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Pete Karageorgos, Manager Of Consumer and Industry Relations for the Ontario branch of the Insurance Bureau of Canada, explains how that black box might work that you put in your care to monitor your driving and maybe lower your car … read more
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VIEWS: 35 PAGES: 8 CATEGORY: Business POSTED ON: 8/10/2011
Sample Research on Herbal Medication document sample
original research FACTORS ASSOCIATED WITH HERBAL THERAPY BY ; Robert Graham USEGardiner,ADULTS IN THELegedza, Andrew C.STATES Paula Anna T.R. MD UNITED Ahn, MD, MPH; ScD; MD, MPH David M. Eisenberg, MD; Russell S. Phillips, MD Objective • To examine the patterns of herbal therapy use an OTC medication in the prior 12 months. Among adults who among adults in the United States and to describe factors associ- used herbs, the most commonly mentioned were echinacea ated with herb use. (41%), ginseng (25%), gingko (22%), and garlic (20%). The most Design • We examined the use of natural herbs from the 2002 frequent conditions for herb use were head or chest cold (30%), National Health Interview Survey (NHIS). We analyzed factors asso- musculoskeletal conditions (16%), and stomach or intestinal ill- ciated with herb use and reasons for herb use with logistic regression. ness (11%). Among those who used herbs in the prior year, factors Results • Factors associated with herb use include the following: associated with using herbs because conventional medical treat- age (45-64 years old), being uninsured, being female, having a ments were too expensive included being uninsured, having poor higher education, living in the West, using prescription medica- health, and being 25-44 years old. tions or over-the-counter (OTC) medications, and self-identified Conclusions • Nearly 1 in 5 people in the US population report as "non-Hispanic other." Factors associated with no herb use using an herb for treatment of health conditions and/or health include being non-Hispanic black and living in the South or promotion. More than half did not disclose this information to a Midwest. Seventy-two percent of those who used herbs used pre- conventional medical professional. (Altern Ther Health Med. scription medications, and 84% of those who used herbs also used 2007;13(2):22-28.) Paula Gardiner, MD, is a research fellow in the Division for ccording to the National Institute of Health's Research and Education in Complementary and Integrative Medical Therapies at Harvard Medical School (HMS) and in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center (BIDMC), in Boston, Mass. At the time this article was written, Robert Graham MD, MPH, was a research fellow in Complementary and Integrative Medical Therapies at HMS and in the Division of A Office of Dietary Supplements, products made from botanicals that are used to maintain or improve health may be called herbal products, botanical products, or phytomedicines.1 Herbal products are a unique class of dietary supplements because they are derived from medicinal plants and not regulated in the United States like pharmaceuticals are. The National Health General Medicine and Primary Care at BIDMC; he is cur- Interview Survey (NHIS) refers to these products as "natural rently director of the walk-in clinic at Mount Auburn hospi- herbs." Few studies have examined the US adult population's use tal in Boston. Anna T.R. Legedza, ScD, is a statistician in the of herbal products and factors associated with herb use. In 1990, Division for Research and Education in Complementary and 2.5% of the US population used 1 or more herbal products.2 In Integrative Medical Therapies at HMS and in the Division of 1997, 42% of the American population used some form of com- General Medicine and Primary Care at BIDMC. Andrew C. plementary and alternative medicine (CAM), with 12% of the Ahn, MD, MPH, is a junior faculty member in the Division for population using herbal medicine.3 Tindle et al noted an increas- Research and Education in Complementary and Integrative ing trend of herb use from 1997 to 2002.4 Various analyses of the Medical Therapies at HMS. David M. Eisenberg, MD, is the NHIS have estimated 10% to 19% of the US population uses Bernard Osher Associate Professor of Medicine in the herbs for health conditions.4-8 Division for Research and Education in Complementary and Despite widespread use, little is known about patterns of Integrative Medical Therapies at HMS and an associate pro- herb use and why patients choose to use herbs. Using data from fessor in Medicine at the of General Medicine and Primary a nationally representative survey, we examined overall preva- Care at BIDMC. Russell S. Phillips, MD, is chief of the lence and patterns of herb use by US adults, factors associated Division of General Medicine and Primary Care at BIDMC. with herb use, prevalence of specific herb use, medical condi- 22 ALTERNATIVE THERAPIES, mar/apr 2007, VOL. 13, NO. 2 Herbal Therapy Use in the United States tions for which herbs are most commonly used, perceived help- herbs combined with conventional medical treatment would fulness, and rates of disclosure to healthcare professionals. help you; (c) a conventional medical professional (CMP) suggest- ed you try natural herbs; (d) you thought it would be interesting METHODS to try natural herbs; and/or (e) You thought a conventional med- Data Source icine treatment would not help you?" We analyzed data from the Sample Core component and the Alternative Health Supplement to the 2002 NHIS. The alter- Other Health-Related Factors native medicine supplement was administered as part of the We considered sociodemographic information on respon- sample adult questionnaire of the 2002 NHIS. The NHIS is an in- dents' age (18-24, 25-34, 35-44, 45-54, 55-64, ≥65); gender; mar- person household survey conducted by the Census Bureau for ital status (married or not married); education (<high school, the National Center for Health Statistics and the principal source high school graduate, some college, college graduate); annual of information in the United States on the health of the civilian, family income (<$15,000, $15,000-34,999, $35,000-64,999, non-institutionalized household population. One adult (ages 18 ≥$65,000); race/ethnicity (Hispanic, non-Hispanic white, non- years or older) was randomly selected from each household to Hispanic black, non-Hispanic other, Asian, American complete this portion of the survey. There were 31,044 complet- Indian/Alaskan native, Asian Indian, Chinese, Filipino); and ed interviews, with a 73.4% response rate. The sampling meth- region of US residence (Northeast, Midwest, South, West). We ods for the NHIS are described elsewhere.9 analyzed health utilization data on the following: health insur- ance status (insured or not insured); usual source of medical care Use of Natural Herbs (place for routine and preventative care); and utilization of The Alternative Medicine Supplement solicited information health services (last visit to health professional). We included from US adults on 19 non-conventional health therapies. The pri- self-perceived health status (excellent, very good, good, fair, mary therapy we examined was natural herb use, defined by the poor). Additionally, we included use of prescription and over- NHIS as "natural herbs with medicinal properties."9 For the pur- the-counter (OTC) medications in the past 12 months. pose of this analysis, we will use the nomenclature specified in the NHIS and refer to herbal products as "natural herbs." The respon- Statistical Analysis dents were specifically asked, "Some people use natural herbs for a Population estimates were calculated using NHIS weights, variety of health reasons. Some people drink an herbal tea to rem- which are calibrated to US 2000 census totals for gender, age, and edy a flu or cold. Others take a daily pill to help with a health con- race/ethnicity of the 2002 US population. Descriptive statistics dition or just stay healthy. Have you ever used natural herbs for were used to examine the prevalence of herb use, the most com- your own health or treatment (for example ginger, echinacea or mon herbs used, medical conditions for which herbs were used, black cohosh including teas, tinctures, and pills)?" Respondents perceived helpfulness of those specific medical conditions, disclo- who answered "yes" were asked, "During the past 12 months, did sure to medical professionals, and insurance coverage. We used you use natural herbs for your own health or treatment?" chi-squared tests to compare proportions of characteristics in herb Respondents who answered "yes" were asked a series of questions users versus non-users. We used bivariable and multivariable about specific health problems or conditions and which of these logistic regression analysis to assess which variables were signifi- conditions were helped by use of natural herbs. Respondents cantly associated with herb use adjusting for race, age, gender, chose from a list of 35 dietary supplements used for health reasons education, income, region, insurance status, usual source of (29 supplements were plant-based; 6 supplements were not plant- healthcare, last visit to a health professional, self-reported health based, including SAM-e, progesterone cream, melatonin, bee status, and OTC and prescription medication use. Among herb pollen, fish oil, and glucosamine with or without chondroitin). We users, 5 multivariable logistic models were completed for the 5 chose to exclude the 6 non–plant-based supplements from our specific reasons for herb use adjusting for race, age, gender, educa- analysis in order to focus exclusively on plant-based herbs or med- tion, income, region, insurance status, usual source of health care, icinal plants. Herbal products are a unique class of dietary supple- self-reported health status, and OTC and prescription medication ments—patients tend to use them in a traditional or cultural use. We selected variables for testing in our logistic model based context, and the key constituents of products can vary due to dif- on the results of previous national studies and entered these vari- ferent growing conditions and processing.8 Respondents also were ables into the final model simultaneously. asked if they disclosed natural herb use to conventional medical The variables tested in our model are listed in Table 1. All professionals including physicians, nurse practitioners, physician analyses were performed using SAS-callable SUDAAN version assistants, psychiatrists, and dentists. 8.1 (Research Triangle Institute, Research Triangle Park, NC) to account for the complex sampling design of the NHIS. Reasons for Natural Herb Use Among herb users, respondents were asked, "For which of RESULTS the following reasons did you choose natural herbs: (a) conven- Baseline Characteristics of Respondents tional medicine treatment (CMT) was too expensive; (b) natural Of the 31,044 respondents, 7,655 (25%) were self-identified Herbal Therapy Use in the United States ALTERNATIVE THERAPIES, mar/apr 2007, VOL. 13, NO. 2 23 TABLE 1 Baseline Characteristics of Respondents Who Used or Did TABLE 1 Baseline Characteristics of Respondents Who Used or Did Not Use Herbs in the Past 12 Months Not Use Herbs in the Past 12 Months During the past 12 During the past 12 months, did you use months, did you use an herb for your own an herb for your own health or treatment? health or treatment? P value <.05 P value <.05 Characteristics % Yes % No is significant Characteristics % Yes % No is significant Population 18.6 81.4 Self-perceived health .0002 n=5,787 n=25,257 status Race/Ethnicity <.0001 (Excellent, very good, 89.2 87.4 Hispanic 10.1 11.2 good) Non-Hispanic white 75.5 72.6 (Fair, poor) 10.7 12.5 Non-Hispanic black 8.7 12.0 Over-the-counter (OTC) <.0001 Non-Hispanic other* 5.7 4.2 medication Age (yrs) <.0001 Yes 84.3 74.4 <24 11.3 13.7 No 15.7 22.7 25-34 18.6 17.7 Prescribed medication <.0001 35-44 22.7 21.0 Yes 72.3 33.4 45-54 22.5 18.1 No 27.1 63.8 55-64 13.8 12.1 >65 11.1 17.8 * (Asian, American Indian/Alaskan native, Asian Indian, Chinese, and Filipino) Sex <.0001 Male 42.3 49.3 as ever having used an herb for their own health and treatment. Female 57.7 50.7 Of these, 5,787 (19 %) of respondents (extrapolated for the US Education Level <.0001 adult population, 38,182,843) reported using an herb for their < High school 9.2 18.0 own health and treatment. Ten percent of respondents reported High school 21.2 27.4 ever having seen an herb practitioner, and 5% of respondents had graduate 35.2 31.2 34.0 seen an herb practitioner within the past year. Some college 21.9 College graduate We compared respondents who use herbs for their own Income ($) <.0001 health and treatment to those who did not by socio-demographic <15,000 14.6 13.3 characteristics, health status, and use of medical services. 15,000-34,999 21.9 18.8 Differences between users and non-users were small but statisti- 35,000-64,999 18.3 13.9 cally significant at (P<.05) for socio-demographic characteristics, >65,000 9.0 5.8 health status, and use of medical services, but not for insurance Did not reply 36.1 48.2 type (Table 1). Eighty-four percent (32,193,416, weighted for US Region <.0001 population) of those who used herbs also used an OTC medica- Northeast 19.7 19.2 tion in the prior 12 months, and 21% of OTC-medication users Midwest 23.1 24.7 took herbs in the prior 12 months. Coincidently, 72% (27,605,577, South 31.8 38.2 25.4 weighted for US population) of those who use herbs also used a West 17.9 Medical insurance .16 prescription medication in the prior 12 months, and 21% of pre- Yes 86.3 85.4 scription-medication users took herbs in the prior 12 months. No 13.8 14.6 Usual source of .04 Multivariable Analysis of Characteristics Associated With medical care Herb Use Yes 88.8 87.1 Factors most strongly associated with herb use in the multi- No 11.2 12.0 variable model included age 45-64 years old; uninsured, female, Last visit to health <.0001 and living in the West compared to living in the Northeast; use of professional prescription medications or OTC medications in the prior 12 ≤6 mos 72.7 67.2 months, non-Hispanic other (Asian, American Indian/Alaskan >6 mos, ≤1yr 13.1 13.9 14.3 native, Asian Indian, Chinese, and Filipino); and greater than a >1 yr, never saw 17.5 high school education. Factors less associated with herb use ( Table continued) included: being non-Hispanic black and living in the South or Midwest (Table 2). 24 ALTERNATIVE THERAPIES, mar/apr 2007, VOL. 13, NO. 2 Herbal Therapy Use in the United States TABLE 2 Multivariable Analysis of Characteristics Associated Among Herb Users, Use of Specific Herbs in the Last 12 Months With Herb Use We computed the frequency of use of the 29 single herbs Use of CAM: Prevalence of included in the NHIS. Of respondents who used herbs for their adjusted odds ratios* own health or treatment, herbs most commonly used were echi- Characteristics (95% confidence interval) nacea (41%), ginseng (25%), ginkgo biloba (22%), garlic (20%), St Race/Ethnicity John's wort (12%), peppermint (12%), ginger (11%), soy (10%), Non-Hispanic white 1.0 ragweed/chamomile, (9%) and kava kava (7%) (Table 3). Non-Hispanic black 0.85 [0.77, 0.95] † Hispanic 1.09 [0.97, 1.22] Patterns of Herb Use to Maintain Health or to Treat Specific Non-Hispanic other ** 1.24 [ 1.03. 1.49] † Conditions, and Reported Helpfulness Age, y (%) The most frequent conditions for which herbs were used, <25 1.0 ranked highest to lowest, include head or chest cold, muscu- 25-34 1.04 [.90, 1.19] loskeletal conditions, stomach or intestinal illness, 35-44 1.12 [.99, 1.27] anxiety/depression, insomnia, severe headache or migraine, 45-54 1.27 [ 1.12, 1.45]† 55-64 1.26 [1.09, 1.46] † menopause, cholesterol, and recurring pain. Of the previous con- >65 0.91 [0.78, 1.07] ditions, those most frequently rated as "helped a great deal," Sex ranked highest to lowest, include stomach or intestinal illness, Male 1.0 menopause, insomnia, recurring pain, severe headache or Female 1.36 [1.26 1.46] † Education Level TABLE 3 Among Herb Users, Specific Herbs Used During the Prior <High school 1.0 12 Months for Health Reasons (N = 5,787) High school graduate 1.47 [1.29, 1.67] † Some College 2.04 [1.80, 2.31]† Estimated number College graduate 2.69 [2.34, 3.11] † of US population, Income ($) Dietary supplement Weighted % in thousands <15,000 1.0 Echinacea 41.0 14,665 15,000-34,999 1.02 [0.90, 1.15 Ginseng 24.5 8,777 35,000-64,999 1.03 [0.90, 1.18] Ginkgo biloba 21.5 7,679 >65,000 1.07 [0.92, 1.26] Garlic supplements 19.9 7,096 Region St John's wort 12.2 4,390 Northeast 1.0 Peppermint 12.0 4,308 Midwest .88 [0.79, 0.99] † Ginger supplements 10.5 3,768 South 0.83 [0.75, 0.93] † Soy supplements 9.7 3,480 West 1.41 [1.26 , 1.58] † Ragweed/chamomile 8.7 3,111 Medical insurance Kava kava 6.8 2,441 Yes 1.0 Valerian 5.9 2,131 No 1.24 [1.11, 1.39] Saw palmetto 5.7 2,054 Usual source of medical care Evening primrose 4.7 1,686 Yes 1.0 Black cohosh 4.2 1,510 No 1.11 [.98, 1.26] † Ma huang (ephedra) 4.1 1,474 Last visit to health professional Licorice 4.1 1,469 ≤6 mos Milk thistle 3.5 1,255 >6mos, ≤1yr .91 [0.82, 1.00] Guarana 3.0 1,085 >1 yr, never saw .93 [.82, 1.05] Comfrey 2.6 938 Self-perceived health status Feverfew 2.4 865 (Excellent, very good, good) 1.0 Dong quai/don gui tong kuei 2.3 815 (fair, poor) 1.09 [.97 1.22] Hawthorn 2.1 733 Over-the-counter medication Cascara sagrada 1.9 663 Yes 1.46 [1.32, 1.62] † Yohimbe 1.8 633 No 1.0 Bladderwrack/kelp 1.4 497 Prescribed medication Senna 1.0 361 Yes 1.27 [1.15, 1.39]† Mexican yam cream .71 254 No 1.0 Chaparral .69 246 The denominator for the statistics exclude people with unknown CAM information. Chasteberry/Vitex .50 179 * The prevalence odds ratios (PORs) were calculated from logistic coefficients. **Asian, American Indian/Alaskan native, Asian Indian, Chinese and Filipino *Herbal names are exactly as noted in NHIS survey † Statistically significant Herbal Therapy Use in the United States ALTERNATIVE THERAPIES, mar/apr 2007, VOL. 13, NO. 2 25 migraine, musculoskeletal conditions, cholesterol, head or chest DISCUSSION cold, and anxiety/depression (Table 4). In 2002, nearly 1 in 5 US adults (that is, more than 38 mil- lion adults) used an herb for their own health or treatment dur- Disclosure of Herb Use to Conventional Health Providers in ing the prior 12 months. There is little known about what factors the Past 12 Months and personal reasons US adults choose to use herbs. Factors Thirty-four percent of respondents disclosed their herb use associated with the use of herbs in the last 12 months included to conventional medical professionals, and 58% did not, with 8% age 45 to 64, being uninsured, being female, living in the West, noting they did not go or talk to a conventional professional in using prescription or OTC medications, being of non-Hispanic the past 12 months. Of the 34% reporting disclosure, 97% told other race/ethnicity, and having greater than a high school edu- their medical doctor, 9% told their nurse practitioner or physician cation. A majority of herb users also were using prescription assistant, 3% told their psychiatrist, and 3% told their dentist. medication and OTC medications in the prior 12 months. The herbs used most commonly were echinacea, ginseng, gingko Multivariable Analysis Examining Reasons for Herb Use in biloba, and garlic. The most frequent conditions for herb use the Past 12 Months were head or chest cold, musculoskeletal conditions, and stom- Among herb users, 28% felt that herb use was very impor- ach or intestinal illness. More than half of respondents who used tant in maintaining health and well-being, while 30% thought it both herbs and prescription medications during the previous 12 was somewhat important, 28% thought it was slightly important, months did not tell any of their CMPs about their herb use. Fifty- and 14% thought it was not at all important. In the logistic multi- eight percent of subjects did not inform any CMPs about their variate analysis, factors associated with using herbs because use of herbs. Herb users who were uninsured, reported poor/fair CMT was too expensive were uninsured, poor/fair self-reported health status, and were 25 to 44 years old were more likely to use health status, and age 25-44 years old. Respondents who chose herbs because a CMT was too expensive. to use natural herbs because herbs combined with CMT would Since 1990, the percentage of the US population using help were more likely to be college-educated prescription-med- herbs has increased from 2.5% to approximately 19%.2,7 Our ication users and less likely to have a usual source of healthcare. estimate for the prevalence of herb use in the US population is For the statement, "a conventional medical professional (CMP) consistent with other large-scale national surveys. 4 , 7, 8 , 10 suggested you try natural herbs," respondents were more likely However, regional and past national studies have found differ- to be prescription medications users of poor/fair self-reported ent rates of use of specific herbs, particularly in racially and health status, and over age 25 (Table 5). With the exception of ethically diverse populations.6,11-13 poor/fair self-reported health status, no statistically significant Factors associated with herb use shown in other national difference was noted in the multivariable logistic model for the studies included being middle-aged, being female, having greater outcome, "herb use associated with conventional medicine treat- than a high school education,14,15 being uninsured,6 living in the ment being not helpful." No statistically significant difference West, 10 and using prescription or OTC medications. 16 These was noted in the multivariable logistic model for the outcome reports are similar to what we have reported. Among the elderly "herb use associated with an interest in trying herbs" except for in the United States, herb use was greatest among females, non- region—respondents from the South were more likely to answer Hispanic ethnic minorities, and those with a higher income, and "yes" compared to the reference group from the Northeast. more years of education.17 In our study, we did not look specifi- TABLE 4 Among Users of Herbs to Treat Specific Health Problems or Conditions, Percent Using Herbs, and Reported Helpfulness (N= 3,315) % Degree of Help Condition N % Use A great deal Some Only a little Not at all Head or chest cold 961 29.8 35.2 43.9 15.8 5.1 Musculoskeletal conditions* 542 16.4 38.3 36.8 15.7 9.3 Stomach or intestinal illness 389 10.6 51.0 35.0 9.8 4.2 Anxiety/depression 213 5.5 28.4 33.1 27.7 10.9 Insomnia 165 4.8 39.5 39.4 11.0 10.1 Severe Headache or Migraine 130 4.2 38.3 46.5 8.1 7.1 Menopause 93 2.7 39.8 38.7 18.2 3.24 Cholesterol 80 2.6 36.6 40.2 10.4 12.7 Recurring pain 70 2.0 39.0 33.8 14.8 12.4 * Musculoskeletal conditions include (1) back pain or problem, (2) neck pain or problem, (3) arthritis, gout, fibromyalgia, lupus, (4) knee problem (not arthritis or joint injury), and (5) joint pain or stiffness 26 ALTERNATIVE THERAPIES, mar/apr 2007, VOL. 13, NO. 2 Herbal Therapy Use in the United States TABLE 5 Multivariable Analysis of Factors Associated With Specifics Reasons Respondents Used Herbs Herbs Combined With CMT A CMP**Suggested You Try CMT* Too Expensive; Odds Would Help You; Odds Ratio Herbs; Odds Ratio Ratio (Confidence Interval) (Confidence Interval) (Confidence Interval) Age (yrs) <25 1.0 NSS† 1.0 25-34 1.75 (1.06-2.88) 2.03 (1.08-3.80) 35-44 1.96 (1.20-3.18) 2.31 (1.29-4.13) 45-54 1.45 (.88-2.40) 2.07 (1.17-3.67) 55-64 1.59 (.94-2.69) 2.43 (1.31-4.52) ≥65 1.24(.66-2.32) 2.52 (1.32-4.80) Education level < High school 1.0 1.0 NSS High school graduate .82 (.54-1.26) 1.14 (.84-1.56) Some college .84 (.57-1.23) 1.22 (.92-1.61) College graduate .65 (.42-.99) 1.61 (1.13-2.30) Income ($) <15,000 1.0 NSS NSS 15,000-34,999 1.06 (.76-1.48) 35,000-64,999 .58 (.38-.88) ≥65,000 .31 (.14-.70) Other .81 (.60-.1.0) Medical insurance Yes 1.0 NSS NSS No 5.39 (4.01-7.24) Usual source of medical care Yes NSS 1.0 NSS No .50 (.37-.69) Self-reported health Excellent, very good and good 1.0 NSS 1.0 Fair to poor 1.86 (1.38-2.52) 1.80 ( 1.47-2.20) 1.56 (1.15-2.11) Prescribed medication 1.0 Yes Not Statistically 1.55(1.15-2.08) No Significant 1.0 Note: Multivariable models adjusted for race, age, sex, income, education, region, insurance status, usual source of health care, self-perceived health status, and OTC and prescribed medication use. Variables that were tested but were not statistically significant on any question include gender, race, region, and OTC medication use. Only variables that had statistically significant findings are reported. *CMT=Conventional medicine treatment **CMP=conventional medical professional †NSS=Not statistically significant cally at the elderly; however, we did find that Asians used more ness, menopause, insomnia, recurring pain, severe headache or herbs, yet the trend was reversed for African Americans, as has migraine, musculoskeletal conditions, cholesterol, head or chest been demonstrated in other analyses. cold, and anxiety/depression. The most frequent conditions for which herbs were used Among herb users, 72% also used prescription medications, include both acute (head or chest cold and stomach or intestinal and 84% used an OTC medication in the prior 12 months. illness) and chronic conditions (musculoskeletal conditions, ie, Although we cannot be sure these data reflect concurrent use, back pain, neck pain, arthritis, gout, fibromyalgia, lupus, knee more than 27 million of people living in the United States might be problems, joint pain, or stiffness). This is inconsistent with previ- taking an OTC medication and an herb or a prescription medica- ous national studies, which reported that the most frequent med- tion and an herb concurrently. In 1997, an estimated 15 million ical conditions for herb use were upper respiratory infections, people took herbal remedies and high-dose multivitamins concur- arthritis, depression, musculoskeletal pain, memory improve- rently with prescription medications.3 Kaufman et al noted that ment, and menopausal symptoms.14,16,18 The conditions for which 16% of prescription drug users also reported use of one or more herbs are rated most helpful include stomach or intestinal ill- herbals/supplements within the prior week.16 Increasing numbers Herbal Therapy Use in the United States of reports describe clinically serious interactions between prescrip- NHIS to capture ethnic minority responses, there appears to be tion drugs and herbs/supplements and concern that the problem both ethnocentric and medico-centric bias in the survey instru- of adverse effects may be under-reported has grown.16,19-25 ment, which may have contributed to an underestimation of the In our study, nearly 60% of respondents who used herbs did prevalence of CAM and herb use in particular, especially among not tell a CMP about their herb use, and this has been seen in non-white ethnic groups.8,31 Further research is needed to explore other analyses. More than half of respondents who used both why patients are not disclosing their herbal product use to con- herbs and prescription or OTC medications did not tell any of ventional healthcare providers, and strategies to facilitate com- their CMPs about their herb use. In other national and smaller munication in this area need to be developed. cross-sectional surveys, approximately 35% to 44 % of those who In conclusion, the use of herbal products by the US popula- take dietary supplements regularly did not share this information tion has increased over the last decade. It is unclear whether pat- with a healthcare provider.3,18,26 The rate of non-disclosure has not terns of herbal therapy use by adults are being influenced by changed significantly since the early 1990s, despite media atten- marketing data vs evidence of efficacy vs safety or other factors. tion and more marketing of dietary supplements.16,19-25 Most herb users do not choose to use herbs because of a lack of In our analysis, reasons for herb use focused on the cost of confidence in CTM, and only those with poor self-reported conventional medicine, the benefits of combined conventional health status or no insurance use herbs because conventional medicine treatment and herbs, and suggestions from healthcare medicine is not helpful or because it is too expensive. More professionals. Our analysis confirms Barnes et al's finding that research about why patients use herbs for acute and chronic con- most herb users do not choose to use herbs because of lack of ditions as well as the cause for the high rates of nondisclosure is confidence in CMT.7 Only those with poor/fair self-reported needed. Herbal products have complex mechanisms of action health status used herbs because "conventional medicine would and complicated pharmacokinetics and can interact with pre- not help." To our knowledge, this is the first time that the charac- scription medications or cause adverse reactions. For patient teristic of being uninsured, of poor/fair health status, and 25 to safety, healthcare professionals should be aware that not only are 44 years old have been correlated with herb use as a result of the their patients using herbal products, but also that the majority of conventional medicine expense. Finally, respondents who used patients are not discussing herb use with them. prescription medication, those older than 25 years of age, and those with fair/poor health status were more likely to choose Acknowledgments herbs because a conventional provider suggested it. The contents of this manuscript are solely the responsibility of the authors and do not necessar- ily represent the official views of the National Center for Complementary and Alternative It is difficult to compare our estimates of prevalence of herb Medicine (NCCAM) or the National Institutes of Health (NIH). The authors thank Dr Kathi use to market data provided by manufacturers for several rea- Kemper and Mark Blumenthal for reviewing earlier revisions of the manuscript. Drs Gardiner, sons. First, the NHIS did not ask about all the herbs with sub- Graham, and Ahn are supported by an NIH Institutional National Research Service Award, stantial market share. In addition, the accuracy of estimates Grant No. T32-AT0051-03, from the NCCAM. Dr Phillips is supported by an NIH Mid-Career based on industry marketing and product surveillance are diffi- Investigator Award K24-AT000589 from the NCCAM, National Institutes of Health. cult to verify.27 The NHIS included questions on the following herbs (top-selling herbs based on 1998 and 2002 market data REFERENCES 1. National Institutes of Health Office of Dietary Supplements. Botanical Dietary and survey data): garlic, gingko biloba, St John's wort, ginseng, Supplements: Background Information. Available at: http://ods.od.nih.gov/fact- echinacea, saw palmetto, kava kava, valerian, evening primrose, sheets/botanicalbackground.asp. Accessed January 25, 2007. 2. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. soy, and black cohosh.16,28,29 However, of the top-selling herbs in Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N 1998 and 2002, the NHIS did not ask about the use of green tea, Engl J Med. Jan 28 1993;328(4):246-252. 3. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the bilberry, grapeseed, cranberry, aloe, and goldenseal or about United States, 1990-1997: results of a follow-up national survey.[see comment]. JAMA. herbs commonly used by racial and ethnic minorities.16,29,30 1998;280(18):1569-1575. 4. Tindle HA, Davis RB, Phillips RS, Eisenberg DM. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Ther Health Med. 2005;11(1):42-49. Study Limitations 5. Ni H, Simile C, Hardy AM. Utilization of complementary and alternative medicine by United States adults: results from the 1999 national health interview survey. Med Care. There are several limitations to our analysis. First, the sur- 2002;40(4):353-358. vey is based on self-reported data; thus, subjects may be under- 6. Fennell D. Determinants of supplement usage. Prev Med. 2004;39(5):932-939. 7. Barnes PM, Powell-Griner E, McFann K, Nahin RL. Complementary and alternative or over-reporting their use of herbs. The term natural herbs medicine use among adults: United States, 2002. Adv Data. May 27, 2004;(343):1-19. (rather than herbal medications or herbal products) might have 8. Graham RE, Ahn AC, Davis RB, O'Connor BB, Eisenberg DM, Phillips RS. Use of com- plementary and alternative medical therapies among racial and ethnic minority adults: been misunderstood by respondents. Respondents who did not results from the 2002 National Health Interview Survey. J Natl Med Assoc. use natural herbs, such as herbs in a tablet or capsule, might not 2005;97(4):535-545. 9. Survey NHI. CAPI Manual for HIS Field Representatives 2002. have disclosed use. The survey listed only 29 herbs, although 10. Yu SM, Ghandour RM, Huang ZJ. Herbal supplement use among US women, 2000. J there are thousands of botanicals sold as combination dietary Am Med Womens Assoc. 2004;59(4):17-24. 11. Harnack LJ, Rydell SA, Stang J. Prevalence of use of herbal products by adults in the supplements or ethnic traditional medicines in the United Minneapolis/St Paul, Minn, metropolitan area. Mayo Clin Proc. 2001;76(7):688-694. States. Additionally, many herbs have unique common names 12. Schaffer DM, Gordon NP, Jensen CD, Avins AL. Nonvitamin, nonmineral supplement use over a 12-month period by adult members of a large health maintenance organiza- based on the region or cultural background. Despite the tion. J Am Diet Assoc. 2003;103(11):1500-1505. improved sampling and collection strategies employed by the 13. Rivera JO, Chaudhuri K, Gonzalez-Stuart A, Tyroch A, Chaudhuri S. Herbal product 28 ALTERNATIVE THERAPIES, mar/apr 2007, VOL. 13, NO. 2 Herbal Therapy Use in the United States use by hispanic surgical patients. Am Surg. 2005;71(1):71-76. 14. Kelly JP, Kaufman DW, Kelley K, Rosenberg L, Anderson TE, Mitchell AA. Recent trends in use of herbal and other natural products. Arch Intern Med. 2005;165(3):281-286. 15. Bruno JJ, Ellis JJ. Herbal use among US elderly: 2002 National Health Interview Survey. Ann Pharmacother. 2005;39(4):643-648. 16. Kaufman DW, Kelly JP, Rosenberg L, Anderson TE, Mitchell AA. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone sur- vey. JAMA. 2002;287(3):337-344. 17. Bruno JJ, Ellis JJ. Herbal Use Among US Elderly: 2002 National Health Interview Survey. Ann Pharmacother. 2005;39(4):643-648. 18. Blendon RJ, DesRoches CM, Benson JM, Brodie M, Altman DE. Americans' views on the use and regulation of dietary supplements. Arch Intern Med. 2005;161(6):805-810. 19. Ernst E. Herb-drug interactions: potentially important but woefully under-researched. Eur J Clin Pharmacol. 2000;56(8):523-524. 20. Mills E, Montori VM, Wu P, Gallicano K, Clarke M, Guyatt G. Interaction of St John's wort with conventional drugs: systematic review of clinical trials. Br Med J. 2004;329(7456):27-30. 21. Fugh-Berman A, Ernst E. Herb-drug interactions: review and assessment of report reli- ability. Br J Clin Pharmacol. 2001;52(5):587-595. 22. Sorensen JM. Herb-drug, food-drug, nutrient-drug, and drug-drug interactions: mech- anisms involved and their medical implications. J Altern Complement Med. 2002;8(3):293-308. 23. Kuhn MA. Herbal remedies: drug-herb interactions. Crit Care Nurse. 2002;22(2):22-28, 30, 32; quiz 34-35. 24. Valli G, Giardina EG. Benefits, adverse effects and drug interactions of herbal therapies with cardiovascular effects. J Am Coll Cardiol. 2002;39(7):1083-1095. 25. Smolinske SC. Dietary supplement-drug interactions. J Am Med Womens Assoc. 1999;54(4):191-192, 195. 26. Leung JM, Dzankic S, Manku K, Yuan S. The prevalence and predictors of the use of alternative medicine in presurgical patients in five California hospitals. Anesth Analg. 2001;93(4):1062-1068. 27. Blumenthal M. Herbs Continue slide in mainstream market: sales down 14 percent. HerbalGram. 2003;58:71. 28. Blumental M. The ABC Clinical Guide to Herbs. Austin, Tex: The American Botanical Council; 2003. 29. Brevoort P. The booming U.S. botanical market. A new overview. HerbalGram. 1998;44:33-46. 30. Rivera JO, Ortiz M, Lawson ME, Verma KM. Evaluation of the use of complementary and alternative medicine in the largest United States-Mexico border city. Pharmacotherapy. 2002;22(2):256-264. 31. Hufford DJ. Cultural and social perspectives on alternative medicine: background and assumptions. Altern Ther Health Med. Mar 1995;1(1):53-61. Herbal Therapy Use in the United States
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text: Irving Lewis Horowitz Become a Fan × BECOME A FAN Get updates about Irving Lewis Horowitz and recommended reads from Simon & Schuster. Plus, get a FREE eBook when you sign up! Email Address Free eBook available to NEW subscribers only. Offer redeemable at Bookshout.com. Code expires 3/31/15. See full terms and conditions. By clicking SIGN UP, I acknowledge that I have read and agreed to the Privacy Policy and the Terms of Use. Books by this Author C Wright Mills An American Utopia By Irving Lewis Horowitz A biography of legendary sociologist C. Wright Mills, author of The Power Elite and White Collar, among other works, by eminent sociologist Irving L. Horowitz.Charles Wright Mills (1916-1962) was a famed sociologist, social commentator and critic. Noted for his anti-authoritarian, flamboyant character and radical ideas, he has been described as an 'American Utopian' – committed to social change, angered by the oppression he saw around him, and critical of what he saw as evidence... Read more about this book Get a FREE eBook when you join our mailing list. Plus, receive updates about Irving Lewis Horowitz,recommended reads and more from Simon & Schuster. Email Address Free eBook available to NEW subscribers only. Offer redeemable at Bookshout.com. Code expires 3/31/15.See full terms and conditions and this month's choices. Irving Lewis Horowitz in the News


text:
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מִצְעַד הָאָבִיב
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Front Lines
10/18/2012 23:11
Hezbollah funeral 370.
(photo credit:Mohamed Azakir/Reuters)
This week, fierce clashes took place in Syria's Homs province, close to the
border with Lebanon, between Free Syrian Army fighters and armed men loyal to
the Lebanese Hezbollah movement. The Lebanese Shi'a group used its positions in
the Bekaa region to fire Katyusha rockets at FSA positions across the
border.The Hezbollah-affiliated fighters, said by one local resident to
number around 5,000 men, operate ostensibly to protect the Shi'a population.
Some 30,000 Lebanese Shi'a live in 20 villages in the area.Hezbollah
leader Hassan Nasrallah claimed that the gunmen were simply local Shi'a
residents who had decided to take up arms to defend themselves without seeking
the advice or permission of Hezbollah.There were few takers for this
version of events. The Syrian rebels regard the Shi'a gunmen as simply another
element in the force available to Syrian dictator Bashar Assad. Fahd al-Masri, a
spokesman for the FSA, noted that rebel forces have observed the movement of
large amounts of arms and ammunition across the border from Lebanon to Syria.
The rocket fire from Hezbollah positions in Lebanon renders Nasrallah's
assertions entirely hollow.Rather, a growing body of evidence suggests
that the events on the border are only a part of a much more significant
Hezbollah presence among the pro-government forces in Syria.This
includes, according to credible reports, an involvement by the movement in
training efforts to turn the Shabiha militia into a more formidable
force.The Alawi Shabiha irregulars are suspected of many of the most
heinous acts of sectarian bloodletting which have marked the Assad regime's
attempt to destroy its opponents.The FSA now claims to be holding 13
Hezbollah prisoners, captured in fighting near the town of Qusayr, close to the
border.Hezbollah's actions on behalf of the Assad regime are serving to
deprive the movement of the last vestiges of its claim to constitute a
grass-roots, Lebanese "resistance" force concerned mainly with fighting
Israel.Events in Syria have made plain what was never really in doubt:
Hezbollah is a sectarian instrument of Iran which formulates policy and acts in
accordance with the perceived interests of an Iran-led
alliance.Domination of Syria enables Tehran to maintain its supply lines
to its proxy on the Mediterranean. It is a vital interest for both the mullahs
and their Lebanese clients.The Shi'a Islamist movement is therefore
deeply invested in the struggle of Assad and the Iran-led interest to triumph
over its foes.The resulting hatred of Hezbollah and Iran to be found in
rebel ranks is deep and fierce.In Idlib province, in the areas from
which the regime army has withdrawn, opposition activists hoard Hezbollah flags.
Many were left behind from the 2006 war, when the Assad regime would deck the
streets with them in solidarity with its ally in Lebanon. The opposition
activists keep the flags in order to burn them during street protests.A
fighter of the Sunni Islamist Tawhid Brigade in Aleppo city interviewed recently
by this reporter refused to even pronounce the name of
Hezbollah.Instead, he referred to the movement as "Hizb a-Shaytan" (the
party of Satan).These sentiments, along with the widespread conviction
that Iran and its local allies are the key factor in prolonging the bloodshed in
Syria, are storing up an account which, in the event of their victory in Syria,
the Sunni rebels are likely to seek to settle.Following the killing of
senior Hezbollah commander Ali Hussein Nasif by the FSA in Homs province last
month, the rebels vowed to take the fight to Hezbollah's strongholds in south
Beirut.Whether or not such action is imminent, the decision of where and
when to strike is ultimately a tactical one.On a strategic level,
Hezbollah is part of Assad's "killing machine," as US Ambassador to the United
Nations Susan Rice recently and eloquently expressed it.Which means that
whatever the tactical details, the FSA and Hezbollah are already in a state of
war.Lebanon itself has stayed mainly free of direct violence related to
the events in Syria. The exception has been the city of Tripoli, where Sunni
Islamist supporters of the rebellion have clashed with Alawi partisans of the
regime along a number of fault lines. These disturbances, while bloody, have
been localized.But in the volatile Bekaa area, where Sunni and Shi'a
populations live in uneasy proximity, each community actively aids its preferred
side in the civil war across the border. Sunni villagers remember well the harsh
conditions imposed upon them by the Syrian military during its long occupation
of the area between 1990 and 2005. Many young men from this area have crossed
the border to fight with the FSA.Shi'a towns, meanwhile, send operatives
across the same border to fight for the other side. Ali Hussein Nasif, for
example, came from the village of Bodai in the western Bekaa, a place of fervent
pro-Hezbollah sentiment.Further afield, evidence has emerged of the
involvement of senior politicians from the opposition March 14 coalition in
efforts to supply arms to the rebels.All of which means that despite the
relative quiet in Lebanon itself, rival Lebanese political forces are deeply
invested in the outcome of the civil war across the border.The Sunni-led
March 14 movement, and Lebanese Sunnis in general, clearly see the fall of the
Assad regime as the key to ending the Shi'a ascendancy established by Hezbollah
over the last half-decade.Hezbollah, meanwhile, is neither willing nor
able to alter its basic nature as a client and proxy of Iran, to whom it owes
its current dominance of Lebanon.It is therefore embarked on an
all-or-nothing gamble on behalf of its masters. This gamble will end either with
the eventual resurgence of the Assad regime – and with it, a strategic triumph
for the Iranian interest in the Levant – or with the Syrian dictator's
destruction. The latter outcome may then bring down a fierce Sunni reckoning on
both Hezbollah and the constituency it controls in Lebanon.Hezbollah, by
its very nature, had no choice but to go down this road. Still, seen from this
angle, the movement's participation in the sending of a drone southwards over
Israel this month looks like a rather plaintive attempt to change the subject.
Hezbollah evidently sought to recall the days when its main military efforts
were not directed against its fellow Arabs.But as the Syrian civil war
threatens to burst its banks and erupt into Lebanon, those days look
increasingly distant.
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Cinnamomum cassia is an evergreen tree species. The species may also be commonly referred to as the Chinese cassia or Chinese cinnamon. C. cassia is a member of the family Lauraceae. It is indigenous to southern China; however the plant is widely cultivated for its aromatic bark that is turned into the common spice "cinnamon". The plant is nurtured and grown most abundant in Asia, specifically in India, Indonesia, Laos, Malaysia, Taiwan, Thailand and Vietnam. Cinnamomum cassia plants...
Cinnamomum burmannii is a flowering tree species. The plant may also be commonly referred to as Indonesian Cinnamon, Padang Cassia or Korintje. C. burmannii belongs to the Lauraceae family. The plant is most commonly known for its spice; the household spice cinnamon is made from the tree's bark. The species is found growing naturally in Southeast Asia and Indonesia, specifically in the West Sumatra and Western Jambi provinces. It prefers tropical climates, requiring wet environments....
- One who brings meat to the table; hence, in some countries, the official title of the grand master or steward of the king's or a nobleman's household.


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Follow along with step-by-step beading projects and share your designs with beaders around the world—it's quick & easy!
- "Teal Swirl": on
"Gorgeous!…" read »
- "Teal Swirl": on
"So beautiful, Angela. Love the colors. Who knew the little unos would look so good wrapped!…" read »
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- "Simple bangle bracelet": on
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"Oh my goodness. I didn't realize you did that whole design with jump rings!! What a…" read »
- "LOS surprises!": on
"You are always trying something new!! And it always looks cool!!…" read »
- "The Best is Yet to Come": on
"I love the contrast in color and size in this necklace. Makes a very striking and…" read »
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- "Simple bangle bracelet": on
"I like it-looks like it was fun to make!…" read »
- "Patriotic Poly Birds": on
"You are very talented with polymer clay!…" read »
- "Simple bangle bracelet": on
"I just love this! I agree, great design and skillful wire work!…" read »
- "Simple bangle bracelet": on
"Simple, yet elegant, fab wire work! a Fave! …" read »
- "Simple bangle bracelet": on
"Elegant design, nice job on the wire work..…" read »
- "Simple bangle bracelet": on
"Great bracelet! I love your wirework. It looks so professional!!…" read »
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"This is so pretty. I too love the earthy colors.…" read »
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"Wow what a stunner! I've seen these stick beads and wondered what to do with…" read »
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About this design:
dragonfly :)
Components:Silver plated chain, gemstones, pewter dragonfly
Read the comments (or add your own)
Julia…you're back!!! We've missed your kumihimo!!
This is very pretty and delicate but it still makes a bold statement. I like it!!
Thank you, darling! We were visiting with our son and his family for about two month I sold some of my kumihimo there . They loved it and I promissed to bring more but they wanted about double length, like 30 "…
I mean we visited them in Moscow, Russia…
Love this chain with the dragonfly! It accents it beautifully! Soooo, did you get any wonderful beads during your visit?
Thank you, Gail … Not really. Next time. Now I know where to go
Love the dragonfly necklaces. My fav is the silver – it has an ethereal look to it, I think.
Thank you ! Both chains with dragonfly where sold very fast in the show/sale yesterday
I love the chain in this one too. Going to buy some more of it
Great way to compliment the dragonfly. Beautiful!
I kinda knew where you meant you were. Hope you had a wonderful visit. I should have also said we missed you as well as your kumihimo.
Thank You, Wanda! I have a weakness for dragonfly
Deb, thank You darling . I missed everyone too… We will go to Moscow in April now
Very feminine and dainty, lovely
Excellent combination with dragonfly and chain!
Great design Julia!! I love dragonflies too I've been looking for chain like this, did you buy it from Lima?
Oh yes! I love the larger chain too. I was at Lord &Taylor a few days ago,and they were selling a lot of necklaces with the large link chain.
Thank you, all so very much. Believe it or not …I bought the chain at Michael's! Were they have their sterling silver and silver plated findings. Tomorrow I will go there and get a couple more. I used the whole length of it, but next time I will get a few links for the earrings
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when turning mostly left the traction control light will come on? What should I have checked or can you tell me if it would be in the front or rear abs?
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2004 Chevrolet Impala Question: traction control
dennis55, 3.8L V6, Muskegon, MI, October 02, 2009, 23:00
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Answer #1sinautoscan.com October 02, 2009, 23:50Master
You have to get a diagnostic it may be a broken sensor or loose connection
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TNT unveiled the cast of its new Nashville-based reality show this week, giving Music City its first look at "Private Lives of Nashville Wives."
The show is set to debut at 9 p.m. Feb. 24, following six of Nashville's high-profile spouses. Centered around the city's country music industry, the show was previously called "Nashville Confidential."
Evolution Media, the company producing "Private Lives," is also the company behind "The Real Housewives of Orange County" and "The Real Housewives of Beverly Hills."
Four of the women have connections to the music industry.
The cast includes Cassie Chapman, wife of Christian music recording artist Gary Chapman; Sarah Davidson, wife of songwriter Dallas Davidson; Betty Malo, wife of The Mavericks' Raul Malo, and her single twin sister, Ana Fernandez; Erika Page White, wife of country singer Bryan White; Jenny Terrell, wife of event planner JT Terrell of Music City Tents and Events; and Tina Brady, wife of Nashville dentist Stan Brady.
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Going for a song: a mysterious vanishing act
A much-loved summer visitor is fast disappearing, and no one knows why
Saturday 23 January 2010
One of Britain's most attractive songbirds has vanished from most of southern England in a dramatic population decline, new research shows.
The whinchat is a summer visitor from Africa with an orange breast and a prominent white eyestripe. It was widely scattered across the country 20 years ago, but is now virtually extinct south of the Pennines, apart from colonies on Salisbury Plain, Exmoor and Dartmoor.
The astonishing extent of its disappearance has been revealed by fieldwork for the new atlas of the breeding birds of Britain and Ireland, which will be published in 2012. This shows a conspicuous thinning-out of whinchat records across the British Isles, compared with those in the last atlas, which covered the period 1988 to 1991.
But the most remarkable aspect of the new research is the wholesale vanishing of Saxicola rubetra from huge swathes of southern England, including areas which were once considered whinchat strongholds, such as the Brecklands of Norfolk, and the New Forest in Hampshire.
"It's a pretty alarming decline," said Dawn Balmer of the British Trust for Ornithology (BTO), who is co-ordinating the Bird Atlas 2007-11 project. Ms Balmer stressed that the results were provisional, and more records might come in for Scotland and Ireland. But southern England, she said, had by now been comprehensively covered and the current map was likely to show the true picture.
"We don't really know why it's gone, because in many of its former breeding areas, such as Shropshire, nothing has really changed. Something could be affecting the species on migration," she said.
Several factors support the theory that the whinchat population may be declining because of problems the birds face on their annual odysseys to and from Africa south of the Sahara.
One is that the whinchat's nearest relative, the stonechat, has more than trebled its numbers since 1995, while the migratory whinchat has decreased by 43 per cent over the same period. The stonechat occupies similar habitats of heathland, gorse and bracken-covered hillsides, but stays in Britain all year.
A second factor is that several other sub-Saharan migrant species are showing similar substantial declines. These species range from the turtle dove (66 per cent decline since 1995) and the wood warbler (60 per cent), to the pied flycatcher (51 per cent), the nightingale (41 per cent) and the cuckoo (37 per cent).
The migrant declines have prompted the BTO to begin research on these species' wintering habitats to see if they are running into trouble during the times they spend in Africa.
The whinchat is much appreciated by birdwatchers. "It's a lovely species, and its song is part of the filigree background sound of spring," said Mark Cocker, author of Birds Britannica.
"Its disappearance is deeply saddening, and further evidence that something truly disturbing is happening to our summer migrants," said Graham Madge, conservation spokesman of the Royal Society for the Protection of Birds.
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Updated: 09/03/2014 5:15 PM
Created: 09/03/2014 5:14 PM KSTP.com
A Ramsey County judge has declined to take sides on a lawsuit over White Bear Lake's low water levels.
Minnesota Public Radio News reports a lawsuit filed by a group of White Bear Lake homeowners against the state Department of Natural Resources claims the agency is responsible for the low water levels. The homeowners say the agency allowed too much groundwater pumping from an aquifer that's connected to the lake.
The agency says weather patterns have caused the plunge in the lake's water line.
In an order issued Friday, the judge said the evidence that's been presented so far doesn't lead to a clear conclusion. But she has said the homeowners have legal grounds to sue the agency.
(Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)
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Endeavour Quay, the Gosport specialist boat yard, has become the home to the newly refitted TP52 5˚ West.
The former TeamOrigin yacht has undergone a service and refit period led by Boat Captain Simon Clarke with her mast down and keel off in the undercover shed at Endeavour Quay. Now back on the water ready to campaign, 5˚ West's Gosport based team will dry sail the TP52 out of Endeavour Quay for the season.
Last week saw the new look vessel out training in the Solent in some extreme conditions including 50 knot winds ahead of this weekend's Easter Regatta.
Endeavour Quay in Portsmouth Harbour is less than 500m from the Solent and offers all the services and amenities required by race crews:
• Open Yard Policy
• 180 tonne travel lift
• Mast crane
• Storage ashore
• Undercover storage up to 40m
• Deep water
• No air-draft restriction
• Excellent transport links
• Local marine service providers
• Local provisioning stores
• Local restaurants and bars
• Local accommodation
Photo: Endeavour Quay
Austal USA combined two classes to graduate a total of 48 members of Austal's cutting-edge four-year apprenticeship program yesterday at a formal ceremony held at the Arthur R.
BAE Systems announced it will invest approximately $100 million to expand drydocking capabilities at its San Diego shipyard.
The investment, which will include
Washington State Ferry M/V Tacoma will return to work on the Seattle/Bainbridge Island route starting March 28 after suffering electrical damage last summer.
With ESPRIT CAM software, Armor Mécanique has the wind in its sails; 50% time savings, better quality and new markets thanks to 3D machining
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Yatching Malta Ltd (YML) - a new public private partnership (PPP) between the government and the Royal Malta Yacht Club (RMYC) was formed with the aim of putting Malta on "the global yachting map".
Taiwan's yacht industry saw its first double-digit growth in nearly a decade, indicating an inspiring revival led by development and sales of larger leisure boats,


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Mike Woodson talks about starting Mike Bibby in the playoffs
Apr 19, 2012, 4:06 PM EDT
From the NY Post's Marc Berman:
Don't be shocked if [Mike Bibby] winds up starting playoff games, with all of Baron's injuries. Woodson got him 36 minutes in Newark, no limits like with Baron. 8 assists, 1 turnover. That's what Woody cares about. Bibby has played in 100 career playoff games. That matters to Woody. "In games like this, you need a stable guy out there that can direct traffic. He played a lot of minutes. I thought he was solid all the way through in terms of running our offense."
Woodson coached Bibby when the 33-year old Arizona product was in Atlanta, so he's certainly familiar with Bibby's game. Bibby was picked up by the Heat after the deadline last season, but ended up being a disaster of historic proportions in the playoffs. Bibby averaged 3.7 points per game on 28.1% shooting in 20.8 minutes a game in last season's playoffs. From a PER standpoint, Bibby had what could be considered the worst playoff run in NBA history. Still, with Jeremy Lin and Baron Davis both battling injuries, the Knicks may have no choice but to hope Bibby can bounce back from last year's playoffs this time around.
- cakemixa - Apr 19, 2012 at 4:20 PM
Didn't know the Knicks were already guaranteed a playoff spot.
- dysraw1 - Apr 19, 2012 at 8:15 PM
Bibby is smart and has good court vision, the problem is that he cannot defend to save his life. I remember when Mike was a young player on the Kings he still wasn't the best defender, but the damage he caused on offense really made him a top point in those days
- thatguywhoisactuallyamiamisportsfan - Apr 19, 2012 at 9:46 PM
LOL, check the playoffs last year, Mr. Woodson. Michael Bibby was nowhere to be found.
Ready for the LeBron jokes, but stick to the topic.
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Near North
Restaurants in Near North
Superstar Chef Marcus Samuelsson, owner of NYC's Red Rooster and winner of Bravo's "Top Chef Masters," brings his skills to bear in Chi-Town at this seafood restaurant in the Affinia Chicago hotel.
One of Streeterville's most exclusive dining spots, Tru features the creativity of chef Anthony Martin, the Chicago Tribune's Chef of the Year in 2010, his first at the helm.
A native of the Emilia-Romagna region in Italy where prosciutto di Parma and Parmigiano-Reggiano originated, chef Luisa Silvia Marani now offers homemade Bolognese sauces and pastas to Chicago's Gold Coast residents at this authentic Italian eatery.
A casual American grill with distinct notes of Mexican flavor in both the decor and the cuisine, Frontera Grill styles itself as being on the culinary "frontier" with its very name.
Home to what Good Morning America named the best burger in the nation, Rockit Bar & Grill is a River North landmark serving upscale American bar fare.
This romantic Magnificent Mile restaurant, an influential part of the Chicago dining since 1984, features the award-winning Italian cuisine of celebrity chef Tony Mantuano.
An offshoot of the New York original, which was made famous by Sex and the City, Chicago's Sushi Samba Rio is now part of a small chain (other locations are in Miami, Las Vegas, and London).
Once a personal chef to Oprah Winfrey, chef Art Smith opened his Table Fifty-Two inside the historic 19th century carriage house of the Biggs Mansion. The Northside restaurant features two stories and rustic décor that includes an open-hearth oven and a pressed copper ceiling.
Upon entering this modern Japanese restaurant, patrons are wowed by a Jeffrey Beers-designed interior adorned with a water wall, oversize mirrors, red leather chairs, and an undulating wooden ceiling hung with copper chandeliers.
An innovative fusion of Indian and Latin American cuisine delights diners at this River North restaurant.
Endorsed by Food & Wine, USA Today and Esquire and even frequented by President Obama, chef Michael Kornick's Near North Side restaurant continues to be a favorite year after year.
Situated inside Chicago's Peninsula hotel, Avenues is a feast for the senses, combining flavorful contemporary cuisine with a lush, elegant atmosphere.
Located on the seventh floor of the Park Hyatt, NoMI is a Michelin one-star restaurant focusing on fresh, regional ingredients. Inside the dining room, hand-blown glass sculptures shaped like branches hang above the most-desired window seats, while restored original mosaic tiles cover the floor.


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Public interest attorney Steven M. Druker, as executive director of the Alliance for Bio-Integrity, initiated a lawsuit that forced the FDA to divulge its files on genetically engineered foods. In the first half, he discussed what he considers to be the biggest scientific fraud of our age - how politically appointed administrators have covered up the warnings of their own scientists about the risks of GMO foods.
In the latter half, Rosemary Ellen Guiley, a leading expert in the metaphysical and paranormal fields, talked about nightmares and dreams, and the messages they convey.