text:
|Genus species var.
|Epimedium koreanum Nakai
|Epimedium grandiflorum ssp. koreanum (Nakai) Kitam.
|Epimedium multifoliolatum (Koidz.) Koidz.
|Epimedium sulphureum Nakai
Russian Far East, China, Eastern Asia, Manchuria, China Southeast, Japan, Korea, Primorye
thickets and woods
|leaves biternate, leaflets adaxially deep green, ovate, glabrous, at base cordate, serrulate, acute, raceme 10-15cm, 4-16-flowered, petals large, spur subulate, 1-2cm
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text: 6 Top Tips for a tip-top Blog 01/30/2015 Many website owners have learned that keeping content fresh keeps visitors returning, a Blog therefore is one of our greatest marketing assets. Giving your visitors good content every day or every week can be very difficult, the tips below will help you write content and say the right sort of things. When writing consider the Blog's objective. Perhaps you have started a Blog as a news tool to inform visitors about what is happening in your business industry or hobby field, maybe you use it to


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Corporate Internet Banking
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Keep Your Passwords Secret - Online passwords, including your 'Verified by Visa' password or 'MasterCard SecureCode', should be kept secret the same way as your ATM PIN (Personal Identification Number).
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Wealth Management Systems announced on Monday that it has acquired the S&P Capital IQ Financial Communications division to "help our clients maximize the value of customer engagement," according to the company.
Wealth Management, which specializes in technology-based rollover services and financial planning tools in the retirement services industry, said the terms of acquisition were not disclosed.
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The acquisition closed Monday. WMSI will now operate from West Palm Beach, Fla.;, Boston; Waltham, Mass.; and New York City. WMSI intends to retain all FC employees and will continue to support and develop the full line of WMSI and FC product offerings.
S&P Capital IQ Financial Communications is a provider of investor education and marketing communication solutions for financial services firms. According to its website, it creates and implements business-specific solutions for clients by bringing together professional guidance, relevant content and flexible delivery.
Check out RIA Growth Inevitable as Brokers Go Indie: S&P Capital IQ on ThinkAdvisor.


text:
Principal Proposed Uses
Other Proposed Uses
- Benign Heart Palpitations
- High Blood Pressure
- Orthostatic Hypotension (in Combination With Camphor)
The name "hawthorn" is derived from "hedgethorn," reflecting this spiny tree's use as a living fence in much of Europe. Besides protecting estates from trespassers, hawthorn has also been used medicinally since ancient times. Roman physicians used hawthorn as a heart drug in the first century AD, but most of the literature from that period focuses on its symbolic use for religious rites and political ceremonies.
During the Middle Ages, hawthorn was used for the treatment of dropsy, a condition we now call congestive heart failure. It was also used for treating other heart ailments as well as for sore throat.
What Is Hawthorn Used for Today?
Meaningful evidence indicates that hawthorn is a safe and effective treatment for congestive heart failure (CHF) . Like other treatments used for CHF, hawthorn improves the heart's pumping ability. However, it may offer some important advantages over certain conventional drugs used for this condition.
Digoxin , as well as other medications that increase the power of the heart, also make the heart more susceptible to dangerous irregularities of rhythm (arrhythmias). In contrast, preliminary evidence indicates that hawthorn may have the unusual property of both strengthening the heart and stabilizing it against arrhythmias. 1-3
It is thought to do so by lengthening what is called the refractory period. This term refers to the short period following a heartbeat during which the heart cannot beat again. Many irregularities of heart rhythm begin with an early beat. Digoxin shortens the refractory period, making such a premature beat more likely, while hawthorn protects against such potentially dangerous breaks in the heart's even rhythm.
Another advantage of hawthorn is its lower toxicity. With digoxin, the difference between the proper dosage and the toxic dosage is dangerously small. Hawthorn has an enormous range of safe dosing. 4
However, keep in mind that digoxin is itself an outdated drug. There are a great many newer drugs for CHF (such as ACE inhibitors) that are much more effective than digoxin. Many of these have been proven to prolong life in people with advanced CHF. There is as yet no reliable evidence that hawthorn offers the same benefit (although one large study found tantalizing hints that it might). 22 One small study concluded that it may be safe to combine hawthorn and digoxin, 23 but whether hawthorn interacts safely with other heart drugs remains to be determined.
Finally, CHF is simply too dangerous a condition to rely solely on self-treatment.
The bottom line : If you have CHF, do not use hawthorn except under close physician supervision.
The bottom line: If you have CHF, do not use hawthorn except under close physician supervision.
In addition to CHF, hawthorn is sometimes used as a treatment for annoying heart palpitations that have been thoroughly evaluated and found to be harmless. Common symptoms include occasional thumping as well as episodes of racing heartbeat. These may occur without any identifiable cause and may not require any medical treatment, except for purposes of comfort. However, there is no evidence that hawthorn is effective for this purpose. Furthermore, because there are many dangerous kinds of heart palpitations, it is absolutely necessary to get a thorough checkup first. It is only worth considering hawthorn as a treatment for palpitations if a doctor tells you that you have no medically significant heart problems.
Hawthorn is sometimes recommended for the treatment of high blood pressure , but its effects appear to be marginal at best. 5,6,13,20 Furthermore, there is some evidence that a combination herbal treatment made from hawthorn and camphor can help prevent the sudden fall in blood pressure that may occur on standing up from a sitting or lying position (orthosatic hypotension). 16,17 In these studies, the mixture acted to increase blood pressure.
Hawthorn has also been tried for other heart-related conditions, such as angina and atherosclerosis in general, but there is no reliable evidence to support these uses.
What Is the Scientific Evidence for Hawthorn?
At least nine reasonable quality, double-blind, placebo-controlled trials, involving a total of more than 750 participants, have found hawthorn effective for the treatment of mild to moderate congestive heart failure . 12,14,15,18,19
In one of the best of these studies, 209 people with relatively advanced congestive heart failure (technically, New York Heart Association [NYHA] class III) were given either 1,800 mg or 900 mg of standardized hawthorn extract or matching placebo. 15 The results after 16 weeks of therapy showed significant improvements in the hawthorn groups as compared to the placebo groups. Benefits in the high-dose hawthorn group included a reduction in subjective symptoms as well as an increase in exercise capacity. Subjective symptoms improved to a similar degree in the lower-dose hawthorn group, but there was no improvement in exercise capacity.
In an analysis that mathematically combined the results of 10 controlled trials involving 855 patients, hawthorn extract was found to be significantly better than placebo for improving exercise tolerance, decreasing shortness of breath and fatigue, and enhancing the physiologic function of an ailing heart in mild to moderate CHF . 24
In another study, however, researchers found that patients with mild-to-moderate CHF taking a special extract of hawthorn,900 mg daily, were more likely to experience an initial worsening of their condition compared to those taking a placebo. But, by the end of six months, there was no difference in the two groups. In light of numerous other studies supporting the safety and effectiveness of hawthorn in CHF, the results of this special extract study need to be repeated before drawing any firm conclusions. 25
A comparative study suggests that hawthorn extract (900 mg) is about as effective as a low dose of the conventional drug captopril. 10 However, while captopril and other standard drugs in the same family have been shown to help reduce hospitalizations and mortality associated with CHF, there is no similar evidence for hawthorn.
The usual dosage of hawthorn is 300 to 600 mg 3 times daily of an extract standardized to contain about 2% to 3% flavonoids or 18% to 20% procyanidins. Studies indicate that full effects may take up to 6 months to develop, although some improvement should be apparent much sooner.
Safety Issues
Hawthorn appears to be generally safe. Germany's Commission E lists no known risks, contraindications, or drug interactions with hawthorn, and mice and rats have been given very large doses without showing significant toxicity. 11 In clinical trials, reported side effects were relatively rare and nonspecific, consisting primarily of mild dizziness, stomach upset, headache, and occasional allergic reactions (skin rash). 21
Perhaps the biggest risk with hawthorn is that using it instead of conventional treatment might increase risk of death or other complications of CHF. In addition, it is not known whether hawthorn can be safely combined with other drugs that affect the heart. Therefore (to reiterate), do not self-treat CHF with hawthorn. A physician's supervision is essential.
Safety in young children, pregnant or nursing women, or those with severe liver, heart, or kidney disease has not been established.
Interactions You Should Know About
- If you are taking any medications that affect the heart: It is possible that taking hawthorn could cause problems.
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


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The patellar tendon connects the kneecap to the lower leg bone. Tendinopathy is an injury to the tendon. It can cause pain, swelling, and limited movement. The injury can include:
- Tendonitis—inflammation of the tendon
- Tendinosis—tiny tears in the tendon tissue with no significant inflammation
Treatment depends on the severity of the injury.
Tendinopathy is generally caused by overuse of a muscle-tendon unit. Over time, the strain on the tendon causes structural changes within the tendon.
Patellar tendinopathy occurs from overuse of the patellar tendon. Overuse may be caused by any activity that requires:
- Intense running
- Jumping
- Frequent stops and starts
- Frequent impact to the knee
- Falls
- Tendon weakness from certain diseases
Risk Factors
Physically active teenagers and young adults are at higher risk. Factors that increase your chance of developing patellar tendinopathy include:
- An increase in the frequency of training
- A sudden increase in the intensity of training
- Changing from one sport to another
- Training on a hard surface
- Repeated improper movements while training
- Muscle weakness or imbalance
- Involvement in basketball, soccer, volleyball, or running
Symptoms may include:
- Pain and tenderness in the patellar tendon below the kneecap
- Pain or tightness in the knee when bending, squatting, or straightening the leg
- Discomfort in the knee when jumping, squatting, or walking up stairs
You will be asked about your symptoms and medical history. A physical exam will be done.
Images may be taken. This can be done with:
Talk with your doctor about the best treatment plan for you. Treatment will depend on the severity of the injury. Options include:
Supportive Care
Your knee will need time to heal. RICE is often the main part of treatment:
- Rest—Activities will need to be restricted at first to reduce shock or vibrations to the knee. Normal activities will be gradually introduced as the injury heals.
- Ice—Ice therapy may help relieve swelling.
- Compression—Compression bandages can provide gentle pressure to help move fluids out of the area.
- Elevation—Keeping the affected area elevated can help fluids drain out or prevent fluids from building up.
A strap called a counterforce brace may be advised to help support the tendon and reduce pain.
Over-the-counter or prescription medications may be advised to reduce pain. Cortisone injections may also be used if other treatments do not reduce inflammation.
Physical Therapy
A physical therapist will assess the knee. An exercise program will be created to help recovery and to strengthen the muscle.
You may need surgery if you have advanced damage to the tendon. Your doctor may also recommend surgery if you have not responded to other treatment methods over a period of several months.
To reduce your chances of getting patellar tendinopathy, take these steps:
- Avoid activities and sports that repeatedly stress the kneecaps, especially those that involve jumping.
- Perform quadriceps muscle stretching and strengthening exercises.
- Increase the frequency and intensity of your exercises gradually.
- Learn proper techniques for sports.
Revision Information
- Reviewer: EBSCO Medical Review Board Teresa Briedwell, PT, DPT
- Review Date: 03/2018 -
- Update Date: 04/29/2014 -


text:
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Supplement Forms/Alternate Names :
- Potassium Chloride
- Potassium Bicarbonate
- Chelated Potassium (Potassium Aspartate, Potassium Citrate)
Principal Proposed Uses
Potassium is a mineral found in many foods and supplements. But you will never see pure potassium in a healthfood store or pharmacy—it is a highly reactive metal that bursts into flames when exposed to water! The potassium you eat, or take as a supplement, is composed of potassium atoms bound to other nonmetallic substances—less exciting, perhaps, but chemically stable.
Potassium is one of the major electrolytes in your body, along with sodium and chloride. Potassium and sodium work together like a molecular seesaw: when the level of one goes up, the other goes down. All together, these three dissolved minerals play an intimate chemical role in every function of your body.
The most common use of potassium supplements is to make up for potassium depletion caused by diuretic drugs. These medications are often used to help regulate blood pressure, but by depleting the body of potassium, they may inadvertently make blood pressure harder to control.
Potassium is an essential mineral that we get from many common foods.
True potassium deficiencies are rare except in cases of prolonged vomiting or diarrhea, or with the use of diuretic drugs.
However, in one sense, potassium deficiency is common, at least when compared to the amount of sodium we receive in our diets. It is probably healthy to take in at least five times as much potassium as sodium (and perhaps 50 to 100 times as much). But the standard American diet contains twice as much sodium as potassium. Therefore, taking extra potassium may be a good idea in order to balance the sodium we consume to such excess.
Bananas, orange juice, potatoes, avocados, lima beans, cantaloupes, peaches, tomatoes, flounder, salmon, and cod all contain more than 300 mg of potassium per serving. Other good sources include chicken, meat, and various other fruits, vegetables, and fish.
There is some evidence that, of the different forms of potassium supplements, potassium citrate may be most helpful for those with high blood pressure. 1
Research indicates that it is important to get enough magnesium , too, when you are taking potassium. 2,3,4 It might be wise to take extra vitamin B 12 as well. 5
Therapeutic Dosages
When used by physicians, potassium is usually measured according to mEq (milliequivalents) rather than the more common mg (milligrams) measurement. For adults, the typical daily requirement of potassium is 40-80 mEq. 20,21
The following table shows the approximate dosage equivalents for the different forms of potassium: 20,21
Therapeutic Uses
Potassium may be mildly helpful for hypertension . 6,7,8
What Is the Scientific Evidence for Potassium?
High Blood Pressure
According to a review of 33 double-blind studies, potassium supplements can produce a slight but definite drop in blood pressure. 9,10 However, two large studies found no benefit. 11,12 The explanation is probably that potassium is only slightly helpful. When a treatment has only a small effect, it is not unusual for some studies to show no effect while others find a modest benefit. It is possible that potassium may only help people who are at least a bit deficient in this mineral.
Evidence suggests that potassium supplements may be most effective for people who eat too much salt. 13
Safety Issues
As an essential nutrient, potassium is safe when taken at appropriate dosages. If you take a bit too much, your body will simply excrete it in the urine. However, people who have severe kidney disease cannot excrete potassium normally and should consult a physician before taking a potassium supplement. Similarly, individuals taking potassium-sparing diuretics (such as spironolactone), ACE inhibitors (such as captopril), 14-18 or trimethoprim/sulfamethoxazole 19 should also not take potassium supplements except under doctor supervision.
Potassium pills can cause injury to the esophagus if they get stuck on the way down, so make sure to take them with plenty of water.
Interactions You Should Know About
If you are taking:
- Loop diuretics or thiazide diuretics : You may need more potassium.
- ACE inhibitors (eg, captopril , lisinopril , enalapril ), potassium-sparing diuretics (eg, triamterene or spironolactone ), or trimethoprim/sulfamethoxazole : You should not take potassium except on the advice of a physician.
- Potassium: You may need extra magnesium and vitamin B 12 .
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


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On this page, we have managed to share the official USB driver for Tecno Q1 Device. If in case you were already searching for the USB driver of this device, then this page will help you out.
There are 3 USB drivers available for your device. Two of them can be used to flash the stock firmware on your Mediatek Device and Last is for normal connecting the device to the computer.
Tecno Q1 CDC driver For Flashing Firmware
Driver Name: CDC Driver
Driver Size: 120 KB
How to Install: Watch Tutorial
Driver Link: Click Here to Start Download
Tecno Q1 VCOM driver For Flashing Firmware
Driver Name: VCOM Driver
Driver Size: 401 KB
How to Install: Watch Tutorial
Driver Link: Click Here to Start Download
Tecno Q1 ADB driver For Normal Connecting
Driver Name: ADB Driver
Driver Size: 8.28 MB
How to Install: Watch Tutorial
Driver Link: Click Here to Start Download
How to install driver manually
Step 1: Download and extract the driver on your computer.
Step 2: Open Device Manager and Click on Add the Legacy Hardware Menu.
Step 3: Click Next.
Step 4: Select Install the hardware that I manually Select from a list.
Step 5: Locate the extracted driver manually on your computer.
Step 6: Click Add.
Step 7: Your Driver will be installed and listed in the Device Manager.
Important Notes:
[*] Driver Signature Error: If you got Driver Signature Error While installing the Driver then See this Video to fix this problem.
[*] If you are trying to flash stock firmware on your device then download CDC and VCOM Driver Only. ADB Driver will not work for flashing the stock firmware.
[*] Tecno Q1 Stock Firmware: You can download Tecno Q1 Stock Firmware from here.


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What Is Rotavirus?
Rotavirus is a virus that is transmitted through stool. It is easily spread by contaminated hands and objects. Symptoms usually begin about 2 days after contact with the virus. Symptoms may include:
- Fever
- Upset stomach
- Vomiting
- Diarrhea
- Loss of interest in eating and drinking
- Dehydration
Rotavirus rarely causes death in developed countries.
What Is the Rotavirus Vaccine?
The rotavirus vaccine is given by mouth. This is a live virus vaccine. This means it contains a living virus can produce immunity to the disease.
The vaccine comes in 2 brands, RotaTeq and Rotarix.
Who Should Get Vaccinated and When?
Your baby will need 2-3 doses. The number of doses depends on which type of vaccine your baby gets. The recommended schedule for giving these doses is:
- 2 months for first dose
- 4 months for second dose
- 6 months for third dose, if needed
This vaccine is not given to older children or adults.
What Are the Risks Associated With the Rotavirus Vaccine?
As with any vaccine, there is a small risk of severe reaction, such as a severe allergic reaction.
Most infants get the vaccine without any problems. In a small number of cases, children may have mild diarrhea or vomiting after getting the vaccine.
There may be a very small risk of a serious bowel obstruction called intussusception .
Who Should Not Get Vaccinated?
Children should not get the vaccine if they:
- Have had a life-threatening allergic reaction from a previous dose or any of its components
- Are very ill
- Have severe combined immunodeficiency
- Have had intussusception or have an abnormality of the intestine
Talk to your doctor if your child has a weak immune system due to the following:
- HIV infection or AIDS
- Is taking long-term steroid medication
- Has cancer or is receiving cancer treatment
What Other Ways Can Rotavirus Be Prevented Besides Vaccination?
It is important that you wash your hands and practice good hygiene.
What Happens in the Event of an Outbreak?
Frequent hand washing and washing of surfaces is recommended to keep the virus from spreading. Dirty linens and clothes should be handled as little as possible. These items should be laundered with detergent and machine-dried.
Revision Information
- Reviewer: David L. Horn, MD
- Review Date: 11/2018 -
- Update Date: 12/20/2014 -


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The Charles Schwab Corp. announced its game-changing commission-free ETF platform to much fanfare on Thursday, but less heralded has been a new ETF education resource launched in the fourth quarter that could help advisors use these ETFs.
Speaking with AdvisorOne ahead of IndexUniverse's InsideETFs Conference, Schwab's head of third-party ETF platform management Beth Flynn says the Schwab ETF Education Exchange is a cross-industry collaborative effort.
"Together with 30 other industry participants, we present educational materials on ETFs for all of our clients," Flynn says. Morningstar, Guggenheim, SPDR University and BlackRock are among the content providers contributing to the site.
"It's way more than Schwab could do on its own," Flynn says.
The site, launched in November, contains whitepapers, tutorials, videos, commentaries, links to webcasts and live education sessions, Flynn says, adding "there's no product sales push; it's purely educational."
Notably, there are three versions of the site, including a dedicated channel for financial professionals.
"There you'll have access to our ETF platform and recommendations for clients—everything from ETFs 101 to sophisticated hedging and overlay strategies," Flynn says.
A recent study commissioned by Schwab found that 45% of investors consider themselves novices when it comes to understanding ETFs, so the new site may aid investors and advisors meet this knowledge deficit.
Other advisor education initiatives Schwab has backed include a quarterly webcast on topics such as trading, best practices or sectors such as commodities. "We typically invite third party experts to join us for the sessions," Flynn says.
Schwab also produces a quarterly newsletter called "Expert Voice on ETFs" and offers advisors various screening and research tools on the Web, she adds.
The role of advisors in ETFs has grown in prominence, Flynn says. That is because individual investors have dominated ETF investing in recent years, but that has changed according to the firm's most recent study of retail investors.
"Advisors have now taken back the lion's share of [ETF asset] flows," she says.
As for the much ballyhooed new commission-free ETF platform, Flynn says that advisors particularly will be pleased by the breadth of offerings spanning all the major investment categories as well as the lack of restrictions on how advisors trade ETFs. For example, there will be no short-term redemption fees.
What's more, Flynn says advisors can expect that more ETFs from both Schwab and other providers will be added to the platform.
"On the Schwab side, there is a healthy pipeline of product development," Flynn says.
Check out AdvisorOne's InsideETFs 2013 enhanced landing page for complete conference coverage.


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Thank you for your interest in making a donation or thinking of us in your will or legacy - however great or small it may be, you can be assured that you will be contributing towards the Railway's longer term future.
We have several ways in which you can do this and whilst we do approach various organisations from time to time, our main source of funding comes from our visitors, members, and generous supporters. We are most grateful for any contribution you can make and which will enable us to pass the line on to future generations for them to enjoy as well.
For our Guide to Wills and Legacies please see here or scroll down below.
If you shop online then you can raise funds without it costing you even one penny please see here or scroll down.
If you would like to make a donation right now then there is a general fund for donations (which includes help towards funding the extension to Princes Risborough) and several designated funds for particular projects - please see the links below.
We also accept certain second-hand goods, such as good-quality railway books with original dust-jackets, for re-sale in our bookshop - please see here or scroll down below.
As an alternative, with the chance of winning some money, please do take a look at our 200 Club monthly lottery.
The Chinnor and Princes Risborough Railway Association Limited is a Registered Charity, Registration Number 1016237.
Guide to Wills and Legacies
Not something we like to think about - but when you're no longer here you can still make a difference
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Help us raise some funds without it costing you much effort or even one penny. Please join today!
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Donations of Railway Books, DVDs, Jigsaw puzzles, Railway models etc
Donate good-quality items for re-sale. See also those items we are sadly unable to accept
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Chinnor Signal Box
To improve and maintain the signalling at Chinnor now and for the future
More details
Restoration & Engineering Centre
The fund dedicated to the building and fitting out of our new Restoration & Engineering Centre
More details
Princes Risboro North Signal Box
This fund is dedicated to the urgent restoration and future maintenance work
More details


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Since 1881
Official Website
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Southwest Welcome Command Staff and Administration Sector 410 Sector 420 Sector 430 Sector 440 Sector 450 Southwest Investigation Southwest Service Team Community Prosecution Community Engagement Unit Crime Response Team Deployment Team Nuisance Abatement Team Crime Watch Crime Prevention Southwest Beats Maps and Information Southwest Explorers Convenience Store Training
Northeast Welcome Commander's Welcome Command Staff and Admininistration Sector 210 Sector 220 Sector 230 Sector 240 Sector 250 Criminal Trespass Affidavit Program Neighborhood Policing Team Nuisance Abatement Team Crime Response Teams Community Engagement Unit Deployment Team Convenience Store Safety Training
Northwest Welcome WEST NILE VIRUS INFO. Division Contacts Commander's Welcome Crime Prevention Crime Report Crime Watch Community Engagement Unit Events Calendar Convenience Store Safety Train Nuisance Abatement Team
Southeast Welcome Commander's Welcome Command Staff and Admin Sector Supervisor List Service Area Team Community Prosecution Volunteer Opportunities Community Engagement Unit Deployment Teams Nuisance Abatement Neighborhood Police Team Crime Response Team Nuisance Abatement Team Convenience Store Training Investigative Team Crime Reports Crime Watch Crime Prevention Maps and Information Police Expolorers
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South Central Welcome Commander Staff and Admin Sector Supervisors Investigative Team Investigative Team Members Community Prosecution Community Engagement Unit Deployment Team Crime Response Team Nuisance Abatement Team Neighborhood Police Team Expolorer Post 1999 Complaint Form
Property Unit Property Unit Intro Fencing of Stolen Property
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On this site, you will find helpful information about each organization's activities, projects, staff, area maps, school programs, frequently asked questions, forms and much more.
Webmaster | Translation Disclaimer
Website is maintained by: The City of Dallas
© 2002-2013 Dallas Police Department. All Rights Reserved.


text: As the crew of HD Cool Wallpapers, we provide you with only the best and handpicked autumn wallpapers in HD quality. Browse and download these HD autumn wallpapers fitting the screen of your desktops, laptops, netbooks, tablets and mobile phones. Bookmark our website, as we will be posting several new sets of HD images daily for you as one of the top quality resources of wallpapers on world wide web. Pleased to help.


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Ducks found shot with blow darts
Hurting wild birds is federal offense
Albuquerque BioPark authorities said they have found wild ducks shot with blow darts.
Officials said the darts were found stuck in the ducks' bills, necks and heads.
Action 7 News reporter Regina Ruiz said it's a crime to shoot ducks with blow darts, but authorities are having a hard time pinpointing who is responsible because the birds travel from pond to pond at Tingley Beach to the Botanical Garden, the zoo and even nearby ditches.
At least one duck has a blow dart that protrudes out several inches on one side of its head.
"She's very weary of people, you can't get anywhere near her," said BioPark veterinarian Ralph Zimmerman. "She's on a frozen-over pond, so getting a boat out there, we have to break ice first."
Zimmerman spotted three ducks struck by blow darts in recent weeks. The birds are wild and hard to catch. He said they might try using a huge net.
"Kind of a rocket-fired net, that will shoot out over the birds," he said. "(If) you get them out in the middle of the water, you can drown them before you can get to them, so there's no easy way to get to them," he said.
While the veterinarian tries to save the ducks, law enforcement wants to snare whoever is responsible for the senseless crime. The BioPark has a message for the person.
"Stop! Why are you hurting birds?" Zimmerman said. "These are wild birds, so there is a federal offense involved. We would be happy to prosecute."
If BioPark officials catch the ducks, they said it would take only a few minutes to remove the darts.
Anyone with information about the darted ducks should call the Albuquerque Police Department.


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The Scandinavian people have always been ahead of the rest of us. Vikings took their boats and raided and pillaged the small farming villages of northern Europe centuries before their victims developed the ability to defend themselves and now, they are at the head of the push in western countries toward free medicine for all residents.
"Scandinavian" countries are linked by the similarities in their languages, but the region is defined by much more. The blond hair, blue eyes and dry sense of humor of Finland or Norway, as well as a general prosperity throughout the countries that some claim makes them the most desirable place in the world to live.
Although Scandinavian countries' general prosperity makes them safe and easy to travel through, the trip itself can get expensive. The cost of living in Sweden, or Denmark makes everyday purchases a major expense and the added cost can sometimes cut your trip short. You may be able to make up the difference, however, by staying in some of the many youth hostels located throughout Scandinavia instead of the full price luxury hotels you might have otherwise traveled through.
In addition to the four big Scandinavian countries, the Faroe Islands in the north Atlantic ocean between Iceland and Norway, are another Scandinavian travel destination. Part of Denmark, the Faroe islands are most often toured between July and August when the weather is best.


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Chillin' with my peeps
A pink bunny will be used for a girl
Please indicate in comments to seller if it is for a BOY OR GIRL! Thank you :)
1-2 weeks
Buyers are responsible for any customs and import taxes that may apply. I'm not responsible for delays due to customs.
But please contact me if you have any problems with your order.
Our turnaround time varies throughout the year depending on order volume. For "current" turnaround time, please refer to our SHOP ANNOUNCEMENT or individual listings.
We offer local pickup in Destrehan, LA. Please use code FREEPICKUP at checkout to waive shipping if you prefer to pickup.
When your order is ready, you will receive an email that it has "shipped." Please read it as it will have detailed pickup instructions.
Size charts & Font options are available here: photos.stitchnola.com
To avoid confusion we prefer you provide the FULL name for the monogram.
We are not responsible if you enter the monogram information in the incorrect order or misspell a name. We will monogram the item exactly how you enter it on your order. Please double check your order to ensure all information is correct!
USPS 1st Class is the preferred shipping method.
If you are under time constraints, please upgrade your shipping accordingly. Priority & Express Shipping upgrades are available at checkout. If you need to upgrade after you have already placed an order, please send us a convo immediately.
Tracking information will be emailed as soon as your order is complete. Please understand we are not responsible if your order is delayed by the postal service. The USPS delivery date is only an estimate and our shop can only guarantee the shipment date. No refunds will be issued for items delayed, lost or damaged by USPS.
Please note all items are handmade to order. We do our best to make each item exactly as pictured but slight variations are possible. Additionally, if a fabric becomes unavailable we have the right to substitute the fabric accordingly.
Items needed before our current processing time require RUSH service. Rush service & priority shipping are 2 different services. With being an extremely busy shop, our turnaround can sometimes be longer than you may need so we offer Rush service to our customers that need an item quickly. Rush service bumps your place in our queue and speeds up the production time for us to actually make your item.
Priority shipping is a shipping upgrade you select for faster delivery by USPS. USPS standard shipping is First Class and typically takes 2-5 days, whereas Priority shipping typically takes 1-3 days for delivery. Please keep in mind once we ship an item, it is out of our control as we can only guarantee the ship date of an item.
We recommend our garments are hand washed and are laid flat to dry. If needed please press with a cool iron.
All items are made to order & take time to complete, not including shipping time. Refunds will not be granted for failure to understand our processing time. If you need your order sooner, please utilize our RUSH service which includes expedited processing time and an upgrade to priority shipping.
We are not responsible if your order is delayed by the postal service. The USPS delivery date is only an estimate and our shop can only guarantee the shipment date. No refunds will be issued for items delayed, damaged or lost by USPS.
We are not responsible if you enter the monogram information in the incorrect order or misspell a name. We will monogram the item exactly how you enter it on your order. Please double check your order!
Yes, we are happy to send a proof for approval before your item is made. You must request a proof in the comment section at checkout when ordering. We do not send proofs prior to purchase. Proofs are generally sent 1-3 days prior to your estimated ship date via etsy convo. There is a 3 proof limit due to the design time and resources involved (this includes font changes). Should you need more than 3 proofs, we are happy to accommodate your request for an additional fee.
Apr 19, 2019
Mar 12, 2017
Mar 29, 2016


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Total Eclipse of Arduino
I have frequently said disparaging things about Arduino. This invariably prompts e-mails from Arduino fans, some thoughtful and some… let's just say heated. I knew the situation was bad when I saw a Slashdot comment on an Arduino book that mentioned something about "Arduino haters like Al Williams…" (keep in mind, I was not involved in any way with the article or the discussion).
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I'd like to say that I really like the Arduino. I'd like to say that, but I just can't. My recent port of lwos (which I will get back to next time) reminded me of just how much I don't like it. But wait — if you are a fan, don't stop reading to send me a nasty e-mail yet. Wait until I get to the end.
Excepting the religious wars about emacs and vi, I am a pretty moderate guy. So, in all fairness, I do like some things about the Arduino. I like that it has brought a new awareness to embedded controllers. I like that it has spawned a lot of cheap daughterboards (don't make me say shield) and clones that can fit them. I really like the Atmel CPUs — in fact, I was using GCC, Atmel, and a bootloader long before the Arduino showed up. The best thing I like is that there are a number of really cool libraries for the Arduino and that makes it very productive (although I also liked Pascal Stang's avrlib library, which had a lot of cool features too and also predates Arduino).
So, gee, that sounds pretty positive. What don't I like? Ok, I'll be honest. Part of my personality is that rabid fans of almost anything puts my guard up. Even the things that I really like, I can (and will) enumerate a long list of flaws that I wish were different. So when you tell me that some tool is perfect (except, of course, emacs which is the exception that proves the rule), I am instantly going to be suspicious.
On the other hand, I'm no fool. If something really is that great, I will get over it and get with the program. But nearly every time I use the Arduino it leaves me frustrated. I say nearly every time. I did some work this semester with a high school student and he wanted to read an IR remote in Java. We built a board, put the Arduino bootloader on it, and instantly found a really nice program on the Internet that did exactly what we wanted. No fuss. But it also wasn't the core of the project.
I recently built an Arduino library for the IDE and also ported lwos to it. The editor is handy, but if you are used to a real programming editor it is frustrating. Sure you can use another editor (and sure, I can make the same argument about many IDEs). But the editor is really super simple and while that's a good thing for a new person, it is frustrating otherwise.
The other thing that is strange is that the IDE doesn't compile your code like you would guess it does. It basically builds a big single C++ file and compiles it. It guesses (mostly correctly) what libraries you need. Mixing in C code is very ugly. C++ is a little easier, as long as you don't want to use any of the Arduino libraries in your code.
Yes, every one of these problems is surmountable. But it is an unnecessary hoop to jump. The real tool underneath is GCC and there is no reason you can't have an "expert" mode with some better editor features and more control over the build process. I get that the tool makes it easy for beginners, but it would be nice to not make the old timers cranky. Besides, it isn't just the old timers. Every beginner will eventually graduate to bigger projects and find the same stumbling blocks.
Last time I mentioned a link to instructions on how to build Arduino code with Eclipse. To tell the truth, I'm not a huge fan of Eclipse (did I mention I like emacs?) but it is certainly capable and well-known. It also has good integration with Atmel debugging tools so, unlike the Arduino IDE, you could actually debug what you write.
Nevermind that link. It was out of date and the instructions no longer worked (assuming they ever did). I did a search and found quite a few instructions that involved doing things like compiling a program in the IDE and then swiping a library file made for the project. That sounds ugly. I wanted to just use Eclipse.
I did a few experiments with the AVR plug in. My code would build, but something kept it from running properly. Then I found the Arduino plug-in here. After you get it set up properly, it manages to build a library for your target and lets you write your Arduino code with Eclipse. There is even a serial monitor view so you can interact with the Serial object in your program.
I like it. Of course, even things I like might have an issue or two. In this case, I wish there were better documentation for the plug-in, and installing it seems to double up with the standard AVR plug-in (I assume the author uses the same base). There are few spots on the website that hint that the plug-in only works on Windows, but then later notes mention that starting with version 1.2.4, it works with Windows, Linux, or OS X. It is running fine for me under Linux.
I can get cheap Arduino hardware. I don't especially dislike the bootloader. I do like the libraries. With this plug-in I can ignore the IDE and the wonky build process it uses, which is really the part I hate. Maybe this plug-in will let me love the Arduino, after all.
One thing I am interested in, by the way, is the Arduino Leonardo. I'll be talking about it soon, but it is interesting because it can impersonate USB HID devices (a topic I've talked about before with the PIC). If building an HID device is as easy as the rest of the Arduino libraries, that would be something to get excited about. Especially if I can dump the hokey IDE.


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The main reason for very few blog posts during December was because I spent most of my spare time collecting data for my Espley One Name Study. I am really pleased with the progress since my last update.
I have now finished transcribing all the England and Wales GRO birth, marriage and death records from 1837 to 2005. I have also transcribed all the IGI information for the Espley name. All this data is in three A4 books (still plenty of room in the third one). This wasn't without its difficulties as I'm sure you can imagine – duplicated entries in the Ancestry index, duplicated entries in the GRO index, some barely readable handwriting in the early GRO records and lots of repetition in the IGI records.
I haven't yet started on the UK census records – and to be honest I have been putting that off because it's not quite as easy. My goal is to make a start on this within the next month.
Over the holidays I set up a spreadsheet to record all the GRO births and I finished typing all the birth information from my index books about two hours ago. I have now created a second spreadsheet for the GRO marriages and made a start typing the information – I am now having a break.
I joined the Guild of One Name Studies and my new member pack arrived today. So I have got lots of information to read including the latest quarterly Journal. This is going to keep me occupied and interested for a while.
I haven't registered the Espley name with the Guild yet because I am still undecided about the variant names to include.
I also joined the Espley group on Facebook and told members about my project. I invited them to get in touch with information and photographs etc.
The other thing we've started to do is to gather information about the origins of the name and search for locations that have Espley in the name.
I suspect that the only progress I make during the next month will be to get as much of the remaining data as possible typed on spreadsheets.
Finally on the techie side of things I also registered a website domain name in case we want to publish all the results and information on our own website.
I know that Jayne is really keen to try and build as many pedigree trees as possible once we have all the information stored in spreadsheets. This isn't a requirement of a One Name Study but I think it will be an interesting project all the same. However this is a long term goal but one I am looking forward to starting – sometime.


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StrabismusSkip to the navigation
Topic Overview
What is strabismus?
Strabismus (say "struh-BIZ-mus") is a vision problem in which both eyes do not look at the same point at the same time. Strabismus most often begins in early childhood. It is sometimes called crossed-eyes, walleye, or squint.
Normally, the muscles attached to each eye work together to move both eyes in the same direction at the same time. Strabismus occurs when the eye muscles don't work properly to control eye movement. When the eye muscles don't work as they should, the eyes may become misaligned and the brain may not be able to merge what one eye sees with what the other eye sees.
A child rarely outgrows strabismus after it has developed. Without treatment, strabismus can cause permanent vision problems. For example, if the child is not using one eye because it is misaligned, he or she can develop poor vision in that eye (called lazy eye or amblyopia ).
Having strabismus can be hard on your child's self-esteem. It affects your child's appearance as well as his or her ability to see well. Other kids may tease your child for being cross-eyed or having a walleye. Be supportive of your child, and seek treatment right away.
What causes strabismus?
Childhood strabismus often has no known cause, although it tends to run in families.
Sometimes strabismus develops when the eyes compensate for other vision problems, such as farsightedness or a cataract . Other things that can increase your child's risk for strabismus include an illness that affects the muscles and nerves, premature birth, Down syndrome, a head injury, and other problems.
Adults may develop strabismus from eye or blood vessel damage. Loss of vision, an eye tumor or a brain tumor, Graves' disease , stroke, and various muscle and nerve disorders can also cause strabismus in adults.
What are the symptoms?
The most common signs are:
- Eyes that don't look in the same direction at the same time. (If your child's eyes are only slightly misaligned, you may not notice.)
- Eyes that don't move together.
- Squinting or closing one eye in bright sunlight.
- Tilting or turning the head to look at an object.
- Bumping into things. (Strabismus limits depth perception.)
An older child may also complain about blurred vision, tired eyes, sensitivity to light, or double vision.
Symptoms may come and go. They may get worse when your child is tired or sick.
A newborn's eyes may be misaligned at first. But the eyes should become aligned by 3 to 4 months of age. In some cases, the eyes may simply seem to be misaligned because the child has a wide bridge of the nose that creates the appearance of crossed eyes. But if your child's eyes aren't aligned all of the time after age 4 months, take your child to the doctor for an eye exam.
How is strabismus diagnosed?
A doctor can often tell that a child has strabismus just by looking at the child's eyes. It may be obvious that the eyes don't look in the same direction at the same time.
The doctor may have the child look at an object while covering and then uncovering each eye. This allows the doctor to see which eye turns, how much it turns, and under what circumstances the abnormal turn occurs. These tests will also help the doctor find out if the child has amblyopia (lazy eye), which sometimes occurs with strabismus.
Most experts suggest that children have an eye exam between the ages of 3 and 5, and earlier in some cases. footnote 1 But no child is too young for an eye exam. If you have concerns about your child's eyes or vision at any age, take him or her to an eye doctor.
How is it treated?
The most common treatments for strabismus are:
- Glasses. Wearing glasses can sometimes correct mild strabismus.
- A temporary eye patch over the stronger eye if your child has amblyopia. This can make the weak eye stronger, which may help align the eyes. Your child may have to wear the patch some or all of the time for a few weeks or months.
- Surgery on the eye muscles. This is often the only way to improve vision and better align the eyes. It may take more than one surgery, and your child may still need to wear glasses.
Other treatments may include medicines and eye exercises.
Treatment for strabismus should begin as soon as possible. In general, the younger the child is when treatment begins, the better the chances are of correcting the problem.
It's also important for your child to get follow-up exams.
Related Information
- U.S. Preventive Services Task Force (2011). Vision screening for children 1 to 5 years of age: U.S. Preventive Services Task Force recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality. Available online: http://www.pediatrics.org/cgi/doi/10.1542/peds.2010-3177.
Other Works Consulted
- American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel (2012). Esotropia and exotropia. (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology. Also available online: http://one.aao.org/CE/PracticeGuidelines/PPP_Content.aspx?cid=689e7270-36c6-4daf-9dab-f6b1ab7286d3.
- American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel (2012). Pediatric eye evaluations. (Preferred Practice Pattern). San Francisco: American Academy of Ophthalmology. Also available online: http://one.aao.org/CE/PracticeGuidelines/PPP_Content.aspx?cid=2e30f625-1b04-45b9-9b7c-c06770d02fe5.
- American Optometric Association (2011). Care of the patient with strabismus: Esotropia and exotropia. Optometric Clinical Practice Guideline. Available online: http://www.aoa.org/x4813.xml.
- Enzenauer RW, et al. (2011). Strabismus. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 2293-2298. New York: McGraw-Hill.
- Motley WW, Asbury T (2011). Strabismus. In P Riordan-Eva, ET Cunningham, eds., Vaughan and Asbury's General Ophthalmology, 18th ed., pp. 238-258. New York: McGraw-Hill.
- Trobe JD (2006). Strabismus. In Physician's Guide to Eye Care, 3rd ed., pp. 137-139. San Francisco: American Academy of Ophthalmology.
ByHealthwise Staff
Primary Medical Reviewer John Pope, MD, MPH - Pediatrics
Adam Husney, MD - Family Medicine
Current as ofDecember 3, 2017
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As a society we are living longer, and we are living with medical issues longer. This places greater need for long term care insurance policies – insurance that covers the gaps left by Medicare and other assistance programs.
At the same time, a growing number of insurance companies are getting out of the long-term care business. Quite simply, it has become nearly impossible to forecast what individuals will need for health assistance, and what that assistance will cost, 20, 30 or 40 years into the future.
That makes it especially challenging for retirement planners to stay abreast on long-term care, and to advise their clients on the best plan for them. But long-term care is an important retirement tool for many, especially if they have assets to protect. The keys are to help your customers really understand what a policy covers, how flexible the policy is, and the criteria for receiving payments.
"Long-term care insurance is intended to do exactly as the name says – to care for you when your Medicare or your other health insurance benefits stop," said Helen Stephens, a certified planner with Aspen Wealth Management in Fort Worth, TX. "Medicare is very limited in what it will pay for beyond 20 days. It will cover skilled nursing for 20 days, and it will do partial for up to 100 days, but after 100 days you're really on your own."
Stephens advises all financial planners that deal with the retirement market to include long-term care as part of their advice overview. This is especially important with couples. Without this insurance, should one spouse require long-term medical care, they could quickly burn through the couple's estate' leaving nothing for the other spouse.
What policies cover
As noted by California Health Advocates, long-term care insurance policies are not standardized. The retirement planner needs to advise clients on the type of benefits that a policy will pay, the care that will be covered, and how easily the individual can access and start using long term care benefits.
Key points to long-term care insurance you will need to advise customers on include:
- Duration of benefits
- Benefit triggers
- Waiting periods
- Daily benefit amount
- Maximum policy benefits
- Inflation protection
How long benefits last
Long-term care policies are typically sold for periods of 12 months or more, but can cover any length of time up to for long as the individual lives. Obviously, the longer the duration of the policy, the more expensive the policy premiums will be for your client.
"The average long term care policy is about five years, " said Pam Dumonceau, a financial advisor with Consistent Values Inc., in Greenwood Village, CO. "Family history is definitely a driver. For example, those that have Alzheimer's in their family history should definitely be looking into this kind of insurance."
Using the examples of activities of daily living (ADL) is the best way to explain long term care insurance to customers, according to Dumonceau. They are the benchmarks for determining when somebody qualifies for assistance and benefits are paid. Those daily activities include the ability to dress oneself, feed oneself, make a meal, bathe oneself, recognizing the need to relieve oneself, personal grooming, and functional mobility. ADLs also include cognitive impairment or dementia caused by Alzheimer's disease or other conditions.
"As people need long-term care, the company will use those as benchmarks. For example, you can do a couple of those things but you can't do them all. When you can't do four out of five, or three out of four, that's when you actually quality for a claim," Dumonceau said.
In the case of California, for example, California Health Advocates notes that benefits must be paid for nursing home care, assisted living and home care when the individual can't perform two of the ADLs listed in the long-term care policy, or when the individual suffers a serious cognitive impairment or dementia.
How long must your clients wait?
Waiting periods for long term care benefits work much like a deductible in a standard insurance policy. Sometimes knows as the elimination or deductible period, this is the amount of time that must elapse before a policy actually begins making payments to a qualifying individual.
"Long-term care insurance is a lot like your car insurance where you have a deductible," Dumonceau said. "There is real value in a 90-day deductible, meaning it won't start until 90 days of impairment. Some polices will start after 30 days, or 60 days, or 180 days. You get a better value, but you have to self-insure for the first three months or six months of the impairment."
Advise your client that each policy varies in how much it will allow for on a daily basis, and for what types of care situation. For example, a policy might allow for a maximum payment of $100 per day for nursing home care, $70 per day for assisted living, and $50 for home care. Other policies might have a blanket maximum payment no matter where the individual is living.
The individual needs to know what to expect for benefits under the long-term care policy, in order to factor in other assistance. Stephen cites the example of her local market, where the cost of a private room in a nursing home is approximately $208 per day. A typical long-term care policy would therefore cover slightly less than half the cost of care.
It is also important to explain to clients how daily benefits are calculated and paid. Some insurance companies pay on a weekly basis, others monthly.
Maximum payouts
Long-term care policies have a maximum payout amount once an individual begins receiving benefits. Insurance companies are generally required to disclose what the maximum payout amount is on the policy.
California Health Advocates gives the example of a policy that pays $100 per day for three years. Your client's maximum benefits would be 365 days x three years x $100 per day, for a total of $109,500. "If you used the full benefit amount every day, your total benefits would last three years. However, if your care costs less or you only used the home care benefit at $50 per day, your policy would last much longer," according to the organization.
"The other thing that people need to be aware of is to make sure that their coverage options are as flexible as possible," Stephens said. "People need to be sure that it covers all types of situations, whether they decide to stay at home; whether they decide to go into a facility; who can care for them at home – does it have to be a licensed care giver, or can it be someone in the family? Most of my clients want to be in their home for as long as they can, so what does that look like, and does it cover the same for people coming into your home?"
When explaining long-term care coverage to your client, advise them on the benefits of inflation protection. Inflation protection does exactly what it implies: protects your client from the rising cost of healthcare and aid in general over time. It enables the individual to receive the same level of benefit payments regardless of what is happening in the economy. "Personally, I think inflation protection is really important on a policy," Stephens said.
Many states require that an individual sign a waiver if they do not wish to receive this protection. The reason is simple: without inflation protection, a person's benefits could very quickly erode.


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Principal Proposed Natural Treatments
Other Proposed Natural Treatments
Herbs and Supplements to Use Only With Caution
The liver is a marvelously sophisticated chemical laboratory, capable of carrying out thousands of chemical transformations on which the body depends. The liver produces important chemicals from scratch, modifies others to allow the body to use them better, and neutralizes an enormous range of toxins. Without a functioning liver, you can't live for very long.
Unfortunately, a number of influences can severely damage the liver. Alcoholism is the most common. Alcohol is a powerful liver toxin that harms the liver in three stages: alcoholic fatty liver, alcoholic hepatitis , and alcoholic cirrhosis. Although the first two stages of injury are usually reversible, alcoholic cirrhosis is not. Generally, more than 10 years of heavy alcohol abuse is required to cause liver cirrhosis. Other causes include hepatitis C infection, primary biliary cirrhosis, and liver damage caused by occupational chemicals and drugs.
A cirrhotic liver is firm and nodular to the touch, and, in advanced cases, is shrunken in size. These changes reflect severe damage to its structure. A high percentage of liver cells have died, and fibrous scar-like tissue permeates the organ.
A cirrhotic liver cannot perform its chemical tasks, leading to wide-ranging impairment of bodily functions, such as the development of jaundice (yellowing of the skin due to unprocessed toxins), mental confusion, emaciation, and skin changes. In addition, the fibrous tissue impedes blood that is supposed to pass through the liver. This leads to abdominal swelling as fluid backs up (ascites), and to bleeding in the esophagus as veins expand to provide an alternative fluid path. Ultimately, coma develops, often triggered by internal bleeding or infection.
Treatments for liver cirrhosis begin with stopping the use of alcohol and all other liver-toxic substances. A number of treatments such as potassium-sparing diuretics can ameliorate symptoms to some extent, but they do not cure the disease.
The liver is too complex for a man-made machine to duplicate its functions, so there is no equivalent of kidney dialysis for liver cirrhosis. Only a liver transplant can help. Unfortunately, this is a very difficult operation, with a high failure rate. In addition, the supply of usable livers is inadequate to meet the need.
Note : Individuals with cirrhosis of the liver should not take any medications, herbs or dietary supplements without first consulting a physician. The liver is in charge of processing many substances taken into the body, and when it is severely damaged, as in liver cirrhosis, ordinarily benign substances may become toxic.
Principal Proposed Natural Treatments
The herb milk thistle might offer various liver-protective benefits. In Europe, it is used to treat viral hepatitis , alcoholic fatty liver, alcoholic hepatitis , liver cirrhosis and drug- or chemical-induced liver toxicity . An intravenous preparation made from milk thistle is used as an antidote for poisoning by the liver-toxic deathcap mushroom, Amanita phalloides . However, the supporting evidence for its use in any of these conditions remains far from definitive.
A double-blind, placebo-controlled study of 170 individuals with alcoholic or non-alcoholic cirrhosis found that in the group treated with milk thistle, the 4-year survival rate was 58% as compared to only 38% in the placebo group. 1 This difference was statistically significant.
A double-blind, placebo controlled trial that enrolled 172 individuals with cirrhosis for 4 years also found reductions in mortality, but they just missed the conventional cutoff for statistical significance. 2 And a 2-year, double-blind, placebo-controlled study of 200 individuals with alcoholic cirrhosis found no reduction in mortality attributable to the use of milk thistle. 3
Other double-blind studies of cirrhotic individuals have found improvements in tests of liver function, 34,35 although one did not. 36
A 2007 review of published and unpublished studies on milk thistle as a treatment for liver disease concluded that benefits were seen only in low-quality trials, and, even in those, milk thistle did not show more than a slight benefit. 51 However, in a 2008 analysis of 19 randomized trials, researchers concluded that milk thistle was significantly more effective at reducing mortality from liver cirrhosis (mostly alcohol-related) compared to placebo, but no more effective at reducing mortality from any cause. 54
For more information, including dosage and safety issues, see the full Milk Thistle article.
Other Proposed Natural Treatments
Individuals with liver cirrhosis have difficulty synthesizing the substance S-adenosylmethionine (SAMe) from the amino acid methionine . 12,13 For this reason, supplemental SAMe (best known as a treatment for depression and osteoarthritis ) has been tried as a treatment for cirrhosis. However, as yet, the evidence that it works is not strong.
A 2-year, double-blind, placebo-controlled trial followed 117 people with alcoholic liver cirrhosis. 14 Overall, those given SAMe didn't do significantly better than those given placebo. However, when the results were re-evaluated to eliminate individuals with severe liver cirrhosis, a significant reduction in mortality and liver transplantation was seen with SAMe.
SAMe has also shown a bit of promise for primary biliary cirrhosis, though evidence is not consistent. 46
For more information, including dosage and safety issues, see the full SAMe article.
Branched-chain Amino Acids
Branched-chain amino acids (BCAAs) are naturally occurring molecules (leucine, isoleucine, and valine) that the body uses to build proteins. Because of how they are metabolized, BCAAs might be helpful for individuals with liver cirrhosis. 24,52,53 However, the evidence that BCAAs actually help is not yet conclusive. Furthermore, individuals with cirrhosis of the liver should not increase amino acid or protein intake except under physician supervision.
For more information, including dosage and safety issues, see the full BCAAs article.
Oligomeric Proanthocyanidins
Individuals with cirrhosis are susceptible to internal bleeding. Highly preliminary evidence suggests that oligomeric proanthocyanidins (OPCs) might help prevent this problem. 25
OPCs are best documented as a treatment for venous insufficiency (closely related to varicose veins ), where they are thought to work in part by stabilizing blood vessels. Individuals with cirrhosis have what amounts to internal varicose veins, caused by the shunting of fluid around the damaged liver. For more information, including dosage and safety issues, see the full OPCs article.
Other Natural Treatments That Might Help
One small study suggests that the supplement carnitine might be helpful for people with hepatic encephalopathy, a life-threatening brain abnormality associated with severe cirrhosis. 55Probiotics have also been studied as a possible treatment for hepatic encephalopathy. But, a 2011 review of 7 randomized trials involving 550 people found inconclusive evidence to support the use of probiotics for this condition. 57
The amino acid taurine might help reduce muscle cramps in individuals with cirrhosis. 27 (However, see the warning in the BCAA section.)
One study suggests that protein from vegetable sources might be preferable to protein from animal sources for people with liver cirrhosis, 28 presumably due to differences in amino acid content.
Preliminary evidence from animal studies suggest that the supplement phosphatidylcholine might help prevent alcoholic liver cirrhosis. 29 The supplement ornithine alpha-ketoglutarate (OKG) and related substance ornithine-l-aspartate have shown promise for treating hepatic encephalopathy. 40,56
Vitamin K has shown a bit of promise for helping prevent liver cancer in people with cirrhosis of the liver. 48
An ayurvedic herbal combination has been studied for the treatment of cirrhosis, but current evidence supporting its use remains incomplete and contradictory. 41,42,49
Antioxidants have been proposed for the treatment of primary biliary cirrhosis, based on the theory that free radicals play a role in the disease process. However, despite apparent promise seen in open trials, a double-blind, placebo-controlled study of 61 subjects failed to find that combination of vitamins A , C and E , selenium , methionine and CoQ 10 produced any benefit in terms of fatigue or other liver-related symptoms. 50
The bones of individuals with biliary cirrhosis often become thin. Taking calcium and vitamin D supplements might help. 30,31 Antioxidants such as vitamin C , vitamin E , and lipoic acid have been tried for biliary cirrhosis, with promising results in very preliminary trials. 32
Herbs and Supplements to Use Only With Caution
Many natural products have the capacity to harm the liver. Furthermore, because of the generally inadequate regulation of dietary supplements that exists at the time of this writing, there are real risks that herbal products, at the least, may contain liver-toxic contaminants even if the actual herbs listed on the label are safe. For this reason, we recommend that people with liver disease do not use any medicinal herbs except under the supervision of a physician. Here, we list some specific information to aid in your decision-making process.
Vitamin A and beta-carotene supplements might cause alcoholic liver disease to develop more rapidly. 37–39
All forms of vitamin B 3 may damage the liver when taken in high doses, including niacin, niacinamide (nicotinamide), and inositol hexaniacinate. (Nutritional supplementation at the standard daily requirement level should not cause a problem.
A great many herbs and supplements have known or suspected liver-toxic properties, including but not limited to:
- Barberry
- Borage
- Chaparral
- Coltsfoot
- Comfrey
- Germander
- Germanium (a mineral)
- Greater celandine
- Certain green tea extracts
- Kava
- Kombucha
- Mistletoe
- Pennyroyal
- Pokeroot
- Sassafras
- and various herbs and minerals used in traditional Chinese herbal medicine
In addition, herbs that are not liver-toxic in themselves are sometimes adulterated with other herbs of similar appearance that are accidentally harvested in a misapprehension of their identity (for example, germander found in skullcap products). Furthermore, blue-green algae species such as spirulina may at times be contaminated with liver-toxic substances called microcystins, for which no highest safe level is known. Some articles claim that the herb echinacea is potentially liver-toxic, but this concern appears to have been based on a misunderstanding of its constituents. Echinacea contains substances in the pyrrolizidine alkaloid family. However, while many pyrrolizidine alkaloids are liver-toxic, those found in echinacea are not believed to have that property.
Whole valerian contains liver-toxic substances called valepotriates; however, valepotriates are thought to be absent from most commercial valerian products, 43 and case reports suggest that even very high doses of valerian do not harm the liver. 44,45
Revision Information
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015 -
- Update Date: 12/15/2015 -


text: Tuesday, March 20, 2012 Final Rule Creates Programs to Help Avoid Adverse Selection in Exchanges A final rule issued Friday by the Department of Health and Human Services implements 3 programs under the Affordable Care Act to help ensure that insurance plans compete on the basis of quality and service and not on attracting the healthiest individuals. The new standards related to risk adjustment, reinsurance, and risk corridors will mitigate the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms and the Affordable Insurance Exchanges (Exchanges) are implemented, starting in 2014. The permanent state-based risk adjustment program provides payments to health insurance issuers that disproportionately attract high-risk populations (such as individuals with chronic conditions). The transitional state-based reinsurance program serves to reduce uncertainty by sharing risk in the individual market through making payments for high claims costs for enrollees. The temporary federally administered risk corridors program serves to protect against uncertainty in rate setting by qualified health plans sharing risk in losses and gains with the federal government. Last week, HHS issued 2 other rules concerning Exchanges. A final rule issued March 12 establishes a framework to help states set up Exchanges. A final and interim rule issued March 16 sets eligibility standards for Medicaid and Children's Health Insurance Program beneficiaries within Exchanges. These rules have significant implications for patients and physical therapists regarding mandatory essential health benefits (EHB), which include the category of "rehabilitative/habilitative services," although the details of EHB will be addressed in future rule-making.


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Corneal transplant is a surgical procedure used to replace a portion of a diseased or damaged cornea with a healthy one. The cornea is the clear, outer surface on the front of the eye.
Reasons for Procedure
A corneal transplant can correct vision problems caused by infections, injuries, or medical conditions that affect the cornea. It is often recommended for the following:
- Keratoconus—a thinning and bulging of the cornea that causes blurred vision
- A cornea scarred from infection or injury
- Clouding of the cornea
- Complications of previous eye surgery
Possible Complications
The procedure is usually highly successful. Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Rejection of the new cornea—the body's defense system attacks the new tissue, damaging it
- Glaucoma
- Problems focusing
- Light sensitivity
- Swelling or detachment of the retina
- Cataract
- Infection
- Bleeding
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications, such as:
The operation is most successful for those who have the following:
- Keratoconus
- Corneal scars
- Corneal dystrophies
It is less successful for those who have corneal infection and severe injury, like a chemical burn.
What to Expect
Prior to Procedure
Your ophthalmologist may do a physical exam and blood tests.
Before the procedure:
- Talk to your doctor about your medications. Also, discuss any herbs or vitamins you take. You may be asked to stop taking some medications up to 1 week before the procedure.
- Arrange to have someone drive you home.
- Arrange for help at home after the procedure.
- Use any eye drops as instructed by your eye surgeon.
- The day before, do not eat or drink anything after midnight unless told otherwise by your doctor.
2 types of anesthesia can be used during a corneal transplant:
- Local anesthesia to numb the eye
- General anesthesia
Description of Procedure
The procedure will be done under a surgical microscope. The damaged part of the cornea will be cut out. The new cornea will then be placed in the opening. The new cornea will be fastened with very fine stitches. Finally, a patch and shield will be put over the eye.
There is another technique called Descemets stripping endothelial keratoplasty (DSEK). DSEK is used for some types of cornea transplants. It may result in shorter recovery time and better vision. With this technique, the doctor removes a much smaller part of the cornea, compared with older procedures.
How Long Will It Take?
1-2 hours
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
You will most likely go home after a few hours in the recovery area.
Post-procedure Care
Recovery at home includes pain management and avoiding certain activities until the eye heals. Other recovery steps may include:
- Using eye drops
- Wearing glasses during the day or a shield at night
- Not rubbing the eye
- Protecting the eye from accidental bumps or pokes
- Avoiding contact sports
Vision may initially be worse than before your surgery before your eye adjusts to the new cornea. It may take several months for it to improve. Stitches are usually left in place for several months. Regular follow-up visits will allow the doctor to monitor how the eye is healing. Do not drive until your doctor says you can.
Call Your Doctor
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:
- Signs of infection, including fever and chills
- Vision symptoms, including decreased vision, floaters, flashing lights, increased light sensitivity, or loss of peripheral vision
- Increased eye redness
- Increased pain
- Persistent nausea or vomiting
If you think you have an emergency, call for medical help right away.
Revision Information
- Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
- Review Date: 11/2018 -
- Update Date: 12/20/2014 -


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Scattered piecesOur handkerchiefs are made of a fine microfiber fabric allowing to clean your hands and face against its soft texture. Design images are dyed using heat sublimation process to ensure fading is kept to a minimum. Machine washable. Measures approximately 11"(w) x 8"(h).
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