when doing close-up work such as:
- Reading
- Needlepoint
- Computer work
Symptoms are often made worse by fatigue or stress.
A vision specialist will ask about your symptoms and medical history. An eye exam will be done. You will be asked to read materials at your normal reading distance while different lenses are placed in front of your eyes. This test determines the extent of your presbyopia.
Presbyopia is usually treated with corrective lenses. Lens options include:
If you already wear glasses, you may need a second set for reading and other set for close-up activities.
Bifocals combine 2 prescriptions into 1 pair of glasses. The upper half of bifocals corrects distance vision and the bottom half corrects close-up vision.
Trifocals are similar to bifocals, except that they have a medium range lens between the distance and near portions to help with intermediate vision tasks.
Another option is progressive lenses, which provide a gradual increase in reading prescription as you look down on the lens. This provides a range of correction for you to use depending on the distance between you and the object you are trying to look at.
If you currently do not need vision correction for distance, then you will only need a pair of glasses to correct your up-close vision. However, some people with perfect distance vision still opt to wear bifocals that are clear on top and have the reading prescription on the bottom so that they can wear them all the time rather than having to put glasses on and off to read.
Contact Lenses
Bifocal contact lenses are available and act the same way as bifocal glasses, with an area for distance and an area for near vision correction. Another option is monovision contact lenses. One eye wears a lens to correct distance vision and the other eye wears a lens to correct near vision.
Conductive Keratoplasty
Conductive keratoplasty (CK) is a procedure performed by an ophthalmologist to correct presbyopia in one eye. The surgeon places a small probe that emits radiofrequency energy into the cornea to reshape it. This is performed in one eye only. The other eye is dominant for distance vision and the eye receiving the CK is focused for near vision.
Laser-assisted in situ keratomileusis (LASIK) is a procedure that uses laser beams to reshape the cornea and correct focusing problems in the eye.
Multifocal Intraocular Lenses
Multifocal intraocular lenses can be placed inside the eye in place of the eye's natural lens. This is typically performed at the time of cataract surgery. The multifocal lens focuses on both distant and near objects simultaneously, often eliminating the need for glasses.
Presbyopia is thought to be ana normal part of the aging process. There are no current guidelines for preventing it or delaying its onset.
Revision Information
- Reviewer: EBSCO Medical Review Board David A. Ostrovsky, MD
- Review Date: 03/2018 -
- Update Date: 05/11/2013 -


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Diagnosis of generalized anxiety disorder (GAD) can be difficult, since the distinction between normal anxiety and GAD is not always apparent. Diagnosis is based on a physical exam, psychological evaluation, and the criteria outlined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The symptoms of GAD must be present for at least 6 months and cause impairment in your ability to function.
Initial Assessment
After obtaining your medical history, you may be asked about worries, anxiety, "nerves," stress, and other symptoms. Your doctor may ask whether your anxiety is acute (brief or intermittent) or chronic (persistent).
Acute anxiety lasts from hours to weeks and usually occurs in response to a particular stressor. Persistent anxiety lasts from months to years and may be considered a part of your temperament. Persistent anxiety does not normally occur in response to stress. In susceptible people, though, stress may increase levels of persistent anxiety.
Evaluation of Medical Disorders
Before generalized anxiety disorder can be diagnosed, your doctor will look for and rule out other medical disorders that could cause your symptoms. Medical conditions commonly associated with anxiety include:
- Hypoglycemia
- Irritable bowel syndrome
- Chronic pain conditions
- Hyperthyroidism
- Cushing's disease
- Mitral valve prolapse
- Carcinoid syndrome
- Hypocalcemia
- Chronic obstructive pulmonary disease (COPD)
- Heart failure
- Tourette's syndrome
- Pheochromocytoma
Your doctor should also ask what medications, herbal supplements , and vitamins you take. You may be asked to stop taking certain medications or supplements so that your doctor can more accurately pinpoint the cause of your symptoms. Medications that can contribute to or worsen anxiety include:
- Steroids
- Over-the-counter cold remedies and diet pills
- Antidepressants
- Angiotensin-converting enzyme (ACE) inhibitors
- Digoxin
- Thyroxine
- Theophylline
Evaluation for Substance Abuse
Use or withdrawal from addictive substances can cause anxiety. Your healthcare provider may ask about your use of alcohol , caffeine , nicotine , addictive medications (particularly sedatives), illegal drugs , and other substances.
Evaluation of Other Psychiatric Disorders
You may be tested for:
- Depression
- Panic disorder
- Post-traumatic stress disorder
- Social phobia
- Obsessive-compulsive disorder
- Social anxiety disorder
- Other psychiatric disorders that often occur with generalized anxiety disorder
Revision Information
- Reviewer: Adrian Preda, MD
- Review Date: 12/2016 -
- Update Date: 05/20/2015 -


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Other Proposed Natural Treatments
Neck pain is a common condition, affecting millions of Americans. In many cases, x-rays do not show anything visibly wrong with the neck, suggesting that the problem is a relatively subtle one involving soft tissues. (Conversely, x-rays of people without neck pain often show arthritis; this suggests that even when positive x-ray results are found in people with neck pain, they may be unrelated.) Subtle or not in origin, the discomfort of neck pain can be severe, and lead to real disability.
The cause of soft-tissue neck pain is not known. Symptoms may follow a whiplash injury, or simply arise, apparently, from bad posture or chronic tension.
NOTE: It is unclear that any conventional medicine intervention for neck pain or whiplash speeds recovery or produces any other long term benefit. 9-10,20
Proposed Natural Treatments
Although several alternative treatments for neck pain have shown promise, none possess meaningful scientific substantiation.
A 2006 review of the literature found 10 controlled studies of acupuncture for chronic neck pain. 21 The pooled results suggest that acupuncture may be more effective than fake acupuncture, at least in the short term. However, overall the study quality was fairly low. Subsequently, a pilot study showed that 10 weeks of acupuncture combined with physical therapy was more effective than either acupuncture or physical therapy alone for chronic neck pain, at least over the short-term. 23 Other randomized trials have found that real acupuncture (versus placebo treatment) improved the quality of life in people with chronic neck pain. 26,28
In another study, 124 people with chronic or acute whiplash were randomized to receive 12 sessions of real or sham electroacupuncture (electricity is applied to the acupuncture points). 27 While those receiving real electroacupunture did have less pain, the results were not clinically significant, and there were no improvements in disability or quality of life. Interestingly, in a study of 177 people with chronic neck pain, fake acupuncture proved more effective than massage. 5 If acupuncture does have an effect on neck pain, it is probably modest.
Millions of Americans report that chiropractic spinal manipulation has relieved their neck pain, but there is as yet little scientific evidence supporting the use of spinal manipulation for this purpose. 1,2,11-12,25 Most studies have found manipulation (with or without related therapies such as mobilization or massage ) to be no more effective than other treatments for this condition.
One large study (almost 200 participants) found that a special exercise program called MedX was more effective than chiropractic spinal manipulation. 3 However, a study reported in 2006 showed that a single high-velocity, low-amplitude (eg, chiropractic-style) manipulation of the neck was more effective than a single mobilization procedure in improving range of motion and pain in people with neck pain. 19 And a 2010 systematic review including 17 randomized trials found mixed results for the benefits of manual therapy (including manipulation and mobilization) combined with exercise. 24 According to these researchers, high-quality studies showed manual therapy plus exercise to be more effective than exercise alone in the short-term, but there was no difference over the long-term.
Other Treatments
Osteopathic manipulation , a form of treatment often compared to chiropractic, is widely believed to help neck pain, but there is as yet no meaningful scientific evidence to support its use for this condition. 14 Many people with neck pain use massage therapy for relief, but, again, scientific support is lacking, and one study found fake laser acupuncture more effective than massage for neck pain. 5
A treatment called prolotherapy , as well as the herb white willow , have shown promise for back pain , and might be useful for neck pain as well.
In one study, an ambitious holistic treatment regimen for neck pain (including craniosacral osteopathy along with Rosen Bodywork and Gestalt Psychotherapy) failed to prove more effective than no treatment. 16
Other herbs and supplements sometimes recommended for neck pain, either on the basis of their use for related conditions, or because of their known medical properties, include boswellia , butterbur , chondroitin , ginger , glucosamine , proteolytic enzymes , and turmeric .
Qigong is an ancient Chinese practice involving various breathing exercises and physical postures, which are thought by its practitioners to enhance general health. In one study, Qigong was no more effective than conventional physical therapy exercise techniques in the treatment of chronic, nonspecific neck pain. 22 Some benefits were also found when Qigong was combined with movement exercises in a review of 27 randomized trials with 3,005 adults. Most of the trials reviewed had biases that may have affected the final results. 30
Dry cupping is an ancient technique used to treat pain. The technique involves placing cups on the skin and then removing the air from the cups to create a vacuum. In a small randomized study, 50 people with chronic neck pain were randomized to dry cupping or the wait-list (no treatment). 29 Those who underwent the treatment reported a decrease in their neck pain. In the absence of a placebo control (sham cupping), however, it is not possible know whether the cupping itself led to beneficial effect in this pilot study.
Biofeedback , hypnosis , and relaxation therapies may offer help for pain in general.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text:
Aodhan LS002 18X8.0 5X114.3 ET35 73.1 Silver Machined Face wheel
Quality is the base of development for AodHan Wheels. The quality management center is established to manage the implementation of quality standard system. The professional department was established to carry out the verification test on new developed product. The test production and verification is carried out strictly according to the condition of test production: CMM dimension inspection, leak detection inspection and imbalance inspection. Impact, bending and rolling test. Property test on paint (chrome pleated) coat: color, gloss, initial hardness and appearance , paint thickness, water resisting property, adhesion after water resisting test, CASS, solvent resisting proper , etc


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text: Thursday, August 30, 2012 In California, a Rough Ride for Senate Bill 924 California physical therapists (PTs) have been infuriated by the legislatively wrangling that California SB 924 has been subject to during the past 2 weeks, made all the more frustrating because the bill is stalled in the Assembly Rules Committee during this last week of the California legislative session. The legislation, a compromise bill brokered by California Senate President Darrell Steinberg and sponsored by state Sen Curren Price, was intended to end a long and bitter battle in the state legislature between the California Chapter and the California Medical Association (CMA) over the issues of direct access to physical therapist services, and whether PTs may be employed by, or be shareholders of, medical corporations, and alternatively whether physicians may be employed by or shareholders of PT corporations. While the chapter supported the direct access elements of SB 924, it was not in favor of the corporation aspect of the bill. Conversely, CMA supported the corporation language in the bill and remained adamantly opposed to allowing direct access. For the most part, the legislation had been moving without major incident through the California legislature; SB 924 passed the Senate unanimously on January 30, and passed the Assembly Business & Professions Committee on June 26. The flare-up started on Thursday, August 16, when SB 924 passed unanimously out of the Assembly Appropriations Committee, but not before the committee made hostile amendments to the direct access aspects of the bill behind closed doors, without input from the California Chapter or the bill's chief sponsor, Sen Price. Under the prior compromise version of SB 924, a signed plan of care from a physician or podiatrist was required to continue treatment after the initial 30 business days or 12 visits provided via direct access; the physical therapist also needed to provide written disclosure to the patient explaining the provisions tied to the direct access law. As amended by the Assembly Appropriations Committee, a diagnosis from a physician or podiatrist must be obtained after the initial 30 business days or 12 visits via direct access in order to continue treatment. The disclosure language the PT must provide to the patient also was amended to add language stating the private insurance may not pay for the services without a physician referral. The amendments made by the Appropriation Committee were held from the public for 5 days before being released, causing an uproar. The bill took another turn on Friday, August 24, when the amendments that were placed into SB 924 during the Assembly Appropriations Committee hearing were removed on the Assembly floor, while new unwelcome amendments were added. But shortly thereafter Assembly Speaker John A. Pérez referred SB 924 to the Assembly Rules Committee, a procedural stall tactic, where SB 924 may stay until the end of the legislative session. If SB 924 is not moved from the Assembly Rules Committee and sent to the Assembly floor for a full vote by midnight Friday, August 31, SB 924 will die. The California Chapter is urging its members to contact their Assembly member to ask for an up–or-down vote on SB 924 by the full Assembly before the midnight deadline this Friday. The full text of the current version of SB 924 is available here. Comments Vote NO on SB 924! My brain-injured son will be taken off his swim therapy because of this stupid bill. His therapist says that they will no longer be paid for their services and the patient must pay cash. Medicare needs to pre approve their care because if the patient thinks he is being covered and then has a $2,000 bill, the patient must pay after the fact. Once again the disabled and seniors get the shaft. Posted by Virginia Johnson on 9/2/2012 1:05 PM After reading the text of the bill there is nothing in it that says anything about Medicare or payment for services. This is a state bill, not a federal bill, so it can't change Medicare policy. Am I missing something? How did you come to that conclusion? Posted by Mike Silver on 9/2/2012 4:42 PM


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Chris Schott, CFA
While Actavis (ACT) narrowed its 2013 guidance expectations in the wake of an unexpected Concerta approval, the company is still poised to post close to 30% EPS growth and potentially double-digit annual EPS growth through 2016. Additionally, the company's more diversified portfolio should allow one-time, one-product events like competition on Concerta or Adderall XR, among other events, to not have an adverse effect on Actavis' overall growth profile. As such, we believe Actavis has one of the best growth profiles in the industry and reiterate our Overweight rating on ACT shares.
While we are modestly reducing our 2013 Actavis EPS estimates to reflect higher spending levels, we see a number of potential upside drivers to results that are not reflected in our current estimates. These include higher than expected Concerta sales (if another competitor is delayed to the market), Pulmicort upside … and incremental product launches beyond Pulmicort. In addition, we continue to believe Actavis' $100-million synergy target for 2013 is beatable.
Charles C. Duncan, Ph.D.
Piper Jaffray & Co.
We are initiating coverage on Inovio Pharmaceuticals (INO) with an Overweight rating and 12-month price target of $1. Inovio is developing a novel DNA-based vaccine platform, utilizing proprietary electroporation technology to create robust immune responses.
Inovio's vaccines have demonstrated provocative immune responses in early studies against multiple non-viral oncology targets (prostate, leukemia, breast, lung), as well as several infectious diseases HIV, HCV, HPV, and the flu.
Our near-term valuation considers only the U.S. opportunity we view in VGX-3100, Inovio's lead candidate for treating cervical dysplasia (HPV).
We recommend risk-tolerant investors to initiate or add to positions in INO shares in anticipation of positive Phase II data in HPV, as well as what we expect to be further clarity from Phase II data for HCV and leukemia, both by YE13, with interim HCV data possible this quarter. These additional data points should serve to validate the breadth of the platform.
Edward Nash
Cowen and Co.
Inovio (INO) reported 3Q12 financial results on Nov. 7. The company reported a loss per share of $0.05 as compared to our estimate of a loss per share of $0.03. Inovio ended 3Q12 with approximately $15.2 million in cash, cash equivalents and short-term investments, which we believe will take them through 3Q13. Inovio's $23 million National Institute of Allergy and Infectious Disease contract is a testament of its platform technology.
Phase II interim data for leukemia and hepatitis C vaccine programs will be reported by the end of 2012 by collaborators. Based on clinical successes thus far and the potential for a proprietary electroporation based delivery system addressing sizable markets, we remain bullish on Inovio and reiterate our Outperform rating.
Karen Andersen, CFA
Roche Holdings (RHHBY) reported 2012 results that were roughly in line with our expectations, as the firm's core EPS of 13.62 Swiss francs per share came in only slightly below our 13.76 Swiss francs estimate.
Roche expects 2013 sales growth at constant currencies to rise a similar 4% level as they did in 2012, which could prove conservative given the accelerating sales growth in 2012 (6% growth in the fourth quarter at constant currencies).
Our 2013 core EPS estimate of 14.65 Swiss francs implies roughly 8% earnings growth for the year, which is in keeping with the firm's relatively vague guidance (to exceed top-line growth). However, we do expect to slightly raise our fair value estimate as we roll our assumptions forward by one year.
Revenue grew to 45.5 billion Swiss francs in 2012, representing 4% growth at constant currencies, with pharmaceuticals growing 5% to 35.2 billion Swiss francs and diagnostics growing 4% to 10.3 billion Swiss francs.
Steve Scala, RPh, CFA
Cowen and Co.
[In mid-December,] Cowen hosted Roche's Chief Executive and discussed strategy and the outlook. Highlights from the meeting are below:
Increased focus on Central Nervous System (CNS) [unit]. Roche is allocating more resources to CNS, as they believe they may be able to make significant advances in this therapeutic category. Trials are proceeding with crenezuamb in early stage and mild-to-moderate Alzheimer's disease and with gantenerumab in prodromal Alzheimer's disease. Roche believes that biomarkers to identify earlier detection are vital to the ultimate success of Alzheimer's disease drugs.
Emerging markets remain an opportunity: Roche sees emerging markets as a large opportunity, with China adding as much as 500 million Swiss francs to top-line growth annually. Management is piloting a tiered-pricing strategy to maximize the value of their products in individual regions. Herceptin currently appears well positioned at the high-end of the price range. Diagnostics are a key driver of growth as China continues to build infrastructure.


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Hospitality Management Development Apprentice – Harvester VAC-48210
This listing has expired
We want our guests to love visiting our pubs, bars and restaurants. So, if you can make it special by providing a friendly face from the moment a guest walks in, we want to speak to you.
You don't even need any experience. So long as you can provide a warm, helpful manner to everyone you meet, we can teach you the ins and outs of working as part of our busy teams.
By taking on a full-time role as a bar and waiting apprentice under the supervision of our passionate teams, alongside your training, you will enhance your service and communication skills and become more confident along the way. Not only will you achieve a Licensed Retail Level 2 Apprenticeship, you will be able to support the running of our businesses, creating some amazing moments and making sure that quality never slips for our guests!
What will your day-to-day involve?
• Help create a warm, friendly and welcoming environment
• Present our food and drink products perfectly
• Keep a safe and hygienic working environment
• Identify the needs of the guest to make every guest feel valued
• Responsibility for cash and company stock
• Be part of great team moments
• Show an appetite for personal development and learning
• Being proud of what you achieve
And it's all taught through:
• A mixture of face to face and remote visits every 4 – 6 weeks,
• 24-hour access to course learning materials for distance learning
• A mixture of on and off the job training, including workshops and webinars
• Reviews every 12 weeks with the Apprentice, Line Manager and Lifetime Trainer
• Feedback sessions to discuss progress
• Obtain Functional Skills in English and Maths
• 30 hours paid work every week
And it doesn't end there! Upon completing your apprenticeship, you can continue onto further apprenticeships or follow other routes to progress your career through our career pathways. Every moment is a chance to prove what you can do, and in a business as big as ours, there is always room to move around when you fancy!
You must be 18 to apply to this due to licencing laws
25 and over £8.21
21 to 24 £7.70
18 to 20 £6.15
Location: Windsor
Position Type: Apprenticeship
Sector: Hospitality
Working Week : 30 Hrs + p/w Incl. Evenings, Weekends & Bank Holidays
Weekly Wage : £184.50
Application Deadline: 04-02-2020
Possible Start Date : 10-02-2020


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Whiplash is a soft tissue neck injury that can include:
- Spraining the neck ligaments
- Straining the neck muscles
- Injury to cervical discs
- Possible nerve injury
Risk Factors
Factors that may increase your chance of whiplash include:
- Motor vehicle accidents
- Sporting events that include full contact
- Falls
- Assaults
Symptoms often develop in the hours after the injury although they can also develop in the days after the injury.
Symptoms may include:
- Stiff neck
- Neck pain
- Numbness or tingling
- Shoulder pain and stiffness
- Decreased range of neck motion
- Muscle spasms
- Headache
- Pain, numbness, or tingling extending down an arm
- Unusual fatigue
You will be asked about your symptoms and medical history. A physical exam will be done.
Most whiplash injuries do not show up on imaging tests. Your doctor may order some tests to make sure that no other injuries have occurred.
Neck images may be taken to look for further damage. Images may be taken with:
An electromyogram may also be done to test for nerve damage.
Talk with your doctor about the best treatment plan for you. Options may include:
- Reducing discomfort with ice and/or heat therapy
- Taking over-the-counter and prescription medications to reduce pain
- Moving as you are able to reduce stiffness
- Physical therapy and exercises
- Joint manipulation of the spine done by a chiropractor or other trained provider
There are no current guidelines for preventing whiplash. It often occurs due to an unexpected event.
Revision Information
- Reviewer: Laura Lei-Rivera, PT, DPT, GCS
- Review Date: 05/2018 -
- Update Date: 06/16/2015 -


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Conflict is a part of our daily lives at work or at home. How we manage conflict has a direct ... specifically, you'll learn- • How conflict is negative and how conflict can be positive in our management ... impact on how fulfilled we feel about our work, the quality of work, and the quality of work from our ...
Communication and Conflict Management
Conflict is a part of our daily lives at work or at home. How we manage conflict has a direct ... specifically, you'll learn- • How conflict is negative and how conflict can be positive in our management ... impact on how fulfilled we feel about our work, the quality of work, and the quality of work from our ...
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IQ tests." — Daniel Goleman What is Emotional Intelligence? It is the awareness of our emotions that ... drive our behavior, and how it impacts others (both positively and negatively), and then learning how to ... manage these emotions. Why is it important to have a high emotional intelligence? Your Emotional ...
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areas such as academics and scholarship, research and innovation, service and involvement, and influence ... said Steven Neal, CFAES professor and associate dean for academic programs. "Recipients are our future ... Agricultural and Biological Engineering Asaad Ahmad, construction systems management, Columbus, Ohio Matthew ...
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through takeout and/or a drive-thru is a good risk management choice, especially for high-risk and elderly ... have now instituted these measures. Ask the manager about the measures the restaurant staff is taking ... Sciences and its outreach and research arms, Ohio State University Extension and the Ohio Agricultural ...


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Forgetful Facebook users or users who login to their account on multiple computers/devices can now log themselves out remotely with Facebook's Remote Logout feature. The...
On Weekend Roundup #135, I mentioned that my wife's Asus Eee 1005HAB was broken and that I was trying to fix it. One of the things I did to...
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Principal Proposed Uses
Other Proposed Uses
- Chronic Viral Hepatitis
- Cirrhosis
- Other Forms of Liver Disease
- Fibromyalgia
- Parkinson's Disease
S-adenosylmethionine is quite a mouthful; the abbreviation SAMe (pronounced samm-ee ) is easier to say. Its chemical structure and name are derived from two materials you may have heard about already: methionine, a sulfur-containing amino acid; and adenosine triphosphate (ATP), the body's main energy molecule.
SAMe was discovered in Italy in 1952. It was first investigated as a treatment for depression, but along the way it was accidentally noted to improve arthritis symptoms—a kind of positive side effect.
Unfortunately, SAMe is an extraordinarily expensive supplement at present. Full dosages can easily cost more than $200 per month.
The body makes all the SAMe it needs, so there is no dietary requirement. However, deficiencies in methionine , folate , or vitamin B 12 can reduce SAMe levels. SAMe is not found in appreciable quantities in foods, so it must be taken as a supplement.
It's been suggested that the supplement trimethylglycine (TMG) might indirectly increase SAMe levels and provide similar benefits, but this effect has not been proven.
Therapeutic Dosages
A typical full dosage of SAMe is 400 mg taken 3 to 4 times per day. If this dosage works for you, take it for a few weeks and then try reducing the dosage. As little as 200 mg twice daily may suffice to keep you feeling better once the full dosage has "broken through" the symptoms.
However, some people develop mild stomach distress if they start full dosages of SAMe at once. To get around this, you may need to start low and work up to the full dosage gradually.
Recently, SAMe has come on the US market at a recommended dosage of 200 mg twice daily. This dosage labeling makes SAMe appear more affordable (if you're only taking 400 mg per day, you'll spend only about a third or a fourth of what you'd pay for the proper dosage), but it is unlikely that SAMe will actually work when taken at such a low dosage.
Therapeutic Uses
A substantial amount of evidence suggests that SAMe can be an effective treatment for osteoarthritis , the "wear and tear" type of arthritis that many people develop as they get older. 1,71
A moderate amount of evidence suggests that SAMe might be helpful for depression . 2,69
Weak and inconsistent evidence hints that SAMe might be helpful for a variety of liver conditions such as cirrhosis , chronic viral hepatitis , pregnancy-related jaundice , and Gilbert's syndrome. 3-10,65-68
SAMe may help the painful muscle condition known as fibromyalgia . 11,12
SAMe has undergone some investigation as a possible supportive treatment for Parkinson's disease . One study suggests that it may reduce the depression so commonly associated with the disease. 13 In addition, the drug levodopa , used for Parkinson's disease, depletes the body of SAMe. 14,15 This suggests that taking extra SAMe might be helpful. However, it is also possible that SAMe could interfere with the effect of levodopa, requiring an increase in dosage.
Highly preliminary evidence suggests that SAMe can protect the stomach against damage caused by alcohol. 16
What Is the Scientific Evidence for S-Adenosylmethionine?
A substantial body of scientific evidence supports the use of SAMe to treat osteoarthritis . 17,71 Double-blind studies involving a total of more than 1,000 participants suggest that SAMe is about as effective as standard anti-inflammatory drugs. In addition, animal evidence suggests that SAMe may help protect cartilage from damage. 18,19
For example, a double-blind, placebo-controlled Italian study tracked 732 people taking SAMe, naproxen (a standard anti-inflammatory drug), or placebo. 20 After 4 weeks, participants taking SAMe or naproxen showed about the same level of benefit as compared to each other, and a superior level of benefit as compared to those in the placebo group.
A more recent double-blind study compared SAMe to celecoxib (Celebrex), a member of the newest class of non-steroidal anti-inflammatory drugs. 64 Celecoxib produced more rapid effects than SAMe, but over time SAMe appeared to catch up. However, the lack of a placebo group makes these results less than fully reliable.
Another double-blind study compared SAMe with the anti-inflammatory drug piroxicam. 21 A total of 45 individuals were followed for 84 days. The two treatments proved equally effective. However, the SAMe-treated individuals maintained their improvement long after the treatment was stopped, whereas those on piroxicam quickly started to hurt again.
Similarly long-lasting results have been seen with glucosamine and chondroitin. This pattern of response suggests that these treatments are somehow making a deeper impact on osteoarthritis than simply relieving symptoms. However, while we have some direct evidence that glucosamine and chondroitin can slow the progression of osteoarthritis, the evidence regarding SAMe is more hypothetical.
In other double-blind studies, oral SAMe has shown equivalent benefits to various doses of indomethacin, ibuprofen, and naproxen. 22-24
The evidence for SAMe for the treatment of depression is provocative but far from definitive. Several double-blind, placebo-controlled studies have found SAMe effective in relieving depression, but most were small and poorly reported, and many used an injected form of the supplement. 25,26 Furthermore, a double-blind, placebo-controlled study of 133 depressed patients, failed to find intravenous SAMe more effective than placebo. Researchers resorted to questionable statistical manipulation of the data to show benefit. 27
Other trials compared SAMe to standard antidepressants rather than to placebo. The best of these was a 6-week, double-blind trial of 281 people with mild depression that compared oral SAMe to imipramine. 28 The results indicated that the two treatments were about equally effective. However, the absence of a placebo group makes this study less than fully definitive.
Other studies have also compared the benefits of oral or intravenous SAMe to those of tricyclic antidepressants and have also found generally equivalent results; however, again, poor reporting and inadequacies of study design (such as too limited a treatment interval) mar the meaningfulness of the reported outcomes. 29-34,63
Researchers have also studied the effectiveness of oral SAMe in combination with antidepressants. Seventy-three patients with treatment-resistant major depression were randomized to take SAMe (800 mg twice daily) or a placebo. 69 Both groups continued to take their selective serotonin reuptake inhibitor (SSRI). Adding SAMe to the treatment increased the rate at which patients responded to their antidepressant medication.
Four double-blind trials have studied the use of SAMe for fibromyalgia , 43-46 three of them finding it to be helpful. Unfortunately, most of these studies used SAMe given either intravenously or as an injection into the muscles, sometimes in combination with oral doses. When you inject a medication, the effects can be quite different than when you take it orally. For that reason, these studies are of questionable relevance.
Nonetheless, the one double-blind study that used only oral SAMe did find positive results. 47 In this trial, 44 people with fibromyalgia took 800 mg of SAMe or placebo for 6 weeks. Compared to the group taking placebo, those taking SAMe had improvements in disease activity, pain at rest, fatigue, and morning stiffness, and in one measurement of mood. In other respects, such as the amount of tenderness in their tender points, the group taking SAMe did no better than those taking the placebo.
It isn't clear whether SAMe is helping fibromyalgia through its antidepressant effects, or by some other mechanism.
Parkinson's Disease
Evidence suggests that levodopa (the drug used to treat Parkinson's disease ) can reduce brain levels of SAMe. 48-50 This depletion may contribute to the side effects of levodopa treatment, as well as the depression sometimes seen with Parkinson's disease. One study found that SAMe taken orally improved depression without changing the effectiveness of levodopa. 51 However, it is also possible that over time taking extra SAMe could interfere with levodopa's effectiveness. (See Safety Issues.)
Safety Issues
SAMe appears to be quite safe, according to both human and animal studies. 52-56 The most common side effect is mild digestive distress. However, SAMe does not actually damage the stomach. 57
Like other substances with antidepressant activity, SAMe might trigger a manic episode in those with bipolar disease (manic-depressive illness). 58-60
Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established.
SAMe might interfere with the action of the Parkinson's drug levodopa. 61 In addition, there may also be risks involved in combining SAMe with standard antidepressants. 62 For this reason, you shouldn't try either combination except under physician supervision.
Interactions You Should Know About
If you are taking:
- Standard antidepressants, including MAO inhibitors , SSRIs , and tricyclics : Do not take SAMe except on a physician's advice.
- Levodopa for Parkinson's disease: SAMe might help relieve the side effects of this drug. However, it might also reduce its effectiveness over time.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


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Happiness Is Where Our Heart Is
My family's unwavering belief in me makes me feel that I can do anything, be anything. This blog is about the people that made a difference in my life and the many journeys we made together. Because of them,I get to dream again...and those dreams, they remind me each day that life is a gift and a blessing. A blessing that is full of goodness, joy and hope.
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Carefree Living
To be carefree is a blessing. It allows us to let go. To move on. It help us forget life's worries and burdens. It teaches us to rediscover that once happy child in all of us. To remember the many … Continue reading
Posted in family, kids, Life, Love, parenting, photography, Summer Adventures, Travels, Weekly Photo Challenge Tagged adventure, Amazing Stories, Big Ben, carefree, Children, Clearwater Beach, Earth, faith, Firstgrader, Florida, God, Grown-ups, Happiness, happy child, Kids, lessons in life, London, love, mom and dad, parenting, Photography, Post A Week, priceless gift, ready 1, secret to happiness, secrets of life, summer, Things to do in Florida, Things to do in London, Travel, Vacation, Weekly Photo Challenge 64 Comments
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The world is full of masterpieces that inspired so many. There's the mysterious smile of Mona Lisa that captivated millions around the world. There's the Big Ben that every child saw when they watched Peter Pan, Wendy and her brothers … Continue reading
Posted in Culture, Events, family, Life, photography, Travels, Weekly Photo Challenge Tagged Art, Big Ben, Eiffel Tower, escape, Europe, happy child, Kate Middleton, kings and queens, Leonardo da Vinci, London, love, Masterpiece, Mona Lisa, mysterious smile, Neverland, new perspective, Paris, Photography, Post A Week, Queen Elizabeth, Romance, summer, Things to do in London, Things to do in Paris, Travel, U.K., Vacation, Weekly Photo Challenge, Windsor Castle 121 Comments


text: Koozies-on-sand-625x By RumShopRyan|2012-12-16T10:47:15-05:00December 16th, 2012|0 Comments Share This Story With Other Salty Souls! FacebookTwitterRedditPinterestEmail About the Author: RumShopRyan Just a salty pirate looking to explore and document the wonders of the Caribbean. Professional blogger, rum judge, consultant, marketer, and consumer of blue water beauty. Leave A Comment Cancel replyComment Save my name, email, and website in this browser for the next time I comment. This site uses Akismet to reduce spam. Learn how your comment data is processed.


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Dog Trotting
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Gravel trails lead dogs to each other at the Hanlon Dog Park in Guelph
The extremely popular Hanlon Dog Park along Highway 6 in Guelph
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'Before' room of Boldt Castle pre-renovation conditions
Making friends on the beach in Door County
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What's a ghost tour without a graveyard?
Victor at the Grand Trunk Station, Caledonia
Victor didn't get picked up this time… next time!
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Well Groomed: Pope and her 'Mad Hatter' themed dogs
Well Groomed: transforming a dog into a chicken for competition


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Brothels in Australia are a market that has become very popular in the last few years. The frustrating demand for Brothels has actually even caused the establishment of many customized clubs and dating services. Some individuals feel that it is a necessity to have an Brothel, as they say it is better to work with someone who is trustworthy and skilled than risk having someone phony along with an amateur.
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The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will attempt to rule out other conditions, such as infection, that may be causing your symptoms. If you are diagnosed with inflammatory bowel disease, testing can also be used to monitor the disease and assess complications.
Tests may include:
- Blood tests—to look for anemia and signs of inflammation
- Stool sample—to look for the presence of blood or infection
The colon and rectum can be examined with:
Imaging tests evaluate the intestines and surrounding structures. These may include:
A biopsy may be taken during these tests. A biopsy is a sample of the intestinal tissue that can be examined under a microscope.
Revision Information
- Reviewer: EBSCO Medical Review BoardDaus Mahnke, MD
- Review Date: 09/2018 -
- Update Date: 07/06/2015 -


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Wisconsin Multifamily Benchmark
A version of this article appears in the March/April 2007 issue of Home Energy Magazine.
March 01, 2007
Madison Gas and Electric's goal was simply to give its customers a sense of the range of electricity and gas costs across a variety of larger multifamily properties.
A building owner or operator asks: How does the energy bill for my 1970s era, 20-unit apartment building compare to the energy bills of other apartment buildings in the city? A developer asks: Should we install individual furnaces, a condensing boiler, or a closed water loop heat pump system in our new multifamily property? The staff of Madison Gas and Electric (MGE)—the primary energy supplier for the growing metropolitan area of Madison, Wisconsin—gets these kinds of questions often. MGE decided in 2005 to undertake a study of multifamily buildings in its service territory, and to build usable benchmarks for multifamily building energy costs so that we could answer these questions accurately. But comparing heating and cooling options for multifamily buildings is complicated. Different heating and cooling strategies involve different fuels. And the fuel may be paid for by tenants, or by landlords, or even through commercial tenant utility accounts. So MGE's goal was simply to give its customers a sense of the range of electricity and natural gas costs across a variety of larger multifamily properties. To conduct the study, MGE enlisted the assistance of the Energy Center of Wisconsin. Dalhoff and Associates ...
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 firstname.lastname@example.com.


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Once among the most common treatments for asthma, theophylline is no longer widely used, having been replaced by drugs that cause fewer side effects.
Theophylline appears to impair the normal conversion of vitamin B 6 into the more active substance pyridoxal 5'-phosphate (PLP). 1–4 These findings have led some researchers to suspect that some of the many side effects of theophylline could be caused, at least in part, by interference with B 6 activity. Indeed, one study found that B 6 supplements might help reduce theophylline-induced tremors. 5
Evidence suggests the herb St. John's wort can lower blood levels of theophylline, making it less effective. 6,7
Oral cayenne might increase the absorption of theophylline, 8 which could lead to an increased risk of theophylline toxicity.
Like cayenne, the supplement ipriflavone may increase levels of theophylline in the body, possibly increasing the risk of toxicity. 9
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text: DALLAS, TX – NOVEMBER 7: Brandan Wright #34 of the Dallas Mavericks dunks against Jonas Valanciunas #17 of the Toronto Raptors on November 7, 2012 at the American Airlines Center in Dallas, Texas. NOTE TO USER: User expressly acknowledges and agrees that, by downloading and or using this photograph, User is consenting to the terms and conditions of the Getty Images License Agreement. Mandatory Copyright Notice: Copyright 2012 NBAE (Photo by Glenn James/NBAE via Getty Images)


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Focus Financial Partners said Thursday that a team with five veteran advisors and $1 billion in client assets had joined its network: Portfolio Strategy Group, an RIA in White Plains, N.Y.
New York-based Focus provides wealth-management and investment services to independent advisors and others. It had nearly $60 billion in client assets and included 125 partnerships as of Dec. 31. It added $14 billion in assets last year.
"We are excited to bring this high-quality investment advisor into the Focus partnership and expand our presence in the very attractive and under-penetrated New York market," said Rudy Adolf, founder and CEO of Focus, in a press release. "PSG's investment management expertise will be a resource to other partners and will strengthen our ability to serve clients."
Portfolio Strategy Group was founded in 1990 by Managing Partner Richard Yoken to serve high-net-worth entrepreneurs and professionals through open-architecture platforms and other programs.
"In the process of seeking a future partner, we placed a paramount emphasis on retaining our independence to achieve our future goals," said Yoken, in a statement. "Through our partnership with Focus, our clients are reassured that we will maintain our culture and rigorous investment management process for the long term. We also look forward to working with Focus to attract additional experienced investment professionals and benefit from the experiences of other Focus partners."
PSG has eight full-time employees, including Managing Directors Edward Scharf, Peter Yorkes, Lawrence Bartimer and Thomas Zottner.
Focus, which has 800 staff members, says it is confident it can bring on more RIA partners like PSG this year. "Through the addition of such firms as PSG, 2012 has been another successful year for Focus, and we look forward to continuing our momentum into 2013," Adolf said.
Earlier this week, Schwab reported that the total value of independent RIA mergers and acquisitions increased 30% in 2012 versus 2011, with assets under management of 45 deals totaling $58.8 billion last year—up from $43.9 billion for 57 deals in 2011. National firms, like HighTower, Focus Financial and United Capital, remained the dominant buyers, finishing 2012 with 25 deals.


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1 Shipping
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(2).Ship by Air express,like USPS,EMS,DHL,TNT etc.They are door to door service.According to different country,we will choose most convenient Air express for you.
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(4).The delivery time is about 15 working days.
(5).We are not responsible for wrong or undeliverable address.Please make sure your shipping address is correct and deliverable.
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★Please note that shipments can occasionally be delayed due to unforeseen circumstances(Such as Festival). All shipments are sent fully insured.★ If you are not satisfied with our products, we offer a full return service. We will do our best to meet your needs, and at the same time.
The things you need to do are: Keep items and attachments attached, including the outer packaging, label, receipt, after the service card and other accessories. The article must be new and unused. Please contact our customer service representatives soon, and start processes back as fast as you can. We are sorry to inform you that we can not offer you return service if the situations occur as follows: 1. Deformation or damage of goods that have caused by the customer himself that affect the resale of goods such as remove it from the label, sleeve or collar stretched out of shape. 2. have been washed. 3. have been contaminated by cosmetics, perfumery, and scents.etc. 4. personal and subjective reasons, not quality issues.
2. Return
(1). We only allow a complete refund for items that have caused problems by us.
(2). If the returning package does not include all the accessories and spare parts shipped with, the cost of the accessories and parts will be deducted from the total product price and can only warrant a partial refund.
(3). If due to any reason, you need to change the size, color, or refund under the reason of "unlike" the postage deducted from the total price of the product.
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We will accept exchanges for a different size or color within 30 days of the original order dispatch. Please contact us with your Order ID and one of our staff will assist you. Would you like to exchange items to a different style, you would get back your items for a refund (as per Return policy) and place a new order for the style you prefer to place.
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text: Tuesday, December 18, 2012 Health Plan Premiums and Deductibles Soar From 2003-2011 Average premiums for employer-sponsored family health insurance plans rose 62% between 2003 and 2011, from $9,249 to $15,022 per year, according to a new Commonwealth Fund report. The report, which tracks state trends in employer health insurance coverage, finds that health insurance costs rose far faster than incomes in all states. Workers also are paying more out-of-pocket as employee payments for their share of health insurance premiums and deductibles have more than doubled. The report, State Trends in Premiums and Deductibles, 2003-2011: Eroding Protection and Rising Costs Underscore Need for Action, finds that total health insurance premiums now amount to 20% or more of annual median family incomes in 35 states, affecting 80% of the US working-age population. In 2011, average annual premiums for family plans ranged from about $12,400 to $13,500 in the lowest-cost states to more than $15,000 a year in 21 states. Premiums averaged from $16,000 to nearly $17,000 in Delaware, Alaska, Connecticut, Vermont, New York, the District of Columbia, New Hampshire, and Massachusetts, which have the highest average family premiums. While average family premiums jumped an average of 62% from 2003 to 2011, median family income rose just about 11%. The increase in premiums ranged from 42% in the lowest-growth state, Tennessee, to 76% in the highest-growth state, New York. Twenty-seven states had increases of 60% or more. The report also finds that employees' premium shares grew. The average annual amount an employee paid toward a family health insurance plan rose from $2,283 in 2003 to $3,962 in 2011—a 74% increase. Deductibles more than doubled from 2003 to 2011, increasing an average of 117% per person during the 8 years the report studied. In 2011, 78% of workers faced deductibles, up from 52% in 2003. Workers in small firms with fewer than 50 employees typically face higher deductibles than those working for larger firms. If historical trends continue, family premiums will reach $24,740 by 2020, an increase of 65% from 2011, says the report. The report and an interactive map featuring premiums in each state are available on The Commonwealth Fund's website.