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Daniel Shakhmundes, Zain Dinath, Derek Pritchett, Rachel Tiano - Chinese Philosophy (PHIL 2P17) - 2005-03-28
Zen Buddhism
The name Zen (Ch'an in Chinese) was derived from the attempt to render the Sanskrit term dhyana meaning "meditation" into Japanese and Chinese. Ch'an Buddhism is a derivative of Chinese Mahayana Buddhism and stresses meditation over adherence to scriptures or doctrine.
According to legend, an Indian monk Bodhidharma, who arrived in China in about 520, founded the school. He taught the Lankavatara Sutra which taught "conscience only". His insight was then transmitted through a series of Chinese patriarchs; the most famous was the Sixth Patriarch, Hui Neng.
Hui Neng stressed the Platform Sutra, which defines enlightenment as the direct seeing of ones original nature, which is the Buddha nature. The 8th and 9th centuries produced many great Ch'an masters such as Ma-tsu, Huang Po, and Lin-chi. Later, Korean monks studying in China learned of Zen and spread it to Japan in the seventh century.
"Awakening - or satori - is the fundamental aim of Zen. It is seeing into your nature, realizing your own Buddhahood, freeing yourself from the cycle of birth and death."
When Buddhism first came to China Taoism and Confucianism heavily influenced it. This resulted in meditation being understood not as concentration as in India, but as things such as conserving energy, reducing desires, living in the here and now etc. Therefore, the Ch'an School put meditation at the center of its practice. Followers gave up the study of traditional Buddhist scriptures to pursue a more intuitive way of enlightenment through meditation, physical training and the study of illogical puzzles known as koans. Koans force one's intellect to consider impossible scenarios until it becomes exhausted, realizes the futility in searching for an answer and gives up. Once the intellect is out of the way, enlightenment (satori) is more readily attained.
It is a common tenet of Buddhism that the direct perception of reality (enlightenment or satori) is necessary to liberate oneself from the cycle of death and rebirth. Satori attained from Zen is not an understanding obtained through intellectual analysis, but rather it is an awareness obtained through a direct experience. The ultimate purpose of Zen practice is to reach the same enlightened state of mind as the Buddha did. Zen meditation is designed to prevent the mind from distractions and achieve wisdom and ultimately reach enlightenment.
Similarities between the Northern and Southern Schools
• Both schools started out with the major premise that Nirvana is identical with the original substance of the Buddha-mind, which is the same as Buddha-nature, and the Buddha-nature is in all men so that all men can become Buddha's.
• Both schools remain within the Buddhist traditions of idealism and universal salvation.
• The Northern school taught that the pure mind arises from absolute quietude and does so only after erroneous thoughts are eliminated
• The Southern school insists that the mind cannot be split into parts and that all of its activities are functions of Thus-ness (True Reality).
• Northern school considers the mind in its undisturbed state as calmness (Samadhi) and the senses in their undisturbed state as wisdom (Prajna).
• Southern school refuses to accept the distinction, regarding both as of one substance and not two. It affirms the unity of the mind and everything else.
Absence of thought; Forgetting our feelings; Letting the mind take its own course; Travel; Never tell too plainly; Koan; Shouting and Beating
• When a commoner suddenly becomes a sovereign it is called a mundane mystery.
• If in the 1st stage of one's spiritual progress (10 stages)
• The initial resolve to perfect wisdom has a correspondence with truth
• They will immediately achieve Buddha hood.
• These types of mysteries are in accord with the Buddha principle of sudden enlightenment.
• Gradual enlightenment comes from the other teachings of Buddhism, which emphasizes on gradual steps towards enlightenment. This means loading the mind of knowledge to understand.
• Sudden enlightenment is the belief of Zen Buddhism. It follows the Buddhist principle having no attachment to the self.
• Zen Buddhism attempts to achieve nirvana without renouncing life and death (different from other Buddhist teachings)
"Why is ignorance the same as spontaneity (Tzu-Jan)"
• "Because ignorance and Buddha-nature come into existence spontaneously" (pg.443)
• One is the basis for the other, therefore when one exists, the other exists and without one there cannot be the other
• An example: It is like gold and minerals; they both come into existence at the same time. After a master has smelted and refined the material, gold and the minerals will be differentiated and further smelting the residual mineral will become dust.
• Gold is an analogy of the Buddha-nature and minerals an analogy of afflictions resulting from passions.
• Therefore the afflictions and Buddha-nature exist simultaneously. If only one exists the other cannot, until all is rid and the purity shows through (gold)
The Recorded Conversation of Zen-Master I-Hsuan
• This conversation, Zen-Master would beat the monk for asking questions.
• Reason being, Seekers of enlightenment in Buddhism do neither need effort, nor questions answered for them. Buddha hood is not to be searched for. Nothing needs to be done to achieve it.
• Enlightenment is a sudden event with no effort needed.
The Platform Scripture
Our A Sourcebook in Chinese Philosophy cites selections from the oldest version of the Liu-tsu t'an-ching
There are five versions of the Liu-tsu t'an-ching that followed the initial, the latest being dated 1291. It was included in the Ming dynasty (1368-1644) editions of the Buddhist Canon of 1420-1440, which goes to show how significant to Buddhism this scripture became.
The Ming Canon version is twice as long as the oldest text. Despite the many corrected mistakes in the oldest copy from the Tun-huang cave, "elaboration does not alter the general story or the fundamental teachings."
The oldest Platform Scripture is ascribed to Hui-neng. Dr. Hu Shih thinks that it was probably by an 8th century monk, most likely a follower of Shen-hui's school.
The scripture begins with an encounter between Priest Hung-jen and Hui-neng, recounted in first-person perspective by the latter.
Further on unfolds the story of how the 6th Patriarch (Hui-neng) came to receive his position/title from the 5th Patriarch (Hung-jen). Though dedication, labours, and discipline, Hui-neng rises to Hung-jen's challenge of writing a verse to exemplify the wisdom inherent in one's nature. The 6th Patriarch gave a detailed statement of the Diamond Scripture to Hui-neng in secret (without the knowledge of anyone in Hung-jen's establishment). The method of sudden enlightenment and a robe were given, as testimony of transmission. For some reason, because of the transmission of the Law, Hui-neng risked harm if he did not leave quickly.
The 6th Patriarch went to what is presently called Canton, in South China. According to Hui-neng's own words in the scripture, he "associated with government officials, disciples who have renounced their families, and lay folk. This, after all, was due to causes operating over many long periods of time."
What kind of life do you think Hui-neng lead, given the implications you conceive upon hearing his circumstances in Canton?
The scripture goes on with Hui-neng's explanation on how one could become enlightened.
"Perfect wisdom is inherent in all people"-- Being deluded holds back enlightenment.
Strong and repeated recommendation/suggestion/advice to "seek the help of good and learned friends of high standing to show them the way to see [their own] nature."
To be enlightened is to attain wisdom
Calmness and wisdom are one substance and the foundation of Hui-neng's method
To say that one follows the other, or that they are different, would imply that the dharmas (elements of existence) posess two different characters
Good words and heart are identifiers of calmness and wisdom
Self-enlightenment and practice do not consist in argument
Consideration of success or failure in attaining enlightenment will result in the dharmas being produced as real entities, in which case one will not be free form the Four Characters [of coming into existence, remaining in the same state, change, and going out of existence]
The enlightenment of anyone who attains it, sudden or gradual, is the same as that of anyone else who attains it - regardless of time
The dharma-body (Law-body or spiritual body) is freed from the physical body through the following:
Absence-of-thought – main doctrine
"Not to be carried away by thought in the process of thought"(A concept likely coming from the influence of various forms of Taoism).
Free yourself from afflictions resulting from passions brought on by thoughts initiated by external objects
One's untainted thought is the substance of true nature or True Thus ness (True Reality)
Absence-of-characters – the substance
"To be free from characters while in the midst of them"
"Not to be defiled by external objects"
The thoughts of others influence you and contaminate your own characters and thoughts
Contemporary marketing tactics of influencing your recognition and nature (magazine covers, etc.) are a good large-scale example of imposing erroneous views (i.e. The monstrous businesses of "Soft-drink" [pop/soda], fast food, and cigarettes).
Nonattachment – foundation
"Man's original nature"
A dharma never has any thought attached to it – it is to be as instinctual
"Man's nature is originally pure"
"It is by false thoughts that True Thus ness is obscured"; this is how one may become deluded
The cultivation of imperturbability (say that three times fast) prevents one's nature from becoming perturbed by the mistakes and defects of people
The scripture goes on to reiterate all the above points in explaining how they may be realized through the given meditation techniques
Metaphysical concepts are brought down, such as the Three Bodies of the Buddha, to dispel idolatry of the Buddha.
Pure [Law] is further explained with the assistance of the metaphysical notions
Enlightenment cannot happen in steps, one split second of truth empties the mind. No questions need to be asked, No questions need answers.
"The Zen emphasizes the spirit of revolt but also determination and removes anything in the way of the mind's direct and immediate intuition of truth"(Pg.449)
"Not only is there not much in Hsung-po's Buddhism; there is not much in Buddhism itself" (pg. 449) *This saying has been repeated time and again by Zen Buddhists. *Also one of the top five most important Buddhist points.
Go back to Chinese Philosophy (PHIL 2P17)


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M u l t i t h r e a d i n g , P a r t Tw o : E x p l o r i n g t h e Ta s k P a r a l l e l L i b r a r y a n d P L I N Q
Typing show conn by itself lists the entire state table. Table 5-5 explains the rest of the parameters for this command. An example of the output of the show conn command is shown here:
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Recent guidelines for chronic or recurrent low back pain recommend non-pharmacologic treatments as first-line options. The objective of this study was thus to explore the perceived usefulness of several conventional and complementary medicine treatments for chronic or recurrent low back pain by primary care physicians and their reported prescribing behavior.
Main outcome measures
Primary care physicians' perceived usefulness of each conventional and complementary medicine treatment and their reported recommendation behavior were considered dependent variables in multivariate logistic regression models. All correlations were computed between binary variables, and phi coefficients were calculated to estimate correlation strengths.
533 primary care physicians answered the questionnaire (response rate: 25.6%). The top 3 conventional treatments most often considered useful by primary care physicians for chronic or recurrent low back pain were physiotherapy (94.8%), nonsteroidal anti-inflammatory drugs (87.9%), and manual therapy (82.5%), whereas the most prescribed conventional treatments were physiotherapy (99.2%), nonsteroidal anti-inflammatory drugs (97.4%), and acetaminophen (94.4%). Osteopathic treatment (78.4%), yoga (69.3%), and therapeutic massage (63.9%) were the complementary medicine treatments most often considered useful by primary care physicians in managing chronic or recurrent low back pain. Being a female physician, younger than 56 years, trained in complementary medicine, or using complementary medicine were all associated with higher perceived usefulness of complementary medicine treatments in general. The most recommended complementary medicine treatments by primary care physicians were osteopathic treatment (87.3%), acupuncture (69.3%), and therapeutic massage (58.7%). Being a female physician, younger than 56, and using complementary medicine were all associated with more complementary medicine recommendation in general.
Our results highlight the importance of better understanding the prescribing patterns of primary care physicians for chronic or recurrent low back pain. Considering the frequency and burden of chronic or recurrent low back pain, programs focusing on the most (cost-) effective treatments should be implemented.
Citation: Rodondi P-Y, Dubois J, Bill A-S, Koutaïssoff D, Ros J, Aveni E, et al. (2018) Primary care physicians' attitude and reported prescribing behavior for chronic low back pain: An exploratory cross-sectional study. PLoS ONE 13(9): e0204613. https://doi.org/10.1371/journal.pone.0204613
Editor: Gustavo de Carvalho Machado, The University of Sydney, AUSTRALIA
Received: May 29, 2018; Accepted: September 11, 2018; Published: September 27, 2018
Copyright: © 2018 Rodondi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the paper and its Supporting Information files.
Funding: This research was funded by the Swiss Academy of Medical Science and the Gottfried and Julia Bangerter-Rhyner Foundation (PYR). http://www.bangerter-stiftung.ch/bangerter/de/stiftung/portrait.html The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Chronic low back pain is a common condition, with a global prevalence situated around 20% [1]. Furthermore, recurrent low back pain is also common, with 33% recurrence within the first year following an acute episode of low back pain (LBP) [2]. Conventional treatment options for chronic or recurrent LBP include drug therapies, nonmedical interventions, and surgery [3]. According to a recent systematic review and meta-analysis including 35 randomized placebo-controlled trials, non-steroidal anti-inflammatory drugs (NSAIDs) reduced pain and disability in the immediate and short-term, but did not have clinically important effects on pain intensity [4]. Regarding opioids, another systematic review and meta-analysis showed a short-term effect on pain, but the effect was small and probably not clinically relevant [5]. When it comes to non-pharmacologic interventions, exercise therapy reduced pain intensity and disability better than usual care and behavioral therapies had an effect on pain intensity [6]. Additionally, current scientific data available about complementary medicine (CM) is increasing. The World Health Organization (WHO) defines CM as "a broad set of health care practices that are not part of that country's own tradition or conventional medicine and are not fully integrated into the dominant health-care system". Some studies suggest that CM non-pharmacologic therapies such as acupuncture [7–9], yoga [10, 11], Tai-Chi [12], Mindfulness-based stress reduction [13], osteopathy [14] and hypnosis [15] might be useful treatment options for patients suffering from chronic LBP [16], although more studies are needed.
Available guidelines regarding the treatment of chronic or recurrent LBP tend to be similar from one country to another [17], and include the initial first-line short-term prescription of medication (acetaminophen and NSAIDs), followed by non-pharmacologic therapies such as cognitive behavioral therapy or some CM, including therapeutic massage, relaxation, yoga, spinal manipulation, and acupuncture[18]. However, the 2017 American College of Physicians guidelines changed the overall paradigm by recommending non-pharmacologic treatments as first-line options [19]. Conventional drug treatments (NSAIDs, opioids, and duloxetine) were to be prescribed only if the first-line treatment failed, with acetaminophen being no longer included in the guidelines, based on a a recent meta-analysis [20]. It is worthy to note that the recent UK guidelines also emphasized on non-pharmacologic treatments for chronic LBP, including some CM if they were part of an exercise program [21]. However, contrary to the American College of Physicians guidelines, the UK guidelines did not recommend acupuncture [22]. They also did not discriminate between first- and second-line treatments.
Practical implementation of guidelines remains a challenge, despite a tremendous amount of scientific literature available to physicians [17]. Although widely disseminated, clinical practice guidelines have limited effect in changing physicians' behavior [23–26]. Lack of agreement with recommendations among primary care physicians (PCPs), lack of applicability due to the heterogeneity of the patient population, various perceptions of treatment effectiveness, PCPs' own professional and personal experience, patients' pressure or perceived pressure, patients' preferences, and environmental factors appeared to be some of the main barriers to the implementation of guidelines in practice [27–36]. Furthermore, physicians' beliefs about low back pain management may influence treatment choices [25, 37]. Given the multiple factors influencing the management of chronic or recurrent LBP, it is important to evaluate treatment preferences and attitudes of PCPs, all the more so as to our knowledge there have been no studies associating treatment preferences of PCPs with their perceived usefulness of these treatments since 1995 [38].
The objective of this study was thus to explore the perceived usefulness of several treatments for chronic or recurrent LBP by PCPs and their reported prescribing behavior, including both conventional and CM options. The factors associated with perceived usefulness and reported prescribing behavior were also explored.
Design, setting, and participants
This exploratory cross-sectional study was conducted by means of a postal questionnaire sent to all PCPs practicing in the French-speaking part of Switzerland (n = 2443). Postal addresses of PCPs were obtained from the local medical societies, and their socio-demographic data from the Swiss Medical Association (FMH). The number of PCPs registered in the local medical societies (n = 2443) differed from those registered in FMH (n = 1757) for 2 possible reasons: there were a high number of false addresses among the local medical societies; and the FMH data included PCPs working outside hospitals only, whereas the data from the local medical societies also included PCPs working inside hospitals. Finally, 2085 questionnaires were sent by post in April 2016, and a reminder was sent 3 weeks later.
The questionnaire included 79 items and was divided into 4 parts: (1) socio-demographic data, (2) PCPs' perceived usefulness of various conventional treatments for chronic or recurrent LBP and their reported prescribing behavior, (3) PCPs' perceived usefulness of CM in general and of specific CM treatments and their recommendations, and (4) PCP's attitude towards and personal use of CM. Perceived usefulness of conventional and CM treatment for chronic or recurrent LBP was compared with reported prescribing or recommendation behavior of PCPs. Perceived usefulness was defined by means of a categorical question asking whether or not physicians agreed that one therapy could be useful in the treatment of chronic or recurrent LBP (see statistical analysis). Reported prescription rates of conventional treatments and recommendations for CM corresponded to the percentage of PCPs who reported having prescribed or recommended any given treatment option at least once to a patient with chronic or recurrent LBP.
Data Sources
In the absence of a validated questionnaire, we built one based on a literature review. Some questions were also adapted from two existing questionnaires [39, 40], one on patients' perceived usefulness of treatments for LBP and the other on physicians' attitude toward complementary medicine. The study questionnaire was piloted and tested in 10 PCPs.
According to the International Association for the Study of Pain, chronic low back pain is characterized as pain lasting or recurring for three months or more [41]. For this study, recurrent low back pain was defined as two episodes or more of low back pain during the past year, with a significant impact on the patient's daily life. This definition was built on a consensus of 15 PCPs, researchers and pain specialists. The Cantonal Commission for the Ethics of Human Research (CER-VD) approved the study (Ref: 303/15). The ethics committee waived the need for consent, as data were collected and analyzed anonymously.
Statistical analysis
Wilson confidence intervals were computed for all proportions [42]. For each conventional and CM treatment, we fitted a multivariate logistic regression model to evaluate the associations between perceived usefulness and the following variables: age (<56 years old, ≥56 years old), gender (male, female), CM training (no, yes), and CM use (no, yes). We did the same for recommendation behavior instead of perceived usefulness. As we considered 29 different treatments and CM treatments in general, we fitted a total of 60 logistic regression models. The models were constructed as follows: the perceived usefulness and reported recommendation behavior were considered as the dependent variable, and age, gender, CM training, and CM use as the independent variables. For the regression models examining variables associated to perceived usefulness we dichotomized usefulness scale (5 levels) as follows: "strongly disagree", "disagree" and "neither agree nor disagree" were recoded as "not useful", while "agree" and "strongly agree" were recoded as "useful". For the regression models examining variables associated to reported recommendation we dichotomized the reported percentage of patients (6 possibilities) to whom a recommendation was done as follow: "0%" were recoded as "do not recommend" while "1–100%" were recoded as "recommend". In models in which the dependent variable (perceived usefulness or reported recommendation behavior) was related to a conventional treatment, we considered CM use in general as an independent variable. On the other hand, in models in which the dependent variable was related to a CM treatment, we considered the use of the corresponding CM as an independent variable. All correlations were computed between binary variables, and therefore phi coefficients were calculated to estimate correlation strengths. The missing values were imputed 20 times by the method of multiple imputation by chained equations. All variables which were used in the analyses were involved in the imputation models. All results are based on the multiple imputation. Data were entered into an Access database and analyzed with R statistical software (version 3.4.2). Missing values were handled with the "mice package" (version 2.30) [43].
Socio-demographic data
Of the 2443 questionnaires sent, 1552 were not returned and 358 were non-eligible. The final sample consisted of 533 questionnaires available for analysis (response rate: 25.6%). Participants did not always respond to all questions: 442 (82.9%) had no missing values among the variables used for the analyses. However, the missing rate per variable did not exceed 3.6%. Fig 1 shows the study participation.
PCPs = primary care physicians.
Among respondents, 323 were men, 196 were women, and 14 did not disclose their gender. In comparison to the overall PCPs practicing in the French part of Switzerland [44], the representativeness of our sample was good in terms of gender, age, and training in CM. Table 1 shows the socio-demographic data of the respondents.
Perceived usefulness of conventional treatments
Conventional therapies most often considered useful by PCPs for the treatment of chronic or recurrent LBP were: physiotherapy (94.8% [95% confidence interval (CI), 92.5–96.4%]), NSAIDs (87.9% [95% CI, 84.9–90.4%]), and manual therapy (82.5% [95% CI, 79.0–85.5%]). Conventional treatments perceived as being less useful were spinal/nerve blocks (77.1% [95% CI, 73.4–80.5%]), muscle relaxants (74.2% [95% CI, 70.3–77.7%]), and opioids (70.9% [95% CI, 67.0–74.6%]). Fig 2 shows a comparison between PCPs' perceived usefulness of conventional and CM treatments and their reported prescribing behavior (in that figure, treatments considered as CM are indicated by an asterisk).
For each treatment, the proportion of PCPs who agree with its usefulness (dark gray) or have already prescribed or recommended it (gray) is shown. Error bars express 95% confidence interval. chronic or recurrent LBP = chronic or recurrent low back pain; PCPs = primary care physicians; NSAIDs = nonsteroidal anti-inflammatory drugs. *Complementary medicine.
In a multivariate analysis, we did not observe a clear influence of gender, age or personal use of CM on perceived usefulness of conventional treatments. However, there was a tendency for PCPs with CM training to find conventional treatments less useful than PCPs without such training. Table 2 shows the perceived usefulness of both conventional and CM treatments by gender, age, training in CM, and personal use of CM.
Reported prescribing behavior for conventional treatments
Treatments most prescribed by PCPs were physiotherapy (99.2% [95% CI, 98.0–99.7%]), NSAIDs (97.4% [95% CI, 95.6–98.4%]), and acetaminophen (94.4% [95% CI, 92.1–96.1%]). Treatments that were less prescribed were opioids (89.1% [95% CI, 86.1–91.5%]), manual therapy (80.3% [95% CI, 76.7–83.5%]), and chiropractic (71.8% [95% CI, 67.8–75.5%]). However, the number of patients to whom these conventional treatments were prescribed varied greatly. Each of the top 3 most prescribed treatments was prescribed by approximatively one third to a half of the PCPs to more than 75% of their patients, whereas more than two thirds of PCPs prescribed treatments such as opioids or spinal/nerve blocks to less than 26% of their patients (Table 3).
In a multivariate analysis, we did not observe a clear influence of gender, age or personal use of CM on reported prescribing behavior of conventional treatments. However, there was a tendency for PCPs with CM training to recommend conventional treatments less often than PCPs without such training.
Perceived usefulness of CM
For CM in general, 71.7% [95% CI, 67.7–75.3%] of the respondents considered it to be useful: in a multivariate analysis women were more convinced than men (OR = 1.8 [95% CI, 1.1–3.0], P = 0.03) and older physicians (≥56 years) perceived it as being less useful than younger physicians did (OR = 0.3 [95% CI, 0.2–0.5], P<0.001). Furthermore, training in CM or the personal use of CM were both associated with higher perceived usefulness of CM in general (OR = 1.9 [95% CI, 1.0–3.4], P = 0.03; and OR = 4.8 [95% CI, 3.0–7.6], P<0.001, respectively).
The top 3 CMs perceived as useful for chronic or recurrent LBP were osteopathic treatment (78.4% [95% CI, 74.7–81.7%]), yoga (69.3% [95% CI, 65.2–73.1%]), and therapeutic massage (63.9% [95% CI, 59.7–67.9%]). Multivariate analysis showed that there was a tendency among female PCPs, and PCPs trained in CM or using CM to consider more often CM treatments useful. We did not observe such a tendency for PCPs' age (Table 2).
Recommendation of CM
Overall, 2.1% ([95% CI, 1.2–3.7%]) of PCPs never recommended any CM for the treatment chronic or recurrent LBP. In a multivariate analysis, women were more likely than men to recommend CM in general (OR = 2.1 [95% CI, 1.1–4.0], P = 0.03). Older PCPs (≥56 years) were less likely to recommend CM in general than were younger PCPs (OR = 0.3 [95% CI, 0.2–0.5], P<0.001). Furthermore, personal use of CM was significantly associated with recommendation of CM in general (OR = 4.8 [95% CI, 2.7–8.7], P<0.001).
Osteopathic treatment (87.3% [95% CI, 84.1–89.9%]), acupuncture (69.3% [95% CI, 65.2–73.1%]), and therapeutic massage (58.7% [95% CI, 54.4–62.9%]) were the 3 most recommended CMs. In a multivariate analysis, there was a tendency among female PCPs, younger PCPs and PCPs trained in CM to recommend CM treatments more than other PCPs. In addition, self-use of a given CM was associated with more recommendation for that particular CM (Table 4).
Finally, 34.6% ([95% CI, 30.7–38.8%]) of the respondents stated that they did not usually recommend CM to patients because they did not know any reliable therapists and 31.0% ([95% CI, 27.2–35.1%]) because they did not have enough knowledge about CM.
Comparison between conventional medicine and CM
Most conventional treatments showed higher rates of prescription than of perceived usefulness, whereas the opposite scenario was observed for most CMs, with the exception of osteopathic treatment and acupuncture. Overall, with the exception of osteopathic treatment, all conventional treatments were more often considered useful than CM treatments (Fig 2). This tendency was confirmed for individual reported prescription behavior. Results showed a significant association between PCPs' perceived usefulness and their reported prescribing behavior (P values of chi-squared tests all <0.001). However, the strength of the correlation (phi coefficient) was weak, which can be explained by the fact that some PCPs prescribed treatments that they did not consider useful and did not prescribe treatment they found useful. The strength of the correlation for conventional and complementary treatments is shown in S1 Table.
This study showed that the top three conventional treatments most often considered useful in the management of chronic or recurrent LBP were physiotherapy, NSAIDs, and manual therapy, whereas the most prescribed conventional treatments were physiotherapy, NSAIDs, and acetaminophen. Osteopathic treatment, yoga, and therapeutic massage were the most often considered useful CMs in the management of chronic or recurrent LBP. The most recommended CM treatments were osteopathic treatment, acupuncture, and therapeutic massage.
Overall, our study showed an association between the perceived usefulness of various treatment options for chronic or recurrent LBP and PCPs' reported prescription or recommendation behaviors. However, the correlation between individual perceived usefulness and reported prescriptions/recommendations was not strong. Results indicated that PCPs tended to prescribe or recommend treatments that they did not perceive as being very useful (mostly conventional medications) and not to prescribe or recommend treatments they found useful (mostly CM). Although such discrepancies between perceived usefulness and prescription behavior have also been identified in the management of acute low back pain, no further investigations of the reasons have so far been conducted [45]. However, numerous studies have investigated factors influencing management of low back pain by PCPs. Factors commonly mentioned that could explain the discrepancies found in our study were patient preferences [31, 46], patient pressure or perceived pressure to obtain medication [33, 35], preservation of the patient-physician relationship [28, 35, 46, 47], PCPs' own professional and personal experiences [28, 31, 32, 48], and physicians' beliefs regarding low back pain [25, 37, 49, 50]. More specifically, our results showed that a significant number of PCPs prescribed some conventional treatments (opioids, spinal/nerve blocks, and muscle relaxants) although they did not consider them to be as useful as other less prescribed treatments (such as manual therapy and osteopathic treatment). The reasons for this may be found in the factors outlined above. Another factor associated with prescribing treatments that were not perceived as being very useful might be the ease with which PCPs could prescribe drugs rather than other treatments. Drugs are immediately available, whereas referral to specialists for other treatments may imply a delay in patient care [32, 34, 51], even more so when treatments are not readily available or cannot be reimbursed by the conventional medical system [36]. However, these observations must be balanced by the fact that some treatments (such as opioids or spinal/nerve blocks) seem to have been prescribed by many PCPs, but to a small number of patients. These results highlight the importance of better understanding the prescribing patterns of PCPs in the context of chronic or recurrent LBP and unveiling reasons associated with low recommendation of some treatments despite scientific data.
Physiotherapy, NSAIDs, and acetaminophen were among the 3 most recommended treatments, which is consistent with what most guidelines used to recommend for first-line treatment in chronic low back pain [3, 17], but inconsistent with the most recent guideline released by the American College of Physicians, which recommends non-pharmacologic treatments as first-line treatment [19]. However, as these guidelines were published after data collection for this study, we cannot make a comment on the potential endorsement of these guidelines by PCPs or not. One study suggested that this high use of drugs might be related to physicians treating chronic pain as if it were acute pain [26].
The top 4 CMs most often perceived as being useful were also the most recommended (Osteopathic treatment, acupuncture, yoga, and therapeutic massage). Interestingly, all four CM treatments have shown some effect in the treatment of chronic or recurrent LBP [9, 14, 16]. These treatments, among others, were already recommended in the ACP's 2007 guidelines as second-line treatments [18] and appear in the 2017 guidelines as first-line options [19].
A majority of PCPs seemed to be familiar with the few CM treatments that can be recommended for chronic or recurrent LBP. However, our results showed that a significant number of PCPs did not usually recommend CM because they did not know any reliable CM provider and hence did not know where to direct their patients. This problem was also highlighted by PCPs in a recent study about management of LBP in primary care in England [32]. Overall, few studies investigated PCPs' recommendation for CM in the context of LBP. However, some hypotheses can be formulated regarding the relatively low frequency of CM recommendations by PCPs. First, the fact that in Switzerland, most CM treatments are not covered by basic health insurance might discourage PCPs from recommending them to their patients [36]. Second, as most CM practitioners in Switzerland are legally not considered part of the medical profession, PCPs might fear malpractice litigations and thus choose not to recommend such treatments to their patients with LBP [48].
Women were more likely than men to consider CM useful and to recommend CM treatments. Other studies have shown that female physicians were more likely to recommend CM treatments than were male physicians [40, 52]. Overall, physicians' age was not strongly associated with perceived usefulness or recommendation of CM. However, PCPs younger than 56 years considered CM in general to be more useful than did older PCPs. Being younger was also associated with more CM recommendations in general. This finding may indicate better acceptance and better knowledge of CM among younger generations of PCPs whose professional activity evolved alongside the increase in CM use in the general population. In our study, physicians trained in at least one CM were more likely to consider CM as being useful and to recommend CM than were physicians who were not trained in CM. Similarly, Corbin and Shapiro [52] found that physicians' belief in specific CM efficacy was related to education in that CM modality and that physicians' education about specific modalities were clearly associated with a high frequency of physician recommendation of that modality to the patient. Moreover, they found that physicians who used CM were almost 7 times more likely to recommend CM to their patients than were physicians who did not use CM [52]. Our results also showed a strong correlation between self-use of CM and perceived usefulness or recommendation of CM in general.
To our knowledge, this study is the first in years to investigate PCPs perceived usefulness of chronic or recurrent LBP treatments and their reported prescription/recommendation behaviors. It is also the first to investigate about many different therapies recommended by PCPs for their chronic or recurrent LBP patients. Moreover, our results are important as our study happened in a period of shift about recommendations for LBP treatments. This study has several limitations. First, there may have been a selection bias in the sense that PCPs interested in pain management and CM may have participated more than others. Second, our study did not investigate the frequency of prescription of one particular treatment but rather the number of PCPs having already prescribed this treatment at least once. Third, our study did not investigate the number of patients to whom CM treatments were recommended. Fourth, the population studied might not be representative of PCPs from other countries. However, our PCPs practiced medicine within a population base of about 2 million residents, living in urban and countryside settings. Finally, as it was an exploratory study, we made many statistical comparisons and some differences or associations may have occurred by chance.
Non-pharmacologic treatments for the management of chronic or recurrent LBP, including CM, seem to be underprescribed in comparison with pharmacological treatments. Considering the frequency and burden of chronic or recurrent LBP, the most (cost-) effective treatments should be proposed to patients. Implementation programs targeting PCPs should be used, as well as better access to and reimbursement for effective non-pharmacologic treatments. Repeating the study in a near future would permit to see if the recommendation of the recent guidelines will be followed by PCPs.
Supporting information
S1 Table. Strength of correlation between PCPs' perceived usefulness of conventional treatments and reported prescribing behavior.
Results of columns 2 to 5 are expressed as a number of participants, omitting missing values. The phi coefficient (column 6) indicates for each treatment the strength of the correlation between the perceived usefulness and the reported prescription behavior. The computation of the phi coefficient is based on the multiple imputations.
S1 File. Study questionnaire (English version).
S2 File. Study questionnaire (French version).
The authors thank Florence Degoumois for her contribution to the design of the study. We wish to thank all participating physicians as well.
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Quick 4-Ingredient Amish Brussels Sprouts Recipe in Onion Cream by 30Seconds Food
Instead of making roasted brussels sprouts, why not cook them how the Amish do? This Amish brussels sprouts recipe has a creamy onion sauce and is simple to make.
If you like this Amish recipe, try broccoli and cauliflower salad, cabbage cakes, lettuce dressing, corn salad, macaroni salad, cucumber salad and four-ingredient egg noodles.
Cuisine: American
Prep Time: 5 minutes
Cook Time: 15 to 20 minutes
Total Time: 20 to 25 minutes
Servings: 4 to 6
- 1 1/2 - 2 pounds brussels sprouts, ends trimmed
- 2 tablespoons butter
- 1/2 cup minced onion
- 1 pint sour cream
Here's how to make it:
- Cook the brussels sprouts until tender. You can boil, steam or bake them.
- Melt the butter in a sauté pan. Add the onions and cook until soft and beginning to brown, about 5 to 7 minutes.
- Turn off the heat and stir in the sour cream and brussels sprouts. Season with salt and pepper.
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text:
A good credit score is one of the most important factors when it comes to financial health. It impacts everything from your ability to get a loan to the interest rates you're offered. If you're looking to get the best credit score you possibly can, there are some tips and tricks you can use.
First, it's important to understand what a credit score is. A credit score is a three-digit number that lenders use to determine your creditworthiness. It's based on factors like the amount of debt you have, your payment history, the length of your credit history, and the types of credit you use. Your credit score is important because it can affect you for years to come.
The highest achievable credit score is 850. To get this number, you must have a long history of paying bills on time, keeping your debt low, and having varied types of credit. It's important to note that the range for "good" credit scores is much lower, usually between 680 and 739.
So what can you do to get the best credit score possible? First, make sure you pay all your bills on time. A late payment can have a huge impact on your credit score. Second, keep your debt levels low. The lower your debt, the better your credit score will be. Third, try to have a mix of different types of credit, such as credit cards, personal loans, and mortgages.
Another important factor is your length of credit history. The longer you've had credit, the better. This shows lenders that you've been responsible with credit for a long time. Finally, make sure you check your credit report regularly. This will help you spot any errors or fraud that could negatively impact your credit score.
Key points:
• The highest achievable credit score is 850
• Pay bills on time, keep debt low, and have varied types of credit
• The longer you've had credit, the better
• Check your credit report regularly
People Also Ask Questions and Answers:
Q: What is the best credit score possible?
A: The highest achievable credit score is 850.
Q: How can I improve my credit score?
A: To improve your credit score, make sure to pay all your bills on time, keep your debt low, and have a mix of different types of credit. Additionally, check your credit report regularly.
Best Credit Score Possible – Highest Rated?
Martin Lewish talks about how people can rebuild their credit score.
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text:
Texas kicked off its 2022 season over the weekend with a dominant 52-10 victory over UL Monroe.
While the current Longhorns took care of business, the future of the program enjoyed a big weekend at the high school level. Texas' 2023 class continues to look the part.
Five-star quarterback Arch Manning is proving his No. 1 ranking right so far this season. Manning tossed three touchdowns in Isidore Newman's big win over Hahnville. Fellow Texas commit Will Randle added a pick-six in the game.
Running back Cedric Baxter had a monster 274 yards, two touchdown performance. The four-star has been a force to start the season for Edgewater High School.
DeSoto's Johntay Cook hauled in another touchdown early in their ballgame. Cook's route running and speed make the five-star a great fit for Texas' offense.
The Longhorns' 2023 class currently sits No. 2 in the nation behind the Alabama Crimson Tide in the 247Sports composite rankings.
Here are some of the best highlights from Texas commits this weekend.
Five-star QB Arch Manning
Five-Star Plus+ QB Arch Manning drops it in to fellow Texas commit Will Randle for a long gain https://t.co/2Tih9TLULp @InsideTexas pic.twitter.com/XgoO7kvqTc
— Charles Power (@CharlesPower) September 3, 2022
Five-star WR Johntay Cook
Texas WR commit Johntay Cook opens the scoring for DeSoto with this nice grab. #HookEmhttps://t.co/l6zjMnOh1b pic.twitter.com/i3F38Oolvr
— Billy Embody (@BillyEmbody) September 4, 2022
Four-star RB Cedric Baxter Jr
#1 back… pic.twitter.com/EL3VNZmjHU
— Cedric "C4" Baxter Jr (@CedricBaxterJr1) September 3, 2022
Four-star CB Malik Muhammad
Texas commit @Returnof7 allowing no easy catches pic.twitter.com/MtOT9ML8ei
— Mike Roach (@MikeRoach247) September 3, 2022
Three-star TE Will Randle
Texas commit Will Randle clocked a verified max speed of 18.5 mph on this 77-yard pick six. Randle's max speed ranked in the top 25% for his position. pic.twitter.com/2HdJF1w3qC
— Recruiting Analytics (@RAanalytics) September 3, 2022


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Play and experiment with this Jack's Make Your Own Glow Creepy Crawlie Clings kit.
Mix up the ingredients and colour, then mould into the creepy critter shape of your choice. When it's set, your crawlie will cling onto smooth surfaces, like glass and windows.
These cool creepy crawlies are even more awesome – they glow in the dark!
Use your imagination and think of fun stories and adventures for your creepy crawlies to play out.
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Corry Dodson
The Presidio, San Francisco, CA
June 21, 2002
Hi, my name is Corry Dodson. I went to school mostly in California but I fanagled this exchange program where I got to go to U Mass and take classes at Smith, which was my ultimate dream. When I got to the East Coast, I did all this research because I was only going to get two classes at Smith in my whole life. I think I had gone on the school tour and I had Aspects, a magazine in which they rate all the teachers. So I was sitting on campus, in the middle of the quad, it was mid-August, I think, when this little short-haired lady comes riding along on her bicycle, goes out the other end, comes back around, and eventually ends up on the bench next to me. She had copies of Spin and Rolling Stone, and she said, "Hi, I'm Danielle." Of course. And I said, "Hi, I'm Corrie." Although she couldn't tell me which classes I should take, she was like a breath of fresh air. I thought, "Wow, I have really landed somewhere. If everybody is like this, I'm going to be golden." Of course, there was never anyone else like her.
|home * guest book * contribute * updates * in her own words * in memory * album * medical links


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(a) There is hereby levied an annual license tax upon the operation of motor vehicles on the public roads or highways for the purpose of paying the costs and expenses of enforcing and administering the tax provided for in this section; and for planning, constructing, improving, maintaining and repairing public roads, highways and streets; maintaining and repairing bridges and viaducts; paying the City's portion of the costs and expenses of cooperating with the department of highways in the planning, improvement and construction of state highways; paying the City's portion of the compensation, damages, cost and expenses of planning, constructing, reconstructing, improving, maintaining and repairing roads and streets; paying any costs apportioned to the City under Ohio R. C. 4907.47; paying debt service charges on notes or bonds of the City issued for such purposes; purchasing, erecting and maintaining street and traffic signs and markets; purchasing, erecting and maintaining traffic lights and signals; and to supplement revenue already available for such purposes.
(b) Such tax shall be at the rate of five dollars ($5.00) per motor vehicle on each and every motor vehicle the district of registration of which, as defined in Ohio R.C. 4503.10 is in the City.
(c) As used in this chapter the term "motor vehicle" means any and all vehicles included within the definition of motor vehicle in Ohio R. C. 4501.01 and 4505.01.
(Ord. 73-39. Passed 2-27-73.)


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The latest version of MX Linux sports updated software, a new kernel, and a tool to make Samba sharing easier. All with the minimum of fuss.
The MX Linux project has announced the 21.1 release of its Linux distribution, known as "Wildflower." It arrives with the minimum of fuss and fanfare, but enough new features to be worth checking out.
What's New in MX Linux 21.1?
The developers announced the new version in a post on the MX Linux blog. The distro is available with three different desktops: XFCE, KDE, and the lightweight Fluxbox window manager. The XFCE and Fluxbox versions are available for 32-bit processors, while all three support 64-bit Intel and AMD processors.
All three variations are based on Debian 11.3 "Bullseye." While curious potential users can download the new version from the MX Linux download page, existing users can obtain the release through the usual upgrade channel. All releases also use version 5.16 of the Linux kernel.
While the new versions will have newer versions of their respective desktop environments, they will also get improvements under the hood that they share in common. The Disk-manager utility has now been added to the official installation images. There's also a tool for managing Samba installations to share files with Windows and Linux users on a network.
MX Linux Is an Understated, Unique Debian Variant
The way that MX Linux announced the new version, with a terse blog post, says a lot about how the developers run their distribution. They're not as flashy as Ubuntu or Red Hat, but seem to prefer simply announcing that a new release is available.
The emphasis on simplicity and choice likely comes from the project's origins as a combination of the AntiX and MEPIS communities. The latter also supported multiple desktops and stressed ease of use.
The project aims for technical simplicity, largely shunning the systemd system for managing processes as fellow Debian variant Devuan does in favor of the older style derived from AT&T's System V Unix, or "SysVInit."
With this release, this understated but user-friendly Linux distribution will likely continue this trend, which is why it has likely attracted such a cult following in the Linux community.
A Choice Based on Debian
MX's base in Debian proves how that distribution's versatility has made it a favorite looking to create variations on it for new Linux distros, including the popular Ubuntu distribution.


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LIVE LOVE CHEER Pillow
(You save )
Below are the available bulk discount rates for each individual item when you purchase a certain amount
- Buy 6 or above and get 25% off
Live Love Cheer Pillow with cheerleader and poms clipart, personalized with cheerleaders name.
The name, cheerleader and heart are all printed in your choice of color.
You choose the fabric on the back of the pillow.
The LIVE LOVE is printed in black flat print or a flat color that matches the fabric you choose for the back of the pillow.
This is a complete pillow, stuffed and sewn shut.


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Cherished Memories - All Pink
Send a gift of lasting tribute that captures their cherished memories of loved ones who have passed on. Our color-soaked, all-pink arrangement of roses, spray roses, snapdragons, alstroemeria, carnations and more is tastefully arranged in a glass cylinder vase to offer a comforting message.
Product ID 95385M
Approximately 14"H X 15"L
What People Are Saying
January 27, 2023
Great experience -- beautiful bouquet, recipient loved the arrangement! Thank you so much!
January 24, 2023
Great she loved them , Thanks so much
January 04, 2023
I sent these flowers to my mother after the loss of my dad. It was very important that they were beautiful.. Mom said that they were prettier than the picture.
Reviews Sourced from Lovingly


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Hatha Flow for Hips
A gentle hatha flow to open hips and prepare for pigeon pose
Vinyasa Flow for backbends
This backbend flow focuses on increasing and strengthening hip extension, rather than on bending from the lumber spine, creating space rather than compression in your low back.
Slow Flow with the moon
Slow it down with this super chill flow from Christine
Outdoor Yoga flow to feel like a queen
A funky class where you can wear your crown and keep your head up, with intriguing and unexpected elements such as voguing and waacking
Slow Flow with the Moon from 26th May
Slow down with Christine in this lunar focussed yoga class to help you relax and unwind.
Vinyasa (ish) Flow for Hip Mobility and Strength
This funky Vinyasa flow will take your body to new places and encourage you to move in new ways, with the aim of building hip strength and mobility. By the time you get to Pigeon can you feel the difference? Expect challenge, heat and deep relaxation.
May 24th Hatha Yoga
Join Emma for class of mindful movement for the whole body.
Energy Shake – Zumba Toning Quickie!
A quickie class, using light weights, to develop upper body and arm strength to some fun tunes.
Energy Stretch – Lower Back Love
A quickie stretch sequence to show your lower back some love! Perfect for when you're feeling a little stiff or achey and need some healing movement. WARNING: This was filmed during building process and there is some annoying sound interference! If you can bare with it it's a nice class and I might try to […]
See – Hear – Feel Meditation
Meditate and move. Just 30 mins to ground, feel present and drop into awareness with mindful movement and this short meditation.


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Franklin American Mortgage Named NAMB Double Diamond Industry Partner
Franklin American Mortgage Company (FAMC) has announced that it has become a Double Diamond Industry Partner with NAMB—The Association of Mortgage Professionals. This exclusive status is given to NAMB's top contributors each year.
"NAMB is the mortgage industry's premier membership organization, and Franklin American Mortgage's Double Diamond Industry Partnership clearly shows our ongoing commitment to the broker channel and the continued growth of FAMC Wholesale Lending," said Andrew Taylor, FAMC's executive vice president, director of National Sales. "Franklin American Mortgage is a long-time supporter of NAMB and we have always been pleased with the results this partnership produces."
Franklin American Mortgage first began sponsoring national and regional NAMB shows in 2008, and became an industry partner in 2012. Recognition form this partnership has helped FAMC grow to become one of the top 12 wholesale lenders in the nation.
"NAMB is excited to welcome Franklin American Mortgage Company as a Double Diamond Industry Partner," said Fred Kreger, president of NAMB. "We applaud their commitment to dedication to the mortgage lending arena and furthering the dream of homeownership for America's consumers. NAMB looks forward to a successful collaboration between the association and FAMC."


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Studio Brat Artiste, Simi releases a beautiful song which she has named "Temper".
The melodious song was taken off her latest project, "To Be Honest". The album comprises of 11 songs which feature artists like Adekunle Gold, Deja, Fave etc.
"Temper" happens to be the ninth song off her "To Be Honest" album.


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Green Sea Turtle Nest
Amidst the king tides over the weekend, we had an inventory where we found a huge surprise, a green sea turtle! We haven't had a green sea turtle nest since 2017 (per Seaturtle.org records). It is a very rare happening across the state and very exciting when it happens. Can't wait to see what the DNA information shows for this mama! Glad she stopped at Edisto!
Conservation efforts are definitely working and we are so thankful for all the hard work of our volunteers here on Edisto Town beach!
Out of 7934 nests across the state of SC, there are only 21 green sea turtle nests this year. We are grateful to have one!!!
All Beach Surveys and turtle activities are performed under permit from SCDNR #MTP548


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Home to two of the Great Lakes, the Mississippi River, and over 2,500 Trout streams, Wisconsin has no shortage of fish to go after! This helpful guide will tell you everything you need to know to get your Wisconsin fishing license before getting out on the water.
Quick View: Wisconsin Fishing Requirements
Before you step aboard a Wisconsin fishing boat, you'll need to get your hands on a Wisconsin fishing license. Your license will be valid in any body of water in the state, so there's no need to worry there. But – and there's always a but – you may need a certain stamp depending on what you're targeting.
If you're going after Salmon or Trout in either Lake Michigan or Lake Superior, you'll need a special permit. The Great Lakes Salmon and Trout stamp will allow you to fish either lake and take home these delicious species.
Inland, you may also require a separate permit. Wherever you go after Trout, you'll have to carry with you an "Inland Trout Stamp." Going after Sturgeon in any of the state's freshwater lakes or rivers will also require a separate stamp.
Who needs a Wisconsin fishing license?
Everyone over the age of 16 needs a license to catch fish in Wisconsin. This applies to state residents as well as visiting anglers, but you'll need to apply for a different license depending on your residency. Don't worry, though, the process is exactly the same. Read on to find out what you need to do.
A resident is considered to be anyone who has lived continually in the state for the last six months or longer. You can prove this through your social security number, state-issued driver's license, proof of earnings, or utility bills.
Your license will be valid across the state, on all freshwater rivers and lakes. However, if you want to go after Salmon in the Great Lakes, or Sturgeon or Trout anywhere in the state, you'll need to purchase a separate stamp.
Who doesn't need a fishing license?
You may be eligible for a free fishing license if you:
- Were born before 1927;
- Are an active duty military member who is a Wisconsin resident visiting home on furlough or leave.
Disabled residents and veterans may also apply for a discounted fishing license. If you are a disabled resident, you can apply for a $7 annual fishing license. While disabled resident veterans are eligible for a $3 license.
If you qualify for any of the above, make sure to bring evidence of your status as a resident and of your disability when making a claim.
What if I fish without a license?
Fishing without a valid Wisconsin fishing license carries a penalty of at least $100. Fines vary from county to county, but you can expect to pay a hefty sum for breaking the rules. Follow the instructions here and you'll have no trouble!
How much is a Wisconsin fishing license?
There's a range of different fishing licenses to choose from, depending on how avid an angler you are. The options differ from residents to non-residents. Wisconsin natives will be able to take advantage of discounts for youth and senior citizens. One-day and two-day permits are also available, as well as annual packages for residents.
|RESIDENT Fishing License – Type
|Annual License
|First-Time Buyer License
|1 Day License
|Junior License (16 & 17 yrs old)
|Senior Citizen License (65+ yrs old)
|Spousal License
|2 Day Great Lakes License
(Includes Salmon/Trout Stamp)
|2 Day Inland Lake Trout License
(Includes Trout Stamp)
|Sturgeon License (Various)
If you're from out of state, you'll have a wider range of packages to choose from. Catering to the tourist market, the Wisconsin DNR offers the same packages available to residents with the addition of a four-day and 15-day fishing license.
Prices for non-resident licenses are more expensive than for residents, and there are no discounts for people of different ages. However, parents with children aged 16 and 17 can take advantage of the annual family package for $65. This will allow two parents and up to two children to fish throughout the year.
|NON-RESIDENT Fishing License – Type
|Annual License
|Annual Family License
|Annual First Time License
|1 Day License
|4 Day License
|15 Day License
|15 Day Family License
|2 Day Great Lakes License
(Includes Salmon/Trout Stamp)
|Sturgeon License (Various)
If you're fishing any of Wisconsin's freshwater rivers or lakes for the first time, you'll be able to apply for a special 1st-Time Annual License.
With over 50% off for both residents and non-residents, everyone can benefit from this generous offer!
The 1st-Time Annual License actually applies to anyone who hasn't held a Wisconsin fishing license in the last 10 years. So, if you were looking to get back to angling, things have just gotten a whole lot easier!
What about fishing stamps?
If you want to take certain species out of the water and home with you in Wisconsin, you'll have to apply for a fishing stamp. In the Great Lakes, you'll need a special permit to harvest Trout and Salmon, while going after any Trout inshore will require a separate stamp, along with Sturgeon.
While a Great Lakes and inland Trout permit will set you back $10 regardless of where you're from, a Sturgeon stamp carries a much bigger price if you're coming from out-of-state.
|Great Lake Salmon/Trout
|Inland Trout
|Sturgeon Hook & Line
|Sturgeon Spearing
The process of obtaining a stamp is the same as getting a license. Apply at the same time with your social security number at hand and a form of ID, and you're ready to get out on the water.
Where can I get my Wisconsin fishing license and stamp?
You can buy your license directly from the Wisconsin DNR online. Sign up with your social security number and print your license as soon as you pay.
If you've forgotten to pick up your license online, or just prefer face-to-face interaction, there's a store around the corner for you. You can pick up your fishing license in a number of hardware stores, tackle shops, Walmart, and many more locations all across the state.
You can even pick up your Wisconsin fishing license in neighboring Illinois or Minnesota.
Common questions about WI fishing licenses
- Can I use my Wisconsin fishing license in other states?
Wisconsin has reciprocal agreements with some of its neighbors concerning fishing licenses. For example, if you're a non-resident with a Wisconsin fishing license, you can also fish the border waters of Iowa, Michigan, or Minnesota.
Residents must always hold a license from the state they are from, but may still cross into another state's waters.
Be careful, though, as you must always adhere to size and bag regulations in whichever state you're fishing. For example, a Michigan-licensed angler would have to obtain a Salmon stamp if they wanted to catch Salmon.
- When is Wisconsin's free fishing weekend?
Twice a year, you'll be able to fish Wisconsin's rich waters without any restrictions. Every third full weekend of January and first weekend of June, you can fish in Wisconsin without a license or a stamp.
Make the most of these limited days and save your money, all the while enjoying some thrilling fishing! Keep in mind, however, that all other regulations like size and bag limits still apply.
- What happens if I lose my Wisconsin fishing license?
If you lose your Wisconsin fishing license, don't worry! As long as you have your license number, you can always get a new copy. Simply log into the same portal from which you bought the license and re-print it. There's nothing to worry about and no additional fee, get back on the fish right away!
And that's it. You're ready to go fishing on all of Wisconsin's wonderful waters. If you have any questions, we recommend getting in touch with your local DNR office. If not, it's time to grab your rod, find a guide near you, and start fishing. Tight lines!


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GUJRANWALA: Pakistan Tehreek-i-Insaf (PTI) on Tuesday demanded the deployment of Rangers during the upcoming by-election in Kamoke (PP-100). The seat had become vacant with the murder of Pakistan Muslim League-Nawaz's (PML-N) Rana Shamshad Ahmad. Talking to reporters, PTI deputy provincial organiser Umar Sarfraz Cheema and by-poll candidate Ehsanullah Virk said that security was a worry. "On July 8, we had sent an application to the Election Commission officials about the security situation. We had requested them to order the deployment of Rangers during polling scheduled for July 26. However, the commission has not taken any action on our request," they said. The PTI leaders said that the provincial government was fully supporting the PML-N candidate in the elections. They claimed that PTI supporters were being harassed. PTI leaders Nasir Cheema, Zulfiqar Bhindar, Rana Sajid Ali Shaukat and Barrister Ali Ashraf Mughal were also present on the occasion.
Published in The Express Tribune, July 22nd, 2015.
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Thank you kindly for the fav on New Roam Innovatus, good sir.
My deepest gratitude for deciding upon following my greatest project's first book, The Balance In Equestria. I hope you'll find yourself entertained and hook till the end of this grand journey! Furthermore, I hope you'll witness my improvement over the chapters I publish and will embrace the memory of this tale that I yarn...
Have a wonderful day!
Goodness, can't imagine why you favorited that dreadful old story. But thank you.
Thanks for faving "The Chronicles of Swarm"!


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Merry Christmas, Divas!
It's Digi DT Jess, and I am so excited to be here on the blog today! I hope you are all having a wonderful holiday season with loved ones.
Today, I'm sharing a simple Christmas card I made using some adorable products from CDD. I've done quite a few other cards this year that were intricate and took a while to make, so a more simple approach was perfect for me!
I started off this card by printing off the adorable Christmas Owl digital stamp. I absolutely love how versatile digital stamps are. You can build scenes or have the stamp be the focus of your card, like I did here. I used Copic markers to color up this cutie and then added a few accents with a white gel pen to brighten things up a bit.
Next, I snagged a piece of cardstock and did some ink smooshing. This is one of my all time favorite techniques for card making. You can get the most amazing backgrounds with almost no supplies! I used Peeled Paint and Forest Moss Distress inks to create this blend. Once I was happy with my results, I used my heat tool to dry my cardstock. Then, I cut a gorgeous scalloped and stitched circle from the 'Stitched in Circles' die set. I used the scraps from my ink blended cardstock to create two 'tails' to go underneath my scalloped circle. This gave it sort of a 'badge' or 'prize ribbon' look. I like it!
I used foam dots to raise the scalloped circle up and give my card a pop of dimension, and then adhered my digital image. I also did some freehand lettering for my sentiment 'Christmas wishes.' To finish off my card, I used some sequins from the 'Berry Christmas' mix. I love that extra bit of sparkle!
What do you guys think? Do you prefer clean and simple cards or ones with more intricate details and layers? Be sure to let us know in the comments!
Thanks for stopping by and spending a little time with us on Christmas Day – I hope all of you Divas out there have a fabulous rest of the year, and I wish you a happy new year, too!


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These black and red half frame sport sunglasses with HD lenses have been designed to utilize pliable, lightweight TR90 polymer for a secure fit. They feature narrow, rectangular mirrored HD lenses housed in a half-frame style, with dual-injected rubber nose pads and earpieces to ensure the Switchback will remain comfortably in place, however long the trail ahead may be.
These black and red sport shades have our amber high definition sunglass lenses to enhance your ability to see depth and contrast, objects are more sharply defined, and colors are bright and vibrant. HD lenses are great for an active lifestyle. Get your pair and see the difference!
• 100% UV protection
• Grilamid® TR90 plastic polymer frame
• Dual-injected rubber nose pads and earpieces
• Inlaid metal logo
I used my switchback mirrored hd sunglasses golfing. They allow you to see the ball when hitting into the sun early in the morning when the sun is just coming up. The shad is perfect for full sun as well. In the heat of over 100 degF they protect your eyes from evaporation when driving in the golf cart. A must have if you are a golfer or just like great protection.
I love my new sunglasses. Thanks
Kept glasses in provided cloth bag and glasses case when not wearing. Somehow there is a huge scratch on lens. When I cleaned lenses, lens popped out of frame. No easy to fit lens back into frame. I was excited when I ordered not so much now. Since I know lenses can be replaced may try different lenses depending on cost. Frame seems solid, lenses are inferior. "HELP" please!
Hi Craig, we want to know more! Please reach out to our team email@example.com or call us: 1-800-525-5097 option 6. We'll take care if it.
Once again they are awesome
I managed a golf course for many years. Not only did I sell hundreds of them but have been a satisfied customer even after retiring 8 years ago.