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It is 6:00 in the morning and I am in the Vienna Airport waiting for my flight back to Dallas. I came over for three intense days of auditions held at the historic Theater an der Wien, where a panel of my colleagues and I heard almost 100 singers from 34 countries. There were representatives from Florence's Maggio Musicale, as well as the opera houses in Antwerp, Toulouse, Santiago, and several German opera houses, including Cologne.
Among the singers auditioning there were a number of Americans who are either based in Europe or were here on an audition tour, including soprano Ava Pine, who was dazzling in arias by Handel and Gounod even at 10:30 in the morning !
Perhaps the most exciting auditions for me were a group of singers from the young artist program at Moscow's famed Bolshoi Theater, and there was one soprano in particular that was really impressive. I expect that she is at the beginning of what promises to be an extraordinary career.
There were so many singers from so many countries that I couldn't help but be struck by the extraordinary passion shared by all of these artists from around the world who have devoted themselves to a life in music.
I was also able to attend two performances while I was here, which was fascinating. The first was a new production of Verdi's IL TROVATORE at the Vienna Volksoper (sort of the Viennese equivalent of the late, lamented New York City Opera or London's English National Opera) which starred tenor Stuart Neill as "Manrico."
Some of you may remember him in the title role of FAUST in Dallas in 1998, and obviously he has moved on to significantly heavier repertoire.
The following evening I attended a stunning new production at the Theater an der Wien of Mozart's IDOMENEO, starrring Richard Croft in the title role. It was conducted by Rene Jacobs and staged by Damiano Michieletti, and performed by a superb cast which also included Marlis Peterson as "Elettra."
The production was somewhat puzzling, but filled with breathtaking imagery and performed with intense commitment. I have not always enjoyed productions of this opera seria, which often seems static, but even with jet lag I was riveted from beginning to end.
It was also wonderful to see Rick Croft, who is on the faculty at the University of North Texas, enjoy such a personal triumph.
Sent via BlackBerry from T-Mobile
Jonathan Pell, Artistic Director
The Dallas Opera

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Facebook, Twitter Help Teens Become More Aware of Global Needs
According to a new study by World Vision, there has been a big jump in teens who say social media makes them more aware of the needs of others.
The 30-Hour Famine study, conducted by Harris Interactive, found that more than half of teens say social media sites like Facebook and Twitter have made them more socially aware.
This is a huge increase from 2011 when only 44 percent said their use of social media made them more aware. The study also found that 2 in 3 teens (68 percent) agree that the benefits of social media outweigh the risks.
"The jump in the number of teens who say social media sites make them more socially aware is a sign of the times," said Regina Corson, senior vice president of Harris Interactive, in a released statement.
According to Pewinternet.org, a project of the Pew Research Center, "Social media use has become so pervasive in the lives of American teens that having a presence on a social network site is almost synonymous with being online." It found that 95 percent of all teens ages 12-17 are now online and 80 percent of those online teens are users of social media sites.
Michele Tvedt is the 30-Hour Famine national manager, which is an initiative of World Vision. She told The Christian Post via email that social media is effective because it makes teens more aware of the needs of others. The problem is they don't always know how to get involved on a practical hands-on level.
"Teenagers are being trained that pressing 'like' on Facebook or retweeting something on Twitter is 'taking action,'" she said.
This is why World Vision is using its 30 Hour Famine initiative to give teens a practical way to take action.
At the end of this month, thousands of teens will go hungry for 30 hours to raise funds and hunger awareness. They will only consume water and juice as they participate in local community service projects at food banks, soup kitchens and homeless shelters.
"The 30 Hour Famine teaches students that to care for the poor, it takes sacrifice … and it takes students from [a] somewhat passive action sometimes found on social media to sacrificial, proactive, educated action," Tvedt said.
This hands-on and proactive approach is effective. Last year 200,000 teenagers participated in the fast raising $10 million.
The funds raised through the 30 Hour Famine are used around the world to fight hunger. This is the main reason it exists, but Tvedt told CP that the initiative is also geared toward educating and empowering teenagers.
"Social media allows a greater reach to teenagers and more open and honest conversation," she said. Right now on Facebook and Twitter, 30 Hour Famine is asking followers to take part in 30 days of fasting, which Tvedt is in the midst of herself.
"Every day, students are encouraged to fast from something different. One day students were asked to fast from shoes and think about the children that walk barefoot for miles every day to gather water. Another day they were asked to sleep next to their bed with only one blanket and think about those who don't have the comfort of a nice bed and warmth," she said.
This has led to increasing awareness by students about the "intricacies of poverty in a way they have never experienced before." But it is also showing them how blessed they are, Tvedt said.
She noted that teens are open to new ideas and initiatives, and "want to create change – we just have to give them opportunities to do so."
Funds raised this year for the 30 Hour Famine will be sent to 10 countries including Haiti, the Horn of Africa, Burundi, Malawi, Pakistan and Afghanistan. Almost 22,000 children die each day from hunger and preventable diseases. Chronic poverty, affecting half the people on earth, is the cause. Nearly 3 billion people live on less than $2 a day.
This year's 30 Hour Famine will take place on Feb. 24-25, and again in late April.


text:
Patient flow diagram for N-acetylcysteine vs placebo in the treatment of trichotillomania.
Massachusetts General Hospital Hair Pulling Scale (MGH-HPS) total scores adjusted for a baseline score of 17.18.
Percentage of patients with trichotillomania with a score of 1 or 2 on the Clinical Global Impression (CGI) improvement scale.
Customize your JAMA Network experience by selecting one or more topics from the list below.
Grant JE, Odlaug BL, Won Kim S. N-Acetylcysteine, a Glutamate Modulator, in the Treatment of Trichotillomania: A Double-blind, Placebo-Controlled Study. Arch Gen Psychiatry. 2009;66(7):756–763. doi:10.1001/archgenpsychiatry.2009.60
© 2023
Trichotillomania is characterized by repetitive hair pulling that causes noticeable hair loss. Data on the pharmacologic treatment of trichotillomania are limited to conflicting studies of serotonergic medications. N-acetylcysteine, an amino acid, seems to restore the extracellular glutamate concentration in the nucleus accumbens and, therefore, offers promise in the reduction of compulsive behavior.
To determine the efficacy and tolerability of N-acetylcysteine in adults with trichotillomania.
Twelve-week, double-blind, placebo-controlled trial.
Ambulatory care center.
Fifty individuals with trichotillomania (45 women and 5 men; mean [SD] age, 34.3 [12.1] years).
N-acetylcysteine (dosing range, 1200-2400 mg/d) or placebo was administered for 12 weeks.
Main Outcome Measures
Patients were assessed using the Massachusetts General Hospital Hair Pulling Scale, the Clinical Global Impression scale, the Psychiatric Institute Trichotillomania Scale, and measures of depression, anxiety, and psychosocial functioning. Outcomes were examined using analysis of variance modeling analyses and linear regression in an intention-to-treat population.
Patients assigned to receive N-acetylcysteine had significantly greater reductions in hair-pulling symptoms as measured using the Massachusetts General Hospital Hair Pulling Scale (P < .001) and the Psychiatric Institute Trichotillomania Scale (P = .001). Fifty-six percent of patients "much or very much improved" with N-acetylcysteine use compared with 16% taking placebo (P = .003). Significant improvement was initially noted after 9 weeks of treatment.
This study, the first to our knowledge that examines the efficacy of a glutamatergic agent in the treatment of trichotillomania, found that N-acetylcysteine demonstrated statistically significant reductions in trichotillomania symptoms. No adverse events occurred in the N-acetylcysteine group, and N-acetylcysteine was well tolerated. Pharmacologic modulation of the glutamate system may prove to be useful in the control of a range of compulsive behaviors.
Trial Registration
clinicaltrials.gov Identifier: NCT00354770.
Trichotillomania is a disabling, underrecognized condition in which individuals repeatedly pull out hair, which leads to noticeable hair loss. Trichotillomania is characterized by the following diagnostic criteria: the recurrent pulling out of one's hair, which results in noticeable hair loss; an increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior; and pleasure, gratification, or relief when pulling out hair.1 Psychosocial problems are common in individuals with trichotillomania and include significantly reduced quality of life, reduced work productivity, and impaired social functioning.2,3
Relatively little is known about the prevalence of trichotillomania in the general population. Clinically significant hair pulling that meets the diagnostic criteria for trichotillomania has been found in 0.6% to 3.9% of college students surveyed.4,5 Other studies examining the rates of trichotillomania in treatment samples have found lifetime rates of 4.4% in adult psychiatric inpatients (sample size = 204)6 and 4.6% in patients with obsessive-compulsive disorder (sample size = 153).7
Although trichotillomania has been described for almost 2 centuries,8 it remains a poorly understood disorder with limited data regarding pathogenesis and treatment.9 Currently, there is no Food and Drug Administration–approved treatment for trichotillomania, despite almost 2 decades of research. In fact, there have been only 6 small (sample sizes = 13-43) placebo-controlled trials of pharmacotherapy published for the treatment of trichotillomania.9 Four of these studies examined a selective serotonin reuptake inhibitor, and 2 investigated clomipramine hydrochloride. A recent meta-analysis10 demonstrated that although clomipramine has moderate efficacy compared with placebo (effect size, −0.68; 95% confidence interval, −1.28 to −0.07), there is no evidence to suggest any benefit for selective serotonin reuptake inhibitors (SSRIs) (effect size, −0.02; 95% confidence interval, −0.32 to 0.35). Even in the case of clomipramine, however, there is little evidence that initial benefits are maintained.11 Given the lack of clearly effective pharmacologic treatments for trichotillomania, additional treatment options are needed.
Glutamatergic dysfunction has been implicated in the pathogenesis of obsessive-compulsive disorder,12,13 a disorder with phenomenologic and possible neurobiological links to trichotillomania.14-17 Clinical studies18-20 support the possible efficacy of glutamatergic modulators, such as N-acetylcysteine, in the treatment of repetitive or compulsive disorders. N-acetylcysteine is a hepatoprotective antioxidant that is converted to cystine, a substrate for the glutamate-cystine antiporter. This antiporter allows for the uptake of cystine, which causes the reverse transport of glutamate into the extracellular space, which stimulates inhibitory metabotropic glutamate receptors and, thereby, reduces synaptic release of glutamate.13,18,21-24 The restoration of the extracellular glutamate concentration in the nucleus accumbens seems to block reinstitution of compulsive behaviors.21,25 Pharmacotherapies that target the prefrontal glutamatergic drive to the nucleus accumbens,25 such as N-acetylcysteine, may, therefore, correct the underlying pathophysiologic abnormalities and symptoms of trichotillomania. Based on these data, we conducted a placebo-controlled, double-blind study to examine the tolerability and efficacy of N-acetylcysteine in the treatment of trichotillomania. We hypothesized that the use of N-acetylcysteine would reduce compulsive hair-pulling behavior in individuals with trichotillomania.
Men and women aged 18 to 65 years with a primary DSM-IV26 diagnosis of trichotillomania were recruited via newspaper advertisements and referrals for medication treatment. All the patients met the DSM-IV criteria for current trichotillomania using the physician-administered Trichotillomania Diagnostic Interview.27 Because 17% of individuals with trichotillomania do not meet the DSM-IV criteria of either tension before or relief or gratification after pulling hair,28 this criterion was not required for study inclusion (46 patients, however, met the full DSM-IV criteria for trichotillomania). The participation of women required a negative β–human chorionic gonadotropin pregnancy test result and the stable use of a medically accepted form of contraception.
The exclusion criteria included (1) unstable medical illness or clinically significant abnormalities on laboratory tests or physical examination at the screening visit; (2) a history of seizures; (3) myocardial infarction within 6 months; (4) current pregnancy or lactation or inadequate contraception in women of childbearing potential; (5) any reported thoughts of suicide; (6) a lifetime history of bipolar disorder type I or II, dementia, or schizophrenia or any other psychotic disorder according to DSM-IV criteria; (7) current (past 3 months) DSM-IV–designated substance abuse or dependence; (8) previous treatment with N-acetylcysteine; and (9) a diagnosis of asthma (owing to the potential of N-acetylcysteine to worsen asthma).
Patients who were currently taking psychotropic medications were allowed into the study as long as the dose of medication had been stable for 3 months before study inclusion and there were no plans to modify the dose during the study. Similarly, patients who were attending individual or group psychotherapy were allowed to participate if attendance had been ongoing weekly for at least 6 months before study entry. Patients who had changed doses of medication or started therapy, based on self-report, were discontinued from the study (changes in treatment were assessed at each study visit, and no one was withdrawn for this reason).
Of 77 individuals screened for the study, 50 with trichotillomania (45 women and 5 men; mean [SD] age, 34.3 [12.1] years) were randomized to receive N-acetylcysteine or placebo. Twenty-seven individuals did not meet the inclusion and exclusion criteria: 13 reported a current substance use disorder, 6 reported symptoms consistent with a lifetime bipolar disorder, 5 had severe asthma, and 3 felt unable to comply with the study schedule.
The 50 randomized patients as a whole reported a mean (SD) age at trichotillomania onset of 12.1 (5.0) years (range, 3-27 years). Patients spent a mean (SD) of 64.9 (59.1) minutes each day pulling hair. Although many patients had multiple triggers, the most common triggers of actual pulling were the feel of the hair (eg, coarse, kinky, or out-of-place hairs) (60%; n = 30), stress (34%; n = 17), and the sight of a hair (22%; n = 11). Most patients (n = 37; 74%) pulled from multiple sites: 33 (66%) pulled from their heads, 30 (60%) from their eyebrows, 25 (50%) from their eyelashes, and 7 (14%) from their pubic area. Twelve patients (24%) pulled without complete conscious awareness. Ten patients (20%) reported ingesting at least part of the hair (ie, root or shaft) after pulling. Seven patients (14%) reported pulling the hair of someone else in addition to their own. Of the 50 patients, 31 (62%) had never sought outpatient mental health treatment for hair pulling.
Although individuals with current bipolar, psychotic, and substance use disorders were excluded, 30 enrolled patients (60%) reported at least 1 clinically important current comorbid disorder: 14 (28%) reported symptoms consistent with major depressive disorder, 14 (28%) had an anxiety disorder (eg, generalized anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, or anxiety disorder not otherwise specified), 18 (36%) had another impulse control disorder (most commonly pathologic skin picking and compulsive nail biting), and 1 (2%) had an eating disorder (ie, bulimia nervosa). Rates of comorbid disorders did not differ between treatment groups, and no particular comorbid disorder was associated with treatment response.
Of the 50 patients, 4 (8%) had ongoing psychotherapy and 28 (56%) were taking a psychotropic medication. Of the 4 patients undergoing psychotherapy, all had been with the same therapist for at least 1 year, and no one was receiving cognitive behavior therapy (when efficacy analyses were performed without these 4 patients, the results were the same). Of the 28 patients taking medication, all had been taking stable doses for at least 6 months: 18 were taking a selective serotonin reuptake inhibitor, 8 were taking a serotonin-norepinephrine reuptake inhibitor, and 2 were taking a stimulant. Rates of psychotropic medication use did not differ between the treatment groups (64% of the placebo group and 48% of the N-acetylcysteine group; χ21 = 1.299; P = .25), and no particular medication was associated with treatment response.
The institutional review board of the University of Minnesota approved the study and the informed consent. One of 2 investigators (J.E.G. or S.W.K.) discussed potential risks of the study, as well as alternative treatments, with the patients. After having received a complete description of the study, patients provided written informed consent. This study was performed in accordance with the Declaration of Helsinki. Data were collected between September 1, 2006, and August 1, 2008.
After screening, eligible patients were assigned to 12 weeks of double-blind N-acetylcysteine or placebo therapy. The investigational pharmacy of the University of Minnesota randomized all the patients (in block sizes of 8 using computer-generated randomization with no clinical information) to either N-acetylcysteine or placebo in a 1:1 manner. All eligible study participants were first given N-acetylcysteine, 1200 mg/d, or matching placebo for 6 weeks. At week 6, the dose was increased to 2400 mg/d (or the same number of matching placebo pills) for the remaining 6 weeks of the study. Dose range selection was based on safety and efficacy data from studies using N-acetylcysteine in human immunodeficiency virus, cocaine dependence, and other impulse control disorders, such as pathologic gambling.29-31 At week 6, the dose was increased unless clinical improvement (ie, cessation of all hair pulling for the entire 3-week period as assessed by the investigator) was attained at a lower dose. Twenty-two patients (88%) in the placebo group received the dose increase, whereas 18 (72%) assigned to N-acetylcysteine received a dose increase (χ21 = 2.000; P = .16). Given the lack of difference between groups in terms of dose increase, change in dose would be unlikely to have affected the masking. Patients who were not compliant with their use of study medication (ie, who failed to take medication for ≥3 consecutive days) were discontinued from the study. Patients were asked at each visit about the number of doses missed per week. Forty-four patients reported never missing a dose, and 6 reported missing at most 1 or 2 doses each month.
Patients were evaluated at study entry using the Trichotillomania Diagnostic Interview, a reliable and valid diagnostic instrument that uses the DSM-IV criteria for trichotillomania.27 Demographics and clinical features of trichotillomania were assessed by the use of a semistructured interview. The ethnicity of patients in the study was defined by self-report and was included to learn more about this variable in trichotillomania. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV.32 Medical history, physical examination, and routine laboratory testing were performed. Patients reported the severity of trichotillomania symptoms using the self-rated Massachusetts General Hospital Hair Pulling Scale (MGH-HPS).33 Investigators assessed trichotillomania symptoms by the use of the physician-administered Psychiatric Institute Trichotillomania Scale (PITS).34 Anxiety symptom severity was rated using the Hamilton Anxiety Rating Scale (HAM-A).35 Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAM-D).36 Psychosocial functioning was evaluated using the self-report version of the Sheehan Disability Scale (SDS),37 and quality of life was evaluated using the Quality of Life Inventory.38
Patients were seen every 3 weeks for 12 weeks. Whichever investigator (J.E.G. or S.W.K.) did not see a particular patient at baseline conducted the progress evaluations for that patient. The primary outcome measure was the MGH-HPS.33 The MGH-HPS is a 7-item self-report scale that rates urges to pull hair, actual amount of pulling, perceived control over the behavior, and distress associated with hair pulling in the past 7 days on a severity scale from 0 to 4 for each item (total scores range from 0 to 28, with higher scores reflecting greater illness severity). The MGH-HPS has demonstrated excellent test-retest reliability, convergent and divergent validity, and sensitivity to change.39 Analysis of the MGH-HPS has demonstrated 2 separate factors, with acceptable reliability for both: "severity" and "resistance and control."40 Separate treatment effects for these 2 factors were also analyzed.
Secondary measures used at each study visit included the following:
The PITS.34 This is a 6-item physician-administered scale that rates hair-pulling symptoms during the past week. The items assess number of hair-pulling sites, time spent pulling and thinking about pulling, resistance to hair-pulling urges, distress, and interference with daily activities. Items are rated from 0 to 7, with higher scores a reflection of greater severity and total scores ranging from 0 to 42. Although the psychometric properties of the PITS have not been well established,41,42 as 1 of the few physician-rated instruments for trichotillomania, it has shown strong correlation with the MGH-HPS (r = 0.63).39
The Clinical Global Impression (CGI) scale.44 This scale consists of a reliable and valid 7-item Likert scale used to assess the severity and improvement of clinical symptoms. The CGI severity scale was used at each visit and ranges from 1 ("not ill at all") to 7 ("among the most extremely ill"). The CGI improvement scale was used at each follow-up visit and ranges from 1 ("very much improved") to 7 ("very much worse"). The CGI scale was used to refer specifically to trichotillomania symptoms and not to the overall psychopathologic condition.
The SDS.37 This reliable, valid 3-item self-report scale assesses functioning in 3 areas of life: work, social or leisure activities, and home and family life. Scores on the SDS range from 0 to 30.
A secondary measure used only at baseline and the study end point was the Quality of Life Inventory.37 This inventory is a valid and reliable 16-item self-administered rating scale that assesses life domains such as health, work, recreation, friendships, love relationships, home, self-esteem, and standard of living.
The HAM-A and the HAM-D. The HAM-A35 is a reliable and valid physician-administered 14-item scale that provides a total measure of overall anxiety. The HAM-D36 is a valid and reliable 17-item physician-administered rating scale that assesses the severity of depressive symptoms.
Safety assessments at each visit included evaluations of sitting blood pressure, heart rate, and weight. Adverse effects were documented and included time of onset and resolution, severity, action taken, and outcome. Common adverse effects of N-acetylcysteine therapy include headache, pruritus, flatulence, increased blood pressure, and fatigue. The investigator recorded the use of concomitant medications in terms of daily dosage, start and stop dates, and reason for use.
Demographic and baseline visit characteristics of the N-acetylcysteine and placebo groups were compared using χ2 and t tests to determine whether group differences existed at randomization. Differences in response between the placebo and N-acetylcysteine groups were adjusted for baseline disparities by use of the baseline score as a covariate.
Primary and secondary measures were examined using analysis of variance modeling analyses (UNIANOVA, SPSS for Windows version 15.0; SPSS Inc, Chicago, Illinois). The baseline value of the measure being analyzed was used as a covariate. The difference in the overall level of posttreatment values, the main effect for treatment, was the test of primary interest. Analyses were performed on all available data by the use of an intention-to-treat population (last observation carried forward). All patients who returned for at least 1 postrandomization visit were included in the intention-to-treat population. Because 7 dependent variables were being examined, a Bonferroni correction was used; tests were 2-tailed, and α = .007 (0.05 / 7 = .007) was used to determine statistical significance.
A retrospective power analysis was performed using a bootstrap approach.43 A total of 10 000 repeated sampling iterations were performed, and significance at P = .007 was achieved in 99.9% of the 2-level active-placebo dichotomy using the primary outcome measure (the MGH-HPS). These results indicate that the significant findings reported are not likely to be based on chance.
Effect sizes were also calculated using the Cohen effect size index d. A d of 0.2 is considered a small effect size, 0.5 is medium, and 0.8 is large. Partial eta squared (η2), which is the proportion of the effect + error variance that is attributable to the effect, was calculated. Interpretation of η2 is that greater than 0.2 is a large effect size, greater than 0.1 is a medium effect size, and greater than 0.05 is a small effect size.
Clinically significant change was determined using the approach developed by Jacobson and Truax.45 The CGI severity scale was used to assess clinically significant change after treatment. For someone to have a clinically significant change, his or her final CGI severity score had to be less than the cutoff score, and his or her change from baseline had to be greater than the reliable change index.
Demographics and clinical characteristics of the patients at baseline are given in Table 1 and Table 2. There were no statistically significant imbalances regarding demographics or baseline trichotillomania symptoms between treatment groups. Baseline trichotillomania scores on both the MGH-HPS and the PITS were consistent with severity scores seen in other studies of trichotillomania.46 In addition, overall baseline psychosocial dysfunction, according to the SDS, was mild, and quality of life was assessed in the "low average" range, both of which are consistent with assessments made in other studies.3 Although some of the baseline scores on the MGH-HPS were in the low range at baseline, the low scorers did not experience a floor effect for symptom change during treatment. In the placebo group, only 2 patients had a minimum score on a single item, and at the end point neither of these patients had a minimum score on any item. In the N-acetylcysteine group, only 1 patient had a minimum item score, and at the end point, this patient also had a minimum score on each of 4 items.
Figure 1 shows the patient disposition throughout the study. Twenty-two of 25 patients (88%) assigned to receive N-acetylcysteine and 22 of 25 patients (88%) assigned to receive placebo completed the 12-week trial. There were no statistically significant pretreatment differences between completers and noncompleters on any measures. The rate of study completion did not differ between treatment groups. Of the 6 patients who did not complete the study, 1 withdrew for health concerns unrelated to the study and 5 withdrew because of an inability to comply with the study schedule. Reasons for study withdrawal did not significantly differ between groups.
Significantly better results on the primary efficacy variable, the MGH-HPS total score, were observed for patients assigned to receive N-acetylcysteine by the study end point (F1,47 = 32.152; P < .001) (Table 2). A significant treatment effect was first detected after 9 weeks of active medication use (P = .002) (Figure 2). In terms of the 2 factors of the MGH-HPS, those assigned to the N-acetylcysteine group demonstrated significant improvement on the severity subscale (F1,47 = 18.245) and on the resistance and control subscale (F1,47 = 37.067; P < .001 for both) (Table 2). The PITS scores were consistent with the MGH-HPS total scores, and the difference between groups on the PITS was significant at the study end point (F1,47 = 12.03; P = .001) (Table 2).
The CGI improvement scale score also demonstrated significant improvement by the study end point. Of patients assigned to the N-acetylcysteine group, 56% were "much" or "very much" improved by the study end point compared with 16% of those taking placebo (χ21 = 8.681; P = .003) (Figure 3). Of patients assigned to receive N-acetylcysteine, 44% (n = 11) had a 50% or greater reduction on the MGH-HPS compared with 0% in the placebo group (χ21 = 14.103; P < .001). Of those who were "much" or very much" improved at the end point according to CGI scale score, a significantly larger percentage reported a 50% reduction in the MGH-HPS score compared with those who were not responders according to CGI scale scores (χ21 = 12.850; P < .001).
Patients assigned to receive N-acetylcysteine, however, did not demonstrate greater response with respect to psychosocial functioning. Although functioning and quality of life improved to a greater numerical extent for those assigned to the N-acetylcysteine group, neither the SDS total score (F1,47 = 2.683; P = .11) nor the Quality of Life Inventory score (F1,47 = 1.337; P = .25) demonstrated a significant difference between the 2 groups (Table 2).
Clinically significant change was calculated for the CGI severity scale. Patients with a CGI severity scale posttreatment score lower than 3 and a change from baseline of at least 2 points achieved a clinically significant change. Clinically significant change was seen in 11 (44%) patients assigned to the N-acetylcysteine group and in 1 (4%) of those assigned to the placebo group (Pearson χ21 = 10.965; P = .001).
Analyses performed on the subset of 44 patients who completed the study demonstrated significant reductions on all measures consistent with the intention-to-treat analyses.
Analysis of baseline variables demonstrated no significant moderators of treatment effect. Preexisting medication status, age, sex, age at trichotillomania onset, education, psychiatric comorbidity, previous treatment history, baseline trichotillomania severity, and psychosocial functioning measures were not statistically significantly correlated with treatment response. In addition, there were no differences in treatment response between patients who met the full DSM-IV diagnostic criteria for trichotillomania compared with those who did not.
There were no reported adverse experiences in patients who received N-acetylcysteine (Table 3). The few adverse experiences were of mild intensity and were reported only by those taking placebo. There were no statistically significant differences in the incidence of adverse events between groups. Mean HAM-D and HAM-A scores remained low throughout the study in both treatment groups (Table 2). No patient reported any subtle physiologic or mood changes that would have allowed him or her to suspect the condition to which they were assigned.
This randomized, double-blind, clinical trial indicates that N-acetylcysteine is safe and more effective than placebo for the treatment of trichotillomania. N-acetylcysteine was effective for trichotillomania on the primary and secondary outcome measures as assessed by physician and patient ratings, with medium to large effect sizes. The beneficial effects of N-acetylcysteine use were seen within 9 weeks of treatment initiation, and this result is consistent with those of previous studies that have found N-acetylcysteine therapy to be effective within days (3 days for the reduction of cocaine urges)47 to a few weeks (8 weeks for gambling behavior).29N-acetylcysteine is an amino acid, is available in health-food stores, is cheaper than most insurance copayments, and seems to be well tolerated. N-acetylcysteine could be an effective treatment option for people with trichotillomania.
Patients assigned to receive N-acetylcysteine experienced a mean reduction (improvement) of 40.9% on the primary outcome measure (ie, MGH-HPS), and a responder rate of 56% (ie, "much" or "very much" improved on the CGI by the study end point). Although a variety of outcome measures have been used in previous studies, when we compare the present results with those of previous studies we find that the percentage reduction in the MGH-HPS score in this study is higher than that seen with medications (8.4%),48 is similar to that reported for combined treatment (medications plus cognitive behavior therapy: 41.5%),46 and is within the range of improvement reported for cognitive behavior therapy alone (34.8%-66.4% reduction in the MGH-HPS score).49,50,57 These findings suggest that N-acetylcysteine compares favorably with existing treatment options available to physicians.
The efficacy of N-acetylcysteine in this study lends further support to the hypothesis that pharmacologic manipulation of the glutamate system (in the nucleus accumbens) may target core symptoms of compulsive behaviors. Pharmacotherapies that target the prefrontal glutamatergic drive to the nucleus accumbens,25 such as N-acetylcysteine, may, therefore, correct the underlying pathophysiologic abnormalities and symptoms of trichotillomania. In addition, N-acetylcysteine increases cysteine and glutathione levels in glial cells.51 Through its effects on glial functioning, N-acetylcysteine may be protective to glial cell functioning during hyperglutamatergic states and may enhance the glial uptake of glutamate by excitatory amino acid transporters.52 Because glial cells are primarily responsible for the clearance of glutamate from the synapse,53 this may be important for understanding the glutamate-modulating effects of N-acetylcysteine.
Although N-acetylcysteine may be a promising treatment for trichotillomania, previous pharmacologic studies9 in trichotillomania have shown that particular treatments have not been effective for all individuals with trichotillomania. In the present study, 44% of patients treated with N-acetylcysteine did not respond. These results may reflect a failure to recognize the heterogeneity of individuals with trichotillomania and how that heterogeneity may necessitate individually tailored treatment approaches.15 Recent research54 has suggested that the obsessive-compulsive spectrum disorders may have various clusters that cohere based on clinical and possibly genetic grounds. Other trichotillomania research55 has suggested that automatic compared with focused pulling, and the degree of each type of pulling, may reflect meaningful differences in terms of clinical presentation, comorbid psychiatric disorders, neuropathophysiologic abnormalities, and treatment response. Although not examined in this study, differences in hair-pulling styles may also help identify subtypes of trichotillomania that respond differentially to N-acetylcysteine. Further research that examines various abnormalities of the impulsive-compulsive neurocircuitry may, therefore, result in the definition of a subtype of trichotillomania that is more likely to respond to glutamatergic agents, such as N-acetylcysteine, and a different trichotillomania subtype that may respond preferentially to serotonergic agents.15 Although these notions remain speculative and require additional research to examine their appropriateness, one future direction for the treatment of trichotillomania may be to better define subtypes of trichotillomania (using clinical symptoms, cognitive testing, neuroimaging, and pharmacogenetics) to guide pharmacologic treatment selection.
Although there were numerically greater improvements in the functional and quality-of-life measures in this study for N-acetylcysteine compared with placebo, we did not find statistically significant improvement for patients taking N-acetylcysteine. The only previous trichotillomania study46 that examined this question also found that neither cognitive behavior therapy nor medication use resulted in improved quality of life during an acute 12-week treatment trial. One possible explanation for the present findings might be the baseline scores. The patients in this study began with only mild functional impairment and a low-average quality of life. Given the limited range for improvement in these scales, it may not have been possible to see statistically significant improvement with the present sample size. Another explanation could be that the functional impairment and quality of life seen in patients with trichotillomania have more to do with the consequences of the pulling (eg, bald spots) than with the pulling itself. Because symptom improvement may occur many weeks before hair grows back, functional impairment and quality of life might be more relevant if measured after several months of symptom improvement. Finally, given that the Cohen d point estimate for the SDS was approaching a medium effect size, the nonsignificant findings for change in functional impairment might be due to low power for this measure (a bootstrap power analysis for the SDS resulted in an estimated power of 35.6% for P < .05).
This study represents, to our knowledge, the first trial of a glutamatergic agent in trichotillomania, but there exist several limitations. First, trichotillomania seems to be a chronic disease that may require long-term therapy. By design, this study did not assess treatment effects beyond the 12-week treatment period, and the longer-term effects of N-acetylcysteine therapy require further evaluation. It is possible that a longer course of therapy could result in continued and even greater reductions in trichotillomania symptoms. Second, this study did not include behavioral therapy. Cognitive behavior therapy has shown benefit for trichotillomania9,56,57 and should be considered in conjunction with pharmacotherapies. Finally, we have not yet examined the optimal N-acetylcysteine dose, and whether some patients would have responded to higher doses needs to be examined.
This investigation suggests that N-acetylcysteine may be effective in the acute treatment of trichotillomania. As effective treatments for hair pulling emerge, it becomes increasingly important that physicians and mental health care providers screen for trichotillomania to provide timely treatment.
Correspondence: Jon E. Grant, JD, MD, MPH, University of Minnesota School of Medicine, Department of Psychiatry, 2450 Riverside Ave, Minneapolis, MN 55454 (firstname.lastname@example.com).
Submitted for Publication: August 26, 2008; final revision received November 19, 2008; accepted November 25, 2008.
Financial Disclosure: Dr Grant has received research grants from the National Institute of Mental Health, Forest Pharmaceuticals, GlaxoSmithKline, and Somaxon Pharmaceuticals; has been a consultant to Pfizer Pharmaceuticals and Somaxon Pharmaceuticals; and has consulted for law offices as an expert regarding impulse control disorders.


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Genesis Rehabilitation Services (GRS) is the leading provider of physical therapy, occupational therapy, speech therapy, respiratory therapy and wellness services for the older adult population. As one of the largest and strongest rehab organizations in the country, GRS partners with skilled nursing facilities, assisted living facilities, independent living facilities, hospitals, home health companies, adult day care programs and outpatient clinics to provide comprehensive therapy services.
Genesis Rehabilitation Services
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(800) 728-8808
Genesis Rehabilitation Services
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International Myeloma Foundation
The cooperation between the Slovak myeloma society (SMyS) and the International Myeloma Foundation (IMF) is developing very well. World experts are interested in participating in important fora of SMyS, and to share their new knowledge with our experts.
The Slovak myeloma society would like to continue this trend. Mgr. Soňa Kráľová and MUDr. Zdenka Štefániková will be leading this effort. Contact for MUDr. Štefániková is email@example.com.
Patient Meetings Across Europe
About IMF
Founded in 1990, the International Myeloma Foundation (IMF) is the first and largest myeloma-specific charity in the world. With more than 450,000 members in 140 countries, the IMF serves myeloma patients, family members, and the medical community. The IMF provides a wide range of programs in the areas of Research, Education, Support, and Advocacy.
RESEARCH The signature project of the IMF's Research division is the Black Swan Research Initiative®, a groundbreaking and collaborative effort to develop the first definitive cure for myeloma. Each year the IMF also awards Brian D. Novis Grants, which promote research for better treatments, management, and practices in the myeloma field. In addition, 200 leading myeloma researchers around the world comprise the IMF's International Myeloma Working Group, a research body that has developed guidelines to treat myeloma patients that are followed around the world. Finally, the Nurse Leadership Board (NLB), made up of nurses from leading myeloma treatment centers, develops recommendations for the nursing care of myeloma patients.
EDUCATION The IMF Patient & Family Seminars, Medical Center Workshops, and Regional Community Workshops are held around the world. These meetings provide up-to-date information presented by leading myeloma specialists and researchers directly to myeloma patients and their families. The IMF Library of more than 100 publications, for patients and caregivers as well as for healthcare professionals, is updated annually and available free of charge. Publications are available in more than 20 languages.
SUPPORT Our toll-free InfoLine at 800-452-CURE (2873) is staffed by coordinators who answer questions and provide support and information via phone and email to thousands of families each year. The IMF sustains a network of more than 150 support groups and offers training for the hundreds of dedicated patients, caregivers, and nurses who volunteer to lead these groups in their communities.
ADVOCACY The IMF Advocacy program trains and supports concerned individuals to advocate on health issues that affect the myeloma community. Working in the US at both the state and federal level, the IMF leads two coalitions to advocate for parity in insurance coverage. The IMF Global Myeloma Action Network works to help gain treatment access for patients around the world. Thousands of IMF-trained advocates make a positive impact each year on issues critical to the myeloma community.
Learn more about the way the IMF is helping to improve the quality of life of myeloma patients while working toward prevention and a cure. Contact us at 800-452-CURE (2873) in the US or 818-487-7455 worldwide, or visit myeloma.org.


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Government investigators have found that JPMorgan Chase devised "manipulative schemes" that transformed "money-losing power plants into powerful profit centers," and that one of its most senior executives gave "false and misleading statements" under oath.
The findings appear in a confidential government document, reviewed by The New York Times, that was sent to the bank in March, warning of a potential crackdown by the regulator of the nation's energy markets.
The possible action comes amid showdowns with other agencies. One of the bank's chief regulators, the Office of the Comptroller of the Currency, is weighing new enforcement actions against JPMorgan over the way the bank collected credit card debt and its possible failure to alert authorities to suspicions about Bernard L. Madoff, according to people who were not authorized to discuss the cases publicly.
Read the rest here at NYTimes.com.


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I wonder if I've lost so much money that it's too late to move everything. I'm afraid to even look at my IRA.
Last year I wrote an article about how I used my Vanguard Tax Exempt Money Market Fund as a high yield checkings account, and this week I suddenly got quite a few hits for that article. So I wondered why that was and found that the yield for the tax exempt money market funds have shot up significantly.
The underlying investments for tax exempt money market funds are municipal short term debt also known as "munis". These are short term bonds or debt notes issued by local governments to build things like schools and libraries. The money earned from these munis are exempt from all federal taxes and also the state taxes of the locale where it is issued. Usually, the money market funds that invest in these short term debts have lower yields than their taxable counterparts since investors get a higher tax equivalent yield. However, the current situation is quite unusual and the yields have turned upside down. For example, the Vanguard California Tax-Exempt Money Market Fund's current yield is 4.66%, and that is nearly twice of the yield of the Vanguard Prime Money Market Fund. Since the California Tax-Exempt Money Market Fund's returns are not subject to state or federal taxes, 4.66% is equivalent to a taxable rate of more than 7% for someone in the 28% federal and 9.3% state tax brackets. A better deal is in the Vanguard Pennsylvania Tax-Exempt Money Market Fund, which has a yield of 5.44% and equates to a pre-tax yield of more than 8% for some Pennsylvanians. Needless to say, these yields are extremely high for tax exempt money market funds.
Why is this happening? This situation is so unusual that Vanguard actually wrote an entire article explaining it . The basic gist of the article is that since credit is tightening, municipal bond issuers have found that they need to increase their yields to attract investors. Since Vanguard simply follows the market, they are getting better yields.
Are these investments safe? Generally money market funds maintain their share values at $1.00 each, but recently we have seen a couple money market funds "break the buck" . Even so, municipal debts are generally considered to be safe investments since they are backed by local governments and their tax bases. Of course, local governments can go bankrupt so there is definitely a risk of default, but tax exempt money market funds generally have a portfolio of many different bonds from a collection of governments, so their risk is lower.
Finally, money market yields change everyday so no one knows how long these high yields will last. However, since money market funds are as liquid as cash, you can always move your money when the yields go down. For now, I really cannot find another "safe" investment vehicle that pays as high as these funds.
Disclosure: I own the Vanguard California Tax-Exempt Money Market Fund (VCTXX) and the Vanguard Prime Money Market Fund (VMMXX)
Disclaimer: The links and mentions on this site may be affiliate links. But they do not affect the actual opinions and recommendations of the authors.
Wise Bread is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.
I wonder if I've lost so much money that it's too late to move everything. I'm afraid to even look at my IRA.
I was looking for something just like this. Any ideas on the brokerage fees associated with these types of accounts?
There is no fee at Vanguard or Fidelity to open a regular account I believe. There are expense ratios on the funds and minimum investments. The expense ratios on these funds are pretty low at Vanguard.
I'm not a credit rating expert, but just wanted to reinforce your point, Xin, that the market is discounting muni bond issuers as being increasingly risky. Inversion of yields is interesting, but suspect. Most state governments are just as fiscally irresponsible as the federal good ol' boys, but with far less resources under their command.
Definitely a great suggestion and something to look into further!
The muni market is in disarray, if you google it you will get discussions about the Auction Rate Securities which are Munis. There were all sorts of reports in the media this past year about being told this was as safe as cash and then when they need the money, they cannot get it out because the muni credit market is locked up. Certian funds (not Vanguard) were unable to redeem mutual fund shares either for periods as long as a month. The other side is munis depend on tax revenue and there will be shirtfalls soon
Risk and reward are supposed to coorelate, if you are getting a higher rate then you are presumably taking on more risk
There is a high yield money market account that is available at http://www.unionfsb.com/ that pays 3.75%.
Great suggestions and I just moved my cash reserves into the Vanguard Tax-Exempt Money Market fund (VMSXX) that is currently yielding 5.84% - far above money market averages and with an industry bottom 0.17% management expense ratio. If you're in the 25% tax bracket, the return on this fund is equivalent of a taxable 7.7% APY! Can't get that anywhere else in the market right now!


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That's because you haven't made a post yet!
The board is set to only list members in the membership list after they make a minimum of one post. Why? Primarily because it helps prevent spam registrations where the spammer or spambot registers and tries to post a link to a website, which may have embedded malicious code, host pornography, be a spoof 'phishing' site trying to get your passwords, financial information, etc.
Most spammers and spambots register and try to insert a web link into their profile as their sole goal, and then never will return and don't actually make any posts, so this keeps a potentially risky website link from being visible -- or worse, clicked on by board members.
The spam protections on the board are already quite rigorous -- that's why you are asked an extra spelling question on registration, and then, why you need to return your validation email for me to manually activate your account. So this is just an extra, final layer of protection.
A second reason is that I don't think there's much point in showing member profiles for people who aren't minimally active as no one would be likely to look at their profile anyway. This way, the members who appear in the profile listings are the ones who are or have been active members.


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For Children of Teen Parents, Most Injuries Due to Falls: Study
Researchers at UT Southwestern Medical Center and Children's Medical Center looked at the causes and types of injuries suffered by children of teen parents. The study included 764 patients younger than age 7 who were treated in the emergency department between 2009 and 2011.
The most common causes of injuries were falls (45 percent) and ingested objects (9 percent). The most common types of injuries were bruising/skin marks (49 percent) and fractures (17 percent).
During the study period, the number of dislocations -- all of which were in the elbow and caused by pulling on an outstretched arm or picking up a child by means other than under the arms -- increased from 4 percent to 7.7 percent. The proportion of head injuries rose from 1 percent to 5.6 percent.
The study appears in the current issue of the Journal of Pediatrics.
The number of children born to teen parents in the United States has decreased since the 1990s, but these children are at increased risk for accidental and abuse-related injuries, according to a journal news release. This higher risk may be due to the fact that many teen parents are poor, uneducated and lack the necessary supervision and safety skills.
In the new study, 93 percent of the injuries were unintentional or likely unintentional. Children with intentional injuries had higher rates of hospital admission, head injuries, multiple injuries and death.
"Injury prevention efforts for teenage parents should be devoted to preventing falls and foreign body ingestions," study author Brian Robertson said in the news release.
These programs should help teenage parents improve their parental supervision skills and learn how to make their homes safer by identifying and correcting injury hazards.
More information
The U.S. Centers for Disease Control and Prevention offers child injury prevention tips.
Student alleges attack at school ... Newsday investigation into LI teacher misconduct ... Fancy vending machine for cars
Student alleges attack at school ... Newsday investigation into LI teacher misconduct ... Fancy vending machine for cars


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I'm delighted to bring you another episode of the Adventures in Arting Podcast! Today's guest is Kelly Purkey:
Kelly is a graphic designer and scrapbooker living on the island of Manhattan. A former product designer & jack of all trades for American Crafts and Studio Calico…
…she recently launched a new boutique company under her name. Kelly Purkey stamps are now available in her shop and at Simon Says Stamp.
Kelly loves good meals, photobooths, and time with her friends.
On the podcast we discuss Kelly's career story, her new adventures — including an upcoming book — and food, of course!
Find Kelly online:
- Blog: www.kellypurkey.com
- Twitter + Instagram: @kellypurkey
- Facebook: https://www.facebook.com/kellypurkeyproducts
Thanks for stopping by!
Find the show on iTunes here.


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Master Bathroom RE-Paint Party
41 comments:
I love the cool colors throughout your home!ReplyDelete
I love that edger I get my painting done so muck quicker with it.ReplyDelete
Ha, I did the same thing. I bought a blue that I thought would be awesome, but it turned out to be a disaster, so like you, I had to start over. Funny thing is, I went with gray as well... Love your blog. Keep up the great work!ReplyDelete
Jessica @ Chapman Place
So much fun! Thanks for sharing, and wow your husband is such a good sport!ReplyDelete
I love that little paint edger thing-a-ma-jig tool too! I won't start a painting project unless I know I have it! The pads rinse out pretty good too!ReplyDelete
How do you get your hubby to be such a great sport! You are lucky!
Ha, ha, ha! The best part is Cason dancing when he doesn't know you're filming. That's it I am posting when we paint and put are carpet in. Too funny!ReplyDelete
EWWWW! I've wanted to paint my bedroom a color like this so thanks! :) LOVE YOUR STYLE SISTA!ReplyDelete
oooh! I love the color! Can I hire you two?! I love your style so much!ReplyDelete
Happy Halloween to the House of Smiths! Your girls look darling! Love the girly-girl bumble bee!
The color is fabulous!ReplyDelete
Aw, thanks for doing the captions! Y'all are sooo cute and I just still can not get over how cute the girls are! xoReplyDelete
Love the gray color! Grays are difficult, kinda like yellows and golds, ya never know til ya try it!ReplyDelete
You guys are a hoot!!!!! I had the same problem with gray... ended up going green! lol I am so ready for the "dream" boards!!!ReplyDelete
What a great video! :) We use the Shur-line tool too, but most likely because our house is almost 60 years old, we still end up with paint on the ceiling. :)ReplyDelete
When we built our house a few years ago, that cheap little edging tool from Shur-Line saved my sanity! I couldn't live without it :)ReplyDelete
Can I just say you are a brilliant blogger!! I LOVE you and your sweet family and I totally think we were sisters in another life. What an inspiration you are.....you and that gorgeous house!! Someday I'm going to Beadboard my ceiling...thank you Cason...oops I mean Shelley. Keep it comin' you perky People!!ReplyDelete
Love this color! We painted our 1/2 bath this color!!ReplyDelete
I like it! I use those edgers all the time. I also use A LOT of baby wipes. They are perfect to roll the wheels of the edger over to make sure all the paint is off them and for cleaning up little 'oops' spots on the wall quickly.ReplyDelete
FYI: FROG TAPE is worth every penny! I just tried it on my blue wall and I will never use anything else... just a tip you know, for your NEXT AmAzInG project!ReplyDelete
I agree! That little paint tool is my favorite painting tool of all time. Love it!ReplyDelete
Love that new color Shelley!! I finally got my cool vinyl on my mixer and will take pictures in the morning and post them :)
This week is kicking my butt. I am ready for Halloween to be over already. Have a fun weekend!!
Love the color & your blog!! Where did you get the green & white rug in your picture? I love it!!ReplyDelete
It's amazing how you can make a video about painting a bathroom so entertaining! Pahaha! Thanks so much!ReplyDelete
You guys are so fun and creative! I love seeing all the projects you have done/or are doing! My hubbie and I tackle alot of projects like you guys, and it is fun to see how you show it on your blog! Out blog is more just a family blog, but you can check it out--www.chapmanchannel.blogspot.com, and see we are!ReplyDelete
- AnonymousOctober 30, 2010 at 8:14 AM
You mentioned you used Glidden paint, how do you like it? I went to Wal-Mart to get a can of Kiltz paint and the lady there said that Wal-mart was not going to be selling Kiltz anymore, that Glidden was going to take its place. By the way, I love the color you chose!!ReplyDelete
Such a cute video! I am on my way to get that edger thingy!ReplyDelete
I swear by the Shur-Line Paint Edger too! Ah-mazing! I loved the helpful man at Lowe's who told me to paint the paint on the the edger with a brush, then edge. Genius!ReplyDelete
OK, I totally love that you guys are having a dance party while doing home makeover projects. You guys rock! I can't wait to see what it looks like.ReplyDelete
Love your new room , you are so creative. Could you do a tutorial on making those little movies, they are so fun.ReplyDelete
I never watch videos online, but I watched yours. Darling! You and your fabulous hubby are a great team. Thanks for making me smile! :) Hope the bathroom turns out super-terrific!!ReplyDelete
It will look great no matter what color you use! But love the grey. . . and there is so much personality in that household I don't know how you handle it!:) Oh, by the way the littlest girl looks just like her Daddy! Wow! Cute, cute family.ReplyDelete
Awesome!!! i know weird question...but where did you get your bedding? I've been looking for the perfect bedding and i love yours...where do i get it?ReplyDelete
Thanks for a good laugh! Love you guys!ReplyDelete
Ok! I'm off to get one of those Shur-Line tools tonight! We're currently painting our sons room, and then it's on to the master bedroom... And we can use all the help we can get!ReplyDelete
We love your lovely blog, and so we nominate you for the "Lovely Award"!!!ReplyDelete
Visit our blog for details!
I love the new color! Grey is the best. We're in a rental with peachy pinky off-white walls. BLEGH. Not my favorite.ReplyDelete
BTW, it was great to meet you at the DownEast Home event! You're so rad. I can't wait to see what you do with your mirror! Oh, and P.S. thanks SO much for the ride home!!
Love your new color! Can I just copy you room for room? Or better yet, will you come and do my house when you get yours done?? Pretty please...ReplyDelete
Hi Shelley! Can I just say that your advice on the Shur-Line tool just about changed my life? Ha! Ok not really but it sure has made painting my kitchen/dining room/breakfast room a whole lot easier. THANK YOU for sharing! I'm absolutely giving you a shout out on my blog for this one :)ReplyDelete
I heart your blog. And your style. Where did you get that darling rug in your bathroom? PLease share!ReplyDelete
- AnonymousNovember 3, 2010 at 3:01 PM
What do you use to video? Your phone or a small video camera? We're needing one for school projects and we've only borrowed someone's flip video camera. Thanks!ReplyDelete
Beth Stephenson
Just thought I would say thank you, from my sister, for mentioning the sureline thing. Saved her life. She is painting her whole rental house and is 7 months pregnant. Beats taping. Thanks again.ReplyDelete
Is it totally creepy to say I want your bed? I love it so.ReplyDelete
The bathroom looks great. I have been wanting to do gray. You've inspired me to...well think about it anyway. :)
I love your blog! (Like love it so much I stalk it 3 times a day! lol) Thanks for all of the great inspirations! You've now made me want to RE-decorate my whole house! ;-)ReplyDelete
Thank you for taking the time to leave your thoughts and comments. We truly love and appreciate each one!


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The Alpha Proton X-Ray Spectrometer on the rover measured the compositions of nine rocks. The silicon content of some of the rocks is much higher than that of the martian meteorites, our only other samples of Mars. The martian meteorites are all mafic and ultramafic igneous rocks, volcanic and intrusive rocks that are relatively low in silicon and high in iron and magnesium. Such rocks would be expected to form by partial melting of the upper mantle of Mars. The melt rises up though the crust and solidifies at or near the surface. The mafic volcanic martian meteorites, referred to as basalts, are the most common rock on Earth and have also been found on the Moon. Based on the composition of the martian meteorites and the presence of plains and mountains that look like features produced by basaltic volcanism on Earth, geologists expected to find primarily basalts on Mars.
The rocks analyzed by Pathfinder, however, are not basalts. If they are volcanic as suggested by their pitted surface texture, presumably formed when gases trapped during cooling left small holes in the rock their silicon content classifies them as andesites. One way that andesites can form is when a basaltic melt from the mantle intrudes deep within the crust. Crystals rich in iron and magnesium form and are separated from the melt, leaving a more silicon-rich melt that erupts onto the surface. The andesites were a great surprise, but because we do not know where these rocks came from on the martian surface, we do not know the full implications of this discovery. If the andesites are representative of the highlands, they suggest that ancient crust on Mars is similar in composition to continental crust on Earth. This similiarity would be difficult to reconcile with the very different geologic histories of the two planets. Alternatively, the rocks could represent a minor fraction of high-silicon rocks on a predominately basaltic plain.
Intriguingly, not all the rocks appear to be volcanic. Some have lineations
that may be layers like those in terrestrial sedimentary rocks, which form
by deposition of smaller fragments of rocks in water. Indeed, rover images
show many rounded pebbles and cobbles on the ground. In addition, some larger
rocks have what look like embedded pebbles and shiny indentations, where
it looks as though rounded pebbles that were pressed into the rock during
its formation have fallen out, leaving holes. These rocks may be conglomerates
formed by flowing liquid water. The water would have rounded the pebbles
and deposited them in a sand, silt and clay matrix; the matrix was subsequently
compressed, forming a rock, and carried to its present location by the flood.
Because conglomerates require a long time to form, if these martian rocks
are conglomerates they suggest that liquid water was once stable and that
the climate was therefore warmer and wetter than at present. A possible
alternative explanation
for the bumpy textures is weathered lithic fragments and crystals in volcanic rocks.
Alpha Proton X-Ray Spectrometer (APXS)
Note: The compositions plotted in the following 5 figures have been superseded by the results presented in: Rieder, R., et al., 1997, The chemical composition of the Martian soil and rocks returned by the mobile Alpha Proton X-ray Spectrometer: Preliminary results from the X-ray mode, Science, 278: 1771-1774.
hap_1.jpg (full size)
In this diagram, preliminary Pathfinder APXS analyses of soils (yellow dots) extend the range of Viking soil analyses. The analysis of Yogi appears to be contaminated by dust adhering to the rock's surface. The rock composition can be estimated by subtracting a portion of dust; the resulting Yogi composition is very similar to that of Barnacle Bill (we assumed 50% dust having the composition of drift analysis A-5 and used a linear mixing model to subtract the dust which is only strictly valid if the dust, where present, is thicker than the APXS penetration depth). Barnacle Bill is also contaminated by dust, but to a lesser extent.
hap_2.jpg (full size)
APXS analyses of Martian soils are compared with Viking soil analyses. Each element is normalized to silicon in this diagram. The yellow boxes representing Viking data include all analyses and their analytical uncertainties reported by B.C. Clark and others (1982) Journal of Geophysical Research, vol. 87, p. 10,064. Although the first APXS soil analysis (A-2) was reported to be almost identical to Viking soils, ssubsequent analyses demonstrate some variability and a few significant differences from Viking analyses. Specifically, soils at the Pathfinder site generally have higher aluminum and magnesium, and lower iron, chlorine, and sulfur. Scooby Doo, which appears to be a sedimentary rock composed primarily of compacted soil, also exhibits a few chemical differences form the surrounding soils. Analysis A-5 represents a deposit of windblown dust (called drift), whereas the other soil analyses may be cemented materials.
hap_3.jpg (full size)
This diagram (preliminary X-ray data) illustrates chemical differences between terrestrial rocks and meteorites inferred to have been derived from Mars. The Martian meteorites (as well as Viking soil analyses) all plot to the left of the fields for Earth rocks. Pathfinder APXS analyses of rocks (stars) and soils (yellow dots) appear to plot in the gap between these previously defined fields, although they are similar to at least one basaltic meteorite. The other two stars represent the compositions of Barnacle Bill and Yogi. The analysis of Yogi appears to be contaminated by dust adhering to the rock's surface. The rock composition can be estimated by subtracting a portion of dust; the resulting Yogi composition is very similar to that of Barnacle Bill (we have assumed 50% dust having the composition of drift analysis A-5 and used a linear mixing model to subtract the dust which is only strictly valid if the dust, where present, is thicker than the APXS penetration depth). Barnacle Bill is also contaminated by dust, but to a lesser extent.
hap_4.jpg (full size)
The Pathfinder APXS chemical analyses of Barnacle Bill and Yogi (corrected for adhering dust) have been recast into plausible minerals using the CIPW norm calculation. If they are fully crystalline igneous rocks, both possibly consist of orthopyroxene (magnesium-iron silicate), feldspars (aluminum silicates of potassium, sodium, and calcium), quartz (silicon dioxide), and other minerals that include magnetite, ilmenite, iron sulfide, and calcium phosphate.
hap_5.jpg (full size)
This commonly used chemical classification for lavas shows that Barnacle Bill and Yogi (corrected for adhering dust) are distinct from basaltic Martian meteorites (shown as red squares). The Pathfinder APXS analyses have been corrected for the presence of a small amount of salt, and sulfur is assumed to be present as sulfide. These rocks plot in or near the field of andesites, a type of lava common at continental margins on the Earth. The preliminary data for alkalis are likely to represent upper limits, so refinement of these analyses could shift them to slightly lower Na2O + K2O and higher SiO2. We do not presently know whether these are igneous (crystallized from a melt), sedimentary (grains/fragments deposited by wind or water or precipitates), or metamorphic rocks (deformed).
The preliminary APXS results on Barnacle Bill, Yogi and soil!
|This image shows the location of Barnacle Bill rock (left of the Sojourner rover) and the approximate location of the full-resolution "multispectral spot" acquired on Barnacle Bill. Lossless (no compression) images were taken in all geology filters using the IMP camera to study in detail the variation of brightness in each filter, which provides information regarding the mineralogy of the material sampled. Spectra were extracted from several study regions (shown to the right of the high resolution view). The green area represents soil found behind the rock. Red patches represent brighter areas on the rock that are interpreted as accumulations of wind-blown dust found in small holes, or vesicles, on the rock. Blue patches represent darker rock faces not contaminated by a soil deposit. The spectra of these materials are shown in the accompanying figure.
Preliminary data acquired from the "multispectral spot" image sequence for Barnacle Bill rock. Images were acquired with no compression in all geology filters. Reflectance spectra (that is, the variation of brightness with wavelength, or color) are shown for background soil (green), soil-like deposits found on and within small holes in the rock (red), and dark portions of the rock face (blue). Comparison of the spectra of these three types of materials demonstrates that the rock has relatively homogeneous composition at the spatial resolution of the patches sampled (about 1-3 cm). That is, all soil-like deposit and rock face spectra cluster in both their overall brightness (reflectance) and shape of their reflectance curves. A more heterogeneous rock would show variable spectral characteristics across its face. Note that the spectra of the soil-like deposit is intermediate to that of the background soil and rock face spectra. This is consistent with the interpretation that the soil-like deposit is a relatively thin layer in which portions of the rock are also sampled within the patches selected.
Also shown are laboratory spectra of oxidized and unoxidized volcanic rocks from Earth. Scientists will compare spectra of terrestrial materials such as these to help determine the composition of the rocks observed at the landing site in combination with data returned by other instruments such as the APXS.
|In the foreground of each image is "Flat Top". Each frame was taken by the IMP camera using a different color filter. The color filters alter the appearance of the image. The red filter has enhanced both the textures of the rocks and the dust on the surface of "Flat Top".
|The Sojourner rover has successfully navigated the rear deployment ramp. This high resolution color image shows the front, left portion of the rover. The micron scale soil beneath the rover was the first specimen examined by the Alpha Proton X-Ray Spectrometer.
|This image shows the Sojourner rover in its traveling configuration. The rover has since stood up and driven onto the surface of Mars. The red rectangle represents the location of the spectral analysis performed by the Imager for Mars Pathfinder.
One of the first "multispectral spots" obtained by the IMP camera was of the Stripe Rock on Sol 4. A multispectral spot measurement obtains small images of a region of interest in all geology filters with no image compression. Stripe rock is of interest to Mars Pathfinder scientists because of a bright vertical stripe that appears on the center of the rock face. It was thought that this stripe might be an intruded vein of material of different composition than the surrounding rock.
The color image of this rock shows that the stripe is of similar color to the surrounding soils (see arrow). A detailed examination of the rock was conducted to extract preliminary reflectance spectra (that is, the variation of brightness with color) from nearby bright and dark soils, the stripe, and the surrounding rock. Although these data require further calibration (e.g., the lower reflectance at 965 nm is not reliable at this time), they do show that the general spectral characteristic of the stripe is quite similar to the nearby dark soil. This suggests that the "stripe" is actually an accumulation of soil deposited in a crack in the rock face.
Mars Pathfinder Mission


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The Dangers of Discontent, Part 1: The Rejection
Remember the story of how God fed the Israelites quail – tons of quail – in the wilderness? It takes up one chapter in the Bible but seems to be just another incident in the litany of complaints the Israelites brought against God and Moses.
How was it different from the other incidents? Why was God so angry? Why so many quail? The story almost raises more questions than it answers. Yet there are a few hints that create intrigue as to its deeper meaning. Contrary to my first impressions, I believe it holds some (almost) hidden lessons about God's mercy and desire to dwell with us and bless us. (more…)


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Happy New Year! I hope your Holidays were wonderful!
I read somewhere last week that saving money is one of the 3 most popular resolutions people make…and since I'm always trying to save money where I can, I thought I'd jot down some ways I save money while still being able to enjoy quilting.
Here are 5 simple ways you can spend less and quilt within your budget:
1. Don't read blogs or Instagram! I probably shouldn't tell you this since I'm a blogger…but it's 100% truth. How many times have you purchased something you saw on a blog or Instagram? Some of my best purchases have come from recommendations I saw on blogs/Instagram….but when I'm trying to save money and not spend (or want), it's best to take a break from sites that might tempt me. It's hard but a biggie!
2. Keep it simple. I have some fancy notions and fun tools…and I hardly ever touch them. Instead I use my good quality basic tools that have lasted me years. When you need to upgrade something…invest in a quality product that will last, and try to avoid buying the latest and greatest of everything! Here's my basics I can't live without:
- Sewing Machine – I have a Juki 2010 I bought last year, a Bernina 440QE I've had for 6 years, and a Bernina 1008 I received when I got married. I mostly use the Juki right now but all of them have different purposes. They have each been great, sturdy, machines I would recommend.
- 24″ x 36″ self healing cutting mat (or an 18″ x 24″ to save space!)
- 6″ x 24″ cutting ruler
- Rotary Cutter
- Fabric scissors, and thread snips (I go through these often so I buy good but inexpensive ones).
- Iron, spray bottle, and wide ironing board
- Curved safety pins, wide masking tape, and a Kwik Klip (can't live without!) for basting
3. Use what you've got. It's like the saying "Make do and Mend", use what you already have and use it up before you buy something new.
- Fabric: I have a lot of unused fabric sitting on my shelves…and sometimes instead of bringing me joy it brings me guilt! If you know you will regret not buying a new fabric line before it's gone, then do it…just make a plan to use it before the "next" new fabric line you have to have comes out! ;) Keep and use your scraps! Here and here are great posts about storing and saving scraps. Some of my favorite scrap projects can be found here, here, here, here, here, or here. Bonnie has TONS of great free ideas here.
- Batting: Save your batting scraps! When my pile of batting scraps gets big, I cut my scraps into a manageable size and straighten the edges, then I sew them together using a zig zag stitch. I sew my scraps together to make the size of a baby-crib quilt, and I use them in my baby quilts. You can save yourself an easy $10 or more by using scrap batting in a baby quilt. I also use my batting scraps to dust…they work so good! I buy my batting on a large roll when it's 50% and I have coupon for free shipping, so it's cheaper and lasts me a long time. Split if with a friend if that's way too much batting for you.
4. Use your fabric money wisely.
- Buy smaller cuts of fabric. I can't even tell you how many times I've purchased a half yard of a whole bunch of fabrics and used a 6″ strip from each half yard to make a quilt, and the rest of it sat on my shelf forever and ever. When I started quilting I only bought 1/4 yards, because I had a tiny budget, and loved a lot of fabrics. I also shopped in person (before online quilt shops!) so it was easier to buy smaller cuts. When you can, buy a smaller cut like 1/4 yards, or fat quarters with even more usable space. It's worth buying quality (quilt shop) fabric…as fabric from chain stores has much lower quality. When you find a sale, buy good quality basics that you can use over and over!
- Use more solids. I did a post on choosing and using solids here.
- Don't waste money on the back. Years ago after I made my first large Twin size quilt, I spent a whopping $68 dollars on the fabric for the backing. Do you know how many times I've looked at that backing since then? Twice…maybe? Was it worth $68 dollars? No way. I learned my lesson. Now I use 108″ wide backing yardage, regular yardage on sale, wide minky, or even cotton sheets. I spend more on backings for quilts I know we will use everyday, like quilts for our beds, and the throw on the couch.
5. Learn to quilt on your own sewing machine. I love love love having quilts quilted on a long arm (I've sent mine to Kathy for years, and I've also recently sent quilts to Kaitlyn, and Melissa), and having a great long arm quilter is invaluable, but also can get expensive if you make a lot of quilts. I try to quilt everything under a Twin myself. Lately a lot more of mine are long arm quilted because they are for shows or a quilt shop…but when it's just for us or a gift, I quilt them. I'll do a post more about this in the future. Leah is a great resource for free motion quilting here, and there is great straight line tips here, and here.
I could go on and on and on about ways to save money…but there are a few for extra motivation. Feel free to add anything to the comments that I missed or great fabric resources (or shops that will cut a 1/4 yard).
Happy quilting!